OBJECTIVE:To analyze the pattern of use of medications use in aged people and associate it with socioeconomic aspects and with the self-rated health. METHODS:A population-based cross-sectional design study with 934 elderly people from Goiania, Midwestern Brazil, between December 2009 and April 2010. Data were collected through a questionnaire. The dependent variable was the number of medications consumed and the independent variables were sex, marital status, education, type of residence, age, income, and self-rated health. Drugs were classifi ed according to the Anatomical Therapeutic Chemical Classifi cation. The inappropriate drugs for the elderly were identifi ed according to the Beers-Fick criteria. The tests used were Chi-square and Fisher's exact test, p was considered signifi cant when < 0.05. RESULTS:The elderly consumed 2,846 medicines (3.63 medications/person). The most commonly consumed were those which act in the cardiovascular system (38.6%). The prevalence of polypharmacy was 26.4% and selfmedication was 35.7%. The most used drugs for self-medication were analgesics (30.8%), 24.6% of the elderly consumed drug considered inappropriate. Women, widows, those aged 80 or over and with worse self-rated health were more likely to practiced more polypharmacy. Most self-medication was associated with lower levels of education and worse self-rated health. CONCLUSIONS:The pattern of drug use by the elderly was similar to that found in the elderly in other regions of Brazil. The number of drugs used, the prevalence of self-medication and practice of polypharmacy and inappropriate drug use were within the national average.
Control and prevention of methicillin-resistant staphylococcus aureus (MRSA) infections should include early identification of patients at higher risk of MRSA acquisition and analysis of isolates by discriminatory bacterial DNA typing methods. One hundred and three MRSA isolates cultured between Sept. 1994 and Sept. 1995 from 62 patients in two teaching hospitals (hospital 1, in Rio de Janeiro; hospital 2, in Minas Gerais) were tested for antimicrobial resistance and genomic DNA was analysed by pulsed-field gel electrophoresis (PFGE). Ten profiles were identified: A, B, C, I and J in hospital 1 and A, B, D, E, F, G and H in hospital 2. PFGE patterns A and B were isolated at both hospitals. The majority (80%) of isolates had similar PFGE patterns (type A). Subtype A1 was isolated at both hospitals, but was more frequent in hospital 2 (54%), while subtype A2 predominated in hospital 1 (63%). MRSA isolates were resistant to the majority of antimicrobial agents tested. However, susceptibility to vancomycin alone was found in 32% of the isolates at hospital 1, whereas 48% of isolates from hospital 2 were susceptible to both vancomycin and mupirocin, and 34% demonstrated susceptibility to vancomycin, mupirocin and chloramphenicol. Thirty-nine percent of all isolates were mupirocin-resistant, with 90% of these belonging to PFGE pattern A. Four main risk factors were associated with MRSA infection or colonisation which may be useful in the early identification of patients at risk: >7 days hospitalisation (%YO), very dependent patients (84%), invasive procedures (79%) and recent antimicrobial therapy (79%). The data demonstrate that PFGE pattern A is disseminated in both hospitals. However, at both hospitals subtypes of pattern A and the other PFGE types were associated with different antibiotic resistance patterns.
Objective: the aim of this study was to identify factors associated with family functionality of non-institutionalized long-lived subjects, who were residents in Goiânia (GO), Brazil. Method: this was a population-based epidemiological study with cross-sectional outline. Evaluation scales of the functional and cognitive capacities were used. Family dynamics was measured using the Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) instrument by making home interviews with 131 long-lived individuals. Results: there was prevalence of the female gender, average of age of 83.87 years old, widowhood condition, and residence in a big family, primary schooling, and self-perception of regular health. A great amount showed independence for self-care and partial dependence for daily life instrumental activities. Family functionality prevailed with score average of 9.06 points. Conclusion: in conclusion, family functionality in long-lived subjects is associated with self-perception of poor/bad health, osteoporosis, and fall. Results allowed characterizing long-lived subjects' family functionality with the aim of valuing and prioritizing family as a caregiver.
Bacterial counts were made of catheter insertion site and of catheter tips to help determine risk factors associated with catheterization of the jugular and subclavian veins. Among the 116 patients included in this study, 69% had central venous catheters (CVC) in the subclavian vein. Seven or more days catheterization (p=0.001) and > or =3 invasive devices (p=0.01) were infection risk factors associated with catheterization of the jugular vein. More than half of the patients presented high colony counts at the insertion site (> or =200 CFU/20 cm2) and 27% of the catheter tips were contaminated. The risk factors associated with contaminated catheter tips were > or =14 days hospital stay (p=0.02), > or =7 days catheterization (p=0.01) and antibiotic therapy (p=0.04). Coagulase-negative staphylococci (CoNS) and Staphylococcus aureus were the most common microorganisms at the insertion site (78%) and in the catheter tip (94%). Five patients presented sepsis (4.1%), four caused by Staphylococci and one by GNB. Twelve patients had the same microorganisms at the insertion site and catheter tip. We found a high prevalence of ORSA (62.5%) and ORCoNS (57.1%) in catheter tips. The high counts of staphylococci, including ORSA and ORCoNS, at the insertion site, and the significant association of this colonization with catheter tip contamination, indicate that the skin is an important reservoir of microorganisms associated with catheter-related bloodstream infection (CR-BSI). Health professionals should be aware of this potential source of infection at the CVC insertion site.
Enquanto o mundo Lucrécio se compôs de átomos inalteráveis, o de Ovídio se compõe de qualidades, de atributos, de formas que definem a diversidade de cada coisa, cada planta, cada animal, cada pessoa; mas não passam de simples e tênues envoltórios de uma substância comum quese uma profunda paixão a agitapode transformar-se em algo totalmente diferente.
Introduction: Patient safety culture has been the reason for great concern for the scientific community due to the high number of failures resulting from the provision of health care. The objective of this study was to evaluate the perception regarding the patient safety culture and their differences between categories, in the professional teams of the adult intensive care unit (ICU). Methodology: This is a cross-sectional descriptive study, with a quantitative approach, to evaluate the patient safety culture developed in the unit adult ICU of a public university hospital. Results: In this survey, 138 employees of the ICU participated, among them: physicians, psychologists, nutritionists, physiotherapists, nurses, nursing technicians, and secretaries. There was a predominance of nursing technicians (76.8%) and work experience time from 5 to ≥ 21 years (62.3%). The overall mean of the safety culture in the ICU was 57.80, and the domains with the best average were stress perception (73.84) and satisfaction at work (72.38) and with the worst mean was the perception of hospital management (42.69). The perception of safety attitudes in the professional category of physicians presented a general average of 61.63, being strengthened to job satisfaction (77,89) and with a higher perception in relation to nurses. Conclusions: The overall ICU average for the patient safety culture was less than 75, which demonstrates a team with weakened safety attitude and, in addition, low perceptions of safety attitudes based on the results of management domains, working conditions and communication failures.
The objective of this study was to analyze the factors and their prevalence associated with family dysfunction, as well as the functional capacity of the elderly population, in the capital of the state of Goiás, Brazil. This was a cross-sectional and analytical study, which was developed with elderly people who reported family dysfunction. Global capacity and family dynamics were analyzed. For the 149 elderly people with family dysfunction, there was prevalence of the female gender, aged between 60 to 69, married, multi-person home, normal health, and presence of pain. Functional capacity evaluation revealed partial dependence for self-care. In the family dynamics, dialog and time shared by the family were the most fragile aspects, with moderate satisfaction for all domains. High family dysfunction remained associated with falls (p=0.003) and previous episodes of acute myocardial infarction (p=0.004) using Poisson's analysis. The elderly expressed preserved functional autonomy and capacity regarding self-care and social living.
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