To profile the use of an operator in immunobiological supplemental health Fortaleza -Brazil, to identify the most prescribed therapeutic regimens and costs. METHODS: Cross-sectional study in two hospitals accredited service provider, from March to November/2012. Data were recorded by medical expertise in computerized management system (Sabius ® ) performed after the medical consultation. Later, these were entered in Microsoft Excell 2007 and analyzed by pharmacists auditors. The cost was calculated from the value contained in Brasíndice Unit 765, using the Consumer Price Max. The doses used for rheumatoid arthritis Etanercept 50 mg, 40 mg Adalimumab, abatacept 750 mg, 300 mg infliximab, 560 mg Tocilizimabe, Rituximab 1g and Golimumab 50 mg based on a 70 kg adult. RESULTS: We analyzed 64 patients with a mean weight 67 kg, of which 70.31% (n = 45) were women aged 30-59 years whose most frequent indications were rheumatoid arthritis (n = 33, 51.56%) and ankylosing spondylitis (n = 19; 29.69%). The most immunobiological commonly prescribed were Infliximab (n = 36; 56.25%), Tocilizimabe (n = 11, 17.19%), abatacept, and Rituximab (n = 8; 12, 50%) and golimumab (n = 1, 1.56%). It was observed that 67% (n = 43) patients were naïve immunobiological and 33% (n = 21) initiated with anti-TNF, whereas 61.9% (n = 13) moved into one another with immunobiological mechanism of action and 38.1% (n = 8) continued with an anti-TNF, changing only the drug. The average cost of treatment/dose first line
Resumo Introdução Mastectomia radical modificada e quadrantectomia são os principais tratamentos cirúrgicos para o câncer de mama; no entanto, podem ocasionar desordens físicas, mentais, sociais e ocupacionais à paciente e sua rede de apoio. Objetivo Analisar o efeito de orientações terapêuticas ocupacionais pré-cirúrgicas na rede de apoio de mulheres submetidas à cirurgia para tratamento de câncer de mama para organizar sua rotina pós-cirúrgica com foco nas Atividades Instrumentais de Vida Diária (AIVD). Método Trata-se de um estudo qualitativo, descritivo-exploratório e longitudinal realizado com 14 mulheres diagnosticadas com câncer de mama e indicadas à cirurgia eletiva, consistindo em orientações personalizadas a sua rede de apoio. Os dados foram coletados em dois momentos: pré- e pós-cirúrgico (após 30 dias) por meio de entrevista semiestruturada via videoconferência gravada e explorados por análise de conteúdo. Resultados As principais orientações fornecidas aos familiares incluíam estratégias para adaptação, graduação e delegação das atividades mais significativas para as participantes. Os achados da pesquisa foram divididos nas seguintes categorias: Família como rede de apoio e o processo de recuperação; Desafios do cuidado; Retorno ao desempenho das AIVD; Segurança da integridade física e emocional; e O terapeuta ocupacional como rede de apoio. As participantes destacaram a relevância do estudo e anseio por ampla cobertura assistencial da terapia ocupacional. Conclusão Os achados sugerem eficácia nas intervenções voltadas à organização da rotina de mulheres mastectomizadas a partir da instrumentalização da rede de apoio para o cuidado colaborativo.
O Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) se instaurou desde 2008 enquanto política nacional indutora de transformações na formação em saúde. Em sua proposta organizacional, o PET-Saúde prevê o pacto colaborativo e interprofissional entre instituições de ensino e da saúde para a construção de ações integradas, desenvolvidas por grupos tutoriais. Desta maneira, estudantes, docentes e profissionais dos serviços de saúde se unem em projetos e ações colaborativas realizadas em campo, de maneira a transformar processos de trabalho e qualificar tanto o ensino como a prática em saúde. O presente artigo descreve o relato das experiências do PET-Saúde, desenvolvido pela Universidade Federal do Paraná em parceria com os municípios de Curitiba e Piraquara, tendo como base a descrição das ações, situações e reflexões vivenciadas pelo grupo tutorial “Educação popular, mobilização e controle social na Saúde”, no período pandêmico de março de 2020 a março de 2021. O artigo relata inicialmente a estruturação do PET-Saúde UFPR, apresentando ações desenvolvidas pelo coletivo voltadas a minimizar o impacto da COVID-19 em pessoas em situação de rua. Destaca-se, ainda, a elaboração de materiais de educação popular sobre a COVID-19 e ações de mobilização popular para garantir condições básicas de subsistência e cuidado contra a doença. Para além, ao relato se integram as ações desenvolvidas para o fortalecimento do controle social e da defesa dos direitos humanos. Ressalta-se a importância de políticas públicas que promovam o estabelecimento de projetos interinstitucionais, impactando de maneira positiva a formação e a especialização das práticas em saúde.
Introduction Modified radical mastectomy and quadrantectomy are the main surgical treatments for breast cancer; however, they can cause physical, mental, social and occupational disorders to the patient and her support network. Objective To analyze the effect of preoperative occupational therapeutic guidance on the support network of women undergoing breast cancer surgery aiming to organize their postoperative routine with a focus on Instrumental Activities of Daily Living (IADL). Method This is a qualitative, descriptive-exploratory, longitudinal study conducted with 14 women diagnosed with breast cancer and referred to elective surgery, consisting of personalized guidance to their support network. Data were collected at two moments: pre- and post-operatively (30 days after surgery) through recorded semi-structured interviews via videoconference, and explored by content analysis. Results The main guidance provided to family members consisted of strategies for adaptation, grading, and delegating of the activities most significant to the participants. The findings were divided into the following categories: Family as a support network and the recovery process; Care challenges; Resuming IADL performance; Assurance of physical and emotional integrity; The occupational therapist as a support network. The participants highlighted the relevance of the study and their desire for broad Occupational Therapy assistance coverage. Conclusion The findings suggest the efficacy of interventions aimed at the routine organization of women who have undergone mastectomy based on the instrumentalization of their support network for collaborative care.
A541and events attributed to OIC including the negative impact on job-related activities. Methods: A prospective longitudinal study conducted in the United States (US), Canada (CN), UK (UK), and Germany (GE) of patients with OIC who have been on opioid therapy for at least four weeks was conducted. OIC related medical history and health care resource use was collected from participants self report. The number of hours missed from work and the extent to which the work productivity and regular daily activities were affected was collected using the WPAI-SHP. Results: A total of 489 eligible participants (US: 238; CN: 38;, GE: 115; UK: 98). Back pain (77%) and joint pain (52%) were the most common pain diagnosis with an average duration of chronic pain and opioid medication use of 10 and 6 years respectively. 27% of participants were currently employed. 18% of participants used at least one prescription laxative; 70% reported using at least one over-the-counter (OTC) laxative with the most common being stimulant laxatives (20%), osmotic laxatives (15%) and stool softeners (7%). 63% of participants reported discussing OIC with a health care provider, 3.0% reported a visit to the emergency room and 2.0% reported being admitted to a hospital because of their OIC during a 6-month time period. 9% of employed participants reported missing an average of 4.6 hours per week because of problems associated with constipation and 32% reported impairment while working due to constipation. ConClusions: The cumulative impact of OTC use, physician office visits and the negative impact on work-related activities for OIC may be substantial.
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