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Quality of care in patients with inflammatory bowel disease from a public health center in Brazil

World Journal of Clinical Cases 2022年第33期10卷 12184-12199页

作者： Debora Mayumi Takamune Giovana Signorelli Astolfi Cury Giulia Ferrás Giedre Soares Prates Herrerias Adriana Rivera jaqueline ribeiro barros Julio Pinheiro Baima Rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine São Paulo State University(Unesp)Medical SchoolBotucatu 18618686São PauloBrazil Research Unit Virgen Macarena University HospitalSeville 41009Spain Department of Medicine Nove de Julho UniversityBauru 17011-102São PauloBrazil Department of Surgery São Paulo State University(Unesp)Medical SchoolBotucatu 18618686São PauloBrazil

BACKGROUND Inflammatory bowel diseases(IBDs)are chronic diseases that demand continuous interaction between patients and healthcare providers.Quality of care(QoC)is a factor that contributes to a patient’s adherence to treatment and its success.AIM To evaluate QoC in patients from a single IBD reference center.METHODS This cross-sectional study included 133 patients from a single Brazilian IBD public health center.QoC was evaluated through the QoC Through the Eyes of Patients with IBD(QUOTE-IBD)questionnaire(based on patient perspectives),which measures eight dimensions of care.We compared QoC among patients with Crohn’s disease and ulcerative colitis and analyzed the clinical and psychological factors associated with QoC satisfaction.Clinical evaluations assessed disease characteristics,quality of life,anxiety,and depression levels.RESULTS Sixty-nine patients with Crohn’s disease and 64 with ulcerative colitis were interviewed.The mean age was 37.26 years±13.05 years,and 63.91%of the patients were women.The mean duration of the disease was 8.44 years±7.59 years,where most patients were in remission(70.31%of patients with ulcerative colitis and 62.32%with Crohn’s disease).The total QoC score of the sample was 8.61 years±1.31 points,indicating that the QoC provided by the center was unsatisfactory.According to univariate logistic regression,patients with Crohn’s disease had higher satisfaction rates than those with ulcerative colitis[odds ratio(OR):2.746;95%confidence interval(CI):1.360-5.541;P=0.0048]and patients on infliximab(OR:2.175;95%CI:1.037-4.562;P=0.0398).CONCLUSION Patients from the IBD public center reported good doctor-patient relationships,but had problems related to the healthcare structure.Evaluation of healthcare centers is of paramount to improve QoC for the patients involved.

关键词： QUOTE-IBD questionnaire Quality of care Crohn’s disease Ulcerative colitis Inflammatory bowel disease Doctor-patient relationship

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Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level:A case report

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World Journal of Clinical Cases 2021年第13期9卷 3219-3226页

作者： Ana Lorena Sousa de Vasconcelos Garate Thiara Barcelos Rocha Luciana Rocha Almeida Rodrigo Quera jaqueline ribeiro barros Julio Pinheiro Baima Rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine São Paulo State University(Unesp)Medical SchoolBotucatu 18618687São PauloBrazil Inflammatory Bowel Disease Program GastroenterologyMedicine DepartmentClínica Universidad de los AndesSantiago 7550000Chile

BACKGROUND Acute severe ulcerative colitis (ASUC) is a complication of ulcerative colitisassociated with high levels of circulating tumor necrosis factor alpha, due to theintense inflammation and faster stool clearance of anti-tumor necrosis factordrugs. Dose-intensified infliximab treatment can be beneficial and is associatedwith lower rates of colectomy. The aim of the study was to present a case of apatient with ASUC and megacolon, treated with hydrocortisone and acceleratedscheme of infliximab that was monitored by drug trough level.CASE SUMMARYA 22-year-old female patient diagnosed with ulcerative colitis, presented withdiarrhea, rectal bleeding, abdominal pain, vomiting, and distended abdomen.During investigation, a positive toxin for Clostridium difficile and colonic dilatationof 7 cm consistent with megacolon were observed. She was treated with oralvancomycin for pseudomembranous colitis and intravenous hydrocortisone forsevere colitis, which led to the resolution of megacolon. Due to the persistentsevere colitis symptoms, infliximab 5 mg/kg was prescribed, monitored by drugtrough level (8.8 μg/mL) and fecal calprotectin of 921 μg/g (< 30 μg/g). Based onthe low infliximab trough level after one week from the first infliximab dose, thepatient received a second infusion at week 1, consistent with the acceleratedregimen (infusions at weeks 0, 1, 2 and 6). We achieved a positive clinical andendoscopic response after 6 mo of therapy, without the need for a colectomy.CONCLUSIONInfliximab accelerated infusions can be beneficial in ASUC unresponsive to thetreatment with intravenous corticosteroids. Longitudinal studies are necessary todefine the best therapeutic drug monitoring and treatment regimen for thesepatients.

关键词： Infliximab Acute severe ulcerative colitis Toxic megacolon Ulcerative colitis Inflammatory bowel disease Case report

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Nursing Process in a Patient with Crohn’s Disease: Case Report

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Open Journal of Nursing 2021年第4期11卷 258-265页

作者： jaqueline ribeiro de barros Giedre Soares Prates Herrerias Madhoor Ramdeen Rogerio Saad-Hossne Rubia Aguiar Alencar Ligia Yukie Sassaki Department of Internal Medicine S&#227 o Paulo State University (Unesp) Medical School Botucatu Brazil Department of Inflammatory Bowel Disease St. Mark’s Hospital London UK Department of Surgery S&#227 o Paulo State University (Unesp) Medical School Botucatu Brazil Department of Nursing S&#227 o Paulo State University (Unesp) Medical School Botucatu Brazil

Background: Inflammatory Bowel Disease is a term that covers intestinal diseases, including ulcerative colitis and Crohn’s disease. Due to the condition of chronic and complex disease, the disease requires specialized nursing care and management in the context of a multi-disciplinary approach. As a guarantee of quality nursing care, it is essential to carry out the nursing process. Considering the commitment to assist the patient with Crohn’s disease, the nurse, through the nursing consultation, is able to diagnose the patient’s needs, proceed to the prescription of care and later evaluate the interventions, having the opportunity to develop work aimed at improving the quality of life of these patients. Objective: To describe the nursing process in a patient with Crohn’s disease. Methods: Exploratory case report study, carried out at the outpatient clinic for inflammatory bowel diseases of a public hospital in the countryside of the state of São Paulo, from June 2019 to October 2019. Data collection was performed through anamnesis, physical examination and analysis of medical records. Results: Female patient, 34 years old, diagnosed with Crohn’s disease. With the completion of the nursing process, it was possible to identify five nursing diagnoses and the elaboration of interventions and outcomes. The nursing evaluation was continuous and the patient adhered to the proposed interventions. Final considerations: The systematization and organization of the work of the nursing team proved to be essential for quality care, with efficiency and effectiveness, guaranteeing the patient comfort, general well-being and good rehabilitation.

关键词： Nursing Care Crohn’s Disease Nursing Process

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The Impact of an Educational Intervention on Inflammatory Bowel Disease for Nurses in Brazil

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Open Journal of Nursing 2020年第12期10卷 1178-1185页

作者： jaqueline ribeiro de barros Adriana Rivera-Sequeiros Julio Pinheiro Baima Fernanda Lofiego Renosto Rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine Medical School S&#227 o Paulo State University (UNESP) Botucatu Brazil Department of Internal Medicine San Juan de Dios del Aljarafe Hospital Seville Spain Department of Surgery Medical School S&#227 o Paulo State University (UNESP) Botucatu Brazil

Background: The inflammatory bowel disease nurse plays a key role in the multidisciplinary team. The aim of the study was to evaluate the inflammatory bowel disease knowledge before and after the educational intervention with nurses. Methods: A cross-sectional, descriptive and comparative study was performed from June to August 2016. The sample consisted of 26 nurses from the nursing staff of a public university hospital in São Paulo State, Brazil. The study was divided into three phases: pre-educational intervention, educational intervention and post-educational intervention (test application). A p-value Results: The study included 26 general nurses with an average of 9.20 ± 5.78 years of experience. There was an increase in safety in administering biological therapy after the course (from 33.34% to 78.26%), and an increase in knowledge about the main inflammatory bowel disease symptoms (64.29% vs 96.30%, p = 0.0224), and about infliximab infusion (35.71% vs 74.07%, p = 0.0404). Conclusion: The educational intervention effectively contributed to the increase of knowledge of the nursing staff.

关键词： Inflammatory Bowel Diseases Knowledge Nursing Education Nurses Continuing Education

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The Impact of a Real-Life Inflammatory Bowel Disease Education Course for Brazilian Physicians from the Perspective of Its Participants

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Open Journal of Gastroenterology 2021年第9期11卷 151-160页

作者： Rodrigo Fedatto Beraldo Julio Pinheiro Baima jaqueline ribeiro de barros Fernanda Lofiego Renosto Rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine Medical School S&#227o Paulo State University (Unesp) Botucatu Brazil Department of Surgery Medical School S&#227o Paulo State University (Unesp) Botucatu Brazil

Background: Physicians must acquire the necessary skills to provide Inflammatory Bowel Disease (IBD) patients with state-of-the-art clinical care, aiming to improve patient’s quality of life and disease outcomes. Purpose: To describe the queries and experiences of doctors enrolled in an IBD education course and to evaluate the impact of the course. Methods: A retrospective study included 100 physicians, of which 78 attended the course. A questionnaire was applied evaluating how the course had an impact on their IBD-knowledge. The 20-hour-course consisted of practical “real-life” activities and theoretical discussions. Results: The majority of doctors’ expertise was in gastroenterology (53%) and coloproctology (44%). A significant portion had no experience with biological therapy for ulcerative colitis (19.4%) or Crohn’s disease (5.05%). The main topics doctors wanted to discuss were biological therapy (93%), new drugs (74%) and differential diagnosis (64%). A considerable number of physicians did not feel confident at prescribing biological therapy before the course (44.4%), a percentage that decreased to 8.5% after the course (p Discussion: The ideal course should have a practical and theoretical component, as well as the support of an experienced multidisciplinary team. A real-life practical-theoretical IBD course proved a success at increasing IBD knowledge.

关键词： Continuing Medical Education Crohn’s Disease Ulcerative Colitis Inflammatory Bowel Disease

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Development of Baccharis dracunculifolia(Asteraceae)Essential Oil Nanoemulsion and Its Biological Activity on Pre-pupae of Cochliomyia hominivorax(Diptera:Calliphoridae)

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Journal of Pharmacy and Pharmacology 2019年第6期7卷 293-308页

作者： jaqueline Seugling Shirley Kuhnen Giuliano Pereira de barros Maria Beatriz Velerinho Letícia Mazzarino Patrizia Ana Bricarello Animal Parasitology Laboratory Agrarian Sciences CenterFederal University of Santa CatarinaFlorianópolis 88034-001Brazil Biochemical and Animal Morphophysiology Laboratory Agrarian Sciences CenterFederal University of Santa CatarinaFlorianópolis 88034-001Brazil NanobioMat Agrarian Sciences CenterFederal University of Santa CatarinaFlorianópolis 88034-001Brazil

Myiasis is considered a serious medical condition in animals and humans that occurs predominantly in tropical countries.Cochliomyia hominivorax is one of the main fly species that causes myiasis and the actual geographic distribution includes the Caribbean and all of South America,except Chile.The use of synthetic insecticides and endectocides in livestock for the myiasis treatment has resulted in insect resistance,while also causing residuals in the environment and contamination of animal food products.Biologically active compounds are considered an alternative for the sustainable management of insects,as they are biodegradable and less damaging to the environment.This study developed a nanoemulsion containing the essential oil of Baccharis dracunculifolia and evaluated its in vitro effects on C.hominivorax larvae.High pressure homogenization was used to develop the nanoemulsion.Larvicidal tests were carried out with the tested products using 15 larvae/repetition,for a total of 150 larvae per treatment.Five different concentrations of the nanoemulsion were tested shortly after preparation and after 120 days of storage.For the fresh formulation,at concentrations of 5,7.5,10,13.5,and 15%(w/v)we found mortality of 28,48,70,84,and 97%,respectively,while for the stored formulation,we found mortality of 17,36,51,81,and 92%.The larvicidal effect was similar,except for the concentrations of 5 and 10%(w/v)(p<0.05).Our results show that the natural based B.dracunculifolia nanoemulsion can be considered a promising alternative for the treatment and control of myiasis caused by C.hominivorax.

关键词： Natural products insecta phytotherapy larvicidal activity myiasis

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