Início A atuação do fisioterapeuta na Unidade de Tratamento Intensivo de COVID-19 -...
8 (2022)
A atuação do fisioterapeuta na Unidade de Tratamento Intensivo de COVID-19 – uma revisão
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Introduction: COVID-19 affects each individual differently, so some infected patients require hospitalization to correct the low oxygen in the blood. Therapeutic interventions to correct this anomaly are usually carried out in intensive care units (ICU), with the participation of the intensive care physiotherapist and include, in addition to drug therapy, oxygen therapy and ventilatory support, which is usually invasive, with the need for prone positioning, oxygenation by extracorporeal membrane and inhaled nitric oxide. Thus, this article aims to present, based on the bibliography, the approaches of the physiotherapist professional in the intensive care units of COVID-19. Review: This study was carried out through a literature review research. For the composition of this work, legislation, technical pronouncements from regulatory bodies and nine scientific productions published in Portuguese in the period 2019 to 2021 were used. Consultations were carried out in the SCIELO and LILACS databases. Discussion: The physical therapy approach varies according to the degree of severity, characteristics and intervention approaches. Among the resources used in clinical practice for physical therapy management in patients diagnosed with COVID-19, oxygen supplementation, invasive mechanical ventilation (IMV), positioning and early mobilization stand out. Final considerations: The findings of this research allowed us to conclude that the intensive care physical therapist is of great importance in the multidisciplinary team in the ICUs and that their role directly collaborates in the treatment and prevention of cardiopulmonary, circulatory and muscle pathologies, considerably reducing the chance of possible future complications.
Keywords: COVID-19, physiotherapy, UTI COVID, intensive care unit.
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O papel do Helicobacter pylori no desenvolvimento do esôfago de Barret: uma revisão sistemática
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Introduction: Barrett’s Esophagus is a premalignant condition of the esophagus in which normal stratified squamous epithelium is replaced by intestinal-type metaplastic columnar epithelium after prolonged injury to the esophageal mucosa due to gastroesophageal reflux disease. Helicobacter pylori is a gram-negative bacterium that selectively colonizes the gastric epithelium and is associated with a number of gastroduodenal diseases. Objectives: This study aimed to assess, by means of a systematic revision, the role of Helicobacter pylori in the development of Barrett’s Esophagus. Methods: The most relevant studies originally published in Portuguese and in English in the last 10 years have been analyzed, having as a reference the MedLine (National Library of Medicine) database. In order to select studies with the greatest scientific evidence, only clinical trials and observational studies have been considered. Results: This revision consists of eight articles with equivalent results concerning the positive and protective role of H. pylori in the development of Barrett’s Esophagus, and of one article with an opposite result given the evidence presented. Conclusion: According to our results and to most conclusions available in literature, although H. pylori favors the prevention of Barrett’s Esophagus, the bacterium is considered the main cause of active chronic gastritis and plays a relevant role in the development of gastric adenocarcinoma and of other gastroduodenal diseases.
Keywords: Helicobacter pylori, association, Barrett’s esophagus.
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Descarte de medicamentos: logística reversa
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Introduction: According to Anvisa, every year about 30 thousand tons of medicines are discarded by consumers in Brazil, unfortunately 81% of them are distributed between garbage and water. Given this concern, in 2020 Decree 10,388 of 2020 was published, which regulates the reverse logistics of medicines, involving the entire process of disposing of domestic, industrialized and/or manipulated medicines, expired or in disuse. The objective was to carry out educational measures that assist in the implementation of the Federal Decree that stipulated the reverse logistics program, as well as analyze the impact of the measures. Material and methods: The present study was carried out with 300 adult individuals aged 18 years or over, residents of the municipality of São João da Boa Vista, who were submitted to a questionnaire to assess their knowledge about discarding medications and were subsequently oriented about correct form and location for disposal. For this, a partnership was formed with three local drugstores and monthly the medicines discarded in these drugstores were weighed and classified as solid, liquid and semi-solid (ointment, cream, gel. Results and discussion: It could be noted that most respondents discard medications in the common garbage. It was also observed that the “homemade drugstore” is present in more than 90% of the homes of the survey participants. After conducting the research and providing adequate guidance on the correct disposal of medications, it was possible to observe an increase of approximately 75% in disposal at the partner collection points. Final considerations: The present study showed that expanding the number of collection points and adopting educational measures are essential for the implementation of Decree 10,388/20, which regulates the reverse logistics of medicines.
Keywords: reverse logistics, drug disposal, collection points, federal decree.
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Estudo da utilização de antimicrobianos em uma população
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Introduction: Antimicrobials are natural or synthetic substances capable of destroying or inhibiting microorganisms. The indiscriminate use of these drugs in people of any age or gender is one of the causes of bacterial resistance. The health professional, especially the pharmacist, must have very broad knowledge to guide patients in relation to the indiscriminate use of antimicrobials, because as a result of incorrect use there can be adverse reactions, bacterial resistance and an increase in hospital admissions, in addition to these factors can lead the patient to death. In hospitals, being the gateway to infections, the use of antimicrobials increases, as a result the length of stay can also be longer. As for the prescription, it is necessary for the physician to have notions of infections, because when antimicrobials are no longer effective, infections suffer progression, without having a therapeutic action to fight them. Side effects can be seen in anyone, some are more susceptible to symptoms. To reduce misuse, it is necessary that the pharmacist provides adequate assistance and guidance to the patient. The aim of this study was to analyse how antimicrobials are used, determining which are the most consumed. This is a cross-sectional descriptive research that approached people who used antimicrobials, this research was intended to address from how they were prescribed to their administration and side effects. Material and methods: The instrument used for data collection was a questionnaire with open and closed questions with the aim of tracing the profile of the people interviewed and evaluating the use of antimicrobials. The questionnaire had 28 questions, in which patients were asked about sex, age, family income, marital status, education, alcohol consumption, physical exercise, smoking, health problems, continuous use medication, use of antimicrobials, prescriptions, side effects and tests, for the classification of drugs, the ATC standards were used. Results and discussion: In this study 67 people participated, where it was possible to observe that 60 (89.6%) people used antimicrobials in 2017. Final considerations: It is concluded that most respondents had a prescription for the use of antimicrobials, which is an important factor in the proper treatment, and it is also important, at the time of dispensing the antimicrobial, that the pharmacist guide the patients, avoiding indiscriminate use, which generate bacterial resistance, adverse reactions, increased hospital admissions and numerous serious causes.
Keywords: antimicrobials, bacteria, antibiotics, bacterial infections.
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Aspectos relacionados a associação entre obesidade e Covid-19: uma revisão integrativa
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Introduction: At the end of 2019, a new type of coronavirus was identified, named SARS-CoV-2 which was found to be responsible for the disease COVID-19. Some patients develop the severe form of the disease, requiring intensive care, such as people with comorbidities. Among these comorbidities, obesity stands out, thus highlighting the importance of knowing aspects related to virus infection, especially its association with this health problem. Review: this is an integrative literature review, using databases such as LILACS, MEDLINE, SciELO and PUBMED, searched through the solutions of the following descriptors in Health Sciences (DeCS) and their correspondents in the Medical Subject Headings (Mesh): Comorbidity. Risk factors. Coronavirus infections. Obesity. Discussion: 32 articles were arranged in the light of the literature, demonstrating the relationship between obesity and SARS-CoV-2 infection. Final remarks: With the study's findings, it was possible to understand that obesity presents itself as a risk factor for severe COVID-19, these factors imply important complications and repercussions of the person with obesity: mechanical ventilation, hospitalization and intensive care
Keywords: comorbidity, risk factors, coronavirus infections, obesity.
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Estudo da prevalência de enteroparasitoses em pacientes de um laboratório privado do município de Santarém
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Introduction: Enteroparasitosis are still marked as a global public health problem, which occurs due to factors related to socioeconomic, environmental and cultural issues, which occurs due to factors related to socioeconomic, environmental and cultural issues. Objective: The research aimed to provide the epidemiological profile of enteroparasitosis in patients treated in the private clinical analysis laboratory, reporting the prevalence and frequency of enteroparasitosis in children, adolescents and adults living in the city of Santarem-PA. Material and methods: This is a cross-sectional descriptive analytical study, carried out through the analysis of parasitological reports referring to patients treated in a private laboratory in the lower amazon region. Results and discussion: Based on the results obtained in the research, it was notorious that the prevalence of intestinal parasitosis was higher in children aged 1-10 years (54%), with the majority of those infected being female, as well as in childhood and adulthood. Final considerations: Through the results obtained, it is evident that it is necessary to improve the basic health condition and health education to raise awareness of the population about the risks and prevention of parasites, thus providing quality of life to the community.
Keywords: enteroparasitosis, Endolimax nana, protozoa, helmi, search.
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Acompanhamento farmacoterapêutico em pacientes idosos de uma entidade de longa permanência de São João Da Boa Vista – SP
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Pharmacotherapeutic monitoring (PA) is a major challenge for the pharmaceutical professional and becomes an important tool to reduce medication errors, which interferes with the effectiveness of treatment, resulting in the improvement or not of health problems and quality of life. In the case of the elderly, the quality of life depends on their ability to combine emotional and physical health, because with advancing age, their functional capacity decreases, and they tend to lose their independence, thus compromising their autonomy. The objective of this study was to carry out the pharmacotherapeutic follow-up of the elderly, in order to alleviate errors related to drug treatment, resulting in an improvement in the quality of life of these patients. Material and methods: A survey was carried out using the Soap Method in which subjective data and objective data were collected, then carried out the evaluation and finally, the action plan for the identified problem. Results and discussion: Of the 10 patients interviewed, the most common pathologies were cardiovascular problems and diabetes mellitus, of the 10 patients interviewed, in 3 there was no drug interaction, however, 7 had drug interactions, referring to their pharmacological treatment, with 32% interactions severe and 68% moderate. Any unwanted effect that could interfere with and impair the patient's pharmacotherapy is defined as Drug Related Problems (DRPs). Final considerations: Pharmacotherapeutic monitoring shows the importance of inserting the pharmacist in the multidisciplinary health team, in which she can exercise and practice the knowledge acquired at graduation, in order to guarantee the efficiency of pharmacotherapy and finally improve the quality of life of patients.
Keywords: pharmacotherapeutic follow-up, elderly, drug-related problems, quality of life, SOAP.
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Gestação na infância e na adolescência de pessoas em situação de vulnerabilidade social
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Introduction: Pregnancy in childhood and adolescence occurs more frequently in girls who go through situations of social vulnerability, such as low income, fragile school access, precarious housing conditions and low access to health services. In this context, it is known that an early pregnancy entails several risks for both mother's and baby's health. The numbers of cases are very high, classifying it as a public health problem, which needs to be studied. Review: The goal of the article was to improve the understanding of pregnancy in childhood and adolescence of girls in social vulnerability situations. The execution was made through scientific articles and programs of health organizations. Discussion: Twenty references were used for the study. Being eleven scientific articles, seven publications from governmental health organizations and two informative websites on the subject. Final considerations: Through the research, the conclusion was that social vulnerabilities are closely linked with pregnancy in childhood and adolescence, and need to be faced and resolved so that this public health problem can be reduced. However, as much as there are preventive programs for early pregnancy, the numbers remain high, characterizing their low efficiency.
Keywords: adolescence, pregnancy, childhood, vulnerabilities.
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Entraves da atenção farmacêutica nas unidades básicas de saúde
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Introduction: Pharmaceutical Care proposes that the pharmaceutical professional acts by identifying, intervening and preventing the Problems Related to Medicines (PRM), through actions that promote rational use. Review: Systematic literature of the integrative type of relevant evidence-based studies, which were published between the years 2007 and 2020 in the Google Scholar, Lilacs, PubMed and SciElo databases, in English, Spanish and Portuguese. Discussion: The literature review allows addressing the main barriers of Pharmaceutical Care in UBS, evaluating the participation of the pharmacist and highlighting its importance in promoting access and rational use of medicines, with approaches that highlight the difficulties of insertion. Final considerations: Despite the barriers faced by the pharmaceutical professional, it is extremely important to act in front of the health team, since the pharmacist has scientific technical knowledge with regard to Pharmaceutical Care, thus promoting effective and quality care. However, it is important that the professional is inserted to carry out the actions inherent to their training, aiming at success in the users' pharmacotherapy.
Keywords: pharmaceutical care, pharmacotherapeutics, PRM, rational use of medicines.
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Interações medicamentosas entre terapias anti-hipertensivas e terapêutica odontológica: revisão de literatura
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Introduction: Arterial hypertension affects a huge part of the Brazilian population and this condition is commonly found within the male and elderly population, leading to the use of anti-hypertensive medication in some cases. Drug interactions may happen in hypertensive patients undergoing dental treatment with real risks of side effects and permanent damage. This literature review aims to clarify the subject of drug interactions that may happen among antihypertensive agents and those implemented in dental treatments in order to increase safety toward patient prescriptions. Review: The methodology involved and extensive bibliographical research on Bireme and Lilacs databases, Scielo indexer, Google Scholar, and literary work available on the subject. The data collection included papers published in the last 12 years, from 2009 to 2021. Discussion: Among the most commonly used medications in routine dental care, the Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) resulted as the most noteworthy aspect of this research due to the enormous incidence of interactions when associated with anti-hypertensive drugs, especially decreasing the expected effects of such drugs in regulating blood pressure. Final considerations: Once the risks of drug interactions in Dentistry are imminent, the routine drug prescription and application must be performed safely and responsibly by professionals and students alike, taking into account the hypertensive patient’s full medical history and understanding the risks that the drug associations may cause.
Keywords: drug interactions, hypertension, antihypertensive agents, dental care.
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Prevalência de dor osteomuscular em idosos atendidos em uma unidade básica de saúde de Petrolina- PE
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Introduction: The population is aging slightly, given this process, there are problems such as musculoskeletal diseases. The objective was to verify the prevalence of musculoskeletal pain in the elderly assisted at a basic health unit in the urban area of Petrolina-PE. Material and methods: The musculoskeletal pain variable was assessed using a structured questionnaire based on the general Portuguese version of the Nordic Musculoskeletal Questionnaire (QNSO) crossculturally adapted for Brazil. Data processing and analysis were performed using the Statistical Package for Social Sciences (SPSS) version 16, after insertion through double typing. Results and discussion: The prevalence of musculoskeletal pain in the elderly cared for in a basic health unit in Petrolina Pe was high, and the most referred body site was the knee area. Final considerations: More studies are needed to demonstrate this prevalence in the elderly with larger samples and covering more locations.
Keywords: musculoskeletal pain, elderly, prevalence.
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As vivências de mulheres HIV positivas durante o acompanhamento do pré-natal e no pós-parto
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Abstract: Introduction: Pregnancy is a moment that brings many emotions in women's lives and the positive diagnosis for HIV will interfere directly in their prenatal care. This study aimed to understand the experiences of HIV-positive women during prenatal and postpartum follow-up. Review: This is a literature review study. The Virtual Health Library (VHL) was used to select the articles that guided the research. In the VHL, the following descriptors were used: HIV, pregnant women, prenatal care, maternity, feelings and mental health care, crossed with each other using the Boolean operator AND to interconnect the descriptors. The filtering criteria for inclusion of the articles were: Portuguese and English, last 5 years and the databases (Lilacs, Scielo, BDENF, MEDLINE). Discussion: After study and analysis of the 11 articles chosen to compose the work, it was possible to identify three aspects that are most part of the experiences of HIV-positive women during pregnancy and postpartum, they are: The feelings, emotions and mental health, the relationship with partners, family members and health professionals and the stereotypes about the diagnosis and how it affects seropositive pregnant and postpartum women. Final considerations: The multiprofessional team needs to have an active listening and clinical look in order to provide a comprehensive care that attends all the biopsychosocial issues of HIV-positive women, from pregnancy planning to postpartum.
Keywords: mental health care, prenatal care, pregnant women, HIV, maternity, feelings.
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