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BACKGROUND AND OBJECTIVES: Prognosis of patients in the intensive care unit (ICU) has a relation with their severity just before admission. The Modifi ed Early Warning Score (MEWS) was used to evaluate the severe condition of patients 12, 24 and 72 hours before admission in the ICU, assess the most prevalent parameters and correlate the MEWS before ICU with the outcome (survival versus death).

We evaluated the effects of vincristine on the gastrointestinal (GI) motility of awake rats and correlated them with the course of vincristine-induced peripheral neuropathy. Vincristine or saline was injected into the tail vein of male Wistar rats (180-250 g) on alternate days: 50 μg/kg (5 doses, N = 10), 100 μg/kg (2, 3, 4 and 5 doses, N = 49) or 150 μg/kg (1, 2, or 5 doses, N = 37). Weight and stool output were measured daily for each animal. One day after completing the vincristine treatment, the animals were fasted for 24 h, gavage-fed with a test meal and sacrificed 10 min later to measure gastric emptying (GE), GI transit and colon weight. Sensory peripheral neuropathy was evaluated by hot plate testing. Chronic vincristine treatments with total cumulative doses of at least 250 μg/kg significantly decreased GE by 31-59% and GI transit by 55-93%. The effect of 5 doses of vincristine (150 μg/kg) on GE did not persist for more than 1 week. Colon weight increased after 2 and 5 doses of vincristine (150 μg/kg). Fecal output decreased up to 48 h after the fifth dose of vincristine (150 μg/kg). Vincristine decreased the heat pain threshold 1 day after 5 doses of 50-100 μg/kg or after 3-5 doses of 150 μg/kg. This effect lasted for at least 2 weeks after the fifth dose. Chronic intravenous vincristine treatment delayed GE and GI transit of liquid. This effect correlated with the peak increase in colon weight but not with the pain threshold changes.

ObjectiveTo analyze the clinical activities performed and the accepted pharmacist recommendations made by a pharmacist as a part of his/her daily routine in an adult clinical intensive care unit over a period of three years.MethodsA cross-sectional, descriptive, and exploratory study was conducted at a tertiary university hospital from June 2010 to May 2013, in which pharmacist recommendations were categorized and analyzed.ResultsA total of 834 pharmacist recommendations (278 per year, on average) were analyzed and distributed across 21 categories. The recommendations were mainly made to physicians (n = 699; 83.8%) and concerned management of dilutions (n = 120; 14.4%), dose adjustment (n = 100; 12.0%), and adverse drug reactions (n = 91; 10.9%). A comparison per period demonstrated an increase in pharmacist recommendations with larger clinical content and a reduction of recommendations related to logistic aspects, such as drug supply, over time. The recommendations concerned 948 medications, particularly including systemic anti-infectious agents.ConclusionThe role that the pharmacist played in the intensive care unit of the institution where the study was performed evolved, shifting from reactive actions related to logistic aspects to effective clinical participation with the multi-professional staff (proactive actions).

Introduction The interpretation of the electrocardiogram (ECG) is fundamental for the identification of cardiovascular diseases, which are among the main causes of death in the world. The acquisition of this competence is essential in the training of the general practitioner and the use of new teaching tools, based on technology such as the use of mobile learning, can facilitate the acquisition of this knowledge. Objectives The objective of this study was to develop and evaluate the usability and the potentiality for the use in medical education of a mobile teaching application for ECG interpretation. Methods With the participation of two health professors and a computer scientist, a systems analyst, a programmer and a graphic designer, a mobile application was developed to teach ECG interpretation using the Java language. For validation analysis, a usability evaluation questionnaire based on the System Usability Scale (SUS) and a questionnaire used to evaluate the suitability of software for use in medical education, previously translated into Portuguese and applied in Brazil, were used. Results The “ECG Fácil” application was developed for off-line use and free access on iOS and Android platforms. In the validation phase of the application, a total of 109 students had free access to the mobile application for 6 weeks and then evaluated usability through a SUS-based questionnaire. The answers to the questionnaire showed good reliability, according to the validation analysis by Cronbach’s alpha coefficient (value: 0.74), and the application presented an excellent acceptance with a mean score on the SUS scale of 85.3. Meanwhile, fifteen faculty members evaluated the application through the questionnaire used to assess the suitability of software for use in medical education, with most agreeing with items indicating that it is suitable for use in medical education. Conclusion The “ECG Fácil” application was considered to be of good usability by students and suitable for educational purpose by teachers. Future studies with this application will be needed to assess the acquisition and retention of knowledge about ECG interpretation by students.