Repositório DSpace :: Navegando por Autor "Amaral, Rita Goreti"

Navegando por Autor "Amaral, Rita Goreti"

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Aspectos jurídicos e sanitários condicionantes para o uso da via judicial no acesso aos medicamentos no Brasil
(2012) Provin, Mércia Pandolfo; Sá, Maria Célia Delduque Nogueira Pires de; Amaral, Rita Goreti
The search for having access to health care and medicines right granted through Judicial Courts has increased in Brazil. What has been nominated “health judicialization” is a multidimensional phenomenon, a need for dealing with it in a multidisciplinary way involving legal-judicial, political-institutional and sanitary approaches has raised. The Health is recognized as a fundamental human right in the Brazilian Constitution giving it a different legal protection under the legal- constitutional order and the country guarantees the right to health are not only the Constitution and the law strictly, but mainly in an normative infralegal arc that define the goals and outcomes to be achieved by public policy. The lawsuits by drugs may be a reflection of the difficulty of access to health services, to empty and downgrading of health care. Therefore, this turns out to affect the judicialization of pharmaceutical care in Brazil.
Atenção farmacêutica em Goiânia: inserção do farmacêutico na estratégia saúde da família
(2010) Provin, Mércia Pandolfo; Campos, Andrea de Paula; Nielson, Sylvia Escher de Oliveira; Amaral, Rita Goreti
In agreement with the Brazilian National Drug Po- licy, the School of Pharmacy of Universidade Federal de Goiás, in partnership with the Municipal Health Department of Goiânia, state of Goiás, created and implemented a university development project suggesting the inclusion of the pharmacist in the Family Health Strategy. Meetings were held in order to introduce the project to the respective primary care units and to train the teams of pharmacists in the exercise of pharmaceutical assistance. In the 12 months of the project, 50 patients with hypertension (70% female), with average age of 50, were assisted. Among those, 40 (80%) presented more than one associated illness and 46 (92%) used 2 or more drugs, simultaneously prescribed. In the study, 154 Medication-Related Problems (MRP) were detected, with an incidence of 3.1 MRP per patient. The most frequent MRP was lack of therapeutic efficacy (49%), and 26.3% of these were caused by lack of treatment adherence. It can be concluded that the health care problems caused by lack of pharmacotherapy effi- ciency assume important proportions. Pharmaceuti- cal Care as a strategy of Pharmaceutical Assistance in Family Health can be an efficient alternative to obtain better clinical and economic results, and to improve the healthcare provided for users of Brazil’s National Health System.
Atendimento pelo SUS na percepção de mulheres com lesões de câncer cervicouterino em Goiânia-GO
(Marcelo Medeiros, 2011-06) Albuquerque, Zair Benedita Pinheiro de; Tavares, Suelene Brito do Nascimento; Manrique, Edna Joana Claudio; Souza, Adenícia Custodio Silva e; Neves, Heliny Carneiro Cunha; Valadares, Janaina Guimarães; Amaral, Rita Goreti
O câncer de colo do útero é prioridade nas políticas de saúde no Brasil. Apesar da existência do fluxo de atendimento estabelecido pelo Sistema Único de Saúde (SUS), fragilidades são observadas na sua operacionalização. Objetivou-se analisar a percepção de mulheres com lesões de colo do útero acerca do atendimento pelo SUS em Goiânia-GO. Estudo descritivo, exploratório de abordagem qualitativa. Os dados foram obtidos por meio de entrevistas, utilizando-se a técnica de incidente crítico e análise de conteúdo. Na percepção das mulheres, o atendimento é permeado por falhas no acolhimento, comunicação, assistência do profissional de saúde, falta de efetividade e pelo desconhecimento do próprio fluxo de atendimento. Evidenciou-se a necessidade de reorientação do atual modelo assistencial de atendimento, com abordagens conscientizadoras, que permitam aos profissionais e aos gestores desenvolverem habilidades de ouvir, acolher e de se responsabilizar pelo cuidado, a fim de promover a transformação dessa realidade. _______________________________________________________________________________________________________________________ ABSTRACT _______________________________________________________________________________________________________________________ Cancer of the uterine cervix is priority of health policies in Brazil. Despite of the flow of care established by the Brazilian Health System(SUS), there is weakness in its operations. This study aimed to analyze the perception of women with uterine cervix lesions on the care by the SUS in Goiania-GO. It is a descriptive study, with exploratory qualitative approach. The data were obtained through interviews using the critical incident technique, and the content analysis. In the perception of women, the care is permeated by failures in reception, communication, assistance of health professionals, and also the failure of effectiveness and ignorance of flow. It was evidenced the need for reorientation of care model offered to population through awareness of the approaches, to enable the professional and managers develop listening skills, reception and responsibility for the care, so that this reality may be changed. _______________________________________________________________________________________________________________________ ABSTRACT _______________________________________________________________________________________________________________________ El cáncer de cuello de útero es una prioridade en las políticas de salud en el Brasil. A pesar de que el flujo de atendimientos está establecido por el Sistema Único de Salud (SUS), se observa algunas debilidades en su funcionamiento. Estudio descriptivo, exploratorio de abordaje cualitativo, con el objetivo de analizar el parecer que tienen las mujeres con lesiones em el cuello del útero referente a la atención brindada por el SUS en Goiânia – GO. Los datos fueron obtenidos a través de entrevista com la utilización de la técnica de incidente crítico y análisis del contenido. Al parecer de las mujeres, la atención está rodeada de fallas en la acogida, comunicación y asistencia del profesional de la salud y falta de efectividad y desconocimiento del flujo de personas. Las evidencias apuntan la necesidad de una reorientación del modelo asistencial ofrecido en la atención a través de abordajes concientizadores, que permitan al profesional y a los gestores, desarrollar habilidade de oir, de acogimiento y de responsabilidad por el cuidado, para promover la transformación de esa realidad.
Avaliação do seguimento de mulheres com exames citopatológicos alterados de acordo com as condutas preconizadas pelo Ministério da Saúde em Goiânia, Goiás
(2014) Araújo, Eduardo Silva; Barbosa, Flávia Moreira; Ázara, Cinara Zago Silveira; Ferreira, Tatyana Xavier Almeida Matteucci; Tavares, Suelene Brito do Nascimento; Amaral, Rita Goreti
The appropriate follow-up for women with abnormal cytopathology tests is important for the treatment of precursor lesions in the initial phase. Objective: To assess whether women saw in Basic Health Care Units with abnormal cytopathology tests were subjected to properly conduct recommended by the Ministry of Health. Method: The study analyzed 12,208 cytopathology results of women attending Units Primary Care in Goiânia, the period 2006- 2008, through the records of Primary Care and Medium Complexity Units. The Epi-info 3.5.1 software was used for data analysis. Results: Of the 12,208 results analyzed, 90.74% were classified as negative, 1.88% as unsatisfactory, 4.74% as less serious injuries, and 2.43% as medium severity injuries. Of the total, 579 women with cytopathology tests classified as atypical squamous cells of undetermined significance, possibly non-neoplastic/low-grade squamous intraepithelial lesion, 41.62% underwent cytology follow-up, 14.85% and 10.19% underwent colposcopy and biopsy, respectively. Of the 297 women with cytopathological findings classified as atypical squamous cells of undetermined significance, high-grade lesion/high-grade squamous intraepithelial lesion cannot be excluded, 42.76% underwent cytopathology follow-up, and 35.02% and 28.96% underwent colposcopy and a biopsy, respectively. Of the 24 women with cytopathological results reported as atypical glandular cells/invasive adenocarcinoma, 20.83% had follow-up cytopathology, and 16.67% and 12.50% of women underwent colposcopy and biopsy, respectively. Conclusion: The majority of women with abnormal cytopathology tests possibly were not subjected to the recommended protocols as recommended by the Ministry of Health.
Avaliação dos indicadores da qualidade dos exames citopatológicos do colo do útero de laboratórios privados do Estado de Goiás credenciados pelo Sistema Único de Saúde
(2014) Ázara, Cinara Zago Silveira; Araújo, Eduardo Silva; Magalhães, Juliana Cristina; Amaral, Rita Goreti
Introduction: Although there are quality control standards for cytopathology testing, most Brazilian laboratories show indicators below the expected. Objective: To evaluate five indicators for internal monitoring of the quality of Unified Health System-accredited private laboratories, monitored and non-monitored by an External Quality Monitoring Laboratory in the State of Goiás. Method: Cross-sectional study. A total of 153,258 tests performed in 44 laboratories were included, among which 14 were monitored e 30 non-monitored, from January 2012 to December 2012, using data from Siscolo. Results: The monitored laboratories showed 1,837 altered tests, with 855 atypical squamous cells, 905 intraepithelial lesions and 350 high grade intraepithelial lesions, while the non-monitored laboratories showed 2,535 altered tests, with 1,436 atypical squamous cells, 890 intraepithelial lesions, and 244 high grade intraepithelial lesions. Approximately 60% of the monitored laboratories and 26% of the non-monitored ones showed a positivity rate of ≥ 3%, while 72% of the monitored laboratories and 10% of the non-monitored ones showed a percentage of ≥ 0.4% of the tests compatible with high grade intraepithelial lesion among satisfactory tests. Approximately 7% of the monitored laboratories and 29% of the non-monitored ones showed a percentage of ≥ 60% of atypical squamous with undetermined significance among the altered studies. Conclusion: Most laboratories that presented indicators within the recommended parameters were participating in the monitoring process of external quality.
Capacitação do Agente Comunitário de Saúde para o rastreamento do câncer do colo do útero
(2013-03) Ferreira, Tatyana Xavier Almeida Matteucci; Tavares, Suelene Brito do Nascimento; Rezende, Iraci Rodrigues de; Manrique, Edna Joana Cláudio; Guimarães, Janaína Valadares; Zeferino, Luiz Carlos; Amaral, Rita Goreti
The most important component of primary prevention of uterine cervical cancer is the high coverage of target po- pulation, however, our scenario is in excess of controls in a small percentage of women target. In regions where the Family Health Strategy was implemented there is a favora- ble scenario for the reorganization of screening for uterine cervical cancer. The aim of this study was to evaluate the acquisition of knowledge of Community Health Workers after training on the prevention of uterine cervical cancer. After the training significantly improved the knowledge of Community Health Agents about the purpose of Pap smear testing, ideal conditions for realization, the causative agent and risk factors for uterine cervical cancer and the results of cervical screening (p <0, 05). There was no improvement of knowledge about the target population and the frequency of correct implementation of the Pap test.
Capacitação do agente comunitário de saúde visando reorganização do rastreamento do câncer do colo do útero
(2013-03) Ferreira, Tatyana Xavier Almeida Matteucci; Tavares, Suelene Brito do Nascimento; Rezende, Iraci Rodrigues de; Manrique, Edna Joana Cláudio; Guimarães, Janaína Valadares; Zeferino, Luíz Carlos; Amaral, Rita Goreti
The most important component of primary prevention of uterine cervical cancer is the high coverage of target population, however, our scenario is in excess of controls in a small percentage of women target. In regions where the Family Health Strategy was implemented there is a favorable scenario for the reorganization of screening for uterine cervical cancer. The aim of this study was to evaluate the acquisition of knowledge of Community Health Workers after training on the prevention of uterine cervical cancer. After the training significantly improved the knowledge of Community Health Agents about the purpose of Pap smear testing, ideal conditions for realization, the causative agent and risk factors for uterine cervical cancer and the results of cervical screening (p <0, 05). There was no improvement of knowledge about the target population and the frequency of correct implementation of the Pap test.
Consumo de medicamentos por idosos, Goiânia, Brasil
(2013) Santos, Thalyta Renata Araújo; Lima, Dione Marçal; Nakatani, Adélia Yaeko Kyosen; Pereira, Lílian Varanda; Leal, Geraldo Sadoyama; Amaral, Rita Goreti
OBJECTIVE: To analyze the pattern of use of medications use in aged people and associate it with socioeconomic aspects and with the self-rated health. METHODS: A population-based cross-sectional design study with 934 elderly people from Goiania, Midwestern Brazil, between December 2009 and April 2010. Data were collected through a questionnaire. The dependent variable was the number of medications consumed and the independent variables were sex, marital status, education, type of residence, age, income, and self-rated health. Drugs were classifi ed according to the Anatomical Therapeutic Chemical Classifi cation. The inappropriate drugs for the elderly were identifi ed according to the Beers-Fick criteria. The tests used were Chi-square and Fisher’s exact test, p was considered signifi cant when < 0.05. RESULTS: The elderly consumed 2,846 medicines (3.63 medications/person). The most commonly consumed were those which act in the cardiovascular system (38.6%). The prevalence of polypharmacy was 26.4% and selfmedication was 35.7%. The most used drugs for self-medication were analgesics (30.8%), 24.6% of the elderly consumed drug considered inappropriate. Women, widows, those aged 80 or over and with worse self-rated health were more likely to practiced more polypharmacy. Most self-medication was associated with lower levels of education and worse self-rated health. CONCLUSIONS: The pattern of drug use by the elderly was similar to that found in the elderly in other regions of Brazil. The number of drugs used, the prevalence of self-medication and practice of polypharmacy and inappropriate drug use were within the national average.
Controle da qualidade em citopatologia cervical: revisão da literatura
(2007) Tavares, Suelene Brito do Nascimento; Amaral, Rita Goreti; Manrique, Edna Joana Cláudio; Souza, Nadja Lindany Alves de; Albuquerque, Zair Benedita Pinheiro de; Zeferino, Luiz Carlos
Cervical cytopathology is an important tool for the detection of precursor lesions of cervical cancer, which are still treatable at that stage, thus resulting in a significant decrease in mortality. However, cervical cytopathology has drawbacks, with the false-negative rate varying from 2 to 50%. False-negative results are mainly due to errors in sample collection, examination, and interpretation. The ultimate objective of routine internal and external quality control in laboratories is to improve the test's diagnostic performance, evaluate screener performance, and identify causes of sample collection errors. Internal quality control can be performed regularly and involves monitoring the sample adequacy, duration of the examination, screener workload, hierarchical review of smears, and review of negative smears. Internal quality control can also include analysis of the cytology/histology correlation, review of previous exams, monitoring of statistics on frequency of lesions and sample adequacy, and deliberate inclusion of abnormal smears in routine exams. Continuing education, personnel training, and periodic proficiency exams are strategies that should be adopted. Random or 100% review of smears, rapid review, and detailed reviews are methods that have advantages and disadvantages for the detection of false-negative results. It is the laboratory's task to define the best strategy for internal quality control that will lead to improvement in technical procedures and consequently in the quality of the service provided by cytopathology laboratories.
Desempenho da metodologia de revisão rápida de 100% em esfregaços citopatológicos do colo do útero com e sem informações clínicas
(2012) Manrique, Edna Joana Cláudio; Souza, Nadja Lindany Alves de; Tavares, Suelene Brito do Nascimento; Zeferino, Luiz Carlos; Amaral, Rita Goreti
This study evaluated the performance of the methodology of 100% rapid review on the cervix Pap smears with and without information on clinical risk criteria by using the average time of one and two minutes assays. A total of 5,395 smears were analyzed, and of these 274 were classified as altered and 5,121 as negative after routine examinations. Of negative smears, 958 had clinical risk criteria information, and they were analyzed by rapid review, which identified ten (1.04 %) as altered by the one minute-revision, and nine (0.93) by using a time of two minutes. Analyzing 4,163 negative smears without clinical risk criteria information by rapid review using the times of one and two minutes, 35 (0.84%) were identified as altered in both procedures. The technique of rapid review showed sensitivity of 83% and 75% for the review time of one minute and two minutes, respectively, in smears with available clinical risk criteria information. No difference was found in detecting false-negative smears with and without available clinical risk criteria information. Also, no difference was found in the rapid review performance for detecting false-negative results by employing one to two-minutes techniques.
Especialização em saúde digital – turma 1: resultado da parceria entre o Ministério da Saúde e a Universidade Federal de Goiás
(Cegraf UFG, 2022-12-23) Braga, Renata Dutra; Zara, Ana Laura de Sene Amâncio; Pedrosa, Sheila Mara; Santos, Silvana de Lima Vieira dos; Amaral, Rita Goreti; Lucena, Fábio Nogueira de; Ribeiro-Rotta, REjane Faria
Fatores associados a resultados falso-negativos de exames citopatológicos do colo uterino
(2006) Franco, Rosana Crisina; Amaral, Rita Goreti; Montemor, Eliana Borin Lopes; Montis, Douglas Munhoz; Morais, Sirlei Siani; Zeferino, Luiz Carlos da
Purpose: to evaluate whether factors related to the adequacy of the sample, cell pattern and cytomorphological criteria are as- sociated with false-negative (FN) results of cervical cytopathology during routine examinations. Methods: this is a case-control study in which the study group included 100 cytopathologic smears with FN results detected during systematic internal quality control consisting of 100% rapid review. For each FN result detected, two smears with a true-positive diagnosis were identifi ed by the same cytotechnician and these constituted the control group, making a total sample size of 300 smears. The variables were established in accordance with the criteria defi ned for the analysis of sample adequacy, cell pattern and cytomorphological analyzed criteria. The results were evaluated using bivariate analysis and logistic regression with stepwise variable selection criteria expressed in OR (95%). Results: the number of atypical cells, the appearance of nuclear chromatin, and the distribution and presentation of atypical cells in the smear were the variables that showed the greatest risk for FN results with OR of 9.6, 4.2, 4.4, and 3.6, respectively. Infl ammatory processes and the presence of blood in the smear were also identifi ed as variables that infl uence the risk of FN results. Conclusions: the majority of the factors associated with FN results are dependent on the conditions and techniques of sample collection, since in the majority of cases, the lesion may not be adequately represented in the smear. Confounding factors such as blood and infl ammatory processes may also impair analysis. With respect to cyto- morphological alterations, thin chromatin strand was the variable that indicated the greatest risk of FN results.
Human papillomavirus prevalence among women with cervical intraepithelial neoplasia III and invasive cervical cancer from Goiânia, Brazil
(2003-03) Santos, Silvia Helena Rabelo dos; Zeferino, Luiz Carlos; Villa, Luisa Lina; Sobrinho, J. P.; Amaral, Rita Goreti; Magalhães, A. V.
This study estimated the prevalence and distribution of human papillomavirus (HPV) types among women with cervical intraepithelial neoplasia (CIN) grade III and invasive cervical cancer from Goiás (Brazil Central Region). Seventy-four cases were analyzed and consisted of 18 CIN III, 48 squamous cell carcinomas, 4 adenocarcinomas, 1 adenosquamous carcinoma and 3 undifferentiated carcinomas. HPV-DNA sequences were examined in formalin- fixed and paraffin-embedded tissues using primers from L1 region GP5+/GP6+. Polymerase chain reaction prod- ucts were typed with dot blot hybridization using probes for HPV 16, 18, 31, 33, 45, 54, 6/11, 42/43/44, 51/52, 56/ 58. The prevalence of HPV was estimated to be 76% (56/74). HPV 16 was the most frequently found type, followed by HPV 33, 18 and 31. The prevalence of untyped HPV was 6%; 79% percent of the squamous cell carcinoma cases and 61% percent of the CIN III were positive for HPV and the prevalence rate of HPV types was the same for the total number of cases. According to other studies, HPV type 16 is the most prevalent virus in all Brazilian regions, but there is variation regarding to other types. Type 18 is the second most prevalent HPV in North, Southeast and South Brazil regions and types 31 and 33 are the second most prevalent HPV in Northeast and Central Brazil, respectively.
Impacto da capacitação dos profissionais de saúde sobre o rastreamento do câncer do colo do útero em unidades básicas de saúde
(2014) Amaral, Ariadne Ferreira; Araújo, Eduardo Silva; Magalhães, Juliana Cristina; Silveira, Erika Aparecida da; Tavares, Suelene Brito do Nascimento; Amaral, Rita Goreti
PURPOSE: To evaluate the impact of training professionals involved in the screening for cervical cancer in Basic Health Units in the city of Goiânia (GO). METHODS: This was and intervention study in which the following data contained in the cervical cytopathology test form were examined: the woman’s personal data, anamnesis, clinical examination and identification of the professional responsible for the collection. Professional training was evaluated by comparing the forms referring to the period from January 2007 to April 2009, before training, with the forms referring to the period from July 2010 to December 2012, after training. The Pearson χ 2 test was used to analyze the results of training, with the 5% level of significance. RESULTS: After training, there was a significantly increased frequency of recording patient schooling (from 67.2 to 92.6%, p<0.001), telephone number (from 78.9 to 98.7%, p<0.001), cervical inspection (from 86.8 to 96.6%, p<0.001), and signs suggestive of sexually transmitted diseases (from 80.8 to 93.5%, p<0.001). There was a reduction in the frequency of performing the exam within an interval of less than one year (p<0.001) and of one year (p<0.001). There was a reduction in the frequency of Pap smear testing in women under 25 years of age, from 22.0 to 17.9% (p<0.001). There was a significant increase in the proportion of satisfactory samples from 70.4 to 80.2% (p<0.001). A reduction of confounding factors was observed. The desiccation frequency was 2.9% before training and 2.0% after training (p<0.001). There was an increase in the frequency of representation of endocervical cells from 79.5 to 88.5% (p<0.001). CONCLUSION: After training, there was a significant improvement in completing the application form, the performance of such tests regarding frequency and the age range recommended by the Ministry of Health, and the adequacy of the sample.
Influência da adequabilidade da amostra sobre a detecção das lesões precursoras do câncer cervical
(2008) Amaral, Rita Goreti; Manrique, Edna Joana Cláudio; Guimarães, Janaína Valadares; Sousa, Paula José de; Mignoli, João Ricardo Queiroz; Xavier, Aparecida de Fátima; Oliveira, Analina
PURPOSE: to evaluate whether the sample adequacy influences the detection of precursor cervical cancer lesions. METHODS: a transversal study from January 2004 to December 2005. A number of 10,951 results of cervical cytotopathological exams from users of the National Health System (Sistema Único de Saúde, SUS) in Goiânia, Goiás, Brazil, was studied. These women had spontaneously looked for the services from the Family Health Program or from the Basic Units of Health. Samples were collected by medical doctors and nurses, through the conventional technique to detect cervical cancer. The analyzed smears were classified by the Bethesda System, the sample adequacy being defined along the routine screening and categorized as: satisfactory, satisfactory but presenting factors that might partially jeopardize the analysis, and unsatisfactory. Results were stored in the Epi-Info 3.3.2 program. The χ² test was used to compare altered results with the adequacy of the samples from cytopathological smears. Differences with probability of rejection of the null hypothesis lower than 5% (p<0.05) were considered as significant. RESULTS: From 10,951 smears, 51.1% were classified as having satisfactory adequacy for analysis, 46.6% as satisfactory, but presenting some limiting factors, and 2.3%, as unsatisfactory. The main factors which have partially jeopardized the analysis were: lack of endocervical cells (52.2%), dried smears (22.8%), purulence (14.9%), or smears with some thick areas (9.5%).
Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory
(2014) Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; Souza, Nadja Lindany Alves de; Amaral, Rita Goreti
URPOSE: To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. METHODS: The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. RESULTS: Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. CONCLUSION: An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.
Intervenção farmacêutica no processo de cuidado farmacêutico: uma revisão
(Marize Campos Valadares, 2008-04) Amaral, Mônica Franco Zannini Junqueira; Amaral, Rita Goreti; Provin, Mércia Pandolfo
Pharmaceutical care appears in Brazilian and international scene as a new professional practice where the pharmacist takes responsibility to ensure that the patient compliance whit your drug therapy and the plan of assistance to achieve positive outcome. In modern pharmacist is essential knowledge, attitudes and skill to allow even integrate to the team of health and interact more with patients and the community, contributing to improved quality of life regarding the optimization of pharmacotherapy and rational use of medicines. Shares of pharmacist, in the model of pharmaceutical care, in their vast majority, are clinical individual acts. But the systematization of pharmaceutical interventions and exchange of information within an information system composed of other health care professionals can contribute to an impact on collective level and promote the safe and rational use of medicines.
Mulheres com atipias, lesões precursoras e invasivas do colo do útero: condutas segundo as recomendações do Ministério da Saúde
(2012) Albuquerque, Zair Benedita Pinheiro de; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; Souza, Adenícia Custódio Silva e; Guimarães, Janaína Valadares; Amaral, Rita Goreti
PURPOSE: To verify whether women with atypias of undetermined significance and precursor lesions or invasive cervical outcomes were referred to Medium Complexity Units (MCU) following the guidelines recommended by the Brazilian Ministry of Health. METHODS: Retrospective study based on the cytopathological outcomes of users of the Unified Health System, seen at Basic Health Assistance Units (BHAU) and referred to MCUs in the municipality of Goiânia, state of Goiás, from 2005 to 2006. We assessed 832 records according to the recommendations of the Brazilian Ministry of Health, as established by the Brazilian Nomenclature for Cervical Cytopathologic Outcomes and Recommended Clinical Practice. To check the distribution of variables such as reasons for referral, results of colposcopy and histopathology and clinical procedures we calculated absolute and relative frequencies, mean, minimum and maximum values. RESULTS: We understood 72.7% of the referrals were not in accordance with the recommendations of the Ministry of Health. There were 605 women with test results classified as atypical squamous cells of undetermined significance, possibly non-neoplasms, and squamous intraepithelial lesion of low level which were sent to MCU, and of these 71.8% were submitted to colposcopy, and 64.7% had histopathological examination which results were classified as 31.0% with non-neoplasms and 44.6% as NIC I. Out of 211 women with results classified as more severe squamous lesions, 86.3% were submitted to colposcopy and 68.7% of these had histopathological examinations. CONCLUSIONS: The results of this study revealed high rates of inappropriate referrals to MCU, which required a high percentage of unnecessary procedures. The recommendations of the Ministry of Health were followed by BHAU and the majority of women received counseling/treatment as recommended.
Pharmaceutical care for hypertensive patients provided within the family health strategy in Goiânia, Goiás, Brazil
(2013-09) Martins, Bárbara Posse Reis; Aquino, Aline Teixeira de; Provin, Mércia Pandolfo; Lima, Dione Marçal; Dewulf, Nathalie de Lourdes Souza; Amaral, Rita Goreti
The aim of Pharmaceutical Care programs is to improve patients’ quality of life, and such programs are particularly effective in the case of chronic diseases such as hypertension. The objective of this longitudinal study was to analyze a Pharmaceutical Care model for hypertensive patients receiving care within the Family Health Strategy (FHS). All patients were being seen by an FHS team affiliated to a primary healthcare unit in Goiânia, Goiás, Brazil. Fourteen patients participated in the study, with each patient receiving six home visits during the Pharmaceutical Care. Overall, 142 drug-related problems were reported, the most common concerning the ineffectiveness of treatment (33.8%). A total of 135 pharmaceutical interventions were performed, 92.6% of which involved pharmacist-patient communication, with 48.8% of these interventions being implemented. Cardiovascular risk decreased in three patients and remained unchanged in nine. In hypertensive patients with diabetes, fasting glucose levels were reduced in six out of nine cases. The Pharmaceutical Care model proposed here was effective in detecting drug-related problems and in proposing interventions to resolve or prevent these problems. Consequently, this may have contributed towards improving clinical parameters, such as fasting glucose levels and cardiovascular risk in hypertensive patients receiving care within the FHS.
Pharmaceutical care for hypertensive patients provided within the family health strategy in Goiânia, Goiás, Brazil
(2013-09) Martins, Bárbara Posse Reis; Aquino, Aline Teixeira de; Provin, Mércia Pandolfo; Lima, Dione Marçal; Dewulf, Nathalie de Lourdes Souza; Amaral, Rita Goreti
The aim of Pharmaceutical Care programs is to improve patients’ quality of life, and such programs are particularly effective in the case of chronic diseases such as hypertension. The objective of this longitudinal study was to analyze a Pharmaceutical Care model for hypertensive patients receiving care within the Family Health Strategy (FHS). All patients were being seen by an FHS team affiliated to a primary healthcare unit in Goiânia, Goiás, Brazil. Fourteen patients participated in the study, with each patient receiving six home visits during the Pharmaceutical Care. Overall, 142 drug-related problems were reported, the most common concerning the ineffectiveness of treatment (33.8%). A total of 135 pharmaceutical interventions were performed, 92.6% of which involved pharmacist-patient communication, with 48.8% of these interventions being implemented. Cardiovascular risk decreased in three patients and remained unchanged in nine. In hypertensive patients with diabetes, fasting glucose levels were reduced in six out of nine cases. The Pharmaceutical Care model proposed here was effective in detecting drug-related problems and in proposing interventions to resolve or prevent these problems. Consequently, this may have contributed towards improving clinical parameters, such as fasting glucose levels and cardiovascular risk in hypertensive patients receiving care within the FHS.

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