46 research outputs found

    BANHO NO LEITO EM CUIDADOS CRÍTICOS: UMA REVISÃO INTEGRATIVA

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    Objetivo: analisar as produções científicas sobre o banho no leito de pacientes adultos em cuidados críticos. Método: revisão integrativa da literatura realizada em 2016 nas bases de dados CINAHL, PubMed, Scopus, LILACS e Web of Science, utilizando os descritores baths, critical care, com o operador booleano and. Resultados: foram incluídos 21 artigos. As publicações tiveram como foco: relacionar o banho no leito com a prevenção e o controle de Infecções Associadas aos Cuidados de Saúde, e descrever e avaliar o procedimento do banho no leito. Conclusão: há lacunas de conhecimento na literatura acerca da melhor técnica de banho no leito, mas a produção científica demonstra que esse procedimento pode provocar alterações nos parâmetros fisiológicos em pacientes adultos em cuidados críticos.Descritores: Banhos. Cuidados críticos. Enfermagem. Unidades de Terapia Intensiva

    Carga de trabalho da enfermagem requerida por pacientes durante internação numa UTI: estudo de coorte

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    Objective: To identify the nursing workload required by adult patients during hospitalization in an Intensive Care Unit (ICU) and in relation to the clinical outcome.Methods: Prospective cohort with 53 patients admitted to an adult ICU between July and September 2018. The Nursing Activities Score (NAS) was used for data collection. Descriptive and inferential statistics were used to compare means. The value of p < 0.05 was considered significant. This study was approved by the Research Ethics Committee (Opinion 2,014,344).Results: There was a predominance of female patients (28 - 52.83%), aged between 17 and 96 years, from the urgency/emergency service (34 - 65.38%), and admitted due to diseases of the circulatory system (18 - 33.96%). The severity of patients according to the SAPS 3 score was 52.32 points and the estimated mortality was of 25.34%. The length of hospital stay ranged from 2 to 38 days and discharge prevailed among the outcomes (39 - 73.58%). The average NAS was 57.41%, equivalent to 13.78 hours of nursing care in a 24-hour period. The average nursing workload at admission was higher than the average measured at the time of clinical outcome (p < 0.001). Patients who died during hospitalization had an average NAS higher than that of patients who survived (p = 0.022).Conclusions: The nursing workload varied over the hospitalization period, being greater on the first day of hospitalization and in the care of patients with a poor prognosis (death).Objetivo: Identificar la carga de trabajo de enfermería requerida por pacientes adultos durante su estadía en una UCI y en relación con el desenlace clínico.Métodos: Estudio de cohorte prospectivo realizado con 53 pacientes hospitalizados en una UCI de adultos entre julio y septiembre de 2018. Se utilizó el Nursing Activities Score (NAS) para la recopilación de datos. Se emplearon estadísticas descriptivas e inferenciales para comparar los promedios. Se consideró el valor de p<0,05 como significativo. Este estudio fue aprobado por el Comité de Ética en Investigación (Opinión 2.014.344). Resultados: Hubo un predominio de pacientes del género femenino (28-52,83%), con edades comprendidas entre 17 y 96 años, procedentes del servicio de urgencia/emergencia (34-65,38%), debido a enfermedades del sistema circulatorio (18-33,96%). La severidad promedio por el SAPS 3 fue de 52,32 puntos y la estimación de mortalidad fue de 25,34%. La duración de la estancia hospitalaria osciló entre 2 y 38 días y prevaleció el alta de los pacientes (39-73,58%). El promedio de NAS fue de 57,41%, equivalente a 13,78 horas de atención de enfermería, durante un período de 24 horas. La carga de trabajo de enfermería promedio al momento de la entrada fue mayor que el promedio medido al momento del desenlace clínico (p<0,001). Los pacientes que progresaron a la muerte durante la hospitalización tuvieron un puntaje NAS promedio más alto que el de los pacientes que sobrevivieron (p=0,022).Conclusiones: La carga de trabajo de enfermería osciló durante el período de estancia hospitalaria, siendo mayor el primer día de hospitalización y en la atención de pacientes con un pronóstico reservado (muerte).Objetivo: Identificar a carga de trabalho da enfermagem requerida por pacientes adultos durante a internação em uma UTI e em relação ao desfecho clínico. Métodos: Coorte prospectiva realizada com 53 pacientes internados em uma UTI de adultos entre julho e setembro de 2018. Utilizou-se o Nursing Activities Score (NAS) para a coleta de dados. Realizou-se a estatística descritiva e inferencial para comparação de médias. Considerou-se como significativo o valor de p <0,05. Este estudo obteve foi aprovado pelo Comitê de Ética em Pesquisa (Parecer 2.014.344). Resultados: Houve predomínio de pacientes do sexo feminino (28 – 52,83%), com idade entre 17 e 96 anos, proveniente do serviço de urgência/emergência (34 – 65,38%), devido a doenças do aparelho circulatório (18 – 33,96%). A gravidade pelo SAPS 3 média foi de 52,32 pontos e estimativa de mortalidade de 25,34%. O tempo de internação variou de 2 a 38 dias e a alta dos pacientes prevaleceu (39 - 73,58%). A média do NAS foi de 57,41%, equivalendo-se a 13,78 horas de assistência de enfermagem, no período de 24 horas. A média da carga de trabalho da enfermagem no momento da admissão foi maior que a média mensurada no momento do desfecho clínico (p<0,001). Os pacientes que evoluíram para o óbito durante a internação apresentaram uma pontuação média no score NAS superior à dos pacientes que sobreviveram (p=0,022). Conclusões: A carga de trabalho da enfermagem variou ao longo do período de internação sendo maior no primeiro dia de internação e no cuidado dos pacientes com prognóstico reservado (óbito)

    EFFECTIVENESS OF AN EDUCATIONAL INTERVENTION FOR THE PREVENTION OF PERIPHERAL VENOUS CATHETER COMPLICATIONS

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    Objective: To evaluate the effectiveness of an evidence-based practice educational intervention in preventing peripheral venous catheter complications.Method: observational study with educational intervention for nursing professionals of a hospital in Minas Gerais, Brazil, about flushing, push-pause and locking techniques. Convenience sampling: 181 catheters in the pre-intervention group and 157 in the post-intervention group. The incidence of complications was evaluated and compared by the Chi-square and Fisher's exact tests.Results: the incidence of complications in the post-intervention group was: 4.5% for obstruction (p=0.000), 10.8% for accidental removal (p=0.265) and 1.9% for phlebitis (p=0.847). The use of the flushing, push-pause and locking techniques resulted in a significant reduction in the incidence of obstruction.Conclusion: the educational intervention enabled updated knowledge and the implementation of flushing, push-pause and locking in nursing practices. The study is a contribution to nursing intervention planning to reduce the occurrence of obstruction

    Hospitalizations and deaths of children and adolescents with Severe Acute Respiratory Infection due to COVID-19 during the epidemiological year of 2020

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    This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of children and adolescents with severe acute respiratory infection (SARI) caused by SARS-CoV-2 nationwide. The study comprised 6,843 children and adolescents hospitalized in 2020 who tested positive for COVID-19, based on data from the Influenza Epidemiological Surveillance Information System. Sociodemographic and clinical profiles, hospitalization frequency, lethality and recovery rates were analyzed. The outcome was recovery or death. The 6,843 children and adolescents comprised 1.9% of SARI hospitalized cases (n = 563,051). Of these, 57.7% developed critical SARI and 90% survived. Comorbidities were present in 40.8%, especially asthma, immunodepression, and neurological and cardiovascular diseases. The main symptoms were fever, cough, dyspnea, respiratory distress, and low oxygen saturation. Among those with critical SARI, 91.4% died. There was a higher frequency of children, especially those under five years of age and of mixed ethnicity. The highest hospitalization frequency occurred in the Southeastern and Northeastern regions, the highest recovery rates in the Southeastern and Southern regions, and the highest lethality rates in the Northern and Northeastern regions. Deaths were associated with ages ranging from 12 to 19 and being under one year of age, living in the Northern and Northeastern regions, progression to critical SARI, and having immunosuppression and cardiovascular disease. In contrast, asthma was associated with lower death rates. The frequency of complications and mortality rates caused by SARS-Cov-2 in the pediatric population are relevant, as well as the severity of the epidemic in the social inequality context and the health services’ frailty

    Percepção de pessoas com hipertensão arterial sobre aspectos que influenciam a adesão ao tratamento

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    Objective: to describe the perception of people with arterial hypertension of the aspects that facilitate and hinder treatment adherence. Method: descriptive qualitative study developed with 16 people met in Nursing consultations. Interviews were conducted with a semi-structured guide and the content analysis technique was used. Data were collected between January and August 2017. Results: having willpower, family and multidisciplinary support, knowledge about the pathology and forms of prevention and fear of death facilitated adherence; on the other hand, little knowledge, laziness, lack of urban infrastructure and climatic conditions, habit of consuming unhealthy foods, alcoholic beverages and tobacco, cost of treatment and forgetfulness of taking the medication hindered adherence. Conclusion: the treatment of hypertension causes changes in the dynamics of life, being essential to have willpower, family and professional support, in addition to overcoming unhealthy habits.Objetivo: descrever a percepção de pessoas com hipertensão arterial sobre os aspectos que facilitam e dificultam a adesão ao tratamento. Método: estudo qualitativo descritivo desenvolvido com 16 pessoas atendidas em consultas de enfermagem. Realizaram-se entrevistas com roteiro semiestruturado e utilizou-se a técnica de análise de conteúdo. Os dados foram coletados entre os meses de janeiro e agosto de 2017. Resultados: observou-se que ter força de vontade, apoio familiar e multiprofissional, conhecimento sobre a patologia e formas de prevenção e medo da morte facilitou a adesão; por outro lado, pouco conhecimento, preguiça, falta de infraestrutura urbana e condições climáticas, hábito de consumir alimentos não saudáveis, bebidas alcoólicas e tabaco, custo do tratamento e esquecimento de tomar a medicação dificultaram a adesão. Conclusão: o tratamento da hipertensão acarreta mudanças na dinâmica da vida para as quais é fundamental ter força de vontade, apoio familiar e profissional, além de superar hábitos não saudáveis

    INTERNAÇÕES HOSPITALARES E MORTALIDADE POR SÍNDROME RESPIRATÓRIA AGUDA GRAVE: COMPARAÇÃO ENTRE OS PERÍODOS PRÉ-PANDÊMICO E PANDÊMICO

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    Objective: To analyze the characteristics and the factors associated with mortality of cases hospitalized for Severe Acute Respiratory Syndrome in a health region, in pre-pandemic and pandemic periods. Methods: A retrospective documentary study of epidemiological surveillance carried out with secondary data from the Influenza Epidemiological Surveillance Information System, regarding the cases of patients belonging to a health region of Minas Gerais, Brazil. Results: During the pandemic period, there was an increase in the number of hospitalizations and deaths due to Severe Acute Respiratory Syndrome, in addition to diferences between socioemographic and clinical-epidemiological characteristics. In both periods, the age and the use of invasive ventilatory support were the predictors of hospital mortality. The mortality in the pandemic period was also associated with male gender, presence of risk factors, admission to an intensive care unit, use of non-invasive ventilatory support and infection by COVID-19. Conclusions: In 2020, the detection rate of Severe Acute Respiratory Syndrome was 21 times higher than in 2019 and new symptoms, such as anosmia and ageusia, were included in their investigation. In both periods evaluated, elderly patients and patients on invasive mechanical ventilation had a higher risk of mortality. With the pandemic, there was a greater number of hospitalizations and factors associated with mortality.Objetivo: Analisar as características e os fatores associados à mortalidade dos casos hospitalizados por Síndrome Respiratória Aguda Grave em uma regional de saúde, nos períodos pré-pandêmico e pandêmico. Métodos: Estudo retrospectivo documental de vigilância epidemiológica realizado com dados secundários provenientes do Sistema de Informação de Vigilância Epidemiológica da Gripe, referentes aos casos de pacientes pertencentes a uma regional de saúde de Minas Gerais, Brasil. Resultados: Observou-se, no período pandêmico, aumento do número de hospitalizações e óbitos por Síndrome Respiratória Aguda Grave, além de diferenças entre as características sociodemográficas e clínico-epidemiológicas. Em ambos os períodos, comportaram-se como preditores da mortalidade hospitalar, a idade e o uso de suporte ventilatório invasivo. A mortalidade no período pandêmico se associou também ao sexo masculino, presença de fatores de risco, internação em unidade de terapia intensiva, uso de suporte ventilatório não invasivo e infecção por COVID-19. Conclusões: Em 2020, a taxa detecção de Síndrome Respiratória Aguda Grave foi 21 vezes maior do que em 2019 e novos sintomas, como a anosmia e ageusia, foram incluídos em sua investigação. Nos dois períodos avaliados, pacientes idosos e em ventilação mecânica invasiva apresentaram maior risco de mortalidade. Com a pandemia, houve maior número de hospitalizações e fatores associados à mortalidade

    Survival of patients with diabetes mellitus hospitalized for acute respiratory syndrome due to COVID-19

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    Given the magnitude of COVID-19 and the increase in hospitalization cases for severe acute respiratory syndrome (SARS), especially among patients with diabetes mellitus, it is essential to understand the epidemiological aspects inherent to the disease and the worsening of cases. Thus, this study aimed to analyze the survival of patients with diabetes mellitus hospitalized for SARS due to COVID-19 in different regions of Brazil. This is a longitudinal study, carried out based on data reported in the Influenza Epidemiological Surveillance Information System during the year 2020. The number of patients with diabetes mellitus among the hospitalized cases of SARS due to COVID-19 in the different regions of Brazil and the lethality rate among them were identified. A comparison of patient profiles of those who survived or did not survive and the Cox regression analysis were performed to evaluate the factors associated with shorter survival of patients. It was found that 51.4% of patients hospitalized with SARS due to COVID-19 had diabetes, and the case lethality rate among them was 45.0%. The Northeastern and Northern regions presented a higher proportion of patients with diabetes mellitus (56.5% and 54.3%, respectively) and a higher lethality rate (53.8% and 59.9%, respectively). The mean survival time of cases with diabetes mellitus hospitalized for SARS due to COVID-19 was estimated to be 35.7 days (0.5 days). A lower survival rate was observed among residents of the Northeastern and Northern regions with skin color reported as non-white, who required admission to Intensive Care Units and invasive mechanical ventilation, and presented respiratory symptoms such as dyspnea, respiratory distress and an oxygen saturation lower than 95%. It is concluded that diabetes mellitus was responsible for the high occurrence and lethality, mainly in the Northeastern and Northern regions, among non-white patients and those with greater clinical severity, which reinforces the importance of taking measures aimed at supporting this population

    Completude das notificações de síndrome respiratória aguda grave no âmbito nacional e em uma regional de saúde de Minas Gerais, durante a pandemia de COVID-19, 2020

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    Objective: To analyze the completeness of notifications of cases of severe acute respiratory illness from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) during the COVID-19 pandemic, in the national database and in a regional database in the state of Minas Gerais, Brazil, in 2020. Methods: Descriptive study of the completeness of sociodemographic variables and those related to the etiology, clinical condition, evolution and diagnostic criteria of SIVEP-Influenza. Completeness was classified as excellent (greater than 95%), good (90 to 95%), fair (80 to 90%), poor (50 to 80%), and very poor (less than 50%). Results: The percentage of variables with excellent completeness was only 18.1% in the national database and 27.8% in the regional database. Conclusion: Low completeness of both SIVEP-Gripe databases was evidenced, making it necessary to improve the work process and routine training of professionals for the correct completion.Objetivo: Analizar la completitud de las notificaciones de casos de síndrome respiratorio agudo severo del Sistema de Información de Vigilancia Epidemiológica de Influenza (SIVEP-Gripe) durante la pandemia de COVID-19, en la base de datos nacional y en una base de datos regional de salud en el estado de Minas Gerais, Brasil, en 2020. Métodos: Estudio descriptivo de la completitud de las variables sociodemográficas y las relacionadas con la etiología, cuadro clínico, evolución y criterios diagnósticos del SIVEP-Influenza. La exhaustividad se clasificó como excelente (más grande que 95%), buena (90 a 95%), regular (80 a 90%), mala (50 a 80%) y muy mala (menos que 50%). Resultados: El porcentaje de variables con excelente completitud fue solo del 18,1% en la base de datos nacional y del 27,8% en la base de datos regional. Conclusión: Se evidenció la baja completitud de ambas bases de datos SIVEP-Gripe, siendo necesario mejorar el proceso de trabajo y la rutina de capacitación de los profesionales para el correcto llenado.Objetivo: Analisar a completude das notificações de casos de síndrome respiratória aguda grave no Sistema de Informação de Vigilência Epidemiológica da Gripo (SIVEP Gripe) durante a pandemia de COVID-19, na base de dados nacional e na base da Unidade Regional de Saúde do estado de Minas Gerais, Brasil, em 2020. Métodos: Estudo descritivo da completude das variáveis sociodemográficas e das relativas à etiologia, condição clínica, evolução e critérios diagnósticos do SIVEP-Gripe. O nível de completude foi classificado como excelente (>95%), bom (90 a 95%), regular (80 a 90%), ruim (50 a 80%) ou muito ruim (<50%). Resultados: O percentual de variáveis com completudo excelente foi de apenas 18,1% na base de dados nacional, e de 27,8% na base de dados regional. Conclusão: Evidenciou-se baixa completude de ambas bases dados do SIVEP-Gripe, tornando-se necessários aperfeiçoamentos no processo de trabalho e capacitações rotineiras dos profissionais para o correto preenchimento

    Atividade Citotóxica do Extrato de Croton Urucurana Baill Contra linhagens de Células Leucêmicas Humanas U937 e THP 1

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          Leukemias are malignant neoplasms that affect blood cells and originate in bone marrow. These are cancers of high incidence and are difficult to treat and there is a constant search for more efficient therapies. The present work investigated the cytotoxic action of the hydroalcoholic extract of Croton urucurana in human leukemia cells U937 and THP-1. The U937 and THP-1 cell lines were plated in a 100 μL/well volume (1x106 cells/mL) in 96-well plates, treated with extracts at final concentrations of 50 μg/mL, 100 μg/mL, 200 μg/mL and 400 μg/mL and 800 μg/mL  for cell viability tests with MTT(-3- (4.5-dimethyl-2-thiazole) 2.5-diphenyl-2H-tetrazolium bromide). After 48h, viability was assessed by MTT and the supernatant was used for determination of the Lactate Dehydrogenase (LD) enzyme. Fluorescence microscopy was used to evaluate apoptosis. The extract was able to reduce cell viability by the MTT assay, increase LD release and induce apoptosis in both cell lines tested at concentrations of 400 and 800 μg/ mL (p≤0.05). The C. urucurana extract presented cytotoxic activity against human leukemic cell lines U937 and THP-1, presenting itself as promising in the search for new antineoplastic agents.As leucemias são neoplasias malignas que acometem as células do sangue e tem origem na medula óssea. São cânceres de grande incidência e de difícil tratamento, havendo, portanto, a uma constante procura por terapias mais eficientes. O presente trabalho investigou a ação citotóxica do extrato hidroalcoólico de Croton urucurana em células leucêmicas humanas U937 e THP-1. As linhagens de células U937, THP-1 foram plaqueadas em volume de 100 μL/poço (1x106 cels/mL) em placas de 96 poços, tratadas com extrato nas concentrações finais de 50 μg/mL, 100 μg/mL, 200 μg/mL e 400 μg/mL e 800 μg/mL para os testes de viabilidade celular com MTT (-3-(4,5-dimetil-2-tiazol) 2,5-difenil-2-H-brometo de tetrazom). Após 48h a viabilidade foi avaliada pelo MTT e o sobrenadante utilizado para dosagem da enzima Lactato Desidrogenase (LD). Microscopia de fluorescência foi usada para avaliar a apoptose. O extrato foi capaz de reduzir a viabilidade celular pelo ensaio MTT, aumentar liberação da LD e de induzir apoptose em ambas as linhagens de células testadas nas concentrações 400 e 800 µg/mL (p≤0,05). O extrato de C. urucurana apresentou atividade citotóxica contra as linhagens de célula leucêmicas humanas U937 e THP-1, apresentando-se como promissor na busca por novos agentes antineoplásicos
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