ABSTRACT
Objetivo: conhecer a percepção de enfermeiros da Estratégia de Saúde da Família sobre segurança do paciente. Métodos: pesquisa qualitativa, realizada em 2016 com 10 enfermeiros, no sul do Brasil,por meio de entrevistas submetidas à Análise de Conteúdo. Resultados: salienta-se a falta de familiarização dos enfermeiros com o assunto. Erros de medicação e quedas foram problemas à segurança dos pacientes e a comunicação efetiva fator promotor. A capacitação das equipes,implementação de instrumentos próprios voltados à segurança do paciente e diminuição da sobrecarga de trabalho foram apontadas enquanto estratégias de melhoria para a segurança do paciente.Considerações finais: o tema segurança do paciente ainda não faz parte da assistência dos enfermeiros da Saúde da Família, mas esses percebem sua importância. Uma cultura de segurança precisa ser implementada nos serviços mediante capacitação desses profissionais por meio de parceria com instituições de ensino.
Objective: to understand the Family Health Strategy nurses perception of patient safety. Methods:qualitative research was conducted in 2016 with 10 nurses, in southern Brazil, through interviewssubmitted to Content Analysis. Results: the nurses lack of familiarity with the subject ishighlighted. Medication errors and falls were problems to patient safety and effectivecommunication is a promoting factor. The training of teams, implementation of own instrumentsfocused at patient safety and reduction of work overload were pointed out as improvement strategies for patient safety. Final Considerations: the theme of patient safety is not yet part of the assistanceof Family Health nurses, but they realize the importance of this. A safety culture needs to beimplemented in services by training nurses through partnership with educational institutions.
Subject(s)
Humans , Primary Health Care , Nursing , Medical Errors , Public Health , Patient SafetyABSTRACT
We investigated thyroid state effect on capacity of rat liver mitochondria to remove exogenously produced H2O2, determining their ability to decrease fluorescence generated by an H2O2 detector system. The rate of H2O2 removal by both non respiring and respiring mitochondria was increased by hyperthyroidism and decreased by hypothyroidism. However, the rate was higher in the presence of respiratory substrates, in particular pyruvate/malate, indicating a respiration-dependent process. Generally, the changes in H2O2 removal rates mirrored those in H2O2 release rates excluding the possibility that endogenous and exogenous H2O2 competed for the removing system. Pharmacological inhibition revealed thyroid state-linked differences in antioxidant enzyme contribution to H2O2 removal which were consistent with those in antioxidant system activities. The H2O2 removal was only in part due to enzymatic systems and that imputable to non-enzymatic processes was higher in hyperthyroid and lower in hypothyroid mitochondria. The levels of cytochrome c and the light emissions, due to luminol oxidation catalyzed by cytochrome/H2O2, exhibited similar changes with thyroid state supporting the idea that non-enzymatic scavenging was mainly due to hemoprotein action, which produces hydroxyl radicals. Further support was obtained showing that the whole antioxidant capacity, which provides an evaluation of capacity of the systems, different from cytochromes, assigned to H2O2 scavenging, was lower in hyperthyroid than in hypothyroid state. In conclusion, our results show that mitochondria from hyperthyroid liver have a high capacity for H2O2 removal, which, however, leading in great part to more reactive oxygen species, results harmful for such organelles.
Subject(s)
Hydrogen Peroxide/pharmacology , Hyperthyroidism/metabolism , Hypothyroidism/metabolism , Mitochondria, Liver/drug effects , Thyroid Gland/metabolism , Animals , Cell Fractionation , Cytochromes c/metabolism , Glutathione Peroxidase/metabolism , Glutathione Reductase/metabolism , Hepatocytes/drug effects , Hepatocytes/metabolism , Hydroxyl Radical/metabolism , Hyperthyroidism/physiopathology , Hypothyroidism/physiopathology , Liver/metabolism , Malates/metabolism , Male , Mitochondria, Liver/metabolism , Oxidative Phosphorylation/drug effects , Oxidative Stress , Oxygen Consumption/drug effects , Pyruvic Acid/metabolism , Rats , Rats, Wistar , Thyroid Gland/physiopathologyABSTRACT
Dypiridamole is a highly efficient chain breaking antioxidant (Iuliano et al., Free Radic. Biol. Med. 18 (1995) 239-247) with an aromatic ring system responsible for an intense absorption band in the 400-480-nm region and for an intense fluorescence. Dipyridamole fluorescence is quantitatively quenched upon reaction with peroxyl radicals. In the presence of a flux of peroxyl radicals generated by thermal dissociation of azo-initiators, dipyridamole fluorescence decays linearly, showing a first-order reaction with respect to peroxyl radicals, and zero-order with respect to dipyridamole. The pH optimum for the fluorescence quenching is in the 7-8 range, from pH 7 to 6, the decay of fluorescence rapidly decreases to became negligible below pH 5.5. Dipyridamole consumption is blocked in the presence of an added chain breaking antioxidant for a time that is proportional to the antioxidant concentration. This effect is shown for ascorbic acid, trolox, vitamin E, uric acid, and N, N'-diphenyl-p-phenylenediamine. The slope of the linear correlation relative to trolox allows calculation of the bimolecular rate constant for a given molecule and peroxyl radicals. Comparison of data obtained by the dipyridamole consumption are comparable to values obtained by the oxygen consumption method.
