RESUMO: No estado do Amapá, o comércio de camarões de água doce é realizada em feiras livres, bares, restaurantes, supermercados e peixarias, onde envolve um número significativo de pessoas denotando sua importância social e econômica. A venda de camarões de água doce e seus derivados tem crescido substancialmente nas últimas décadas. No entanto, os protocolos de preparação, manuseio e conservação realizados sem considerações de higiene muitas vezes faz o consumo de camarões perigosos para os consumidores. O objetivo deste estudo foi diagnosticar os aspectos higiênico-sanitários no comércio de camarão de água doce, além de descrever a variação do preço e dinâmica de fornecimento desse camarão, em feiras populares das cidades de Macapá e Santana entre Fevereiro e novembro de 2011. O ambiente visual, a construção, a instalação, o equipamento, o mobiliário e utensílios, a presença de vetores e pragas urbanas, o abastecimento de água, a gestão de resíduos e os manipuladores foram analisados de acordo com base nas recomendações da Resolução-RDC nº. 216/04 da Agência Nacional de Vigilância Sanitária (ANVISA). Os resultados demonstram que, apesar de a comercialização de camarão se movem quantidades significativas de recursos, as feiras Macapá e Santana não mostraram condições de infraestrutura e higiene adequados. A manipulação inadequada e higiene observada pode afetar a qualidade bioquímica e microbiológica de camarões comercializados e facilitar a transmissão de patógenos para os consumidores. As variações de preços dos camarões ao longo do ano estão diretamente relacionados com as variações sazonais de oferta, tamanho e formas de comercialização, demonstrando claramente a ocorrência de um período de safra na região. Macrobrachium amazonicum foi a espécie com maior variação de volume e de preço durante o estudo. Afuá foi a região com maior oferta em volume de camarões durante o estudo. Palavras-chave: comércio de camarão, mercado, oferta-procura, higiene da feira.
Objective:To characterize medication incidents occurred in an outpatient emergency service. Method: Descriptive, documental, retrospective and quantitative research. The International Classification for Patient Safety was the theoretical reference for the construction of the instrument used to collect and analyze the data from 119 notification and investigation forms of incidents occurred in 2014 in a teaching hospital. Data were collected twice, compared, corrected and transcribed to an Excel worksheet. The SPSS 19.0 Software and the non-parametric Mann-Whitney test were used in the analysis; p<0.05 indicated statistical significance. Results: A total of 142 incidents were analyzed, most of them involving the nursing team; 93.7% were avoidable; one-third involved high-alert medications; the majority involved parenteral administration. Harm was rare but proportional to the time elapsed for error detection. Management failures prevailed, especially omission. Conclusion: Most of the incidents analyzed were characterized as potentially harmful and avoidable, with emphasis on personnel factors as contributors.
RESUMO: Este estudo objetivou buscar evidências científicas que abordassem os principais erros de medicação e suas causas observados pela enfermagem nas instituições hospitalares de internação integral, bem como, descrever as estratégias utilizadas para promover a segurança medicamentosa nestas instituições. Foram selecionados 79 artigos de três bases de dados, entre os anos de 2004 a 2015. Os tipos de erros mais citados foram dose imprópria 35 (13,3%), omissão de dose 30 (11,5%), e horário errado 29 (11,1%). As causas mais citadas foram as relacionadas ao fator humano 43 (35,2%), sistema 37 (30,3%) e comunicação 22 (18%). As estratégias que se destacaram foram implantação de protocolos de segurança de preparo e administração de medicamentos, prescrição eletrônica, inclusão do profissional farmacêutico na equipe e treinamento/orientação da equipe. Acredita-se que esta revisão possa contribuir para melhoria do processo de administração de medicamentos e para criação de estratégias de prevenção que fomentem a segurança do paciente.
We verified clinical and psychopedagogic aspects of congenital cases with ocular sequelae, 13 years after toxoplasmosis outbreak in Santa Isabel do Ivaí, and current seroprevalence of this zoonosis in pregnant women. Audiologic and ophthalmologic evaluations were performed in congenital cases, in addition to collection of clinical and psychopedagogic data. In pregnant women, current seroprevalence was observed. Among affected teenagers, 2 of 5 are behind in school grade, and 4 of 5 reported learning difficulties, requiring psychopedagogic monitoring, as well as ocular complaints. We observed predominance of small, scarred, dispersed, type II chorioretinal lesions (hypopigmented halo and hyperpigmented central area), and 1 case of ocular relapse. All patients presented normal audiologic assessment. Among 131 pregnant women, 62 (47.3%) were seronegative and 39 (29.8%) were IgG reactive. Only 1 reported acquiring infection during the outbreak. This is one of the few studies in Brazil showing the outcome of congenital toxoplasmosis, a decade after infection, in one of the world's largest outbreaks.
Introduction Henoch-Schönlein purpura is a multisystem small vessel vasculitis. Neurologic manifestations are uncommon. Posterior reversible encephalopathy syndrome is a rare complication of Henoch-Schönlein purpura with typical clinical and neuroimaging findings that occurs most commonly in the setting of severe hypertension and renal injury. Case presentation A seven-year-old girl was admitted to our institution presenting with clinical and laboratory findings suggestive of Henoch-Schönlein purpura. Glucocorticoid therapy was initiated, but five days following her admission, she developed altered consciousness, seizures, arterial hypertension, and cortical blindness. Brain MRI scan revealed areas of vasogenic oedema in parieto-occipital lobes, consistent with posterior reversible encephalopathy syndrome. She was immediately initiated on antihypertensives and antiepileptics, which successfully improved her neurologic symptoms. Further laboratory work-up disclosed a rapidly progressive glomerulonephritis secondary to Henoch-Schönlein purpura that was the likely cause of her sudden blood pressure elevation. Immunosuppressive therapy was undertaken, and at one-year follow-up, the patient exhibited complete renal and neurologic recovery. Conclusion Posterior reversible encephalopathy syndrome is a severe complication of Henoch-Schönlein purpura. If promptly diagnosed and treated, children with Henoch-Schönlein purpura presenting with posterior reversible encephalopathy syndrome usually have a good prognosis. Clinicians should be familiar with the characteristic presentation of posterior reversible encephalopathy syndrome and be aware that hypertension and renal injury may predispose Henoch-Schönlein purpura patients to developing this complication.
Objectives: to identify, classify, and analyze modes of failure in the medication process. Methods: evaluative research that used the Healthcare Failure Mode and Effect Analysis (HFMEA) in a service of bone marrow transplant from June to September 2018, with the participation of 35 health workers. Results: 207 modes of failure were identified and classified as mistakes in verification (14%), scheduling (25.6%), administration (29%), dilution (16.4%), prescription (2.4%), and identification (12.6%). The analysis of risk showed a moderate (51.7%) and high (30.9%) need of intervention, leading to the creation of an internal quality assurance group and of continued education activities. Conclusions: the Healthcare Failure Mode and Effect Analysis showed itself to be a tool to actively identify, classify, and analyze failures in the process of medication, contributing for the proposal of actions aimed at patient safety.
In 1990, the first Teratogen Information Service in Brazil (SIAT) was implemented in the Medical Genetics Service at Hospital de Clinicas de Porto Alegre. SIAT is a free-to-use information service both to health professionals and the general population, especially to women who are pregnant or planning pregnancy. The main objective of this paper is to present the activities of SIAT in its initial years (1990-2006), compared to those in the last decade (2007-2017). In addition we review the scientific contribution of SIAT in the field of human teratogenesis. Since 1990, SIAT received 10,533 calls. Use of medications were the main reason for concern, accounting for 74% of all questions, followed by other chemical exposures (occupational, cosmetics, environmental), and maternal infectious diseases. Among its main contributions to scientific knowledge was the collaboration for the identification of two new human teratogens: misoprostol in the 1990s and Zika virus in 2015/16. In conclusion, SIAT is still evolving, as is the Medical Genetics Service that hosts it. Through its 27 years of existence more than 300 undergraduate and graduate students have rotated at SIAT. Presently, SIAT is expanding the research to experimental teratogenesis and to investigation of molecular mechanisms of teratogens.
Objetivo: Identificar a conduta do enfermeiro diante dos casos de depressão gestacional e puerperal, bem como descrever sinais ou sintomas da depressão. Métodos: Trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa, com buscas de artigos nas bases de dados da BVS, SciELO, LILACS e PubMed, publicados entre os anos de 2015 a 2020, disponíveis nos idiomas português, inglês e espanhol. A pesquisa foi realizada entre janeiro a maio de 2020. Utilizou-se um quadro para distinguir os artigos que se encaixaram na questão norteadora. Resultados: Revisaram-se 23 artigos, sendo agrupados por semelhança na temática apontando as principais condutas do enfermeiro diante de gestante e puérpera com depressão, bem como os sinais e sintomas característicos da doença. Identificou-se, que o acolhimento e humanização no atendimento à mulher, promovem bem-estar, redução de danos, vínculo entre profissional e cliente. Considerações finais: Torna-se imprescindível a criação de novas pesquisas sobre a temática abordada, a fim de propor consultas, intervenções de enfermagem direcionadas e qualificadas à gestante e puérpera.
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