Atuação do enfermeiro na prescrição de contraceptivos hormonais na rede de atenção primária em saúde

O estudo teve como objetivo conhecer e analisar a atuação do enfermeiro na prescrição dos contraceptivos hormonais reversíveis na Rede de Atenção Primária a Saúde. Trata-se de um estudo transversal e descritivo, tendo como sujeitos 64 enfermeiros lotados nas unidades assistenciais no período de setembro a novembro de 2010 no município de Rio Branco-Acre. Os dados foram coletados mediante entrevistas estruturadas utilizando um questionário. Os resultados evidenciaram que 96,9% dos enfermeiros prescrevem os métodos anticoncepcionais e que 90,6% tem conhecimento da legislação que rege a prescrição de enfermagem. Foi observado que a escolha do método contraceptivo pelos enfermeiros baseia-se na escolha da cliente e anamnese (36% e 34% respectivamente), e que 90% sempre orientavam quanto às vantagens e desvantagens de cada método. Assim, para escolher um método contraceptivo de forma livre e informada, os métodos devem estar disponíveis e devem ser dispensados por profissionais capacitados, após orientação correta e completa

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries.

OBJECTIVES:Although the majority of the global population lives in developing countries, most of the epidemiological data related to intensive care unit (ICU) acute kidney injury (AKI) comes from developed countries. This systematic review aims to ascertain the methodology of studies on ICU AKI patients in developing and developed countries, to determine whether epidemiological comparisons between these two settings are possible, and to present a summary estimate of AKI incidence. METHODS:A systematic review of published studies reporting AKI in intensive care units (2005-2015) identified in PubMed, LILACS, and IBECs databases was conducted. We compared developed and developing countries by evaluating study methodology, AKI reference serum creatinine definitions, population characteristics, AKI incidence and mortality. AKI incidence was calculated with a random-effects model. RESULTS:Ninety-two studies were included, one of which reported data from both country categories: 60 from developed countries (1,057,332 patients) and 33 from developing countries (34,539 patients). In 78% of the studies, AKI was defined by the RIFLE, AKIN or KDIGO criteria. Oliguria had 11 different definitions and reference creatinine 23 different values. For the meta-analysis, 38 studies from developed and 18 from developing countries were selected, with similar AKI incidence: 39.3% and 35.1%, respectively. The need for dialysis, length of ICU stay and mortality were higher in developing countries. CONCLUSION:Although patient characteristics and AKI incidence were similar in developed and developing countries, main outcomes were worse in developing country studies. There are significant caveats when comparing AKI epidemiology in developed and developing countries, including lack of standardization of reference serum creatinine, oliguria and the timeframe for AKI assessment. Larger, prospective, multicenter studies from developing countries are urgently needed to capture AKI data from the overall population without ICU access

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries.

OBJECTIVES:Although the majority of the global population lives in developing countries, most of the epidemiological data related to intensive care unit (ICU) acute kidney injury (AKI) comes from developed countries. This systematic review aims to ascertain the methodology of studies on ICU AKI patients in developing and developed countries, to determine whether epidemiological comparisons between these two settings are possible, and to present a summary estimate of AKI incidence. METHODS:A systematic review of published studies reporting AKI in intensive care units (2005-2015) identified in PubMed, LILACS, and IBECs databases was conducted. We compared developed and developing countries by evaluating study methodology, AKI reference serum creatinine definitions, population characteristics, AKI incidence and mortality. AKI incidence was calculated with a random-effects model. RESULTS:Ninety-two studies were included, one of which reported data from both country categories: 60 from developed countries (1,057,332 patients) and 33 from developing countries (34,539 patients). In 78% of the studies, AKI was defined by the RIFLE, AKIN or KDIGO criteria. Oliguria had 11 different definitions and reference creatinine 23 different values. For the meta-analysis, 38 studies from developed and 18 from developing countries were selected, with similar AKI incidence: 39.3% and 35.1%, respectively. The need for dialysis, length of ICU stay and mortality were higher in developing countries. CONCLUSION:Although patient characteristics and AKI incidence were similar in developed and developing countries, main outcomes were worse in developing country studies. There are significant caveats when comparing AKI epidemiology in developed and developing countries, including lack of standardization of reference serum creatinine, oliguria and the timeframe for AKI assessment. Larger, prospective, multicenter studies from developing countries are urgently needed to capture AKI data from the overall population without ICU access