Distribuição da mortalidade materna no estado da paraíba no período de 2007 a 2016

Backgrounds and Objectives: to evaluate the distribution of maternal mortality in the state of Paraíba from 2007 to 2016. Methods: a documental and quantitative research, with secondary data obtained from the online database and free access to the Mortality Information System . The population was composed of women of childbearing age living in the state of Paraíba, who died of maternal death in the period 2007 to 2016. The data were analyzed by descriptive statistics and compared with the literature pertinent to the subject studied. Results: There were 324 deaths, with a higher prevalence during pregnancy, delivery or abortion up to 42 days postpartum (74.3%) and among women aged between 30 and 39 years (78.4%), with schooling ignored (48.8%) and single marital status (36.4%), where death resulted from direct causes (78.7%), with predominance of deaths in the microregions of João Pessoa and Campina Grande. Conclusion: the maternal mortality profile has been receiving special attention in the state of Paraíba, due to the presence of high maternal mortality ratios, accompanied by preventable causes in the majority of cases.Justificatión y objetivos: evaluar la distribución de la mortalidad materna en el estado de Paraíba en el período de 2007 a 2016. Método: investigación del tipo documental y cuantitativa, realizada con datos secundarios obtenidos de la base de datos online y de acceso libre del Sistema de Información sobre Mortalidad . La población fue compuesta por mujeres en edad fértil residentes en el estado de Paraíba, que murieron por muerte materna en el período de 2007 a 2016. Los datos fueron analizados por estadística descriptiva y confrontados con la literatura pertinente al tema estudiado. Resultados: ocurrieron 324 muertes, con mayor predominio durante el embarazo, el parto o el aborto hasta 42 días de puerperio (74,3%), en mujeres en el grupo de edad entre 30 y 39 años (74,4%), con escolaridad ignorada (48,8%) y de estado civil soltera (36,4%), en que el óbito resultó de causas directas (78,7%), de color / raza parda (74,4%), destacándose los síndromes hipertensivos específicos del embarazo (27,5%), con predominio de muertes en las microrregiones de João Pessoa y Campina Grande . Conclusión: el perfil de mortalidad materna viene mereciendo atención especial en el Estado de Paraíba, debido a la presencia de los altos valores de razón de la mortalidad materna, acompañados de causas evitables en la mayoría de los casos.Justificativa e Objetivos: avaliar a distribuição da mortalidade materna no estado da Paraíba no período de 2007 a 2016. Métodos: pesquisa do tipo documental e quantitativa, realizada com dados secundários obtidos a partir do banco de dados online e de acesso livre do Sistema de Informações sobre Mortalidade. A população foi composta por mulheres em idade fértil residentes no estado da Paraíba, que foram a óbito por morte materna no período de 2007 a 2016. Os dados foram analisados por estatística descritiva e confrontados com a literatura pertinente ao tema estudado. Resultados: ocorreram 324 óbitos, com maior predomínio durante a gravidez, o parto ou o aborto até 42 dias de puerpério (74,3%), mulheres na faixa etária entre 30 e 39 anos (41%), de cor/raça parda (74,4%), com escolaridade ignorada (48,8%) e de estado civil solteira (36,4%), em que o óbito resultou de causas diretas (78,7%), destacando-se as síndromes hipertensivas específicas da gravidez (27,5%), com predominância de mortes nas microrregiões de João Pessoa e Campina Grande. Conclusão: o perfil de mortalidade materna vem merecendo atenção especial no Estado da Paraíba, devido á presença dos altos valores de razão da mortalidade materna, acompanhados de causas evitáveis na maioria dos casos

Incidence of urinary retention in a tertiary post operative hospital

Patients in the immediate post-operative period have several clinical features and when they are admitted in the post-anesthetic recovery room the signs and symptoms that affect the patient physically and psychologically resulting of surgical procedures begin to emerge. Urinary retention occurs frequently in these patients, as some anesthetics contribute to the development of this clinical condition. This research aims to analyze the incidence of urinary retention after surgery of patients of various specialties, correlating the type of anesthesia and the need for urinary catheterization. This study is characterized as exploratory, descriptive, with quantitative approach and was performed in a hospital of high complexity in Juazeiro do Norte. The sample was composed of the patients admitted to the post-anesthetic recovery room and during that time they presented urinary retention. Data analysis was demonstrated by the tables relating to the literature. The study contributed to the growth of scientific knowledge for hospital staff under study, as there were a large number of species records about urinary retention of patients undergoing surgical procedures that were admitted to the patient unit, especially in surgical units. That worried the nursing staff on the efficiency of systematization so there was an improvement in the quality of care, as many times, such deductions were accompanied by distension and suprapubic pain. Through these results, we could identify some interventions that have contributed to solve this nursing diagnosis, involving the whole multidisciplinary team and ensure the patient unit staff understood holistically the issues involved in this clinical condition and to be more involved in this process

Aneurysmal Bone Cyst of the Zygomatic Arch Causing Limited Mouth Opening

The Aneurysmal Bone Cyst (ABC) is an expansive osteolytic, radiolucent, multilocular, excentric, origin-dismissed lesion consisting of spaces filled with blood in any segment of the skeleton, being most frequently encountered in the diaphysis of the long bones or spinal cord. It may occur as distinct clinic-pathologic entity or as pathophysiologic alteration of a preexisting lesion, like giant-cells lesion, fibrous dysplasia, ossifying fibroma, osteoblastoma, epiphysary chondroblastoma and even malignant lesions as osteossarcoma. This paper reports a rare case of ABC in the zygomatic arch of a young female patient who presented facial asymmetry and progressive limitant mouth opening, treated by ressective surgical procedure and discusses the clinical, imaginological, histological and treatment features of this pathology.Â

The Team Of The Family Health Strategy And The Doctrinal Principles Of The Unified Health System: Perceptions And Applicability

Introduction: The SUS, which was guaranteed by the Brazilian Constitution of 1988 and regulated by organic laws of health, offers a system governed of doctrinal principles (universality, fairness and completeness) concerning the philosophy of the system and extend the concept of health and the right to it. On the promotion of these principles, the municipalization of health is referred to as a policy of decentralization which incorporates basic health attention, permeated by the principles of the SUS, where inserts in this context the basic health units (UBS) that are entrance doors of the population to the system. When considering that the proposals brought by the family health strategy (FHS) are great potential to restructure the welfare model and the Organization of health services, and these proposals based on the principles governing the SUS, becomes essential, inter alia, that the worker member of this team have involvement and knowledge of the project, as well as on its goals and principles governing it. Objective: Check the knowledge and promotion of doctrinal principles of the SUS by active team of FHS in the town of Juazeiro do Norte in the State of Ceará (CE), Brazil.  Method: This work deals with a transversal nature study exploratory, qualitative approach. The survey was conducted in the family health strategy of the city of Juazeiro do Norte-CE, with top level professionals (physician, nurses and dentists) who work on units during the collection period. The collection was performed through a semi structured interview and the data analyzed by means of the collective subject discourse. This study was submitted to the Ethics Committee of the College Lion Sa, having the opinion of approved (nº: 1.067.638).  Results: the results showed that the professionals have demonstrated no knowledge of, nor promote some doctrinal principles of the SUS coherently. The knowledge that they have are fragmented and incipient, and Praxis (theory combined with practice) is still far from being achieved.  Conclusion: The findings of this research show gaps as the promotion of the principles of the SUS by professionals who act. The ineffective knowledge on how SUS is organized and on what basis rests, leads to improper practices, making deployment and consolidation process.   Keywords: Doctrinal Principles of the SUS. Unified health system. The family health strategy

General anesthetics in children: neurotoxic or neuroprotective?

Introduction: general anesthetics are involved in neuroprotection in adults after ischemic events and cognitive impairment, thus, they also may be associated with learning disorders in children exposed to them before three years of age. Objective: Describe about the neurotoxic effects of general anesthetics in experimental animals and children. Method: This is a systematic review, performed from search in databases and on PubMed using the keywords "neurotoxicity" and "general anesthetics," and "general anesthetics," "neurotoxicity", "children", "young child "and" pediatric ". Results: The search resulted in 185 articles. Out of these, 78 met our inclusion criteria. We found that there was a significant evidence of neurotoxicity induced by general anesthetics in experimental animals that were just born, resulting in late and permanent cognitive deficits. This effect was associated with multiple exposures, exposure length of time and combination of drugs. However, some studies found cognitive impairment after a single exposure to anesthetic. Conclusion: There is insufficient evidence to state that general anesthetics are neurotoxic and have the potential to trigger learning and behavior disabilities in children. However, we suggest caution in indicating surgery in children under three years old, analyzing risk-benefit and inserting the family in the decision process.   Keywords: Neurotoxicity; Neuroprotection; Cognitive Impairment; Children; General Anesthesics     &nbsp

ESTRESSE E USO DE ÁLCOOL EM ENFERMEIROS QUE TRABALHAM EM URGÊNCIA E EMERGÊNCIA

A Qualidade de vida no trabalho parece estar cada vez mais prejudicada, em função de mudanças por que tem passado o mundo nos tempos atuais. Nesse sentido, nosso trabalho procurou identificar parâmetros da Qualidade de Vida dos Profissionais de Enfermagem do Município de Cajazeiras-PB. Diversos são os fatores e as responsabilidades que recaem sobre o profissional da saúde, principalmente os que trabalham em urgência e emergência, muitos dos quais fogem ao seu controle. A metodologia utilizada foi a quantitativa, correlacional, do tipo ex post facto. Os sintomas psicológicos mais apontados foram problemas com a memória, insônia e pensamento recorrente. Além disso, 21,9% faz uso de risco quanto ao álcool e 15,6% dos sujeitos apresentaram nível de estresse na fase II – Exaustão. Portanto, a preocupação com a qualidade de vida dos profissionais da enfermagem, se apresenta como de extrema relevância, pois são nas mãos desses profissionais que nos deparamos com o limite entre a sobrevivência ou não, nas mais críticas situações humanas.(http://dx.doi.org/10.14295/cad.cult.cienc.v13i2.845

Monitoring the Suspension of Surgical Procedures

Introduction: A surgical suspension generates a series of hassles and dissatisfaction of the patient and his family. Preparations for surgery involve an entire remodeling of the professional, social and family schedule, as well as other factors such as expectations regarding the results and the fear of the unknown. Objective: A quantification and identification of the reasons for surgical cancellations was realized for a better understanding and guidance to the leadership team's actions on this issue. Thus, their monitoring is important in the search for actions to make the surgery center´s processes more effective, favoring possibilities for improvement in the quality of hospital services. This way, the objective of this research was to identify the main causes for the cancellations of surgical procedures. Method: Study of documentary and retrospective type, quantitative, performed in the surgical center of a hospital in the city of Juazeiro do Norte, CE, Brazil. Data collection was performed through digital files of the 'syshosp' system used to record performed and suspended surgical procedures. Data were collected from January to December 2014 and analyzed using simplified statistics and presentation through a table. Results: The justifications for cancellation of procedures related to the organizational aspects of the institution were highlighted as main reasons for surgical suspension:  the priority for urgency, lack of material resources / equipment required for the surgical procedure and no hospitalization of surgical patients. There were also those related to the lack of staff, being most of them because of the surgeon's inability to attend and absence of anesthesiologist causing the impossibility of building the surgical team. Finally, the suspensions regarding priority for emergencies are highlighted. It was observed that the main determinants for surgical suspensions were those related to the organization of the hospital, with a total of 267 (51.1%), standing out among these: technical problems (16.1%), no admission (42, 3%), lack of material (13.5%) and the priority for urgency (21%). Discussion: The Brazilian Ministry of Health (Ministério da Saúde) defines the surgery suspension rate by the number of suspended surgeries divided by the total of scheduled surgeries in a given period and multiplied by 1003. During the studied period, there were 6591 scheduled surgeries 6069 surgeries were performed and there were 522 suspensions. Thus, the overall average rate of suspension obtained was 7.9%. Compared to other studies and the goals of the institution (5%), it is clear that this is a high rate, but manageable. Conclusion: It was observed that the suspensions of surgeries must be carefully monitored and analyzed by the entire team involved in order to disseminate this indicator and its possible consequences to all. The process of identification of consequences is still weak and needs to be strengthened to an effective action plan. It was revealed that the main cause of surgical cancellations during the surveyed year was related to the organization of the hospital, emphasizing the importance of updating the interaction of processes with the sectors that influence this indicator and preparation of strategic planning with everybody´s involvement so you can minimize the data, as it directly affect the patient, professionals and the hospital, resulting from the patient´s dissatisfaction to the longer permanency of the patient in hospital

Video laryngoscopy as a device for removal of foreign body in the laryngopharynx

Background: Foreign bodies in the hypo pharynx unusually present needle stick nature, and not tend to perforate the mucosa. The most common in this region are described EC spines of fish, but a wide variety of objects have been found. In this case were rice husk (oryza sativa). The following  case report describe the foreign body removing with devices usually used for intubation.Case report: a female patient, 28 years old, admitted to the emergency HRC with complaints of pain and irritation in the throat (herringbone). Was referred for endoscopy diagnosis of foreign body in the oesophagus and submitted to EDA under general anesthesia without visualizing abnormalities.  Conclusions: video laryngoscopy devices  can be used to remove most foreign body in the hypo pharynx after several attempts by other techniques

PSICOLOGIA DO TRÂNSITO: UMA REVISÃO SISTEMÁTICA

A questão do trânsito hoje é encarada como um problema social. A pressa e a aceleração a que estamos submetidos devido às novas tecnologias, tem impactado o nosso dia-a-dia e nossas atitudes frente ao trânsito. Essas tem sido pouco estudadas, embora a sociedade já demande por conhecimentos mais sistematizados nesta área. Há ainda muita ambivalência quanto ao que é certo ou errado em termos de  direitos e deveres de cada um e, quanto às regulamentações pertinentes. O presente estudo se propôs a uma revisão sistemática da literatura sobre Psicologia do Trânsito de 2004 a 2013. Envolveu 23 artigos, selecionados de maneira aleatória nas bases de dados Scielo, BVS e PubMed, utilizando-se as palavras-chave: psicologia do trânsito, violência no trânsito, condutores, direção perigosa, motoristas, motociclistas, volante. De uma maneira geral, os resultados foram dispostos em 4 categorias de assuntos tratados nos artigos selecionados: 1) Avaliação psicológica (8 artigos – 34,8%); 2)Violência no trânsito (2 artigos – 8,7%); 3) Políticas públicas (4 artigos – 17,4%); 4) Comportamento do condutor (9 artigos – 39,1%). Os estudos demonstraram que a produção científica na área da Psicologia do Trânsito no Brasil, ainda é bastante incipiente. Os resultados demonstraram a necessidade de fortalecimento de políticas públicas de trânsito. Também que é necessária a promoção de uma maior visibilidade dos trabalhos desenvolvidos pelo Psicólogo do Trânsito, através do compartilhamento de suas experiências em periódicos científicos. Dessa forma, colaborando para a atualização da temática e embasando a execução de políticas públicas para o setor.  Também que há necessidade de fortalecimento de políticas públicas de trânsito. Para isso é imprescindível que os psicólogos se façam mais presentes na criação e fortalecimento de associações científicas e profissionais de Psicologia do trânsito, como importantes espaços de interlocução com a sociedade e o Governo Federal. Recomenda-se maior investimento em estudos sobre a validade preditiva dos testes psicológicos utilizados na habilitação de motoristas, de maneira  que se possa estabelecer relações entre desempenhos nos testes e comportamento no trânsito.(http://dx.doi.org/10.14295/cad.cult.cienc.v13i2.850