PERFIL DE LOS ACCIDENTES DE TRABAJO EN UN HOSPITAL DE TERESINA, PI

Os acidentes de trabalho configuram importante problema de saúde pública devido ao elevado índice deabsenteísmo, afastamento, custo, tratamento e indenização. Realizou-se um estudo quantitativo-descritivo-retrospectivoque objetivou conhecer o perfil dos acidentes de trabalho que vitimaram os funcionários de um hospital público deTeresina, em 2007. Os dados foram coletados de 53 fichas notificadoras, utilizando-se um roteiro elaborado previamente.Como resultado, obteve-se que 92,2% das vítimas eram do sexo feminino, 34,3% tinham entre 20 e 29 anos, 43,4% eramtécnicos/auxiliares de enfermagem, 20,4% dos acidentes ocorreram no pronto-socorro, 90,5% aconteceram em dias úteis,com 49% no período matutino, 62,2% dos casos foram causados por perfurocortantes, onde 26,7% das ocorrênciasevidenciaram o manuseio de material cirúrgico, atingindo membros superiores em 67,9% dos episódios. Falhas no seguimentopós-acidente foram observadas, bem como diversidade na notificação. Urge implantar uma planilha informatizada noserviço para melhorar o seguimento e assistência do profissional acidentado.Work-related accidents are an important public health problem, due to absenteeism, removal from work, cost,treatment and compensation. We conducted a quantitative-descriptive study, which aimed to identify the profile ofworkplace accidents which affected the employees of a public hospital in Teresina in 2007. Data were collected from 53notifying forms using a script prepared in advance. As a result it was found that 92.2% of the victims were female, 34.3%were between 20-29 years, 43.4% were nursing technicians, 20.4% occurred in the emergency room, 90.5% occurred onweekdays, 49% occurred in the morning, 62,2% of cases occurred from sharp materials. 26.7% of cases showed thehandling of surgical material, reaching the upper limbs in 67.9% of the episodes. The deployment of a computerizedspreadsheet to improve the monitoring and assistance of the injured professional is urgent.Los accidentes de trabajo configuran importante problema de salud pública debido al elevado índice deabsentismo, alejamiento, costo, tratamiento e indemnización. Se realizó un estudio cuantitativo-descriptivo-retrospectivo,cuyo objetivo fue conocer el perfil de los accidentes de trabajo que victimaron los empleados de un hospital público deTeresina en 2007. Los datos fueron recolectados a partir de 53 fichas notificadoras utilizándose un guión preparadopreviamente. Como resultado se obtuvo que 92,2% de las víctimas eran de sexo femenino, 34,3% tenían entre 20 y 29 años, 43,4% eran técnicos/auxiliares de enfermería, 20,4% de los accidentes ocurrieron en el pronto-socorro, 90,5% ocurrieron en días útiles, con 49% en el periodo matutino, 62,2% de los casos fueron causados por perforo-cortantes, donde 26,7% delas ocurrencias evidenciaron el manoseo de material quirúrgico, alcanzando miembros superiores en 67,9% de los episodios.Fallas en el seguimiento pos-accidente fueron observadas bien como diversidad en la notificación. Urge implementar unaplanilla informatizada en el servicio para mejorar el seguimiento y la asistencia del profesional accidentado

ABORDAGENS TERAPÊUTICAS NA HIPERTENSÃO PULMONAR PERSISTENTE NEONATAL

Objective: To evaluate the different therapeutic approaches available for the treatment of Persistent Pulmonary Hypertension of the Newborn (PPHN). Methodology: This is a wide-ranging literature review in which the research is based on the question "What are the therapeutic approaches for the treatment of neonatal persistent pulmonary hypertension?". The research was conducted in 2023 by consulting the Medical Literature Analysis and Retrievel System Online (MEDLINE) and Scientific Electronic Library Online (SciELO) databases. Results: Therapeutic approaches for the treatment of neonatal persistent pulmonary hypertension include the use of drugs such as milrinone and sildenafil, non-selective pulmonary vasodilators, inhaled nitric oxide when available, mechanical ventilation and the possibility of vasopressin in refractory cases. The choice of therapy depends on the severity of the condition and the resources available. Milrinone and sildenafil are common due to their vasodilator properties. Inhaled nitric oxide is preferred in severe cases, and mechanical ventilation plays a crucial role. Vasopressin may be an option in refractory cases, but its dose and safety are less well documented. Conclusion: PPHN is a challenging condition that requires a careful therapeutic approach. Based on the therapeutic options discussed in this study, it is clear that the choice should be guided by the severity of the patient, individual clinical characteristics and the availability of resources.Objetivo: Evaluar los diferentes enfoques terapéuticos disponibles para el tratamiento de la hipertensión pulmonar persistente neonatal (HPPN). Metodología: Se trata de una amplia revisión bibliográfica en la que la investigación se basa en la pregunta "¿Cuáles son los abordajes terapéuticos para el tratamiento de la hipertensión pulmonar persistente neonatal?". La investigación se realizó en 2023 consultando las bases de datos Medical Literature Analysis and Retrieval System Online (MEDLINE) y Scientific Electronic Library Online (SciELO). Resultados: Los enfoques terapéuticos para el tratamiento de la hipertensión pulmonar persistente neonatal incluyen el uso de fármacos como milrinona y sildenafil, vasodilatadores pulmonares no selectivos, óxido nítrico inhalado cuando está disponible, ventilación mecánica y la posibilidad de vasopresina en casos refractarios. La elección del tratamiento depende de la gravedad de la enfermedad y de los recursos disponibles. La milrinona y el sildenafilo son habituales por sus propiedades vasodilatadoras. El óxido nítrico inhalado es preferible en los casos graves, y la ventilación mecánica desempeña un papel crucial. La vasopresina puede ser una opción en los casos refractarios, pero su dosis y seguridad están menos documentadas. Conclusión: La HPPN es una enfermedad difícil que requiere un enfoque terapéutico cuidadoso. Basándose en las opciones terapéuticas analizadas en este estudio, está claro que la elección debe guiarse por la gravedad del paciente, las características clínicas individuales y la disponibilidad de recursos.Objetivo: Avaliar as diferentes abordagens terapêuticas disponíveis para o tratamento da Hipertensão Pulmonar Persistente Neonatal (HPPN). Metodologia: Trata-se de uma ampla revisão da literatura em que a construção da pesquisa está amparada na questão "Quais são as abordagens terapêuticas para o tratamento da hipertensão pulmonar persistente neonatal?" A pesquisa foi conduzida em 2023, por meio da consulta às bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE) e Scientific Electronic Library Online (SciELO). Resultados: As abordagens terapêuticas para o tratamento da hipertensão pulmonar persistente neonatal incluem o uso de medicamentos como milrinona e sildenafil, vasodilatadores pulmonares não seletivos, óxido nítrico inalado quando disponível, ventilação mecânica e possibilidade de vasopressina em casos refratários. A escolha da terapia depende da gravidade da condição e dos recursos disponíveis. A milrinona e o sildenafil são comuns devido às suas propriedades vasodilatadoras. O óxido nítrico inalado é preferencial em casos graves, e a ventilação mecânica desempenha um papel crucial. A vasopressina pode ser uma opção em casos refratários, mas sua dose e segurança são menos documentadas. Conclusão: A HPPN é uma condição desafiadora que requer cuidadosa abordagem terapêutica. Com base nas opções terapêuticas discutidas neste estudo, fica claro que a escolha deve ser orientada pela gravidade do paciente, características clínicas individuais e disponibilidade de recursos

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Long-term safety and efficacy of patisiran for hereditary transthyretin-mediated amyloidosis with polyneuropathy: 12-month results of an open-label extension study

© 2020 Elsevier Ltd. All rights reserved.Background: Hereditary transthyretin-mediated amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We assessed the safety and efficacy of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Methods: This multicentre, open-label extension (OLE) trial enrolled patients at 43 hospitals or clinical centres in 19 countries as of Sept 24, 2018. Patients were eligible if they had completed the phase 3 APOLLO or phase 2 OLE parent studies and tolerated the study drug. Eligible patients from APOLLO (patisiran and placebo groups) and the phase 2 OLE (patisiran group) studies enrolled in this global OLE trial and received patisiran 0·3 mg/kg by intravenous infusion every 3 weeks with plans to continue to do so for up to 5 years. Efficacy assessments included measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress, with analysis by study groups (APOLLO-placebo, APOLLO-patisiran, phase 2 OLE patisiran) based on allocation in the parent trial. The global OLE is ongoing with no new enrolment, and current findings are based on the interim analysis of the patients who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received one or more dose of patisiran up to the data cutoff. This study is registered with ClinicalTrials.gov, NCT02510261. Findings: Between July 13, 2015, and Aug 21, 2017, of 212 eligible patients, 211 were enrolled: 137 patients from the APOLLO-patisiran group, 49 from the APOLLO-placebo group, and 25 from the phase 2 OLE patisiran group. At the data cutoff on Sept 24, 2018, 126 (92%) of 137 patients from the APOLLO-patisiran group, 38 (78%) of 49 from the APOLLO-placebo group, and 25 (100%) of 25 from the phase 2 OLE patisiran group had completed 12-month assessments. At 12 months, improvements in mNIS+7 with patisiran were sustained from parent study baseline with treatment in the global OLE (APOLLO-patisiran mean change -4·0, 95 % CI -7·7 to -0·3; phase 2 OLE patisiran -4·7, -11·9 to 2·4). Mean mNIS+7 score improved from global OLE enrolment in the APOLLO-placebo group (mean change from global OLE enrolment -1·4, 95% CI -6·2 to 3·5). Overall, 204 (97%) of 211 patients reported adverse events, 82 (39%) reported serious adverse events, and there were 23 (11%) deaths. Serious adverse events were more frequent in the APOLLO-placebo group (28 [57%] of 49) than in the APOLLO-patisiran (48 [35%] of 137) or phase 2 OLE patisiran (six [24%] of 25) groups. The most common treatment-related adverse event was mild or moderate infusion-related reactions. The frequency of deaths in the global OLE was higher in the APOLLO-placebo group (13 [27%] of 49), who had a higher disease burden than the APOLLO-patisiran (ten [7%] of 137) and phase 2 OLE patisiran (0 of 25) groups. Interpretation: In this interim 12-month analysis of the ongoing global OLE study, patisiran appeared to maintain efficacy with an acceptable safety profile in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Continued long-term follow-up will be important for the overall assessment of safety and efficacy with patisiran.info:eu-repo/semantics/publishedVersio