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Background: Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the overproduction of white blood cells, leading to symptoms such as fatigue, infections, and other complications. CML patients must take measures to prevent infections to mitigate the exacerbation of cancer cell proliferation and comorbidities. Methods: This study investigated whether vitamin C can suppress the hyperinflammatory activation of K-562 cells induced by lipopolysaccharide (LPS) and whether purinergic signaling (ATP and P2X7 receptor) and autophagy play a role in it. Two different doses of vitamin C (5 µg/mL and 10 µg/mL) were employed, along with the lysosome inhibitor chloroquine (CQ; 100 µM), administered 2 h prior to LPS stimulation (10 ng/mL) for a duration of 22 h in K-562 cells (3 × 105 cells/mL/well). Results: Both doses of vitamin C reduced the release of interleukin-6 (IL-6) (5 µg/mL, p < 0.01 and 10 µg/mL, p < 0.01) and tumor necrosis factor (TNF) (5 µg/mL, p < 0.01 and 10 µg/mL, p < 0.01) induced by LPS. Furthermore, in LPS + CQ-stimulated cells, vitamin C at a concentration of 10 µg/mL inhibited the expression of LC3-II (p < 0.05). Conversely, both doses of vitamin C led to the release of the anti-inflammatory cytokine interleukin-10 (IL-10) (5 µg/mL, p < 0.01 and 10 µg/mL, p < 0.01), while only the 10 µg/mL dose of vitamin C induced the release of Klotho (10 µg/mL, p < 0.01). In addition, both doses of vitamin C reduced the accumulation of ATP (5 µg/mL, p < 0.01 and 10 µg/mL, p < 0.01) and decreased the expression of the P2X7 receptor at the mRNA level. Conclusions: Vitamin C inhibits the hyperinflammatory state induced by LPS in K-562 cells, primarily by inhibiting the ATP accumulation, P2X7 receptor expression, and autophagy signaling.
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Leucemia Mielógena Crónica BCR-ABL Positiva , Lipopolisacáridos , Humanos , Lipopolisacáridos/farmacología , Ácido Ascórbico/farmacología , Receptores Purinérgicos P2X7 , Autofagia , Adenosina Trifosfato/farmacologíaRESUMEN
Endophytes are considered an essential source of natural products. Skin is the body's largest organ; its primary function is the protection of other organs, and aging is one of the most relevant problems associated with this organ. UV radiation generates reactive oxygen species (ROS), which lead to skin degeneration and consequent aging. The main endogenous antioxidants that neutralize ROS are enzymatic antioxidants such as superoxide dismutase (SOD), catalase, glutathione peroxidase, and glutathione reductase, and non-enzymatic antioxidants, such as glutathione and α-tocopherol. Nuclear receptors are involved in molecular mechanisms that control the aging process, especially peroxisome proliferator-activated receptors (PPAR), which regulate the function and expression of genes that modulate the balance between matrix metalloproteinases (MMP) activity and the expression of collagen. Some natural compounds, such as polyphenols, can activate PPAR and reduce the activation of MMP and collagen degradation. In this work, the antioxidant activity of the mycelia methanolic extracts of two endophytic fungi isolated from leaves of Bauhinia variegata, named BvFV and BvFIX, their action as PPAR agonists, and their effect on the activity of antioxidant defense system enzymes were evaluated. The mycelia methanolic extract of BvFV showed a weak agonist effect on PPARß/δ, a high capability to inhibit lipid peroxidation, increased catalase activity, and increased superoxide dismutase activity by approximately 64%. In contrast, BvFIX increased catalase activity and increased superoxide dismutase activity in a dose-dependent manner, with an increase of 49.62% ± 7.87%, 56.64% ± 12.27%, and 240.46% ± 26.11% at concentrations of 25 µg/mL, 50 µg/mL and 100 µg/mL, respectively, in human dermal fibroblasts submitted to oxidative stress. These results suggest that the metabolites of the mycelia of endophytic fungi studied are promising to act in the chemoprevention of skin aging.
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Background: The World Health Organization (WHO) ethanol-based handrub (EBHR) formulation contains 1.45% glycerol as an emollient to protect healthcare workers' (HCWs) skin against dryness and dermatitis. However, glycerol seems to negatively affect the antimicrobial efficacy of alcohols. In addition, the minimal concentration of glycerol required to protect hands remain unknown. We aim to evaluate the tolerance of HCWs to the WHO EBHR formulation using different concentrations of glycerol in a tropical climate healthcare setting. Methods: We conducted a cluster-randomized, double-blind, crossover study among 40 HCWs from an intensive care unit of a tertiary-care hospital in Brazil, from June 1st to September 30, 2017. We tested the WHO EBHR original formulation containing 1.45% glycerol against three other concentrations (0, 0.5, and 0.75%). HCWs used one formulation at a time for seven working days during their routine practice and then had their hands evaluated by an external observer using the WHO scale for visual inspection. Participants also used a WHO self-evaluation tool to rate their own skin condition. We used a generalized estimating equations of the logit type to compare differences between the tolerability to different formulations. Results: According to the independent observation, participants had 2.4 times (95%CI: 1.12-5.15) more chance of having a skin condition considered good when they used the 0.5% compared to the 1.45% glycerol formulation. For the self-evaluation scale, participants were likely to have a worst evaluation (OR: 0.23, 95%CI: 0.11-0.49) when they used the preparation without glycerol compared to the WHO standard formulation (1.45%), and there were no differences between the other formulations used. Conclusion: In a tropical climate setting, the WHO-modified EBHR formulation containing 0.5% glycerol led to better ratings of skin tolerance than the original formulation, and, therefore, may offer the best balance between skin tolerance and antimicrobial efficacy.
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Etanol/efectos adversos , Glicerol/análisis , Desinfección de las Manos/métodos , Piel/efectos de los fármacos , Adulto , Estudios Cruzados , Método Doble Ciego , Etanol/química , Femenino , Personal de Salud , Humanos , Unidades de Cuidados Intensivos , Masculino , Atención Terciaria de Salud , Clima Tropical , Organización Mundial de la SaludRESUMEN
BACKGROUND: Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a "Train-the-Trainers" (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. METHODS: We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. RESULTS: Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. CONCLUSIONS: The TTT in hand hygiene model proved to be effective in enhancing participant's knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.
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Educación , Higiene de las Manos/métodos , Higiene de las Manos/normas , Control de Infecciones/métodos , Personal de Salud , Humanos , Infecciones , Irán , Malasia , México , Enfermeras y Enfermeros , Médicos , Entrenamiento Simulado , Sudáfrica , España , Encuestas y Cuestionarios , Tailandia , Organización Mundial de la SaludRESUMEN
SUMMARY OBJECTIVE To study depression symptoms' incidence of medical interns (first year of medical residency) and its correlation with occupational characteristics, satisfaction and stress about their training program. METHODS Prospective Cohort Study conducted at Escola Paulista de Medicina, Universidade Federal de São Paulo. First year residents, N = 166, from a teaching hospital were invited to answer the Beck Depression Inventory (BDI) and an occupational questionnaire in a prospective longitudinal study. BDI score variation was related with socio-demographic aspects and occupational characteristics using linear regression models. RESULTS 111 subjects participated (67%); the BDI-score increased in 8 months (mean = 2.75 ± 3.29 vs. 7.00 ± 5.66; p<0.0001). The depressive symptoms' incidence was 9.01% (score>15). BDI-score variation had mean = 4.25 ± 4.93, ranging from -8 to 28. Residents not satisfied with professional training acquired (β = 3.44; p = 0.004), with their personal life (β = 2.97; p = 0.001), or who felt stressed in the relationship with senior residents (β = 2.91; p = 0.015) presented 3 more points of BDI-score after 8 months comparing to those without these perceptions; and being unsatisfied with the nursing team increased BDI-score after 8 months in 2 more points (β = 1.95; p = 0.025). CONCLUSION Among the factors that interfere with depression in interns is the occupational characteristics, which might be enhanced by the training facility. Addressing these dissatisfaction and stressful issues should help the university provide better care of interns' mental health.
RESUMO OBJETIVO Estudar a incidência de sintomas depressivos em residentes de medicina de 10 ano e sua correlação com características ocupacionais, satisfação e estresse no programa. MÉTODOS Coorte prospectivo realizado na Escola Paulista de Medicina, Universidade Federal de São Paulo. Foram convidados 166 médicos residentes do hospital universitário para responder ao Inventário de Depressão Beck (BDI) e a um questionário ocupacional num estudo prospectivo longitudinal. O escore da variação do BDI foi relacionado com aspectos sociodemográficos e características ocupacionais usando um modelo de regressão linear. RESULTADOS Cento e onze sujeitos participaram (67%); o escore do BDI aumentou em oito meses (média = 2,75 ± 3,29 vs. 7,00 ± 5,66; p<0,0001). A incidência dos sintomas depressivos foi de 9,01% (escore>15). A variação do escore do BDI teve média = 4,25 ± 4,93 (de -8 a 28). Residentes não satisfeitos com o treinamento profissional (β = 3,44; p = 0,004), com a vida pessoal (β = 2,97; p = 0,001) ou que se sentem estressados na relação com residentes seniores (β = 2,91; p = 0,015) apresentaram 3 pontos a mais do escore do BDI depois de oito meses em comparação com aqueles sem tais percepções; estar insatisfeito com a equipe de enfermagem aumentou o escore do BDI em 2 pontos (β = 1,95; p = 0,025). CONCLUSÃO Entre os fatores que interferem na depressão em residentes estão as características ocupacionais que podem ser melhoradas no treinamento. Esclarecer tais pontos pode ajudar a instituição a prover um melhor cuidado em saúde mental.
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Humanos , Masculino , Femenino , Adulto , Adulto Joven , Depresión/epidemiología , Estrés Laboral/epidemiología , Internado y Residencia/estadística & datos numéricos , Cuerpo Médico de Hospitales/psicología , Escalas de Valoración Psiquiátrica , Brasil/epidemiología , Modelos Lineales , Incidencia , Estudios Prospectivos , Encuestas y Cuestionarios , Estudios Longitudinales , Salud Laboral/estadística & datos numéricos , Estado Civil , Distribución por Sexo , Estadísticas no Paramétricas , Satisfacción en el TrabajoRESUMEN
OBJECTIVE: To study depression symptoms' incidence of medical interns (first year of medical residency) and its correlation with occupational characteristics, satisfaction and stress about their training program. METHODS: Prospective Cohort Study conducted at Escola Paulista de Medicina, Universidade Federal de São Paulo. First year residents, N = 166, from a teaching hospital were invited to answer the Beck Depression Inventory (BDI) and an occupational questionnaire in a prospective longitudinal study. BDI score variation was related with socio-demographic aspects and occupational characteristics using linear regression models. RESULTS: 111 subjects participated (67%); the BDI-score increased in 8 months (mean = 2.75 ± 3.29 vs. 7.00 ± 5.66; p<0.0001). The depressive symptoms' incidence was 9.01% (score>15). BDI-score variation had mean = 4.25 ± 4.93, ranging from -8 to 28. Residents not satisfied with professional training acquired (ß = 3.44; p = 0.004), with their personal life (ß = 2.97; p = 0.001), or who felt stressed in the relationship with senior residents (ß = 2.91; p = 0.015) presented 3 more points of BDI-score after 8 months comparing to those without these perceptions; and being unsatisfied with the nursing team increased BDI-score after 8 months in 2 more points (ß = 1.95; p = 0.025). CONCLUSION: Among the factors that interfere with depression in interns is the occupational characteristics, which might be enhanced by the training facility. Addressing these dissatisfaction and stressful issues should help the university provide better care of interns' mental health.
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Depresión/epidemiología , Internado y Residencia/estadística & datos numéricos , Cuerpo Médico de Hospitales/psicología , Estrés Laboral/epidemiología , Adulto , Brasil/epidemiología , Femenino , Humanos , Incidencia , Satisfacción en el Trabajo , Modelos Lineales , Estudios Longitudinales , Masculino , Estado Civil , Salud Laboral/estadística & datos numéricos , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Distribución por Sexo , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The aim of this study was to verify the prevalence of bed-sharing and factors associated with this sleeping environment in an urban population in Southern Brazil. This was a cross-sectional nested cohort study with 233 mother-infant pairs selected at the maternity ward of the University Hospital in Porto Alegre. When the infant was 3 and 6 months old, home visits were performed to collect data on bed-sharing and associated variables. The main outcome was the place shared by the mother and infant for sleeping. Variables with p < 0.2 were included in a Poisson regression model. At 3 and 6 months, 31.2% and 28.5% of infants slept with their mothers at night. At 3 months, prevalence was higher for single mothers (PR: 1.56; CI: 1.01-2.39) and mothers sharing the home with the infant's maternal grandmother (PR: 1.70; CI: 1.09-2.65). Prevalence of bed-sharing at 3 months was high and associated with single mothers and sharing the home with the infant's maternal grandmother.
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Lechos/estadística & datos numéricos , Relaciones Madre-Hijo , Sueño , Adulto , Brasil/epidemiología , Lactancia Materna , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Conducta Materna , Prevalencia , Factores Socioeconómicos , Muerte Súbita del Lactante/prevención & control , Población UrbanaRESUMEN
Esse estudo tem o objetivo de verificar a prevalência de coleito de mães e lactentes e fatores associados em população urbana no Sul do Brasil. Trata-se de estudo transversal aninhado em uma coorte de 233 duplas de mãe-filho selecionadas na maternidade do Hospital de Clínicas de Porto Alegre. Quando a criança completava 3 e 6 meses de vida, coletavam-se, em visitas domiciliares, dados sobre prática do coleito e variáveis associadas. O desfecho principal foi o compartilhamento do espaço de dormir entre a criança e sua mãe. Variáveis com p < 0,2 na análise bivariada entraram em modelo de regressão de Poisson. Aos 3 e 6 meses, 31,2 por cento e 28,5 por cento das crianças dormiam junto com suas mães à noite. Aos 3 meses, a prevalência foi maior entre mães sem companheiro (RP: 1,56; IC95 por cento: 1,01-2,39) e em coabitação quando com a avó materna da criança (RP: 1,70; IC95 por cento: 1,09-2,65). A prevalência de coleito aos três meses na população estudada é alta, associando-se à mãe sem companheiro e coabitação com a avó materna.
The aim of this study was to verify the prevalence of bed-sharing and factors associated with this sleeping environment in an urban population in Southern Brazil. This was a cross-sectional nested cohort study with 233 mother-infant pairs selected at the maternity ward of the University Hospital in Porto Alegre. When the infant was 3 and 6 months old, home visits were performed to collect data on bed-sharing and associated variables. The main outcome was the place shared by the mother and infant for sleeping. Variables with p < 0.2 were included in a Poisson regression model. At 3 and 6 months, 31.2 percent and 28.5 percent of infants slept with their mothers at night. At 3 months, prevalence was higher for single mothers (PR: 1.56; CI: 1.01-2.39) and mothers sharing the home with the infant's maternal grandmother (PR: 1.70; CI: 1.09-2.65). Prevalence of bed-sharing at 3 months was high and associated with single mothers and sharing the home with the infant's maternal grandmother.
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Adulto , Femenino , Humanos , Lactante , Masculino , Lechos , Relaciones Madre-Hijo , Sueño , Lactancia Materna , Brasil/epidemiología , Estudios Transversales , Conducta Materna , Prevalencia , Factores Socioeconómicos , Muerte Súbita del Lactante/prevención & control , Población UrbanaRESUMEN
O presente trabalho apresenta o relato de experiências do Serviço de Atenção Psicossocial Integrada em Saúde (SAPIS) nos Programas de Ligação (PROLIG). O SAPIS foi implantado em junho de 2002, no Hospital São Paulo (HSP), com o objetivo de promover uma atenção mais ampla às necessidades gerais e específicas do hospital no que diz respeito aos aspectos psicossociais bem como de reorganizar a inclusão de profissionais de saúde mental nas enfermarias e ambulatórios. Esse estudo tem como objetivo descrever a atuação do psicólogo como profissional de ligação em saúde mental no atendimento às demandas específicas de unidades do HSP. A tarefa do profissional de ligação em saúde mental envolve a assistência psicológica ao paciente e seu familiar assim como o desempenho do papel de especialista em saúde mental junto à equipe multiprofissional. Temos encontrado em nossa prática, no entanto, algumas dificuldades para a implementação e a manutenção de algumas propostas. Concluímos que a atuação do psicólogo como profissional de ligação de saúde mental tem promovido mudanças nos cuidados em saúde nessa instituição, porém ainda exige uma profunda reflexão e maior envolvimento da instituição e de políticas de saúde que viabilizem mudanças estruturais para a construção de uma efetiva prática integral e integrada nessa área.
This paper presents the experience of the Psychosocial Service of Integrated Attention in Health (SAPIS) in a consultation-liaison psychiatry program (called PROLIG). The SAPIS was implemented in June 2002 at the São Paulo Hospital (HSP) to promote a broad attention to general and specific hospital psychosocial needs and also to reorganize the inclusion of mental health professionals in ambulatories and wards. This paper aims at describing the role of psychologists as mental health liaison professionals attending specific demands at these units of HSP. Their task involves providing psychological assistance to the patient and his family, as well as being a mental health specialist to the multi-professional team. Nevertheless, some difficulties have been found to implement and maintain these proposals. Concluding, psychologists as mental health liaison professionals promote changes in the health care offered by this institution; however, a deeper reflection and engagement of this institution as well as an implementation of health care policies are demanded to enable structural changes for the construction of an integral and integrated effective practice.
El presente trabajo presenta el relato de experiencias del Servicio de Atención Psicosocial Integrado en Salud (SAPIS) en los Programas de Conexión (PROLIG). El SAPIS fue implantado en junio de 2002, en el Hospital Sao Paulo (HSP), con el objetivo de promover una atención más amplia a las necesidades generales y específicas del hospital en lo que se refiere a los aspectos psicosociales así como de reorganizar la inclusión de profesionales de salud mental en las enfermerías y ambulatorios. Este estudio tiene como objetivo describir la actuación del psicólogo como profesional de conexión en salud mental en el servicio a las demandas específicas de unidades del HSP. La tarea del profesional de conexión en salud mental implica la asistencia psicológica al paciente y su familiar así como el desempeño del papel de especialista en salud mental junto al equipo multiprofesional. Hemos encontrado en nuestra práctica, sin embargo, algunas dificultades para la implementación y el mantenimiento de algunas propuestas. Concluimos que la actuación del psicólogo como profesional de conexión de salud mental ha promovido cambios en los cuidados en salud en esa institución, sin embargo aún exige una profunda ponderación y mayor implicación de la institución y de políticas de salud que hagan viables los cambios estructurales para la construcción de una efectiva práctica integral e integrada en esa área.
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Humanos , Medicina de la Conducta , Política de Salud , Salud Mental , Servicios de Salud Mental , Atención Dirigida al Paciente , Psicología , Psicología Clínica , Salud PúblicaRESUMEN
O presente trabalho apresenta o relato de experiências do Serviço de Atenção Psicossocial Integrada em Saúde (SAPIS) nos Programas de Ligação (PROLIG). O SAPIS foi implantado em junho de 2002, no Hospital São Paulo (HSP), com o objetivo de promover uma atenção mais ampla às necessidades gerais e específicas do hospital no que diz respeito aos aspectos psicossociais bem como de reorganizar a inclusão de profissionais de saúde mental nas enfermarias e ambulatórios. Esse estudo tem como objetivo descrever a atuação do psicólogo como profissional de ligação em saúde mental no atendimento às demandas específicas de unidades do HSP. A tarefa do profissional de ligação em saúde mental envolve a assistência psicológica ao paciente e seu familiar assim como o desempenho do papel de especialista em saúde mental junto à equipe multiprofissional. Temos encontrado em nossa prática, no entanto, algumas dificuldades para a implementação e a manutenção de algumas propostas. Concluímos que a atuação do psicólogo como profissional de ligação de saúde mental tem promovido mudanças nos cuidados em saúde nessa instituição, porém ainda exige uma profunda reflexão e maior envolvimento da instituição e de políticas de saúde que viabilizem mudanças estruturais para a construção de uma efetiva prática integral e integrada nessa área.(AU)
This paper presents the experience of the Psychosocial Service of Integrated Attention in Health (SAPIS) in a consultation-liaison psychiatry program (called PROLIG). The SAPIS was implemented in June 2002 at the São Paulo Hospital (HSP) to promote a broad attention to general and specific hospital psychosocial needs and also to reorganize the inclusion of mental health professionals in ambulatories and wards. This paper aims at describing the role of psychologists as mental health liaison professionals attending specific demands at these units of HSP. Their task involves providing psychological assistance to the patient and his family, as well as being a mental health specialist to the multi-professional team. Nevertheless, some difficulties have been found to implement and maintain these proposals. Concluding, psychologists as mental health liaison professionals promote changes in the health care offered by this institution; however, a deeper reflection and engagement of this institution as well as an implementation of health care policies are demanded to enable structural changes for the construction of an integral and integrated effective practice.(AU)
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Humanos , Salud Mental , Servicios de Salud Mental , Psicología , Atención Dirigida al Paciente , Medicina de la Conducta , Política de Salud , Salud Pública , Psicología ClínicaRESUMEN
Introdução: A reinternação hospitalar precoce é um indicador de qualidade assistencial. Além de desconforto ao paciente, acarreta ônus ao sistema de saúde, fazendo-se necessária uma avaliação do perfil dos pacientes de maior risco. Objetivo: Definir o perfil dos pacientes com reinternação precoce em um hospital universitário. Metodologia: Seleção de todos pacientes clínicos, cirúrgicos e pediátricos que reinternaram em até 7 dias após alta hospitalar nos meses de janeiro a março de 2007. Resultados: Entre 5363 internações, 135 (3%) adultos e 71 (7%) crianças reinternaram em 7 dias. A maioria dos pacientes eram do sexo masculino, com internação nos últimos 3 meses pelo mesmo diagnóstico. As especialidades com maior taxa de reinternação na população adulta foram medicina interna (9,7%), hematologia (9,1%), cardiologia (5,7%), emergência adulto (5,5%), gastroenterologia (5,2%) e cirurgia geral (2,2%). A maioria das internações adultas se deveu a doenças cardiovasculares (20), gastrintestinais (18), respiratórias (17), neoplásicas (17) e urinárias (13). As comorbidades mais comuns nos adultos foram hipertensão arterial (39%), diabetes (24%), tabagismo (18,5%), insuficiência renal (17%), cardiopatia isquêmica (16%), doença pulmonar obstrutiva crônica (16%) e insuficiência cardíaca (15%). As reinternação pediátricas foram predominantemente na população oncológica (42,4%). A média de comorbidades foi de 2,7 por paciente adulto. Do total das reinternações, 13% das crianças e 5 % dos adultos foram a óbito. Conclusão: Os dados apresentados permitem um melhor conhecimento do perfil de pacientes com reinternação precoce, sendo na sua maioria pacientes portadores de neoplasias e múltiplas comorbidades clínicas, devido ao perfil de pacientes crônicos atendidos na instituição.
Background: Early hospital readmission is an indicator of hospital quality of care. It is important to assess readmission risk factors, as it imposes additional burden on patients, families and high cost to healthcare system. Objectives: To define the characteristics of patients with early readmission to a university hospital. Methods: Selection of all patients readmitted in 7 days after hospital discharge from January to March of 2007. Results: All 5363 patients admitted were assessed. 135 (3%) adults and 71 (7%) children were readmitted in 7 days. Most of them were males, with previous admission in the last 3 months with the same diagnosis. Specialities with most common readmission tax in adults were internal medicine (9.7%), hematology (9%), cardiology (5.7%), adult emergency (5.5%), gastroenterology (5%) and general surgery (2.2%). Main causes of adult readmissions were cardiovascular disease (20), gastrintestinal disease (18), respiratory disease (17), cancer (17) and urinary tract disease (13). Most common co-morbidities in adults were hypertension (39%), diabetes (24%), smoke (18.5%), renal failure (17%), ischemic heart disease (16%), chronic obstructive lung disease (16%) and heart failure (15%). Pediatric readmissions were mainly on oncology population (42.4%). Adults had co-morbidities rate of 2.7. Thirteen percent of children and 5 % of adults died during readmission. Conclusions: Patients characteristics may identify those at higher risk of early readmission. Most of them had multiple medical co-morbidities or had oncologic diagnosis. These findings reflect the chronic condition of patients admitted to our institution.
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Humanos , Masculino , Lactante , Preescolar , Niño , Indicadores de Calidad de la Atención de Salud , Readmisión del Paciente/normas , Evaluación de Procesos y Resultados en Atención de Salud/métodos , Atención HospitalariaRESUMEN
Foram analisadas as condiçöes de oclusäo de 141 crianças do subúrbio ferroviário de Salvador/BA, de ambos os sexos, no período intertransitório da dentadura mista. A prevalência de má oclusöes foi alta (71 por cento) e a condiçäo mais presente foi o apinhamento dentário e mordida aberta, esta última fortemente associada a hábitos deletérios. A idade do período intertransitório também foi considerada baixa e a associaçäo à perda precoce da dentiçäo decídua com esta, e com as oclusopatias, reforçam a importância de intervençäo precoce nestas crianças para evitar maiores danos à saúde bucal
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Humanos , Masculino , Femenino , Niño , Estudios Transversales , Dentición Mixta , Maloclusión/epidemiología , Maloclusión/etiología , PrevalenciaRESUMEN
A cárie dental é o principal problema de saúde bucal que acomete a população brasileira. Levantamentos epidemiológicos e progamas de educação e prevenção vem sendo desenvolvidos no intuito de mensurar e reduzir os índices de cárie. A proposta deste estudo foi, através de um levantamento epidemiológico, conhecer a condição de saúde bucal dos alunos de uma escola pública localizada no subúrbio de Salvador, e a partir dos resultados desenvolver um trabalho de redução da doença, trabalhando na dimensão epidemiológica do conceito de risco. Para os exames foram utilizados os índices CPO-S e ceo-d, seguindo-se os critérios da OMS. Foi utilizado também o índice Medi-Med nos seus componentes Dente (D), Gengiva (G) e Mente (M) seguindo os critérios: dente, gengiva e mente doentes ou sadios. Os altos índices encontrados demonstraram que esta comunidade possui uma alta prevalência e ausência de controle da doença cárie, tomando evidente a necessidade de desenvolver um Programa de Saúde e Prevenção dentro de uma perspectiva integral de saúde bucal
Asunto(s)
Humanos , Masculino , Femenino , Niño , Caries Dental/epidemiología , Salud BucalRESUMEN
Devido a grande demanda de crianças que procuram atendimento odontológico na clínica de odontopediatria da FOUFBA, há 4 anos foi criado um curso de urgência dentro da disciplina, com a finalidade de atender essas crianças com queixa de dor, trauma, etc, e que não conseguiram vaga para tratamento clínico, uma vez que a capacidade de absorção dessa demanda encontra-se bastante limitada. Este estudo mostra a realidade deste serviço, analisando a prevalência da queixa principal, diagnóstico e procedimentos, considerando ainda a idade e o sexo dos pacientes