http://repositorio.ufc.br/handle/riufc/56888 Wed, 08 Apr 2026 15:18:20 GMT 2026-04-08T15:18:20Z http://repositorio.ufc.br/handle/riufc/83381 Título: Care bundle: estratégias para gestão de antimicrobianos em um hospital referência em transplantes no nordeste brasileiro Autor(es): Ruivo, Ana Karolina Pedrosa Abstract: Introduction: Infections caused by multidrug-resistant bacteria represent a serious public health problem and are associated with high mortality rates. Among the strategies recommended to deal with this problem is the implementation of Antimicrobial Stewardship Programs (AMPs). Immunosuppressive therapy has been effective in reducing rejection in transplant patients, but vulnerability to opportunistic infections and multidrug-resistant pathogens remains a complication with a significant impact. To this end, the use of a care bundle for the management of antibiotic therapy is an important tool for guiding conduct, ensuring patient safety through the systematization of care. Objective: To evaluate the use of a care bundle in the management of antimicrobial use in a transplant unit. Methods: This is an observational, descriptive, and retrospective study based on the analysis of data from a database stored by the Antimicrobial Stewardship Program unit, containing the record of antimicrobial stewardship strategies (ATM) carried out during the years 2020, 2021, and 2023 in a high-complexity hospital, which were processed and interpreted through a quantitative analysis of the information. Results: 398 patients were followed up in the transplant unit, with a mean age of 52±17 years, and 98.2% (n=1683) of the strategies were accepted. The average length of stay for liver transplantation (LT) was 67 days in 2020, 32.08 days in 2021, and 18.82 days in 2023, while for kidney transplantation (RT) it was 33.5 days in 2020, 32.16 days in 2021, and 21.66 days in 2023. The average treatment time for HT was 37 days in 2020, 26.23 days in 2021, and 17.88 days in 2023, and for RT it was 28.7 in 2020, 24.44 in 2021, and 20.09 in 2023. The most prevalent indications for TMJ treatment were ICS (47.2%), ITRS (21.6%), and ITGU (11.8%). A total of 1,390 prescribed ATMs were monitored, of which 73.38% (n=1020) were therapeutic reserves and 11.37% (n=158) were strategic, and the most prescribed classes were penicillins in association with beta-lactamase inhibitors (21.2%), glycopeptides (19%), carbapenems (18.6%), polymyxins (8.3%), and aminoglycosides (8.2%). A total of 1,713 proposed strategies were identified, 98.2% of which were accepted (n=1,683), and those with the highest frequency were reducing treatment time (30.8%), ending treatment (18%), escalation (15.9%), and dose adjustment (15.5%). Discussion: The strategies used are consistent with the recommendations of the Infectious Diseases Society of America (IDSA), which point out the importance of adjusting the time and antimicrobial spectrum according to the patient's clinical profile in order to avoid antimicrobial resistance. The registration of 73.38% of ATMs as therapeutic reserves shows a strategic focus on their rational use. The main types of infections transmitted are consistent with the literature, which associates bloodstream and respiratory infections with higher morbidity and mortality rates in immunosuppressed patients. Conclusion: The study demonstrated the relevance of using care bundles as part of the PGA, which can improve clinical outcomes and control antimicrobial resistance. The strategies applied revealed a possible positive impact on reducing the average length of stay and the rational use of antimicrobials. However, under-reporting and data loss reinforce the need to integrate digital technologies for real-time and more accurate antimicrobial monitoring and the need for continuous training of multi-professional teams in order to ensure greater reliability. Tipo: TCC Mon, 01 Jan 2024 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/83381 2024-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/83380 Título: Principais manifestações em pacientes oncohematologicos associados a coexistência do mieloma múltiplo com a amiloidose de cadeias leves: revisão integrativa da literatura Autor(es): Sales, Ernandes Félix Abstract: Introduction: Multiple myeloma (MM), also called Kähler's disease, myelomatosis, and plasma cell myeloma, is a malignant neoplasm of hematological origin characterized by the unregulated and clonal proliferation of plasma cells in the bone marrow. It is a disease that brings numerous problems to the health of its sufferers, especially when associated with other diseases that can contribute to a worse prognosis. One of these is Amyloidosis, which is characterized by being a set of rare diseases, in which fragments of proteins, folded into a highly stable configuration (pleated sheets of the “beta” type), are pathogenically deposited in the extracellular space of organs and tissues as insoluble fibrils. Objective: To identify in the literature studies that deal with the main complications associated with the coexistence of Multiple Myeloma and Light Chain Amyloidosis in hematological cancer patients. Methodology: The present study is an integrative review of the literature that seeks to identify productions that describe the main manifestations of hematological cancer patients where multiple myeloma and light chain amyloidosis coexist between the years 2019 and 2024. Results: A total of 13 studies were included in this research, 2 (15%) studies from LILACS, 5 (38%) studies from PubMed, 3 (23%) studies from CINAHL and 3 (23%) studies from SCOPUS. Of these studies, 5 were published in China; 1 in Spain; 1 in Ukraine; 1 from Chile; 1 from Italy; 1 from Ireland; 1 from Costa Rica; 1 from Singapore; one of them, it was not possible to identify the country of origin. The predominance of the studies was in the English language, 12 of them, and only 02 in the Spanish language. No articles in Portuguese were identified. Discussion: The coexistence between Multiple Myeloma (MM) and Light Chain Amyloidosis (AL) is an event with a considerable degree of frequency. In the studies used in this research, it is clear that this association has numerous disastrous consequences for the health of patients. Cardiac involvement was the event most frequently cited by studies. It is important to highlight that heart disease in MM and AL has a potentially very serious severity, which can lead to a reduction in the overall survival of patients and even death. Conclusion: The coexistence between Multiple Myeloma and Light Chain Amyloidosis has numerous systemic repercussions. Mainly, it is observed that cardiac involvement is the most predominant and has the greatest morbidity and mortality for patients. Tipo: TCC Mon, 01 Jan 2024 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/83380 2024-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/83314 Título: Fatores associados ao óbito de bebês com gastrosquise: um estudo retrospectivo Autor(es): Rodrigues, Larissa de Oliveira Bernardo Abstract: Gastroschisis is a congenital anomaly with an increasing incidence around the world. In addition, the mortality rate from this disease is higher in low and middle-income countries. The aim is to verify the factors associated with death in babies diagnosed with gastroschisis in a tertiary maternity hospital. This is a retrospective hospital-based cohort study carried out at the Assis Chateaubriand Maternity School (MEAC). The medical records of newborns with gastroschisis were analyzed and the inclusion criteria were: pregnancy with a live fetus with a gestational age > 24 weeks; prenatal diagnosis confirmed by the MEAC/UFC obstetrics team; diagnosis confirmed by the MEAC/UFC neonatology team and the MEAC/UFC pediatric surgery team. The variables were collected using REDCap and the statistical analyses were carried out using R software. This study was submitted to and approved by MEAC's Research Ethics Committee, under protocol number 7040683. It was observed that babies whose mothers came from the countryside were 4.2 times more likely to die, and that the babies who died had started prenatal care significantly earlier than the babies who survived. Babies with complex gastroschisis were 4.05 times more likely to die, and failure to perform primary closure in the first approach increased these chances by 7 times. In addition, the babies who died had spent significantly more days on invasive mechanical ventilation. For parenteral nutrition, admission to the Neonatal Intensive Care Unit and hospitalization, the time was significantly shorter, so that the longer the period, the lower the chances of death. The use of a peripherally inserted central catheter and the occurrence of metabolic acidosis were associated with death. Among the variables included in the multivariate logistic regression, the number of days using invasive mechanical ventilation showed a statistically significant association with the outcome of death. Thus, in view of the associations found, it can be seen that in addition to the early diagnosis of gastroschisis, it is necessary to improve the care provided to babies with gastroschisis in orderto reduce the number of deaths. Tipo: TCC Mon, 01 Jan 2024 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/83314 2024-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/83279 Título: Percepção do paciente oncohematológico a respeito da participação da família no seu cuidado em um hospital universitário Autor(es): Cipriano, Jéssica de Melo Abstract: This article reports on oncohematological patients' perceptions of family participation in their care at a university hospital. The aim was to assess whether the presence of the family member favors the patient's emotional comfort and adaptive process during hospitalization in the hematology ward. In order to obtain the results and answers to the problem presented in this work, we decided to carry out a study using a qualitative methodology, based on national studies researched in the Scielo database, Google Scholar, specialized websites on the subject and in university repositories and books, which are of significant importance in defining and constructing the concepts discussed in this analysis. In addition to the bibliographic survey, a sociodemographic questionnaire was used for data collection, as well as semi-structured interviews with patients admitted to the aforementioned ward. The research was able to contribute to the expansion of knowledge regarding family participation in treatment, understanding it as a basic unit of care, which helped in discussions about the importance of including the family in patient care. The study's relevance was justified by the fact that it enabled reflection on comprehensive patient care strategies, understanding the family as a partner of the health team. Tipo: TCC Mon, 01 Jan 2024 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/83279 2024-01-01T00:00:00Z