Mariangela da Silva Nunes

Immediate post-craniotomy headache.

Introduction Headache is the most common adverse event immediately following craniotomy and is due to the surgical procedure and meningeal irritation. Objectives The aim of this study was to investigate the prevalence of headache during the first week after a craniotomy, as well as headache intensity, whether pain was registered in the patients medical records, the use of analgesics and predictors of headache. Methods Ninety-one patients who underwent craniotomy were evaluated from the first to the seventh post-operative day. The variables analysed were gender, age, medical history, indication for craniotomy, surgery, occurrence of headache, pain registration in the medical records, length of hospital stay and analgesics consumption. Results On the second post-operative day, 29.2% of patients had a headache and there was under-reporting of this pain in the patients’ records. The analgesics used were non-steroidal anti-inflammatory in 75% of cases. An age of <45 years (odds ratio = 3.0, p = 0.041) and surgery duration lasting >4 hours (odds ratio = 3.7, p = 0.019) were associated with the occurrence of immediate post-craniotomy headache. Conclusion Further training should be provided to professionals caring for patients undergoing craniotomy to better manage post-operative headache.

Epidemiological aspects of dengue in Aracaju, State of Sergipe, Brazil

INTRODUCTION The dengue fever remains to be a disease of serious public health concern, and its incidence has increased in the past decades. This study aimed to characterize the epidemiological incidence of dengue in the period 2001-2010. METHODS This is an epidemiological study of dengue in the municipality of Aracaju, state of Sergipe, in the period between 2001 and 2010, whose data were obtained from the Information System of Diseases Notifications. A descriptive analysis of the number of confirmed cases of dengue, according to year, semester, sanitary district, age, and sex, was performed. RESULTS There were 16,462 confirmed cases, especially in 2008, which obtained the highest incidence of the disease, with 10,485 confirmed cases. The first semester obtained the highest registration of cases during the years of research; this was predominated by females between 15 and 49 years old. With regard to the territorial distribution, the second district of the municipality obtained the highest number of cases. CONCLUSIONS In 2008, in the City of Aracaju, SE, a significant increase in the proportion of dengue cases compared with other years was verified. However, a fast decline in the other years was observed, possibly because of the intensification of preventive actions to combat the mosquito that transmits the dengue virus.

Fall-related traumas in urgent care centers

OBJECTIVE: To identify the scope and the characteristics of fall-related traumas in urgent care centers in Sergipe, Brazil and to verify potential associations among the following variables: gender, age, and where the event occurred. METHOD: This descriptive, cross-sectional study with a quantitative approach was conducted in the urgent care centers of two public referral hospitals in the state of Sergipe, Brazil. The data collection was conducted in November 2010, after approval was obtained from the Human Research Ethics Committee, through a structured interview with a sample of 509 fall victims. RESULTS: Most of the participants were male, between 0 and 19 years old, single, with no impairments or preexisting diseases, nor regular use of medication or alcohol. The victims were brought to the hospital by ambulance and were accompanied. Most events occurred at home, were same-level falls, and most frequently resulted from slipping and tripping during recreational activities with a subsequent fracture, contusion or sprain. Most victims were discharged from the hospital after care delivery. Statistically significant associations were found between place of fall and age and gender. CONCLUSION: There is a high incidence of seeking out care in urgent care centers due to falls, which constitutes a severe public health problem that affects both genders in different age groups. The adoption of preventive measures aimed to reduce such events is urgently required.

Characterization of victims of trauma treated in an emergency hospital

Objective: to describe the socio-demographic profile of victims of trauma treated in an emergency hospital in Sergipe, Brazil. Method: this is an ecological, retrospective, and quantitative study. The sample consisted of 301 medical records of patients treated between January 2006 and July 2008 at Hospital de Urgencia in Sergipe. The collection was carried out within the period from September to December 2008, after the approval by the Research Ethics Committee of Universidade Federal de Sergipe under the Protocol 2448.0.000.107-08. The variables under study were age, gender, external cause, the most severely affected body region, length of hospital stay, Glasgow Coma Scale, and outcome. The data were analyzed through the software Statistical Package for the Social Sciences (SPSS) version 16.0. Results: the average age was 27.8 years, with a prevalence of males (85.7%), individuals from Sergipe state towns, apart from the capital (56.2%), victims of traffic accidents (47.2%) and aggression (27.6%), predominance of cranioencephalic trauma (61.5%), between Friday and Monday (71.5%), average length of hospitalization of 10 days and hospital discharge (74.1%). Conclusion: the higher frequency of cranioencephalic trauma in male young adults, victims of weekend accidents, suggests the need for intensifying the traffic accident prevention strategies to minimize the occurrence and possible consequences related to trauma. Descriptors: wounds and injuries; mortality; accidents, traffic; external causes.

Glucose solution is more effective in relieving pain in neonates than non‐nutritive sucking: A randomized clinical trial

Few studies have compared the analgesic effect of 25% glucose and non‐nutritive sucking. We compared the analgesic effect of 25% glucose and non‐nutritive sucking in newborns undergoing hepatitis B vaccination. Our hypothesis is that 25% glucose is more effective in relieving pain than non‐nutritive sucking.

Pain in patients undergoing appendectomy

BACKGROUND AND OBJECTIVES:Pain is a subjective manifestation of unpleasant, personal and untransferable experience, produced by tissue injury involving physical and chemical body mechanisms. This study aimed at identifying the presence of acute pain in the postoperative period of appendectomy, at checking pain records, at describing postoperative complications and at comparing pain management and the adequacy of analgesia.METHODS:This is a transversal, descriptive and quantitative study. Sample was made up of 41 patients submitted to appendectomy. A semi-structured interview was carried out with information about use of analgesics, presence of postoperative pain, pain site, consequences of pain and visual analog scale. To evaluate pain management and the quality of analgesia, the Pain Management Index proposed by the World Health Organization was calculated.RESULTS:From total sample, 61% were males, mean age was 34.36±11.64 years, 70.7% were married and all patients have referred pain. In 90.2% of cases there was no pain recording in medical charts. Surgical incision was the major pain site and its primary consequence was impaired physical mobility. As to pain intensity, 22.2% of patients had moderate pain and were inadequately treated according to Pain Management Index.CONCLUSION:There has been considerable inadequacy of analgesia, pain recording in medical charts was scarce and no nursing professional has recorded pain. Surgical incision was major pain complaint site and impaired mobility was the primary complication. Our data bring about the need for investments in health professionals qualification with regard to pain management.

Traumatic Brain Injury: Consequences and Family Needs

Traumatic Brain Injury (TBI) is one of the most common injuries resulting from external causes and constitutes a global public health problem of great significance. TBI is mainly caused by traffic accidents, violence and falls, with a strong impact on the population’s morbidity and mortality. TBI is a complex injury caused by a cascade of changes in the brain and throughout the body. Its consequences, especially neuropsychiatric ones, do not appear immediately, a characteristic of a silent epidemic (Hampton, 2011). It is considered to be a chronic disease process, according to the World Health Organization, presenting one or more of the following characteristics: permanent, caused by nonreversible pathological alterations, requires special treatment to rehabilitate the patient, or a long period of observation, supervision and care (Masel & DeWitt, 2010). It affects people of all ages, with a higher incidence among those who are 15 to 24 years old and 75 years old or older. It occurs twice as frequently in men as in women, half of all cases are associated with alcohol and can result in physical, cognitive, and psychosocial disability. Due to the large number of cases with disabilities, prevention is of great importance (National Institutes Health [NIH], 1999). There is a worldwide concern to promote widespread awareness, warning people of all classes and ages about how serious a problem TBI is becoming. Good education, knowledge of risk factors and prevention reduces the incidence of trauma and its consequences.

Cefaleia pré-operatória em pacientes submetidos a pinçamento de aneurisma cerebral não roto

JUSTIFICATIVA E OBJETIVOS: A cefaleia e um dos principais sintomas referidos por pacientes com aneurisma cerebral. Como outras dores sao, frequentemente, ignoradas pela equipe multiprofissional. Apesar de importante, a avaliacao da cefaleia no pre-operatorio de pincamento de aneurisma cerebral e um desafio para a equipe de saude. O objetivo deste estudo foi avaliar a cefaleia pre-operatoria em pacientes submetidos a pincamento de aneurisma nao roto. METODOS: Estudo descritivo, exploratorio, de abordagem quantitativa, realizado entre setembro de 2014 e maio de 2015 no setor de neurocirurgia e na unidade de terapia intensiva de um hospital de medio porte. A casuistica foi constituida por 28 pacientes no pre-operatorio de craniotomia eletiva para o tratamento de aneurisma cerebral nao roto. Utilizaram-se os testes de Mann-Whitney, Kruskal-Wallis e Exato de Fisher e adotou-se nivel de significância de 5%. RESULTADOS: Demonstrou-se que 78,6% dos pacientes eram do genero feminino com media de idade de 46,7 anos. A cefaleia pulsatil de localizacao frontal e intensidade moderada foi a dor mais prevalente. Nauseas e vomitos tambem estiveram presentes, assim como a dor no globo ocular. A dor piorou com o esforco fisico e balanceio da cabeca. Houve diferenca estatisticamente significativa para as variaveis: recorrencia da dor e dor em globo ocular. CONCLUSAO: Este estudo esclarece os principais itens a serem investigados na avaliacao da cefaleia do paciente com aneurisma cerebral e suas caracteristicas a fim de facilitar o diagnostico precoce e a melhora antecipada na recuperacao neurologica.BACKGROUND AND OBJECTIVES: Headache is a major symptom referred by patients with brain aneurysm. As other types of pain, it is often ignored by the multiprofessional team. Although important, headache evaluation in the preoperative period of brain aneurysm clamping is a challenge for the health team. This study aimed at evaluating preoperative headache of patients submitted to unrupted aneurysm clamping. METHODS: This is a descriptive, exploratory and quantitative study carried out between September 2014 and May 2015 in the neurosurgery sector and the intensive care unit of a medium-sized hospital. Sample was made up of 28 patients in the preoperative period of elective craniotomy to treat unrupted brain aneurysm. Mann-Whitney, Kruskal-Wallis and Fisher Exact tests were used with significance level of 5%. RESULTS: It was observed that 78.6% of patients were females with mean age of 46.7 years. Moderate pulsing and frontal headache was the most prevalent pain. Nausea and vomiting were also present, as well as pain in the eye. Pain has worsened with physical effort and shaking the head. There has been statistically significant difference for the variables pain recurrence and pain in the eye. CONCLUSION: This article clarifies major items to be investigated to evaluate headache of brain aneurysm patients and its characteristics to help early diagnosis and better neurologic recovery.

Inhibition of Drug-Sensitive and Drug-Resistant Mycobacterium Tuberculosis Strains by Essential Oil from Croton Argyrophylloides Mull. Arg.

Objetcitve: To assess in vitro effects of essential oil extracted from Croton argyrophylloides against clinical and standard strains of Mycobacterium tuberculosis , comparing its resistance and sensitivity profiles to drugs commonly used in therapy. Method: In the present study, chemical composition and antimycobacterial activity of essential oils extracted from aerial parts of Croton argyrophylloides collected in Curituba district, Sergipe, Brazil were analysed. The oil was studied by GC and GC-MS and its antimicobacterial activity (MIC) was tested against 49 clinical and standard covers H 37 RV using the REMA method. To access sensitivity to isoniazid, rifampicin, ethambutol and streptomycin it was used proportions indirect test method. Results: Twenty-seven chemicals were identified, totalizing 95.98% of the composition of essential oil. The oil presented good antibacterial activity (MIC = 97 to 195 g / ml) against strains of Mycobacterium tuberculosis H37Rv and pattern one. Conclusion: On pharmacological activities of these species confirmed in vitro scientific support for its use in traditional herbal preparations.

Knowledge of health professionals about pain and analgesia

BACKGROUND AND OBJECTIVES: Pain relief is a basic human right and an ethical issue involving all health professionals. This study aimed at describing what professionals of a multidisciplinary hospital team know about pain and analgesia. METHODS: This is a descriptive, cross-sectional study with quantitative approach, carried out at the Teaching Hospital of the Federal University of Sergipe. Sample was made up of 33 physicians, 26 nurses, 10 physiotherapists, 8 pharmacists and 5 psychologists. Data collection tool was a self-applied questionnaire encompassing knowledge about definitions and types of pain, evaluation and measurement, pharmacological and non-pharmacological management, and professional qualification in pain. Data were analyzed by simple descriptive statistics and are presented as tables. RESULTS: Participants of the study were predominantly females (72.0%), young adults (40.2%), with residence as maximum qualification (53.7%). Pain was considered discomfort/unpleasant sensation (46.3%) and chronic pain was defined as a symptom 48.8%). Only one professional reported using multimodal treatment for pain relief. Most professionals stated having acquired knowledge about pain and analgesia after graduation (79.3%) and that they feel the need for specific qualification (70.7%). CONCLUSION: This study has provided a situational diagnosis of the knowledge of the multiprofessional team of the hospital, showing that there is inconsistency between participants’ theoretical basis and their role in handling pain and humanizing assistance.