Educação interprofissional e prática colaborativa na formação em educação física: reflexões de uma experiência na perspectiva da tutoria

This article aims to describe the characteristics of the curricular component “interprofessional health module”, offered to undergraduate health students at the University of Pernambuco (UPE) and to present a report of experiences in tutoring activities, with particular emphasis on the analysis of the Physical Education core scenario. This strategy of interprofessional education and collaborative practice, pioneered in the state, works in two pedagogical moments (concentration and dispersion), providing the student with an understanding of the collaborative work process from the perspective of comprehensiveness and care in network health care. Students from the first period of courses in the health area recognize during the concentration the possibilities of their core activities in articulation with others and have contact with concepts of collective health. During the dispersion, students build and perform interprofessional actions, in an educational institution linked to the family health strategy, and body practices are commonplace strategies. It is noticed that there is a change in attitude about the possibility of acting in the Brazilian Unified Health System (SUS); however, the contents of collective health, including interprofessionality and collaborative practices, must permeate the entire training path in Physical Education, providing the qualification for comprehensiveness. of Attention in SUS.Esse artigo objetiva descrever as características do componente curricular “módulo interprofissional em saúde” oferecido aos estudantes de graduação da área de saúde na Universidade de Pernambuco e apresentar um relato das experiências vivenciadas em atividades de tutoria, com destaque para a análise do cenário do núcleo da educação física. Essa estratégia de educação interprofissional e de prática colaborativa funciona em dois momentos pedagógicos, concentração e dispersão, que possibilitam o estudante entender o processo colaborativo de trabalho na perspectiva da integralidade e do cuidado na atenção à saúde em rede. Durante a concentração, estudantes do primeiro período reconhecem as possibilidades de atuação de seu núcleo em articulação com os demais e têm contato com conceitos da saúde coletiva. Durante a dispersão, os estudantes constroem e executam ações interprofissionais em uma instituição de ensino vinculada à estratégia de saúde da família, sendo as práticas corporais estratégias corriqueiras. Percebe-se que há uma mudança de atitude sobre a possibilidade de atuação no Sistema Único de Saúde (SUS); entretanto, é preciso que os conteúdos da saúde coletiva, inclusive a interprofissionalidade e as práticas colaborativas, perpassem toda a trajetória de formação em educação física, propiciando a qualificação para a integralidade da atenção no SUS

Causes of renal failure in patients with decompensated cirrhosis and its impact in hospital mortality

Background. Renal failure (RF) is reported to occur in 11-49% of the patients with decompensated end-stage liver disease (ESLD) and has been associated with increased mortality, particularly in the occurrence of hepatorenal syndrome (HRS) type 1. Aims. To evaluate the frequency and outcome of RF in patients admitted to the hospital due to decompensated ESLD and to assess the impact of the underlying cause of RF on survival.Material and methods. Four hundred and six patients (65% males, mean age 62 ± 12 years) with decompensated ESLD were evaluated for the occurrence of RF (defined as serum creatinine 3 1.5 mg/mL). The underlying cause of RF was reckoned in each subject and compared to outcome.Results. Renal failure was observed in 39% of the patients at admission and in 10% of the subjects during hospitalization. Mortality was significantly higher in subjects with RF (26 vs. 1%, p < 0.000001). Hypovolemia, bacterial infections, parenchymal kidney diseases and HRS were identified as causes of RF in, respectively, 40, 32, 15 and 12% of the cases. Mortality was significantly higher in those subjects with HRS type 1 and bacterial infections, when compared to other causes of RF.Conclusions. Renal failure occurs in nearly half of the patients with decompensated ESLD. It is most commonly caused by hypovolemia and bacterial infections. Occurrence of RF has an adverse impact in patient survival, particularly in those subjects with bacterial infections and HRS type 1, prone to develop progressive renal dysfunction despite intensive medical care