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1.
Esc. Anna Nery Rev. Enferm ; 26: e20210203, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356215

ABSTRACT

RESUMO Objetivo analisar as características individuais, clínicas e os fatores associados à mortalidade de pacientes com COVID-19, em hospital público do estado do Paraná, Brasil. Métodos estudo seccional, retrospectivo, documental (n= 86), com pacientes adultos internados, de março a junho de 2020. Resultados a mortalidade foi de 12,8%, o grupo de maior risco foi de idosos com comorbidades, especialmente, cardiovasculares. A chance de óbito foi 58 vezes maior em idosos, comparada aos adultos, e oito vezes maior naqueles com comorbidades, comparadas aos hígidos. A maioria dos pacientes apresentou sintomatologia respiratória, febre e mialgia. Tratamento à base de antibióticos, anticoagulantes e antivirais, associado ao suporte ventilatório. As principais complicações foram hipóxia, insuficiência renal aguda e infecção secundária. Conclusão e implicações para a prática idosos com comorbidades cardiovasculares que necessitaram de cuidados intensivos apresentaram maior chance de óbito. Os resultados de um dos centros de referência na pandemia possibilitam discutir medidas epidemiológicas adotadas, com ênfase em conceitos restritivos nos primeiros meses.


RESUMEN Objetivo analizar las características individuales, clínicas y los factores asociados a la mortalidad en pacientes con COVID-19 en un hospital público del estado de Paraná. Métodos estudio transversal, retrospectivo, documental (n = 86), con pacientes adultos hospitalizados, de marzo a junio de 2020. Resultados la mortalidad fue del 12,8%, grupo de mayor riesgo para los ancianos con comorbilidades, especialmente enfermedades cardiovasculares. La probabilidad de muerte fue 58 veces mayor en los ancianos en comparación con los adultos y ocho veces mayor en aquellos con comorbilidades en comparación con los sanos. La mayoría de los pacientes presentaban síntomas respiratorios, fiebre y mialgia. Tratamiento a base de antibióticos, anticoagulantes y antivirales, asociado al soporte ventilatorio. Las principales complicaciones fueron hipoxia, insuficiencia renal aguda e infección secundaria. Conclusión e implicaciones para la práctica los ancianos con comorbilidades cardiovasculares que requirieron cuidados intensivos tenían una mayor probabilidad de muerte. Los resultados de uno de los centros de referencia pandémica permiten discutir las medidas epidemiológicas adoptadas, con énfasis en conceptos restrictivos en los primeros meses.


ABSTRACT Objective to analyze the individual and clinical characteristics and the factors associated with mortality in patients with COVID-19, in a public hospital in the state of Paraná, Brazil. Methods a cross-sectional, retrospective, documentary study (n= 86), with adult inpatients, from March to June 2020. Results mortality was 12.8%, the highest risk group was the elderly with comorbidities, especially cardiovascular ones. The chance of death was 58 times higher in the elderly compared to adults, and eight times higher in those with comorbidities compared to the healthy ones. Most patients presented with respiratory symptoms, fever, and myalgia. Treatment was based on antibiotics, anticoagulants and antivirals, associated with ventilatory support. The main complications were hypoxia, acute renal failure, and secondary infection. Conclusion and implications for practice elderly people with cardiovascular comorbidities who required intensive care had a higher chance of death. The results from one of the reference centers in the pandemic make it possible to discuss epidemiological measures adopted, with emphasis on restrictive concepts in the first months.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Health Profile , COVID-19/mortality , Antiviral Agents/therapeutic use , Patients' Rooms , Brazil , Comorbidity , Retrospective Studies , Risk Factors , Azithromycin/therapeutic use , Cough , Dyspnea , Renal Insufficiency/complications , Fever , Interactive Ventilatory Support , Myalgia , COVID-19/therapy , Inpatients/statistics & numerical data , Intensive Care Units , Length of Stay/statistics & numerical data , Hypoxia/complications , Anticoagulants/therapeutic use
2.
Arq. ciências saúde UNIPAR ; 25(2): 125-131, maio-ago. 2021.
Article in Portuguese | LILACS | ID: biblio-1252370

ABSTRACT

A doença crítica crônica (DCC) descreve pacientes que sobreviveram ao episódio inicial de doença crítica, mas que permanecem dependentes da unidade de terapia intensiva (UTI) por períodos prolongados ou pelo resto de suas vidas. O presente estudo objetivou caracterizar pacientes traumatizados e hospitalizados na Unidade de Terapia Intensiva com Doença Crítica Crônica. Foram coletados dados de internações por trauma UTI no interior do Paraná de 2013 a 2016, dessa maneira, foi traçado o perfil epidemiológico e realizado associações e comparação dos grupos analisados (total de pacientes traumatizados hospitalizados em UTI em comparação com os pacientes traumatizados que desenvolveram DCC). Notou-se que dos 417 indivíduos traumatizados investigados, 41 (9,8%) foram classificados com DCC. Além disso, o sexo masculino, menor índice de comorbidades, maior gravidade do trauma e ferimentos contusos estiveram relacionados ao desenvolvimento da DCC. Os pacientes com DCC apresentaram complicações cirúrgicas (87,8%), e 41,5% evoluíram a óbito. Portanto, os pacientes com DCC permanecem por longo período na UTI (com uma média de 19,88 dias), os quais necessitam de cuidados intensivos de enfermagem e da equipe multiprofissional.(AU)


Chronic critical illness (CCI) describes patients who survived the initial episode of critical illness, but who remain dependent of the intensive care unit (ICU) for extended periods or for the rest of their lives. This study aimed at characterizing traumatized patients hospitalized in the Intensive Care Unit with Chronic Critical Illness. Data from ICU trauma hospitalizations in the interior of the state of Paraná were collected from 2013 to 2016, and with them, the epidemiological profile was drawn up, associations were made, and the analyzed groups were compared (total traumatized patients hospitalized in the ICU compared to traumatized patients who developed CCI). It was observed that from the 417 traumatized individuals investigated, 41 (9.8%) were classified as having CCI. In addition, it was observed that gender (male), a lower rate of comorbidities, greater severity of trauma, and blunt injuries were related to the development of CCI. Patients with CCI had surgical complications (87.8%), and 41.5% died. Therefore, CCI remain in the ICU for a long period (with an average of 19.88 days), which require intensive nursing care and the use of a multidisciplinary team.(AU)


Subject(s)
Humans , Wounds and Injuries/complications , Chronic Disease/epidemiology , Intensive Care Units/trends , Epidemiology, Descriptive , Retrospective Studies , Inpatients/statistics & numerical data
3.
Clin. biomed. res ; 41(1): 6-11, 2021. ilus
Article in Portuguese | LILACS | ID: biblio-1255236

ABSTRACT

Introdução: A utilização da ventilação não invasiva (VNI) é importante no tratamento de pacientes críticos internados em unidades de terapia intensiva (UTI), apresentando resultados significativos quando avaliada e instituida no momento adequado. Os benefícios da VNI são evidentes em diferentes etiologia, favorecendo a evolução clínica dos pacientes e diminuindo tempo de internação. O uso da VNI como resgate apresenta resultados desfavoráveis, porém o uso de VNI preventiva ou, facilitadora parece promissor neste cenário. Objetivo: Avaliar as indicações para utilização da VNI em pacientes críticos, identificar, e analisar os desfechos da resposta à VNI, o tempo de internação, e outros benefícios para estabelecer possíveis desfechos nos pacientes críticos internados nesta unidade. Métodos: Estudo de coorte retrospectivo, realizado através de análise de prontuários de pacientes maiores de 18 anos, ambos os sexos, admitidos na UTI adulto e submetidos a VNI, no período de agosto de 2018 a agosto de 2019. Resultados: Foram incluídos 114 pacientes, 57% do sexo masculino, com idade de 69 ±13 anos, que ficaram internados por 13,2 ± 11,8 dias, apresentando uma pontuação de SAPS 3 59±14 pontos, sendo a IRpA o motivo do uso de VNI mais frequente, representando 64,9% da amostra, seguido da VNI de forma preventiva após extubação (17,5%). Obtivemos um total de 66,9% de sucesso na utilização da VNI. Conclusão: A utilização da VNI no perfil dos pacientes críticos internados, apresentaram sucesso para o uso na maioria dos casos, mostrando melhores desfechos clínicos e propiciando diminuir o tempo de internação na UTI, e alta desta unidade. (AU)


Introduction: The use of noninvasive ventilation (NIV) is important in the treatment of critically ill patients admitted to the intensive care unit (ICU), showing significant results when evaluated and introduced at the appropriate time. The benefits of NIV are evident in different etiologies by favoring the clinical outcome of patients and reducing the length of hospital stay. The use of NIV as a rescue therapy has produced unfavorable results. However, the use of preventive or facilitating NIV seems promising in this scenario. Objective: To evaluate indications for the use of NIV in critically ill patients and to identify and analyze the outcomes of NIV response, length of hospital stay, and other benefits in order to establish possible outcomes in critically ill ICU patients. Methods: This was a cohort study with a retrospective review of the medical records of patients aged 18 years or older, of both sexes, who were admitted to the adult ICU and received NIV from August 2018 to August 2019. Results: A total of 114 patients were included, 57% were men and the mean age was 69 (SD, 13) years. The mean length of hospital stay was 13.2 (SD, 11.8) days, and SAPS score was 3.59 (SD, 14). Acute respiratory failure was the main reason for NIV use, accounting for 64.9% of cases, followed by preventive NIV after extubation (17.5%). The success rate of NIV use was 66.9%. Conclusions: The use of NIV in critically ill ICU patients was successful in most cases, leading to improved clinical outcomes and reduced length of ICU stay, with faster discharge from this unit. (AU)


Subject(s)
Humans , Male , Female , Noninvasive Ventilation , Inpatients/statistics & numerical data , Intensive Care Units , Cohort Studies , Death , Length of Stay
4.
Rev Assoc Med Bras (1992) ; 66(Suppl 2): 71-76, 2020. tab
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136390

ABSTRACT

SUMMARY OBJECTIVE Coronavirus disease 2019 (COVID-19) is an emerging health threat caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Previous studies have noted hypertension is associated with increased mortality due to COVID-19; however, it is not clear whether the increased risk is due to hypertension itself or antihypertensive agents. We aimed to evaluate the impact of antihypertensive agents on the clinical outcomes of hypertensive patients with COVID-19. METHODS Our study included 169 consecutive hypertensive patients hospitalized due to COVID-19 between March 20 and April 10, 2020. The demographic characteristics, clinical data, and type of antihypertensive agents being used were reviewed. RESULTS The mean age of patients was 65.8±11.7 years.30 patients(17.7%) died during hospitalization. A total of 142 patients(84%) were using angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), 91 (53.8%) were using diuretics, 69 (40.8%) were using calcium channel blockers (CCBs), 66 (39.1%) were using beta-blockers, 12 (7.1%) were using alpha-blockers, and 5 (2.9%) were using mineralocorticoid receptor antagonists (MRAs). There was no significant difference between survivors and non-survivors based on the type of antihypertensive agents being used. Binary logistic regression analysis showed that the type of the antihypertensive agent being used had no effect on mortality [OR=0.527 (0.130-2.138), p=0.370 for ACEIs/ARBs; OR=0.731 (0.296-1.808), p=0.498 for CCBs; OR=0.673 (0.254-1.782), p=0.425 for diuretics; OR=1.846 (0.688-4.950), p=0.223 for beta-blockers; OR=0.389 (0.089-1.695), p=0.208 for alpha-blockers; and OR=1.372 (0.107-17.639), p=0.808 for MRAs]. CONCLUSION The type of antihypertensive agent being used had no effect on the clinical course and mortality in hypertensive patients with COVID-19. The use of these agents should be maintained for the treatment of hypertension during hospitalization.


RESUMO OBJETIVO A doença de coronavírus 2019 (COVID-19) é uma ameaça emergente à saúde causada por um novo coronavírus denominado síndrome respiratória aguda grave coronavírus 2 (Sars-COV-2). Estudos anteriores observaram que a hipertensão está associada a um aumento da mortalidade devido ao COVID-19, no entanto, não está claro se o aumento do risco pertence à própria hipertensão ou a agentes anti-hipertensivos. Nosso objetivo foi avaliar o impacto de agentes anti-hipertensivos nos resultados clínicos em pacientes hipertensos com COVID-19. MÉTODOS Nosso estudo incluiu 169 hipertensos consecutivos internados por COVID-19 entre 20 de março e 10 de abril de 2020. As características demográficas, dados clínicos e o tipo de anti-hipertensivos em uso foram revistos. RESULTADOS A idade média dos pacientes foi de 65,8±11,7 anos. Trinta pacientes (17,7%) faleceram durante a internação. Cento e quarenta e dois pacientes (84%) usavam inibidores da enzima de conversão da angiotensina (ACEIs) ou bloqueadores dos receptores da angiotensina II (ARBs), 91 (53,8%) usavam diuréticos, 69 (40,8%) usavam bloqueadores dos canais de cálcio (CCBs), 66 (39,1%) usavam betabloqueadores, 12 (7,1%) usavam bloqueadores alpha e cinco (2,9%) usavam antagonistas dos receptores de mineralocorticoides (MRAs). Não houve diferença significativa entre sobreviventes e não sobreviventes com base no tipo de agentes anti-hipertensivos em uso. A análise de regressão logística binária mostrou que o tipo de agente anti-hipertensivo utilizado não teve efeito na mortalidade (OR=0,527 (0,130-2,138), p=0,370 para ACEIs/ARB; OR=0,731 (0,296-1,808), p=0,498 para CCBs; OR=0,673 (0,254-1,782), p=0,425 para diuréticos; OR=1,846 (0,688-4,950), p=0,223 para bloqueadores beta; OR=0,389 (0,089-1,695), p=0,208 para bloqueadores alpha e OR=1,372 (0,107-17,639), p=0,808 para MRAs). CONCLUSÃO O tipo de agente anti-hipertensivo utilizado não teve efeito no curso clínico e na mortalidade em pacientes hipertensos com COVID-19. O uso desses agentes deve ser mantido no tratamento da hipertensão durante a hospitalização.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Pneumonia, Viral/complications , Hospital Mortality , Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus , Hypertension/drug therapy , Antihypertensive Agents/adverse effects , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Coronavirus Infections , Coronavirus Infections/diagnosis , Pandemics , Betacoronavirus , Hypertension/mortality , Inpatients/statistics & numerical data , Middle Aged , Antihypertensive Agents/therapeutic use
5.
Einstein (Säo Paulo) ; 18: eAO5427, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133722

ABSTRACT

ABSTRACT Objective: To assess the surgical antibiotic prophylaxis. Methods: This was a descriptive study performed at a public tertiary care university hospital gathering prescription, sociodemographic and hospitalization data of inpatients admitted in 2014 who used antimicrobial drugs. This data were obtained from the hospital electronic database. The antimicrobial data were classified according to the anatomical, therapeutic chemical/defined daily dose per 1,000 inpatients. An exploratory analysis was performed using principal component analysis. Results: A total of 5,182 inpatients were prescribed surgical antibiotic prophylaxis. Of the total antimicrobial use, 11.7% were for surgical antibiotic prophylaxis. The orthopedic, thoracic and cardiovascular postoperative units, and postoperative intensive care unit comprised more than half of the total surgical antibiotic prophylaxis use (56.3%). The duration of antimicrobial use of these units were 2.2, 2.0, and 1.4 days, respectively. Third-generation cephalosporins and fluoroquinolones had the longest use among antimicrobial classes. Conclusion: Surgical antibiotic prophylaxis was inadequate in the orthopedic, postoperative intensive care, thoracic and cardiovascular postoperative, gynecology and obstetrics, and otolaryngology units. Therefore, the development and implementation of additional strategies to promote surgical antibiotic stewardship at hospitals are essential.


RESUMO Objetivo: Avaliar a utilização de antibioticoprofilaxia cirúrgica. Métodos: Foi realizado um estudo descritivo em um hospital universitário de cuidado terciário por meio de coleta de dados de prescrição, sociodemográficos e de hospitalização sobre todos os pacientes internados em 2014 que utilizaram pelo menos um medicamento antimicrobiano. Esses dados foram coletados da base de dados eletrônica do hospital. O consumo de antimicrobianos foi analisado de acordo com a classificação anatômica terapêutica e química/dose diária definida por mil pacientes-dia. Realizou-se uma análise exploratória por meio da análise de componentes principais. Resultados: Um total de 5.182 pacientes internados receberam prescrição de antibioticoprofilaxia cirúrgica, que corresponde a 11,7% do total de antibióticos utilizados no hospital. As unidades de ortopedia, pós-operatória de cirurgia torácica e cardiovascular e terapia intensiva pós-operatória foram responsáveis pela utilização de mais da metade (56,3%) da antibioticoprofilaxia cirúrgica. A duração de uso desses antimicrobianos nessas unidades foi 2,2, 2,0 e 2,4 dias, respectivamente. Cefalosporinas de terceira geração e fluoroquinolonas foram as classes de antimicrobianos com tempo de utilização mais longo. Conclusão: A utilização de antibioticoprofilaxia cirúrgica foi inadequada nas unidades de ortopedia, pós-operatória de cirurgia torácica e cardiovascular, terapia intensiva pós-operatória, ginecologia e obstetrícia e otorrinolarigonlogia. Portanto, são importantes o desenvolvimento e a implantação de estratégias que promovam o uso racional de antibioticoprofilaxia cirúrgica nos hospitais.


Subject(s)
Humans , Drug Prescriptions/statistics & numerical data , Surgical Procedures, Operative/adverse effects , Bacterial Infections/prevention & control , Bacterial Infections/drug therapy , Antibiotic Prophylaxis/methods , Inpatients/statistics & numerical data , Surgical Procedures, Operative/methods , Surgical Wound Infection/prevention & control , Drug Utilization Review , Antibiotic Prophylaxis/adverse effects , Hospitalization , Anti-Bacterial Agents/therapeutic use
6.
Rev. bras. enferm ; 72(6): 1632-1638, Nov.-Dec. 2019.
Article in English | LILACS, BDENF | ID: biblio-1042181

ABSTRACT

ABSTRACT Objective: Analyze the meaning of being an elderly person living in a long-term institution. Method: Qualitative study based on Martin Heidegger's thought. Twelve phenomenological interviews were conducted with people aged over 60 years living in a long-term institution for the elderly in the city of Itabuna, Bahia, Brazil. Results: The units of meaning identified were: experience of progressive loss of autonomy and independence, perception of living in an institution as an inevitable circumstance; and being-with becoming being-alone/being-lonely. After the identification of ontic aspects and hermeneutical understanding, the unit of meaning was constructed: meaning of being an elderly person living in a long-term institution. Final considerations: The ontological needs referring to being an elderly person remain forgotten. As we are ontic and ontological, limited care to the ontic instance indicates deficiencies in institutionalization. Improvements are required to ensure the right to age with quality of life to this population.


RESUMEN Objetivo: desvelar el sentido de ser-persona-anciana viviendo en una institución de larga estadia. Método: investigación cualitativa con base en el pensamiento de Martin Heidegger. Se realizaron 12 entrevistas fenomenológicas con personas mayores de 60 años que residían en una institución de larga estadia para ancianos en la ciudad de Itabuna, Bahia, Brasil. Resultados: se obtuvieron los siguientes significados: vivir la pérdida progresiva de la autonomía e independencia; percebir la ida a la institución como un camino circunstancial inevitable y ser-con se convierte en ser-solo/estar solo. Tras aprehender los aspectos ónticos, se hizo posible la comprensión hermenéutica y la construcción de la unidad de significación: el sentido de ser-persona-anciana viviendo en institución de larga estadia. Consideraciones finales: las necesidades ontológicas que tienen en cuenta el ser-persona-anciana siguen olvidadas. Como somos óntico y ontológico, el cuidado limitado a la instancia óntica señala carencias en la institucionalización. Son necesarias mejoras para que les garantice a ese grupo de población el derecho al envejecimiento con calidad de vida.


RESUMO Objetivo: desvelar o sentido de ser-pessoa-idosa vivendo em instituição de longa permanência. Método: pesquisa qualitativa fundamentada no pensamento de Martin Heidegger. Foram realizadas 12 entrevistas fenomenológicas com pessoas acima de 60 anos que residem em uma instituição de longa permanência para idosos na cidade de Itabuna, Bahia, Brasil. Resultados: as unidades de significados desveladas foram: vivência da perda progressiva de autonomia e independência; percepção da ida à instituição como trajetória circunstancial inevitável e o ser-com torna-se ser-só/ser-solitário. Após apreensão dos aspectos ônticos foi possível a compreensão hermenêutica e a construção da unidade de significação: o sentido de ser-pessoa-idosa vivendo em instituição de longa permanência. Considerações finais: as necessidades ontológicas, as quais atentam para o ser-pessoa-idosa seguem esquecidas. Como somos ôntico e ontológico, o cuidado limitado à instância ôntica sinaliza deficiências na institucionalização. Melhorias são necessárias para garantir a esse grupo populacional o direito de envelhecer com qualidade de vida.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Inpatients/psychology , Institutionalization , Quality of Health Care/standards , Brazil , Interviews as Topic/methods , Qualitative Research , Geriatrics/methods , Geriatrics/standards , Inpatients/statistics & numerical data , Middle Aged
7.
Geriatr., Gerontol. Aging (Impr.) ; 13(2): 88-94, abr-jun.2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1096820

ABSTRACT

INTRODUÇÃO: Este estudo teve o objetivo de apresentar os resultados do primeiro ano de atendimento da Unidade de Cuidados Paliativos de um hospital geral de média complexidade. MÉTODO: Foram coletados dados demográficos, clínicos, status funcional e o número de mortes ocorridas no hospital dos pacientes internados no primeiro ano da unidade, os quais foram analisados por estatística descritiva. RESULTADOS: Foram atendidos 129 pacientes (140 internações e 11 reinternações), com idade média de 80 anos, e 57% eram mulheres. Em 67% das internações na unidade, os pacientes morreram, e em 32%, receberam alta. O tempo médio de internação foi de 11,1 dias e o tempo médio na Unidade de Cuidados Paliativos foi de 5,5 dias. A maioria dos pacientes tinha doenças neurológicas, como sequelas de doenças cerebrovasculares e síndromes demenciais, e baixo escore de funcionalidade. Dos óbitos ocorridos na instituição no período analisado, 59% foram na Unidade de Cuidados Paliativos, com maior proporção nas faixas etárias mais elevadas. CONCLUSÃO: A unidade atendeu uma demanda existente relacionada ao aumento das doenças crônicas e ao envelhecimento populacional, que necessitam de cuidados paliativos. É necessário expandir o acesso aos cuidados paliativos para pacientes internados em hospitais.


INTRODUCTION: This study aimed to report the results of a Palliative Care Unit's first year of operation in a general hospital of medium-complexity care. METHOD: Data on demographic and clinical characteristics, functional status, and number of in-hospital deaths were collected regarding patients admitted to the unit during its first year of operation. Descriptive statistics were used to analyze the data. RESULTS: In total, 129 patients were treated (140 admissions and 11 readmissions). Their mean age was 80 years, and 57% were female. Patients died in 67% of unit admissions, while in 32% they were discharged. The mean length of hospital stay was 11.1 days, and the mean length of Palliative Care Unit stay was 5.5 days. Most patients had neurological conditions, such as sequelae of cerebrovascular diseases and dementia syndromes, and low functional scores. Of all in-hospital deaths recorded in the period, 59% occurred in the Palliative Care Unit, with a higher proportion in older ages. CONCLUSION: The unit met an existing demand related to increased prevalence of chronic diseases and population aging, requiring palliative care services. Expanding access to palliative care is needed for patients admitted to hospitals.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Palliative Care/organization & administration , Palliative Care/statistics & numerical data , Humanization of Assistance , Inpatients/statistics & numerical data , Brazil , Hospital Mortality , Health Care Surveys , Health Services for the Aged/supply & distribution , Hospital Administration
8.
Prensa méd. argent ; 105(3): 99-105, may 2019. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1025198

ABSTRACT

Introducción: El tratamiento antirretroviral de alta eficacia (TARGA) ha desplazado a las infecciones oportunistas como principal causa de hospitalización en infectados por el HIV. Sin embargo, algunos autores hallaron que las causas de internación por HIV en Buenos Aires no cambiaron a pesar del acceso universal al TARGA desde 1996. Pacientes y Métodos. Para confirmar estos resultados revisamos todos los ingresos hospitalarios ocurridos durante tres años en un hospital general de la ciudad de Buenos Aires. Resultados: 57 pacientes (34 hombres) tuvieron 79 hospitalizaciones: 43 ingresaron sólo una vez y los 14 restantes tuvieron dos o más ingresos hasta totalizar 36 internaciones. La edad fue de 44.46 ± 11.55 años (promedio ± desvío estándard), 43 pacientes (75.45%) se sabían HIV + y 28 de ellos (65.12%) recibían TARGA al ingreso, 31 hospitalizaciones (39.24%) fueron causadas por enfermedades marcadoras de SIDA; 35 (44.30%) por infecciones no marcadoras de SIDA (INMS) y 13 (13.46%) por enfermedades no infecciosas. Tuberculosis fue el diagnóstico más frecuente (11 casos, 13.92%), seguida por meningitis a Cryptococcus neoformans en 9 (11.39%) y toxoplasmosis cerebral en 6 (7.59%). Entre las INMS, la neumonía fue la principal causa de hospitalización (13 pacientes, 16.46%). Discusión: Estos resultados confirman resultados previos comunicando que las causas de hospitalización en infectados por el HIV no cambiaron en respuesta al TARGA en Buenos Aires, lo que puede estar reflejando problemas de detección o adherencia, o puede estar relacionado con resistencia viral, razones sociales o cualquier combinación de estos factores (AU)


Introduction. High Active Antiretroviral Treatment (HAART) displaced opportunistic infections as the main cause of hospitalization in HIV infected patients. However, some authors found that causes for hospitalization in HiV infected patients did not changed at Buenos Aires although this country offers universal access to HAART since 1996. Patients and Methods. We analyzed all the HIV related admissions recorded during three years at a general hospital. Results. 57 patients (34 men) were hospitalized 79 times. 43 out of them were hospitalized only one time. The reaining 14 were hospitalized 36 times. Age was 44.46 ± 11.55 years (mean ± standard deviation). 43 patients (75.45%) had a previous diagnosis of HIV infection. 28 of them (65.12%) received HAART. 31 hospitalizations (39.24%) were caused by AIDS defining events. 35 (44.30%) related to non-AIDS-defining infections diseases (NADID), and 13 (13.46%) to non-infections diseases. Tuberculosis was the prevalent illness (11 cases, 13.92%), followed by cryptoccal meningitis in 9 (11.39%) and cerebral toxoplasmosis in 6 (7.59%). Among NADID, pneumonia was the main cause of admission (13 patientes, 16,46%). Discussion: These results confirm previous reports showing that causes of HIV related hospitalization remain unchanged in spite of HAART at Buenos Aires, which may be reflecting problems of detection and adherence, or may be related to local viral resistance, social reasons, or any combination of these factors (AU)


Subject(s)
Humans , Adult , Middle Aged , Communicable Diseases/diagnosis , Statistical Analysis , Retrospective Studies , HIV/immunology , Antiretroviral Therapy, Highly Active/statistics & numerical data , Drug Resistance, Viral/immunology , Noncommunicable Diseases , Inpatients/statistics & numerical data
9.
Rev. Assoc. Med. Bras. (1992) ; 65(5): 603-610, May 2019. tab, graf
Article in English | LILACS | ID: biblio-1012962

ABSTRACT

SUMMARY OBJECTIVE: To investigate the profile of motivations for smoking among inpatients at a hospital in southern Brazil. METHODS: A survey study involving hospitalized smokers. The Modified Reasons for Smoking Scale (MRFSS) and its domains were analyzed according to gender and dependence degree. RESULTS: The sample consisted of 85 adults (mean age 53 years), low schooling/family income, and well-adjusted in terms of gender (male= 52.9%) and clinical (48%) or surgical (47%) specialty. Most were in Action as the motivational stage (68%), with elevated smoking exposure (median = 39 years/packs) and dependence degree of nicotine (56.4%). The highest domains of the MRFSS were: Smoking Pleasure (4.34 ± 1.2), Relaxation/Tension Reduction (4.24 ± 1.2) and Dependence (3.8±1.4). Significantly, women presented higher scores, in domain Relaxation/Tension Reduction (4.7±0.9). In those with elevated nicotine dependence, higher scores were observed in the Automatism/Habit and Stimulation domains. CONCLUSIONS: Smoking Pleasure and Relaxation/Tension Reduction, especially in women and Automatism, in those more dependents, are factors that should be more highlighted in future strategies for smoking cessation in inpatients.


RESUMO OBJETIVO: Investigar o perfil de motivações para o tabagismo entre pacientes internados em um hospital do sul do Brasil. MÉTODOS: Estudo tipo survey que incluiu pacientes tabagistas hospitalizados. Utilizou-se a Escala de Razões para Fumar Modificada (ERPFM) e seus domínios, analisados em função do sexo e do grau de dependência. RESULTADOS: A amostra foi composta por 85 adultos (média de 53 anos), com baixa escolaridade/renda familiar e equilibrada quanto ao sexo (masculino= 52,9%) e por especialidade clínica (48%) ou cirúrgica (47%). A maioria estava em estágio motivacional Ação (68%), com carga tabágica (mediana= 39 anos/maços) e grau de dependência à nicotina elevados (56,4%). Os domínios de maior escore da ERPFM foram: Prazer de Fumar (4,34 ± 1,2), Relaxamento/Redução da Tensão (4,24 ± 1,2) e Dependência (3,8 ± 1,4). De forma significativa, com maior pontuação, as mulheres apresentaram o domínio Relaxamento/Redução da Tensão (4,7 ± 0,9). Naqueles com maior grau de dependência, observou-se com significância, escores mais elevados nos domínios Automatismo/Hábito e Estimulação. CONCLUSÕES: Prazer de Fumar e Relaxamento/Redução da Tensão, especialmente em mulheres e Automatismo, naqueles mais dependentes, são fatores que devem ser mais valorizados em futuras estratégias de cessação de tabagismo em hospitalizados.


Subject(s)
Humans , Male , Female , Adult , Aged , Smoking/epidemiology , Inpatients/statistics & numerical data , Motivation , Risk-Taking , Socioeconomic Factors , Time Factors , Brazil/epidemiology , Smoking/psychology , Surveys and Questionnaires , Risk Factors , Age Factors , Smoking Cessation , Statistics, Nonparametric , Middle Aged
10.
Trends psychiatry psychother. (Impr.) ; 41(1): 27-35, Jan.-Mar. 2019. tab
Article in English | LILACS | ID: biblio-1004836

ABSTRACT

Abstract Introduction User satisfaction assessment in mental health services is an important indicator of treatment quality. The objective of this study was to evaluate treatment satisfaction in a sample of inpatients with mental disorders and the associations between levels of satisfaction and clinical/sociodemographic variables. Methods This exploratory study investigated 227 psychiatric inpatients who answered the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and the Perception of Change Scale (EMP). SATIS scores were analyzed according to associations with clinical and sociodemographic data. Pearson correlations were used to correlate SATIS scores with other variables. Results We found a high degree of satisfaction with care at the psychiatric inpatient unit assessed. In general, patients rated maximum satisfaction for most items. The highest satisfaction scores were associated with patients receiving treatment through the Brazilian Unified Health System (SUS) and with less education. SATIS showed a moderate positive correlation with EMP. The worst evaluated dimension was physical facilities and comfort of the ward. Conclusion Patients treated via SUS may be more satisfied than patients with private health insurance when treated in the same facility. The evaluation of treatment satisfaction can be used to reorganize services at psychiatric inpatient units.


Resumo Introdução A avaliação da satisfação do usuário nos serviços de saúde mental é um importante indicador da qualidade do tratamento. O objetivo deste estudo foi avaliar a satisfação com o tratamento em uma amostra de pacientes internados com transtornos mentais e as associações entre os níveis de satisfação e variáveis clínicas/sociodemográficas. Métodos Este estudo exploratório investigou 227 pacientes psiquiátricos internados que responderam a Escala de Satisfação do Paciente com os Serviços de Saúde Mental (SATIS-BR) e a Escala de Percepção da Mudança (EMP). Os escores SATIS-BR foram analisados segundo associações com dados clínicos e sociodemográficos. Correlações de Pearson foram usadas para correlacionar escores SATIS com outras variáveis. Resultados Encontramos alto grau de satisfação com o atendimento na unidade de internação psiquiátrica avaliada. Em geral, os pacientes atribuíram satisfação máxima para a maioria dos itens. Os maiores escores de satisfação foram associados a pacientes em tratamento pelo Sistema Único de Saúde (SUS) e com menor escolaridade. A SATIS mostrou uma correlação positiva moderada com EMP. A pior dimensão avaliada foi associada às instalações físicas e conforto da enfermaria. Conclusão Pacientes com cobertura pelo SUS podem estar mais satisfeitos do que pacientes com planos privados de saúde quando tratados na mesma unidade. A avaliação da satisfação com o tratamento pode ser usada para reorganizar serviços em unidades de internação psiquiátrica.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Psychiatric Department, Hospital/statistics & numerical data , Patient Satisfaction , Inpatients/statistics & numerical data , Insurance, Health/statistics & numerical data , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Brazil , Cross-Sectional Studies , Middle Aged
11.
Clin. biomed. res ; 39(4): 279-283, 2019.
Article in English | LILACS | ID: biblio-1053445

ABSTRACT

Introduction: This study analyzed dental consultation requests to the division of oral and maxillofacial surgery in a Brazilian tertiary hospital. Methods: A cross-sectional study with data collected retrospectively from inpatients' electronic medical records containing dental consultation requests made between January 2013 and December 2017. Results: 327 consultation requests were analyzed. Mean (SD) patient age was 38.71 (24.4) years; 164 (50.2%) were male and 267 (81.7%) were Caucasian. Regarding systemic conditions, 34 (10.4%) were classified as ASA I, 86 (26.3%) as ASA II, 182 (55.7%) as ASA III, and 25 (7.6%) as ASA IV. Dental consultations were mostly requested by the internal medicine team (n = 42, 12.8%). The most common reason for consultation was septic teeth (n = 131, 40.1%). Complementary tests were required in 188 (57.5%) cases. Surgical intervention was required in 82 (25.0%), with tooth extraction as the most prevalent procedure (20.2%). The most demanding service was inpatient care, with 276 (84.4%) requests. Cases were resolved in 249 (76.1%). Conclusions: The division of oral and maxillofacial surgery in our hospital deals with a great amount of consultations, contributing with surgical procedures to the adequacy of patients' oral health with a high effectiveness rate. Our data illustrate the contribution of dentists in a hospital setting, assisting the medical team in providing comprehensive care for inpatients. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Antisepsis/methods , Oral Health/statistics & numerical data , Tooth Extraction/statistics & numerical data , Oral Surgical Procedures , Inpatients/statistics & numerical data
12.
Braz. j. biol ; 78(4): 644-652, Nov. 2018. tab
Article in English | LILACS | ID: biblio-951608

ABSTRACT

Abstract The aim of this study was to evaluate the frequency of Candida species between a non-hospitalized and a hospitalized population. For this purpose, samples of saliva were sampled through sterile swabs, moistened in peptone water and rubbed in the oral cavity of 140 individuals, from which, 70 were hospitalized patients from the Medical Clinic of a Teaching Hospital and the other 70 were non-hospitalized subjects. All saliva samples were plated in Sabouraud Dextrose agar added with Chloramphenicol and incubated at 36 °C for 48 hours. The morphology identification was performed through macroscopic and microscopic characterization, the CHROMagar Candida medium and the VITEK® system Yeast Biochemical Card (bio Mérieux SA, France). The results showed a colonization of Candida spp. in 85.7% the hospitalized individuals, where the species found were C. albicans (60%), C. tropicalis (23.4%), C. krusei (3.3%) and Candida spp. (13.3%). In the non-hospitalized individuals the colonization by Candida spp was 47.1%, and the species found were: C. albicans (45.5%), C.krusei (9.1%), C. guilliermondii (9.1% %), C. tropicalis (3.0%), C. famata (3.0%) and Candida spp. (30.3%). In spite of their presence in oral cavity in both groups, Candida spp. was more frequently isolated in hospitalized individuals, who were 6.73 times more likely to have this fungus in the oral cavity and were 3.88 times more likely to have Candida albicans.


Resumo O objetivo deste estudo foi avaliar a frequência de espécies de Candida entre uma população de indivíduos não-hospitalizados e hospitalizados. Para isto, amostras de saliva foram coletadas através de swabs estéreis, umedecidas em água de peptona e friccionadas na cavidade bucal de 140 indivíduos, dos quais 70 eram pacientes internados em uma Clínica Médica de um Hospital Escola e os outros 70 eram indivíduos não hospitalizados sem contato com ambiente hospitalar. Todas as amostras de saliva foram plaqueadas em ágar Sabouraud dextrose adicionadas de cloranfenicol e incubadas a 36 °C durante 48 horas. A identificação morfológica foi realizada através da caracterização macroscópica e microscópica, com o meio CHROMagar Candida e do sistema VITEK® Biochemical Card (bio Mérieux SA, França). Os resultados mostraram uma colonização de Candida spp. em 85,7% dos indivíduos hospitalizados, onde as espécies encontradas foram: C.albicans (60%), C. tropicalis (23,4%), C. krusei (3,3%) e Candida spp. (13,3%). Nos indivíduos não-hospitalizados a colonização por Candida spp foi de 47,1%, e as espécies encontradas foram: C. albicans (45,5%), C. krusei (9,1%), C. guilliermondii (9,1%), C. tropicalis (3,0%), C. famata (3,0%) e Candida spp. (30,3%). Apesar de sua presença na cavidade oral em ambos os grupos, Candida spp. foi mais freqüentemente isolada em indivíduos hospitalizados, que foram 6,73 vezes mais propensos a ter este fungo na cavidade oral e foram 3,88 vezes mais propensos a ter Candida albicans.


Subject(s)
Humans , Male , Female , Middle Aged , Outpatients/statistics & numerical data , Candida/isolation & purification , Candidiasis/diagnosis , Candidiasis/microbiology , Inpatients/statistics & numerical data , Saliva/microbiology , Candida/classification , Candida/growth & development , Colony Count, Microbial , Culture Media , Mouth/microbiology
13.
Arch. endocrinol. metab. (Online) ; 62(5): 514-522, Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-983795

ABSTRACT

ABSTRACT Objective: Glycemic control has been increasingly recognized as a critical element in inpatient care, but optimal management of blood glucose in the hospital setting remains challenging. The aims of this study were to describe and evaluate the impact of the implementation of an inpatient multidisciplinary glucose control management program on glucose control in hospitalized patients. Materials and methods: Retrospective analysis of medical records and glucose monitoring data obtained by point- of-care testing (POCT) in hospitalized patients before (May 2014) and after (June 2015 and May 2017) the implementation of the program. Results: We analyzed 6888, 7290, and 7669 POCTs from 389, 545, and 475 patients in May 2014, June 2015, and May 2017, respectively. Hyperglycemia (≥ 180 mg/ dL) occurred in 23.5%, 19.6%, and 19.3% POCTs in May 2014, June 2015, and May/2017, respectively (p < 0.001), while severe hyperglycemia (≥ 300 mg/dL) was observed in 2.5%, 2.2%, and 1.8% of them, respectively (p = 0.003). Hyperglycemia (≥ 180 mg/dL) reduced significantly from May 2014 to June 2015 (16.3%, p < 0.001) and from May 2014 to May 2017 (178%, p < 0.001). No significant changes occurred in hypoglycemic parameters. Conclusions: The implementation of an inpatient multidisciplinary glucose control management program led to significant reductions in hyperglycemic events. The key elements for this achievement were the development of institutional inpatient glycemic control protocols, establishment of a multidisciplinary team, and continuing educational programs for hospital personnel. Altogether, these actions resulted in improvements in care processes, patient safety, and clinical outcomes of hospitalized patients.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Blood Glucose/analysis , Point-of-Care Testing/statistics & numerical data , Hyperglycemia/prevention & control , Inpatients/statistics & numerical data , Reference Standards , Time Factors , Program Evaluation , Reproducibility of Results , Retrospective Studies , Risk Factors , Diabetes Mellitus/prevention & control , Diabetes Mellitus/drug therapy , Treatment Adherence and Compliance , Hyperglycemia/etiology , Hyperglycemia/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use
14.
Rev. méd. Chile ; 146(7): 862-868, jul. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-961472

ABSTRACT

Background: Detecting patients at risk of falls during hospital stay is of utmost importance to implement preventive measures. Aim: To determine the frequency of patients with a high risk of falls admitted to a medical-surgical ward. To assess the preventive measures implemented. Materials and Methods: Review of medical records of 376 patients aged 20 to 97 years (28% older than 70 years) admitted to a clinical hospital in a period of four months. Results: Eleven percent of patients had a history of falls, 50% had a sensory deficit, 68% had unstable gait, 8% had a neurological risk condition, 8% had drowsiness or disorientation, 4% had psychomotor agitation or delirium, 86 % used high risk medications, 73% used 2 or more high risk drugs and 72% were using devices that decrease mobility. One hundred forty-one patients (38%) had a high risk of falling. The mean age of the latter was 77 years, 89% had a sensory deficit, 96% had unstable gait, 4% had psychomotor agitation or delirium and 98% used high risk drugs. Less than 1% had a medical prescription of a caregiver, physical restraints or antipsychotics, however, 21% of patients had a caregiver. Conclusions: The percentage of patients with a high risk of falling is important. The main risk factors were sensory deficit, unstable gait and the use of high risk medications. The low frequency of preventive measures prescriptions is striking.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Accidental Falls/statistics & numerical data , Hospitalization/statistics & numerical data , Inpatients/statistics & numerical data , Accidental Falls/prevention & control , Chile , Incidence , Risk Factors , Length of Stay
15.
Ciênc. Saúde Colet ; 23(5): 1521-1530, Mai. 2018. tab
Article in Portuguese | LILACS | ID: biblio-890572

ABSTRACT

Resumo O interesse na qualidade de vida de pessoas com transtornos mentais moradores de residências terapêuticas é um importante indicador para a avaliação da intervenção terapêutica na área da saúde. A atividade física pode contribuir para uma boa qualidade de vida. Avaliamos a qualidade de vida e os níveis de atividade física em moradores das residências terapêuticas da grande Porto Alegre. Estudo de série de casos (n = 68), tendo como instrumentos SF-36, EuroQol, IPAQ e questões sociodemográficas. Os resultados obtidos pelo SF-36 demonstraram que o domínio do estado geral de saúde foi o menor (57,47 ± 14,27). Os maiores scores encontrados foram nos aspectos sociais (77,39 ± 20,21) e nos físicos (77,57 ± 39,71). Ao menos um problema (moderado ou extremo), em no mínimo uma dimensão, foi evidenciado em 82% dos moradores por meio do EuroQol. Os níveis de atividade física mostraram que a maioria dos moradores são insuficientemente ativos (48,5%) e 14,7% sedentários. Os domínios dor e mobilidade sugerem que os moradores não são incentivados suficientemente à atividade física. Conhecer a percepção da qualidade de vida dos moradores das residências terapêuticas é fundamental para estabelecer políticas públicas eficazes.


Abstract Interest in the quality of life of people with mental disorders living in therapeutic residential care facilities is an important indicator for the evaluation of therapeutic interventions in the area of health. Physical activity can contribute to a good quality of life. This study evaluated the quality of life and levels of physical activity of people living in therapeutic residential care facilities in the metropolitan area of Porto Alegre. This case series study (n = 68) used SF-36, EuroQol and IPAQ and social-demographic questions. The SF-36 results showed that the domain of general health received the lowest scores (57.47 ± 14.27). The highest scores were in terms of social aspects (77.39 ± 20.21) and physical aspects (77.57 ± 39.71). When using EuroQol, at least one problem (mild or extreme) in at least one dimension was evident among 82% of the residents. The physical activity levels showed that most of the participants were insufficiently active (48.5%) and 14.7% were sedentary. The domains of pain and mobility suggested that the residents were not being encouraged enough to perform physical activities. Knowledge about the perceptions of those living in therapeutic residential care facilities is critical in order to establish effective public policies.


Subject(s)
Humans , Male , Female , Adult , Aged , Quality of Life , Exercise/physiology , Sedentary Behavior , Mental Disorders/psychology , Pain/epidemiology , Residential Facilities , Brazil , Surveys and Questionnaires , Inpatients/statistics & numerical data , Middle Aged
16.
Arch. argent. pediatr ; 115(6): 377-384, dic. 2017. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-887401

ABSTRACT

Introducción. Las dermatosis son frecuentes en niños. Nuestro objetivo fue describir las interconsultas con dermatología de niños hospitalizados. Población y métodos. Se analizaron las solicitudes de interconsultas con dermatología pediátrica de 539 pacientes consecutivos (de 0 a 18 años de edad) entre enero de 2004 y abril de 2010; para determinar en la interconsulta, el grupo de dermopatías, diagnóstico principal, departamento solicitante, patrón diagnóstico, modalidad de tratamiento y derivación a otro departamento. Resultados. De 539 niños hospitalizados, 310 (57, 51%) eran varones y 229 (42, 49%), mujeres. El departamento de pediatría general (37, 5%), fue el que consultó más frecuentemente, seguido por oncología (15, 6%) y cirugía pediátrica (11%). La mayoría (32%) habían sido hospitalizados por una dermopatía o enfermedad relacionada. Las alergias cutáneas (47%) fueron las principales dermatosis consultadas, seguidas por enfermedades infecciosas (14, 7%) y trastornos sistémicos con manifestaciones cutáneas (10, 2%). La dermatitis atópica (7, 4%) y el eccema sin clasificar (7, 4%) fueron las dermatosis más frecuentes, seguidos de la urticaria papulosa (5, 4%). En el 80% de los pacientes, el diagnóstico fue clínico; requirieron biopsia cutánea el 15, 9% y análisis de laboratorio el 4%. El 51% de los pacientes requirió tratamiento local, el 6%, tratamiento sistémico, el 31%, sistémico combinado y ningún tratamiento en el 11, 1%. Se derivó a otro departamento al 2% de los pacientes. Conclusiones.Este estudio obtuvo datos importantes sobre los trastornos de piel y su tratamiento en niños hospitalizados desde la perspectiva de la interconsulta.


Introduction. Although skin diseases are associated with low rate of hospitalization, dermatological manifestations are frequent in hospitalized patients. The aim of the study was to describe the inpatient dermatological consultations in a pediatric teaching hospital. Population and Methods. Recorded data from inpatient pediatric dermatology consultation requests on a total of 539 consecutive inpatients (aged 0-18 years) from January 2004 to April 2010 were analyzed for consult diagnosis, dermatological disease group, primary diagnosis, requesting department, diagnostic pattern, treatment modality and referral to another department. Results. Of the 539 inpatients, 310 (57.51%) were males and 229 (42.49%) were females. The most frequent requesting department was general pediatrics (37.5%) followed by oncology (15.6%) and pediatric surgery (11.1%). Most of the patients (32.1%) had been hospitalized for dermatological or related disease followed by acute lymphoblastic leukemia (4.1%), chronic renal failure (2.6%), bronchopneumonia (2.6%) and epilepsy (2.4%). Allergic skin diseases (47.1%) were the leading group of dermatoses, which were followed by infectious diseases (14.7%), and systemic diseases with cutaneous manifestations (10.2%). Atopic dermatitis (7.4%) and unclassified eczema (7.4%) were the most frequent dermatoses followed by papular urticaria (5.4%). Most of the patients (80.0%) had diagnosis on clinical basis, whereas skin biopsy was performed in 15.9% and laboratory investigation in 4.1% of the patients. Local treatment was applied to 50.8% of the patients, systemic treatment to 5.8%, local and systemic treatment together to 31.0% while no treatment was given to 11.1%. Only 1.9% of the patients were referred to another department. Conclusions. This study provided important data on the spectrum of skin disorders and their management in pediatric inpatients from the consultation perspective in a pediatric teaching hospital with multispecialty clinics.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Referral and Consultation/statistics & numerical data , Skin Diseases/epidemiology , Dermatology/statistics & numerical data , Inpatients/statistics & numerical data , Skin Diseases/diagnosis , Retrospective Studies , Sex Distribution , Hospitals, Pediatric , Hospitals, Teaching
17.
Salud pública Méx ; 59(4): 408-415, Jul.-Aug. 2017. tab
Article in Spanish | LILACS | ID: biblio-903775

ABSTRACT

Resumen: Objetivo: Las personas con trastornos del desarrollo intelectual (TDI) suelen presentar peor estado de salud que la población general. El objetivo de este estudio es evaluar el acceso y la morbimortalidad hospitalaria en los pacientes con TDI y compararla con la población general. Material y métodos: Se realizó un estudio transversal retrospectivo y se compararon los datos de los ingresos y altas hospitalarias entre pacientes con TDI y sin dichos transtornos, en Ciudad Real, España. Resultados: De un total de 51 325 altas, 441 (0.9%) correspondían a personas con TDI. Estas personas presentaban significativamente menos ingresos programados que la población general y menos intervenciones quirúrgicas y, a su vez, más ingresos debidos a enfermedades mentales y del sistema respiratorio. Conclusiones: Las personas con TDI tienen patrones de morbilidad diferentes a los del resto de la población. Además este estudio revela posibles dificultades en el acceso a la atención sanitaria en estas personas.


Abstract: Objective: People with intellectual developmental disorders (IDD) have worse health statuses in comparison with general population. The objective of this paper is to compare access and hospital morbimortality in people with IDD and general population. Material and methods: We conducted a retrospective cross-sectional analytical study and analyzed data on admissions and discharges between IDD patients and the rest of them, in Ciudad Real, España. Results: Out of 51 325 hospital admissions, 441 (0.9%) belonged to the group of persons with IDD. The IDD group had fewer programmed hospitalization than the general population and fewer surgical interventions. They presented more admissions for mental disorders and respiratory system diseases. Conclusions: The data presented confirm TDI population have different patterns of disease. Furthermore, this study reveal potential difficulties in access to health care in this population.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Morbidity , Persons with Mental Disabilities/statistics & numerical data , Hospitalization/statistics & numerical data , Inpatients/statistics & numerical data , Intellectual Disability/epidemiology , Patient Admission/statistics & numerical data , Patient Discharge/statistics & numerical data , Socioeconomic Factors , Comorbidity , Cross-Sectional Studies , Retrospective Studies , Health Status Indicators , Mexico/epidemiology
18.
Arq. bras. cardiol ; 108(3): 217-227, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-838704

ABSTRACT

Abstract Background: Major Depressive Disorder (MDD) is one of the most common mental illnesses in psychiatry, being considered a risk factor for Acute Coronary Syndrome (ACS). Objective: To assess the prevalence of MDD in ACS patients, as well as to analyze associated factors through the interdependence of sociodemographic, lifestyle and clinical variables. Methods: Observational, descriptive, cross-sectional, case-series study conducted on patients hospitalized consecutively at the coronary units of three public hospitals in the city of Rio de Janeiro over a 24-month period. All participants answered a standardized questionnaire requesting sociodemographic, lifestyle and clinical data, as well as a structured diagnostic interview for the DSM-IV regarding ongoing major depressive episodes. A general log-linear model of multivariate analysis was employed to assess association and interdependence with a significance level of 5%. Results: Analysis of 356 patients (229 men), with an average and median age of 60 years (SD ± 11.42, 27-89). We found an MDD point prevalence of 23%, and a significant association between MDD and gender, marital status, sedentary lifestyle, Killip classification, and MDD history. Controlling for gender, we found a statistically significant association between MDD and gender, age ≤ 60 years, sedentary lifestyle and MDD history. The log-linear model identified the variables MDD history, gender, sedentary lifestyle, and age ≤ 60 years as having the greatest association with MDD. Conclusion: Distinct approaches are required to diagnose and treat MDD in young women with ACS, history of MDD, sedentary lifestyle, and who are not in stable relationships.


Resumo Fundamento: O transtorno depressivo maior (TDM) é um dos distúrbios mentais mais comuns em psiquiatria, sendo um fator de risco para síndrome coronariana aguda (SCA). Objetivo: Avaliar a prevalência de TDM em pacientes com SCA, assim como analisar os fatores associados através da interdependência de variáveis sociodemográficas, clínicas e de estilo de vida. Métodos: Estudo observacional, descritivo e transversal conduzido em pacientes hospitalizados consecutivamente nas unidades coronarianas de três hospitais públicos na cidade do Rio de Janeiro num período de 24 meses. Todos os participantes responderam a um questionário padrão sobre dados sociodemográficos, clínicos e de estilo de vida, assim como participaram de uma entrevista clínica estruturada do DSM-IV sobre episódio depressivo maior atual. Aplicou-se um modelo log-linear de análise multivariada para avaliar associação e interdependência, com nível de significância de 5%. Resultados: Análise de 356 pacientes (229 homens) com idade média e mediana de 60 anos (DP ± 11,42; 27-89). Encontrou-se uma prevalência pontual de TDM de 23%, e significativa associação de TDM com as variáveis sexo, estado civil, sedentarismo, classificação Killip e história de TDM. Ao controlar por sexo, observou-se associação estatisticamente significativa entre TDM e sexo, idade ≤ 60 anos, sedentarismo e história de TDM. O modelo log-linear identificou as variáveis história de TDM, sexo, sedentarismo e idade ≤ 60 anos como tendo a maior associação com TDM. Conclusão: Os resultados indicam a necessidade de abordagens distintas para diagnosticar e tratar TDM em mulheres jovens com SCA, história de TDM, sedentarismo e que não estejam em relações estáveis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Depressive Disorder, Major/complications , Depressive Disorder, Major/epidemiology , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/psychology , Acute Coronary Syndrome/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Sex Factors , Prevalence , Cross-Sectional Studies , Interviews as Topic , Multivariate Analysis , Surveys and Questionnaires , Risk Factors , Age Factors , Sex Distribution , Sedentary Behavior , Inpatients/statistics & numerical data
19.
Rio de Janeiro; s.n; fev. 2017. 199 f p. ilus, tab, graf.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-849507

ABSTRACT

A Educação para a Saúde do Paciente Hospitalizado representa um elemento do cuidado indispensável para a diminuição e a prevenção de agravos à saúde, pois por meio dela é possível vislumbrar um autocontrole por parte dos pacientes e, consequentemente, um aumento da autoestima e da própria independência. Considerando a dificuldade encontrada na literatura acerca dessa temática no cenário hospitalar, há a necessidade de contextualizar os conceitos e as ideias que entremeiam a Educação para a Saúde do Paciente Hospitalizado presente no cuidado de enfermagem. Neste sentido, o objetivo principal desse estudo é: Elaborar o conceito Educação para a Saúde do Paciente Hospitalizado com enfoque no cuidado realizado pelo(a) enfermeiro(a), expresso nas bases literárias e na prática dos enfermeiros. Trata-se de um estudo qualitativo que adota como metodologia as estratégias de Derivação, Síntese e Análise de Conceito propostas por Walker e Avant (2011). A análise dos resultados foi realizada através do software NVivo 11 pro. O levantamento dos dados foi realizado através da busca a bases literárias e de entrevistas aos enfermeiros de um hospital do município do Rio de Janeiro. Para a investigação das fontes contidas no corpus de análise do programa, foram selecionados 15 textos oriundos de periódicos e 35 provenientes das transcrições das entrevistas, totalizando 50 fontes de textos. Os resultados identificaram o conceito Educação para a Saúde do Paciente Hospitalizado por meio da definição dos seus atributos, antecedentes, consequências e da construção do caso modelo, caso limite, caso contrário, os referentes empíricos e a definição teórica desse conceito, evidenciando a presença de vários termos definidores e exibindo a carência de uma padronização desse conceito. Os atributos essenciais desse conceito são: 1) Realização do cuidado de enfermagem, como oportunidade para a educação para a saúde; 2) Compartilhamento de conhecimento sobre a saúde e a terapêutica; 3) Comprometimento, disposição e disponibilidade dos enfermeiros com a educação para a saúde do paciente; 4) Receptividade dos pacientes, familiares e acompanhantes ao processo de educação para a saúde. A Educação para a Saúde do Paciente Hospitalizado destaca-se em processo de evolução de ideias, pensamentos, construtos e atitudes na Enfermagem. A elaboração desse conceito contribuiu para o relevo da enfermagem no cenário hospitalar e, através dessa abordagem, possibilitou o crescimento, visibilidade e amplitude à sua utilização como elemento do cuidado de enfermagem.(AU)


Subject(s)
Humans , Health Education , Inpatients/statistics & numerical data , Nursing Care , Patient Education as Topic
20.
Clin. biomed. res ; 37(3): 157-162, 2017. graf
Article in English | LILACS | ID: biblio-859755

ABSTRACT

Introduction: Patients who are at risk of malnutrition are potential candidates for the use of enteral nutritional therapy (ENT), since it allows a more effective control of the patient's nutrition. When oral food intake is impossible or insufficient, enteral nutrition is the most appropriate physiological option aiming at the maintenance of gastrointestinal trophism. Studies show us that the protein-caloric needs of the hospitalized patients are seldom reached in the feeding tube supply, staying routinely between 70% and 80% of their needs. Methods: A descriptive study was conducted based on secondary data collected by the Multidisciplinary Team of Nutritional Therapy of a university hospital in Brazil to compare the caloric intake received by the hospitalized patients when in enteral nutritional therapy with their real needs. Results: A total of 43 adult inpatients who were in exclusive enteral nutrition were assessed. It was observed that the mean caloric intake received by the patients was 1,767±271kcal/day, reaching 94% of the estimated caloric needs, which were 321kcal/day. In relation to the nutritional status of the analyzed patients, it was found that 38% were at nutritional risk. Conclusion: The creation of protocols of nutritional support is of great importance to guide professionals in the prescription of ENT, aiming to improve the nutritional intake offered to hospitalized patients (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Energy Intake , Enteral Nutrition/methods , Inpatients/statistics & numerical data , Nutritional Requirements , Brazil , Emergency Service, Hospital , Intensive Care Units , Nutrition Assessment , Outcome and Process Assessment, Health Care , Retrospective Studies
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