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1.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 8(1): e202, jun. 2021. tab, graf
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1248716

ABSTRACT

Se realizó un analisis de la tasa de cesáreas en dos maternidades públicas de referencia de Uruguay (Hospital de Clínicas y Centro Hospitalario Pereira Rossell) utilizando la clasificación de Robson para compararlas entre sí, mediante un estudio observacional, descriptivo, retrospectivo y transversal en un periodo de 10 años y 10 meses (2009-2019). Se analizaron 85.526 nacimientos (7.685 (8,9%) en el Clínicas vs 77.841 (91.1%) Pereira Rossell). El porcentaje de cesáreas por año en el Clínicas fue 49,2% ± 5 vs 29,3% ± 3 en Pereira Rossell. Los grupos de Robson más prevalentes fueron 1, 5A y 10 en el Clínicas vs 3, 1 y 5A en Pereira Rossell. En ambos centros los grupos con mayor contribución relativa a la tasa global de cesáreas fueron: 5A, 10 y 1. Ambos centros presentan un aumento en la tasa de cesárea en la última década, pese a que se asisten poblaciones dispares entre cada uno de ellos. Se debe seguir buscando estrategias que ayuden a reducir la tasa de cesáreas principalmente en pacientes sin cesáreas anteriores o con una única cesárea previa, en caso de no presentan contraindicaciones para el parto vaginal.


An analysis of the caesarean section rate was carried out in two reference public maternity wards in Uruguay (Hospital de Clínicas and Centro Hospitalario Pereira Rossell) using Robson's classification to compare them with each other, through an observational, descriptive, retrospective and cross-sectional study in a period 10 years and 10 months (2009-2019). 85,526 births were analyzed (7,685 (8.9%) in the Clinics vs 77,841 (91.1%) Pereira Rossell). The percentage of caesarean sections per year in the Clinics was 49.2% ± 5 vs 29.3% ± 3 in Pereira Rossell. The most prevalent Robson groups were 1, 5A and 10 in the Clinicas vs 3, 1 and 5A in Pereira Rossell. In both centers, the groups with the highest relative contribution to the overall rate of cesarean sections were: 5A, 10 and 1. Both centers show an increase in the rate of cesarean section in the last decade, despite the fact that different populations are attended between each of them. Strategies should continue to be sought to help reduce the rate of cesarean sections, mainly in patients without previous cesarean sections or with a single previous cesarean section, if they do not present contraindications for vaginal delivery.


Foi realizada análise da taxa de cesárea em duas maternidades públicas de referência do Uruguai (Hospital de Clínicas e Centro Hospitalario Pereira Rossell), utilizando a classificação de Robson para compará-las, por meio de estudo observacional, descritivo, retrospectivo e transversal. em um período de 10 anos e 10 meses (2009-2019). Foram analisados 85.526 partos (7.685 (8,9%) nas Clínicas vs 77.841 (91,1%) Pereira Rossell). A porcentagem de cesarianas por ano nas Clínicas foi de 49,2% ± 5 vs 29,3% ± 3 em Pereira Rossell. Os grupos de Robson mais prevalentes foram 1, 5A e 10 nas Clínicas vs 3, 1 e 5A em Pereira Rossell. Em ambos os centros, os grupos com maior contribuição relativa para a taxa global de cesárea foram: 5A, 10 e 1. Ambos os centros apresentam aumento da taxa de cesárea na última década, apesar de diferentes populações serem atendidas entre cada um deles. Estratégias devem continuar a ser buscadas para ajudar a reduzir a taxa de cesárea, principalmente em pacientes sem cesárea anterior ou com cesárea única, se não apresentarem contra-indicações para parto normal.


Subject(s)
Humans , Female , Pregnancy , Cesarean Section/statistics & numerical data , Hospitals, Maternity/statistics & numerical data , Hospitals, University/statistics & numerical data , Uruguay/epidemiology , Cesarean Section/trends , Prevalence , Cross-Sectional Studies , Retrospective Studies , Hospitals, Public/statistics & numerical data
2.
Evid. actual. práct. ambul ; 24(1): e002113, 2021. tab
Article in Spanish | LILACS | ID: biblio-1179134

ABSTRACT

Antecedentes. La continuidad del cuidado (CoC) suele describir en qué medida los pacientes ven al mismo profesional a lo largo del tiempo. Constituye un elemento necesario para garantizar la longitudinalidad en la atención, elemento clave dela atención primaria y de la medicina familiar en particular, entendido como el cuidado centrado en la persona a lo largo del tiempo, independientemente del tipo de problema consultado. Esta ha sido vinculada con una serie de beneficios para los pacientes y algunos indicadores duros de utilización de servicios de salud, por ejemplo visitas a la central de emergencias(CE), internaciones hospitalarias y mortalidad. En Argentina y América Latina no habíamos podido identificar estudios que dieran cuenta del nivel local de CoC o de su impacto en la utilización de los servicios de salud. Objetivo. Cuantificar los niveles de CoC de los afiliados de un Seguro de Salud de un Hospital Universitario Privado y describir su asociación con la utilización de servicios de salud, tales como consultas a la CE e internaciones hospitalarias. Métodos. Estudio observacional, descriptivo, de cohorte retrospectiva; realizado sobre la totalidad de afiliados que hubieran realizado al menos dos consultas programadas con un médico de atención primaria entre 2015 y 2016.Las mediciones principales consistieron dos indicadores: el índice del proveedor usual de cuidados y el índice de continuidad del cuidado (UPC y COC, respectivamente, por sus iniciales en inglés) -cuyos valores oscilan entre 0 y 1, y se interpretan como: el paciente siempre fue atendido por diferentes médicos vs siempre por el mismo médico-y el recuento de visitas a la CE e internaciones hospitalarias. Resultados. Fueron identificados 112.062 pacientes con una mediana de edad de 59 (P5-P95;4 a 87) años. Las medianas(P5-P95) de los indicadores de continuidad, UPC y COC, fueron 0,66 (0,25 a 1) y 0,33 (0,04 a 1), respectivamente. Se observó una asociación inversa y estadísticamente significativa entre los indicadores de CoC y la cantidad de visitas a la CE, evidenciada por una razón de incidencia decreciente de consultas contra quintilos crecientes de COC (tomando como referencia el quintilo más bajo de continuidad). Esta asociación no pudo demostrarse para las internaciones. Conclusiones. Los niveles de CoC alcanzados y su impacto en la utilización de servicios de salud reflejan valores semejantes a los de otros estudios publicados fuera de nuestra región y podrían aportar elementos útiles para delinear estrategias tendientes a la mejora de la calidad de la atención médica. (AU)


Background. Continuity of care (CoC) usually describes the extent to which patients see the same professional over time. It is a necessary element to ensure continuity of care, a key element of primary care and family medicine, in particular, understood as person-centred care over time, regardless of the type of problem consulted. It has been linked to a series of benefits for patients as well as to hard indicators of health services utilization (e.g. emergency room [ER] visits, hospitalizations) and mortality. In Argentina and Latin America, we have not been able to identify studies that account for the local level of CoC and its impact. Objective. To quantify the CoC levels among members of a private university hospital's health insurance scheme and to describe its association with the use of health services, such as ER visits and hospitalizations. Methods. Observational, descriptive, retrospective cohort study; conducted on the total number of members who hadmade at least two schedurivled consultations with a primary care physician between 2015 and 2016.The main outcomes were two indicators: the usual provider continuity index and the continuity of care index (UPC and COC, respectively) -both range between 0 and 1, and are interpreted as: the patient was always treated by different doctorsvs. always by the same doctor- and the number of visits to the ER and hospitalizations. Results. A total of 112,062 patients with a median age of 59 (P5-P95, 4 to 87) years were identified. The median (P5-P95) of the continuity indicators, UPC and COC, was 0.66 (0.25 to 1) and 0.33 (0.04 to 1), respectively. A significant inverse association was observed between the CoC indicators and the number of ER visits, evidenced by adecreasing incidence rate of consultations versus increasing quintiles of CoC (taking the lowest quintile of continuity as a reference). This association was not observed for hospitalizations. Conclusions. The levels of CoC reached and their impact on the use of health services reflect similar values to those of other studies published outside our region and could provide useful elements for outlining strategies aimed at improvingthe quality of medical care. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Quality of Health Care/statistics & numerical data , Continuity of Patient Care/statistics & numerical data , Argentina , Physician-Patient Relations , Primary Health Care/statistics & numerical data , Retrospective Studies , Patient-Centered Care , Family Practice , Health Services/statistics & numerical data , Hospitals, University/statistics & numerical data , Insurance, Health/statistics & numerical data
3.
Rev. panam. salud pública ; 45: e16, 2021. tab
Article in English | LILACS | ID: biblio-1252024

ABSTRACT

ABSTRACT Objective. To determine the distribution of cesarean sections performed in teaching hospitals participating in the Project for Improvement and Innovation in the Care and Teaching of Obstetrics and Neonatology (Apice ON) using the Robson Classification. Methods. Cross-sectional descriptive study on cesarean sections performed at Apice ON hospitals according to the Robson Classification, using secondary data from the 2017 Live Births Information System on the year prior to project implementation, hence a baseline study. Hospitals are described according to their geographic distribution and cesarean section rates, using absolute and relative frequencies. Results. The proportions of newborns by Robson groups were similar to those proposed by the World Health Organization, except for Group 5 (with previous cesarean section) and Group 10 (preterm), with regional differences. The teaching hospitals' average cesarean section rates ranged from 24.8% to 75.1%, exceeding by far the recommended values, even in Robson groups considered low risk for cesarean section (Groups 1 to 4). Conclusions. Brazilian teaching hospitals displayed cesarean section rates higher than those recommended by the World Health Organization for all groups; a worrisome fact, as by teaching they induce attitudes in future professional practices. These results highlight the importance of a reliable information system. Monitoring and evaluation of cesarean sections using the Robson Classification can be an important tool to guide management and propose actions to reduce rates. Countries with high cesarean section rates might explore this hypothesis in their teaching hospitals in order to define policies for the reduction of their rates.


RESUMEN Objetivo. Utilizar la clasificación de Robson para determinar la distribución de las cesáreas realizadas en los hospitales universitarios que participan en el proyecto para la mejora y la innovación en la atención y la enseñanza de la obstetricia y la neonatología (Apice ON). Métodos. Se empleó la clasificación de Robson para realizar un estudio descriptivo transversal sobre las cesáreas realizadas en los hospitales del proyecto Apice ON. Se utilizaron datos secundarios procedentes del Sistema de Información de Nacidos Vivos del 2017 correspondientes al año anterior a la ejecución del proyecto, a modo de estudio de referencia. Los hospitales se clasifican según su distribución geográfica y sus tasas de realización de cesáreas, usando frecuencias absolutas y relativas. Resultados. Las proporciones de recién nacidos por grupos de Robson fueron similares a las propuestas por la Organización Mundial de la Salud, a excepción de los grupos 5 (con cesárea anterior) y 10 (prematuro), con diferencias regionales. Las tasas de cesárea promedio de los hospitales universitarios variaron entre el 24,8% y el 75,1%. Estos valores superan con creces los valores recomendados, incluso para grupos de Robson considerados de bajo riesgo de cesárea (grupos 1 a 4). Conclusiones. Los hospitales universitarios de Brasil mostraron tasas de realización de cesáreas superiores a lo recomendado por la Organización Mundial de la Salud para todos los grupos. Este hecho es preocupante, ya que estos centros pueden incentivar ciertas actitudes en la práctica de los profesionales que forman. Estos resultados ponen de relieve la importancia de un sistema de información fiable. El seguimiento y la evaluación de la realización de cesáreas mediante la clasificación de Robson puede ser una herramienta útil para guiar la gestión y proponer medidas dirigidas a reducir las tasas. Esta hipótesis puede ser de interés para aquellos países con tasas elevadas de cesárea, cuyos hospitales universitarios podrían emplear este enfoque para definir políticas de reducción de sus tasas.


RESUMO Objetivo. Determinar a distribuição dos partos cesárea realizados em hospitais de ensino integrantes do Projeto de Aprimoramento e Inovação no Cuidado e Ensino em Obstetrícia e Neonatologia (Apice ON) de acordo com a Classificação de Robson. Métodos. Estudo descritivo transversal de partos cesárea realizados em hospitais integrantes do Projeto Apice ON de acordo com a Classificação de Robson com base em dados secundários do Sistema de Informação sobre Nascidos Vivos (SINASC) de 2017 no ano anterior à implantação do projeto. Trata-se, portanto, de um estudo da linha de base. A análise foi realizada segundo a distribuição geográfica e as taxas de partos cesáreas dos hospitais, com o uso de frequências absolutas e relativas. Resultados. Os percentuais de recém-nascidos pelos grupos da Classificação de Robson foram similares aos propostos pela Organização Mundial da Saúde (OMS), exceto para os grupos 5 (parto cesárea anterior) e 10 (parto prematuro), com variação regional. A taxa média de partos cesárea nos hospitais de ensino oscilou entre 24,8% e 75,1%, um patamar que está bem acima dos níveis recomendados, inclusive nos grupos de baixo risco para cesárea (grupos 1 a 4). Conclusões. Os hospitais de ensino no Brasil têm taxas de partos cesárea maiores que as recomendadas pela OMS para todos os grupos. É um fato preocupante porque o aprendizado é um indutor das práticas profissionais futuras. Os resultados deste estudo apontam para a importância de sistemas de informação confiáveis. O monitoramento e avaliação das cesáreas de acordo com a Classificação de Robson constituem um instrumento útil para orientar a conduta e propor ações para reduzir das taxas. Os países com altos índices de cesáreas deveriam considerar este modelo nos seus hospitais de ensino visando definir políticas para a redução das taxas.


Subject(s)
Humans , Female , Pregnancy , Cesarean Section/classification , Cesarean Section/statistics & numerical data , Hospitals, Maternity/statistics & numerical data , Hospitals, University/statistics & numerical data , Brazil , Cross-Sectional Studies , Health Information Systems
4.
Medicina (B.Aires) ; 80(3): 219-228, jun. 2020. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-1125073

ABSTRACT

Se observa un proceso de feminización de la profesión médica, sin embargo, el acceso masivo de las mujeres se asocia a nuevas desigualdades de género, denominadas segregación horizontal y vertical. La segregación horizontal se manifiesta en la desigual distribución de hombres y mujeres en ciertas especialidades médicas y la segregación vertical, en la escasa representación de las mujeres en la mayoría de los altos cargos profesionales. El objetivo de este estudio fue determinar cómo se distribuyen hombres y mujeres en las distintas instancias del proceso que implica el ingreso al sistema de residencias médicas de un hospital universitario de Buenos Aires, Argentina y analizar la segregación horizontal y vertical de género en el proceso de ingreso a las residencias médicas. A partir de datos de postulantes a un hospital universitario, en el período 2015-2017, se realizó un análisis de regresión logística múltiple para ajustar el odds ratio de ser hombre o mujer con potenciales confundidores. No se observó asociación entre ser hombre o mujer y la realización del examen, su aprobación y el ingreso a entrevista. El odds ratio ajustado para el ingreso a la residencia de los hombres con respecto a las mujeres fue 2.03 (1.44-2.85). Para las residencias quirúrgicas fue 2.75 (1.54-4.92) y para las clínicas fue 1.89 (1.17-3.00). En la inscripción, las mujeres optaron mayormente por residencias clínicas, y los hombres por quirúrgicas. Se observó segregación horizontal y vertical en el proceso de ingreso a la residencia. Visibilizar la segregación de género permitirá generar una sociedad equitativa.


A process of feminization of the medical profession is observed, however, the massive access of women is associated with new gender inequalities named horizontal and vertical segregation. Horizontal segregation manifests itself in the unequal distribution of men and women in certain medical specialties and vertical segregation, in the limited representation of women in most high professional positions. The objective of this study was to determine how men and women are distributed in the different stages of the process that involves entering the medical residency system of an universitary hospital from Buenos Aires, Argentina, and to analyze the horizontal and vertical segregation of gender in the process of admission to medical residencies. Based on data from applicants to an universitary hospital, in the 2015-2017 period, a multiple logistic regression analysis was conducted to adjust the odds ratio of being male or female with potential confounders. There was no association between being man or woman and the performance of the exam, its approval and the admission to the interview. The adjusted odds ratio for the admission to the residency of men with respect to women was 2.03 (1.44-2.85). For the surgical residencies it was 2.75 (1.54-4.92) and for clinical it was 1.89 (1.17-3.00). In the inscription, women opted mainly for clinical residencies, and men for surgical purposes. Horizontal and vertical segregation was observed in the process of the residency. Making gender segregation visible will allow generating an equitable society.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Hospitals, University/statistics & numerical data , Internship and Residency/statistics & numerical data , Medical Staff, Hospital/statistics & numerical data , Argentina , Logistic Models , Sex Factors , Multivariate Analysis , Retrospective Studies , Sex Distribution , Statistics, Nonparametric
5.
Braz. j. infect. dis ; 24(1): 7-12, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089323

ABSTRACT

ABSTRACT Background: This study aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis from 2013 to 2017 in a major teaching hospital in China. Methods: Trends in antifungal drug susceptibility of 217 consecutive non-repetitive cryptococcal isolates collected from patients of an university hospital in China were analyzed between 2013 and 2017. Of those, 98 isolates were conserved for identification by internal transcribed spacer (ITS) sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system. Multilocus sequence typing (MLST) was used to designate molecular types. Clinical characteristics of the 98 patients with cryptococcosis during the period of 2013-2017 were retrospectively evaluated. Results: There was a trend for gradual increase in the MIC range of fluconazole was from 2013 to 2017. The conserved 98 clinical cryptococcal isolates included 97 C. neoformans and one C. gattii, and 90 (91.8%) isolates belonged to ST5 genotype VNI. Out of the 98 patients with cryptococcosis, 28 (28.6%) were HIV-infected and 32 (32.7%) had no underlying diseases. HIV-infected patients had higher mortality than HIV-uninfected patients (28.6% vs 14.3%, p = 0.147). Conclusions: Most of the patients with cryptococcosis were not HIV-infected in this study, while patients with HIV had a higher mortality. Reduced susceptibility to fluconazole was observed among C. neoformans isolates, most of them belonged to ST5 genotype VNI having an impact on the effective dose of fluconazole.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cryptococcosis/microbiology , Cryptococcosis/epidemiology , Hospitals, University/statistics & numerical data , Time Factors , Microbial Sensitivity Tests , China/epidemiology , Cross-Sectional Studies , Retrospective Studies , Statistics, Nonparametric , Cryptococcosis/drug therapy , Cryptococcus neoformans/isolation & purification , Cryptococcus neoformans/drug effects , Cryptococcus neoformans/genetics , Cryptococcus gattii/isolation & purification , Cryptococcus gattii/drug effects , Cryptococcus gattii/genetics , Multilocus Sequence Typing , Genotype , Antifungal Agents/therapeutic use
6.
Rev. chil. endocrinol. diabetes ; 13(4): 166-169, 2020. tab
Article in Spanish | LILACS | ID: biblio-1123623

ABSTRACT

Introducción: En Chile en las últimas décadas ha aumentado la población de personas mayores de 65 años. La tirotoxicosis en este grupo está asociada a complicaciones como fibrilación auricular (FA), insuficiencia cardiaca (ICC), osteoporosis y aumento de la mortalidad. En algunos casos puede presentarse con síntomas no específicos, cuadro conocido como hipertiroidismo apático. Objetivos: Evaluar las características clínicas de la tirotoxicosis en personas mayores. Método: Serie de casos retrospectiva. Se analizaron fichas clínicas de pacientes mayores de 65 años con el diagnóstico de tirotoxicosis controlados en nuestro centro entre enero de 2012 y mayo de 2018. Resultados: En el periodo estudiado 54 pacientes fueron diagnosticados de tirotoxicosis. Se excluyen 4 por datos incompletos. El 80% corresponden a mujeres. La mediana de edad fue 71 años (rango 65-94), sin diferencias por género (p=0,61). La etiología más frecuente fue enfermedad de Graves (EG) en 64%, seguido por bocio multinodular hiperfuncionante en 20%, adenoma tóxico en 10% y asociada a fármacos en 6%. De los pacientes con EG, 28% presentó orbitopatía distiroidea (OD) clínicamente evidente. Un 30% se diagnosticó en contexto de baja de peso, deterioro cognitivo o patología cardiovascular, sin presentar síntomas clásicos de hipertiroidismo. Un 16% presentó FA, 14% ICC y 6% fractura osteoporótica. El 28% fue diagnosticado durante una hospitalización o requirió ser hospitalizado durante los meses siguientes. Los mayores de 75 años presentan una mayor probabilidad de hipertiroidismo apático (OR 5,1, IC95% 1,15-22,7 p=0,01). Además, las complicaciones aumentan en mayores de 75 años, encontrándose en este grupo todos los casos de FA. Conclusiones: La etiología más común de tirotoxicosis fue la EG, a diferencia de lo reportado en otras poblaciones. Un número importante de pacientes debutó sin síntomas clásicos de hipertiroidismo, principalmente mayores de 75 años, por lo que se debe tener una alta sospecha en este grupo etario.


Introduction: Hyperthyroidism in the elderly can produce severe complications such as atrial fibrillation (AF), heart failure (CHF) and osteoporosis. In the elderly, thyrotoxicosis may have only nonspecific symptoms, known as apathetic hyperthyroidism. Objective: To evaluate the clinical characteristics of thyrotoxicosis in the elderly. Methods: Retrospective case series. We reviewed clinical records of patients with thyrotoxicosis older than 65 years, between January 2012 and March 2019. Results: During this period, 54 patients were diagnosed with thyrotoxicosis. Four patients were excluded due to incomplete data. 80% were women. The average age was 73 years (range 65-94), without age difference between gender (p=0,61). The most frequent etiology was Graves' disease in 64%. Hyperfunctioning multinodular goiter was confirmed in 20%, toxic adenoma in 10% and drug-associated in 6%. Twenty eight percent of Graves' disease patients had dysthyroid orbitopathy. Thirty percent presented as apathetic hyperthyroidism. Sixteen percent of the patients presented AF, 14% CHF, and 6% osteoporotic fracture. Twenty-eight percent were diagnosed during hospitalization or required hospitalization in the following months. Those older than 75 years had a greater probability of presenting apathetic hyperthyroidism (OR 5.1, 95% CI 1.15- 22.7 p=0.01). Complications increase in this age group, with all cases of AF. Conclusions: The most common etiology of thyrotoxicosis in this group was GD. This differs from other populations. A significant number of patients presented without classic symptoms of hyperthyroidism, especially in people older than 75 years. Special attention should be paid to atypical symptoms of hyperthyroidism in this group.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Thyrotoxicosis/epidemiology , Thyrotoxicosis/complications , Thyrotoxicosis/diagnosis , Thyrotoxicosis/etiology , Adenoma , Graves Disease , Retrospective Studies , Age Factors , Age Distribution , Hospitals, University/statistics & numerical data , Hyperthyroidism/epidemiology
7.
Rev. bras. enferm ; 73(supl.2): e20200434, 2020. tab
Article in English | LILACS, BDENF | ID: biblio-1115416

ABSTRACT

ABSTRACT Objective: to identify prevalence and factors associated with anxiety and depression in nursing professionals who work to cope with COVID-19 at a university hospital. Methods: a cross-sectional observational study using a sociodemographic questionnaire and Hospital Anxiety and Depression Scale, with 88 nursing professionals. Data were analyzed using absolute and relative frequency and Statistical Package for the Social Sciences. Results: there was prevalence of anxiety (48.9%) and depression (25%). The majority of the sample consisted of women over 40 years old, married or in a common-law marriage, white, with higher education or graduate degree, with an income above 3,000.00 reais, public servants, working 40 hours a week and working in the hospital from 1 to 5 years. Conclusion: we must consider the impact on mental health nursing caused by COVID-19 and intervene with coping strategies to minimize the suffering of professionals.


RESUMEN Objetivo: identificar la prevalencia y los factores asociados con la ansiedad y la depresión en profesionales de enfermería que trabajan para hacer frente a COVID-19 en un hospital universitario. Métodos: estudio observacional transversal, con cuestionario sociodemográfico y el software Statistical Package for the Social Sciences, con 88 profesionales de enfermería. Los datos se analizaron utilizando la frecuencia absoluta y relativa, utilizando el paquete estadístico para el software de ciencias sociales. Resultados: hubo prevalencia de ansiedad (48,9%) y depresión (25%). La mayoría de la muestra estaba compuesta por mujeres, mayores de 40 años, casadas o en una relación estable, blancas, con educación superior o educación de posgrado, con ingresos superiores a 3.000,00 reais, licitadas, con un régimen laboral de 40 Horas semanales y tiempo en el hospital de 1 a 5 años. Conclusión: se debe considerar el impacto en la salud mental de la enfermería causado por COVID-19 e intervenir con estrategias de afrontamiento para minimizar el sufrimiento de los profesionales.


RESUMO Objetivo: identificar a prevalência e fatores associados à ansiedade e depressão em profissionais de enfermagem que atuam no enfrentamento da COVID-19 em hospital universitário. Métodos: estudo observacional transversal, com questionário sociodemográfico e Escala de Medida de Ansiedade e Depressão, com 88 profissionais de enfermagem. Os dados foram analisados por meio de frequência absoluta e relativa, utilizando o software Statistical Package for the Social Sciences. Resultados: houve prevalência de ansiedade (48,9%) e de depressão (25%). A maioria da amostra foi composta por mulheres, com mais de 40 anos, casadas ou em união estável, de cor branca, com ensino superior ou pós-graduação, com renda superior a R$3.000,00, concursadas, com regime de trabalho de 40 horas semanais e tempo de atuação no hospital de 1 a 5 anos. Conclusão: deve-se considerar o impacto na saúde mental da enfermagem acarretado pela COVID-19 e intervir com estratégias de enfrentamento para minimizar o sofrimento dos profissionais.


Subject(s)
Humans , Male , Female , Adult , Anxiety/etiology , Pneumonia, Viral/complications , Pneumonia, Viral/nursing , Stress, Psychological , Adaptation, Psychological , Health Personnel/psychology , Coronavirus Infections/complications , Coronavirus Infections/nursing , Depression/etiology , Pneumonia, Viral/epidemiology , Brazil/epidemiology , Mental Health , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Coronavirus Infections/epidemiology , Pandemics , Betacoronavirus , Hospitals, University/statistics & numerical data , Middle Aged
8.
Neumol. pediátr. (En línea) ; 15(4): 491-497, 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1146396

ABSTRACT

INTRODUCTION: cystic fibrosis (CF) is a chronic, progressive disease with multisystem involvement and high mortality. An early diagnosis and a multidisciplinary approach lead to longer survival and better quality of life. OBJECTIVE: to characterize the patients who died with CF diagnosis in the period between 2011 and 2017 in the Hospital Universitario San Vicente in Colombia. METHODOLOGY: descriptive study of case series, with retrospective data collection. Results: 168 patients with CF were found in follow-up at the institution during the study period, of which 17 died (10,1%). Eleven deaths corresponded to children under 15 years old (64.7%), with equal distribution of gender (women 52.9% and men 47.1%). The median age at diagnosis was 3 years and median death 12 years. The most frequent clinical compromise was sinopulmonary and gastrointestinal. Pulmonary hypertension occurred in 29.4%. All the patients had a severe functional and nutritional compromise and 82.4% were colonized by Pseudomona aeruginosa. None had multidisciplinary management and most had a low socioeconomic level. BiPAP was used as a palliative measure in 6 patients and all died from ventilatory failure. CONCLUSION: CF mortality in our population continues to present at an early age. The diagnosis of the disease is still made late, compared to developed countries. There was a high proportion of bacterial colonization of the airway and the patients presented a severe clinical and functional status before dying.


INTRODUCCIÓN: la fibrosis quística (FQ) es una enfermedad crónica, progresiva, con compromiso multisistémico y de alta mortalidad. Un diagnóstico temprano y un manejo multidisciplinario llevan a una mayor sobrevida y mejor calidad de vida. OBJETIVO: caracterizar los pacientes que fallecieron con diagnóstico de FQ en el periodo comprendido entre 2011 y 2017 en el Hospital Universitario San Vicente Fundación (HUSVF) de Colombia. METODOLOGÍA: estudio descriptivo de series de casos, con recolección de la información de forma retrospectiva. RESULTADOS: Se encontraron 168 pacientes con FQ en seguimiento en la institución durante el periodo del estudio, de los cuales 17 fallecieron (10.1%). Once muertes correspondieron a menores de 15 años (64.7%), hubo una distribución de género equitativa (mujeres 52.9% y hombres 47.1%). La mediana de edad al momento del diagnóstico fue de 3 años y la de muerte 12 años. El compromiso clínico más frecuente fue sinopulmonar y gastrointestinal. La hipertensión pulmonar se presentó en el 29.4%. Todos los pacientes tenían un grave compromiso funcional, nutricional y el 82,4% estaban colonizados por Pseudomonas aeruginosa. Ninguno tuvo manejo multidisciplinario y la mayoría presentaban un bajo nivel socieconómico. En 6 pacientes se utilizó BiPAP como medida paliativa y todos murieron por falla ventilatoria. CONCLUSIÓN: la mortalidad por FQ en nuestra población se sigue presentando a edades tempranas. El diagnóstico de la enfermedad aún se realiza de forma tardía, comparado con países desarrollados. Hubo alta proporción de colonización bacteriana de la vía aérea y los pacientes presentaron un estado clínico y funcional grave antes de morir.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Cystic Fibrosis/mortality , Poverty , Pseudomonas aeruginosa/isolation & purification , Socioeconomic Factors , Epidemiology, Descriptive , Retrospective Studies , Burkholderia cepacia/isolation & purification , Colombia , Cystic Fibrosis/microbiology , Malnutrition , Hospitals, University/statistics & numerical data
9.
Rev. bras. oftalmol ; 78(6): 370-374, nov.-dez. 2019. graf
Article in Portuguese | LILACS | ID: biblio-1057909

ABSTRACT

Resumo Objetivo: A queratite infeciosa é uma doença de incidência relativamente elevada e é responsável por um número importante de internamentos. Neste estudo pretende-se estudar diversas características epidemiológicas e clínicas associadas às queratites infeciosas de alto risco num hospital terciário em Portugal. Métodos: Realizou-se um estudo retrospetivo, onde foram incluídos todos os doentes internados por abcesso da córnea no Centro Hospitalar Universitário do Porto (CHUP), entre Abril de 2013 a Março de 2018. Caracterizou-se a população em relação aos fatores de risco, apresentação clínica, tempo de internamento, resultados de culturas, resistência antibiótica in vitro, tratamento efetuado e resultado funcional. Resultados: O estudo incluiu 105 doentes. Os principais fatores de risco foram antecedentes de cirurgia de córnea, uso de lentes de contacto e história recente de trauma ocular. 74,3% dos doentes tiveram cultura positiva com 87,9% a corresponderem a cultura bacteriana pura, sendo a Pseudomonas aeruginosa e o Streptococcus pneumoniae os agentes etiológicos mais frequentes. 27,9% das culturas positivas eram resistentes a 3 ou mais classes de antibióticos. Todos os doentes iniciaram tratamento com colírios fortificados. 29,5% dos doentes necessitaram de realizar transplante de córnea. Ao final de 6 meses de seguimento, apenas 20,9% apresentavam AV>20/40. Conclusão: Na maioria dos casos, a etiologia foi bacteriana. Observou-se um número considerável de bactérias multirresistentes. Apesar do tratamento ter permitido uma melhoria da visão na maioria dos casos, um número considerável de doentes ficou com sequelas visuais importantes.


Abstract Objective: Infectious keratitis is a pathology with a high incidence and is responsible for a large number of prolonged stay hospital admissions. The purpose was to analyze the epidemiological and clinical data associated with high risk microbial keratitis at a central hospital in Portugal. Methods: A retrospective study of all inpatients presenting with corneal abscess in Centro Hospitalar Universitário do Porto, from April 2013 to March 2018 was performed. Target population was characterized by risk factors, clinical features, length of stay, culture results, in vitro antibiotic resistance, treatment and outcome. Results: This study included 105 patients. The main risk factors were previous corneal surgery, contact lenses wear and recent history of ocular trauma. 74.3% of patients had a positive culture, 87.9% of these corresponding to a pure bacterial culture, with Pseudomonas aeruginosa and Streptococcus pneumoniae being the most common pathogens. 27.9% of positive cultures were resistant to 3 or more classes of antibiotics. All patients began treatment with fortified drops. 29.5% of patients required a corneal transplant. After 6 months of follow-up, only 20.9% presented a VA>20/40. Conclusion: Most cases were caused by bacteria. A considerable number of multi-resistant bacteria was identified. Despite most cases having improved after treatment, a large number of patients had a significant visual acuity sequelae.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Eye Infections, Bacterial/epidemiology , Eye Infections, Fungal/epidemiology , Eye Infections, Parasitic/epidemiology , Eye Infections, Viral/epidemiology , Keratitis/epidemiology , Ophthalmic Solutions , Portugal , Bacteria/isolation & purification , Viruses/isolation & purification , Drug Resistance, Microbial , Acanthamoeba/isolation & purification , Eye Infections, Bacterial/microbiology , Eye Infections, Bacterial/therapy , Eye Infections, Fungal/microbiology , Eye Infections, Fungal/therapy , Eye Infections, Parasitic/microbiology , Eye Infections, Parasitic/therapy , Eye Infections, Viral/microbiology , Eye Infections, Viral/drug therapy , Retrospective Studies , Risk Factors , Corneal Transplantation , Fungi/isolation & purification , Hospitals, University/statistics & numerical data , Inpatients , Keratitis/microbiology , Keratitis/therapy
10.
Braz. j. infect. dis ; 23(4): 231-236, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1039230

ABSTRACT

Abstract Introduction: Vaccination with tetanus-diphtheria-acellular pertussis (Tdap) has been recommended for healthcare workers (HCWs) by Brazilian Ministry of Health since November 2014. Objective: To describe the strategies implemented to improve Tdap uptake, cumulative vaccine coverage after each intervention, variables associated to Tdap vaccination, and reasons for non-vaccination among HCWs of the main building of a quaternary hospital attached to the Sao Paulo University Medical School. Methods: A list of HCWs eligible for pertussis vaccination was generated. From April to December 2015, the following interventions were implemented: note on intern journal reminding the importance of pertussis vaccination; email to the head nurses strengthening vaccine recommendations; lectures on pertussis and Tdap for physicians of Obstetrics and Neonatology Clinics; on-site vaccination by mobile teams at the Obstetrics, Neonatology, and Anesthesiology Clinics. Vaccine coverage was accessed at the end of each month. Multivariate Poisson regression model with a robust error variance was used to evaluate variables associated with Tdap vaccination. Reasons for non-vaccination were evaluated from January to May 2017 through phone calls for HCWs who had not received Tdap. Results: The study included 456 HCWs. After the interventions, Tdap coverage raised from 2.8% to 41.2%. In the multivariate analysis, occupation (physician), working place (obstetrics or anesthesiology) and influenza vaccination in 2015 were independently associated to Tdap vaccination. The main reason for non-vaccination was unawareness of Tdap recommendations. Conclusions: Tdap uptake among HCWs was low in our hospital. Providing vaccination at convenient places/times for HCW seems to be the most efficient strategy to increase vaccine uptake.


Subject(s)
Humans , Male , Female , Adult , Health Personnel/statistics & numerical data , Diphtheria-Tetanus-acellular Pertussis Vaccines , Vaccination Coverage/methods , Vaccination Coverage/statistics & numerical data , Hospitals, University/statistics & numerical data , Time Factors , Brazil , Poisson Distribution , Population Surveillance , Multivariate Analysis , Workplace/statistics & numerical data , Immunization Programs/methods
11.
Rev. bras. enferm ; 72(3): 767-773, May.-Jun. 2019. tab
Article in English | LILACS, BDENF | ID: biblio-1013546

ABSTRACT

ABSTRACT Objective: To evaluate nurse safety culture in a teaching hospital, as well as to verify differences in the safety culture dimensions between services. Method: cross-sectional, quantitative study, conducted from October to December 2015, in a university hospital. The instrument Hospital Survey on Patient Safety Culture was applied. Results: A total of 195 nurses from four different services participated in the study. Significant difference between services were identified for five dimensions of safety culture: organizational learning (P=0.012); return of information and communication about error (P=0.014); management support for patient safety (P=0.001); general perceptions about patient safety (P=0.005); and frequency of event notification (P=0.003). Conclusion: The medical clinic service had the highest statistical difference between the dimensions. These evaluations allow managers to identify the differences between the same hospital's services, serving as a warning and assisting in the services' improvement.


RESUMEN Objetivo: Analizar la cultura de seguridad de los enfermeros de un hospital escuela y examinar las diferencias de los aspectos de esa cultura entre los servicios realizados. Método: Estudio transversal y cuantitativo, realizado de octubre a diciembre de 2015, en un hospital universitario. Se utilizó el instrumento Hospital Survey on Patient Safety Culture. Resultados: Participaron 195 enfermeros de cuatro servicios. Se identificó una diferencia significativa entre los servicios en los cinco aspectos de la cultura de seguridad: el aprendizaje organizacional (p = 0,012); la información de retorno y la comunicación con respecto al error (p = 0,014); el soporte de la gestión para la seguridad del paciente (p = 0,001); las percepciones generales sobre la seguridad del paciente (p = 0,005); y la frecuencia de comunicación de eventos (p = 0,003). Conclusión: El servicio en clínica médica presentó una mayor diferencia estadística entre los aspectos identificados. Estas evaluaciones pueden permitir que los gestores identifiquen las diferencias entre los servicios del mismo hospital, sirviendo como advertencia y perfeccionando los servicios.


RESUMO Objetivo: Avaliar a cultura de segurança dos enfermeiros de um hospital de ensino e verificar as diferenças das dimensões dessa cultura entre os serviços. Método: Estudo transversal e quantitativo, realizado em outubro a dezembro de 2015, em um hospital universitário. Foi aplicado o instrumento Hospital Survey on Patient Safety Culture. Resultados: Participaram 195 enfermeiros de quatro serviços. Identificou-se diferença significativa entre os serviços para cinco dimensões de cultura de segurança: aprendizado organizacional (p = 0.012); retorno da informação e comunicação a respeito de erro (p = 0.014); suporte da gestão para segurança do paciente (p = 0.001); percepções gerais sobre segurança do paciente (p = 0.005); e frequência da notificação de eventos (p = 0.003). Conclusão: O serviço de clínica médica apresentou maior diferença estatística entre as dimensões. Essas avaliações permitem que os gestores identifiquem as diferenças entre os serviços do mesmo hospital, servindo de alerta e aperfeiçoando os serviços.


Subject(s)
Humans , Male , Female , Adult , Safety Management/standards , Nurses/psychology , Nursing Services/standards , Brazil , Organizational Culture , Attitude of Health Personnel , Cross-Sectional Studies , Surveys and Questionnaires , Safety Management/statistics & numerical data , Statistics, Nonparametric , Hospitals, University/organization & administration , Hospitals, University/statistics & numerical data , Middle Aged , Nurses/standards , Nurses/statistics & numerical data , Nursing Services/statistics & numerical data
12.
Arq. neuropsiquiatr ; 77(5): 315-320, Jun. 2019. tab, graf
Article in English | LILACS | ID: biblio-1011335

ABSTRACT

ABSTRACT Embolic stroke of undetermined source (ESUS) is an important group of cryptogenic strokes that are in evidence due recent ongoing trials. We reviewed medical records at discharge from the stroke unit of all patients who met ESUS criteria and attended our institution between February 2016 and July 2017. Among 550 stroke patients, 51 had ESUS. We found that hypertension (60%), diabetes mellitus (34%), and smoking (36%) were the most prevalent risk factors. The mean National Institutes of Health Stroke Scale (NIHSS) scores were 7 at admission and 4 at discharge, while median scores on the modified Rankin scale were 0 and 2 at admission and discharge, respectively. Our sample had similar ages, risk factors prevalence and NIHSS scores at admission and discharge when compared with European and North American cohorts. Although a small cohort, our study suggests that the ESUS population is similar in countries with different health financing.


RESUMO Acidentes vasculares cerebrais (AVC) embólicos de fonte indeterminada (ESUS) é um grupo importante de pacientes com AVC criptogênico que estão em evidência devido a recentes ensaios clínicos. Foram revisados os prontuários médicos na alta da unidade de AVC de todos os pacientes que preencheram os critérios para ESUS atendidos em nossa instituição entre fevereiro de 2016 e julho de 2017. Entre 550 AVCs, 51 eram pacientes com ESUS. Hipertensão (60%), diabetes mellitus (34%) e tabagismo (36%) foram os fatores de risco mais prevalentes. Os escores médios do National Institutes of Health Stroke Scale (NIHSS) foram 7 na admissão e 4 na alta, enquanto os escores médios na escala de Rankin modificada (mRs) foram 0 e 2 na admissão e alta, respectivamente. Nossa amostra teve idade, prevalência de fatores de risco, escores NIHSS na admissão e alta, quando comparados com coortes europeias e norte-americanas semelhantes. Apesar de ser uma pequena coorte, nosso estudo sugere que a população ESUS é semelhante em países com diferentes níveis de financiamento em saúde.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Stroke/epidemiology , Intracranial Embolism/epidemiology , Hospitals, University/statistics & numerical data , Patient Admission/statistics & numerical data , Patient Discharge/statistics & numerical data , Brazil/epidemiology , Registries , Prevalence , Retrospective Studies , Risk Factors , Statistics, Nonparametric
13.
An. bras. dermatol ; 94(1): 42-46, Jan.-Feb. 2019. graf
Article in English | LILACS | ID: biblio-983727

ABSTRACT

Abstract: Background: Skin cancer is a highly prevalent condition with a multifactorial etiology resulting from genetic alterations, environmental and lifestyle factors. In Brazil, among all malignant tumors, skin cancers have the highest incidences. Objective: To retrospectively evaluate the incidence, prevalence and profile of basal cell carcinoma, squamous cell carcinoma and cutaneous melanoma in Campos dos Goytacazes and region. Methods: In total, 2,207 histopathological reports of a local reference hospital were analyzed between January 2013 and December 2015, of which 306 corresponded to the neoplasms studied. Results: Of the 306 reports evaluated, 232 basal cell carcinomas (75.9%), 55 squamous cell carcinomas (18%) and 19 cutaneous melanomas (6.5%) were identified. The face was the most involved anatomical site (58.8%) and women (51%) were the most affected gender. The temporal analysis revealed a decrease in the overall incidence of 3.4% from 2013 to 2014 and 5.4% from 2014 to 2015. There was a 10.1% increase in basal cell carcinomas and 38% in melanomas in this period; however, there was a decrease in the number of squamous cell carcinomas of 14.8% during the studied years. Study limitations: Some samples of cutaneous fragments had no identification of the anatomical site of origin. Conclusion: Research that generates statistical data on cutaneous tumors produces epidemiological tools useful in the identification of risk groups and allows the adoption of more targeted and efficient future prevention measures.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Melanoma/epidemiology , Skin Neoplasms/pathology , Brazil/epidemiology , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/pathology , Medical Records , Incidence , Prevalence , Cross-Sectional Studies , Retrospective Studies , Sex Distribution , Age Distribution , Hospitals, University/statistics & numerical data , Melanoma/pathology
14.
Rev. pesqui. cuid. fundam. (Online) ; 11(1): 216-221, jan.-mar. 2019.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-968511

ABSTRACT

Objetivo: Conhecer o entendimento dos enfermeiros de um hospital de ensino sobre os elementos do seu processo de trabalho.Método: Pesquisa exploratória-descritiva,da qual participaram 14 enfermeiros de unidades de internação. Resultados: Os resultados evidenciam duas concepções de objeto de trabalho: os usuários do hospital e suas famílias; e a assistência em saúde. O cuidado foi ratificado como finalidade do trabalho do enfermeiro, contudo, os trabalhadores conduzem o processo de trabalho em prol da cura, com foco ainda na doença. Os instrumentos de trabalho utilizados pelos enfermeiros traduziram-se em conhecimentos científicos aplicados para desempenhar a atividade profissional. O corpo do trabalhador também foi descrito como ferramenta de trabalho. Conclusão: Destaca-se a necessidade de investimentos em pesquisa que discutam o processo de trabalho do enfermeiro no âmbito hospitalar, para possibilitar maior visibilidade a este trabalho


Objective: To know the understanding of the nurses of a teaching hospital about the elements of their work process. Method: Exploratory-descriptive research, in which 14 nurses from hospitalization units participated. Results: The results show two conceptions of work object: the users of the hospital and their families and the other is health care. Care was ratified as the purpose of the work of the nurse, yet the workers lead the work process in favor of healing, with still focus on the disease. The work tools used by nurses translated into applied scientific knowledge to perform the professional activity. The worker's body was also described as a working tool. Conclusion:It is important to highlight the need for investments in research that discuss the nurses' work process in the hospital setting, in order to make this work more visible


Objetivo: Conocer el entendimiento de los enfermeros de un hospital de enseñanza sobre los elementos de su proceso de trabajo. Método: Investigación exploratoria-descriptiva, en el cual participaron 14 enfermeros de unidades de internación. Resultados: Los resultados evidencian dos concepciones de objeto de trabajo: los usuarios del hospital y sus familias y la otra es asistencia en salud. El cuidado fue ratificado como finalidad del trabajo del enfermero, sin embargo los trabajadores conducen el proceso de trabajo en pro de la curación, con foco aún en la enfermedad. Los instrumentos de trabajo utilizados por los enfermeros se tradujeron en conocimientos científicos aplicados para desempeñar la actividad profesional. El cuerpo del trabajador también fue descrito como herramienta de trabajo. Conclusión: Se destaca la necesidad de inversiones en investigación que discutan el proceso de trabajo del enfermero en el ámbito hospitalario, para posibilitar mayor visibilidad a este trabajo


Subject(s)
Humans , Male , Female , Hospitals, University/statistics & numerical data , Job Satisfaction , Nurses , Nursing Care
15.
Rev. méd. Chile ; 147(1): 34-40, 2019. tab
Article in Spanish | LILACS | ID: biblio-991370

ABSTRACT

Background: Perioperative cardiac arrest (PCA) is a rare but important event in the operating room. Aim: To describe PCA events at a Clinical Hospital in Santiago, Chile. Material and Methods: Registry of PCA that occurred in the operating room (OR) and during procedures not carried out in the OR between September 2006 and November 2017. Precipitating events, type of anesthesia and results of resuscitation maneuvers were described. Results: Eighty events (five outside of the OR) during 170,431 surgical procedures were recorded, resulting in an incidence of 4.4 events per 10,000 interventions. Hypotension/hypoperfusion was the most frequently found preexisting condition (42.5%). The main cause was the presence of preoperative complications (57.5%). Nineteen cases (23.8%) were attributable to anesthesia, with an incidence of 1.11 per 10,000 anesthetic procedures. Survival rate at hospital discharge was 52.5%. The figure for PCA caused by anesthesia was 84.2%. Conclusions: The incidence of PCA and its survival is similar to that reported abroad. In general, PCA has a better prognosis than other types of cardiac arrest, especially if it has an anesthetic cause.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Heart Arrest/epidemiology , Hospitals, University/statistics & numerical data , Intraoperative Complications/epidemiology , Time Factors , Chile/epidemiology , Incidence , Survival Rate , Risk Factors , Hospital Mortality , Heart Arrest/etiology , Intraoperative Complications/etiology , Anesthesia/adverse effects , Anesthesia/statistics & numerical data
16.
Rev. gaúch. enferm ; 40(spe): e20180303, 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1004101

ABSTRACT

Resumo OBJETIVO Avaliar as notificações e caracterizar os incidentes de quedas dos pacientes adultos internados em unidades clínicas e cirúrgicas de um hospital universitário na região sul do país, no período de 2011 a 2014. MÉTODO Estudo descritivo, transversal e retrospectivo, realizado no período de dezembro de 2016 a dezembro de 2017. A amostra foi de 1112 notificações, abrangendo todos os pacientes internados que foram notificados com ocorrência de quedas no período estudado. Os dados foram analisados por meio de estatística descritiva e analítica. RESULTADOS Foram predominantes na amostra os pacientes do sexo feminino e idosos, onde 69,4% dos incidentes não apresentaram dano. A ocorrência de quedas foi significativamente maior no período noturno. Limitação para deambular e estar desacompanhado foram os fatores mais prevalentes nas condições do paciente antes da queda. CONCLUSÃO Queda é um evento multifatorial que necessita avaliação periódica dos fatores de risco pela equipe para planejar sua prevenção.


Resumen OBJETIVO Evaluar las notificaciones y caracterizar los incidentes de caídas de los pacientes adultos internados en unidades clínicas y quirúrgicas de un hospital universitario en la región sur del país, en el período 2011 a 2014. MÉTODO Estudio descriptivo, transversal y retrospectivo, realizado en el período de diciembre de 2016 a diciembre de 2017. La muestra fue de 1112 notificaciones, abarcando a todos los pacientes internados que fueron notificados con ocurrencia de caídas en el periodo estudado. Los datos fueron analizados por medio de estadística descriptiva y analítica. RESULTADOS: Fueron predominantes en la muestra los pacientes del sexo femenino y ancianos, donde el 69,4% de los incidentes no presentaron daño. La ocurrencia de caídas fue significativamente mayor en el período nocturno. La limitación para deambular y estar desatendido fueron los factores más prevalentes en las condiciones del paciente antes de la caída. CONCLUSIÓN La caída es un evento multifactorial que necesita evaluación periódica de los factores de riesgo por el equipo para planificar su prevención.


Abstract OBJECTIVE To evaluate the occurrences and to characterize the falling incidents of adult patients hospitalized in clinical and surgical units of a university hospital in the southern region of the country, in the period from 2011 to 2014. METHOD Descriptive, cross-sectional and retrospective study, carried out from December 2016 to December 2017. The sample consisted of 1112 reports, covering all hospitalized patients who were notified with falls occurring in the studied period. Data were analyzed using descriptive and analytical statistics. RESULTS Female and elderly patients were predominant in the sample, in which 69.4% of the incidents did not present any damage. The occurrence of falls was significantly higher at night. Limitation to walking and being unaccompanied were the most prevalent factors in the patient's conditions before the fall. CONCLUSION The fall is a multifactorial event that requires periodic evaluation of the risk factors by the team to plan their prevention.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Accidental Falls/statistics & numerical data , Hospitals, University/statistics & numerical data , Risk Management , Seizures/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Diagnosis-Related Groups , Sex Distribution , Age Distribution , Confusion/epidemiology , Mobility Limitation , Patient Safety , Maintenance and Engineering, Hospital , Middle Aged
18.
Rev. bras. enferm ; 71(6): 2883-2890, Nov.-Dec. 2018. tab
Article in English | LILACS, BDENF | ID: biblio-977614

ABSTRACT

ABSTRACT Objective: To outline the clinical-epidemiological profile of patients submitted to Percutaneous Coronary Intervention in a Reference Hospital in Urgent Cardiology Clinic of the state of Rio Grande do Norte. Method: This is a descriptive, exploratory, prospective study with a quantitative approach developed in a Brazilian University Hospital with patients submitted to Percutaneous Coronary Intervention. Data collection occurred between April and October 2017. Results: The sample consisted of 222 patients, of whom 58.10% underwent Elective Percutaneous Coronary Intervention and 41.89% were primary, 65.3% males, with a mean age of 62.7. In comorbidities "Hypertension", "Acute Myocardial Infarction", "Current Smoking" and "Physical Inactivity" were highlighted. Conclusion: In the elective patients, there was a high prevalence of risk factors and in patients with urgent cases, high time of total ischemia. It is necessary to create strategies to structure the care line, to improve the effectiveness of treatment and to minimize adverse outcomes.


RESUMEN Objetivo: Trazar el perfil clínico-epidemiológico de los pacientes sometidos a la Intervención Coronaria Percutánea en un Hospital de referencia en urgencia cardiológica del estado de Rio Grande do Norte. Método: Se trata de un estudio descriptivo, exploratorio, prospectivo con abordaje cuantitativo, desarrollado en un Hospital Universitario brasileño con pacientes sometidos a la Intervención Coronaria Percutánea. La recolección de datos ocurrió entre abril y octubre de 2017. Resultados: La muestra compuesta por 222 pacientes. De esos, 58,10% fueron sometidos a la Intervención Coronaria Percutánea electiva y el 41,89% a la primaria, el 65,3% del sexo masculino; la media de edad fue de 62,7. En las comorbilidades, se destacaron Hipertensión Arterial Sistémica, Infarto Agudo de Miocardio previo, tabaquismo actual y sedentarismo. Conclusión: En los pacientes electivos, hubo alta prevalencia de factores de riesgo y en los pacientes de urgencia, elevado tiempo de isquemia total. Se hace necesario la creación de estrategias para estructurar la línea de cuidado, mejorar la eficacia del tratamiento y minimizar los resultados adversos.


RESUMO Objetivo: Traçar o perfil clínico-epidemiológico dos pacientes submetidos à Intervenção Coronária Percutânea em um Hospital de referência em urgência cardiológica do estado do Rio Grande do Norte. Método: Trata-se de um estudo descritivo, exploratório, prospectivo, com abordagem quantitativa, desenvolvido em um Hospital Universitário brasileiro com pacientes submetidos à Intervenção Coronária Percutânea. A coleta de dados ocorreu entre abril e outubro de 2017. Resultados: Amostra composta por 222 pacientes, destes, 58,10% foram submetidos à Intervenção Coronária Percutânea eletiva e 41,89% à primária, 65,3% do sexo masculino, com média de idade de 62,7. Nas comorbidades, destacaram-se "Hipertensão Arterial Sistêmica", "Infarto Agudo do Miocárdio Prévio", "Tabagismo Atual" e "Sedentarismo". Conclusão: Nos pacientes eletivos, houve alta prevalência de fatores de risco e nos pacientes da urgência, elevado tempo de isquemia total. Faz-se necessário a criação de estratégias para estruturar a linha de cuidado, melhorar a eficácia do tratamento e minimizar os desfechos adversos.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Percutaneous Coronary Intervention/statistics & numerical data , Brazil/epidemiology , Prospective Studies , Risk Factors , Percutaneous Coronary Intervention/methods , Hospitals, University/organization & administration , Hospitals, University/statistics & numerical data , Middle Aged , Myocardial Infarction/surgery , Myocardial Infarction/epidemiology
19.
Rev. bras. enferm ; 71(5): 2535-2542, Sep.-Oct. 2018. tab
Article in English | LILACS, BDENF | ID: biblio-958716

ABSTRACT

ABSTRACT Objective: To analyze the association between nursing diagnoses and sociodemographic and clinical characteristics in people living with AIDS. Method: Cross-sectional study with 100 people living with AIDS in a University Hospital. Data collection took place between January and July 2015, using an interview script and physical examination. The association occurred through Pearson's Chi-Square Test and Fisher's Exact Test. Results: The most prevalent nursing diagnoses were: ineffective protection, poor knowledge, lack of adherence and sexual dysfunction. Significant associations were observed among nursing diagnoses with the following sociodemographic and clinical characteristics: marital status, place of residence, level of schooling, family income, modes of transmission of acquired immunodeficiency virus, current opportunistic infection, abandonment of treatment, difficulty of access to health services and use of alcohol and illicit drugs. Conclusion: The diagnoses presented significant associations with sociodemographic and clinical aspects.


RESUMEN Objetivo: Analizar la asociación entre los diagnósticos de enfermería y características sociodemográficas y clínicas en personas que viven con el sida. Método: Estudio transversal realizado con 100 personas que viven con el sida en un Hospital Universitario. La recolección de datos ocurrió entre enero y julio de 2015, utilizando un guion de entrevista y examen físico. La asociación ocurrió por medio de las pruebas chi-cuadradas de Pearson y el exacto de Fisher. Resultados: Los diagnósticos de enfermería más prevalentes fueron: protección ineficaz, conocimiento deficiente, falta de adhesión y disfunción sexual. Se observaron asociaciones significativas entre los diagnósticos de enfermería con las siguientes características sociodemográficas y clínicas: situación conyugal, lugar de vivienda, nivel de escolaridad, ingreso familiar, forma de exposición al virus de la inmunodeficiencia adquirida, infección oportunista actual, abandono de tratamiento, dificultad de acceso al servicio de salud y uso de alcohol y de drogas ilícitas. Conclusión: Los diagnósticos presentaron asociaciones significativas con aspectos sociodemográficos y clínicos.


RESUMO Objetivo: Analisar a associação entre os diagnósticos de enfermagem e características sociodemográficas e clínicas em pessoas vivendo com Aids. Método: Estudo transversal realizado com 100 pessoas vivendo com Aids em um Hospital Universitário. A coleta de dados ocorreu entre janeiro e julho de 2015, utilizando-se um roteiro de entrevista e exame físico. A associação ocorreu por meio dos testes qui-quadrado de Pearson e exato de Fisher. Resultados: Os diagnósticos de enfermagem mais prevalentes foram: proteção ineficaz, conhecimento deficiente, falta de adesão e disfunção sexual. Observaram-se associações significantes entre os diagnósticos de enfermagem com as seguintes características sociodemográficas e clínicas: situação conjugal, local de moradia, nível de escolaridade, renda familiar, forma de exposição ao vírus da imunodeficiência adquirida, infecção oportunista atual, abandono de tratamento, dificuldade de acesso ao serviço de saúde e uso de álcool e de drogas ilícitas. Conclusão: Os diagnósticos apresentaram associações significativas com aspectos sociodemográficos e clínicos.


Subject(s)
Humans , Male , Female , Adult , Aged , Socioeconomic Factors , Nursing Diagnosis/statistics & numerical data , HIV Infections/psychology , Nursing Diagnosis/methods , Brazil , HIV Infections/complications , Cross-Sectional Studies , Hospitals, University/organization & administration , Hospitals, University/statistics & numerical data , Middle Aged
20.
J. pediatr. (Rio J.) ; 94(5): 539-545, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-975986

ABSTRACT

Abstract Objective: To describe the characteristics of children and adolescentes with chronic diseases of outpatient clinics at a tertiary university hospital. Methods: A cross-sectional study was performed with 16,237 patients with chronic diseases followed-up in one year. The data were collected through the electronic system, according to the number of physician appointments in 23 pediatric specialties. Patients were divided in two groups: children (0-9 years) and adolescents (10-19 years). Early (10-14 years) and late (15-19 years) adolescent groups were also analyzed. Results: Of the total sample, 56% were children and 46% were adolescents. The frequencies of following pediatric specialties were significantly higher in adolescents when compared with children: cardiology, endocrinology, hematology, nephrology/renal transplantation, neurology, nutrology, oncology, palliative and pain care, psychiatry, and rheumatology (p < 0.05). The frequencies of emergency service visits (30% vs. 17%, p < 0.001), hospitalizations (23% vs. 11%, p < 0.001), intensive care unit admissions (6% vs. 2%, p < 0.001), and deaths (1% vs. 0.6%, p = 0.002) were significantly lower in adolescents than in children. However, the number of physician appointments (≥13) per patient was also higher in the adolescent group (5% vs. 6%, p = 0.018). Further analysis comparison between early and late adolescents revealed that the first group had significantly more physician appointments (35% vs. 32%, p = 0.025), and required more than two pediatric specialties (22% vs. 21%, p = 0.047). Likewise, the frequencies of emergency service visits (19% vs. 14%, p < 0.001) and hospitalizations (12% vs. 10%, p = 0.035) were higher in early adolescents. Conclusions: This study evaluated a large population in a Latin American hospital and suggested that early adolescents with chronic diseases required many appointments, multiple specialties and hospital admissions.


Resumo Objetivo: Descrever características de crianças e adolescentes com doenças crônicas de clínicas ambulatoriais em um hospital universitário terciário. Métodos: Um estudo transversal foi realizado com 16.237 pacientes com doenças crônicas acompanhados em um ano. Os dados foram coletados por meio de dados do sistema eletrônico de acordo com o número de consultas médicas em 23 especialidades pediátricas. Os pacientes foram divididos em dois grupos: crianças (0-9 anos) e adolescentes (10-19 anos). Também foram analisados grupos de jovens adolescentes (10-14 anos) e adolescentes mais velhos (15-19 anos). Resultados: 54% eram crianças e 46% eram adolescentes. As frequências das seguintes especialidades pediátricas foram significativamente maiores em adolescentes em comparação a crianças: cardiologia, endocrinologia, hematologia, nefrologia/transplante renal, neurologia, nutrologia, oncologia, cuidados paliativos e cuidado da dor, psiquiatria e reumatologia (p < 0,05). As frequências de visitas a serviços de emergência (30%, em comparação a 17%, p < 0,001), internações (23%, em comparação a 11%, p < 0,001), internações em unidade de terapia intensiva (6%, em comparação a 2%, p < 0,001) e óbitos (1%, em comparação a 0,6%, p = 0,002) foram significativamente menores em adolescentes do que em crianças. Contudo, o número de consultas médicas (≥ 13) por paciente (também) foi maior em grupos de adolescentes (5%, em comparação a 6%, p = 0,018). A comparação de análises adicionais entre jovens adolescentes e adolescentes mais velhos revelou que o primeiro grupo apresentou um número significativamente maior de consultas médicas (35%, em comparação a 32%, p = 0,025) e precisou de mais de duas especialidades pediátricas (22%, em comparação a 21%, p = 0,047). Da mesma forma, as frequências de visitas a serviços de emergência (19%, em comparação a 14%, p < 0,001) e internações (12%, em comparação a 10%, p = 0,035) foram maiores em jovens adolescentes. Conclusões: Este estudo avaliou uma grande população em um hospital da América Latina e sugeriu que jovens adolescentes com doenças crônicas precisaram de muitas consultas, diversas especialidades e internações hospitalares.


Subject(s)
Humans , Male , Female , Infant, Newborn , Child, Preschool , Child , Adolescent , Adult , Young Adult , Chronic Disease/classification , Ambulatory Care Facilities/statistics & numerical data , Hospitals, University/statistics & numerical data , Brazil , Chronic Disease/therapy , Cross-Sectional Studies
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