Perfil de mulheres atendidas em hospital de alta complexidade devido a agressão por queimadura pelo parceiro

Objective: To describe the epidemiological profile of women who suffered assault due to burns by their intimate partner and were treated at a referral hospital for trauma emergencies in the State of Minas Gerais, Brazil. Method: This cross-sectional study analyzed the medical records of 19 women who were victims of assault due to burns by their intimate partner from 2016 to 2019in a referral hospital for trauma emergencies in Minas Gerais. Results: Most victims were Brown, married, with children, worked informally, and were assaulted at home. Care included very urgent/orange priority treatment, severe second-degree burns, hospitalization, surgical procedures, complications, and post-discharge outpatient follow-up. Conclusion: Health services must establish mechanisms to track and investigate violence against women, preventing the worsening of their condition and offering adequate support. Professionals must be prepared at all levels of care and use surveillance and promotion strategies.Objetivos: Describir el perfil epidemiológico de mujeres que sufrieron agresión por quemaduras por parte de su pareja íntima, atendidas en un hospital de referencia para trauma, urgencia y emergencia en el Estado de Minas Gerais. Método: Estudio transversal que analizó las historias clínicas de víctimas de agresión por quemaduras corporales por parte de un compañero íntimo de 2016 a 2019. Los datos fueron sometidos a análisis estadístico descriptivo. Resultados: La mediana de edad de las 19 mujeres maltratadas fue de 38 años. La mayoría eran morenas (68,42%), casadas (52,63%), con hijos (73,68%), tenían trabajo informal (47,37%) y sufrían agresiones en el hogar (73,68%). En cuanto a la atención, el nivel de prioridad más frecuente fue muy urgente/naranja (61,54 %), quemadura muy grave de segundo grado (89,47 %), necesidad de hospitalización (94,74 %), procedimiento quirúrgico (78,95 %), con complicaciones (57,89 %). %) y seguimiento ambulatorio posterior al alta (73,68%). Conclusión: Las víctimas fueron graves y demandaron atención especializada y de alta complejidad, con repercusiones posteriores a la quemadura para las mujeres agredidas.Objetivo: Descrever o perfil dos atendimentos a mulheres que foram agredidas pelo parceiro íntimo e sofreram queimaduras em hospital de referência em trauma, urgência e emergência do Estado de Minas Gerais. Método: estudo transversal, que analisou prontuários de 19 mulheres vítimas de agressão por queimadura realizadas pelo parceiro íntimo em um hospital de referência em trauma, urgência e emergência no período de 2016 a 2019. Resultados: A maioria das vítimas era parda, casada, com filhos, trabalhava informalmente e foi agredida na residência. O atendimento incluiu prioridade muito urgente/laranja, queimaduras graves de 2º grau, internação, procedimentos cirúrgicos, complicações e acompanhamento ambulatorial pós-alta. Conclusão: Os resultados indicam atendimentos de alta complexidade, o que implica necessidade de os serviços de saúde estabelecerem mecanismos de rastreamento e investigação da violência contra a mulher, bem como preparo da equipe, prevenindo agravamentos e oferecendo suporte adequado

PREVALENCIA DE PRÁCTICAS DE INTEGRACIÓN Y COMPLEMENTACIÓN EN PACIENTES SOMETIDOS A LA QUIMIOTERAPIA ANTINEOPLÁSICA

Objective: To analyze the prevalence of integrative and complementary practices in patientsundergoing antineoplastic chemotherapy.Method: A quantitative, observational, cross-sectional study was conducted at a ChemotherapyOutpatient Unit of a university hospital in Belo Horizonte, Minas Gerais. The sample consistedof 70 patients with data obtained between October 2017 and May 2018. Data were analyzedusing the SPSS program through descriptive and inferential statistics.Results: The predominant cancers were breast and colon/rectal. The prevalence of integrativepractices was 77.1%, with spirituality being the most used. The funding for the practices waspredominantly not provided by the Brazilian Nation Health System. No associated factorswere found regarding the use of integrative practices.Conclusion: The patients reported benefits of using integrative complementary practices. Itis relevant that nurses know the prevalence of their use and have knowledge to indicate orcontraindicate them, when necessary.Objetivo: analisar a prevalência das práticas integrativas e complementares em pacientes querealizam quimioterapia antineoplásica.Método: estudo quantitativo, observacional, transversal, realizado em um Ambulatório deQuimioterapia de um hospital universitário de Belo Horizonte, Minas Gerais. A amostra foi compostapor 70 pacientes com dados obtidos entre outubro de 2017 e maio de 2018. Os dados foramanalisados no programa Statistical Package for Social Science utilizando-se estatística descritiva einferencial.Resultados: os cânceres predominantes foram mama e cólon e reto. A prevalência de utilização depráticas integrativas foi de 77,1%, sendo a espiritualidade a mais utilizada. O custeio das práticas foipredominantemente não realizado pelo Sistema Único de Saúde. Não foram encontrados fatoresassociados para utilização de práticas integrativas.Conclusão: os pacientes referem benefícios da utilização das práticas integrativas complementares.É relevante que o enfermeiro conheça a prevalência de sua utilização e tenha conhecimento paraindicá-las ou contraindicá-las, quando necessário.Objetivo: analizar la prevalencia de las prácticas de integración y complementación enpacientes de quimioterapia antineoplásica.Método: estudio cuantitativo, observacional, trasversal, que se realizó en un Ambulatorio deQuimioterapia de un hospital universitario de Belo Horizonte, Minas Gerais. La muestra secompuso por 70 pacientes con datos que se obtuvieron entre octubre de 2017 y mayo de2018. Se analizaron los datos por medio del programa Statistical Package for Social Science,utilizándose estadística descriptiva y de inferencia.Resultados: los cánceres predominantes fueron el de mama y colon y recto. La prevalencia deutilización de prácticas integradoras fue de 77,1%, siendo la espiritualidad la más recurrente.El costeo de las prácticas no fue predominantemente realizado por el Sistema Único de Salud.No se encontraron factores asociados para utilización de prácticas integradoras.Conclusión: los pacientes refieren beneficios de la utilización de las prácticas integradorascomplementarias. Es relevante que el enfermero conozca la prevalencia de sus usos y tengaconocimiento para proponerlas o no, cuando necesario

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care

Strategies and performance of the CMS silicon tracker alignment during LHC Run 2

The strategies for and the performance of the CMS silicon tracking system alignment during the 2015–2018 data-taking period of the LHC are described. The alignment procedures during and after data taking are explained. Alignment scenarios are also derived for use in the simulation of the detector response. Systematic effects, related to intrinsic symmetries of the alignment task or to external constraints, are discussed and illustrated for different scenarios

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.Results: A total of 3288 patients were included in the analysis, of whom 301 (9.2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0.001). There were no significant differences in rates of readmission between these groups (6.6 versus 8.0 per cent; P = 0.499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0.90, 95 per cent c.i. 0.55 to 1.46; P = 0.659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34.7 versus 39.5 per cent; major 3.3 versus 3.4 per cent; P = 0.110).Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56–1.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine