Navegando por Assunto "Hospital Universitário João de Barros Barreto"

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Aspectos epidemiológicos, clínicos e evolutivos da tuberculose em idosos de um hospital universitário de Belém - Pará
(Universidade Federal do Pará, 2016-02-29) CHAVES, Emanuele Cordeiro; SANTOS, Maria Izabel Penha de Oliveira; http://lattes.cnpq.br/9592128667013030; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163
Physiological changes, especially the immune, make the most vulnerable elderly to infections such as tuberculosis, a disease that this group is specific both in clinical presentation and in its therapeutic management. The objective was to evaluate the epidemiological, clinical and evolutionary aspects of tuberculosis in elderly patients at a university hospital in Belém - Para. It is a study of a retrospective cohort study, conducted at the University Hospital João de Barros Barreto, where 82 records were analyzed of cases of tuberculosis in elderly patients diagnosed from 2009 to 2013, and as a complementary way of obtaining information was obtained from the database of the National System for Notifiable Diseases of the State Department of Public Health. For statistical analysis we used the electronic program Statistical Package for Social Sciences (SPSS) version 22.0, and applied the test G, assuming level α = 0,05 (5%) and value P≤0,05. The study was approved by the Research Ethics Committee of the Tropical Medicine Center under Opinion No. 1.081.347. Most elderly were male (n = 53; 64,6%), aged 60-69 years, both among men (n = 34; 64,2%) and among women (n =13; 44,8%), with a statistically significant difference (p=0,009), new cases of tuberculosis (n = 78; 95,1%), with pulmonary clinical form (n = 62; 75,6%), associated diseases (n = 57; 69,5%) and length of stay greater than 21 days (n = 38; 46,3%). Fever (n = 55; 67,1%), dyspnea (n =53; 64,6%), weight loss (n =50; 61,0%), productive cough (n = 49; 59,8%) and chest pain (n=42; 51,2%) were the primary signs and symptoms evidenced. Regarding treatment, there was a high percentage of adverse events (n=41; 50%), especially gastrointestinal symptoms (n = 29; 70,7%). Most seniors evolved with cure (n = 49; 59,8%), but emphasizes that death from tuberculosis was considerable in the study group (n=13; 15,9%), mainly occurring during hospitalization up 7 days. As for the exposure variables and outcome for healing and death from tuberculosis, there was a statistically significant difference in the age range of variables (p = 0,017), length of stay (p = 0,000) and adverse reactions (p = 0,018). We conclude that the clinical presentation and therapeutic management of tuberculosis in the elderly is different, so it is necessary to strengthen strategies that facilitate early identification of TB suspects elderly in the community, which should take place mainly through Primary.
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Avaliação da utilização e segurança de medicamentos em pacientes idosos internados em um hospital universitário
(Universidade Federal do Pará, 2013-12-23) CUENTRO, Vanessa da Silva; SILVA, Marcos Valério Santos da; http://lattes.cnpq.br/0379783635000306; ANDRADE, Marcieni Ataíde de; http://lattes.cnpq.br/8514584872100128
The increase in the elderly population contributes to the higher prevalence of numerous and varied pathologies, whose pharmacological treatments generally include features that lead to the practice of polypharmacy, a factor that has a major impact on the safety of elderly patients, given that polypharmacy is largely responsible for the adverse drug reactions and drug interactions. The objective was to evaluate the safety and use of prescription medications in elderly patients aged 60 years and admitted to the University Hospital João de Barros Barreto, Universidade Federal do Pará. This is a cross-sectional, observational study of descriptive character and exploratory data collection to analysis of medical records was performed, the data were processed using the SPSS 20.0 statistical program. The results showed that the mean age was 71.9 years, 52.7 % women, elderly women showed older than male patients. The hospitalization obtained an average of 21.7 days, average of diagnoses per patient was 2.6. The principal diagnosis of hospitalization was cardiovascular diseases (20.3%). The average number of drugs prescribed per admission was 6.8. The most commonly used drugs were part of the digestive and metabolic system (32.4%), the prevalence of potentially inappropriate prescribing of medications evaluated during hospitalization was 11.2 %, higher among women (58.8%), the potentially inappropriate medication prescriptions was more often in Butylscopolamine (25.2%). In regard to potential drug interactions, were identified in 65.5% of prescriptions, with an average of 8.6 per patient, medication interactions are involved in most of the cardiovascular system (38.6%), most of the interactions potential drug had moderate severity (75.3 %), potential pharmacokinetic interactions of action accounted for 65.4% of prescriptions and hypotension and hyperkalemia together accounted for 30.7% of the RAM , the management strategy was the most frequent monitoring signs and symptoms (65.7%) and with respect to monitoring the blood pressure amounted to 21.8%. In this study, the factors related to polypharmacy were length of hospital stay, number of diagnoses, drug interaction and the amount of inappropriate medications and were seen as a determinant in the occurrence of polypharmacy clinical variables: "number of diagnoses "and" length of stay ". Given these results, there is a need to adopt strategies for the optimization of pharmacotherapy provided to the elderly patient.
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Avaliação do programa de HIV/Aids na concepção dos usuários: o caso em um hospital de referência em Belém-PA
(Universidade Federal do Pará, 2010) MENDES, Marcelo Monteiro; SOUSA, Maria do Socorro Batista de; http://lattes.cnpq.br/7985347783921988; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Study regarding the evaluation of the HIV / AIDS in a referral hospital in the design of the users. The purpose of this study was to describe the design of the users in the inpatient unit and outpatient program on HIV / AIDS in a university hospital in Belém-PA. For the study were plotted as specific objectives: to present the suggestions of users of the program to improve the development of program activities and provide minimal tools for building an evaluation model for the program. Reference was used in the landscape of HIV / AIDS, health policies in Brazil and AIDS, and evaluation of programs and services in health. The method and approach were qualitative, descriptive case study. We used a structured semi-structured interviews on the topic. The research was conducted in the dependency HUJBB, more specifically in the services of the HIV / AIDS, in which respondents were users of the NCS and hospitalized at the clinic of infectious and parasitic diseases. By analyzing the data, the lines were divided into four categories: characterization of the user as to access the service, the motivation of the user quality of service; difficulties facing the service and guidance activities, expectations for improving the program. The search result clarifies the restrictions and qualities of the program, the dissatisfaction of the user in accessing the service, the high degree of motivation and the lack of it; the main difficulties of adhering to the guidelines and program activities, such as fear to facing death, lack of resource to get the service, the prejudice faced by people with HIV / AIDS and sexual promiscuity, and user expectations for the program: fast service, better infrastructure. It concludes with the improvements that can contribute to the quality of life of users, support is enough demand for professionals to attend the program and provide comprehensive treatment to people living with HIV / AIDS seen at HUJBB program.
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“Doutora, eu vim tentar a sorte”: o atalhar no Hospital Público João de Barros Barreto
(Universidade Federal do Pará, 2016-04-26) TAVARES, Aderli Goes; CARDOSO, Denise Machado; http://lattes.cnpq.br/2685857306168366; SÁ, Samuel Maria de Amorim e; http://lattes.cnpq.br/3256903697536068
The study focused on users' access to public health services, in this case access to the University Hospital João de Barros Barreto (HUJBB), a hospital Unified Health System (SUS) located in the urban area in the neighborhood of Guama, in Belém, PA. The focus of the study were the social networks of relationships built by ‘guamaenses’ users to access medical consultations in medical clinic specialties, pulmonology, endocrinology at the hospital's specialty clinic. The informal approach was called "shortcuts" and is configured as an internal social organization that adds partial social networks (BARNES, 1987) external and internal. "Shortcuts" are part of a rhizome social structure (DELEUZE & GUATTARI, 2000), with entries for different spaces and a work process focused on designing hegemonic hospital-and philanthropic health. In hospitals, workers, particularly physicians, operate by "negotiated" (CARAPINHEIRO, 2005). The problem of inefficiency of SUS regulation to organize access and other SUS structural problems when the lower supply that demand prevents the exercise of universal access of citizens to health services and contribute to the discovery and building innovations for access , which Castoriadis (1982) interprets as "instituting" in an institution or what Carapinheiro (2005) points out as "therapeutic pathways." In case, the informal access in HUJBB is called "docking", the "door of hope" and was interpreted as a subsystem of the SUS, living with a syncretic public administration, with marks of public administration with rationalists impersonal principles and culture relational Brazilian. Between the rational and impersonal, SUS and marginality in the system, users and workers found the "gaps" in the formal system. They administer them through rational knowledge and relational and personalized, the very last of the formation of the Brazilian people, and use them to extend the standards and rules, they did not break the rules and do not make the "shortcut" the legal, and rather build a bridge within the SUS itself that makes it worth the recommended universal to access constitutionally Brazilians, reducing the waiting time and possibly allowing rehabilitate the health of users, preventing death.
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Estado nutricional e marcadores clínico-bioquímicos em indivíduos portadores de carcinoma gastrointestinal
(Universidade Federal do Pará, 2014-11-04) MIRANDA, Tayana Vago de; ARAÚJO, Marília de Souza; http://lattes.cnpq.br/9371703949781020
The nutritional status of patients with gastrointestinal carcinoma is frequently affected, being aggravated by the carcinogenesis that promote activation of the inflammatory process and subsequent activation of the immune system, with production of cytokines and acute phase proteins, such as C-reactive protein, which results in hypermetabolism, accelerating weight loss and progresses to cachexia. This study aimed to analyze the nutritional status and biochemical-clinical markers in patients with gastrointestinal carcinoma, treated at Hospital Universitário João de Barros Barreto (HUJBB), in Belém-PA. Was conducted a descriptive, observational and cross-sectional study involving patients with gastrointestinal carcinoma treated at HUJBB from december 2013 to july 2014. Nutritional assessment was conducted by anthropometric parameters, which included body mass index (BMI), percentage weight loss (%PWL), arm circumference (AC), arm muscle circumference (AMC), arm muscle area corrected (CAMA), triceps skinfold thickness (TST) and muscle adductor pollicis (MAP), biochemical parameters, by classifying hemoglobin, total lymphocyte count (TLC), albumin, transferrin, index-inflammatory nutritional prognosis (IPIN ) and subjective parameters, using the subjective global assessment produced by the patient (ASG-PPP), besides the identification and classification of cachexia. 44 patients were evaluated, 63.3% were male with a mean age of 61.2 years (±13.3); 95.50% were natural of Pará, 45.50% living in the countryside, 50.00% had incomplete education in primary and 52.30% had no family income. 63.60% of the patients evaluated, had stomach cancer; of these, 50.00% were in clinical stage IV and 73.30% in surgical treatment, with an average hospital stay of 45.85 days (± 32.97). In nutritional assessment was obtained 20.50% eutrophy in adults and 42.30% for seniors through BMI, however, in isolated assessment of muscle and fat compartments, there was 59.10% of severe depletion by of CAMA, 54.50% by the TST, 75.00% with the presence of depletion in AC and 68.18% in AMC. Severe weight loss was observed in 61.36% of the patients and in the MAP was obtained higher prevalence of moderate depletion (30.20%). At biochemical parameters, there was severe reduction in hemoglobin to 61.40% of patients, slight depletion of CTL in 56.80%, 47.70% for albumin and 45.50% with moderate depletion in transferrin. In the assessment of IPIN, was obtained medium risk complication for 56.80% of the patients. In ASG-PPP, 63.60% of patients were classified into severe malnutrition and the presence of symptomatic cachexia, was 54.50%. With regard to the correlation analysis, it was found that there was a positive and significant correlation of BMI with AMC, AC, TST, CAMA, MAP and hemoglobin; AMC with AC, and CAMA; AC with TST, CAMA, MAP, and hemoglobin; TST, CAMA; CAMA with MAP. In the principal component analysis, it was found as the most sensitive methods to detect malnutrition the assessment of AC, CAMA, AMC, BMI, TST, MAP, IPIN and evaluation of cachexia. Thus, the results obtained in this study indicate the nutritional impairment in patients with gastrointestinal carcinoma by different parameters, thus demonstrating that malnutrition occurs globally, with loss of both adipose tissue, muscle tissue as well as changes biochemical level.
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Estudo psicanalítico sobre a feminização da epidemia do HIV/AIDS com usuários do Hospital Universitário João de Barros Barreto
(Universidade Federal do Pará, 2008-09-12) LEBREGO, Arina Marques; MOREIRA, Ana Cleide Guedes; http://lattes.cnpq.br/9245673017553186
This study aimed to investigate the processes of subjectivation of women having no steady partners and their exposition to HIV/AIDS in order to identify overdetermination factors of vulnerability. As method, we used a case study, aiming at a in-depth analysis which allowed the identification of a greater number of subjective determinants related to the problem considered. The study presents fragments of clinical cases of women living with AIDS, hospitalized in the wards of the João de Barros Barreto University Hospital (HUJBB) in the State of Pará, Brazil. Based on the analysis of transference and countertransference, we showed as results what each case, in its singularity, reveals from the therapeutic encounter. In clinical case I, we found that the patient, whom we called Dinah, had a female masochistic mode of psychopathological subjectivation, what caused her to show some satisfaction when exposed to suffering, and to position herself as a victim in her emotional and sexual relationships. Those relationships were overdetermined by a imaginary identification with cultural ideals about the woman human being, conceiving images of men and women, and therefore of herself and her partners, as antithetical pairs of strength/weakness, active/passive, power/submission. This ideal of composite person of a virgin woman and a man only, caused Dinah to deny her fears of contamination, and to passively accept unprotected sexual relations, leaving the sexual initiative to her partner, and, thereby, becoming vulnerable to HIV infection. In clinical case II, Alice, which has a melancholic, self-destructive mode of subjectivation, positioned herself in her emotional and sexual relationships by incessantly searching for her self-destruction through an unconscious vulnerability to HIV. Having contracted AIDS and infected her husband and other partners, even after knowing her diagnosis, Alice remained trapped in a deadly silence, and prevented herd]self from taking care of her health and seeking continuous medical care, making herself vulnerable to re-infection. In clinical Case III, Ana Laura, is a woman who has gone through violence several times since childhood, for instance, she underwent child sexual abuse, was exploited as a domestic worker, was abandoned by her parents. After having her first baby, the child was taken from her without her consent by a maternal aunt who gave her to others. Ana Laura used that as a reason to prostitute herself on quay of Belém Port, where she worked until she was hospitalized. That was where negotiation for more expensive unprotected sex was a common practice, and so Ana Laura negotiated her life, selling unprotected sex and ended up getting infected by HIV. The helplessness and the violence that this patient went through are therefore the overdetermination factors of her vulnerability to HIV infection. As conclusions, we highlight that the women looked after without steady partners, did not care to protect themselves, and are not in accordance with the studies showing that those women negotiate the use of condom more freely and are less vulnerable to HIV. This demonstrates the importance of studies addressing the psychic, social, political and cultural aspects, so as to reveal the modes of production of subjectivity of the subjects in their singularity, beyond data measurement, in order to establish strategies for more effective health prevention.
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Impacto na incidência de infecção relacionada a cateter vascular central após medidas de educação na unidade de terapia intensiva do Hospital Universitário João de Barros Barreto
(Universidade Federal do Pará, 2007) COSTA, Maria Heliana Alencar da; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Central venous catheters are commonly employed in the management of critically ill patients in intensive care units (ICU). Primary bloodstream infections resulting from central venous catheterization (CVC-BSI) are a common cause of excess morbidity, mortality, and medicalcare costs associated in the ICU setting. Many strategies have been used to decrease the risk of CVC-BSI and educational initiatives aimed at improving CVC insertion and care has been demonstrated successful results. The purpose of the study was to determine the impact of an educational program targeted to specific points observed during CVC care practices on decreasing CVC-BSI rates in ICU setting. This was a preintervention and postintervention study. Barros Barreto Hospital is a 260-bed university urban teaching hospital located in Belém city, Pará, Brazil and its ICU is a 10-bed surgical-medical unit. In this ICU, reported CVC-BSI from January 2003 to December 2005 was 11.8 episodes of CVC-BSI per 1000 CVC-days. Between January 2006 and July 2007 this study was carried in this setting. An educational program based on CDC Guidelines for Prevention of Intravascular Catheter- Related Infection directed to nurses and physicians was developed by a multidisciplinary task force to highlight correct practices for CVC care. Posters concerning CVC-BSI pathogenesis and prevention, tips about importance of handwashing were available in the unit. BSI-CVC rates were monitored in the following 12-months period after educational intervention. Twenty episodes of catheter-associated bloodstream infections (11.8 per 1,000 catheter-days) occurred in the 36 months before the introduction of the education program. Following implementation of the intervention, the rate of catheter-associated bloodstream infection decreased to four episodes in 1667 catheter-days (2.4 per 1,000 catheter-days), a decrease of 78%. Behavior changes such as adherence to hand hygiene before manipulating CVC and CVC dressing was dramatically enhanced after the educational intervention (49.5% to 98.5% and 15.4% to 96.9%, respectively) [p < .0001]. A multiple approach included a focused educational strategy targeted to specific problems observed during a careful evaluation of CVC care practices, and policy changes can lead to decrease in the incidence of bloodstream infections associated to CVC. Educational programs directed to healthcare professionals may lead to decrease in cost, morbidity, and mortality associated to healthcare-related infections.
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A integralidade na prática clínica e institucional e na relação ensino-serviço: um estudo de caso sobre a formação do psicólogo em hospital público
(Universidade Federal do Pará, 2009-07-01) SOUZA, Ana Vicentina Santiago de; OLIVEIRA, Paulo de Tarso Ribeiro de; http://lattes.cnpq.br/9266787581530443; MOREIRA, Ana Cleide Guedes; http://lattes.cnpq.br/9245673017553186
This work consists of studying the clinical and institutional practice in the psychologist’s formation under the perspective of the totality in health in the João de Barros Barreto Academical Hospital - HUJBB. The choice of the study field was due to the knowledge of the hospital while work area, as well as for the fact of this to be one of the three only places in Unique Wealth System SUS that serve as practice for the Course of Psychology of UFPA, where it is propitiated the students to have contact with the clinical and institutional practice, applying theoretical-methodological backgrounds of Psychoanalysis, institutional analysis, processes group and of communication and knowledge of Public Health. Being used of the qualitative approach, the procedures of collection of data were the semi-structured interview, the questionnaires and the participant observation. Among the important aspects in the study was observed: the constant fragmentation of the several involved professionals’ work and the psychologist’s search for a space more consolidated and articulate of performance in the team of health; the lack of previous knowledge of collective health on the part of the students motivating a concentrated effort of the supervisors and field advisors in the relationship teaching-service; the failed of the physical facilities and of the equipments of the hospital generating difficulties, but, simultaneously, stimulating an expressed subjectivity in the collaboration between employees and students; the effort of the Service of Psychology in drill the work centered in the medical act and in the sick body for an attention marked by the relationship with the patient as subject and for the different manners of psychopathologic subjectivization that constitute the theoretical-methodological problem placed for your psychotherapic effectiveness; and, finally, its insert in the teams multiprofessionals. The plot formed by the group of those protagonisms it configures the psychologist’s challenge, with the other professionals, to understand and to carry out the wholeness of the attention, in permanent exercise of construction in the hospital. Two theoretical stand out in the argument that problematizes the integral attention in the hospital - Canguilhem, for the discussion of the concept of health while possibility to live in conformity with the middle and Winnicott, in the possible clinical perspective in that adapts.
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O luto pela perda da saúde: vivências de ser mãe de uma criança com Fibrose Cística
(Universidade Federal do Pará, 2012-12-14) ALMEIDA, Nancy Limeira de; SOUZA, Airle Miranda de; http://lattes.cnpq.br/5311796283730540
The objective of this study is to understand the way mothers of children suffering from Cystic Fibrosis cope with the loss of the health of their child, considering that any evolution of the disease poses a death threat to the life of the child, when the absence of treatment adherence. Cystic Fibrosis is an incurable and lethal chronic genetic disease, with guarded prognosis, requiring high impact treatment and intensive care. The methodology is based on a qualitative clinical approach, with a particular focus on content analysis. Eleven mothers of children diagnosed with Cystic Fibrosis and benefiting from the "Cystic Fibrosis Support Programme" of João de Barros Barreto University Hospital took part in this study. Data were collected through a semi-structured interview with the mother and by realizing two drawings aimed at understanding the mourning of these mothers in relation to the disease of their child, the losses and the significance associated with the illness of the health of the child. The results indicate that the mothers experience the mourning for the health loss of their child by redefining the concepts associated with death and end of life. This is confirmed by the hypothesis that the mother of a child suffering from cystic fibrosis knows the disease, is fully aware of the lethal risks associated and considers that the symptomatic treatment undergone can improve the quality of life of her child. For them, the proximity of the existence of an imminent death leads to a reorganization as well as to internal, external, personal and family changes contributing to redefining the meaning of their life, since the moment when they face the disease.
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Nas trincheiras de combate, o abatimento: adicção e AIDS
(Universidade Federal do Pará, 2011) MIRANDA, Alex Nazareno Ferreira de; VILHENA, Junia de; http://lattes.cnpq.br/5162153387744785; MOREIRA, Ana Cleide Guedes; http://lattes.cnpq.br/9245673017553186
After three decades of the emergence of AIDS in the world, we are still speechless in the face of a dreaded disease to be pronounced by the weight of his name brings death. The disease, which emerged as a curse for sexual minorities, sex workers and drug users, printed on their bodies and their souls the symbol of immediate death, shameful and painful. Throughout this journey, his body had viral "imaged" by medical science that could not be removed from the mathematization that AIDS equals death, which would reduce the status of "a disease". This dissertation intends to provide an overview of AIDS, pointing out their appearance, the identification of the virus and the metaphors used for positioning of the disease in biological and moral locus of the modern world. We used metaphors of stigmatizing diseases, passed on places of care, to present the University Hospital João de Barros Barreto as a space marked by the stigma of TB and AIDS, which gives the image of horror to the people of Para . In this space, we met people whose helplessness and dependency relationships to an object/act external to the ego can have them brought to exposure to HIV. Of these, it was pointed to a case study of this phenomenon. In an attempt to understand the relationship with the object of addiction, were sought mainly Winnicottian the concepts of "environment maternante good enough", "transitional object" beyond "addiction", worked by Joyce McDougall. With the work done, it was observed that the gap reported in psychotherapy, very present in patients, is surrounded by addictive relationships, as a defense mode which lets you take the object as a replacement external breast vital. To listen to these dependences, we used the clinical perspective of Winnicott, with the possibility of repositioning the patient to modify their internal and external reality from a creative act.
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Perfil de utilização de antimicrobianos em pacientes idosos de um hospital universitário de Belém
(Universidade Federal do Pará, 2015-02-23) SOUSA, Kassio Cardoso; SILVA, Marcos Valério Santos da; http://lattes.cnpq.br/0379783635000306; ANDRADE, Marcieni Ataíde de; http://lattes.cnpq.br/8514584872100128
The medicine progress and improvement in general life conditions of the population led to the increase of life expectancy and contributed to population aging. There are important clinical characteristics in elderly people as the fact that those individuals show a series of alterations which interfere directly in the pharmacokinetics’ processes. The medicines constitute the most used treatments within health services, in the knowledge that, in developing countries, around 30% of the health resources are destined to those products. In that way Studies of Medicines Use are important strategic tools for the rationalization of the drugs’ use. That being so this research has as a goal to investigate the profile of prescription and use of antimicrobials for elderly persons interned in the clinics: medical clinics, clinics of infectious and parasitic diseases, the intensive treatment center and the surgical clinic of the academic Hospital João Barros Barreto (HUJBB) in the period from 2009 to 2012, aiming for observing the initiatives directed to the patient security regarding the antimicrobials use. It consists in a transversal study, observational and characteristically descriptive. The sample was composed of 299 recorded and interned patients who received the treatment with at least one antimicrobial on a regular basis. In relation to the socio-demographic profile of the elderly patients admitted in the HUJBB during the studying period, it was noticed that the most frequent gender was the feminine with 44%, and the average of the internship duration was of 18,90 days, and the most frequent age range stood between 60 and 70 years old with 46,15%, the civil status was married with 52,21%, declaring themselves ―pardos*‖ (69,90%), coming from the capital city (72,24%) and with an internship duration until 30 days utmost (82,94%). About the profile of prescription and use of antimicrobials for the elderly patients, was spotted that the cephalosporin category of third generation was the most proscribed with 29,94%, followed by the quinolones with 17,15% and Macrolides with 9,30%. Among the 23 antimicrobials found in the medicals prescriptions, the ceftriaxone was the most used with 20,13% followed by the ceftazidime with 10,50% and the clarithromycin with 9,85%. The most frequent pathologies reached the respiratory tract with: DPOC (10,16%), bronchiectasis infecting (8,07%) and pneumonia (4,30%) and the most frequent administration route used for elderly people was the intravenous with 84%. Combining the infection state of the respiratory tract (28,13%) with the most frequent use of antimicrobials of the cephalosporin category and the quinolones’ one, 47,09% were totalized. As for the clinical state outcome, 72% of the patients were discharged. The prescription profile for the rational use of antimicrobials for elderly people is provided in the advocated directives for the rational use of the medicines, as well as intended for the patient security.
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Prescrições medicamentosas de pacientes atendidos no ambulatório de geriatria de um hospital universitário: estudo transversal descritivo
(2014-08) CUENTRO, Vanessa da Silva; ANDRADE, Marcieni Ataide de; GERLACK, Letícia Farias; BÓS, Ângelo José Gonçalves; SILVA, Marcos Valério Santos da; OLIVEIRA, Alex Ferreira de
The scope of this study was to evaluate drug prescriptions for elderly patients in the geriatric outpatient ward of a hospital. A cross-sectional descriptive study was conducted in a university hospital, with the application of a questionnaire. Patients aged > 60 years were interviewed about their drug prescriptions and a total of 208 patients were interviewed. The average number of drugs used per person was 3.8 and the drugs most used were for the cardiovascular system (37%). 406 potential interactions were identified in 140 patients (67.3%), and duplicate therapy was found in two prescriptions. The potentially inappropriate drug most used for the elderly was nifedipine (2.4%). Data from this study support the relevance of the issue of drug use among the elderly, thus reinforcing the importance of the evaluation of the process of the prescription of drugs for this population.
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Representações sociais sobre a Aids e a Terapia Anti-Retroviral: influências no tratamento de pessoas vivendo com HIV/Aids
(Universidade Federal do Pará, 2010) CUNHA, Janaina Barbosa Gomes; BARRETTO, André Maurício Lima; http://lattes.cnpq.br/3046718437592588; CHAVES, Ernani Pinheiro; http://lattes.cnpq.br/5741253213910825
As Antiretroviral therapy evolves, AIDS has acquired chronic disease characteristics especially in those countries in which access to medication is actually guaranteed. Brazil has become a model country since it has a health care program that has presented good results towards epidemic control. In November 1996, the Brazilian National Health Care System announced a law which established the mandatory nature of free access to antiretroviral medicat ion for all those who needed it. The obtained results with treatment – that is, progressive reduction of viral load and maintenance and/or reestablishment of immune system functioning – have been associated to outstanding benefits on physical health of HIV-positive patients which allow these people to resume and materialize their life projects. However, universal access to medication that enables free-of-cost treatment for HIV carriers still faces adherence issues. Considering a more restricted understanding, adherence may be defined as a person’s behavior – such as taking medicine, following guidelines of a diet or adopting changes in life style – that relates to recommendations established by the health care team. In this context, this study proposes to analyzing HIV-positive subjects´ social representations of antiretroviral treatment and its implications on their adherence process to it, therefore featuring images and meanings these HIV-positive individuals who have adhered or not adhered to antiretroviral therapy have about this kind of treatment and its consequences on their lives as well as standing out the objectifications and anchorages that form their social representations. Methodology was based on theoretical formulations about qualitative research, prioritizing interviews focused on Explicitness Method of Underlying Speech. These interviews were held at Parasite and Infectious Diseases Special Reference Unit – this unit belongs to the network of Pará State Health Secretariat health care units – and at João de Barros Barreto University Hospital, more specifically at Parasite and Infectious Diseases Clinical Unit.
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A sexualidade de mulheres vivendo com AIDS: contribuições da psicanálise
(Universidade Federal do Pará, 2013) FLEXA, Jucélia Pereira; CECCARELLI, Paulo Roberto; http://lattes.cnpq.br/6109293223271452; MOREIRA, Ana Cleide Guedes; http://lattes.cnpq.br/9245673017553186
The feminization of HIV/aids is a reality in Brazil, according to the Health Ministry's epidemiological data. This work is based on the psychoanalysis referential and presents the case study of Larissa, outpatient at the ambulatory for Specialized Assistance in HIV/aids of the University Hospital João de Barros Barreto. The starting point was the hypothesis that women living with HIV/aids may present subjective consequences before a traumatic diagnosis associated with taboos such as death and sexuality. For Larissa having aids meant rejection, discrimination and abandonment by her partner and parents. On her visits she expressed her concern with how to tell her boyfriend about the virus, fearing an aggressive reaction, talked about her childhood and an adolescence of conflicts with her parents, her father's aggression and complained about her mother, mainly for her not having said anything related to sexuality. In her romantic relationships with men and problems with the law, one might think, according to psychoanalytic theory, that her helplessness may have lead her to masochism. Larissa's ideal of love with these partners points to aspects of a romantic love, in which she expected to find protection and trust. Furthermore, this research also highlights the presence of uneasiness between mothers and daughters realted to talks pertaining to sexuality, the body and female desire, that is, the absence of sexual education which in Larissa's case, left her at the mercy of her partners, without resources to protect herself from diseases such as aids and teenage pregnancy. Larissa's account is in line with those of other female patients living with HIV, investigated in this research, and can serve as a warning to the problem presented on the Brazilian Epidemiological Bulletin of 2012's data, where the incidence of cases of HIV infection in young people from 13 to 19 years is increasing, women being the majority. For Larissa, being able to talk about her sexuality at the clinic, allowed her to find the meanings of the traumatic aspects experienced in her childhood and adolescence, to face her internal conflicts and her sense of helplessness, to think about her relationship with her mother and her daughters and, finally, to say she was "learning to be a woman", which, for her, meant being "more prepared" for life.