ABSTRACT
BACKGROUND: Congenital syndrome of Zika virus (CSZV) is associated with neuromotor and cognitive developmental disorders, limiting the independence and autonomy of affected children and high susceptibility to complications, so palliative care needs to be discussed and applied. AIM: To identify factors associated with emergency visits and hospitalizations of patients with CSZV and clinical interventions performed from the perspective of palliative care. DESIGN: This is a cross-sectional study with bidirectional longitudinal component. Data were collected between May and October 2017 through the review of medical records and interviews with relatives of patients hospitalized. SETTING/PARTICIPANTS: The study was developed in a tertiary care hospital involving patients with confirmed CSZV born as of August 2015 and followed up until October 2017. Patients under investigation were excluded. RESULTS: 145 patients were followed up at the specialized outpatient clinic, 92 (63.5%) were consulted at least once in the emergency room, and 49% had already been hospitalized, with the main reason being neurological causes, while 24.1% had never required any emergency visit or hospitalization. No risk factors were associated with the occurrence of consultations or hospitalizations. Such events happened at an early age and were accompanied by a high number of invasive procedures and interventions. An approach in palliative care was only identified in two hospitalized patients. CONCLUSIONS: For the patient with known severe malformations caused by congenital infection by the Zika virus with indication of palliative care, this approach could be used in order to allow life without suffering and disproportionate invasive method.
ABSTRACT
Objetivo: perquirir acerca da regulamentação das relações de trabalho na enfermagem e refletir sobre os aspectos jurídicos de sua jornada de trabalho. Metodologia: trata-se de um estudo reflexivo, que analisou as relações de trabalho da equipe de enfermagem com foco em sua jornada de trabalho, com um olhar direcionado aos aspectos jurídicos que envolvem a temática. Resultados: a equipe de enfermagem não dispõe de proteção legal específica acerca de sua jornada de trabalho, apesar de desenvolver um trabalho essencial à vida e de estar presente na quase totalidade das instituições de saúde. A população tem direito de ser atendida por profissionais competentes e saudáveis, tendo em vista que a assistência segura e de qualidade, além de moralmente requerida, é mais econômica, pois evita danos e reduz ações judiciais contra os serviços de saúde. Para tanto surge a discussão sobre o Projeto de Lei 2.295/2000, que defende carga horária de 30 horas semanais, refletindo uma conquista histórica da classe de enfermagem, que se fundamenta em aspectos biológicos, sociais e econômicos. Conclusão: a redução da jornada de trabalho permite a prestação de uma assistência mais segura e representa nada mais que a concretização do arcabouço jurídico protecionista vigente.
Objective: to assert concerning the regulation of labor relations in nursing and to reflect on the legal aspects of working in nursing. Methodology: this is a reflective study that examined the working relationships of the nursing staff to focus on its workday with targeted legal aspects involving the theme. Results: the nursing staff has no specific legal protection about its workday, while developing essential work to life and to be present in almost all health institutions. The population is entitled to be served by healthy and competent professionals, in order that safe and quality care, and morally required, it is more economical because it prevents damage and reduces lawsuits against health services. For this discussion on the Draft Law 2295 /2000, which advocates a workload of 30 hours per week, reflecting a historic conquest of the nursing class, which it is based on biological, social and economic aspects. Conclusion: the reduction in working hours allows the provision of a safer care and represents nothing more than the realization of the current protectionist legal framework.
Subject(s)
Humans , Nursing , Work Hours , Occupational HealthABSTRACT
UNLABELLED: The HLAMatchmaker algorithm, which allows the identification of "safe" acceptable mismatches (AMMs) for recipients of solid organ and cell allografts, is rarely used in part due to the difficulty in using it in the current Excel format. The automation of this algorithm may universalize its use to benefit the allocation of allografts. Recently, we have developed a new software called EpHLA, which is the first computer program automating the use of the HLAMatchmaker algorithm. Herein, we present the experimental validation of the EpHLA program by showing the time efficiency and the quality of operation. The same results, obtained by a single antigen bead assay with sera from 10 sensitized patients waiting for kidney transplants, were analyzed either by conventional HLAMatchmaker or by automated EpHLA method. Users testing these two methods were asked to record: (i) time required for completion of the analysis (in minutes); (ii) number of eplets obtained for class I and class II HLA molecules; (iii) categorization of eplets as reactive or non-reactive based on the MFI cutoff value; and (iv) determination of AMMs based on eplets' reactivities. We showed that although both methods had similar accuracy, the automated EpHLA method was over 8 times faster in comparison to the conventional HLAMatchmaker method. In particular the EpHLA software was faster and more reliable but equally accurate as the conventional method to define AMMs for allografts. CONCLUSION: The EpHLA software is an accurate and quick method for the identification of AMMs and thus it may be a very useful tool in the decision-making process of organ allocation for highly sensitized patients as well as in many other applications.
