Sustentabilidade na Saúde – água e seu consumo

A gestão eficiente da água pode ter um impacto considerável na preservação. Recurso natural imprescindível para a sobrevivência, considerado inesgotável vem sendo tratado de maneira pouco cuidadosa por entidades públicas e privadas tornando o recurso escasso, mais escasso ainda. Na área de saúde poucos estudos são divulgados entre nós, dificultando despertar nos dirigentes a necessidade de gerir com maior efetividade o seu consumo. Neste artigo os Hospitais de Ensino certificados no Estado de São Paulo foram monitorados e comparados no consumo de água com levantamento bibliográfico em outros países. Surpreende a quantidade de artigos existentes, o que demonstra que a preocupação existe, obrigando-nos a debater o que acontece entre nós, permitindo que decisões e inovações a respeito sejam tomadas

Consequences of the Prolonged Waiting Time for Patients Candidates for Heart Surgery

OBJECTIVE - To assess mortality and the psychological repercussions of the prolonged waiting time for candidates for heart surgery. METHODS - From July 1999 to May 2000, using a standardized questionnaire, we carried out standardized interviews and semi-structured psychological interviews with 484 patients with coronary heart disease, 121 patients with valvular heart diseases, and 100 patients with congenital heart diseases. RESULTS - The coefficients of mortality (deaths per 100 patients/year) were as follows: patients with coronary heart disease, 5.6; patients with valvular heart diseases, 12.8; and patients with congenital heart diseases, 3.1 (p<0.0001). The survival curve was lower in patients with valvular heart diseases than in patients with coronary heart disease and congenital heart diseases (p<0.001). The accumulated probability of not undergoing surgery was higher in patients with valvular heart diseases than in the other patients (p<0.001), and, among the patients with valvular heart diseases, this probability was higher in females than in males (p<0.01). Several patients experienced intense anxiety and attributed their adaptive problems in the scope of love, professional, and social lives, to not undergoing surgery. CONCLUSION - Mortality was high, and even higher among the patients with valvular heart diseases, with negative psychological and social repercussions