De los Comités de Ética Asistencial hacia una Bioética Institucional / From the Commithees on Assitance Ethics to Institutional Bioethics

Throughout these 40 years, the Hospital or healthcare Ethics Committees, either at the initiative of the professionals themselves or the health units and in the latter decade also on the recommendation of health authorities both at international and national level, this is how the Organization of the United Nations for Education, Science and Culture (UNESCO) in the Universal Declaration on Bioethics and Human Rights of October 2005 (1) in its article 19 regarding committees: "Committees should be created, promoted and supported, at the appropriate level of independent, multidisciplinary and pluralistic ethics with a view to: a) evaluate ethical, legal, scientific and social problems relevant issues raised by research projects relating to Humans; b) provide advice on ethical problems in clinical contexts; c) evaluate the advances of science and technology, formulate recommendations and contribute to the preparation of guidance on the issues that fall within the scope of this Declaration; " (one) This consensus document does not specify whether the committees are of type assistance, research, local, national or international; however, it makes the characteristics of these and their functions. Considering: the premises of Gamboa GA. et al. (2) as well as the UNESCO recommendations (1), we can say that: "The Committees Bioethics are, in summary, those interdisciplinary instances of the institutions where they can well serve as a reflexive conscience for the personal and collective improvement of all who are part of that institution or benefit from its services

Estudio de utilización de psicofármacos en pacientes internados en el hospital Aeronáutico Central / Study of psychiatric medications use in inpatients at the hospital Aeronáutico Central

Introducción : El manejo de psicofármacos en la práctica hospitalaria es frecuente ante diversas situaciones médico quirúrgicas. El estudio del consumo de psicofármacos puede dar una idea sobre el uso racional de este tipo de tratamiento y eventualmente sobre su abuso y dependencia. Objetivos: Determinar la prevalencia y el tipo de psicofármacos utilizados y determinar qué servicio prescribe el psicofármaco. Materiales y métodos: Se realizó un estudio descriptivo, transversal y prospectivo, de las prescripciones diarias de psicofármacos y se registraron las mismas en una planilla de cálculo diseñada para tal fin. Resultados : Se analizaron las prescripciones correspondientes a 881 pacientes. La edad promedio de los pacientes es 68,9 años. El 32,3 % de los pacientes (285) tienen prescripto algún psicofármaco. Conclusiones : Se encontró un consumo global de psicofármacos cercano a 32% de los pacientes internados. El médico clínico es el prescriptor principal de ésta medicación.

Introduction: Psychiatric medications are usually used in hospital practice in different medical and surgical situations. The study of psychiatric medications consumption may shed light on the rational use of this type of treatment and, possibly, on their abuse and dependence. Objectives: To determine the prevalence and type of psychiatric medications used and to establish which department prescribes each drug. Material and methods: A descriptive, cross sectional and prospective study was carried out of daily psychiatric medications prescriptions, which were recorded in a specially created spreadsheet. Results: Prescriptions corresponding to 881 patients were analyzed. Average age of patients is 68.9 years. 32.3% ofpatients (285) have been prescribed some kind of psychiatric drug. Conclusions: An overall psychiatric medications consumption in near 32% of inpatients was found. Clinicians are the ones who most prescribe these medications.

El abordaje de los consumos de drogas por equipos asistenciales de salud: el caso de la maternidad y la adolescencia / Approach to drugs consumption by assistencial teams of health

La importancia de un buen funcionamiento de los equipos de salud a la hora de intervenir, requiere del trabajo interno de los mismos, sostenido por el cuidado, la capacitación y la reflexión de los que participan, para lograr una "actitud" emancipadora frente a problemáticas psicosociales complejas, tales como las paternidades y los consumos de drogas de los adolescentes.

Promoçäo e incentivo ao aleitamento materno: iniciativa Hospital Amigo da Criança / Promoting and supporting breast-feeding: baby Friendly Hospital Initiative

O objetivo deste artigo é analisar a Iniciativa Hospital Amigo da Criança no Brasil. Essa iniciativa, que visa a apoiar, proteger e promover o eleitamento materno foi idealizada em 1990, em um encontro realizado em Florença, Itália, com a participaçäo do Brasil e promovido pela OMS e UNICEF. O objetivo básico consiste na mobilizaçäo de profissionais de saúde, funcionários de hospitais e maternidades para mudanças em rotinas e condutas visando a prevenir o desmame precoce. Os estabelecimentos de saúde, para se tornarem Hospitais Amigos da Criança, precisam ser submetidos a avaliaçöes, tendo como base o cumprimento de cada um dos Dez Passos para o Sucesso do Aleitamento Materno (conjunto de metas elaboradas no mesmo encontro por um grupo de especialistas de saúde e nutriçäo de vários países). No Brasil, a avaliaçäo coordenada pelo PNIAM, realizada em duas etapas e, se aprovado, o hospital, quando vinculado ao SUS, recebe pagamento sobre assistência ao parto e atendimento no pré-natal. Atualmente, já existem 64 hospitais aprovados no Brasil. Dados do PNIAM mostram que a adoçäo dos dez passos e o trabalho de incentivo ao aleitamento materno resultaram em significativo aumento dos índices de amamentaçäo no Brasil.