Sonia Maria Oliveira de Barros

HIV-infected pregnant women have greater adherence with antiretroviral drugs than non-pregnant women

The objective of the study was to evaluate the influence of pregnancy on the level of adherence with antiretroviral (ARV) drugs, in a prospective cohort of 72 pregnant women and 79 non-pregnant women. Adherence was measured by pill counting and self-reporting. Women were deemed adherent if 95% or more of all ARV had been taken as prescribed, in two occasions. According to pill counting, 43.1 and 17.7% of pregnant and non-pregnant women, respectively, met the criteria of adherence (P = 0.001); in the postpartum, adherence declined to 20.6% (P = 0.002). In both groups, adherence rates by self-reporting were significantly higher as compared with pill counting (P = 0.001). In multivariate regression analysis, age >29 years (odds ratio [OR] 3.58, confidence interval [CI] 95% 0.10–0.75, P = 0.011), mean number of pills/day <6 (OR 2.53, CI 95% 1.07–6.01, P = 0.035), and being pregnant (OR 3.33, CI 95% 1.36–8.13, P = 0.008) were independently associated to greater adherence.

Avaliação de risco de úlcera por pressão: propriedades de medida da versão em português da escala de Waterlow

OBJECTIVE: To evaluate the sensitivity and specificity properties of Portuguese version of the Waterlow scale. METHODS: Field test of the scale among forty-four patients admitted to medical units in over sized university hospital for a period of 15 days. RESULTS: Patients who developed pressure ulcer had higher scores on the Waterlow scale than those without PU (18.1±3.4 and 12.8±5.4, p<0.001, respectively). Stepwise logistic regression indicated that skin type and appetite were significant predictors for the development of PU. The ROC curve analysis showed that score of 15 suggest the best combination of sensitivity and specificity, 87% and 76%, respectively. CONCLUSION: The results suggest that the Portuguese version of the Waterlow scale was an accurate and effective tool to predict the development of pressure ulcer in patients admitted to medical surgical units.OBJECTIVE: To evaluate the sensitivity and specificity properties of Portuguese version of the Waterlow scale. METHODS: Field test of the scale among forty-four patients admitted to medical units in over sized university hospital for a period of 15 days. RESULTS: Patients who developed pressure ulcer had higher scores on the Waterlow scale than those without PU (18.1±3.4 and 12.8±5.4, p<0.001, respectively). Stepwise logistic regression indicated that skin type and appetite were significant predictors for the development of PU. The ROC curve analysis showed that score of 15 suggest the best combination of sensitivity and specificity, 87% and 76%, respectively. CONCLUSION: The results suggest that the Portuguese version of the Waterlow scale was an accurate and effective tool to predict the development of pressure ulcer in patients admitted to medical surgical units.

Conjunto Internacional de Dados Essenciais de Enfermagem: comparação com dados na área de Saúde da Mulher

OBJECTIVE: To compare the International Data Set - Essentials of Nursing - with the nursing data set used in data collection forms for the area of Womens Health. METHODS: This is an observational, retrospective, descriptiveand correlational study, developed from forms of data collection of interest of nursing in the health area of motherhood validated. RESULTS: In the first category, from all six present items, four were included. In the second, all can be considered as present, including the gender item, although it was not explicit, was included because of the studied area. The third category was completely covered by the forms. CONCLUSION: The forms used were considered satisfactory, serving for the purposes of documentation and analysis of the nursing work process and making possible to quantify and qualify their contribution to the quality of care provided to women in the sectors studied.

Consulta de enfermagem a gestantes com anemia ferropriva

This study was carried out with the following objectives: to set up a protocol of data survey and nursing diagnosis, and to detect the most frequent nursing diagnosis among pregnant women with iron deficiency anemia. The protocol was applied in 52 nursing visits to pregnant women who presented hemoglobin values lower than 11.0 g/dl. The most frequent nursing diagnosis were: altered nutrition, risk to infection, impaired maintenance of the home; knowledge deficit on adequate feeding; risk to fetal injury regarding decrease in uteroplacental perfucion; non-compliance risk. Based on nursing diagnoses, interventions and nursing expected results with its application were planned.Este trabalho teve como objetivos: construir um protocolo de levantamento de dados e diagnosticos de enfermagem, e conhecer os diagnosticos de enfermagem mais frequentes. O protocolo construido foi aplicado em 52 consultas de enfermagem para as gestantes que apresentavam valores de hemoglobina menores que 11,0g/dl. Os diagnosticos de enfermagem mais frequentes foram: nutricao alterada, risco para infeccao, manutencao do lar prejudicada; deficit de conhecimento sobre a alimentacao, risco para lesao fetal relacionada a diminuicao da perfusao utero-placentaria.; risco de nao-comprometimento. A partir dos diagnosticos de enfermagem foram planejadas as intervencoes e os resultados esperados com a sua aplicacao.

Redução da transmissão vertical do HIV: desafio para a assistência de enfermagem

With the crescent rates of HIV infection within female population in reproductive age, we may observe a correspondent increase in congenital infections. Thus, the obstetric nurse must be updated to participate and to develop programs of pre-natal care for HIV pregnant women. The purpose of this study was to review the pre-natal follow-up of this population regarding nursing care. Authors did not intend to approach all aspects of this subject, especially considering that investigations extend the great improvements already achieved since the acknowledge of the disease.Com as crescentes taxas de infeccao pelo HIV na populacao feminina em idade fertil podemos observar um aumento correspondente de infeccoes congenitas. A enfermeira obstetra deve, portanto, estar atualizada para a participacao e desenvolvimento de programas de assistencia pre-natal as gestantes portadoras do HIV. Este trabalho tem como objetivo fornecer uma revisao sobre o acompanhamento pre-natal desta populacao para a assistencia de enfermagem. Nao se pretende esgotar o assunto, uma vez que pesquisas ampliam os enormes avancos ja ocorridos desde o reconhecimento da doenca.

Predictors of high-quality cord blood units

Analysis of umbilical cord blood (UCB) transplants shows a correlation between engraftment and total number of infused cells. Thus, it is worth evaluating what maternal and neonatal characteristics and collection techniques may affect the quality of UCB units.

A five-year review of vertical HIV transmission in a specialized service: cross-sectional study

CONTEXT AND OBJECTIVE: Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it. DESIGN AND SETTING: Cross-sectional study developed at the University Hospital of Santa Maria (RS), Brazil. METHODS: A cross-sectional study was conducted on a sample of 198 notification forms and medical records of HIV-positive pregnant women and exposed children. RESULTS: The vertical transmission rate was 2.4%, and three children had been infected by vertical HIV transmission. The statistically significant risk factor was the use of injectable drugs. Delayed reporting of pregnancy, absence of antiretroviral therapy during pregnancy, lack of proper prenatal care, incapacity to perform viral load detection tests and CD4+ T cell counts and obstetric and maternal clinical complications were reported. CONCLUSIONS: The vertical transmission rate was high and the recommended intervention measures were not adopted in full. Adequate prophylactic measures need to be implemented in HIV-positive pregnant women prenatally and during the antenatal, delivery and postpartum periods.

A cross-sectional study of umbilical cord blood donor profiles and their influence on umbilical cord blood collection in a Brazilian hospital

BACKGROUND AIMS Umbilical cord blood (UCB) cells are a new alternative to bone marrow source for hematopoietic stem cell transplantation and their use has increased in the last decade. Thus efforts are being made to improve the umbilical cord blood units quality. Besides compatibility, other factors, such as the total nucleated cell (TNC) count and the percentage of CD34(+) cells in the product, are very important for a successful transplant outcome. Our aim was to describe our donor population and assess the best cord blood collection technique at Hospital Israelita Albert Einsteins cord blood bank (São Paulo, Brazil). METHODS This was a retrospective study in which all analyses were performed simultaneously. A Students t-test was used for qualitative variables for non-matched samples. For qualitative analyses, we used either the chi-square test or the exact Fishers test. RESULTS The stratification of the population characteristics allowed us to determine which ones had an impact on unit volume, TNC count and percentage of CD34(+) cells. A significant correlation was observed between donor characteristics and the quality of UCB units as related to maternal and gestational age, type of pregnancy, route of delivery, cord blood collection technique and birth weight. CONCLUSIONS We found that cord blood collection technique and newborn weight were significantly correlated with the TNC content. The collection technique used at our institution significantly improved the UCB unit volume and consequently the TNC count. Some findings, such as the impact of maternal age and newborn weight, have led us to re-evaluate our protocol in order to achieve better results.

Práticas obstétricas e resultados maternos e neonatais: análise fatorial de correspondência múltipla em dois centros de parto normal

Objective: To describe the obstetric practices and maternal and neonatal outcomes of two normal birth centers in the Municipality of Sao Paulo, comparing the intra and extra hospital units. Methods: Observational, cross-sectional and retrospective study, with secondary data obtained from 192 records of the institutions involved. The study variables were the practices selected for normal birth: the use of oxytocin, the type of breaking the amniotic membranes, the performance of episiotomy or perineotomy and, the time of maternal and neonatal stay. It was developed a computerized tool for data collection, based on the study’s variables. The data were processed by multivariate statistical analysis. Results: In the intra-hospital birth center, the most frequently used interventions were related to: the use of oxytocin, artificial rupture of amniotic membranes and maternal and neonatal length of staying larger than 48 hours, postpartum. In the extra-hospital birth center had a higher frequency of parturients with: no tearing of perineum after delivery, membrane rupture spontaneously and maternal and neonatal length of staying less than 48 hours, postpartum. The maternal and neonatal outcomes showed no complications related to utilized practices. Conclusion: The birth practices differ little, when comparing the two types of Normal Birth Centers; both followed the recommendations of the World Health Organization and implemented the interventions only in specific cases.

International Essential Data Set for Nursing: a comparison with data in the area of Women's Health

OBJECTIVE: To compare the International Data Set - Essentials of Nursing - with the nursing data set used in data collection forms for the area of Womens Health. METHODS: This is an observational, retrospective, descriptiveand correlational study, developed from forms of data collection of interest of nursing in the health area of motherhood validated. RESULTS: In the first category, from all six present items, four were included. In the second, all can be considered as present, including the gender item, although it was not explicit, was included because of the studied area. The third category was completely covered by the forms. CONCLUSION: The forms used were considered satisfactory, serving for the purposes of documentation and analysis of the nursing work process and making possible to quantify and qualify their contribution to the quality of care provided to women in the sectors studied.