Rev Esc Enferm USP2014; 48(3):537-51 www.ee.usp.br/reeusp/ RESUMEN Objetivo: Identificar los factores de riesgo para la ocurrencia de caídas en pacientes adultos hospitalizados. Método: Revisión integradora de la literatura de artículos publicados entre los años 1989 al 2012 en las bases de datos LILACS, SciElO, MEDLINE y Web of Science. Resultados: La muestra final estuvo compuesta por setenta y un artículos. Entre los factores de riesgo de caídas indicados en esta revisión están los relacionados con el paciente (intrínsecos), con el ambiente hospitalario y con el proceso de trabajo de los profesionales de la salud, especialmente enfermería (extrínse-cos). Conclusión: La detección sistemática de factores de riesgo asociados a caídas fue identificada como un factor que contribuye a la reducción de este daño, favoreciendo de esta manera su no ocurrencia, la que a pesar de ser prevenible puede acarrear consecuencias graves, incluyendo la muerte. DESCRIPTORESAccidentes por caídas Pacientes interno Hospitalización Seguridad del paciente Atención de enfermeira Revisión RESUMOObjetivo: Identificar os fatores de risco para a ocorrência de quedas em pacientes adultos hospitalizados. Método: Revisão integrativa realizada nas bases de dados LILACS, SciELO, MEDLINE e Web of Science, abrangendo artigos publicados entre 1989 e 2012. Resultados: Setenta e um artigos compuseram a amostra final do estudo. Os fatores de risco para quedas apresentados nesta revisão foram relacionados ao paciente (intrínsecos), ao ambiente hospitalar e ao processo de trabalho dos profissionais da saúde, em especial à enfermagem (extrínsecos). Conclusão: A triagem sistemática de fatores de risco para queda foi identificada como fator contribuinte para a redução desse agravo, auxiliando a não ocorrência deste evento que, apesar de ser prevenível, pode determinar consequên-cias graves incluindo o óbito. DESCRITORES Acidentes por quedas Pacientes internados Hospitalização Segurança do paciente Cuidados de enfermagem Revisão ABSTRACTObjective: Identifying risk factors for the occurrence of falls in hospitalized adult patients. Method: Integrative review carried out in the databases of LILACS, SciELO, ME-DLINE and Web of Science, including articles published between 1989 and 2012. Results: Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). Conclusion: The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the nonoccurrence of this event that, despite being preventable, can have serious consequences including death. DESCRIPTORS
In a sample without smokers, morbidly obese, or diabetic patients, AHI is the main predictor of CAD. SA should integrate the set of risk factors routinely assessed in clinical investigation for coronary disease risk stratification.
The use of the Brazilian CPOT and BPS versions showed good reliability and validity in critically ill adults unable to self-report. A standardized procedure, the SNSPA, was used for the first time in the validation process of these tools and helped us improve the validation process.
Objective: To assess, by Rankin scale, the functional disability of patients who had a malignant middle cerebral artery (MCA) ischemic stroke, who underwent decompressive craniotomy (DC) within the first 30 days. Methods: A cross-sectional study in a University hospital. Between June 2007 and December 2014, we retrospectively analyzed the records of all patients submitted to DC due to a malignant MCA infarction. The mortality rate was defined during the hospitalization period. The modified outcome Rankin score (mRS) was measured 30 days after the procedure, for stratification of the quality of life. Results: The DC mortality rate was 30% (95% CI 14.5 to 51.9) for the 20 patients reported. The mRS 30 days postoperatively was ≥ 4 [3.3 to 6] for all patients thereafter. Conclusion: DC is to be considered a real alternative for the treatment of patients with a malignant ischemic MCA infarction.Keywords: craniotomy; cerebral infarction; intracranial hypertension. RESUMOObjetivo: Avaliar a capacidade funcional de pacientes com acidente vascular cerebral isquêmico no território da artéria cerebral média (ACM) submetidos à craniotomia descompressiva (CD) no período de 30 dias pela escala de Rankin. Métodos: Estudo transversal em um hospital universitário. Entre junho de 2007 e dezembro de 2014, analisados retrospectivamente os registros de todos os pacientes submetidos a CD devido a enfarte maligno na ACM. A taxa de mortalidade foi definida durante o período de internação. O resultado da estratificação da qualidade de vida foi através da escala Rankin modificado (mRS) mensurado em 30 dias após o procedimento. Resultados: A taxa de mortalidade CD foi de 30% (IC 95% 14,5-51,9) para os 20 pacientes relatados. A mRS 30 dias de pós-operatório foi => 4 [3,3-6] para todos os pacientes. Conclusão: CD deve ser considerada uma alternativa real para o tratamento de pacientes com enfarte isquêmico no território da ACM.Palavras-chave: craniotomia; infarto cerebral; hipertensão intracraniana.A decompressive craniotomy (DC) has been a therapeutic option for an infarction of the middle cerebral artery (MCA) region. The goal of the surgical treatment is the reduction of the intracranial hypertension. The procedure is based on a fronto-parieto-temporal craniotomy, ipsilateral to the lesion, followed by plastic reconstruction of the dura mater, allowing immediate decompression of the brain 1,2,3,4,5 .Some complications, such as infection of the surgical area, temporal muscle hematoma with cerebral compression, intracerebral hemorrhage, or worsening of the neurological condition may follow DC 2,3,4 . In order to clearly define the indication for the surgical treatment and to decrease complications derived from DC in a university hospital in southern Brazil, a specific protocol for DC in the treatment of intracranial hypertension derived from ischemia of the MCA region has been implemented since 2007, in conjunction with the neurology department. Even though studies have demonstrated the efficacy of DC in patients presenting with ma...
In conclusion, simple questionnaire-based diagnostic tools can be included in the screening procedures of patients with angina to detect the need for further OSA evaluation. In conclusion, the BQ is an effective instrument for this purpose.
Sleep disordered breathing (SDB) is related to coronary artery disease (CAD), but the mechanisms are uncertain. SDB is characterized by periods of intermittent hypoxia and free radical formation. This study tested the hypothesis that carbonylation can be the link between SDB and CAD. It included 14 cases with CAD and 33 controls with <50% coronary narrowing. CAD cases have higher erythrocyte carbonyl levels than controls (p = 0.012). Positive correlation was observed between apnea-hypopnea index (AHI) and erythrocyte carbonyl concentration (rho = 0.310; p = 0.027). To predict CAD, including as regressors: AHI, erythrocyte carbonyl, gender, age and body mass index, the significant variables in the Poisson multiple regression model were AHI and erythrocytes carbonyl. An increase of 1 pmol/gHb in erythrocyte carbonyl levels increases by 1.8% the risk of CAD and one unit of AHI increases by 3.8% the risk of CAD. The present findings represent the first evidence in humans that SDB may cause CAD through protein carbonylation.
These results indicate that PON-1 and ox-LDL are important predictors of CAD, however they may not be directly related to SDB.
Objective: to evaluate the knowledge of nurses from two general hospitals on heart failure (HF) syndrome and the factors that interfere with the guidance they provide to patients. Methods: knowledge was assessed by the 14-item Nurses' Knowledge of Heart Failure (NKHF) questionnaire. Participants were also asked about guidance, guidance limitations, and self-assessment of knowledge on HF. Results: fifty-one nurses were evaluated, 82.4% of which achieved a percentage of 70% of correct answers. Symptoms of advanced HF and use of sildenafil were the items that had the lowest 1
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