The study's objectives were to compare nursing workload among adults, elderly and very elderly patients, including in the analyses the interventions and evolution of the workload between admission and discharge. This prospective longitudinal study involved 600 adult patients in general ICU in four city hospitals in Sao Paulo. The results showed that, independent of the age, it had the similarity of the nursing workload in the admission, as well as in the evolution of the patients' care. Differences between the groups were observed in the NAS on ICU's discharge and the following instrument's items: Monitoring and titration and Hygiene procedures in admission, Respiratory support and Intravenous hyperalimentation in discharge and Mobilization and positioning in discharge and admission. In conclusion, the results evidenced that the age interfered only in specific aspects of the nursing workload required by patients in ICUs.
Background and objectives
To date, it is unclear whether antigen matching is effective in reducing antibody development and whether transfusing blood from non‐Caucasian donors reduces alloimmunization in sickle cell disease patients (SCP). This study was designed to evaluate the effectiveness of an antigen‐matching strategy supplied by a mixed donor population, in reducing alloimmunization in SCPs.
Methods
Eighty SCPs transfused with C‐, E‐ and K‐matched units and 2000 donors were genotyped for the most relevant RBC antigens, and resulting genotypic frequencies were compared. Also, alloantibodies specificity and clinical complications were evaluated in SCPs.
Results
A high alloimmunization rate was observed despite the prophylaxis protocol (62·1%). The main cause underlying lack of effectiveness was transfusion of non‐matched units in external hospitals. Even though our donor population was ethnically mixed, it still exhibited antigenic differences in relation to SCPs (C and Fya). Frequency of clinical complications was similar between alloimmunized and non‐alloimmunized patients.
Conclusions
Prospective antigen matching is an unattractive alloimmunization prophylaxis for SCPs if not associated with strategies to minimize the hazards related to transfusions at non‐index hospitals. Even in a highly mixed donor population, antigenic discrepancies in SCPs are high, increasing the risk of antibody development.
Resumo Ainda que a articulação entre corpo, saúde e contexto político-econômico seja extremamente complexa e mediada por processos heterogêneos, é possível problematizar o discurso produzido pela mídia sobre corpo e saúde. Este estudo teve por objetivo apresentar algumas reflexões sobre os discursos e práticas contemporâneos acerca da saúde, com enfoque nos aspectos corporais e na relação entre estética corporal e bem-estar do indivíduo. A linha argumentativa desenvolvida preconiza que, na rede discursiva que se propaga pelas grandes mídias, cria-se uma concepção de saúde intimamente atrelada ao mercado de consumo. Neste ensaio, alguns discursos midiáticos sobre saúde são analisados, tendo em vista compreender aspectos do mercado simbólico que se organiza calcado nos signos-saúde. A construção do “corpo saudável” é tematizada e problematizada por meio do percurso teórico empreendido. No novo ideal apolíneo emergente na contemporaneidade, o corpo é um objeto moldável a ser cultivado por meio de dietas e hábitos alimentares espartanos, educado em sessões exaustivas de exercícios físicos, modelado por substâncias anabolizantes, corrigido por cirurgias plásticas com finalidade estética e regulado por padrões socioculturais que almejam alcançar a imortalidade mascarada no mito da eterna juventude. Para aprimorar os cuidados em saúde, os profissionais devem compreender as transformações que incidem na imagem do corpo que tem sido valorizada na era contemporânea.
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