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1.
Sr Care Pharm ; 35(1): 34-37, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31883543

RESUMO

The objective of this manuscript is to review an ambulatory care pharmacist service that evolved into a pharmacotherapy, polypharmacy service with multiple submodels. The practice is located in a multispecialty, tertiary care, destination medical clinic in Florida. Ambulatory care pharmacist services have evolved to demand expertise in multiple, specialized areas to address the more complex medical issues of the polypharmacy patient. Many of these patients are older than 65 years of age, with broad medical care needs. A number of changes have led to the need for these expanded services: the growth and diversification of pharmacists' ambulatory care services, the multitude of sophisticated medications, the continued direct-to-consumer commercialization, the growth of dietary supplements, and the implementation of pharmacogenomic testing, In addition, new advances in clinical and laboratory technologies make polypharmacy a viable pharmacist clinical specialty. With the broad knowledge base needed for these patients, a polypharmacy pharmacist may function as a pharmacology troubleshooter expert.


Assuntos
Farmacêuticos , Polimedicação , Idoso , Assistência Ambulatorial , Florida , Humanos
2.
Nurs Educ Perspect ; 41(1): 54-56, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860491

RESUMO

For a new ambulatory care nursing course in an undergraduate baccalaureate program, a standardized patient simulation was created to support the clinical component of the course. The goals were for students to enhance their critical thinking skills, apply the nursing process to an ambulatory setting, apply learned skills to the non-acute care setting, and increase their confidence. The simulation format included three stations: skills refresher, telehealth, and clinic. Volunteers from faculty, clinical preceptors, and nursing management acted as clients for the mock clinical settings. Feedback was positive and supported this simulation as an educational option.


Assuntos
Assistência Ambulatorial , Bacharelado em Enfermagem , Treinamento com Simulação de Alta Fidelidade , Competência Clínica , Humanos , Estudantes de Enfermagem
3.
Medicine (Baltimore) ; 98(50): e18100, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852069

RESUMO

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.


Assuntos
Assistência Ambulatorial , Pressão Sanguínea/fisiologia , Diabetes Mellitus/fisiopatologia , Hipertensão/fisiopatologia , Oscilometria/métodos , Análise de Onda de Pulso/métodos , Rigidez Vascular/fisiologia , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Sístole
4.
Pediatr Dent ; 41(3): 179, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31840650

RESUMO

Purpose: Primarily, to analyze how application of silver diamine fluoride (SDF ) impacts the odds of presenting to urgent care (UC ) while awaiting dental treatment under general anesthesia (GA ). Secondarily, to analyze descriptive data from UC visits to identify trends associated with a prolonged GA wait time.
Methods: Retrospective chart audit of a sample of patients on the GA waitlist for complete oral rehabilitation from January 1st, 2014 to December 31st, 2016. Data points collected include total GA wait time, SDF application, UC presentation, number of encounters, chief complaint and treatment. Age, dmft, sex, race, ethnicity, and identification as special needs were incorporated into data analysis to identify potential trends.
Results: Of 1,219 charts, 661 charts were included for analysis. The average wait for GA was 364.8 days. 171/661 patients (26%) presented to UC during this time with pain being the most common chief complaint (73%) and extraction being the most common treatment (55% of UC encounters). The average time between waitlist placement and UC presentation was 171 days. 153/575 non-SDF patients presented to UC (27%) compared to 18/86 (21%) SDF patients. There was positive correlation between days spent on the GA waitlist and number of UC visits (P =.047).
Conclusions: Though odds of presenting to UC were decreased with SDF application, this was not found to be statistically significant. There was a significant correlation between the amount of time spent on the GA waitlist and the number of urgent care encounters. More data points could provide more significant results.


Assuntos
Cárie Dentária , Assistência Ambulatorial , Anestesia Geral , Assistência Odontológica , Humanos , Estudos Retrospectivos
5.
Medicine (Baltimore) ; 98(46): e17220, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725600

RESUMO

The purpose of this study was to determine the trends in consumption of antibiotics and evaluate the antibiotic prescription rates in the pediatric population in Lithuania during 2003 to 2012.A cross-sectional study. Data of systemic antibiotic use in pediatric population for outpatient treatment was derived from National Health Insurance Fund database. Consumption was expressed as WHO ATC defined daily dose (DDD)/1000 children/day and as a number of prescriptions written in the general population per year. Statistical analysis was performed using the SPSS/W 20.0 software (Statistical Product and Service Solutions for Windows).Total utilization of antibiotics (expressed in DDD units) during study period increased by 8.40% (from 5.67 to 6.19 DDD/1000 children/day) and by 5.96% expressed in prescription rate (from 585.84 to 622.97 prescriptions/1000 children/year). The most popular antibiotic group was macrolides which showed the highest increase of utilization 5.9 times (from 0.27 DDD/1000 children/day in 2003 to 1.66 DDD/1000 children/day in 2012).The most common indications for antibiotic prescribing for children in 2012 were acute bronchitis (25.6%), acute tonsillitis (21.7%) and acute pharyngitis (14.6%). Amoxicillin had the highest probability to be chosen to treat acute tonsillitis (prob. [probability] = .2875) and acute pharyngitis (prob. = .5553). Clarithromycin had the highest probability to be chosen to treat acute bronchitis (prob. = .4222).Most of the diseases treated with antibiotics were viral infections. The most commonly prescribed antibiotics were broad-spectrum. The consumption of antibiotics was evenly increasing during 2003 to 2012 period, but the distribution of separate antibiotic group remained the same.


Assuntos
Assistência Ambulatorial/tendências , Antibacterianos/uso terapêutico , Uso de Medicamentos/tendências , Vigilância da População , Padrões de Prática Médica/tendências , Criança , Estudos Transversais , Feminino , Humanos , Lituânia/epidemiologia , Masculino
7.
Z Evid Fortbild Qual Gesundhwes ; 146: 28-34, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31570212

RESUMO

INTRODUCTION AND AIM: The ambulatory specialized care (ASV) act (Sect. 116b of the Social Code Fifth Book [SGB V]) is intended to enable patients with a rare disease or a special course of disease or patients needing a highly specialized treatment to get access to outpatient care by office-based as well as hospital doctors. Data concerning care, service performance and fees - in comparison to the usual contract with the statutory insurance or the former Sect. 116b SGB V - are lacking. We explored the question whether differences in reimbursement between ASV and the previous system exist and which factors are influencing them. METHODS: We analyzed ICD-10 diagnoses, performance parameters as well as budgets and service fees in the former care system of medical oncologists in the institutions of three ASV participants of two federal countries treating gastrointestinal malignancies. We compared the results (fees, remuneration) to those from the statutory contract system and the former ambulatory care of hospitals and calculated the differences. Data were analyzed descriptively and analytically using SPSS. RESULTS: The analyses showed significant differences in the reimbursement rates between both office-based teams due to different budgets in the statutory contract system of the different federal countries. This led to additional remuneration of 12.5 to 49 % in ASV. The increase in fees of the hospital-guided team was exclusively due to the ASV-only fees of chapter 51 of EBM since there were no limitations of budgets even in the former system. DISCUSSION AND CONCLUSION: Exemplified with the ASV subgroup GIT, our study shows for the analyzed medical specialty that the difference in reimbursement in ASV is mostly due to the federal country-specific budgets and that the increase in honoraria can be substantial. Due to differences in budgets and quota systems, there may be different results in other ASV indications and specialist groups as well as in other federal states. Irrespective of these arguments, further aspects need to be taken into account when participation in ASV is considered.


Assuntos
Instituições de Assistência Ambulatorial/economia , Neoplasias Gastrointestinais , Custos de Cuidados de Saúde , Reembolso de Seguro de Saúde , Assistência Ambulatorial/economia , Custos e Análise de Custo , Neoplasias Gastrointestinais/economia , Alemanha , Humanos , Oncologia , Mecanismo de Reembolso , Especialização
8.
Pflege ; 32(6): 334-342, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31640473

RESUMO

Technology commitment in outpatient care Abstract. Background: New technologies are becoming increasingly important in outpatient care. The willingness of professional carers to use new technologies is often considered to be low, especially where older and female carers are concerned who play a large role in outpatient care. However, reliable data on technology commitment in outpatient care are not yet available for German-speaking countries. AIM: This paper aims to provide insights into the state of technology commitment in outpatient care. METHODS: For data collection, the standardised assessment of technology commitment was used, which determines technology readiness via the facets "technology acceptance", "technology competence conviction" and "technology control conviction" (26-2Neyer et al., 2012). A first data collection (2013) concentrated on nursing services in the federal state of Lower Saxony (n = 263), a second data collection (2017) was carried out with a nationwide care service provider (n = 593). RESULTS: For the first time, the results of the present investigations provide differentiated insights into questions of technology commitment in outpatient care in Germany. In particular, there are indications of differences in the willingness to use technology in outpatient care depending on the age group of the interviewees. CONCLUSION: The introduction of new technologies into the everyday life of caregivers requires demographically sensitive concepts for preparing and supporting the users.


Assuntos
Assistência Ambulatorial , Atitude do Pessoal de Saúde , Tecnologia Biomédica , Cuidadores/psicologia , Alemanha , Humanos
9.
Rev Med Suisse ; 15(669): 1962-1966, 2019 Oct 30.
Artigo em Francês | MEDLINE | ID: mdl-31663695

RESUMO

In ambulatory care, the community pharmacist and the general practitioner most often interact through the dispensing of medicines in pharmacies following a prescription from the physician. However, this interaction can be reinforced by other practices that can increase the quality and safety of care. Interprofessional collaboration is possible through the development of increasing interrelationships, particularly in the sharing of information through dialogue on common objectives that integrate the perspectives of patients and professionals, and through joint decision-making. In this article, interprofessional collaboration between pharmacists and general practitioners is described, as well as data from the literature and some concrete examples from the regular practice of pharmacists and physicians in Unisanté.


Assuntos
Assistência Ambulatorial/organização & administração , Comportamento Cooperativo , Relações Interprofissionais , Farmacêuticos , Médicos , Humanos , Segurança do Paciente
10.
JAAPA ; 32(2): 52, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31579253

RESUMO

PAs and NPs have broad prescribing authority in the United States, yet little is known about how the quality of their prescribing practices compares with that of physicians. The quality of prescribing practices of physicians, PAs, and NPs was investigated through a serial cross-sectional analysis of the 2006-2012 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS). Ambulatory care services in physician offices, hospital EDs, and outpatient departments were evaluated using a nationally representative sample of patient visits to physicians, PAs, and NPs. Main outcome measures were 13 validated outpatient quality indicators focused on pharmacologic management of chronic diseases and appropriate medication use. The study sampled 701,499 patient visits during the study period, representing about 8.3 billion visits nationwide. Physicians were the primary provider for 96.8% of all outpatient visits examined; PAs and NPs each accounted for 1.6% of these visits. The proportion of eligible visits in which quality standards were met ranged from 34.1% (angiotensin-converting enzyme inhibitor use for patients with heart failure) to 89.5% (avoidance of inappropriate medications in older adults). The median overall performance across all indicators was 58.7%. On unadjusted analyses, differences in quality of care between PAs, NPs, and physicians for each indicator did not consistently favor one practitioner type over others. After adjustment for potentially confounding patient and provider characteristics, the quality of prescribing by PAs and NPs was similar to the care delivered by physicians for 10 of the 13 indicators evaluated, and no consistent directional association was found between provider type and indicator fulfillment for the remaining measures. Although significant shortfalls exist in the quality of ambulatory prescribing across all practitioner types, the quality of care delivered by PAs, NPs, and physicians was generally comparable.1.


Assuntos
Profissionais de Enfermagem , Assistentes Médicos , Médicos , Idoso , Assistência Ambulatorial , Estudos Transversais , Pesquisas sobre Serviços de Saúde , Humanos , Estados Unidos
11.
Rev Med Suisse ; 15(665): 1770-1774, 2019 Oct 02.
Artigo em Francês | MEDLINE | ID: mdl-31580022

RESUMO

Nowadays, new psychotropic treatments might result on rapid onset of weight gain also related to other factors such as individual vulnerability, poor diet and lack of exercise. Many studies have reported that weight gain is only the premise of a series of metabolic disturbances and cardiovascular complications. In this context, we have established since June 2017 in an ambulatory centre in Geneva, a 4F program (Fit, Fun, Feel and Food), to optimize the measures and strategies needed to prevent and reduce weight gain in these patients. This transversal program is naturalistically and systematically centered on physical activity, healthy diet and improved body perception. We will show some preliminary results of 4F program.


Assuntos
Antipsicóticos/efeitos adversos , Terapia por Exercício , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Serviços Preventivos de Saúde , Ganho de Peso , Assistência Ambulatorial , Imagem Corporal , Humanos , Transtornos Mentais/psicologia , Suíça , Ganho de Peso/efeitos dos fármacos
14.
JAMA ; 322(9): 824-833, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31479137

RESUMO

Importance: Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections. Objective: To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP. Design, Setting, and Participants: A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups. Interventions: Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness. Main Outcomes and Measures: The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed. Results: Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, -0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, -21.9 per 1000 HCP-seasons [95% CI, -48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, -8.9 per 1000 HCP-seasons, [95% CI, -33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, -8.6 per 1000 HCP-seasons [95% CI, -28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, -11.3 per 1000 HCP-seasons [95% CI, -23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group. Conclusions and Relevance: Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza. Trial Registration: ClinicalTrials.gov Identifier: NCT01249625.


Assuntos
Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Máscaras , Dispositivos de Proteção Respiratória , Adulto , Assistência Ambulatorial , Feminino , Humanos , Incidência , Controle de Infecções/métodos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/transmissão
15.
Am J Occup Ther ; 73(5): 7305185010p1-7305185010p10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484020

RESUMO

IMPORTANCE: Leaders in the occupational therapy profession have called for occupational therapy's inclusion in primary care, but little is known about the occupational needs of patients in this setting. OBJECTIVE: To explore the need for and potential role of occupational therapy in a team-based primary care clinic. DESIGN: A qualitative descriptive study using a convenience sample of clinicians and patients. Meetings and semistructured interviews were recorded, transcribed, and coded by multiple coders using a general immersion-crystallization approach to identify relevant themes. SETTING: Outpatient complex care clinic of an urban academic medical center. PARTICIPANTS: The study included a voluntary sample of clinicians and patients from the complex care clinic. Patients were recruited from a staff-provided list; eligible patients had attended the clinic for at least 1 yr. All patients had multiple chronic conditions and were uninsured or received Medicaid. RESULTS: Researchers attended 10 clinician team meetings and conducted 13 patient interviews and 10 clinician interviews. Four domains of patient need were identified by both patients and clinicians: complex medical management, patients' limited resources, mental health needs, and challenges to occupation. Clinicians also identified cognitive-behavioral challenges affecting care, including lack of engagement and poor problem solving. CONCLUSIONS AND RELEVANCE: The makeup of the clinic team reflected their intent to address medical, socioeconomic, and mental health domains. However, cognitive-behavioral challenges and patients' occupational limitations were not consistently addressed. Thus, patients had unmet needs that occupational therapy practitioners were qualified to address. WHAT THIS ARTICLE ADDS: This study adds to the available literature examining patient needs and clinician challenges in a primary care clinic. Patients have occupational needs that are not being addressed in primary care, indicating a need for occupational therapy in this setting.


Assuntos
Terapia Ocupacional , Assistência Ambulatorial , Humanos , Equipe de Assistência ao Paciente/normas , Assistência Centrada no Paciente/normas , Atenção Primária à Saúde/normas , Pesquisa Qualitativa
16.
Schmerz ; 33(5): 384-391, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31473816

RESUMO

BACKGROUND: Geriatric patients often suffer from a long history of pain and have a limited life expectancy. Cannabinoid receptor agonists like dronabinol may be an effective, low-risk treatment option for geriatric patients with chronic pain. OBJECTIVES: The effectiveness and side effects of dronabinol therapy in geriatric patients are analyzed. The effects of the approval requirement are presented. METHODS: In our retrospective monocentric cohort study, the study population comprised all geriatric patients over the age of 80 years who were treated in our office since the cannabis law came into effect on 10 March 2017 until 17 July 2018 (evaluation date). Geriatric, nonpalliative pain patients (group A) and geriatric palliative patients (group B) were investigated. The basis of the evaluation was a questionnaire sheet that we use in our office with details of dosages, pain intensity, treatment effects and side effects from dronabinol therapy. RESULTS: By using dronabinol, 21 of the 40 geriatric patients (52.5%) achieved pain relief of more than 30%, 10% of the patients of more than 50%. On average, about four symptoms or side effects related to previous treatment were positively influenced. 26% of patients reported side effects. The rejection rates on the part of the health insurances were 38.7% (group A) and 10.3% (group B). CONCLUSIONS: This study is one of the few analyses of the use of Dronabinol in geriatric patients. We show that cannabis-based drugs (in this case dronabinol) are an effective, low-risk treatment option that should be considered early in therapy. Regarding the indication spectrum, further clinical studies and an approval-free test phase are necessary.


Assuntos
Assistência Ambulatorial , Dronabinol , Dor , Cuidados Paliativos , Idoso , Assistência Ambulatorial/economia , Assistência Ambulatorial/normas , Estudos de Coortes , Dronabinol/uso terapêutico , Humanos , Dor/tratamento farmacológico , Cuidados Paliativos/economia , Cuidados Paliativos/normas , Estudos Retrospectivos
17.
Rev Med Suisse ; 15(663): 1668-1670, 2019 Sep 18.
Artigo em Francês | MEDLINE | ID: mdl-31532118

RESUMO

Mobility and shifting of treatment sites to the community is useful and necessary for some individuals with addictions who are unable to access traditional treatment programs. The article presents different treatment models : Assertive community treatment, Housing First and transition programs. The main effects of the programs presented are a reduction in days of hospitalization and the use of emergency services, as well as an improvement in adherence to outpatient care. These are encouraging results given the significant difficulties of a population which often presents the phenomenon of «â€…revolving doors ¼ with very high rates of readmissions and lack of treatment continuity.


Assuntos
Medicina do Vício , Comportamento Aditivo , Serviços Comunitários de Saúde Mental , Medicina do Vício/métodos , Medicina do Vício/normas , Assistência Ambulatorial , Comportamento Aditivo/terapia , Hospitalização , Humanos
18.
Arq. bras. cardiol ; 113(2 supl.1): 110-110, set., 2019.
Artigo em Português | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1017332

RESUMO

INTRODUÇÃO: o envelhecimento populacional é um fenômeno observado em todo mundo e também na população brasileira e esta associado ao aumento da incidência de doenças cardiovasculares, impactando na qualidade de vida, morbidade e mortalidade, apesar do aumento do número de pacientes muito idosos, existe ainda escassez de dados sobre os mesmos. A realização de perfil clínico epidemiológico de nonagenários fornece informações relevantes quanto ao sexo, prevalência de doenças e fármacos em uso. Estes dados podem auxiliar na avaliação de condutas e tratamento farmacológico nesta faixa etária. MÉTODO: estudo retrospectivo, descritivo e observacional, desenvolvido a partir da revisão de prontuários de pacientes com idade igual ou superior a 70 anos. Destes, foram analisados os pacientes com idade igual ou superior a 90 anos que compareceram a consulta ambulatorial em hospital terciário de Cardiologia, de janeiro a dezembro de 2018. As variáveis quantitativas foram apresentadas em forma de média, desvio padrão e gráficos com valores expressos em percentuais e/ou porcentagem de prevalência. RESULTADOS: dos 5100 prontuários de pacientes com idade igual ou superior a 70 anos, cerca de 312 (6,11%) eram nonagenários, com idade média de 93,4 anos (±2,44), sendo 60% do sexo feminino. As principais doenças encontradas foram hipertensão arterial sistêmica (93%), diabetes mellito (25%), dislipidemia (25%), doença arterial coronariana (18%), fibrilação atrial (18%) e insuficiência cardíaca (14%). Os medicamentos mais prescritos foram: estatina (84%), diuréticos (52%), aspirina (41%), bloqueadores de receptor de angiotensina (39%), betabloqueador (39%), inibidor de enzima de conversão (31%). CONCLUSÃO: os pacientes nonagenários estudados neste trabalho são predominantemente mulheres, quase que a totalidade hipertensos e um quarto deles, dislipidêmicos e diabéticos. Destacou-se a maior concomitância destas três doenças associadas em nonagenários. (AU)


Assuntos
Humanos , Doenças Cardiovasculares , Epidemiologia , Assistência Ambulatorial , Idoso de 80 Anos ou mais
20.
Wiad Lek ; 72(7): 1229-1235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398147

RESUMO

The palliative care patient is definitely a unique type of patient. Due to the complexity of the symptoms requires a holistic therapeutic approach. Modern methods of treatment in palliative and hospice care underline an important role of physio, kinesiotherapy and pharmacological treatment coexistence. The rehabilitation reduces clinical symptoms, accompanying the basic disease and increases the quality of life of palliative patients and their families. It becomes an inseparable element of treatment, both in outpatient care as well as in stationary care and home care. Due to the high dynamics onset of cancer in the group of geriatric patients there is a need for a broader analysis of the topic. The goal of palliative care is to achieve the best possible quality of life for patients and their families.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Neoplasias , Cuidados Paliativos , Assistência Ambulatorial , Humanos , Qualidade de Vida
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