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Reações adversas a medicamento sem pacientes hospitalizados por insuficiência hepática crônica moderada ou grave em hospitais do Nordeste do Brasil

Thu, 01 Jan 2026 00:00:00 GMT

Título: Reações adversas a medicamento sem pacientes hospitalizados por insuficiência hepática crônica moderada ou grave em hospitais do Nordeste do Brasil Autor(es): Araújo, Breno Queiroz de Abstract: Chronic liver failure (CLF) is characterized by progressive and irreversible loss of liver function, which may lead to alterations in the pharmacokinetics of various medications and increased susceptibility to adverse drug reactions (ADRs). In this context, the clinical pharmacist plays a fundamental role in the prevention, identification, and management of these reactions. This study aimed to characterize the incidence, determinants, and clinical relevance of ADRs in patients hospitalized with moderate to severe CLF in hospitals in the Northeast region of Brazil. This is an observational, analytical, multicenter prospective cohort study that included patients with moderate to severe CLF (Child-Pugh B or C) hospitalized in seven hospitals in Northeast Brazil between September 2023 and January 2026. Daily collection of clinical, laboratory, and pharmacotherapeutic data was performed, with active surveillance of ADRs through medical record review, trigger tools, and reports from the healthcare team and patients. ADRs were coded according to the Medical Dictionary for Regulatory Activities (MedDRA®) and classified regarding causality, severity, and preventability using validated tools. Data analysis was performed using Stata 15®, adopting a significance level of p < 0.05. A total of 252 patients were included, with a predominance of males (59.1%) and a mean age of 59.2 years. Overall, 38.9% of patients experienced at least one ADR, totaling 207 events. The most frequent ADRs involved gastrointestinal, nervous system, and metabolic disorders, with furosemide, lactulose, and carvedilol identified as the main suspected drugs. Most ADRs were classified as probable or possible, of mild severity, and largely preventable. ADRs were associated with longer follow-up time, previous upper gastrointestinal bleeding, and laboratory abnormalities suggestive of hepatic and renal dysfunction, such as elevated urea, bilirubin, and aspartate aminotransferase (AST), as well as hyponatremia. ADRs were also associated with relevant clinical outcomes, including hepatorenal syndrome, prophylactic variceal ligation, acute-on-chronic liver failure, jaundice, and hepatic coma. In conclusion, ADRs are frequent in patients with CLF, many of which are preventable, and are associated with worse clinical outcomes, highlighting the need for rigorous pharmacotherapeutic monitoring and strategies to ensure safe medication use in this population. Tipo: Dissertação

Protocolo assistencial de enfermagem para prevenção dos cânceres de mama e colo de útero em pessoas transmasculinas: estudo metodológico

Thu, 01 Jan 2026 00:00:00 GMT

Título: Protocolo assistencial de enfermagem para prevenção dos cânceres de mama e colo de útero em pessoas transmasculinas: estudo metodológico Autor(es): Silva, Denise Montenegro da Abstract: The present study aimed to develop a nursing care protocol for the prevention of breast and cervical cancers among transmasculine individuals. This methodological study was conducted from June 2024 to January 2026, following the Iowa Model of Evidence-Based Practice to Promote Excellence in Health through eight stages: identifying a research question; securing organizational support by recognizing the topic as a priority; conducting a scoping review; designing and implementing a pilot for practice change, involving the team while considering preferences, resources, constraints, and approval processes; developing a protocol and implementation plan, collecting data, and evaluating processes; assessing whether the practice change was appropriate and ready for implementation; integrating the change directly into the current system while monitoring key indicators; and, finally, disseminating the results. The validation stage was conducted using a hybrid format (face-to-face and online). Content validation was performed by seven specialist nurses (online), five individuals from the target care population (hybrid format with members of the Associação Transmasculina do Ceará), and five primary healthcare nurses who evaluated the usability of the protocol (online). Only the penultimate stage was not fully completed. Data were analyzed and presented using descriptive statistics, including absolute and relative frequencies. In addition, item-level content validity indices and the specific calculation required by the evaluation tool were computed. Ethical principles were observed throughout all stages of the study, ensuring participant anonymity. The study results included: the production of a scoping review published in a highly relevant international journal; systematic meetings with the transmasculine population to understand perceptions and preferences regarding the topic; organization, analysis, and interpretation of the data culminating in the development of the protocol; and content validation, in which the overall protocol evaluation by specialists was 0.85, indicating good overall quality, with Domain 5 (Applicability) showing the lowest level of agreement (0.71). Among the transmasculine population, the overall evaluation was 0.95, with Domain 6 (Editorial Independence) presenting the lowest level of agreement (0.55). Following the validation stage, evaluators’ considerations were analyzed, and the relevant modifications were incorporated into the instrument. Regarding usability, the protocol was recognized as a practical and easily implementable tool. In conclusion, the protocol demonstrated valid content and usability within the context of primary healthcare, enabling nurses to guide preventive care practices through evidence-based actions delivered in a more inclusive manner to transmasculine populations. Tipo: Tese

Estética do sorriso

Wed, 01 Jan 2025 00:00:00 GMT

Título: Estética do sorriso Autor(es): Passos, Vanara Florêncio; Costa, Cecília Atem Gonçalves de Araújo; Hagn, Carolina; Aragão, Lívia Maria Martins; Cavalcante, Ingrid Maria Lopes; Nobre, Beatriz Gomes; Maciel, Gabriela de Oliveira; Hansen, Sarah; Lima, Gabriele Louise Santos; Botelho, Milena de Fátima Cavalcante; Lima, Vitória Camurça; Alves, Victória Mariana Santos; França, Maria Maiara Militão; Cavalcante, Tiago Urbano Feitosa Tipo: Livro

Protocolo clínico para o rastreamento do câncer do colo do útero no Sistema Prisional

Thu, 01 Jan 2026 00:00:00 GMT

Título: Protocolo clínico para o rastreamento do câncer do colo do útero no Sistema Prisional Autor(es): Silva, Caroline Bessa da; Aquino, Priscila de Souza; Pinheiro, Ana Karina Bezerra; Pontes, Ana Thereza Carvalho Tipo: Livro