Search

To analyze the knowledge and safety of primary health care professionals in the management of chronic kidney disease in its early stages. Integrative literature review carried out in four steps. The search took place in the following databases: MEDLINE via PubMed, Web of Science, Scopus and BVS. The descriptors used were “Primary Health Care” AND “Kidney Diseases” AND “Health Knowledge, Attitudes, Practice” and the quality of the analysis was checked by means of the Hierarchy of Evidence for Intervention Studies”. Fifteen articles were found, with a predominance of qualitative and descriptive method; the results showed insufficient knowledge of health professionals and interest in the best approach in the initial stage of the disease. Thus, it is inferred that the knowledge and security of primary health care professionals depend on individual factors and institutional initiative for the adoption of clinical guidelines and training. Therefore, prepared professionals and organized care, using protocols, would bring benefits both to patients as to the evolution and outcome of the disease and savings to health services.

Objective: To identify in the literature the execution and frequency of standardized hand hygiene techniques by nursing professionals who work in surgical center units. Method: Integrative review by primary studies indexed in online databases, in all languages. Results: Two articles were selected that answered the guiding question and met the inclusion criteria. The results pointed to the low adherence and frequency of hand hygiene. Conclusion: Therefore, it is important to seek strategies to train the professional, which makes him/her capable of identifying obstacles that impede the correct HM technique and orientate it in relation to the appropriate frequency of hand washing in an efficient way. Promotion of improved health care.

Resumo Objetivo: Validar o conteúdo e a aparência dos protocolos gráficos para avaliação da estrutura, processo e resultado do cuidado seguro de enfermagem ao paciente politraumatizado em situação de emergência. Métodos: Estudo metodológico e quantitativo. Para a coleta de dados, aplicou-se a técnica de Delphi em duas rodadas (Delphi I e Delphi II). A amostra do Delphi I consistiu em 15 juízes e o Delphi II arrolou 13 juízes. Considerou-se válidos aqueles itens dos protocolos com Índice de Validação de Conteúdo (IVC) maior que 0.78 e consenso de mais de 70,0% na técnica de Delphi. Os dados foram analisados por meio de estatística descritiva e inferencial (Teste de Wilcoxon e Binomial). Adotou-se o ρ-valor ≤ 0,05 para a significância estatística. Além disso, aplicou-se o Alfa de Cronbach (α) para avaliar a consistência interna dos protocolos. Considerou-se confiável aquele item que apresentasse o α ≥ 0,7. Resultados: Todos os requisitos de avaliação dos protocolos alcançaram concordância entre os juízes superior a 80,0%, bem como todos os itens alcançaram níveis de avaliação estatisticamente significativos. Ao final do Delphi II, os três protocolos se apresentaram expressivamente válidos (estrutura [IVC = 0,92]; processo [IVC = 0,96]; e, resultado [IVC = 0,96]) e confiáveis (estrutura [α = 0,95]; processo [α = 0,95]; e, resultado [α = 0,89]). Conclusão: Atingiu-se a validação de conteúdo e de aparência dos protocolos integralmente, assim como, a validação interna com exímio.

Vaccines or immunobiologicals have antigenic properties and, in public health, are considered an important strategy in the prevention and control of immuno-preventable diseases. The objective of this study was to carry out review of the nursing staff's role in vaccine care. This is a scoping review, conducted in first semester of 2017, with data collected in 17 national and international databases. To guide the evaluation of the selected materials, an instrument composed of some collection indicators was used. The final sample consisted of eight publications. The data was inserted into the Microsoft Excel 2010 Program, and analyzed in a descriptive way. The identification of a variety of actions of the nursing team in the care with vaccines was verified and grouped in: vaccine room; behavior in the vaccine room; refrigerator care; organization of vaccines inside the refrigerator; monitoring and register of changes in temperature; measures adopted with vaccines under suspect; behaviors regarding vaccines in thermal boxes; professional knowledge in the vaccine room and other important behaviors. Given this evidence, it is essential to detect factors that may compromise the quality and conservation of vaccines. For this, it is understood the need for training aimed at the professionals involved in the immunization and the importance of supervision activities in the vaccine room by the nurse.

construct and validate an instrument for evaluation and evolution of chronic wounds. The content and apparent validities were appreciated by experts, the reliability by the analysis of concordance between evaluators using the interclass correlation coefficient and to verify the construct validity was used the instrument Pressure Ulcer Scale for Healing. the analysis of the scores of the instrument by the ICC showed an excellent and significant correlation (K = 0.914) and to verify the construct validity of the instrument, the Pearson correlation coefficient, whose result was 0.573, showed a statistically significant and strong correlation between the scores instrument and the Pressure Ulcer Scale for Healing. Most of the concordances of the items were classified as moderate or substantial. The instrument is valid and reliable. It is suggest longitudinal studies in larger populations, semantic validation in a sample of nurses, and an illustrative guide to standardize concepts in order to improve the evaluation of metric properties.

Abstract Objective: To analyze "nursing education" using Rodgers' evolutionary conceptual analysis. Method: An analysis was performed based on Rodgers' evolutionary conceptual analysis. Data collection was performed in June 2017 using the following databases: Lilacs, SciELO, Scopus, Cinahl, Web of Science, PubMed and Cochrane with the descriptors "teaching" and "nursing". The year of publication, country of origin, concept, attributes, antecedents, consequences, surrogate terms and related concepts were evaluated in the analysis of the studies. Results: The antecedents and consequences were punctuated in determinant aspects for the construction of the concept of nursing education and characteristics inherent to the training process; surrogate terms address factors of educational follow-up; the attributes of the concept may be related to the fundamentals of the teaching-learning process and resources related to teaching strategies. Conclusion: The concept of nursing education is dynamic and seeks to train professionals so that they can offer adequate care to the patient according to the transformations and needs of different populations.

OBJETIVOS: Analisar as correções obtidas através da instrumentação segmentar seletiva torácica, utilizando parafusos pediculares, em pacientes portadores de escoliose idiopática com modificador lombar B ou C; verificar a segurança da técnica e a descompensação das curvas compensatórias não instrumentadas; observar a perda de correção das curvas instrumentadas e não instrumentadas com o tempo. MÉTODOS: Estudo retrospectivo de pacientes portadores de escoliose idiopática com curvas 1B, 1C, 2B e 2C submetidos a tratamento cirúrgico por via posterior utilizando parafusos pediculares. As variáveis analisadas foram: sexo, idade, níveis acometidos pela escoliose, níveis instrumentados, número de parafusos pediculares utilizados, classificação segundo Lenke, ângulos de Cobb pré-operatórios coronal e sagital (incluindo inclinações), ângulos de Cobb no pós-operatório imediato e tardio e perda da correção das curvas com o tempo. Foram submetidos 20 pacientes portadores de escoliose idiopática à tratamento cirúrgico seletivo de agosto/2004 a outubro/2007. Destes, 18 permanecem em acompanhamento e foram incluídos no trabalho porque satisfizeram os critérios de inclusão. RESULTADOS: A média do ângulo de Cobb no pré-operatório foi de 52,61º, no pós-operatório imediato foi de 17,89º e no pós-operatório tardio, 22,15º, com média de correção imediata de 34,72° e perda de correção média 4,26º em 39,78 meses. Obteve-se uma correção espontânea média imediata de 22,62° nas curvas compensatórias não instrumentadas e perda média de 2,72º dessa correção em 39,78 meses. Não ocorreram complicações neurológicas, infecciosas ou descompensações das curvas lombares. CONCLUSÃO: Todos os pacientes apresentaram melhora substancial em termos estéticos, clínicos e radiológicos. Ocorreram perdas parciais da correção com o tempo, porém sem culminarem em descompensação das curvas não instrumentadas. Este trabalho mostra indícios de eficácia e segurança do tratamento cirúrgico seletivo da escoliose idiopática utilizando-se parafusos pediculares a médio/longo prazo.

OBJETIVO: a proposta deste trabalho é comparar os resultados clínicos e radiológicos dos pacientes submetidos à artrodese transforaminal aberta e minimamente invasiva. MÉTODOS: quarenta e cinco pacientes foram submetidos à artrodese lombar transforaminal pelo Grupo de Cirurgia Espinhal do Hospital Lifecenter/Ortopédico de Belo Horizonte, no período de Dezembro de 2005 a Maio de 2007, sendo 15 no grupo de artrodese aberta e 30 pacientes do grupo de artrodese minimamente invasiva (MIS). As indicações para a artrodese intersomática foram: doença degenerativa do disco, associada ou não a hérnia de disco ou estenose do canal; espondilolistese de baixo grau espondilolítica ou degenerativa; e síndrome pós-laminectomia/discectomia. As variáveis analisadas foram: tempo de cirurgia, tempo de internação hospitalar, necessidade de hemotransfusão, escala analógica visual de dor (VAS) lombar e dos membros inferiores, Oswestry, índice de consolidação da artrodese e retorno ao trabalho. RESULTADOS: o seguimento mínimo foi de 24 meses. Havia oito homens e sete mulheres no Grupo Aberto e 17 homens e 13 mulheres no Grupo MIS. O tempo cirúrgico médio foi de 222 minutos e 221 minutos, respectivamente. Houve melhora significativa da VAS e Oswestry no pós-operatório em ambos os grupos. O tempo de internação hospitalar variou de 3,3 dias para o Grupo Aberto e 1,8 dias para o Grupo MIS. O índice de fusão obtido foi de 93,3% em ambos os grupos. Houve necessidade de hemotransfusão em três pacientes no Grupo Aberto (20%) e nenhum caso MIS. CONCLUSÕES: a transforaminal lumbar interbody fusion (TLIF) minimamente invasiva apresenta resultados similares em longo prazo quando comparado à TLIF aberta, com os benefícios adicionais de menor morbidade pós-operatória, menor período de internação e reabilitação precoce.OBJETIVO: la propuesta de este trabajo es comparar los resultados clínicos y radiológicos de los pacientes sometidos a la artrodesis transforaminal abierta y mínimamente invasiva. MÉTODOS: cuarenta y cinco pacientes fueron sometidos a la artrodesis lumbar transforaminal por el Grupo de Cirugía Espinal del Hospital Lifecenter/Ortopédico de Belo Horizonte, en el periodo de Diciembre de 2005 a Mayo de 2007, siendo 15 en el grupo de artrodesis abierta y 30 pacientes del grupo de artrodesis mínimamente invasiva (MIS). Las indicaciones para la artrodesis intersomática fueron: enfermedad degenerativa de disco, asociada o no a hernia de disco o estenosis del canal; espondilolistesis de bajo grado espondilolítica o degenerativa; y síndrome post-laminectomía/discectomía. Las variables analizadas fueron: tiempo de cirugía, tiempo de internación hospitalar, necesidad de hemotransfusión, escala analógica visual de dolor (VAS) lumbar y de los miembros inferiores, Oswestry, índice de consolidación de la artrodesis y regreso al trabajo. RESULTADOS: el seguimiento mínimo fue de 24 meses. Fueron ocho hombres y siete mujeres en el Grupo Abierto y 17 hombres y 13 mujeres en el Grupo MIS. El tiempo quirúrgico promedio fue de 222 minutos y 221 minutos, respectivamente. Hubo mejora significativa del VAS y Oswestry en el postoperatorio en ambos grupos. El tiempo de internación hospitalar varió de 3.3 días para el Grupo Abierto y 1.8 días para el Grupo MIS. El índice de fusión obtenido fue de 93.3% en ambos grupos. Hubo necesidad de hemotransfusión en tres pacientes en el Grupo Abierto (20%) y ningún caso MIS. CONCLUSIONES: la TLIF mínimamente invasiva presenta resultados similares a largo plazo cuando comparada con TLIF abierta, con los beneficios adicionales de menor morbilidad postoperatoria, menor periodo de internación y rehabilitación precoz.OBJECTIVE: the aim of this article is to compare the clinical and radiological results of patients who underwent open and minimally invasive transforaminal lumbar interbody fusion. METHODS: forty-five patients underwent transforaminal lumbar interbody fusion by the Department of Spine Surgery of Hospital Lifecenter/Ortopédico, between December 2005 and May 2007, 15 of them were in the open interbody fusion group, and 30 in the minimally invasive one. The indications were: the degenerative disc disease associated or not with discal herniation or stenosis; low grade lythic or degenerative spondylolisthesis and post-discectomy/laminectomy syndrome. The variables analyzed were operative time, length of hospital stay, need for blood transfusion, visual analogical pain scale (VAS), Oswestry functional disability index, solid fusion and return to work. RESULTS: the minimum follow-up was two years. There were eight men and seven women in the Open Group, and 17 men and 13 women in the MIS Group. The mean operative time was 222 minutes and 221 minutes, respectively. There was improvement on the VAS and Oswestry scores in both groups. The mean hospital stay was 3.3 days for Open, and 1.8 days for the MIS group. The fusion rate obtained was 93.3% in both groups. Blood transfusion was necessary for three patients (20%) of the Open Group. CONCLUSIONS: the MIS TLIF has similar results to open TLIF in two years follow-up, with additional benefits of less postoperative morbidity, shorter hospital stay and sooner rehabilitation.

ABSTRACT Objective: to describe the content validation process of a Virtual Learning Object to support the teaching of nursing care systematization to nursing professionals. Method: methodological study, with quantitative approach, developed according to the methodological reference of Pasquali's psychometry and conducted from March to July 2016, from two-stage Delphi procedure. Results: in the Delphi 1 stage, eight judges evaluated the Virtual Object; in Delphi 2 stage, seven judges evaluated it. The seven screens of the Virtual Object were analyzed as to the suitability of its contents. The Virtual Learning Object to support the teaching of nursing care systematization was considered valid in its content, with a Total Content Validity Coefficient of 0.96. Conclusion: it is expected that the Virtual Object can support the teaching of nursing care systematization in light of appropriate and effective pedagogical approaches.

Objective: To semantically validate the indicators of the nursing outcome Dry Eye Severity in adult patients admitted to the intensive care unit. Methods: Methodological study of semantic validation developed with 15 nurses from an adult general ICU of a public university hospital located in the Northeast of Brazil. Data collection took place between the months of February and April 2019. For data analysis, the Kappa test was used with a value equal to or greater than 85% agreement. A value of p

Introduction The cornea is an avascular and transparent layer of connective tissue crucial to retinal image quality. Diseases can impair its quality, affecting vision. Keratoplasty is the only therapy capable of restoring vision quality in severe corneal involvement. Despite the established practice of transplantation, access to corneal tissue is limited in many places, and the quality of retrieved corneas is not always adequate, resulting in disqualification. Not all factors affecting tissue quality are fully understood due to the multifactorial nature of processes and variations in procedures globally.Objective The objective is to map the global literature to establish the factors associated with the clinical and sociodemographic conditions of donors, and the conditions inherent in the processing of corneas that can influence the quality of this tissue for transplantation purposes.Methods and analysis A scoping review will be developed based on the methodological framework of the Joanna Briggs Institute. The scientific report will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension checklist for Scoping Reviews. Searches will be conducted in 30 indexed and 12 grey literature databases, without time or location restrictions. The selection of studies will be carried out in three distinct phases: screening, eligibility and inclusion. After defining the sample, data from the selected studies will be systematically extracted into an electronic spreadsheet. The results will be presented descriptively through tables and graphs of absolute and relative frequency. In addition, the PRISMA Scoping Review flow chart will be presented to present the process of searching, including and excluding articles and documents.Ethics and dissemination This scoping review study does not require prior ethical approval as it uses publicly available and already published studies. The research protocol is registered in the Open Science Framework (osf.io/bw6r7). The findings will be submitted for publication in peer-reviewed scientific journals and presented at ophthalmology and/or transplantation conferences through oral presentations or posters.

Resumo Objetivo Validar o conteúdo e a aparência de um protocolo gráfico para avaliação do cuidado seguro de enfermagem a pacientes em hemodiálise. Método Estudo metodológico com abordagem quantitativa, organizado em três procedimentos: teóricos, a partir de uma scoping review; empíricos, na qual ocorreu processo de construção do protocolo gráfico e checklist para avaliação do cuidado seguro; por fim, os analíticos, para a validação propriamente dita com uso da técnica Delphi e participação de nove juízes especialistas em duas rodadas para o alcance da concordância. Resultados Elaboraram-se o checklist e o protocolo gráfico. Quanto à validade de conteúdo, em Delphi I, três critérios obtiveram Coeficiente de Validade de Conteúdo =0,77 no checklist. No que corresponde ao Delphi II, foram alcançados 80% em todos os itens referentes ao Coeficiente de Validade de Conteúdo, e todos os índices ficaram acima de 0,80. A validação de aparência ocorreu utilizando critérios de Suitability Assessment of Materials no Delphi I. Foi possível atingir um Coeficiente de Validade de Conteúdo total maior que 0,80 em todos, enquanto que, no Delphi II, os protocolos alcançaram concordância maior que 80% e Coeficiente de Validade de Conteúdo maior que 0,88, já que o checklist apresentou maior Coeficiente de Validade de Conteúdo com 0,91. Conclusão Apresentam-se o protocolo gráfico e o checklist para avaliação do cuidado seguro aos pacientes em hemodiálise válidos em seu conteúdo e aparência.

Introduction: Organ transplantation is one of the most successful advances in modern medicine. However, a legal system is necessary for its practice to be free from ethical flaws and to respect donors, recipients, and family members. Objective: To map the global legislation regulating the donation, capture and distribution processes of organs and tissues from deceased donors for transplants. Method: A scoping review according to the Joanna Briggs Institute was conducted in the following databases: Medline, CINAHL, Virtual Health Library, SCOPUS, Web of Science, Science Direct, and EMBASE, as well as gray literature, and reported according to the PRISMA extension for scoping reviews. Results: We identified 3302 records, of which 77 were analyzed which enabled mapping the type of consent adopted and the existence of current legislation for harvesting organs and tissues after circulatory and brain death. Conclusion: Opt-out consent predominates in Europe, and there is harvesting after brain and circulatory death. Opt-out predominates in the Americas, while Opt-in and harvesting of organs and tissues after brain death predominate in Asia and Oceania. The procurement of organs and tissues from deceased donors is practically non-existent in Africa.

ABSTRACT Objective: To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students. Methods: Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively. Results: Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments. Conclusion: The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.

ABSTRACT Objective: to analyze the concept associated with diagnostic proposition Ocular dryness in adult patients hospitalized in an Intensive Care Unit, identifying its attributes, antecedents and consequences. Methods: a methodological study carried out through concept analysis, operationalized by scoping review. Results: the analysis of 180 studies allowed the identification of two attributes, 32 antecedents and 12 consequences. The attributes were tear film deficiency and ocular signs and/or symptoms. The prevalent antecedents were incomplete eyelid closure (lagophthalmos) and blinking mechanism decrease. Major consequences included conjunctival hyperemia and decreased tear volume. Conclusions: this study allowed constructing nursing diagnosis Ocular dryness, part of domain 11, class 2, with 12 defining characteristics, 12 related factors, seven populations at risk and 13 associated conditions. This problem-focused proposal may provide targeted care by promoting early detection and implementing interventions that reduce the risk of ocular damage.

Objetivo: descrever as percepções e vivências de docentes da graduação de enfermagem sobre o ensino de segurança do paciente. Método: estudo transversal, descritivo, quali quantitativo, realizado com professores de enfermagem de uma universidade federal, realizado de setembro a novembro de 2018. Os dados foram coletados através de um formulário eletrônico e processados de forma descritiva simples com auxílio do software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires. Resultados: a amostra foi composta por 21 docentes e emergiram três classes: primeiros passos e estímulos para o ensino de segurança do paciente no curso de enfermagem (42,5%), ações realizadas em prol do ensino de segurança do paciente na graduação (26,4%) e agentes promotores de mudanças no ensino de segurança do paciente na graduação de enfermagem (31,1%). Conclusão: os docentes reconheceram a segurança do paciente como um tema transversal e importante no processo formativo, mas com pouca expressividade na instituição. Descritores: Enfermagem. Segurança do Paciente. Ensino. Docente. Educação Superior.

Objetivo: avaliar os fatores clínicos preditores para o ressecamento ocular e para o diagnóstico de enfermagem Risco de ressecamento ocular em pacientes no pós-operatório em Unidade de Recuperação Pós-Anestésica. Método: estudo transversal realizado entre maio e agosto de 2017. Amostra foi de 157 pacientes adultos submetidos a procedimentos cirúrgicos eletivos. Os dados foram analisados mediante estatística descritiva e inferencial. Resultados: o diagnóstico clínico de ressecamento ocular prevaleceu em 85,35% dos pacientes, e o diagnóstico de enfermagem Risco de ressecamento ocular em 14,65%. Observou-se diferenças estatísticas entre a hiperemia, lacrimejamento excessivo e teste de Schirmer insuficiente com o diagnóstico de ressecamento ocular no olho direito e com o diagnóstico Risco de ressecamento ocular. No olho esquerdo o teste de Schirmer foi insuficiente. Conclusão: a hiperemia, o lacrimejamento excessivo e o teste de Schirmer insuficiente são fatores clínicos preditores relevantes no perioperatório para promover medidas preventivas e/ou detectar precocemente o ressecamento ocular. Descritores: Diagnóstico de Enfermagem. Síndromes do Olho Seco. Saúde ocular. Centros Cirúrgicos. Período PósOperatório. Enfermagem Perioperatória.

Resumo Objetivo: analisar os fatores associados ao insucesso do Transplante de Células-Tronco Hematopoiéticas (TCTH) em pacientes submetidos ao retransplante de Células-Tronco Hematopoiéticas (RCTH). Método: estudo quantitativo do tipo caso-controle para avaliar pacientes submetidos ao RCTH. Para tanto, utilizou-se amostra pareada de dois controles para cada caso (2:1). O grupo caso foi constituído pelos prontuários de saúde com todos os pacientes que foram submetidos ao RCTH (28) e o grupo controle (56) incluiu pacientes que receberam apenas um transplante. Três variáveis nortearam o pareamento: sexo, diagnóstico e tipo de transplante. Resultados: vinte e quatro (85,71%) pacientes do grupo caso receberam retransplante devido a recidiva da doença e quatro (14.29%) devido a falha do enxerto. Uma diferença estatística foi encontrada na análise entre os pacientes que não usaram o ácido ursodesoxicólico, analgésicos opioides ou imunossupressores. A necessidade de um RCTH entre aqueles que usaram estes medicamentos de forma inapropriada foi 16,12, 12,79 e 4,5 vezes maior, respectivamente, do que entre os que as usaram corretamente. Conclusão: houve uma diferença relacionada ao motivo que levou ao retransplante e os indivíduos analisados. A conclusão é que a razão preditiva para retransplante nesta amostra foi a recidiva da doença.

ABSTRACT Objectives: To analyze the temporal trend of mortality from sickle cell anemia in Brazil, by region, in the period 1997-2017. Methods: epidemiological study, with an ecological design, with a temporal trend, carried out with data from the Mortality Information System. For descriptive analysis, absolute and relative frequencies were used. In the correlation analysis, the ANOVA test was used, followed by Tukey’s post-test. The temporal trend was obtained using the cubic polynomial regression test. Results: 6,813 deaths from sickle cell anemia were registered. Brown individuals (50.87%) were more frequent, with a predominance of males (50.4%), aged between 25 and 34 years and a higher incidence of deaths in the Midwest (0.25/100 thousand inhabitants). The time curve showed an increasing trend of deaths in the country between 1997 and 2015 (R2 = 0.98). Conclusions: sickle cell anemia showed increasing mortality in the 21 years analyzed and alerts health professionals and managers.

ABSTRACT Objective: To analyze the time trend, spatial distribution, and the cases of human immunodeficiency virus/acquired immunodeficiency syndrome cases with social determinants of health. Methods: Ecological and analytical study, carried out based on the cases of human immunodeficiency virus/acquired immunodeficiency syndrome notified in a state in the Brazilian Midwest, from 2009 to 2018. The study used descriptive analysis, polynomial regression, and geospatial analysis. Results: In 10 years, there were 9,157 notifications, growing each year. There was a growing trend for both sexes (p

Fibrinolytic Therapy (FT) is an important form of treatment for cases of Acute Myocardial Infarction (AMI), especially in those places where Primary Percutaneous Coronary Intervention (PPCI) is not available, which is the main form of treatment and can be used even in the prehospital care. Aimed to describe the clinical outcomes of the use of FT in prehospital care for treating patients with AMI. This research covered a total of 53 patients and was carried out from march to october 2017, referring to the care provided from january 2015 to december 2016 in two stages, in which the first occurred with the Mobile Emergency Service (SAMU) and Walk-in Emergency Care Units (UPA), and the second in the referenced hospital services as gateways to those units. Data were collected from secondary sources. The clinical outcomes of FT considered in the form of absolute and relative frequencies and measures of central tendency were considered. The main signs and symptoms at admission were chest pain (84.62%), sweating (36.54%), dyspnea (26.92%), hypertension (19.23%), nausea (17.31%), malaise (17.31%) and emesis (13.46%). The main characteristic of chest discomfort was chest pain (70.45%). The FT drug administered in all patients was tenecteplase. The median time from symptom-to-door was 180 minutes, while symptom-reperfusion was 300 minutes and door-to-needle 160 minutes. Regarding the outcome, 74.47% had clinical improvement, 19.15% died, 4.25% had refractory AMI and 2.13% had reinfarction. The main characteristic of clinical improvement was the reversal of chest pain (68.57%), characterized as myocardial reperfusion criteria. The present study presented the main outcomes of FT use with improvement of those patients who were treated with it, and shorter times related to chest discomfort and the administration of FT were responsible for increasing the outcomes of clinical improvement and decreasing the outcome of death.

ABSTRACT Objective: to summarize the extrication techniques of entrapped car crash victims with potential spinal injury. Method: a literature review study, of scoping review type, using the MEDLINE/PubMed, CINAHL, Scopus, Science Direct, Web of Science, Cochrane Library and gray literature data sources, without time frame, with studies that addressed extricating techniques extrication of entrapped car crash victims. Results: a total of 33 studies were included that enabled identifying and summarizing the different types of extrication and respective devices for extrication of entrapped car crash victims, indicated according to injury assessment and the victim’s clinical condition. All pointed to the need for techniques to maintain neutral alignment and prevent spine twists. Conclusion: this study indicated that injury assessment with an emphasis on the victim’s clinical condition provides a coherent decision-making regarding the technique and device to be used. However, carrying out other comparative studies between existing techniques may help in the decision-making process more assertively.

IntroductionThe quality of the corneal tissue can be influenced by several factors inherent to the recipient, donor, and to the donation and transplantation process. The donated corneal tissue can be classified by its quality as excellent, good, regular, bad, or unacceptable for transplantation, evaluating it in a slit lamp.ObjectiveTo analyze the relationship between the clinical and sociodemographic variables of the donors and the donation process and the classification of the quality of the corneal tissue collected for transplantation.MethodsThis is an epidemiologic study, retrospective cohort type, which addressed the process of cornea donation by the Human Eye Tissue Bank in a reference service in Northeast Brazil. The sample consisted of corneas processed by the Human Eye Tissue Bank of Rio Grande do Norte (n = 419). For descriptive and inferential analysis, the study used the Statistical Package for the Social Sciences (SPSS) software, version 25.0, and considered a significance level of 0.05. Logistic regression analysis was used for the adjustment of the final model.ResultsIt was verified that the epidemiological profile showed a prevalence of individuals with a mean age of 42.54 years old, male (73.99%), and living in the metropolitan region of the state capital (75.66%). When analyzing the relationship between the clinical and sociodemographic variables of the donors, it was identified that those aged 45 years old or less had better quality corneas (excellent and good), while the chronological variables were predictive factors for corneas of regular and bad qualities.ConclusionThe identification of the factors inherent to the donation process and predictors of corneal tissue quality contribute to minimizing the risk of transplantation and to a better ocular prognosis.

ABSTRACT Objective: to analyze the characteristics, related factors, and consequences of physical violence and verbal abuse against nurses working with risk stratification. Methods: a cross-sectional, descriptive and quantitative study carried out with 80 nurses who work with risk stratification in emergency services. Data were collected using an adapted instrument and analyzed using (uni)bivariate inferential statistics. Results: companions were the main perpetrators of verbal abuse (86.1%); and patients inflicted physical violence (100%). Professionals with up to five years of experience are 74% less likely to suffer physical violence (p=0.029). Women suffer 5.83 times more verbal abuse than men (p=0.026). Sadness (15.8%) and fear of the aggressor (15.3%) were the main consequences of verbal abuse; and fear of the aggressor (22.2%) and stress (22.2%) were results of physical violence. Conclusion: violence is influenced by institutional, professional and client aspects. Therefore, coping with it requires multidimensional strategies.

Objetivo: analisar a ocorrência de sífilis gestacional e congênita à luz da vulnerabilidade, no período de 2008 a 2018, no Mato Grosso do Sul. Método: estudo transversal, retrospectivo, de caráter analítico e abordagem quantitativa, com base em dados secundários coletados no Sistema de Informações e Agravos de Notificação. Resultados: houve aumento progressivo de sífilis gestacional e congênita ao longo dos 11 anos, com predomínio em populações vulneráveis e associação (p

Objective: to determine clinical and epidemiological profile of surgical patients with ocular dryness and to the Nursing diagnostic and risk of dry eye, in the postoperative period. Methods: cross-sectional study, with 82 patients in the postoperative period. For analysis, it were used frequencies, the distribution centers’ measures and respectives variabilities. Results: equivalent prevalence between ocular dryness and the nursing diagnosis. The average age was 57.7 years for patients with ocular dryness and 59.6 years for those with risk diagnosis. In both groups, there was a predominance of females, cardiovascular surgeries and general anesthetic usage. The length of the surgical procedure averaged 105 minutes for patients with ocular dryness and 67.5 minutes for those with risk diagnosis. Conclusion: predominance of women in middle age undergoing elective surgeries by cardiovascular reasons for both groups, however, with distinct time of surgical procedure.

RESUMO Objetivo Sumarizar fatores de risco e indicadores de mortalidade em pacientes com doença falciforme. Método Revisão integrativa em periódicos indexados nas bases de dados CINAHL, PubMed/MEDLINE, Science Direct/SCOPUS, SciELO e Web of Science. A questão norteadora foi elaborada por meio da estratégia Population, variable, outcome (PVO). A busca ocorreu no portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior entre outubro e novembro de 2018. Resultados Dos 19 artigos, 18 eram coorte e um ensaio clínico randomizado. A amostra foi constituída, em sua maioria, pelo sexo feminino e genótipo HbSS. Se repetiram mais a taxa de mortalidade cumulativa e a curva de mortalidade global. Sete estudos identificaram fatores de risco com associação estatisticamente significativa para morte. Os mais frequentes foram o baixo nível de hemoglobina, variáveis hepáticas (enzimas fosfatase alcalina e transaminase glutâmico oxalacética) e cardiovasculares (velocidade de regurgitação da válvula tricúspide ≥ 2,5m/s). Conclusão e implicações para a prática Indicadores de mortalidade constituem ferramentas de manejo de pacientes com doença falciforme e prevenção de riscos e complicações. Há necessidade de estudos sobre os fatores relacionados à mortalidade desses pacientes. A prevenção do óbito, certamente, promoverá uma melhoria na qualidade de vida e na sobrevida dessa população.

ABSTRACT Objective: To discuss the methods employed to evaluate the effectiveness of clinical surface cleaning and disinfection (C&D). Method: This is a theoretical reflection based on scientific studies and the experience of the authors. Knowledge and current gaps, the need for further studies, and practical application of the methods were approached. Results: There are four main methods used to evaluate the effectiveness of clinical surface C&D: visual inspection, fluorescent markers, microbiological cultures, and adenosine triphosphate (ATP) bioluminescence. The first two are used to evaluate the process and to predict adherence to protocols by the staff, and the last two are employed to evaluate the results, therefore being the most relevant to assess the risk of infection. Final considerations: The ideal method was not found, because all of them showed limitations. There is a need for strategies to optimize the precision of these methods.

Introduction: Hematopoietic stem cell transplantation (HSCT) is a procedure that replaces diseased cells with healthy cells by infusing hematopoietic stem cells. Objective: To identify in the literature the nursing publications that addresses HSCT of Umbilical Cord Blood (UCB). Method: This is an integrative review, which has been searched through electronic databases: Virtual Health Library, National Library of Medicine (PUBMED/MEDLINE), Science Direct and SCOPUS. The following inclusion criteria were established: studies available in any language, studies addressing HSCT of umbilical cord blood and a study published in its entirety. Results: The electronic search process of the studies resulted in a total of 978 studies, of which five comprised the review sample. The selected studies addressed the nurses' knowledge about SCU transplantation, the collection and storage of SCU and the SCU database. Conclusion: The present study provided an insight into the importance of the role of nurses in HSCTWC, since their commitment to the team of SCU public banks is important to achieve better results, with a larger number of donors and greater customer satisfaction And their families.

Aim: to describe and discuss the experiences and importance of the research group for the Nursing student training. Method: experimental report study, which addresses the role of the group for professional training and nursing research and presents the contributions that this space of knowledge construction provides to its members. Results: the members of the group are instigated to have a critical thinking and to have the opportunity to relate the knowledge acquired in the university with the experiences in real working contexts and in the nursing praxis through the research projects, which awakens the reflexibility on diverse contexts. Final considerations: involvement in Research Groups allows and facilitates the advancement of knowledge production, which increasingly distances nursing from the old paradigm of "technique through technique" and allows the action of a thoughtful/reflective practice.

Objetivo: revisar artigos de pesquisa visando a análise do impacto de tecnologias inovadoras na vida de diabéticos adultos. Método: trata-se de uma revisão integrativa de produção levantada nas bases de dados MEDLINE, CINAHL, LILACS, Web of Science, Springer Link e bibliotecas eletrônicas SciELO e PubMed. Foram incluídos ensaios clínicos randomizados, em Português, Inglês ou Espanhol, entre 2012 e 2016. Resultados: Identificaram-se 669 publicações, das quais 12 compuseram a amostra. Identificaram-se 11 tecnologias distintas, que envolveram desde a utilização de aplicativos para smartphones, farmacoterapias, dispositivos de monitorização até intervenções especializadas. A maioria impactou positivamente na vida dos diabéticos para o controle metabólico eficaz e dos níveis de Hemoglobina Glicada, redução de episódios de hiper/hipoglicemia, maior adesão ao tratamento, entre outros, enquanto apenas uma apresentou aspectos desfavoráveis. Conclusão: há a necessidade de aprimoramento das tecnologias, bem como realização de estudos com desenhos de pesquisa de maior acurácia e com métodos mais robustos de investigação. ABSTRACT Objective: to review research articles with a view to examining the impact of innovative technologies on the lives of adult diabetics. Method: this integrative review of production found in the MEDLINE, CINAHL, LILACS, Web of Science, Springer Link and SciELO and PubMed electronic libraries included randomized clinical trials in Portuguese, English or Spanish published between 2012 and 2016. Results: of the 669 publications identified, 12 formed the sample, in which 11 different technologies were identified, ranging from the use of smartphone applications, pharmacotherapies, and monitoring devices to specialized interventions. Most impacted the lives of diabetics beneficially towards effectively controlling metabolic and glycated hemoglobin levels, reducing episodes of hyper- or hypoglycemia, increasing treatment adherence, and so on, while only one displayed adverse effects. Conclusion: there is a need for improved technologies, as well as for studies with more accurate research designs and more robust research methods. RESUMEN Objetivo: revisar artículos de investigación con vistas a analizar el impacto de las tecnologías innovadoras en la vida de diabéticos adultos. Método: se trata de una revisión integrativa recopilada de las bases de datos MEDLINE, CINAHL, LILACS, Web of Science, Springer Link y de las bibliotecas electrónicas SciELO y PubMed. Se incluyeron los ensayos clínicos randomizados en portugués, inglés o español, entre 2012 y 2016. Resultados: se identificaron 669 publicaciones, de las cuales 12 compusieron la muestra. Se identificaron 11 tecnologías distintas que involucraron desde el uso de aplicaciones para smartphones, farmacoterapias, dispositivos de monitorización hasta intervenciones especializadas. La mayoría tuvo impacto positivo en la vida de los diabéticos para el control metabólico eficaz y de los niveles de Hemoglobina Glicolisada, reducción de episodios de hiper / hipoglucemia, mayor adhesión al tratamiento, entre otros; sólo una presentó aspectos desfavorables. Conclusión: es necesario el perfeccionamiento de las tecnologías, así como realización de estudios con dibujos de investigación de mayor precisión y con métodos más robustos de investigación.

Hematopoietic stem cell transplantation (HSCT) affects serious risks for the patient, including death. For this reason, it is considered a treatment that can cure or can present morbidities and lead to death. In this context, patients experience the first psychological conflicts before this transplant. To describe the psychological suffering developed by patients transplanted with hematopoietic stem cells from a referral service in the state of Rio Grande do Norte. This is a cross-sectional study with a quantitative, descriptive, hospital-based approach developed with patients submitted to HSCT at a referral service in the state of Rio Grande do Norte. Data were collected between March and September of 2016, through the evaluation of the medical records of 43 patients who underwent HSCT and developed some type of psychological distress. Among 43 patients with psychological disorders, 51.16% were female, 62.79% developed anxiety 32.56% developed insomnia and 20.93% developed depression. Of these, 27.91% had a main diagnosis indicating the transplantation of Multiple Myeloma (MM), and 58.14 received autologous transplantation. It was observed that the patient had psychological suffering from the diagnosis until the end. The health professional praxis also must go beyond the resolution of physical human responses and, especially in these cases, it should aim at the early identification of signs and symptoms of psychological distress, being possible to achieve the real health needs and treat them with effectiveness.

The Hematopoietic stem cell transplantation (HSCT) is used in children as a definitive treatment for various oncological, immune deficiencies, hemoglobinopathy, and malignancies diseases that involve the hematological system, congenital metabolism disorders, among others. To characterize the clinical and epidemiological profile of children and adolescents submitted to HSCT at a referral service in the state of Rio Grande do Norte. This is a quantitative, retrospective, observational, descriptive and analytical quantitative approach approaching the medical records of children and adolescents submitted to HSCT in a referral hospital service for this type of transplantation in the state of Rio Grande do Sul North (RN). The final sample consisted of 35 records patients aged between 2 and 18 years old who underwent HSCT from February 2008 to December 2015 and who presented the data necessary for the study. The records analyzed showed a little majority of male patients (51.42%) and 60.00% of these men were students and 71.42% lived in the state of the Rio Grande do Norte. According to the clinical characteristics, 34.3% of the patients had Acute Lymphoblastic Leukemia and 25.71% had Acute Myeloid Leukemia as the main diagnosis. Gastrointestinal toxicities were the most frequent (97.1%) and all patients received antineoplastic/chemotherapeutic and antiemetic treatment. The allogeneic HSCT was the most frequently performed (57.14%) and the most used source of Hematopoietic progenitor cells (HPC) was the peripheral blood (54.29%) and 5.71% of these patients developed the Graft versus Host Disease (GVHD), of which one was affected by acute GVHD and another by chronic GVHD. Septsis was the most frequent cause of death (60%). The profile of the clinical variables presented by the children and adolescents of this study shows that the most prevalent diagnosis was ALL, the most frequent toxicities were gastrointestinal, cardiac, respiratory and hematological, the most common HSCT was allogeneic peripheral blood and the greatest cause of mortality was sepsis. These data are similar to studies conducted in North America, Europe and Asia.

Objetiva-se descrever a frequência, os materiais disponíveis e utilizados e a execução padronizada da técnica de higienização das mãos entre os profi ssionais de enfermagem circulantes que atuam em sala operatória em um hospital público do nordeste brasileiro. Estudo de abordagem quantitativa, de corte transversal, descritivo e observacional, realizado no Centro Cirúrgico de um hospital público em Natal, Rio Grande do Norte, Brasil. Verifi couse que a frequência de higienização das mãos foi baixa, principalmente quando relacionada a procedimentos não técnicos na unidade, como após o uso de sanitário e depois de refeições[...] Palavras-chave: Infecção Hospitalar; Higiene das Mãos; Enfermagem; Salas Cirúrgicas; Centros Cirúrgicos. ABsTRAcT The aim is to describe the frequency, the available and used materials and the standardized execution of the hand hygiene technique among the circulating nursing professionals who work in an operating room in a public hospital in the Brazilian Northeast. Study with a quantitative approach and a cross-sectional, descriptive, and observational design conducted at the surgical center of a public hospital in Natal, Rio Grande do Norte, Brazil. It was found that the frequency of hand washing was poor, especially when related to non-technical procedures at the facility, such as after using the bathroom and after eating snacks [...] Keywords: Cross Infection; Hand Hygiene; Nursing; Operating Rooms; Surgical Centers.

Objetivo identificar as principais complicações intraoperatórias dos pacientes que realizaram ceratoplastias e sua relação com fatores clínicos e cirúrgicos. Método estudo transversal, observacional. Realizou-se um censo dos pacientes submetidos a ceratoplastias que totalizou 258 procedimentos. Resultados foram registradas 22 complicações intraoperatórias, todas em ceratoplastias penetrantes. Do total, 59,09% foram realizadas em pacientes do sexo masculino com idade média de 58,5 anos. A principal complicação intraoperatória notificada foi a perda vítrea (36,36%). Encontrou-se relação estatisticamente significativa entre a variável “complicação intraoperatória” e as variáveis “cirurgia prévia”, “ceratoplastia combinada com extração de catarata” e “botão corneano do receptor maior que 8,0 mm”. Conclusão identificar as principais complicações intraoperatórias da ceratoplastia possibilita à enfermagem compreender quais fatores podem interferir nesses procedimentos, apontar possíveis fatores preditores das complicações e buscar medidas de controles para que tais complicações não ocorram.

Resumo OBJETIVOS Descrever o processo de construção de hipermídia para apoiar o ensino da Sistematização da Assistência de Enfermagem (SAE). Métodos: Pesquisa metodológica de desenvolvimento de uma tecnologia educacional. As etapas de construção da hipermídia ocorreram de fevereiro de 2015 a março de 2016 e integraram estudos teóricos, realização de grupo focal com docentes e processo de desenvolvimento da tecnologia educacional à luz do referencial da Teoria da Aprendizagem Significativa. RESULTADOS: A hipermídia é composta por conteúdo interativo e apresenta uma tela inicial com um mapa conceitual que orienta um caminho livre de aprendizado sobre quatro aspectos estruturantes na aprendizagem da SAE: conceito, histórico e benefícios; aspectos ético-legais; operacionalização; e Processo de Enfermagem: etapas e integração do técnico em enfermagem. CONCLUSÕES Concluiu-se que é fundamental que as tecnologias educacionais sejam construídas a partir de uma fundamentação pedagógica que sustente sua incorporação nos ambientes de ensino.

RESUMO Objetivo: Refletir acerca do ensino inovador da enfermagem a partir do referencial das epistemologias do Sul, de Boaventura de Souza Santos. Métodos: Trata-se de um ensaio teórico. Foi utilizado o referencial das epistemologias do Sul segundo Boaventura de Souza Santos, com destaque para os conceitos: descolonização do saber; pensamento pós-abissal; e ecologia dos saberes. Resultados: A proposta de refletir acerca do ensino inovador da enfermagem sob a perspectiva das epistemologias do Sul traduz-se no entendimento de que a abordagem de Boaventura pode subsidiar a efetivação do processo de ensinar-aprender que tem por base o reconhecimento da pluralidade de conhecimentos em interações sustentáveis e dinâmicas entre eles sem comprometer a autonomia de todos. Conclusão: Realçou-se a essencialidade de se compreender que as tecnologias para o ensino devem integrar um processo pedagógico mais amplo, resultante de reflexões teóricas e de competências dialógicas do enfermeiro enquanto educador.

With the development of new surgical techniques, instrumentation and pharmacological advances, corneal transplant procedures can undergo changes directly in the clinical profile of patients with the indication for penetrating keratoplasty technique. The aim of this study was to identify the clinical profile of patients undergoing penetrating keratoplasty and the main indicating conditions at a university hospital in Northeast Brazil. This is an epidemiological, cross-sectional, descriptive study performed using data from medical records of 241 patients who underwent keratoplasty between January/2010 and December/2014. From the total keratoplasties performed in the hospital during the study period, 88.37% were carried out by penetrating technique. Of these, 50.44% were performed in male patients with an average age of 55.2 years. The main indications were keratoconus, followed by bullous keratopathy and keratitis. Preexisting clinical conditions for penetrating keratoplasty were found, such as changes in vascularization, glaucoma, previous surgery, aphakic and pseudophakic eyes and keratoplasties combined with other types of surgeries. Knowledge of the clinical profile of patients who underwent penetrating keratoplasty enabled identification of the main ocular diagnoses that result in this type of transplant as a therapeutic indication. From this, it is possible to point out the main pre-existing medical conditions of penetrating keratoplasty that may represent potential risk factors for complications in the postoperative period and even lead to graft failure. We suggest that further studies be carried out on a thematic.

Describing the epidemiological characterization of patients awaiting cornea transplant (on the waiting list) of a reference service in the state of Rio Grande do Norte. A cross-sectional quantitative study conducted between January and April 2015 with patients on the waiting list (n = 62) registered by the Center for Notification, Collection and Distribution of Organs. Data were analyzed using the Statistical Package for the Social Sciences, version 20.0. Inferential analysis was carried out between the variable 'corneal disorder' and other variables of interest. Mean age of the patients was 49.68 years, and 54.84% were females. Keratoconus was the main initial condition found. The type of corneal disorder had a statistically significant association with the variables of gender and age. The keratoconus was the main indicator for cornea transplant. Factors such as age and gender may be related to the onset corneal endothelium disorders. We suggest that further studies be carried out in order to better evaluate the established association between the types of corneal disorders and the variables of gender and age, considering these may represent important epidemiological indicators for early detection of clinical manifestations and complications affecting the cornea in patients who are waiting for the corneal transplant.

Sumarizar os fatores de risco para a retinopatia da prematuridade em recém-nascidos internados em unidade de terapia intensiva neonatal a partir de estudos primários publicados em bases de dados. Trata-se de uma revisão integrativa realizada nas seguintes bases: SCOPUS, PubMed, Science Direct, Web of Science e CINAHL. A amostra final foi constituída por 26 artigos. Elencou-se categorias temáticas com os fatores de risco da retinopatia da prematuridade, a saber: fatores relacionados à terapêutica clínica, ao uso de medicamentos, comorbidades relacionadas à retinopatia da prematuridade, características neonatais, características clínicas associadas à retinopatia da prematuridadee fatores maternos. Conhecer os fatores de risco implica na detecção precoce da retinopatia mediante adoção de medidas preventivas como monitoramento da oxigenoterapia, ventilação mecânica e transfusões sanguíneas, além da avaliação das características neonatais, de maneira a permitir uma triagem oftalmológica que impeça o desenvolvimento da doença,suas sequelas e/ou viabilize tratamento na fase inicial da doença.

The objective was to validate the content of an instrument on nasogastric intubation skills based on Pasquali's model of content validation. This was a methodological study conducted with 23 nursing teachers in public higher education institutions in Rio Grande do Norte. The Content Validation Index (CVI) and Kappa Index was applied. In the overall evaluation, the instrument obtained a CVI with values above 0.75 with a total CVI of 0.95 and a total Kappa of 0.91. However, some changes were made on the instructional sequence requirements of the topics, and to vocabulary. The instrument proved to be reliable and trustworthy in facilitating nursing care quality and can be used for health services and educational institutions to assess skill levels of professionals and undergraduate students. However, the instrument requires additional stages for a more precise and specific content validation.

Aim: to report the experience of scholarship students participating in the project "Building concepts in undergraduate nursing education in the light of the theory of meaningful learning: construction of concept maps using the Cmap Tools® software". Method: report of experience of scholarship students about a project included in the Integrated Action Notice published by an institution of higher education and developed between the months of January to September 2013. Results: these are presented in three axes proposed by the project: teaching, research and extension. Thus, there was a minicourse on conceptual maps and instruction on the software, the production of scientific papers on the topic addressed and the contribution of scholarship students in scientific studies. Final considerations: the scholarship students reflected on the teaching-learning process, with bases directed to the learner, since it constitutes the subject in training to actively participate in building their cognitive structure

OBJECTIVE: to estimate survival, mortality and cause of death among users or not of hydroxyurea with sickle cell disease.METHOD: cohort study with retrospective data collection, from 1980 to 2010 of patients receiving inpatient treatment in two Brazilian public hospitals. The survival probability was determined using the Kaplan-Meier estimator, survival calculations (SPSS version 10.0), comparison between survival curves, using the log rank method. The level of significance was p=0.05.RESULTS: of 63 patients, 87% had sickle cell anemia, with 39 using hydroxyurea, with a mean time of use of the drug of 20.0±10.0 years and a mean dose of 17.37±5.4 to 20.94±7.2 mg/kg/day, raising the fetal hemoglobin. In the comparison between those using hydroxyurea and those not, the survival curve was greater among the users (p=0.014). A total of 10 deaths occurred, with a mean age of 28.1 years old, and with Acute Respiratory Failure as the main cause.CONCLUSION: the survival curve is greater among the users of hydroxyurea. The results indicate the importance of the nurse incorporating therapeutic advances of hydroxyurea in her care actions.

As síndromes mielodisplásicas constituem um grupo de doenças de ordem clonal hematopoética evidenciadas por estudos em todo o mundo. A estimativa de sobrevida dos pacientes e de casos que apresentam evolução leucêmica requer investigação na população brasileira, pois não se conta com nenhum dado dessa natureza. Assim, este estudo objetivou caracterizar e estimar a sobrevida e evolução leucêmica de portadores de síndromes mielodisplásicas acompanhados em um serviço de referência. Trata-se de um estudo de coorte retrospectiva realizada de janeiro de 2000 a dezembro de 2010. Para análise descritiva foi utilizado o programa Epi Info 2002, versão 3.5.2, e para os cálculos das probabilidades de sobrevida foi empregado o método de Kaplan-Meier pelo uso do programa Statistic Package for Social Sciences (SPSS), versão 10.0. Os cálculos da probabilidade de associação entre as características analisadas e o gênero foram realizados pelos testes do qui-quadrado de tendência, de Fisher, Mann Whitney, e de Log Rank. O nível de significância considerado foi de 0,05. O trabalho foi aprovado em seus aspectos ético e metodológico pelo Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes (HUOL), sob o Protocolo n. 432/10. Dos 29 pacientes selecionados, houve predomínio de idosos, do sexo masculino, com baixa escolaridade. Apresentaram baixa probabilidade acumulada de sobrevida e índices de evolução leucêmica em torno de 27%, sem nenhum resultado satisfatório para o tratamento quimioterápico, bem como nenhuma indicação de transplante de medula óssea como possibilidade de cura. Fazem-se necessárias pesquisas com populações maiores para caracterização em todo território nacional.