ABSTRACT
RESUMO Mudanças epidemiológicas decorrentes do envelhecimento populacional motivaram transformações nos sistemas de saúde mundiais. Desde 1990, emergem discussões sobre Cuidados Intermediários (CI), visando diminuir hospitalizações, melhorar a coordenação do cuidado e estimular políticas públicas de cuidados próximos ao território. Este trabalho objetivou apresentar e analisar a literatura científica sobre CI, enfatizando serviços de Hospitais Comunitários. Realizou-se uma revisão integrativa, combinando os descritores "Intermediate Care", "Community Hospitals", "Intermediate Care Facilities", "Long-Term Care", "Hospitals Chronic Disease" e "Rehabilitation Services", nos idiomas português, inglês e espanhol, nas bases Portal Regional da Biblioteca Virtual em Saúde, PubMed e Biblioteca Digital Brasileira de Teses e Dissertações. Após processo de busca e elegibilidade, foram incluídos 30 documentos para síntese qualitativa, provenientes de: Reino Unido, Noruega, Espanha, Dinamarca, Austrália e Itália. Resultados apontam para a eficácia, a efetividade e a eficiência dos CI, com boas avaliações por parte de profissionais e usuários. Os CI, como estratégia de fortalecimento da Atenção Primária à Saúde, redução de internações, favorecimento da independência funcional dos pacientes e seu retorno à comunidade, apresentam-se como uma inovação em saúde e aposta promissora. Entretanto, persistem lacunas na literatura que ensejam mais estudos sobre o tema, com vistas a subsidiar a tomada de decisão.
ABSTRACT Epidemiological changes resulting from populational aging have led to changes in global health systems. Since 1990, discussions on Intermediate Care (IC) have emerged, with a view to reducing hospitalizations, improving care coordination, and stimulating public care policies close to the territory. This work aims to present and analyze the scientific literature on CI, emphasizing services from Community Hospitals. An integrative review was carried out, combining the descriptors "Intermediate Care", "Community Hospitals", "Intermediate Care Facilities", "Long-Term Care", "Hospitals Chronic Disease", and "Rehabilitation Services", in Portuguese, English and Spanish, in the Regional Portal of Virtual Health Library, PubMed and Digital Library of Thesis and Dissertations bases. After the search and eligibility process, 30 documents were included for qualitative synthesis, coming from: The United Kingdom, Norway, Spain, Denmark, Australia and Italy. Results point to the efficacy, effectiveness and efficiency of ICs, with good evaluations by professionals and users. ICs, as a strategy to strengthen Primary Health Care, reduce hospital admissions, favor patients' functional independence and return to the community, are presented as a health innovation and promising bet. However, there are gaps in the literature that lead to more studies on the topic, with a view to supporting decision making.
ABSTRACT
La farmacovigilancia es una rama de la Farmacología de reciente evolución. Surge por acontecimientos desencadenados con la explosión farmacológica después de la II Guerra Mundial, que permitieron grandes avances en el tratamiento de enfermedades que antes conducían rápida e inexorablemente a la muerte o a una grave incapacidad. Objetivo: monitorear los tratamientos administrados con agonistas adrenérgicos empleados en el paciente grave. Método: se realizó un estudio de tipo observacional prospectivo en pacientes que recibieron tratamiento con agonistas adrenérgicos en la unidad de cuidados intermedios del Hospital Municipal Manuel Piti Fajardo de Florida, Camagüey; desde enero a julio de 2010. La muestra quedó constituida por 71 pacientes. Para el estudio se tuvieron en cuenta variables sociodemográficas, epidemiológicas, tipo y grado de severidad, causalidad, mecanismos de producción de las reacciones adversas medicamentosas, así como el desenlace final de las mismas. Resultados: se obtuvo más de un cincuenta por ciento de pacientes con sospechas de reacción adversa medicamentosa a predominio de aquellos en que se detectaron manifestaciones como taquicardia, palidez e hipertensión arterial entre los signos y síntomas, según el agonista adrenérgico administrado se observóefectos de (tipo A) en aquellos que adquirieron un grado de severidad moderado, clasificadas como probadas, donde el mayor por ciento de la muestra necesitó tratamiento para la resolución de los síntomas
Pharmacovigilance is a branch of Pharmacology of recent development. It arises by events triggered with the pharmacological explosion after the Second World War, which allowed great advances in the treatment of diseases which before lead to a rapid and inexorably death or a severe disability.Objective: to observe treatments administered with adrenergic agonists used in the severe patient. Methods: a prospective observational study was performed on patients who were treated with adrenergic agonists in the intermediate care unit at the Municipal Hospital Manuel "Piti" Fajardo, Florida, Camagüey; from January to July 2010. The sample was constituted by 71 patients. The study took into account sociodemographic and epidemiological variables, type and degree of severity, causation, mechanisms of production of drug adverse reactions, as well as their final outcome. Results: more than fifty percent of patients with suspicion of adverse drug reaction was obtained to predominance of those in which were detected manifestations such as tachycardia, pallor and hypertension between signs and symptoms,according to adrenergic agonist was observed (type A) effects in those who acquired a moderate degree of severity, classified as proven, where the greatest percent of the sample needed treatment to the resolutionof symptoms