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1.
Article in English | LILACS | ID: biblio-1381654

ABSTRACT

Introduction: Although the acquired immunodeficiency syndrome (AIDS) has no cure, antiretroviral treatment has considerably increased the survival of people living with the disease or with the human immunodeficiency virus (HIV), reducing the incidence of opportunistic infections in these patients. Thus, this treatment changed mortality rates and diversified the causes of death, including reasons related to increased longevity, such as chronic noncommunicable diseases, common in the uninfected population. Therefore, the current epidemiological transition motivated us to study the death profile of people with HIV/AIDS in the state of Santa Catarina. Objective: To investigate case characteristics, as well as the time trend and distribution of deaths, among people with HIV/AIDS in Santa Catarina between 2010 and 2019. Methods: In this ecological, epidemiological study, we consulted all death records from the Santa Catarina Mortality Information System that had HIV/AIDS among the causes and occurred between 2010 and 2019. Results: A total of 5,174 death records were analyzed. In the period, the mean mortality rate among people with HIV/AIDS was 7.64 deaths per 100 thousand inhabitants (95% confidence interval ­ 95%CI 6.61­8.67) ­ 8.99 in 2010 and 6.06 in 2019 ­, showing a downward trend of 0.38% per year. Conclusion: We identified a downward trend in mortality. Deaths were concentrated on the coast, in more populous cities. Furthermore, the finding of improper completion of the death certificate points to the need to invest in improving the training of professionals responsible for this document.


Introdução: Embora a síndrome da imunodeficiência adquirida (AIDS) não tenha cura, o tratamento antirretroviral aumentou consideravelmente a sobrevida das pessoas que vivem com a doença ou com o vírus da imunodeficiência humana (HIV), diminuindo a ocorrência de infecções oportunistas nesses pacientes. Assim, esse tratamento mudou as taxas de mortalidade e diversificou as causas de óbito, incluindo motivos relacionados ao aumento da longevidade, como doenças crônicas não transmissíveis comuns à população não infectada. Dessa forma, a atual transição epidemiológica motiva o estudo do perfil dos óbitos em pessoas com HIV/AIDS no estado de Santa Catarina. Objetivo: Investigar as características dos casos, a tendência temporal e a distribuição dos óbitos em pessoas com HIV/AIDS no estado de Santa Catarina entre os anos de 2010 e 2019. Métodos: Neste estudo epidemiológico com delineamento ecológico, foram consultados todos os registros de óbitos do Sistema de Informação sobre Mortalidade de Santa Catarina ocorridos entre os anos de 2010 e 2019 que apresentassem entre as causas o HIV/AIDS. Resultados: Foram analisados 5.174 registros de óbitos. A taxa de mortalidade média entre pessoas com HIV/AIDS do período foi de 7,64 óbitos a cada 100 mil habitantes (95% intervalo de confiança ­ IC95% 6,61­8,67), sendo de 8,99 em 2010 e 6,06 em 2019, mostrando tendência de queda de 0,38 pontos percentuais ao ano. Conclusão: Observou-se tendência de queda na mortalidade. A concentração dos óbitos foi na faixa litorânea, em cidades mais populosas. Ademais, a constatação do falho preenchimento da declaração de óbito aponta para a necessidade de investir no aprimoramento do treinamento dos profissionais responsáveis por esse documento.


Subject(s)
Humans , Epidemiologic Studies , Mortality , HIV , Death Certificates , Acquired Immunodeficiency Syndrome , Anti-Retroviral Agents
2.
Article in English | LILACS | ID: biblio-1381742

ABSTRACT

Introduction: People living with the human immunodeficiency virus (HIV) are generally overweight or have an altered body composition as compared to healthy individuals, showing a change in nutritional profile over time. Objective: The aim of the study was to characterize the nutritional status, estimate the prevalence of lipodystrophy, and examine the association between lipohypertrophy and lipid profile alterations, and other clinical data of HIV-infected individuals. Methods: This was a cross-sectional study on male and female subjects living with HIV, treated at a specialized outpatient clinic, aged 18 years old and over, whether using the antiretroviral therapy or not. Results: The sample consisted of 420 people with a mean age of 43.8 years (standard deviation 11.7). The length of time of the HIV infection averaged 74.6 months, and 91% of the respondents were on antiretroviral therapy. Lipodystrophy prevalence was 35.7%. Of these, 82 (54.7%) presented lipohypertrophy, 61 (40.7%) had lipoatrophy and 7 (4.6%) had a mixed syndrome. Female gender, body mass index, fat percentage, waist circumference and waist-hip ratio were positively associated with the presence of lipohypertrophy (p<0.001). High mean total cholesterol (p=0.015) and LDL fraction (p=0.028) also showed a statistically significant association with lipohypertrophy. The sampled participants had a nutritional profile compatible with overweight or obesity. No association was found between lipohypertrophy and ART and the therapy duration. Conclusion: Considering the consequences of overweight as a cause of various pathological conditions, preventive measures and interventions are highly recommended for this population.


As pessoas que vivem com o HIV geralmente têm excesso de peso ou composição corporal alterada em relação aos indivíduos saudáveis, apresentando uma mudança no perfil nutricional ao longo do tempo. Objetivo: O objetivo do estudo foi caracterizar o estado nutricional, estimar a prevalência de lipodistrofia e examinar a associação entre lipohipertrofia e alterações no perfil lipídico e outros dados clínicos de indivíduos infectados pelo HIV. Métodos: Estudo transversal com indivíduos dos sexos masculino e feminino vivendo com HIV, atendidos em ambulatório especializado, com idade igual ou superior a 18 anos, em uso ou não de terapia antirretroviral. Resultados: A amostra foi composta de 420 pessoas com média de idade de 43,8 anos (desvio padrão 11,7). O tempo de infecção pelo HIV foi em média de 74,6 meses e 91% dos entrevistados estavam em terapia antirretroviral. A prevalência de lipodistrofia foi de 35,7%. Destes, 82 (54,7%) apresentavam lipohipertrofia, 61 (40,7%) lipoatrofia e 7 (4,6%) síndrome mista. Sexo feminino, índice de massa corporal, percentual de gordura, circunferência da cintura e relação cintura-quadril foram positivamente associados à presença de lipohipertrofia (p<0,001). As médias elevadas de colesterol total (p=0,015) e fração LDL (p=0,028) também mostraram associação estatisticamente significante com lipohipertrofia. Os participantes da amostra apresentavam perfil nutricional compatível com sobrepeso ou obesidade. Não foi encontrada associação entre lipohipertrofia e terapia antirretroviral e duração da terapia. Conclusão: Considerando as consequências do excesso de peso como causa de diversas patologias, medidas e intervenções preventivas são altamente recomendadas para essa população.


Subject(s)
Humans , Nutritional Status , HIV , Lipodystrophy , Body Mass Index , Waist-Hip Ratio , Obesity
3.
Enferm. foco (Brasília) ; 12(2): 312-318, set. 2021. tab, ilus
Article in Portuguese | LILACS, BDENF | ID: biblio-1291524

ABSTRACT

Objetivo: Descrever os casos de violência sexual, identificar as características sociodemográficas das vítimas e da agressão, verificar a adesão à quimioprofilaxia e a realização de coletas sorológicas de um Hospital Geral do Sul do Brasil, durante o período de janeiro de 2007 a dezembro de 2017. Métodos: Delineamento de coorte histórica em que foram analisadas as fichas de notificação compulsória e dados do prontuário, entre janeiro de 2007 a dezembro 2017. Resultados: No período, 118 pessoas procuraram atendimento hospitalar por violência sexual. A mediana de idade das vítimas foi de 14 (IIQ 12,25), variando de 1 a 78 anos. Houve predomínio de notificações entre mulheres (84,7%), raça branca (83,9%), escolaridade de 0 a 8 anos de estudo (43,2%), solteira (63,6%). Identificou-se um caso reagente para sífilis, e somente 5,9% tiveram adesão ao seguimento proposto. Conclusão: A baixa adesão ao protocolo de atendimento aumenta os riscos à saúde e chance de sequelas pelo agravo, sendo necessária outras estratégias dos serviços para ações de continuidade das ações profiláticas e terapêuticas. (AU)


Objective: Describe the cases of sexual violence, identify the sociodemographic characteristics of the victims and the aggression, verify adherence to chemoprophylaxis and the performance of serological collections at a General Hospital in Southern Brazil, from January 2007 to December 2017. Methods: A historical cohort study in which compulsory notification forms and medical record data were analyzed from January 2007 to December 2017. Results: During the years of the study, 118 people looked for a hospital care for sexual violence. The average age of the reported victims was 14 (IQ 12.25), ranging from 1 to 78 years of age. The reports were predominant among women (84.7%), white race (83.9%), low education with 0-8 years of schooling (43,2%), single (63.6%). A reactive case for syphilis was identified, and only 5.9% adhered to the proposed follow-up. Conclusion: The low adherence to the protocol of care increases the health risks and chance of sequel by the injury, requiring other strategies of the services for continuity of prophylactic and therapeutic actions. (AU)


Objetivo: Describir los casos de violencia sexual, identifique las características sociodemográficas de las víctimas y la agresión, verifique la adhesión a la quimioprofilaxis y la realización de colectas serológicas en un Hospital General del Sur de Brasil, desde enero de 2007 hasta diciembre de 2017. Métodos: Delineamiento de corte histórica en que fueron analizadas las fichas de notificación compulsoria y de datos del prontuario, entre enero de 2007 a diciembre de 2017. Resultados: En el período, 118 personas buscaron atendimiento hospitalario por violencia sexual. La media de edad de las víctimas fue de 14(IIQ 12,25), variando de 1 a 78 años. Hubo predominio de notificaciones entre mujeres (84,7%) raza blanca (83,9%), escolaridad de 0 a 8 años de estudio (43,2%), soltera (63,6%). Se identificó un caso positivo de sifilis y solamente 5,9% tuvieron adhesión al seguimiento propuesto. Conclusión: la baja adhesión al protocolo de atendimiento aumenta los riesgos a la salud y la chance de sequelas pelo agravamiento, siendo necesaria otras estrategias de los servicios para acciones de continuidad de las acciones profilácticas y terapéuticas. (AU)


Subject(s)
Anti-Retroviral Agents , Sex Offenses , Disease Notification , Health Services Accessibility
4.
J. pediatr. (Rio J.) ; 97(4): 420-425, July-Aug. 2021. tab
Article in English | LILACS | ID: biblio-1287045

ABSTRACT

Abstract Objective This study aimed to investigate human adenovirus 36 (Adv36) as an associated factor for adiposity in children and adolescents aged 9-12 years. Methods This was a case-control study comparing overweight (cases) and eutrophic (controls) children and adolescents aged 9-12 years based on their body mass index in relation to human adenovirus 36 serology. Human adenovirus 36-specific neutralizing antibodies were assessed using the serum neutralization assay, and a questionnaire regarding the subjects' personal backgrounds, breastfeed history, age of starting daycare, and eating and exercise habits was also applied. Results A total of 101 (51, eutrophic; 50, overweight) children were included in the study. The Adv36 seropositivity rate was of 15.8%, which increased the chance of being overweight by 3.17 times (p = 0.049). Enrollment in a full-time daycare center before the age of 24 months increased the chance of being overweight by 2.78 times (p = 0.027). Metabolic parameters (total cholesterol and blood glucose) were insignificantly different among children who were seropositive or seronegative for human adenovirus 36. Conclusion This study concluded that excessive weight was positively associated with seropositivity for human adenovirus 36. Early enrollment in a full-time daycare was also an associated factor for obesity. Such data, confirmed in new studies, reinforces the role of human adenovirus 36 in the increase of childhood adiposity.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Adenoviruses, Human , Pediatric Obesity , Body Mass Index , Case-Control Studies , Adenoviridae , Adiposity
5.
Article in Portuguese | LILACS | ID: biblio-1292403

ABSTRACT

Objetivo: avaliar a prevalência de sífilis adquirida na população ≥50 anos residente em Santa Catarina, sua distribuição geográfica e tendência no período 2013-2018. Métodos: estudo ecológico exploratório, analisando dados na plataforma virtual da Diretoria de Vigilância Epidemiológica, relativos às notificações de sífilis na população catarinense com ≥50 anos, sendo a faixa etária dividida em quatro grupos: 50-59 anos, 60-69 anos, 70-79 anos e ≥80 anos. Resultados: a taxa de ocorrência de sífilis na população estudada aumentou de 18,2 para 110,7 casos /100.000 habitantes no período. O incremento foi observado em todas as faixas etárias a partir dos 50 anos e sexos, destacando-se a população de 50-59 anos. As maiores incidências foram verificadas nas macrorregiões Grande Florianópolis e Planalto Norte/Nordeste. Conclusão: houve crescimento exponencial do agravo no período 2013-2018, na população referida, para ambos os sexos, ocorrendo de forma diferenciada segundo macrorregião de saúde. Os resultados obtidos preocupam e merecem atenção da gestão pública.


Aims: To evaluate the prevalence of acquired syphilis in the population ≥ 50 years old residing in Santa Catarina with, it's geographic distribution and trends from 2013 to 2018. Methods: Exploratory ecological study, analyzing data in the virtual platform of Epidemiological Surveillance Board, concerning syphilis notifications from the population of Santa Catarina ≥50 years old, with age divided into four groups: 50-59 years, 60-69 years, 70-79 years and ≥80 years. Results: the occurrence of syphilis in the said population increased from 18.2 to 112.7 cases/100.000 residents in the period. The increment was perceived in all age groups over 50 years and sexes, standing out the 50-59 age group. The highest incidences were found in the macro regions of "Grande Florianópolis" and "Planalto Norte-Nordeste". Conclusion: there was an exponential growth of the disease between 2013 - 2018, for both sexes, occurring differently according to each macro region of health. The obtained results are concerning and deserve attention from the public management.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Syphilis , Sexually Transmitted Diseases , Health of the Elderly
6.
Braz. J. Pharm. Sci. (Online) ; 57: e18064, 2021. tab, graf
Article in English | LILACS | ID: biblio-1339301

ABSTRACT

Medication discrepancies are of great concern in hospitals because they pose risks to patients and increase health care costs. The aim of this study was to estimate the prevalence of inconsistent medication prescriptions to adult patients admitted to a hospital in southern Santa Catarina, Brazil. This was a patient safety study on patients recruited between November 2015 and June 2016. The participants were interviewed and had their medical records reviewed. Discrepant medications were considered those that did not match between the list of medicines taken at home and the prescribed drugs for treatment in a hospital setting. Of the 394 patients included, 98.5% took continuous-use medications at home, with an average of 5.5 medications per patient. Discrepancies totaled 80.2%, The independent variables associated with the discrepancies were systemic arterial hypertension, hypercholesterolemia, vascular disease, number of medications taken at home, and poor documentation of the medications in the medical record. Findings from this study allowed us to conclude there was a high rate of prescription medication misuse. Medication reconciliation is crucial in reducing these errors. Pharmacists can help reduce these medication-related errors and the associated risks and complications.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Pharmacists/ethics , Drug Prescriptions/standards , Health Care Costs , Medication Reconciliation/ethics , Medication Errors/adverse effects , Patients/classification , Pharmaceutical Preparations , Medical Records/statistics & numerical data , Patient Safety , Drug Misuse/statistics & numerical data , Hospitals/supply & distribution
7.
Rev. Soc. Bras. Med. Trop ; 54: e03852021, 2021.
Article in English | LILACS | ID: biblio-1347104

ABSTRACT

Abstract The use of coronavirus disease 2019 RNA vaccines in pregnant women led to reports on the first cases of newborns with antibodies to sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a phenomenon that was unknown when using immunizations with inactivated viruses. Thus, this study aimed to report a case of passive anti-SARS-CoV-2 immunity in a newborn through immunoprophylaxis of a pregnant woman who received the CoronaVac® vaccine in the third trimester of pregnancy. Twenty-four hours after delivery, samples were collected from the newborn and screened by enzyme immunoassays, which revealed antibodies to SARS-CoV-2.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious , Vaccines , COVID-19 , Infectious Disease Transmission, Vertical/prevention & control , SARS-CoV-2
8.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 38: e2018390, 2020. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136737

ABSTRACT

ABSTRACT Objective: To estimate the incidence of congenital syphilis and temporal trends of the reported cases of the disease in the state of Santa Catarina between 2007 and 2017. Methods: Observational study with retrospective cohort design, with secondary data from the Injury of Notification Information System (SINAN). Linear trend test and geoprocessing were performed to verify the behavior of the cases in the period. Results: There were 2,898 reported cases of congenital syphilis in the period, with an average of 2.9 per 1,000 live births in the period. There was an exponential increase of 0.9 percentage points per year, considered statistically significant (p<0.001). There was no difference between the incidences of cases in the different regions of the State. The fatality rate was 8.5%, considering deaths from syphilis, miscarriages and stillbirths. The profile was predominant of white mothers, with low schooling and 11.8% did not perform prenatal care. For this reason, 26.9% of them had a diagnosis of syphilis at the time of delivery. Most of the pregnant women (51.9%) had inadequate pharmacological treatment and 65.1% of the partners were not treated. Conclusions: There was an exponential increase tendency in cases of congenital syphilis in the State of Santa Catarina in the period studied in all regions of the State, which reveals the failure of prenatal care, late diagnosis and inadequate treatment of the pregnant woman and her partner.


RESUMO Objetivo: Estimar a incidência de sífilis congênita e a tendência temporal dos casos notificados da doença no estado de Santa Catarina no período entre 2007 e 2017. Métodos: Estudo observacional com desenho de coorte retrospectiva, com dados secundários coletados no Sistema de Informação de Agravos de Notificação (SINAN). Foi realizado o teste de tendência linear e o geoprocessamento para verificar o comportamento dos casos no período. Resultados: No período, foram notificados 2.898 casos de sífilis congênita, com média de 2,9 a cada mil nascidos vivos. Houve crescimento exponencial de 0,9 ponto percentual ao ano, sendo estatisticamente significante (p<0,001). Não houve diferença entre a incidência de casos nas diferentes regiões do Estado. A taxa de letalidade foi de 8,5%, considerando os óbitos por sífilis, os abortos e os natimortos. O perfil predominante foi de mães da raça branca e com baixa escolaridade. Do total de mães analisadas, 11,8% não realizaram pré-natal - por esse motivo, 26,9% delas tiveram o diagnóstico de sífilis no momento do parto. A maioria das gestantes (51,9%) teve tratamento farmacológico inadequado e 65,1% dos parceiros não foram tratados. Conclusões: No período estudado, houve tendência de aumento exponencial dos casos de sífilis congênita em todas as regiões do Estado de Santa Catarina, o que revela a falha no pré-natal, o diagnóstico tardio e o tratamento inadequado da gestante e do seu parceiro.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Syphilis, Congenital/mortality , Syphilis, Congenital/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Delayed Diagnosis/adverse effects , Prenatal Care , Syphilis, Congenital/complications , Time Factors , Brazil/epidemiology , Information Systems/standards , Sexual Partners , Abortion, Spontaneous/epidemiology , Incidence , Retrospective Studies , Mortality/trends , Treatment Failure , Infectious Disease Transmission, Vertical/statistics & numerical data , Educational Status , Live Birth/epidemiology , Stillbirth/epidemiology , Mothers/statistics & numerical data
9.
Epidemiol. serv. saúde ; 29(3): e2020233, 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1124745

ABSTRACT

Objetivo descrever os sinais e sintomas mais frequentes na infecção pelo vírus da síndrome respiratória aguda grave coronavírus 2 (SARS-CoV-2). Métodos revisão narrativa da literatura realizada em abril de 2020; a busca foi realizada em bases eletrônicas e complementada com revisão manual das referências dos trabalhos selecionados e das publicações do Ministério da Saúde do Brasil. Resultados o espectro da doença clínica mostrou-se variado; febre, tosse e dispneia foram os sinais/sintomas mais frequentes, no entanto, podem não estar presentes, dificultando a definição de caso; sintomas gastrointestinais e alteração de olfato ou paladar têm sido relatados entre casos leves; a dispneia foi frequente entre casos graves e com evolução ao óbito. Conclusão considerando-se a escassez de testes diagnósticos e a diversidade de sintomas, os serviços de saúde devem utilizar uma definição de caso sensível, de forma a serem adotadas ações adequadas de vigilância, prevenção e tratamento.


Objetivo describir las señales y síntomas más frecuentes en la infección por el virus del Síndrome Respiratorio Agudo Severo Coronavirus 2 (SARS-Cov-2). Métodos revisión de la literatura narrativa realizada en abril de 2020. La búsqueda se realizó de forma electrónica y se complementó con una revisión manual de las referencias y publicaciones del Ministerio de Salud de Brasil. Resultados el espectro de la enfermedad clínica fue variado. La fiebre, la tos y la disnea fueron las señales / síntomas más frecuentes, sin embargo, es posible que no estén presentes, lo que dificulta la definición del caso. Se han informado síntomas gastrointestinales y cambios en el olfato o el gusto entre los casos leves. La disnea fue frecuente entre los casos graves y progresó hasta la muerte. Conclusión teniendo en cuenta la escasez de pruebas diagnósticas y la diversidad de síntomas, los servicios de salud deben utilizar una definición de caso sensible, para adoptar las acciones apropiadas para la vigilancia, prevención y tratamiento.


Objective to describe the most frequent signs and symptoms of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods this is a narrative literature review carried out in April 2020; the search was performed on electronic databases and complemented with a manual review of the references of the selected papers and Brazilian Ministry of Health publications. Results the spectrum of clinical disease was wide; fever, coughing and dyspnea were the most frequent signs/symptoms, however, they may not be present, thus hindering case definition; gastrointestinal symptoms and loss of taste or smell have been reported among mild cases; dyspnea was frequent among severe and fatal cases. Conclusion considering the scarcity of diagnostic tests and the diversity of symptoms, health services should use a sensitive case definition, in order to adopt appropriate surveillance, prevention and treatment actions.


Subject(s)
Humans , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Symptom Assessment/trends , Diagnosis, Differential , Pandemics
10.
Epidemiol. serv. saúde ; 29(4): e2020499, 2020. graf
Article in English, Portuguese | LILACS | ID: biblio-1124773

ABSTRACT

Apresenta-se o relato de experiência da integração entre serviços de saúde públicos e privados, gestores e universidade, para a vigilância e controle da epidemia de COVID-19 em Tubarão, SC, Brasil. A cidade, universitária, cenário de grande fluxo de pessoas de diferentes locais do país, foi um dos primeiros municípios do estado catarinense com transmissão comunitária do SARS-CoV-2. São detalhadas as medidas adotadas com a criação do Comitê de Monitoramento da COVID-19, do Centro de Operações de Emergências Municipais em Saúde, e do Plano de Contingência da Doença. Passados 100 dias de pandemia, foram 5.979 casos notificados e 431 (7,2%) confirmados, dos quais 5 (1,2%) foram a óbito. Decisões precoces - suspensão imediata das atividades de comércio e eventos com aglomeração - podem ter limitado a propagação do vírus. As parcerias estabelecidas trazem inovação e subsidiam a gestão pública nas tomadas de decisão pautadas em evidências científicas.


Se presenta la experiencia de la integración entre los servicios de Salud Pública y privados, los administradores y la universidad para la vigilancia y el control de la epidemia de COVID-19 en Tubarão, Santa Catarina, Brasil. La ciudad universitaria, con un gran flujo de personas de diferentes partes del país, fue uno de los primeros municipios del estado con transmisión comunitaria de SARS-CoV-2. Las medidas adoptadas se detallan con la creación del Comité de Monitoreo COVID-19, el Centro de Operaciones Municipales de Emergencia en Salud y un Plan de Contingencia de la Enfermedad. Después de 100 días de pandemia, se reportaron 5,979 casos, 431 (7,2%) confirmados, de los cuales cinco (1,2%) murieron. Las decisiones precoces, la suspensión inmediata de las actividades comerciales y de los eventos con aglomeración han reducido la propagación del virus. Las asociaciones establecidas aportan innovación y subsidian la gestión pública en la toma de decisiones basadas en evidencia científica.


This article presents an experience report about integration between public and private health services, health service managers and the academy, for surveillance and control of the COVID-19 epidemic, in the municipality of Tubarão, Santa Catarina, Brazil. The city is home to a university and has a large flow of people from different parts of the country, as well as being one of the first municipalities in the state of Santa Catarina to report cases of community transmission of SARS-CoV-2. The measures adopted included the implementation of the COVID-19 Monitoring Committee, the Municipal Health Emergency Operations Center, and the COVID-19 Contingency Plan. After 100 days of pandemic, 5,979 cases had been reported, 431 (7.2%) had been confirmed, of which five (1.2%) died. Early decisions, such as the immediate suspension of business activities and crowded events, may have reduced the spread of the virus. The partnerships put into place have provided innovation and supported public service management in decision-making based upon scientific evidence.


Subject(s)
Humans , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Public-Private Sector Partnerships/organization & administration , Health Plan Implementation , Interinstitutional Relations , Brazil/epidemiology , Advisory Committees , Pandemics , Public Health Surveillance , Epidemiological Monitoring
11.
Rev. Soc. Bras. Med. Trop ; 53: e20200579, 2020. tab, graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1143872

ABSTRACT

Abstract INTRODUCTION: Coronavirus disease 2019 (COVID-19), a potentially fatal disease, is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The number of cases has increased rapidly, but information on the clinical characteristics remains limited. METHODS: Cohort study. We collected and analyzed epidemiological, demographic, and clinical data of critically and noncritically ill patients and compared the outcomes. RESULTS: The mean age of hospitalized patients with COVID-19 was 54 years (standard deviation 16.9; 53.8% men), 29% required ICU admission, and 18.6% died. CONCLUSIONS: The main risk factors for ICU admission were age over 60 years, obesity, and preexisting chronic lung diseases.


Subject(s)
Humans , Male , Female , Coronavirus Infections/epidemiology , Brazil/epidemiology , Retrospective Studies , Risk Factors , Critical Illness , Pandemics , Hospitalization , Intensive Care Units , Middle Aged
12.
J. bras. nefrol ; 41(4): 492-500, Out.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056600

ABSTRACT

Abstract Introduction: Intradialytic hypotension (IDH) is a major complication of hemodialysis, with a prevalence of about 25% during hemodialysis sessions, causing increased morbidity and mortality. Objective: To study the effects of sertraline to prevent IDH in hemodialysis patients. Methods: This was a double-blind, crossover clinical trial comparing the use of sertraline versus placebo to reduce intradialytic hypotension. Results: Sixteen patients completed the two phases of the study during a 12-week period. The IDH prevalence was 32%. A comparison between intradialytic interventions, intradialytic symptoms, and IDH episodes revealed no statistical difference in the reduction of IDH episodes (p = 0.207) between the two intervention groups. However, the risk of IDH interventions was 60% higher in the placebo group compared to the sertraline group, and the risk of IDH symptoms was 40% higher in the placebo group compared to the sertraline group. Survival analysis using Kaplan-Meier estimator supported the results of this study. Sertraline presented a number needed to treat (NNT) of 16.3 patients to prevent an episode from IDH intervention and 14.2 patients to prevent an episode from intradialytic symptoms. Conclusion: This study suggests that the use of sertraline may be beneficial to reduce the number of symptoms and ID interventions, although there was no statistically significant difference in the blood pressure levels.


Resumo Introdução: A hipotensão intradialítica (HID) é uma das principais complicações da hemodiálise, com uma prevalência de cerca de 25% durante as sessões de hemodiálise, causando aumento da morbimortalidade. Objetivo: Estudar os efeitos da sertralina na prevenção da HID em pacientes em hemodiálise. Métodos: Este foi um ensaio clínico duplo-cego, cruzado, comparando o uso de sertralina versus placebo para reduzir a hipotensão intradialítica. Resultados: Dezesseis pacientes completaram as duas fases do estudo durante um período de 12 semanas. A prevalência de HID foi de 32%. Uma comparação entre intervenções intradialíticas, sintomas intradialíticos (ID) e episódios de HID não revelou diferença estatística na redução dos episódios de HID (p = 0,207) entre os dois grupos de intervenção. No entanto, o risco de intervenções para HID foi 60% maior no grupo placebo em comparação com o grupo Sertralina, e o risco de sintomas ID foi 40% maior no grupo placebo em comparação com o grupo Sertralina. A análise de sobrevida utilizando o estimador de Kaplan-Meier corroborou os resultados deste estudo. A sertralina apresentou um número necessário para tratar (NNT) de 16,3 pacientes para prevenir um episódio de intervenção de HID e 14,2 pacientes para prevenir um episódio de sintomas intradialíticos. Conclusão: Este estudo sugere que o uso de sertralina pode ser benéfico para reduzir o número de sintomas e intervenções de HID, embora não tenha havido diferença estatisticamente significante nos níveis pressóricos.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Renal Dialysis/adverse effects , Serotonin Uptake Inhibitors/therapeutic use , Sertraline/therapeutic use , Renal Insufficiency/therapy , Hypotension/physiopathology , Placebos/administration & dosage , Blood Pressure/drug effects , Blood Pressure/physiology , Double-Blind Method , Prevalence , Renal Dialysis/mortality , Cross-Over Studies , Renal Insufficiency/complications , Hypotension/prevention & control , Hypotension/epidemiology
14.
J. Bras. Patol. Med. Lab. (Online) ; 55(1): 98-113, Jan.-Feb. 2019. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1002361

ABSTRACT

ABSTRACT Introduction: Fetal death is defined as the death of the product of conception, regardless of gestational age. Objectives: The objective of this study was to investigate the maternal (obstetrical and placental) risk factors and the necropsy findings associated with fetal death, based on data obtained from the Verification of Death Service [Serviço de Verificação de Óbito (SVO)] in Florianópolis, Santa Catarina, Brazil. Material and method: This is an observational, cross-sectional study using secondary data. Were included the reports released between 2010 and 2015, with a diagnosis of fetal deaths at gestational age of 20 weeks or more. Results: During the period evaluated, 210 autopsies were performed. From these, 15.2% (n = 32) presented umbilical cord abnormalities, 22.4% (n = 47) placental abnormalities, 49.5%(n = 104) maternal health problem related to pregnancy, and 10% (n = 21) previous maternal disease. Among the fetal characteristics involved, it was observed that 6.7% (n = 14) presented meconium aspiration and 5.2% (n = 11) fetal malformations. In this study, 21.9%(n = 46) did not have their causa mortis defined. Discussion: The findings of this study show a statistically significant association (p <0.05) between meconium aspiration and full term pregnancy, hospital origin and normal birth weight. Such information is in agreement with the literature, which shows signs of intrauterine hypoxia, such as the presence of meconium, which are more prevalent in full term pregnancy. Conclusion: Among the causes of fetal death, ascending infection was the most prevalent; the maternal death related to pregnancy were the ones that stood out the most.


RESUMEN Introducción: Muerte fetal se define como muerte del producto de la concepción independientemente de la duración del embarazo. Objetivos: El objetivo de este trabajo fue investigar los factores de riesgo maternos (obstétricos y placentarios) y los hallazgos de la autopsia asociados a muerte fetal con base en los datos obtenidos en el Servicio de Verificación de Muerte [Serviço de Verificação de óbitos (SVO)] de Florianópolis, Santa Catarina, Brasil. Materialy método: Este es un estudio observacional, de diseno transversal, que utilizó datos secundarios. Se incluyeron informes de autopsia de fetos con edadgestacional de 20 semanas o más, practicadas entre 2010 y 2015. Resultados: En el período evaluado se realizaron 210 autopsias. Entre estas, 15,2% (n = 32)presentaron alteraciones de cordón umbilical; 22,4% (n = 47), de placenta; 49,5% (n = 104), enfermedades maternas relacionadas con el embarazo; y 10% (n = 21), enfermedades maternas previas. Entre las características fetales implicadas, se encontróque 6,7% (n = 14) presentaron aspiración meconialy 5,2% (n = 11), malformaciones fetales. En este estudio, 21,9% (n = 46) no tuvieron sus causas de muerte determinadas. Discusión: Los hallazgos de esta investigación muestran una relación estadísticamente significativa (p < 0,05) entre aspiración meconial y gestación a término, procedencia hospitalaria y peso adecuado al nacimiento. Estas informaciones están de acuerdo con la literatura, que trae senales de hipoxia intrauterina, como la presencia de meconio, más frecuentes en los embarazos a término. Conclusión: Entre las causas de muerte fetal, infección ascendente fue la más común; las causas de muerte materna relacionadas con el embarazo fueron las que más se destacaron.


RESUMO Introdução: Óbito fetal se define como morte do produto da concepção independente do tempo da gestação. Objetivos: O objetivo deste estudo foi investigar os fatores de risco maternos (obstétricos e placentários) e os achados de necropsia associados ao óbito fetal a partir de dados obtidos no Serviço de Verificação de Óbito (SVO) de Florianópolis, Santa Catarina, Brasil. Material e método: Trata-se de um estudo observacional, com delineamento transversal, que utilizou dados secundários. Foram incluídos laudos com diagnóstico de óbito fetal e idade gestacional de 20 semanas ou mais, realizados entre 2010 e 2015. Resultados: No período avaliado, foram realizadas 210 autópsias. Destas, 15,2% (n = 32) apresentaram alterações de cordão; 22,4% (n = 47), de placenta; 49,5% (n = 104), doenças maternas relacionadas com a gestação; e 10% (n = 21), doenças maternas prévias. Entre as características fetais implicadas, observou-se que 6,7% (n = 14) apresentaram aspiração meconial e 5,2% (n = 11), malformações fetais. Neste estudo, 21,9% (n = 46) não tiveram sua causa mortis definida. Discussão: Os achados desta pesquisa mostram associação estatisticamente significativa (p < 0,05) entre aspiração meconial e gestação a termo, procedência hospitalar e peso adequado ao nascer. Tais informações estão em concordância com a literatura, que traz sinais de hipóxia intraútero, como a presença de mecônio, mais prevalentes em gestação a termo. Conclusão: Entre as causas de óbito fetal, a infecção ascendente foi a maisprevalente; as causas de morte materna relacionadas com a gestação foram as que mais se destacaram.

15.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(1): 27-33, Jan.-Mar. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-985138

ABSTRACT

RESUMO Objetivo: Verificar o perfil e a adequabilidade do uso de antibacterianos em crianças hospitalizadas. Métodos: Estudo transversal. Foi feita a análise de todas as crianças que utilizaram antibacterianos durante a internação de janeiro a dezembro de 2015, em um hospital filantrópico de direito privado de grande porte no sul do Brasil. As informações foram obtidas por revisão dos prontuários e incluíram dados demográficos (idade, sexo, raça e peso corporal) e clínicos (motivo da internação, uso deantibacterianos e desfecho clínico). Utilizou-se estatística descritiva. Resultados: Dos 318 pacientes incluídos, 61,3% eram do sexo masculino. A faixa etária variou de 2 a 11 anos (média: 5,8±2,9 anos de idade). A prevalência do uso de antibacterianos foi de 24,4% considerando o total de 1.346 crianças que foram hospitalizadas. O tempo de internação apresentou mediana de quatro dias. O principal motivo de internação foi clínico e o antibacteriano mais prescrito foi a cefazolina, sendo a via intravenosa predominante. Em relação ao uso de antibacterianos, 62,2% apresentaram prescrições de antibacterianos consideradas adequadas. A subdosagem e a superdosagem tiveram, respectivamente, os valores de 11,7 e 14,6% dos pacientes incluídos. Quanto aos intervalos de administração, 8% foram caracterizados com intervalos longos e 3,5%, curtos. Conclusões: Apesar de a prevalência encontrada do uso de antibacterianos nas crianças hospitalizadas não ser tão elevada, parte considerável da amostra apresentou inadequabilidade quanto ao uso desse tipo de medicamento, se considerados a dose e o intervalo de utilização. Esses dados são motivo de preocupação para o desenvolvimento de resistência bacteriana e ocorrência de reações adversas.


ABSTRACT Objective: To examine the profile and appropriate use of antibiotics among hospitalized children. Methods: A cross-sectional study was conducted with children who had taken antibiotics during hospitalization in a private philanthropic hospital in Southern Brazil, from January to December 2015. The data were obtained by reviewing medical records, encompassing demographic data (age, gender, ethnicity, and body weight) and clinical data (causes of hospitalization, use of antibiotics, and clinical outcome). Descriptive statistics was used to present the data. Results: Of the 318 participants included in the study, 61.3% were male patients. The age range varied between 2 and 11 years, with mean age of 5.8±2.9 years. The prevalence of antibiotics was 24.4% out of the 1,346 hospitalized children. Median hospital stay was four days. The main cause of hospitalization was clinical instability, and the most commonly prescribed antibiotics was Cefazolin, mostly administered intravenously. Regarding the administration of antibiotics, 62.2% were adequately prescribed, even though underdose was 11.7%, and overdose was 14.6% in the studied patients. Antibiotic administration intervals were characterized as long in 8% of cases, and short in 3.5% of cases. Conclusions: Although the prevalence of antibiotics among hospitalized children was not that high, a considerable part of the sample presented inadequacy regarding the dosage and range of use. These data raise concerns about bacterial resistance and adverse reactions.


Subject(s)
Humans , Male , Female , Child , Hospitalization/statistics & numerical data , Medical Records, Problem-Oriented/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Brazil/epidemiology , Child, Hospitalized/statistics & numerical data , Cross-Sectional Studies , Length of Stay/statistics & numerical data , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/adverse effects
16.
Rev. Soc. Bras. Med. Trop ; 52: e20180418, 2019. tab, graf
Article in English | LILACS | ID: biblio-1041510

ABSTRACT

Abstract INTRODUCTION: We evaluated the epidemiological and clinical profile of reported cases of bee sting incidents in Santa Catarina, Brazil. METHODS: This retrospective cohort study included all reported cases of bee sting incidents among the population of Santa Catarina from 2007 to 2017. RESULTS: In total, 8,912 cases were reported, corresponding to an overall rate of 12.3/100,000 population. The mean age was 29,8 years with 60.2% men. The lethality rate was 0.2%. CONCLUSIONS: Santa Catarina has a high incidence rate of bee stings, which is higher than the national average. The data presented in this study may be underestimated.


Subject(s)
Humans , Animals , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Bee Venoms/poisoning , Bees , Insect Bites and Stings/mortality , Brazil/epidemiology , Incidence , Retrospective Studies , Cohort Studies , Disease Notification , Spatial Analysis , Middle Aged
17.
Braz. J. Pharm. Sci. (Online) ; 55: e17739, 2019. tab
Article in English | LILACS | ID: biblio-1039073

ABSTRACT

To estimate the frequency of the use of medicines listed in the Screening Tool to Alert Doctors to the Right Treatment (START) and Screening Tool of Older Person's Prescriptions (STOPP) criteria version 2 among the elderly. A cross-sectional study was conducted on elderly who were attended in medical clinic and cardiology sectors in a hospital in southern Brazil attended at a hospital from February through September 2016. A data-collection tool was used to obtain information on variables, such as demographic and clinical data, and medications used before and during the hospitalization period. The adequacy of the medicines taken was examined with regard to omission (START) or inappropriate use (STOPP). This study was approved by the Research Ethics Committee of the University of Southern Santa Catarina. A total of 307 subjects were included in the final sample. The mean age was 75.2 years (SD = 8; range 65-102). Of the total, 93.5% had had at least one potential prescribing omission (PPO) listed in the START criteria, whereas 95.4% used at least one medicine of the STOPP criteria. PPO was significantly associated with lower mean age (74.9 years, SD = 7.9 versus 79.0 years, SD = 8.8) among the elderly who did not have PPOs detected by the START criteria (p-value=0.03). Furthermore, PPO was associated with longer hospital stay (18 versus 9 days; p-value=0.03). This study revealed inadequate prescription affecting 99.3% of the participating patients. To the best of our knowledge, this was the first to use the START and STOPP criteria, version 2, in Brazil.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aged , Drug Evaluation/instrumentation , Potentially Inappropriate Medication List/standards , Hospitals/classification , Unified Health System/classification , Polypharmacy , Inappropriate Prescribing
18.
Sci. med. (Porto Alegre, Online) ; 28(4): ID30301, out-dez 2018.
Article in English | LILACS | ID: biblio-963668

ABSTRACT

AIMS: To analyze factors associated with physical activity levels among older women attending social groups for the elderly. METHODS: A cross-sectional study was conducted with elderly women enrolled in the Municipal Social Development Foundation in the city of Tubarão, in south Brazil. Sociodemographic and health status variables were evaluated through questionnaires administered during interviews, and by anthropometric evaluation. The level of physical activity was assessed using the Modified Baecke Questionnaire for the Elderly. Quality of life was assessed using the World Health Organization Quality of Life Assessment for older adults. RESULTS: Out of 306 elderly women included in the study, 214 (69.9%) were defined as physically inactive and 92 (30.1%) were active. The proportion of physically active participants between 60-69 years of age was 52.2%, between 70-79 years was 40.2% and equal or more than 80 years was 7.6% (p=0.011). No other sociodemographic or anthropometric characteristics were associated with physical activity. In the non-adjusted analysis there was association between physical activity and better quality of life, as well as with fewer diseases. There was a weak negative correlation between physical activity and number of diseases (correlation coefficient=0.215) and a weak positive correlation between physical activity and quality of life scores (correlation coefficient=0.284). In the adjusted analysis, physical activity remained as a protection factor for loss of quality of life: prevalence ratio=0.88 (95% confidence interval=0.81-0.96), p=0.003. CONCLUSIONS: The study concluded that physical activity in elderly women was associated with better quality of life, even when adjusted for age


OBJETIVOS: Analisar os fatores associados aos níveis de atividade física em mulheres idosas que frequentam grupos sociais para idosos. MÉTODOS: Estudo transversal, realizado com mulheres idosas cadastradas na Fundação Municipal de Desenvolvimento Social, na cidade de Tubarão, no sul do Brasil. As variáveis sociodemográficas e de estado de saúde foram avaliadas por meio de questionários aplicados durante as entrevistas e por avaliação antropométrica. O nível de atividade física foi avaliado pelo Questionário Baecke Modificado para Idosos. A qualidade de vida foi avaliada pelo questionário World Health Organization Quality of Life assessment for older adults. RESULTADOS: Das 306 idosas incluídas no estudo, 214 (69,9%) foram definidas como fisicamente inativas e 92 (30,1%) como ativas. A proporção de participantes fisicamente ativas entre 60-69 anos de idade foi de 52,2%, entre 70-79 anos foi de 40,2% e igual ou maior que 80 anos foi de 7,6% (p=0,011). Nenhuma outra característica sociodemográfica ou antropométrica foi associada à atividade física. Na análise não ajustada houve associação entre atividade física e melhor qualidade de vida, assim como com menos doenças. Houve correlação negativa fraca entre atividade física e número de doenças (coeficiente de correlação= ­0.215) e positiva fraca entre atividade física e nível de qualidade de vida (coeficiente de correlação=0.284). Na análise ajustada, a atividade física permaneceu como fator de proteção para perda de qualidade de vida: razão de prevalência=0,88 (intervalo de confiança 95%=0,81-0,96), p=0,003. CONCLUSÕES: O estudo concluiu que a atividade física em mulheres idosas foi associada à melhor qualidade de vida, mesmo na análise ajustada por idade.


Subject(s)
Aging , Health of the Elderly , Aged , Exercise , Comorbidity
19.
Rev. Bras. Saúde Mater. Infant. (Online) ; 18(3): 461-469, July-Sept. 2018. tab
Article in English | LILACS | ID: biblio-1013107

ABSTRACT

Abstract Objectives: to analyze both frequency and risk factors for seroconversion among newborns of HIV-positive mothers to HIV. Methods: a cohort study was conducted with children residing in Southern Region of Santa Catarina. Secondary data from the notification files and medical records of newborn's mothers of infected infants were used. The participants were all the newborns from 2005 to 2015 that were exposed to HIV through vertical transmission and attended a municipal health care center. Results: there were 104 cases of infant exposure to HIV. Seroconversion was confirmed in three cases, two of them died of AIDS during the study period. Breastfeeding (PR= 32.7; CI95%= 10.7-99.5; p= 0.002) and non-use of antiretroviral drugs during pregnancy (PR=18.2; CI95%= 2.0-163.0; p= 0.008) were risk factors for HIV seroconversion. Conclusions: seroconversion rates among neonates in Southern Region of Santa Catarina were similar to the national average. Seroconversion was associated with non-use of antiretroviral therapy during pregnancy and breastfeeding.


Resumo Objetivos: investigar a frequência e analisar os fatores de risco para soroconversão entre nascidos vivos de mães soropositivas ao HIV. Métodos: foi realizado estudo de coorte, com crianças residentes na Região Sul de Santa Catarina. Foram usados dados secundários referentes a ficha de notificação e acompanhamento de criança exposta ao HIV e revisão do prontuário das mães das crianças infectadas. Participaram do estudo todos os nascidos vivos no período de 2005 a 2015 expostos ao HIV por transmissão vertical atendidos no serviço municipal de saúde. Resultados: houve 104 exposições ao HIV, sendo que em três casos se confirmou soroconversão e dois foram a óbito por Aids.O aleitamento materno (RP=32,7; IC95%=10,7-99,5); p=0,002) e o não uso de antirretroviral durante a gestação (RP=18,2; IC95%=2,0-163,0); p=0,008) foram fatores de risco para a soroconversão. Conclusões: a soroconversão em neonatos na Região Sul de Santa Catarina foi similar à média nacional. Houve associação com não utilização de terapia antirretroviral durante a gestação e aleitamento materno.


Subject(s)
Humans , Infant, Newborn , Acquired Immunodeficiency Syndrome/transmission , HIV , HIV Seropositivity/transmission , Infectious Disease Transmission, Vertical , Live Birth , Breast Feeding , Infant, Newborn , Risk Factors , Cohort Studies , Anti-Retroviral Agents , Health Services
20.
Rev. bras. anestesiol ; 68(2): 122-127, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-897824

ABSTRACT

Abstract Background and objectives: Pain is an aggravating factor of postoperative morbidity and mortality. The aim of this study was to compare the effects of methadone versus morphine using the numerical rating scale of pain and postoperative on-demand analgesia in patients undergoing myocardial revascularization. Method: A randomized, double-blind, parallel clinical trial was performed with patients undergoing coronary artery bypass grafting. The subjects were randomly divided into two groups: morphine group and methadone group. At the end of cardiac surgery, 0.1 mg.kg−1 adjusted body weight of methadone or morphine was administered intravenously. Patients were referred to the ICU, where the following was assessed: extubation time, time to first analgesic request, number of analgesic and antiemetic drug doses within 36 h, numerical pain scale at 12, 24, and 36 h postoperatively, and occurrence of adverse effects. Results: Each group comprised 50 patients. Methadone showed 22% higher efficacy than morphine as it yielded a number-needed-to-treat score of 6 and number-needed-to-harm score of 16. The methadone group showed a mean score of 1.9 ± 2.2 according to the numerical pain scale at 24 h after surgery, whereas as the morphine group showed a mean score of 2.9 ± 2.6 (p = 0.029). The methadone group required less morphine (29%) than the morphine group (43%) (p = 0.002). However, the time to first analgesic request in the postoperative period was 145.9 ± 178.5 min in the methadone group, and 269.4 ± 252.9 in the morphine group (p = 0.005). Conclusions: Methadone was effective for analgesia in patients undergoing coronary artery bypass grafting without extracorporeal circulation.


Resumo Justificativa e objetivos: A dor é fator agravante da morbidade e mortalidade pós-operatória. O objetivo foi comparar o efeito da metadona versus morfina quanto à dor e demanda de analgesia pós-operatória em pacientes submetidos à revascularização do miocárdio. Método: Ensaio clínico randomizado, duplo-cego, em paralelo. Pacientes submetidos à cirurgia de revascularização do miocárdio foram randomizados por blocos em dois grupos: Grupo Morfina (Gmo) e Grupo Metadona (Gme). No fim da cirurgia cardíaca, 0,1 mg.Kg−1 peso corrigido de metadona ou morfina foi administrado por via venosa. Os pacientes foram levados à UTI, onde foram avaliados o tempo até a extubação e a necessidade do primeiro analgésico, o número de doses necessárias de analgésicos e antieméticos em 36 horas, a escala numérica de dor em 12, 24 e 36 horas após a cirurgia e a ocorrência de efeitos adversos. Resultados: Foram incluídos 50 pacientes em cada grupo. A metadona apresentou eficácia 22% maior do que a morfina com Number Needed to Treat(NNT) de 6 e Number Needed to Harm(NNH) de 16. Gme apresentou média de dor pela escala numérica em 24 horas após o procedimento de 1,9 ± 2,2 em comparação com o Gmo, cuja média foi de 2,9 ± 2,6 (p= 0,029). O Gme necessitou de menos morfina de resgate 29% do que o grupo Gmo 43% (p= 0,002). Entretanto, o tempo até a necessidade de analgésico no pós-operatório foi de 145,9 ± 178,5 minutos no Grupo Gme e de 269,4 ± 252,9 no Gmo (p= 0,005). Conclusões: A metadona mostrou-se eficiente para a analgesia em cirurgias cardíacas de revascularização do miocárdio sem circulação extracorpórea.


Subject(s)
Humans , Male , Female , Pain, Postoperative/drug therapy , Coronary Artery Bypass , Analgesia, Patient-Controlled , Pain Management/methods , Analgesics, Opioid/therapeutic use , Methadone/therapeutic use , Morphine/therapeutic use , Pain, Postoperative/diagnosis , Pain Measurement , Double-Blind Method , Middle Aged
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