O artigo tem como objetivo avaliar a percepção da relação médico-paciente por estudantes de medicina da Universidade Federal do Maranhão no decorrer do curso. Trata-se de um estudo transversal, de abordagem quantitativa, realizado entre outubro de 2017 a março de 2018, no qual foram aplicados dois questionários: Escala de Orientação do Paciente-Praticante (PPOS) e Questionário Sócio-Demográfico. A coleta de dados abrangeu 181 estudantes de uma escola de modelo pedagógico do Aprendizado Baseado em Problemas (ABP). Como resultado, as respostas da pesquisa apontaram um PPOS escore total de 4,34, significando atitudes mais centradas no médico e na doença; cuidado de 4,78, demonstrando que as expectativas, sentimentos e circunstâncias da vida do paciente interferem no processo de tratamento e, por último, poder de 3,90, que infere uma atitude mais focada no médico, considerando o ‘poder’ do médico para decidir a melhor conduta a ser tomada. A análise dos resultados permitiu observar divergências com a literatura, onde o modelo ABP, em vez de apresentar atitudes mais voltadas para o paciente, apresentou atitudes mais voltadas para o médico e/ou doença. Além da relação de período e gênero, não houve associação estatisticamente significante de nenhuma outra variável do questionário sócio-demográfico.
AIMSThe objective of this study has been to evaluate, prospectively, to what extant the administration of antibiotics in surgical prophylaxis conforms with the established guide-lines laid down by the infections Comralilecs. MATERIAL AND METHODSAn incidence prospective multicontre study with a five weeks duration was carried out in 3 hospitals. All operated patients (n=562) were included with the exception of those from eye, ear, nose and throat surgery. A specially demgned form was used for data collection. The data used came from anesthesia and pharmacotherapeimc profiles.The valuation of prophylactic treatment was performed by a team of two pharmacists and one surgeon.hldication, antibiotic election, initiation and duration of prophylaxis were analyzed, RESULTSThirty-seven percent of 207 patients studied received antibiotic phrophylactic treatment Although there were differences betw-cn hospitals, an average of 40% of the antibiotic administered did not conform with the guide-lines established in each centre. The results "~ere 57%, 56% and 13% respectively. The adininistration of antibiotic phrophylaxis more than an hour before strutting surgery was the main inappropriate use (44%). CONCLUSIONSProspective studiesare useful for evaluating the use of antibiotics ill surgical prophylaxis. They enable the inclusion of a large number of patients and also an oblective measurement of the level of adherence to the Infection Comreattees recomanded guidu-lmes. This in turn determines wether or not corrective measures should be taken,
There is ample evidence that the pharmacokinetics of drugs in infants and children may differ markedly from those in adults. The goals of phannacokinetics is to maximize efficacy, minimize toxicity and drug interactions, enhance compliance, and reduce cost of medications. Studies with drugs including anticonvulsants, antimicrobials, digoxin, methotrexate and theophylline have demonstrated that these goals are achievable. Genetic and racial background, underlying disease, concurrent drugs, and nutritional status can influence pharmacokinetics. Population pharmacokinetics can provide useful data even when limited number of samples are available from a large number of patients. Pharmacokinetic monitoring is influenced by numerous factors including dose and dosage form, method of drug administration, times of sample collection, analytical and forecasting methods, and implementation of dosage recommendations. The future of pharmacokinetics, in large part would depend on correlating its parameters to the markers of efficacy and/or toxicity of medications. The ultimate goal of pharmacokinetics should be to improve the quality of life and health outcomes in infants and children.
O penfigoide gestacional é uma rara dermatose bolhosa autoimune específica da gravidez. Acredita-se que anticorpos ataquem antígenos epidérmicos específicos e provoquem a separação da junção dermoepidérmica da pele e a formação de bolhas. O quadro em geral se inicia com placas eritematosas pruriginosas periumbilicais com posterior disseminação pelo corpo e evolução para lesões bolhosas. Acomete principalmente primíparas no segundo ou terceiro trimestre e costuma responder bem ao tratamento com corticoide sistêmico. Exame histopatológico e imunofluorescência direta são fundamentais para o diagnóstico. Há risco de efeitos adversos fetais, como baixo peso ao nascer e parto prematuro. Relatamos um caso de uma paciente com quadro exuberante no final do terceiro trimestre com excelente resposta ao tratamento e com nascimento de recém-nascido a termo e saudável.
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