Álvaro Pereira

Transfer of Clarithromycin to Gastric Juice is Enhanced by Omeprazole in Helicobacter pylori -Infected Individuals

Background: The effects of proton-pump inhibitors and Helicobacter pylori infection on the distribution of drugs employed for the eradication of H. pylori are poorly understood. The aim of this study was to investigate the effects of a 7-day oral administration of 20 mg omeprazole on the distribution of clarithromycin in the gastric juice of individuals with H. pylori infection. Methods: Eighteen H. pylori infected dyspeptic male volunteers without endoscopic lesions were enrolled in a study with an open, randomized, two-period crossover design and a 21-day washout period between phases. Plasma and gastric juice concentrations of clarithromycin in subjects with and without omeprazole pretreatment were measured by means of liquid chromatography coupled to tandem mass spectrometry. Results: The maximum concentration of clarithromycin (C max ) and the area under the time-concentration curve from 0 to 2 h (AUC 0-2h ) were significantly higher in gastric juice than in plasma. Omeprazole treatment further augmented clarithromycin C max and AUC 0-2h in gastric juice approximately 2-fold ( P < 0.05). Conclusions: Short-term treatment with omeprazole in H. pylori -positive volunteers increases the amount of clarithromycin transferred to the gastric juice, confirming a synergism between these drugs. Our results suggest the presence of an active transport mechanism for clarithromycin from plasma to the gastric lumen, which is influenced by omeprazole.Background: The effects of proton-pump inhibitors and Helicobacter pylori infection on the distribution of drugs employed for the eradication of H. pylori are poorly understood. The aim of this study was to investigate the effects of a 7-day oral administration of 20 mg omeprazole on the distribution of clarithromycin in the gastric juice of individuals with H. pylori infection. Methods: Eighteen H. pylori infected dyspeptic male volunteers without endoscopic lesions were enrolled in a study with an open, randomized, two-period crossover design and a 21-day washout period between phases. Plasma and gastric juice concentrations of clarithromycin in subjects with and without omeprazole pretreatment were measured by means of liquid chromatography coupled to tandem mass spectrometry. Results: The maximum concentration of clarithromycin (C max ) and the area under the time-concentration curve from 0 to 2 h (AUC 0-2h ) were significantly higher in gastric juice than in plasma. Omeprazole treatment further augme...

Cuidando do paciente no processo de morte na Unidade de Terapia Intensiva

The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.

Transfer of Metronidazole to Gastric Juice: Impact of Helicobacter pylori Infection and Omeprazole

Background: The effects of Helicobacter pylori infection associated with inhibition of gastric acid secretion on the distribution of medications used for H. pylori eradication are poorly understood. The aim of this study was to investigate the effects of a 7-day administration of 20 mg omeprazole on the transfer of metronidazole from plasma to the gastric juice of individuals with and without H. pylori infection. Methods: Fourteen H. pylori-positive and 14 H. pylori-negative male volunteers were enrolled in a study with an open, randomized, two-period crossover design with a 21-day washout period between phases. Plasma, salivary, and gastric juice concentrations of metronidazole in subjects with and without omeprazole treatment were measured with reversed-phase high-performance liquid chromatography/liquid chromatography. Results: Metronidazole peak concentration (Cmax

Sistematização da Assistência de Enfermagem ao portador de Diabetes Mellitus e Insuficiência Renal Crônica

This is a clinical case study developed during the practical activities of the discipline Surgical Clinical Nursing I, of course of Graduation in Nursing of a public university of Bahia State, that aimed to report the application of the Systematization of Nursing Assistance in the assistance to a client whit Diabetes Mellitus and Chronic Renal Insufficiency. With the development of the study, especially after the positive improvement of the client, face to assistance planned and implemented and considering the reflections that emerged, it was possible to evidence the need for interface between Systematization of Nursing Assistance, the nursing staff and client in the care process, at the excellence and uniqueness of nursing care.Tratou-se de um estudo de caso clinico desenvolvido durante as atividades praticas da disciplina Enfermagem Clinico-Cirurgica I, do curso de Graduacao em Enfermagem de uma universidade publica do Estado da Bahia, que objetivou relatar a aplicacao da Sistematizacao da Assistencia de Enfermagem na assistencia a um paciente portador de Diabetes Mellitus e Insuficiencia Renal Cronica. Com o desenvolvimento do estudo, em especial apos a melhora positiva da paciente face as condutas planejadas e implementadas e, considerando as reflexoes que emergiram, foi possivel constatar a necessidade da interface entre a Sistematizacao da Assistencia de Enfermagem, equipe de enfermagem e paciente no processo do cuidar, frente a excelencia e singularidade dos cuidados de enfermagem

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

OBJECTIVE To estimate the time of decision (TD) to look for medical care and the time of arrival (TA) at the health service for men (M) and women (W) suffering from acute myocardial infarction and to analyze the influence of the interpretation of pain and pain resistance behaviors during these times. METHODS This is an exploratory research, performed at the university hospital in Salvador/Bahia. 43 W and 54 M were interviewed. To study the dependence among sociodemographic and gender variables, the Fisher Exact Test was used. To analyze times, a geometric mean (GM) was used. In order to verify the association between the GM of TD and TA and the judgment of pain, and between the GM of TD and TA and the behavior of resistance to pain, as well as to test the time of interaction between the gender variable and other variables of interest, the robust regression model was used. The statistical significance adopted was 5%. RESULTS The GM of the TD for M was 1.13 h; for W, 0.74 h. The GM of the TA was 1.74 h for M and 1.47 h for W. Those who did not recognize the symptoms of AMI and presented behavior of resistance to pain had higher TD and TA, being the associations significant. Gender did not change the associations of interest. CONCLUSION The findings demonstrate the importance of health education aiming at the benefits of early treatment.

Comfort for a good death: perspective nursing staff's of intensive care

Objective: It is a qualitative research aimed to know the meaning of nursing care for a good death from the perspective of a team of intensive care nursing. Methods: Symbolic Interactionism was adopted as a theoretical framework and content analysis of Bardin as the methodological framework for analysis. Ten nurses were interviewed, who experienced the care of the terminally ill person, in the ICU of a hospital specializing in oncology. Results: It showed that the meaning of caring for a good death focuses on the promotion of comfort as the central category and three subcategories: Relief of physical discomforts, social and emotional support and maintenance of the health and body positioning. Conclusion: To care for a good death means to promote comfort as a results of therapeutic interventions that combine rationality and sensitivity in interactions of health professionals with patients and their families, ensuring their dignity.Objetivo: Trata-se de uma pesquisa qualitativa que objetivou conhecer o significado do cuidar em enfermagem para uma boa morte na perspectiva de uma equipe de enfermagem intensivista. Metodos: Adotou-se o Interacionismo Simbolico como referencial teorico e a Analise de Conteudo de Bardin como referencial metodologico para analise. Foram entrevistados 10 profissionais de enfermagem, que vivenciavam o cuidado a pessoa em processo de terminalidade, numa UTI de um hospital especializado em oncologia. Resultados: O significado do cuidar para uma boa morte centra-se na promocao do conforto como categoria central e tres subcategorias: Alivio de desconfortos fisicos, Suporte social e emocional e Manutencao da integridade e do posicionamento corporal. Conclusao: Cuidar para uma boa morte significa promover conforto como um resultado de intervencoes terapeuticas que conciliem racionalidade e sensibilidade nas interacoes dos profissionais de saude com o paciente e sua familia assegurando a sua dignidade.

Conforto para uma boa morte: perspectiva de uma equipe de enfermagem intensivista

Objective: It is a qualitative research aimed to know the meaning of nursing care for a good death from the perspective of a team of intensive care nursing. Methods: Symbolic Interactionism was adopted as a theoretical framework and content analysis of Bardin as the methodological framework for analysis. Ten nurses were interviewed, who experienced the care of the terminally ill person, in the ICU of a hospital specializing in oncology. Results: It showed that the meaning of caring for a good death focuses on the promotion of comfort as the central category and three subcategories: Relief of physical discomforts, social and emotional support and maintenance of the health and body positioning. Conclusion: To care for a good death means to promote comfort as a results of therapeutic interventions that combine rationality and sensitivity in interactions of health professionals with patients and their families, ensuring their dignity.Objetivo: Trata-se de uma pesquisa qualitativa que objetivou conhecer o significado do cuidar em enfermagem para uma boa morte na perspectiva de uma equipe de enfermagem intensivista. Metodos: Adotou-se o Interacionismo Simbolico como referencial teorico e a Analise de Conteudo de Bardin como referencial metodologico para analise. Foram entrevistados 10 profissionais de enfermagem, que vivenciavam o cuidado a pessoa em processo de terminalidade, numa UTI de um hospital especializado em oncologia. Resultados: O significado do cuidar para uma boa morte centra-se na promocao do conforto como categoria central e tres subcategorias: Alivio de desconfortos fisicos, Suporte social e emocional e Manutencao da integridade e do posicionamento corporal. Conclusao: Cuidar para uma boa morte significa promover conforto como um resultado de intervencoes terapeuticas que conciliem racionalidade e sensibilidade nas interacoes dos profissionais de saude com o paciente e sua familia assegurando a sua dignidade.

Caring for the patient in the process of dying at the Intensive Care Unit

The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.The objective of this study is to characterize how nursing care is performed at the ICU to patients with no possibility of cure. Ten nurses were interviewed. The field study was performed at the Intensive Care Unit of a public teaching hospital. For the nurses, there is no uniform pattern of care. Furthermore, according to their reports, it was observed that there is an overestimation of the technical care over the emotional, social and spiritual aspects. It was, however, observed that nurses are strongly with the suffering of the family in view of their loss. Results show that nurses must understand death as a part of the life cycle and review care as the essence of nursing, thus increasing the discussions on the issue in both the academic and daily practice environments.

Pain tolerance during myocardium infarction

Purpose: To evaluate pain tolerance as a prodromic symptom in men and women who had a myocardium infarction. Methods: This was a quantitative-qualitative exploratory study with 43 women and 54 men from a public hospital. Demographic data were analyzed with percentages and qualitative data were analyzed with content analysis according to gender. Results: The men’s mean age was 55.3 years. The women’s mean age was 61.5 years. Both genders had low educational level and professional inactivity. Men lived with a significant other and had higher family income than women. There was no difference regarding pain tolerance between men and women. Both men and women tried to maintain control over their life and to reproduce social constructions in daily life regarding being male and female. Conclusion: Heath care professional actions for the prevention of delaying seeking medical care for coronary

Tolerância à dor no infarto do miocárdio

Purpose: To evaluate pain tolerance as a prodromic symptom in men and women who had a myocardium infarction. Methods: This was a quantitative-qualitative exploratory study with 43 women and 54 men from a public hospital. Demographic data were analyzed with percentages and qualitative data were analyzed with content analysis according to gender. Results: The men’s mean age was 55.3 years. The women’s mean age was 61.5 years. Both genders had low educational level and professional inactivity. Men lived with a significant other and had higher family income than women. There was no difference regarding pain tolerance between men and women. Both men and women tried to maintain control over their life and to reproduce social constructions in daily life regarding being male and female. Conclusion: Heath care professional actions for the prevention of delaying seeking medical care for coronary