Proposal for the implementation and monitoring of a health care nursing protocol for patients with external ventricular drains.

Objective: To structure a proposal for implementing and monitoring the nursing care protocol for the safety of adult patients with external ventricular drains.

Method: Descriptive exploratory research based on Implementation Science, with intentional sampling. Carried out in a hospital complex in southern Brazil, between May and December 2022, in four stages: online questionnaire on knowledge of care for patients with external ventricular shunt for nurses; matrix of proposed indicators with key actors; self-instructional online course for nurses; synthesis of the existing protocol.

Promoting clinical reasoning with meta-memory techniques to teach broad differential diagnosis generation in a pediatric core clerkship.

Objectives: Clinical reasoning with generation and prioritization of differential diagnoses (DDx) is a key skill for medical students, but no consensus exists on the best method to teach these skills. Meta-memory techniques (MMTs) may be useful, but the efficacy of individual MMTs is unclear.

Methods: We designed a 3-part curriculum for pediatric clerkship students to teach one of 3 MMTs and provide practice in DDx generation through case-based sessions.

External Ventricular Drains: Development and Evaluation of a Nursing Clinical Practice Guideline.

External ventricular drains (EVDs) are common in intensive care for neurocritical patients affected by different illnesses. Nurses play an essential role to ensure safe care, and guidelines are tools to implement evidence-based care. Thus, the aim of this study was to develop and evaluate the quality of a clinical guideline for critically ill patients with EVDs.

Comparative efficacy of amitriptyline, duloxetine and pregabalin for treating fibromyalgia in adults: an overview with network meta-analysis.

Treatment recommendations for fibromyalgia (FM) include a range of predominantly pharmacological treatment options designed to ensure the maintenance of symptoms and improvement in the quality of life of these patients. Our aim is to identify and compare the efficacy of amitriptyline (AMT), duloxetine (DLX), and pregabalin (PGB) for reducing pain intensity by 30% (R30%) and 50% (R50%) in adult patients with fibromyalgia. The review was conducted in the Medline/PubMed, Cochrane Library, and Embase databases up to February 2022.

Time Management and Task Prioritization Curriculum for Pediatric and Internal Medicine Subinternship Students.

Introduction: As a physician, it is important to develop time management and task prioritization skills early to promote future career success. In medical education, there is minimal structured time to teach these skills prior to residency. Stephen Covey's Time Management Matrix Technique (TMMT) is one strategy that can be used to develop these skills.

Deprescribing clonazepam in primary care older patients: a feasibility study.

Background Inappropriate use of clonazepam by older adults is associated with cognitive impairment, delirium, and falls. Strategies to optimize its use are important to increase patient safety. Objective To evaluate the feasibility of a clonazepam deprescription protocol in the elderly.

The training of future clinical geneticists: Evaluation and reflection on the ACMG Foundation for Genetic and Genomic Medicine Summer Genetics Scholars Program.

Purpose: The purpose of the Summer Genetics Scholars Program of the ACMG Foundation for Genetic and Genomic Medicine is to expose medical students to medical genetics and genomics early during school with the aim of increasing the number of physicians pursuing a career in this field. This survey study evaluated the Summer Genetics Scholars Program on the achievement of its goals.

Methods: Former Summer Genetics Scholars who had completed medical school were sent a 13-question survey aimed at evaluating the program and obtaining feedback about their experiences.

LIVER TRANSPLANTATION: TACROLIMUS BLOOD LEVELS VARIATION AND SURVIVAL, REJECTION AND DEATH OUTCOMES.

Background: Immunosuppressive drugs have important role in transplant of solid grafts, it aim avoid episodes of acute and chronic rejection and improving graft survival and patient survival. In Brazil, in 2016, liver transplantation was the third most frequent, with 1,880 transplants performed, of which 150 in Rio Grande do Sul. Several studies evaluated the association between variability in blood levels of immunosuppressive tacrolimus and late acute cellular graft rejection.

Drug-induced liver injury and COVID-19: A review for clinical practice.

Coronavirus disease 2019 (COVID-19) consists of a systemic disease that can present many complications. The infection presents broad clinical symptoms and a high rate of transmissibility. In addition to severe acute respiratory syndrome, the patients manifest complications beyond the respiratory system.

COVID-19 evidence for all: development of a learning object in health teaching.

Objective: Describe the development of a learning object focused on scientific evidence about COVID-19.

Method: Experience report on the production of a learning object based on the DADI web sites methodology, aimed at adults and children, built by nurses and academics from a Brazilian Federal University in 2020. Data collection in databases and reference organizations.

Overview of drug induced liver injury in Brazil: What is the role of public health policy on the evidence?

Background: Adverse drug reactions are responsible for increased costs and morbidity in the health system. Hepatotoxicity can be induced both by non-prescription drugs and by those used for chronic diseases. It is the main cause of safety-related drug marketing withdrawals and could be responsible for irreversible and fatal injuries.

Nursing assistance in patient care with external ventricular drain: a scoping review.

Objectives: to map the available evidence about nursing care aimed at adult patients using external ventricular drain.

Methods: this is a review using the scoping review method.

Results: Initially, 965 studies were identified and, after the eligibility criteria, a sample of 54 publications was obtained.

The accuracy of the Manchester Triage System in an emergency service.

Objective: To verify the accuracy of the Manchester Triage System (MTS) and the outcomes of adult patients in an emergency hospital service.

Method: Cross-sectional study, conducted through an inspection of records of risk classification of adult patients treated in the emergency service of a hospital.

Results: The patients (n = 400) were classified according to priority levels, in red (0.

Validation methods of nursing protocols: an integrative review.

Objective: to identify scientific production about validation methods of nursing care protocols.

Method: an integrative review with search at Scielo, Pubmed/MEDLINE, Virtual Health Library, Web of Science, Scopus, and EBSCOhost. The descriptors "validation studies", "validation studies as topic", "protocols", "clinical protocols", "practice guidelines as topic", "nursing" and "nursing assessment" and the uncontrolled descriptor "validation" were used.

Education to prevent ventilator-associated pneumonia in intensive care unit.

Objective: to evaluate nursing adherence to the Ventilator-Associated Pneumonia Prevention Bundle and the incidence rate, before and after Continuing education.

Methods: a quasi-experimental, retrospective study with a total of 302 patients on mechanical ventilator admitted to the Intensive Care Unit. Data obtained from the application of the bundle, from June 2017 to June 2018.

Cost and Effectiveness of the Treatment of Chronic Hepatitis C in Brazil: Real-World Data.

Objectives: To introduce and discuss the cost and effectiveness of using sofosbuvir, daclatasvir, and simeprevir antivirals, in combination or not with peginterferon alfa and ribavirin, for the treatment of hepatitis C, as based on real-world data.

Methods: We analyzed the treatment and outcomes of 253 patients from a retrospective cohort held in a specialized assistance service in the municipality of Porto Alegre, Brazil. Regarding costs, we considered only the direct costs of the antiviral medications per unit (pills), according to the financial receipts of the public procurements.

Judicialization of access to medicines in four Latin American countries: a comparative qualitative analysis.

Background: The valuation of medicines as health needs vary depending on the stakeholders involved (users, prescribers, managers, etc.) and their expectations. These factors modulate the role of medicines as a health need and influence access to medicines, and could be useful to explain the rising of Judicialization of access to medicines.

Drug and herb-induced liver injury: A critical review of Brazilian cases with proposals for the improvement of causality assessment using RUCAM.

Introduction And Objectives: Although hepatotoxicity accounts for 10% of adverse drug reactions, it remains poorly understood and underreported. This study aimed to summarize case reports of herb- and drug-induced liver injury in Brazil.

Methodology: Systematic review in the following databases: PubMed, SciELO, Science Direct, CAPES, and gray literature.

Liver transplantation and the use of KAVA: Case report.

Background: Self-medication and the belief that herbal products are free of health risks are common in Brazil. The kava (Piper methysticum), known for its anxiolytic action, has a widespread popular use. Hepatotoxicity of kava is reported, including cases of liver transplantation and death.

Hepatitis C in Brazil: lessons learned with boceprevir and telaprevir.

In 2012, the first-generation protease inhibitors telaprevir (TVR) and boceprevir (BOC) were introduced in the Brazilian health system for treatment of chronic hepatitis C, after their approval by the National Committee for Health Technology Incorporation (CONITEC). However, these medicines were discontinued in 2015. The short period of use in therapy and their high cost require a discussion about the consequences for patients and for the health system of the early incorporation of new therapies.

Hyperglycemia in critical patients: Determinants of insulin dose choice.

Objective:: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia.

Method:: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level.

Towards a theoretical model on medicines as a health need.

Medicines are considered one of the main tools of western medicine to resolve health problems. Currently, medicines represent an important share of the countries' healthcare budget. In the Latin America region, access to essential medicines is still a challenge, although countries have established some measures in the last years in order to guarantee equitable access to medicines.

[Cost analysis of treatment for severe rheumatoid arthritis in a city in southern Brazil].

Treatment of rheumatoid arthritis involves the use of medicines, non-pharmaceutical therapies, medical appointments, and complimentary tests, among other procedures. Based on sources of payment, this article presents the direct medical costs related to treatment of rheumatoid arthritis. The cost analysis included 103 patients with severe rheumatoid arthritis treated at the Specialized Division of Pharmaceutical Care in Florianopolis, Santa Catarina State, Brazil.

An Estimate of the Cost of Hepatitis C Treatment for the Brazilian Health System.

Objectives: Hepatitis C therapy in Brazil is expensive due to the cost of antiviral drugs and demands on medical resources. The objective of this study was to estimate the direct costs per patient of chronic hepatitis C therapy in a Brazilian setting.

Method: A microcosting study from a public health system perspective.

[Evaluation of the quality of propranolol and enalapril tablets supplied in the public health system in a southern Brazilian city].

The acquisition of medication by the Brazilian public health service through bidding processes based on the lowest price criterion is a source of concern with respect to the quality of the products offered to the population. The scope of this work was to evaluate the quality of Enalapril 10 mg and Propranolol 40 mg tablets bought via the bidding process and supplied by the public health system in a city in the state of Santa Catarina, Brasil, over the course of a year. The visual aspect, weight variation, friability, drug content and dissolving time were analyzed.