Farmacovigilância: terapia semi-intensiva da oncopediatria em um hospital filantrópico / Pharmacovigilance: semi-intensive oncopediatric therapy in a philanthropic hospital

Objetivo: analisar a utilização de medicamentos prescritos no setor de terapia semi-intensiva da oncopediatria em um hospital filantrópico, tendo em vista o desenvolvimento da farmacovigilância na prática farmacêutica. Métodos: foi realizada avaliação das prescrições médicas e pesquisa bibliográfica nas bases de dados sobre medicamentos no período de junho de 2015 a junho de 2016. As variáveis adotadas foram relacionadas às características sociodemográficas, clínicas, e os medicamentos prescritos foram classificados de acordo com a Anatomical Therapeutic Chemical Classification (ATC). Foram incluídas todas as prescrições oncológicas da unidade de terapia semi-intensiva, considerando a faixa etária de 0-18 anos, estratificada em 0-11 anos, 12-14 anos e 15-18 anos, no período de junho de 2015 a junho de 2016, excluindo aquelas que não atendiam aos requisitos. Os dados foram compilados no programa Statistical Package for the Social Sciences (SPSS), versão 22.0. Resultados: a maioria dos pacientes pertencia ao sexo masculino com prevalência na faixa etária entre 00-11 anos. A leucemia linfoide aguda foi o diagnóstico mais observado, e o desfecho de alta melhorada representou mais da metade da amostra. As classes terapêuticas mais prescritas corresponderam aos antineoplásicos, anti-infecciosos e aos que atuam no Sistema Nervoso Central (SNC). Conclusões: os resultados sugerem que o tratamento farmacológico, em unidade de terapia intensiva, envolve um grupo extenso de medicamentos, com predomínio de antineoplásicos, antibióticos e fármacos que atuam no SNC. É necessária atenção especial para a conduta terapêutica no atendimento à população pediátrica, visando minimizar, sobretudo, os eventos adversos inerentes ao tratamento oncológico.

Objective: ito analyze the use of drugs as prescribed in the semi-intensive therapy sector of oncopediatrics in a philanthropic hospital, in view of the development of pharmacovigilance in pharmaceutical practice. Methods: the evaluation of medical prescriptions and bibliographic research was carried out in the databases on drugs from June 2015 to June 2016. The variables adopted were related to sociodemographic, clinical characteristics and the prescribed drugs were classified according to the Anatomical Therapeutic Chemical Classification (ATC). All the oncological prescriptions of the semi-intensive therapy unit were included, considering the age range 0-18 years, stratified in 0-11 years, 12-14 years and 15-18 years, in the period from June 2015 to June of 2016, excluding those that did not meet the requirements. The data were compiled in the Statistical Package for the Social Sciences (SPSS), version 22.0. Results: most of the patients belonged to males with a prevalence in the age range between 00-11 years old. Acute lymphoblastic leukemia was the most observed diagnosis and the improved high endpoint accounted for more than half of the sample. The most prescribed therapeutic classes corresponded to: antineoplastic, anti-infectious and those acting on the Central Nervous System (CNS). Conclusions: the results suggest that pharmacological treatment in an intensive care unit involves an extensive group of drugs, with a predominance of antineoplastics, antibiotics and drugs acting in the CNS. Special attention is required for therapeutic management in the pediatric population, in order to minimize the adverse events inherent to cancer treatment.

Salud de familias con niños y adolescentes con cáncer / Health of families with children and adolescents with cancer

Introducción: la salud familiar implica un enfoque sistémico que involucra el funcionamiento y el tránsito armónico de la familia por las etapas del ciclo vital. Objetivo: diagnosticar la salud de familiares que tienen niños y adolescentes que padecen cáncer, pertenecientes al Policlínico Universitario 4 de Abril del municipio Guantánamo. Método: se realizó un estudio descriptivo de corte transversal, en 9 familias que se encontraron durante el período septiembre de 2013 a junio de 2014. Se utilizó el modelo teórico-metodológico de evaluación de la salud familiar que incluye como instrumentos de evaluación la prueba de percepción del funcionamiento familiar y el inventario de características familiares de riesgo. Resultados: el cruzamiento de los resultados dio lugar a la matriz de salud familiar. Las crisis paranormativas estaban presentes en el 66.6 por ciento de las familias por desmembramiento. Solo el 33.3 por ciento de las familias fue funcional. En el contexto socio-económico y cultural en el 77.7 por ciento de las familias se evidenciaron características que constituyen riesgo potencial para la salud del grupo. Conclusiones: las familias estudiadas presentaron afectación grave de la salud familiar por alta prevalencia de características de riesgo, así como el predominio de la disfuncionalidad familiar, situación ésta que las ubica en una condición de sobre esfuerzo para afrontar la vida cotidiana(AU)

Introduction: family health implies a systemic approach that involves the functioning and the harmonious transition of the family through the stages of the life cycle. Objective: to diagnose the health of family members who have children and adolescents suffering from cancer, belonging to the 4 de Abril University Polyclinic of the Guantanamo municipality. Method: a descriptive cross-sectional study was carried out in 9 families found from September 2013 to June 2014. The theoretical-methodological model of family health assessment was used, which includes as evaluation instruments, the perception test of the family functioning and the inventory of risk family characteristics. Results: the crossing of the results gave rise to the family health matrix. Paranormative crises were present in 66.6por ciento of families due to dismemberment. Only 33.3 percent of the families were functional. In the socio-economic and cultural context in 77.7 percent of the families, characteristics that constitute a potential risk to the health of the group were evidenced. Conclusions: the studied families presented serious affectation of family health due to a high prevalence of risk characteristics, as well as the predominance of family dysfunctionality, a situation that places them in a condition of over exertion to face daily life(AU)

Parámetros bioeléctricos in vitro e in vivo, estimados con los analizadores Bodystat®1500-MDD y BioScan®98 / Bioelectrical parameters in vitro and in vivo estimated with analyzers Bodystat®1500-MDD and BioScan®98

Se efectuó un estudio comparativo de 2 analizadores comerciales de bioimpedancia eléctrica corporal (Bodystat® 1500-MDD y BioScan®98) en el Servicio de Oncopediatría del Hospital Infantil Sur de Santiago de Cuba, desde septiembre hasta octubre del 2009, para lo cual se realizó una simulación in vitro con los calibradores de cada equipo y un estudio in vivo de 32 adultos aparentemente sanos y 32 niños con diferentes afecciones. La resistencia eléctrica y la reactancia capacitiva se estimaron con ambos analizadores; además, se calcularon el módulo de impedancia y el ángulo de fase. La prueba t-student de 2 medias para muestras apareadas y el método de Bland-Altman fueron los criterios estadísticos usados. No existieron diferencias significativas entre ambos analizadores al introducir los factores de corrección para la resistencia eléctrica y la reactancia capacitiva; por tanto, es posible usarlos indistintamente para caracterizar bioeléctricamente a los individuos aparentemente sanos y pacientes con diferentes enfermedades.

A controlled trial with 2 body electrical impedance commercial analyzers was carried out (Bodystat® 1500-MDD and BioScan®98) at the Pediatric Oncology Department of the Southern Children Hospital in Santiago de Cuba, from September to October 2009, for which an in vitro simulation with gauges of each device and an in vivo study in 32 apparently healthy adults and 32 children with different conditions were conducted. Electrical resistance and capacitive reactance were estimated with both analyzers, and impedance module and phase angle were also calculated. The two-means Student's t test for paired samples and the Bland-Altman method were used as statistical criteria. There were not significant differences between the two analyzers by introducing correction factors for electrical resistance and capacitive reactance; therefore, it is possible to use either to characterize bioelectrically apparently healthy individuals and patients with different conditions.

Enfoque interdisciplinar a la calidad de vida y de muerte en Oncopediatría / Interdisciplinary approach to quality of life and death in Oncopediatrics

Muchos médicos que brindan asistencia a niños y adolescentes con cáncer tributarios de cuidados paliativos fracasan al intentar curar la enfermedad y con ello prolongar la vida y en ese intento poblado de buenas intensiones pero carente de profesionalidad y ética es que se convierten en fuentes de sufrimientos para los pacientes, familiares y hasta para el propio equipo de trabajo al mantener una conducta de obstinamiento terapéutico en la mayoría de los casos; en otros, aún cuando comprenden la realidad de una muerte próxima no hacen un manejo adecuado de los factores psicológicos, espirituales y sociales para ayudar a un buen morir. ¿Es calidad de vida, en una persona que está al final de su vida o es calidad de muerte hasta el último momento de su existencia?; en otras palabras son cuidados por la vida al final de la vida y para ello se necesita de un manejo terapéutico adecuado del proceso vivir/morir en estos grupos de edades, objetivos de este artículo, donde las características del desarrollo ontogénico lo hace ser más difícil que en los adultos. Es una tarea dura y difícil, para la cual necesitamos de preparación y un verdadero trabajo interdisciplinario pero gratificante y de gran aportación a nuestro crecimiento personal, porque ¿existirá una tarea más noble y humana que acompañar a niños y adolescente en los últimos días de su existencia por la vida?(AU)

Many physicians offering assistance to children and adolescents presenting cancer needed of palliative care fail trying to cure the disease and thus to extend the life and in that attempt of good intentions but lacking of professionalism and ethics become suffering sources for patients, relatives and for the working staff for maintaining a therapeutic obstinacy in most cases; in other, even though they understand the reality of a near death don't make an appropriate management of psychological , spiritual and social factors to help in a good death. Is it quality of life, is it a person ending its life or it is death quality until the last moment of its existence? , in other words, are cares for life at the end of the life and thus it is necessary an appropriate therapeutic management of the to live/to die in these age groups, which are the objective of present paper, where the features of ontogeny development make it more difficult than in the adult ones. It is a hard and difficult task, being necessary training and a real interdisciplinary work but at the same time rewarding and of a great contribution to our personal growth, because, there will be a more noble and human task that to be the company of children in the last days of existence by the life?(AU)