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1.
Rev. enferm. UERJ ; 28: e35054, jan.-dez. 2020.
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-1117622

ABSTRACT

Objetivo: avaliar a mobilidade do cliente com dermatose imunobolhosa antes e após aplicação do curativo com gaze vaselinada. Método: estudo quase experimental, interinstitucional, com clientes com dermatoses imunobolhosas hospitalizados em um hospital estadual e um hospital federal do Estado do Rio de Janeiro e uma instituição do Mato Grosso do Sul. Utilizou-se a lógica fuzzy para classificar a mobilidade dos sujeitos antes, 24 horas após e uma semana após aplicação do curativo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: Incluídos 14 participantes, sendo nove com pênfigo vulgar, dois com pênfigo foliáceo e três com penfigóide bolhoso, entre 27 e 82 anos, predominando 11 mulheres. Após 24 horas, nenhum participante se considerou com baixa mobilidade, sete passaram a mobilidade média, e sete, alta, o que foi mantido uma semana após aplicação do curativo. Conclusão: constatou-se significativo aumento da mobilidade logo nas primeiras 24 horas após aplicação do curativo.


Objective: to assess the mobility of clients with immunobullous dermatoses, before and after applying vaseline gauze dressings. Method: in this quasi-experimental, interinstitutional study of inpatients with immunobullous dermatoses at a state hospital and a federal hospital in Rio de Janeiro State and an institution in Mato Grosso do Sul (Brazil), patient mobility before, 24 hours after, and one week after applying the dressing was classified using fuzzy logic. The study was approved by the research ethics committee. Results: 14 participants, nine with pemphigus vulgaris, two with pemphigus foliaceus, and three with bullous pemphigoid, aged between 27 and 82 years old, and predominantly (11) women. After 24 hours, none of the participants considered their mobility to be poor, seven began to be moderately mobile, and seven were highly mobile, and continued so one week after applying the dressing. Conclusion: mobility increased significant in the first 24 hours after applying the dressing.


Objetivo: evaluar la movilidad de clientes con dermatosis inmunobullosa, antes y después de la aplicación de apósitos de gasa con vaselina. Método: en este estudio cuasi-experimental, interinstitucional de pacientes hospitalizados con dermatosis inmunobullosa en un hospital estatal y un hospital federal en el estado de Río de Janeiro y una institución en Mato Grosso do Sul (Brazil), la movilidad del paciente antes, 24 horas después y una semana después la aplicación del apósito se clasificó mediante lógica difusa. El estudio fue aprobado por el comité de ética en investigación. Resultados: se incluyeron 14 participantes, nueve con pénfigo vulgar, dos con pénfigo foliáceo y tres con penfigoide ampolloso, con edades comprendidas entre 27 y 82 años, y predominantemente mujeres (n=11). Después de 24 horas, ninguno de los participantes consideró que su movilidad fuera pobre, siete comenzaron a ser moderadamente móviles y siete eran altamente móviles, y así continuaron una semana después de la aplicación del apósito. Conclusión: la movilidad aumentó significativamente en las primeras 24 horas después de la aplicación del apósitoconsideraba con baja movilidad, siete comenzaron a tener movilidad media y siete, alta, que se mantuvo una semana después de aplicar el apósito. Conclusión: hubo un aumento significativo en la movilidad en las primeras 24 horas después de aplicar el apósito.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Petrolatum/therapeutic use , Bandages , Skin Diseases, Vesiculobullous/therapy , Pemphigoid, Bullous/therapy , Pemphigus/therapy , Mobility Limitation , Brazil , Fuzzy Logic , Pressure Ulcer/prevention & control , Secondary Prevention , Non-Randomized Controlled Trials as Topic , Hospitals, Public , Inpatients , Nursing Care
2.
Invest. educ. enferm ; 38(1): [E06], febrero 15 2020. Diagram 1, Tab 1, Tab 2, Tab 3, Tab 4
Article in English | LILACS (Americas), COLNAL | ID: biblio-1051974

ABSTRACT

Objective. To evaluate effectiveness of Milieu Therapy in reduction of conflict and containment rates among schizophrenia patients. Methods. This study utilized quasi experimental non-equivalent control group pre-post design. One hundred schizophrenia patients admitted in acute psychiatric wards were non-randomly assigned to either of the experimental (n=50) or control group (n=50). The experimental group received both milieu therapy and routine hospital treatment. The Milieu Therapy intervention Included environmental modification and structuring ward activities, establishing effective interaction with patient, and teaching caregivers on managing conflict behavior of patient. The control group received only routine treatment in the hospital. Outcome measures on conflict and containment rates were evaluated for both the groups at baseline and at 2nd, 3rd and 15th day. The Patient­Staff Conflict Checklist Shift Report (PCC-SR) was used to collect information about rates of conflict and containment. Results. Compared with control group, the experimental group participants showed decrease in aggressive behavior, self-harm behavior and general rule breaking behavior at baseline and 2nd, 3rd and 15th day (F=4.61, p<0.004, η2=0.04; F=11.92, p<0.001, η2=0.11; F=6.94, p<0.001, η2=0.06) over seven days interval. Conclusion. The present study findings provided evidence for the effectiveness of integrating Milieu Therapy in psychiatric acute wards in reducing conflict behaviors among schizophrenia patients. Milieu therapy should be considered as an integral part of psychiatric care settings in these patients.


Objetivo. Evaluar la efectividad de la terapia Milieu en la reducción de las tasas de conflicto y contención entre los pacientes con esquizofrenia. Métodos. Este estudio utilizó un diseño cuasi experimental con grupo control no equivalente y evaluación pre y posintervención. Cien pacientes con esquizofrenia hospitalizados en salas psiquiátricas en un hospital público en Karnataka (India) se asignaron de forma no aleatoria a los grupos experimental (n=50) y control (n=50). El grupo experimental recibió la terapia de Milieu, además del tratamiento hospitalario de rutina. La terapia de Milieu incluyó la modificación ambiental y la estructuración de las actividades de la sala, el establecimiento de una interacción efectiva con el paciente y la enseñanza a los cuidadores sobre el manejo del comportamiento conflictivo del paciente. El grupo control recibió solamente el tratamiento de rutina en el hospital. Las medidas de resultado (tasas de conflictos y de contención) se evaluaron en ambos grupos en los días de inicio, 2º, 3º y 15º posadmisión. El Patient­Staff Conflict Checklist Shift Report (PCC-SR) se utilizó para la recolección de la información acerca de las tasas de conflicto y contención. Resultados. En comparación con el grupo de control, los participantes del grupo experimental mostraron una disminución en el comportamiento agresivo, el comportamiento de autolesión y el comportamiento de incumplimiento de las reglas generales al inicio y al segundo, tercer y décimo quinto día (F=4.61, p<0.004, η2=0.04; F=11.92, p<0.001, η2=0.11; F=6.94, p<0.001, η2=0.06). Conclusión. Los hallazgos del presente estudio proporcionaron evidencia de la efectividad de la Terapia Melieu en la reducción de comportamientos conflictivos en el paciente esquizofrénico hospitalizado en fase aguda. La Terapia Milieu debe considerarse como una parte integral en los entornos de atención de estos pacientes.


Objetivo. Avaliar a eficácia da terapia Milieu na redução das taxas de conflito e contenção entre pacientes com esquizofrenia. Métodos. Este estudo utilizou um desenho quase-experimental com um grupo controle não equivalente e avaliação pré e pós-intervenção. Cem pacientes com esquizofrenia hospitalizados em salas psiquiátricas em um hospital público de Karnataka (Índia) foram designados não aleatoriamente para os grupos experimental (n = 50) e controle (n = 50). O grupo experimental recebeu terapia Milieu, além de tratamento hospitalar de rotina. A terapia de Milieu incluiu modificação ambiental e estruturação das atividades da enfermaria, estabelecendo uma interação efetiva com o paciente e ensinando os cuidadores sobre o gerenciamento do comportamento conflitante do paciente. O grupo controle recebeu apenas tratamento hospitalar de rotina. As medidas de resultado (taxas de conflito e contenção) foram avaliadas em ambos os grupos nos dias de início, 2, 3 e 15 após a admissão. O Relatório de Mudança de Lista de Verificação de Conflitos entre Pacientes e Funcionários (PCC-SR) foi usado para coletar informações sobre taxas de conflitos e contenção. Resultados. Comparados ao grupo controle, os participantes do grupo experimental mostraram uma diminuição no comportamento agressivo, no comportamento autolesivo e no não cumprimento das regras gerais no início e no segundo, terceiro e décimo quinto dia (F = 4,61, p <0,004, η2 = 0,04; F = 11,92, p <0,001, η2 = 0,11; F = 6,94, p <0,001, η2 = 0,06). Conclusão Os achados do presente estudo forneceram evidências da eficácia da Terapia Melieu na redução de comportamentos conflitantes no paciente esquizofrênico hospitalizado na fase aguda. A terapia Milieu deve ser considerada como parte integrante do ambiente de atendimento desses pacientes.


Subject(s)
Humans , Psychiatric Department, Hospital , Schizophrenia , Self-Injurious Behavior , Inpatients , Milieu Therapy
3.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 221-225, jan.-dez. 2020. tab
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-1048046

ABSTRACT

Objetivo: identificar os tipos de medicamentos mais utilizados por idosos hospitalizados e relacioná-los com o risco de desenvolvimento de lesão por pressão. Método: estudo descritivo e documental, realizado em um hospital de referência em traumas de Fortaleza, Ceará. A amostra constituiu-se por 48 prontuários e a coleta de dados ocorreu no período de agosto de 2015 a fevereiro de 2016. Resultados: ocorreu a análise dos 48 prontuários de pacientes idosos acamados que se encontravam internados na Unidade de Terapia Intensiva e enfermaria. A média de idade desses idosos foi de 75 anos com presença de 54,2% do sexo masculino e 45,8% do sexo feminino. Desse total, os fármacos que mais apareceram e tem relação com o desenvolvimento da lesão são: os anti-hipertensivos, analgésicos, diuréticos, drogas vasoativas e antibiótico. Conclusão: os tipos de medicamentos mais utilizados nos idosos deste estudo estavam diretamente relacionados às alterações no sistema circulatório do idoso


Objective: the study's main purpose has been to identify the types of medication most used by hospitalized-elderly people, while relating them to the risk of developing pressure injury. Method: it is a descriptive and documental study, which was performed in a trauma referral hospital from the Fortaleza city, Ceará State. The sample consisted of 48 medical records and the data collection took place from August 2015 to February 2016. Results: through the analysis of 48 medical records from elderly patients hospitalized in both Intensive Care Unit and ward, the following results were found: the average age of those elderly individuals was 75 years old, with 54.2% being males and 45.8% being females. Bearing in mind the total, the drugs that appeared the most and were also related to the development of pressure injury were as follows: antihypertensives, analgesics, diuretics, vasoactive drugs and antibiotics. Conclusion: the types of medication most used by the elderly patients addressed in this study were directly related to alterations in their circulatory system


Objetivo: identificar los tipos de medicamentos más utilizados por ancianos hospitalizados y relacionarlos con el riesgo de desarrollo de lesión por presión. Método: estudio descriptivo y documental, realizado en un hospital de referencia en traumas de Fortaleza, Ceará. La muestra se constituyó por 48 prontuarios y la recolección de datos ocurrió en el período de agosto de 2015 a febrero de 2016. Resultados: ocurrió el análisis de los 48 prontuarios de pacientes ancianos acamados que se encontraban internados en la Unidad de Terapia Intensiva y enfermería. El promedio de edad de estos ancianos fue de 75 años con presencia de 54,2% del sexo masculino y el 45,8% del sexo femenino. De ese total, los fármacos que más aparecieron y tienen relación con el desarrollo de la lesión son: los antihipertensivos, analgésicos, diuréticos, drogas vasoactivas y antibiótico. Conclusión: los tipos de medicamentos más utilizados en los ancianos de este estudio estaban directamente relacionados a las alteraciones en el sistema circulatorio del anciano


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Pressure Ulcer , Drug-Related Side Effects and Adverse Reactions/complications , Inpatients , Health of the Elderly , Risk Factors
4.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-782300

ABSTRACT

PURPOSE: To determine nurse staffing by classifying patients based on their nursing care needs and to benchmark current staffing against the Safer Nursing Care Tool (SNCT) staffing requirements.METHODS: Cross-sectional data were collected from four general wards at a tertiary hospital. Nursing activities conducted by 86 registered nurses were observed at 10-minute intervals. The nursing care needs of 780 inpatients were measured with two dimensions: acuity (10 nursing activities) and dependency (four activities of daily living).RESULTS: Nurses worked for 9.3 hours per shift on average, reflecting overtime work of 1.3 hours per nurse. Nurses spent 37% of their time on direct care, 54% on indirect care, and 9% on associated work. Nursing hours per patient day increased as nursing care needs became higher. Patients were classified into four groups based on their level of nursing care needs. The staffing ratio of groups 1-4 was 1:9.8, 1:8.0, 1:7.0, and 1:4.6, respectively. The current staffing (i.e., nursing hours) was as low as 53% of the SNCT benchmark, resulting in informal caregiving by patients' family or their privately hired attendants.CONCLUSION: Appropriate and safe staffing is required to meet patients' nursing care needs and to improve the quality of nursing care.


Subject(s)
Benchmarking , Humans , Inpatients , Nurses , Nursing Care , Nursing , Patients' Rooms , Tertiary Care Centers
5.
Article in English | WPRIM (Western Pacific) | ID: wprim-782270

ABSTRACT

OBJECTIVES: The study aimed to develop and compare predictive models based on supervised machine learning algorithms for predicting the prolonged length of stay (LOS) of hospitalized patients diagnosed with five different chronic conditions.METHODS: An administrative claim dataset (2008–2012) of a regional network of nine hospitals in the Tampa Bay area, Florida, USA, was used to develop the prediction models. Features were extracted from the dataset using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Five learning algorithms, namely, decision tree C5.0, linear support vector machine (LSVM), k-nearest neighbors, random forest, and multi-layered artificial neural networks, were used to build the model with semi-supervised anomaly detection and two feature selection methods. Issues with the unbalanced nature of the dataset were resolved using the Synthetic Minority Over-sampling Technique (SMOTE).RESULTS: LSVM with wrapper feature selection performed moderately well for all patient cohorts. Using SMOTE to counter data imbalances triggered a tradeoff between the model's sensitivity and specificity, which can be masked under a similar area under the curve. The proposed aggregate rank selection approach resulted in a balanced performing model compared to other criteria. Finally, factors such as comorbidity conditions, source of admission, and payer types were associated with the increased risk of a prolonged LOS.CONCLUSIONS: Prolonged LOS is mostly associated with pre-intraoperative clinical and patient socioeconomic factors. Accurate patient identification with the risk of prolonged LOS using the selected model can provide hospitals a better tool for planning early discharge and resource allocation, thus reducing avoidable hospitalization costs.


Subject(s)
Bays , Chronic Disease , Cohort Studies , Comorbidity , Dataset , Decision Trees , Florida , Forests , Hospitalization , Humans , Inpatients , International Classification of Diseases , Learning , Length of Stay , Machine Learning , Masks , Patient Discharge , Resource Allocation , Sensitivity and Specificity , Socioeconomic Factors , Supervised Machine Learning , Support Vector Machine
6.
Article in English | WPRIM (Western Pacific) | ID: wprim-782186

ABSTRACT

PURPOSE: Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study.METHODS: We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset.RESULTS: AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24).CONCLUSION: AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.


Subject(s)
Abdominal Pain , Administration, Intravenous , Anti-Bacterial Agents , Child , Constipation , Diarrhea , Humans , Incidence , Inpatients , Lactobacillus reuteri , Lactobacillus rhamnosus , Probiotics , Prospective Studies , Protective Factors , Urinary Tract Infections
7.
Article in English | WPRIM (Western Pacific) | ID: wprim-811125

ABSTRACT

BACKGROUND: The number of patients with systemic lupus erythematosus (herein, lupus) undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) is increasing. There is disagreement about the effect of lupus on perioperative complication rates. We hypothesized that lupus would be associated with higher complication rates in patients who undergo elective primary THA or TKA.METHODS: Records of more than 6.2 million patients from the National Inpatient Sample who underwent elective primary THA or TKA from 2000 to 2009 were reviewed. Patients with lupus (n = 38,644) were compared with those without lupus (n = 6,173,826). Major complications were death, pulmonary embolism, myocardial infarction, stroke, pneumonia, and acute renal failure. Minor complications were wound infection, seroma, deep vein thrombosis, hip dislocation, wound dehiscence, and hematoma. Patient age, sex, duration of hospital stay, and number of Elixhauser comorbidities were assessed for both groups. Multivariate logistic regression models using comorbidities, age, and sex as covariates were used to assess the association of lupus with major and minor perioperative complications. The alpha level was set to 0.001.RESULTS: Among patients who underwent THA, those with lupus were younger (mean age, 56 vs. 65 years), were more likely to be women (87% vs. 56%), had longer hospital stays (mean, 4.0 vs. 3.8 days), and had more comorbidities (mean, 2.5 vs. 1.4) than those without lupus (all p < 0.001). In patients with THA, lupus was independently associated with major complications (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1 to 1.7) and minor complications (OR, 1.2; 95% CI, 1.0 to 1.5). Similarly, among patients who underwent TKA, those with lupus were younger (mean, 62 vs. 67 years), were more likely to be women (93% vs. 64%), had longer hospital stays (mean, 3.8 vs. 3.7 days), and had more comorbidities (mean, 2.8 vs. 1.7) than those without lupus (all p < 0.001). However, in TKA patients, lupus was not associated with greater odds of major complications (OR, 1.2; 95% CI, 0.9 to 1.4) or minor complications (OR, 1.1; 95% CI, 0.9 to 1.3).CONCLUSIONS: Lupus is an independent risk factor for major and minor perioperative complications in elective primary THA but not TKA.


Subject(s)
Acute Kidney Injury , Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , Comorbidity , Female , Hematoma , Hip Dislocation , Hip , Humans , Inpatients , Knee , Length of Stay , Logistic Models , Lupus Erythematosus, Systemic , Myocardial Infarction , Pneumonia , Pulmonary Embolism , Risk Factors , Seroma , Stroke , Venous Thrombosis , Wound Infection , Wounds and Injuries
8.
Article in English | WPRIM (Western Pacific) | ID: wprim-811068

ABSTRACT

PURPOSE: The incidence of drug-induced liver injury (DILI) has been increasing; however, few algorithms are available to identify DILI in electronic health records (EHRs). We aimed to identify and evaluate DILI with an appropriate screening algorithm.METHODS: We collected data from 3 university hospitals between June 2015 and May 2016 using our newly developed algorithm for identifying DILI. Among patients with alanine transferase (ALT) ≤ 120 IU/L and total bilirubin (TB) ≤ 2.4 mg/dL in blood test results within 48 hours of admission, those who either had 1) ALT > 120 IU/L and TB > 2.4 mg/dL or 2) ALT > 200 IU/L at least once during hospitalization were identified. After excluding patients with liver disease-related diagnosis at discharge, medical records were retrospectively reviewed to evaluate epidemiological characteristics of DILI.RESULTS: The total number of inpatients was 256,598, of whom 1,100 (0.43%) were selected by the algorithm as suspected DILI. Subsequently, 365 cases (0.14% of total inpatients, 95% confidence interval, 0.13–0.16) were identified as DILI, yielding a positive predictive value of 33.1%. Antibiotics (n = 214, 47.2%) were the major class of causative drug followed by chemotherapeutic agents (n = 87, 19.2%). The most common causative drug was piperacillin-tazobactam (n = 38, 8.4%); the incidence of DILI by individual agent was highest for methotrexate (19.4 cases/1,000 patients administered the drug). Common reasons for excluding suspected DILI cases were ischemic hepatitis and postoperative liver dysfunction.CONCLUSIONS: Using our EHR-based algorithm, we identified that approximately 0.14% of patients developed DILI during hospitalization. Further studies are needed to modify criteria for more accurate identification of DILI.


Subject(s)
Alanine , Anti-Bacterial Agents , Bilirubin , Diagnosis , Chemical and Drug Induced Liver Injury , Drug-Related Side Effects and Adverse Reactions , Electronic Health Records , Hematologic Tests , Hepatitis , Hospitalization , Hospitals, University , Humans , Incidence , Inpatients , Liver , Liver Diseases , Mass Screening , Medical Records , Methotrexate , Pharmacoepidemiology , Retrospective Studies , Transferases
9.
Article in English | WPRIM (Western Pacific) | ID: wprim-811064

ABSTRACT

PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.


Subject(s)
Adrenal Cortex Hormones , Asthma , China , Comorbidity , Disease Progression , Education , Female , Food Hypersensitivity , Hospitalization , Humans , Hypertension , Inpatients , Medication Adherence , Mortality , Multivariate Analysis , Pulmonary Disease, Chronic Obstructive , Retrospective Studies , Risk Factors , Seasons , Self Care , Smoke , Smoking
10.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 1132-1138, jan.-dez. 2020. graf, tab
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-1117968

ABSTRACT

Objetivo: Analisar a ocorrência de internação por transtornos psiquiátricos decorrentes do uso de substâncias psicoativas em um hospital psiquiátrico de referência. Método: Estudo censitário, retrospectivo, analítico e de abordagem quantitativa, realizado a partir de 123 registros de internações. Resultados: Obteve-se que a média de idade dos pacientes internados em 2015 foi de 40,7, a maioria era do sexo masculino (66,7%), provenientes da zona urbana (78%) e com histórico de reinternações (52,8%). As múltiplas drogas e outras substâncias psicoativas (39,8%) constituíram-se como as principais substâncias de abuso pelos pacientes. Além disso, verificou-se que, entre os pacientes internados, houve presença de comorbidades psiquiátricas. Conclusão: Diante disso, evidencia-se a necessidade de estratégias voltadas para a prevenção e o tratamento adequado aos distúrbios ocasionados pelo uso de álcool e outras drogas


Objective: To analyze the occurrence of hospitalization for psychiatric disorders resulting from the use of psychoactive substances in a referral psychiatric hospital. Method: A census, retrospective, analytical and quantitative approach, based on 123 records of hospitalizations. Results: The mean age of hospitalized patients in 2015 was 40.7, the majority were male (66.7%), from the urban area (78%) and had a history of readmissions (52, 8%). Multiple drugs and other psychoactive substances (39.8%) were the main substances of abuse by patients. In addition, it was found that among hospitalized patients, there were psychiatric comorbidities. Conclusion: In view of this, it is evident the need for strategies aimed at prevention and appropriate treatment of disorders caused by the use of alcohol and other drugs


Objetivo: Analizar la ocurrencia de internación por trastornos psiquiátricos derivados del uso de sustancias psicoactivas en un hospital psiquiátrico de referencia. Metodo: Estudio censitario, retrospectivo, analítico y de abordaje cuantitativo, realizado a partir de 123 registros de internaciones. Resultados: Se obtuvo que la media de edad de los pacientes internados en 2015 fue de 40,7, la mayoría era del sexo masculino (66,7%), provenientes de la zona urbana (78%) y con histórico de reinternaciones (52, 8%). Las múltiples drogas y otras sustancias psicoactivas (39,8%) se constituyeron como las principales sustancias de abuso por los pacientes. Además, se verificó que, entre los pacientes internados, hubo presencia de comorbilidades psiquiátricas. Conclusión: Ante ello, se evidencia la necesidad de estrategias dirigidas a la prevención y el tratamiento adecuado a los disturbios ocasionados por el uso de alcohol y otras drogas


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Substance-Related Disorders/epidemiology , Drug Users/statistics & numerical data , Hospitals, Psychiatric , Retrospective Studies , Alcoholism/therapy , Hospitalization , Inpatients , Mental Disorders/therapy
11.
Rev. méd. Minas Gerais ; 30: e-3003, 2020.
Article in Portuguese | LILACS (Americas) | ID: biblio-1116887

ABSTRACT

Introdução: Pacientes portadores de vasculopatia periférica internam recorrentemente para procedimentos cirúrgicos ou tratamento clínico devido a complicações da doença de base. O real impacto da desnutrição nesses pacientes durante a internação ainda é pouco compreendido. Objetivo: Investigar os fatores de risco associados à mortalidade em pacientes internados com doença vascular periférica devido a complicação da doença vascular. Métodos: Estudo observacional retrospectivo avaliou cento e dezessete pacientes acima de 18 anos admitidos no serviço de cirurgia vascular de hospital terciário no período de junho de 2013 a agosto de 2014 por complicação da doença vascular. Avaliados parâmetros clínicos, comorbidades, dados demográficos, complicações durante a internação e estado nutricional. Dados coletados por meio de entrevista, aplicação do questionário Avaliação Global Subjetiva (AGS), exame físico e laboratoriais e dados de prontuário. Resultados: Cento e dezessete pacientes com doença vascular periférica avaliados em relação a complicações vasculares durante internação. Mortalidade geral de 7,7% e pacientes desnutridos ou com suspeita de desnutrição eram 39% da amostra Através da análise multivariada, tanto a classificação AGS (OR 6,15 CI 1,092-34,74 P = 0,039) quanto a presença de doença cardíaca (OR 8,51 CI 1,56-47,44 P = 0,015) foram fatores preditores independentes para mortalidade. Pacientes com doença vascular classificados em suspeita de estarem desnutridos ou desnutridos apresentaram chance de ir a óbito durante a internação aumentada em 6,15 vezes, enquanto a cardiopatia elevou essa chance 8,51 vezes. Conclusão: Pacientes internados por complicação de doença vascular periférica apresentam como fatores de risco para mortalidade a desnutrição e a presença de doença cardíaca.(AU)


Patients with peripheral vasculopathy are routinely hospitalized for surgical procedures or clinical treatment due to complications of the underlying disease. The real impact of malnutrition in these patients during hospitalization is still poorly understood. Aim: This study aimed to assess mortality predictors in patients with peripheral vascular disease during hospitalization. Methods: This retrospective observational study evaluate one hundred and seventeen patients over 18 years admitted to the vascular surgery service of a tertiary hospital in the period of June 2013 and August 2014 due to complications of vascular disease. They were assessed for clinical parameters, comorbidities, demographics, complications during hospitalization and nutritional status. Data were collected through interviews, the questionnaire Subjective Global Nutritional Assessment (SGA), laboratory exam and physical examination. Results: One hundred and seventeen patients with peripheral vascular disease were followed during admission due to vascular complications. Overall mortality was 7.7%, and malnourished patients or patients at nutritional risk were 39,0% of the sampled population By multivariate analysis both rating by SGA (OR 6.15, CI 1.092 to 34.74, P = 0.039), the presence of heart disease (OR 8.51 CI 1,56 to 47.44 P = 0.015) were independent predictors of mortality. When the patient was classified as malnourished or suspected of being malnourished by SGA it increased 6.15 times the odds of death during hospitalization, while the presence of heart disease increased by 8.51 times. Conclusion: Patients hospitalized for complications of peripheral vascular disease present as risk factors for mortality: malnutrition and the presence of heart disease. (AU)


Subject(s)
Nutritional Status , Peripheral Vascular Diseases , Peripheral Arterial Disease , Nutrition Assessment , Risk Factors , Mortality , Malnutrition , Hospitalization , Inpatients
12.
MedUNAB ; 23(1): 95-106, 2020/03/30.
Article in Spanish | LILACS (Americas) | ID: biblio-1087911

ABSTRACT

Introducción. Las caídas son un importante problema de salud pública. La Organización Mundial de la Salud (OMS) estima que anualmente se producen 646,000 caídas con consecuencias fatales, convirtiéndolas en la segunda causa de muerte por lesiones no intencionales a nivel mundial. Las mayores tasas de mortalidad asociadas a este evento corresponden a los mayores de 60 años. Como resultado, los adultos mayores disminuyen su movilidad, pueden presentar alteraciones cognitivas y resultar socialmente aislados, lo que aumenta el riesgo de caídas posteriores, costos de salud e índices de mortalidad. Durante el proceso de hospitalización, factores intrínsecos del adulto mayor, sumado al ambiente hospitalario, generan un entorno propicio para la producción de eventos adversos, impulsando al personal de salud a tomar medidas de prevención específicas enfocadas en este grupo etario en particular. El presente manuscrito tiene como objetivo describir el proceso de implementación de la guía de Prevención de Caídas y disminución de las lesiones derivadas de las caídas de la Registered Nurses' Association of Ontario (RNAO), en la Unidad de cuidados del adulto mayor (UCAM) en Clínica las Condes (CLC). Temas de reflexión. A través de un enfoque interdisciplinar el cual desarrolla 5 puntos principales de acción: adquisición de infraestructura específica, contratación de personal médico y de enfermería especializado en cuidados del adulto mayor, capacitación continua que incluya actualización de conocimientos sobre cuidados del adulto senescente y, finalmente, supervisión de enfermería durante todo el proceso de prevención. Conclusiones. La implementación de estrategias interdisciplinares para la prevención de caídas en adultos mayores es una herramienta basada en evidencia científica que genera disminución de este evento adverso y de las lesiones que posteriormente se desarrollan producto de una caída durante la hospitalización del adulto senescente. Cómo citar: Coltters-Miranda C, Belmar-Valdebenito A. Experiencia de implementación de una guía de prevención de caídas como trabajo interdisciplinar en una unidad de cuidados del adulto mayor. MedUNAB. 2020;23(1):95-106. doi:10.29375/01237047.3610


Introduction. Falls are a serious public health problem. The World Health Organization (WHO) estimates that there are 646,000 falls per year, which have a fatal outcome, making them the second leading cause of unintentional injury death worldwide. The highest mortality rates associated with these falls are among senior citizens aged over 60 years. Falls can reduce senior citizens' mobility, cause them to suffer from cognitive disorders and make them socially isolated, increasing the risk of subsequent falls, health costs and mortality rates. During the hospitalization process, intrinsic factors for elderly patients, added to the hospital conditions, generate an environment conducive to the occurrence of adverse events, driving health staff to take specific prevention measures focused on this age group in particular. This article aims to describe the implementation process of the guidelines for fall prevention and injury reduction of the Registered Nurses' Association of Ontario (RNAO) in the Elderly Care Unit (UCAM, for the Spanish original) of Clínica las Condes (CLC). Reflection topics. through an interdisciplinary approach that develops five main action points: acquisition of a specific infrastructure; procurement of medical and nursing staff specialized in elderly care; ongoing training that includes knowledge refresher courses on elderly care; and, finally, nursing supervision throughoutthe prevention process. Conclusions. The implementation of interdisciplinary strategies for preventing falls in senior citizens is a tool based on scientific evidence that reduces the cases of this adverse event and of the injuries that subsequently develop as a result of a fall during the hospitalization of the elderly patient. Cómo citar: Coltters-Miranda C, Belmar-Valdebenito A. Experiencia de implementación de una guía de prevención de caídas como trabajo interdisciplinar en una unidad de cuidados del adulto mayor. MedUNAB. 2020;23(1):95-106. doi:10.29375/01237047.3610


Introdução. As quedas são um grande problema de saúde pública. A Organização Mundial da Saúde (OMS) estima que, anualmente, ocorrem 646.000 quedas com consequências fatais, tornando-as a segunda principal causa de morte por lesões não intencionais em todo o mundo. As taxas mais altas de mortalidade associadas a esse evento correspondem a pessoas com mais de 60 anos. Como resultado, os idosos diminuem sua mobilidade, podem apresentar alterações cognitivas e serem socialmente isolados, aumentando o risco de quedas subsequentes, custos de saúde e taxas de mortalidade. Durante o processo de hospitalização, fatores intrínsecos do idoso, agregados ao ambiente hospitalar, geram um ambiente propício à produção de eventos adversos, incentivando o pessoal de saúde a tomar medidas específicas de prevenção focadas nessa faixa etária específica. O objetivo deste manuscrito é descrever o processo de implementação da Guia de Prevenção de Quedas e redução de lesões resultantes de quedas da Registered Nurses' Association of Ontario (RNAO), na Unidade de Atendimento ao Idoso (UCAM) na Clínica Las Condes (CLC). Reflexão. mediante uma abordagem interdisciplinar que desenvolve cinco pontos principais de ação: aquisição de infraestrutura específica, contratação de equipe médica e de enfermagem especializada no cuidado ao idoso, capacitação contínua que inclua a atualização do conhecimento sobre o atendimento ao adulto senescente e, por fim, a supervisão de enfermagem em todo o processo de prevenção. Conclusões. A implementação de estratégias interdisciplinares para a prevenção de quedas em idosos é uma ferramenta baseada em evidências científicas que promove uma diminuição desse evento adverso e das lesões que subsequentemente se desenvolvem como resultado de uma queda durante a hospitalização do adulto senescente. Cómo citar: Coltters-Miranda C, Belmar-Valdebenito A. Experiencia de implementación de una guía de prevención de caídas como trabajo interdisciplinar en una unidad de cuidados del adulto mayor. MedUNAB. 2020;23(1):95-106. doi:10.29375/01237047.3610


Subject(s)
Accidental Falls , Patient Care Team , Primary Prevention , Aged , Evidence-Based Nursing , Inpatients
13.
Rev. polis psique ; 10(1): 123-143, 2020.
Article in Portuguese | LILACS (Americas), INDEXPSI | ID: biblio-1102615

ABSTRACT

O estudo analisa versões de usuários de serviços de saúde mental sobre a internação psiquiátrica involuntária. Para alcançar esse objetivo, faz uma revisão crítica da literatura em base de dados especializada, observação do cotidiano de instituições de atendimento a pessoas com transtorno mental que passaram ou se encontram em situação de internação psiquiátrica involuntária e entrevistas semiestruturadas com essas pessoas. A análise se pauta no princípio genealógico e no conceito de versões. Os resultados mostram que alguns estudos em saúde mental têm privilegiado o discurso de autores e profissionais da rede de saúde sobre o assunto em detrimento dos usuários. Nas entrevistas que realizamos, os usuários denunciam práticas manicomiais geradoras de exclusão e violação de direitos, seja nos serviços psiquiátrico-hospitalares ou nos de atenção psicossocial. Conclui-se pela necessidade de retomar o discurso dos usuários nos estudos científicos e no cotidiano dos serviços para orientar práticas em saúde mental.


The study analyzes versions of users of mental health services on involuntary psychiatric hospitalization. In order to reach this goal, it reviews the literature in a specialized database, observes the daily life of care institutions for people with mental disorders who have passed or are in the situation of involuntary psychiatric hospitalization and, performs semi-structured interviews with these people. Analysis is based on the genealogic principle and the concept of versions. Results show that mental health studies have privileged the discourse of authors and health network professionals on the subject to the detriment of users. Users interviewed reported practices that generate exclusion and violation of rights, whether in psychiatric-hospital services or psychosocial care services. It concludes that is necessary to recover the discourse of the users in scientific studies and psychosocial care services in order to guide mental health practices.


El estudio analiza versiones de usuarios de servicios de salud mental sobre internación psiquiátrica involuntaria. Para eso, hace una revisión crítica de la literatura en base de datos especializada, observación del cotidiano de instituciones de atención a personas con trastorno mental que pasaron o están en situación de internación psiquiátrica involuntaria y entrevistas semiestructuradas con esas personas. El análisis enfoca el principio genealógico y el concepto de versiones. Los resultados muestran que los estudios en salud mental han privilegiado discursos de autores y profesionales de la red de salud sobre el tema en detrimento de los usuarios. Los usuarios entrevistados denunciaran prácticas manicomiales generadoras de exclusión y violación de derechos, sea en los servicios psiquiátrico-hospitalarios o en la atención psicosocial. Se concluye por la necesidad de retomar el discurso de los usuarios en los estudios científicos y en el cotidiano de los servicios para orientar prácticas en salud mental.


Subject(s)
Humans , Male , Female , Involuntary Treatment, Psychiatric , Inpatients/psychology , Life Change Events , Mental Health Services , Domestic Violence , Family Relations , Mental Disorders/therapy
14.
Article in Portuguese | LILACS (Americas) | ID: biblio-1088518

ABSTRACT

Resumo Objetivo Identificar prevalência e fatores associados à lesão renal aguda em pacientes clínicos intensivos, e compará-los com um grupo controle; analisar se a coexistência de fatores constitui preditor de risco para o desenvolvimento de lesão renal aguda. Métodos Estudo caso-controle, com abordagem quantitativa, realizado em unidade de terapia intensiva geral adulto do interior de São Paulo, Brasil, com 205 pacientes que desenvolveram lesão renal aguda e o mesmo número de controles, durante os anos de 2014 e 2015. Coleta de dados realizada mediante levantamento dos registros de prontuário. Relações foram estatisticamente significativas se p<0,05. Resultados A prevalência de lesão renal aguda foi de 7,5% e os principais fatores associados foram: hipertensão arterial (p=0,004; OR=1,9615; IC=1,0491-3,6645); hipovolemia (p=0,006; OR=5,6071; IC=1,6382-19,1854); insuficiência cardíaca (p=0,003; OR=5,3123; IC=1,7521-16,1051); noradrenalina (p<0,0001; OR=9,4913; IC=4,4824-20,0981); dopamina (p=0,0009; OR=3,5212; IC=1,6701-7,4242); dobutamina (p=0,0131; OR=5,2612; IC=1,4172-19,5323); e antibióticos simultâneos (p<0,0001; OR=3,7881; IC=2,0253-7,0884). A coexistência de mais de três fatores de risco foi estatisticamente significante para lesão renal aguda (p<0,0001; OR=5,0074; IC=2,5601-9,7936). Conclusão A lesão renal aguda é um evento multifatorial que se associou à doença de base, às complicações decorrentes da gravidade dos participantes e à utilização de medicamentos nefrotóxicos. Ter três ou mais fatores de risco aumentou as chances para o desenvolvimento da doença.


Resumen Objetivo Identificar prevalencia y factores asociados a la lesión renal aguda en pacientes clínicos intensivos y compararlos con un grupo de control; analizar si la coexistencia de factores constituye predictor de riesgo para el desarrollo de lesión renal aguda. Métodos Estudio caso-control, con enfoque cuantitativo, realizado en unidad de cuidados intensivos general adulto del interior del estado de São Paulo, Brasil, con 205 pacientes que desarrollaron lesión renal aguda y el mismo número de controles, durante los años 2014 y 2015. Recolección de datos realizada mediante recopilación de registros de historia clínica. Relaciones fueron estadísticamente significativas si p<0,05. Resultados La prevalencia de lesión renal aguda fue de 7,5% y los principales factores asociados fueron: hipertensión arterial (p=0,004; OR=1,9615; IC=1,0491-3,6645); hipovolemia (p=0,006; OR=5,6071; IC=1,6382-19,1854); insuficiencia cardíaca (p=0,003; OR=5,3123; IC=1,7521-16,1051); noradrenalina (p<0,0001; OR=9,4913; IC=4,4824-20,0981); dopamina (p=0,0009; OR=3,5212; IC=1,6701-7,4242); dobutamina (p=0,0131; OR=5,2612; IC=1,4172-19,5323); y antibióticos simultáneos (p<0,0001; OR=3,7881; IC=2,0253-7,0884). La coexistencia de más de tres factores de riesgo fue estadísticamente significante para la lesión renal aguda (p<0,0001; OR=5,0074; IC=2,5601-9,7936). Conclusión La lesión renal aguda es un evento multifactorial que se asoció a la enfermedad de base, a las complicaciones resultantes de la gravedad de los participantes y a la utilización de medicamentos nefrotóxicos. Tener tres o más factores de riesgo aumentó las chances de desarrollo de la enfermedad.


Abstract Objective Identify the prevalence and associated factors of acute renal injury in intensive clinical patients and compare them with a control group; analyze if the coexistence of factors serves as a predictor for the risk of developing acute renal injury. Method Case-control study with a quantitative approach, developed at a general adult intensive care unity in the interior of São Paulo, Brazil, involving 205 patients who developed acute renal injury and the same number of controls, during 2014 and 2015. Data were collected through a survey of patient file records. Relationships were statistically significant if p<0.05. Results The prevalence of acute renal injury was 7.5% and the main associated factors were: arterial hypertension (p=0.004; OR=1.9615; CI=1.0491-3.6645); hypovolemia (p=0.006; OR=5.6071; CI=1.6382-19.1854); heart failure (p=0.003; OR=5.3123; CI=1.7521-16.1051); noradrenaline (p<0.0001; OR=9.4913; CI=4.4824-20.0981); dopamine (p=0.0009; OR=3.5212; CI=1.6701-7.4242); dobutamine (p=0.0131; OR=5.2612; CI=1.4172-19.5323); and simultaneous antibiotics (p<0.0001; OR=3.7881; CI=2.0253-7.0884). The coexistence of more than three risk factors was statistically significant for acute renal injury (p<0.0001; OR=5.0074; CI=2.5601-9.7936). Conclusion Acute renal injury is a multifactorial event associated with the baseline disease, the complications deriving from the severity of the patients' condition and the use of nephrotoxic drugs. Having three or more risk factors increased the chances for the development of the disease.


Subject(s)
Humans , Male , Female , Aged , Critical Care , Acute Kidney Injury/epidemiology , Inpatients , Intensive Care Units , Case-Control Studies , Evaluation Studies as Topic , Medical Records , Retrospective Studies , Risk Factors
15.
Enferm. actual Costa Rica (Online) ; (37): 155-167, Jul.-Dez. 2019. tab, graf
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1039762

ABSTRACT

Resumo O objetivo desta pesquisa foi identificar os sentimentos dos cuidadores familiares de pacientes adultos hospitalizados referidos nas produções científicas. Revisão integrativa realizada a partir de análise de conteúdo, conforme proposto por Bardin nas bases de dados eletrônicas (PubMed, Lilacs e Scielo), utilizando-se as palavras-chave "Sentimentos" "Cuidador familiar" "Hospital" e "Hospitalização " Foram analisados 21 estudos permitiu discutir temas como: sofrimento psicológico; preocupações relacionadas ao cuidado; sentimentos ambíguos; e restrições na vida social. Conclui-se que a identificação dos sentimentos de cuidadores familiares de adultos hospitalizados pode servir de base para o (re)planejamento das ações de intervenção e cuidados praticadas pelos profissionais de saúde, bem como apontam a necessidade de implantação de programas e protocolos de ação voltados a esse público.


Resumen El objetivo de esta investigación fue identificar los sentimientos de los cuidadores familiares de los pacientes adultos hospitalizados a los que se hace referencia en las producciones científicas. Se trata de una revisión Integrativa basada en el análisis de contenido, según lo propuesto por Bardin en las bases de datos electrónicas (PubMed, LILACS y SciELO), utilizando las palabras clave "sentimientos" "cuidador familiar" "Hospital" y "hospitalización" resultados: el análisis de los 21 estudios nos permitió discutir temas como: angustia psicológica; preocupaciones de cuidado; sentimientos ambiguos; y las restricciones a la vida social. Consideraciones finales: la identificación de los sentimientos de los cuidadores familiares de adultos hospitalizados puede servir como base para la (re) planificación de las acciones de intervención y atención llevadas a cabo por profesionales de la salud, así como la necesidad de implementar programas y protocolos de acción dirigidos a esta audiencia.


Abstract The objective of this research was to identify the feelings of family caregivers of hospitalized adult patients referred to in scientific productions. It is an integrative review based on content analysis, as proposed by Bardin in the electronic databases (PubMed, Lilacs and Scielo), using the keywords "Feelings" "Family caregiver" "Hospital" and "Hospitalization" Results: the analysis of the 21 studies allowed us to discuss topics such as: psychological distress; care concerns; ambiguous feelings; and restrictions on social life. Final Considerations: The identification of the feelings of family caregivers of hospitalized adults can serve as a basis for the (re) planning of intervention and care actions carried out by health professionals, as well as the need to implement programs and protocols of action aimed at this audience.


Subject(s)
Humans , Adult , Middle Aged , Mental Health , Caregivers , Expressed Emotion , Emotions , Emotion-Focused Therapy , Inpatients
16.
Rev. enferm. Inst. Mex. Seguro Soc ; 27(4): 182-187, Oct-dic 2019.
Article in Spanish | LILACS (Americas), BDENF | ID: biblio-1087580

ABSTRACT

En el hospital, el personal de enfermería a diario se encuentra con enfermos con un alto nivel de dependencia y con su cuidador familiar, el llamado paciente invisible, quien modifica su vida cotidiana para responder a las necesidades que el enfermo requiere. Ahora bien, los cuidadores familiares sin capacitación y orientación tienen más riesgo de presentar claudicación familiar; por consiguiente, la enfermera es esencial para la prevención de la claudicación familiar, el contacto directo con el paciente permite realizar intervenciones oportunas que minimicen las repercusiones del cuidado del enfermo en la salud de los cuidadores.


In the hospital, nursing staff daily encounters patients with a high level of dependency from their family caregiver, the so-called the invisible patient, who modifies his daily life to respond to the needs that the patient requires. However, family caregivers, without training and orientation is more likely to present family claudication, therefore, the nurse is essential for the prevention of it. Direct contact with the patient allows timely interventions that minimize the impact of patient care on the health of caregivers.


Subject(s)
Humans , Patients , Professional-Family Relations , Disease , Nursing , Caregivers , Family Relations , Inpatients , Nursing Staff , Nursing Staff, Hospital , Mexico
17.
Medicentro (Villa Clara) ; 23(3): 225-237, jul.-set. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1091048

ABSTRACT

RESUMEN Introducción: la candidiasis es una infección fúngica causada principalmente por especies de candida no albicans que aparece generalmente en la piel o las membranas mucosas de los pacientes. Objetivos: caracterizar la incidencia de especies de candida con mayor número de aislamientos en los pacientes pediátricos hospitalizados, en el Hospital Mariana Grajales (Servicio de Neonatología) y Hospital José Luis Miranda, en el período 2013 - 2018, en Villa Clara. Métodos: estudio descriptivo y transversal con 50 aislamientos del género candida en hemocultivos de pacientes hospitalizados Hospital Mariana Grajales (Servicio de Neonatología) y Hospital José Luis Miranda (Servicio de Terapia Intensiva), Villa Clara, de enero 2013 - septiembre 2018. Se utilizó la estadística descriptiva e inferencial, mediante el test de Ji cuadrado de Pearson (x2) o el test exacto de Fisher a las variables: año de estudio, tipo de hospital, tipo de servicio y especie de candida aislada. Resultados: los mayores aislamientos de candidiasis invasiva correspondieron al pediátrico, en el servicio de Terapia Intensiva, 2018 (única con significación estadística).En esta misma unidad, el grupo de candida spp obtuvo el mayor índice, seguido de candida tropicalis, sin significaciones estadísticas. En el servicio de Neonatología el mayor número de aislamientos correspondió a candida spp, seguido de candida guillermondii, ambas sin significación estadística. Conclusiones: el servicio de Terapia Intensiva fue el que mayor número de casos de candidiasis invasiva y el año 2018 fue el más representativo. El grupo de candida spp fueron las especies que más se aislaron en ambos hospitales.


ABSTRACT Introduction: candidiasis is a fungal infection caused mainly by non-albicans Candida species that usually appears on the skin or mucous membranes of patients. Objective: to characterize the incidence of Candida species with the highest number of isolates in hospitalized pediatric patients, at Mariana Grajales Hospital (Neonatology Service) and José Luis Miranda Hospital, in the period 2013 - 2018, in Villa Clara. Methods: descriptive and cross-sectional study with 50 Candida genus isolates in blood cultures of patients hospitalized at Mariana Grajales Hospital (Neonatology Service) and José Luis Miranda Hospital (Intensive Care Service), Villa Clara, from January 2013 to September 2018. Descriptive and inferential statistics using Pearson's chi-squared test (χ2) or Fisher's exact test to the variables: year of study, type of hospital, type of service and isolated Candida species. Results: the largest isolates of invasive candidiasis corresponded to the Intensive Therapy service from the pediatric hospital in 2018 (only with statistical significance). In this same hospital, the Candida spp group obtained the highest index, followed by Candida tropicalis, without statistical significance. The largest number of isolates corresponded to Candida spp in the Neonatology service, followed by Candida guillermondii, both without statistical significance. Conclusions: the Intensive Therapy service was the one with the highest number of cases of invasive candidiasis and the year 2018 was the most representative. The group of Candida spp was the most isolated species in both hospitals.


Subject(s)
Candidiasis, Invasive , Pediatrics , Inpatients
18.
Rev. medica electron ; 41(4): 862-878, jul.-ago. 2019. tab
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1094094

ABSTRACT

RESUMEN Introducción: las enfermedades cardiovasculares constituyen la principal causa de muerte en la mayoría de los países. Se describen los factores de riesgo para enfermedad coronaria como no modificables: edad, sexo y antecedentes familiares; y modificables relacionados al estilo de vida: tabaquismo, dislipidemia, obesidad, sedentarismo, diabetes, uso abusivo de alcohol y la enfermedad hipertensiva. Objetivo: caracterizar los factores de riesgo asociados a la cardiopatía isquémica en Atención Secundaria de Salud. Materiales y métodos: estudio observacional, descriptivo transversal en pacientes ingresados en el Hospital "Mártires del 9 de Abril" de Sagua la Grande, en el periodo comprendido entre los años 2016 y 2017. Integraron la muestra 96 pacientes que ingresaron con diagnóstico de cardiopatía isquémica. Se describieron las características demográficas de los mismos; fueron identificados los factores de riesgo y se determinó la frecuencia de asociación de otras formas clínicas de ateromatosis. Resultados: los pacientes fueron mayores de 60 años de edad; la mayoría tenían color de la piel blanca; presentaban antecedentes patológicos familiares de cardiopatía isquémica; las principales formas de cardiopatía isquémica fueron: angina e insuficiencia cardiaca; todos los pacientes presentaron uno o más factores de riesgo cardiovascular, los más significativos fueron, hipertensión arterial, tabaquismo aumento de la circunferencia abdominal y personalidad tipo "A". Conclusiones: la mayoría de los pacientes exhibieron alteraciones en el electrocardiograma: descenso del segmento ST, bloqueo de rama izquierda del haz de His y fibrilación auricular; se observó hipertrigliceridemia y se apreció asociación entre enfermedad renal crónica y angina.


ABSTRACT Introduction: cardiovascular diseases are the main cause of death in most of the countries. The risk factors for coronary disease are described as unmodifiable: age, sex and family history; and modifiable related to lifestyle: smoking, dyslipidemia, obesity, sedentary lifestyle, diabetes, abusive use of alcohol and hypertensive disease. Objective: to characterize the risk factors associated to ischemic heart disease in secondary health care. Material and methods: observational, cross-sectional, descriptive study in patients admitted in "Mártires del 9 de Abril" Hospital, Sagua la Grande, between 2016 and 2017. The sample consisted of 96 patients admitted with a diagnosis of ischemic heart disease. Their demographic characteristics were described; the risk factors were identified and the frequency of association of other clinical forms of atheromatosis was determined. Results: the patients were aged more than 60 years; most of them were white people and had family pathological antecedents of ischemic heart disease; the main forms of ischemic heart disease were angina and heart failure; all patients showed one or more cardiovascular risk factors being arterial hypertension, smoking, increase of abdominal circumference and type A personality the most significant ones. Conclusions: the majority of patients showed alterations in the electrocardiogram: ST segment decrease, His bundle left branch blockage and atrial fibrillation; hypertriglyceridemia was observed and there was an association between chronic kidney disease and angina.


Subject(s)
Humans , Aged , Tobacco Use Disorder/etiology , Risk Factors , Myocardial Ischemia/diagnosis , Myocardial Ischemia/genetics , Myocardial Ischemia/epidemiology , Hypertension/etiology , Inpatients , Cardiovascular System/physiopathology , Epidemiology, Descriptive , Cross-Sectional Studies , Abdominal Circumference , Observational Study , Heart Failure/etiology , Angina Pectoris/etiology , Life Style
19.
Rev. medica electron ; 41(4): 889-898, jul.-ago. 2019. tab
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1094096

ABSTRACT

RESUMEN Introducción: La neumonía adquirida en la comunidad constituye un importante problema de salud a nivel global, en Cuba es la cuarta causa de muerte. Los índices pronósticos ayudan a detectar tempranamente los pacientes de alto riesgo, pero esto tiene baja sensibilidad y especificidad. Objetivo: determinar durante la anamnesis factores pronósticos de mortalidad en la neumonía adquirida en la comunidad. Materiales y métodos: estudio analítico longitudinal retrospectivo con un grupo donde se aplicaron pruebas no paramétricas y cálculo de riesgo relativo. Resultados: edad de 78 ± 10 años con 53 % femeninas. La mortalidad global de 57 % antecedentes de diabetes mellitus, 53 % enfermedad cerebro vascular anterior 34 %, el 42 % estaba encamados. El 38 % tenían más de cinco días enfermos y el 69 % estaba consumiendo antimicrobianos antes del ingreso. El 23 % padecían de insuficiencia cardiaca congestiva y el 73 % de enfermedad pulmonar obstructiva crónica. El síndrome confusional fue un buen predictor de mortalidad (x2=0,05) (RR=2,8). El encamamiento prolongado no predijo mortalidad a los cinco días (x2=0,43). El uso de antimicrobianos previos incremento el riesgo en (RR=0,8) con (x2=0,05). La insuficiencia cardiaca fue el mejor predictor (x2=0,006) (RR=1,2). La enfermedad pulmonar obstructiva crónica predijo con(x2=0,019) y (RR=1,47). Conclusiones: se considera como factores fuertemente predictivos el antecedente de insuficiencia cardiaca, de enfermedad pulmonar obstructiva crónica y el paciente que acude con síndrome confusional.


ABSTRACT Introduction: community acquired pneumonia is an important health problem around the world, and in Cuba it is the fourth cause of death. Prognostic indexes help to detect early the patients at high risk, but they have low sensibility and specificity. Objective: to determine the mortality prognostic factors in the community acquired pneumonia during the anamnesis. Material and methods: analytic, retrospective, longitudinal study in a group applying non-parametric tests and relative risk calculation. Results: age: 78 ± 10 years; 53 % of women. Global mortality of 57 %; 53 % had antecedents of diabetes mellitus; 34 % had previous cerebro-vascular disease, and 42 % were bedridden patients. 38 % was sick more than five days and 69 % took antimicrobials before being admitted. 23 % suffered congestive heart failure and 73 % chronic obstructive pulmonary disease. Confusional syndrome was a good predictor of mortality (x2=0.05) (RR=2.8). Long confinement to bed did not predict mortality at the fifth day (x2=0.43). The previous use of antimicrobials increased the risk (RR=0.8) con (x2=0.05). Heart failure was the best predictor (x2=0.006) (RR=1.2). Chronic obstructive pulmonary disease predicted with (x2=0.019) y (RR=1.47). Conclusions: antecedents of heart failure and chronic obstructive pulmonary disease, and the patient arriving with confusional syndrome are considered strongly predictive factors.


Subject(s)
Humans , Pneumonia/diagnosis , Pneumonia/etiology , Pneumonia/mortality , Pneumonia/prevention & control , Prognosis , Mortality , Patient Acuity , Medical History Taking , Retrospective Studies , Longitudinal Studies , Pulmonary Disease, Chronic Obstructive/diagnosis , Emergency Medical Services , Analytical Epidemiology , Heart Failure/diagnosis , Inpatients , Intensive Care Units , Migraine Disorders/diagnosis
20.
Enferm. foco (Brasília) ; 10(3): 76-81, jul. 2019. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1050000

ABSTRACT

Objetivo: Conhecer a prevalência do delirium em uma Unidade de Terapia Intensiva Clínica e Cirúrgica pública. Métodos: Abordagem quantitativa descritiva de corte transversal, com pacientes de 18 anos ou mais internados em um hospital público de Porto Alegre-RS, com utilização da escala Confusion Assessment Method in a Intensive Care Unit (CAM-ICU). Resultados: A prevalência do delirium foi 36%. Apresentaram relação com o delirium, com significância estatística: média de idade dos pacientes, a mediana de dias de internação hospitalar e em UTI, tipo de UTI, motivo de internação, doença neurológica anterior, uso de sedação, ventilação mecânica e utilização de haloperidol. Conclusões: Este estudo conclui que o delirium apresentou prevalência de 36%, demonstrando que esta síndrome apresenta prevalência significante em Unidade de Terapia Intensiva, portanto, o reconhecimento de seus sinais e sintomas é fundamental para a sua prevenção, aliada a aplicação de escalas de rastreio. (AU)


Objective: To know the prevalence of delirium in a Public Intensive Care Clinic and Surgical Unit. Methodology: Descriptive quantitative cross-sectional approach with patients aged 18 years or more admitted to a public hospital in Porto Alegre, Brazil, using the Confusion Assessment Method in the Intensive Care Unit (CAM-ICU). Results: The prevalence of delirium was 36%, in a sample of 335 patients interviewed. The mean age of the patients, median days of hospital stay and ICU, type of ICU, reason for hospitalization, previous neurological disease, use of sedation, mechanical ventilation and use of haloperidol were statistically significant. Conclusions: This study concludes that delirium presented a prevalence of 36%, demonstrating that this syndrome presents a significant prevalence in the Intensive Care Unit, therefore, the recognition of its signs and symptoms is fundamental for its prevention, allied to the application of screening scales. (AU)


Objetivo: Conocer la prevalencia del delirium en una Unidad de Terapia Intensiva Clínica y Quirúrgica pública. Metodologia: En el presente trabajo se analizaron los resultados obtenidos en el análisis de los resultados obtenidos en el estudio. Resultados: La prevalencia del delirium fue del 36%, en una muestra de 335 pacientes entrevistados. En la mayoría de los casos, se observó un aumento en la incidencia de la enfermedad de Chagas en el momento de la intervención, Conclusiones: Este estudio concluye que el delirium presentó prevalencia del 36%, demostrando que este síndrome presenta prevalencia significante en Unidad de Terapia Intensiva, por lo tanto, el reconocimiento de sus signos y síntomas es fundamental para su prevención, aliada a la aplicación de escalas de rastreo. (AU)


Subject(s)
Delirium , Nursing , Neurocognitive Disorders , Inpatients , Intensive Care Units
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