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Biomedical subjects

M S Koizumi

Publications and source records attributed to M S Koizumi.

At least 19 recordsLinked to original sources

[Morbidity and mortality due to traumatic brain injury in São Paulo City, Brazil, 1997].

There are few epidemiological studies on traumatic brain injury (TBI), and those that allow broad comparative analyses of this problem are even more scarce, due to methodological obstacles. Usually, the studies address head injury (they include the cranial envelopments and content) but are reported as TBI, given the difficulty of mutual exclusion. It is also common for them to be centered at specific severity levels, only for hospitalized victims or according to the external cause, such as traffic accidents. With full respect to these limits, this study had as its objective the estimation of the TBI incidence in patients resident and in-hospital, in the hospital network in the city of São Paulo, Brazil, in 1997, as well as the estimation of TBI-caused mortality amongst external causes, at this same time and locale. Data for the study consisted of Ministério da Saúde data on hospital discharges, analyzed based on Autorizações de Internação Hospitalar (AIH) and obituary data on external causes, contained in the Programa de Aprimoramento das Informações de Mortalidade (PROAIM) data base. It was found that 29 717 patients were hospitalized due to lesions and poisoning; of these 3 635 (12%) had TBI; the hospitalization rate was 0.36/1000 pop.; and hospital mortality was 10%. The mortality coefficient due to external causes was 87.3/100 000 pop. Minimum TBI mortality rate is estimated at a minimum of 26.2 and a maximum of 39.3/100000 pop.

Adolescent↗

[Chronic pain and depression: study of 92 patients].

Was examined the influence of depression in the occurrence and pain intensity. Patients presenting advanced cancer (n = 92) were evaluated. The patients were divided in 2 groups, with or without pain during the week preceding the interview. Pain and depression were evaluated. Pain was observed in 62.0% of the cases and lasted 10 months as an average. It was moderate in the majority of patients and severe in 1/5 of them. Depression was related with the presence and intensity of pain. Patients with pain presented higher depression scores than patients without pain (p < 0.05). Higher pain scores were also correlated with higher depressive scores (p < 0.05).

Aged↗

[What do patients with head injuries remember about their time of hospitalization?].

Traumatic brain injured (TBI) patients with different trauma severity were analyzed about their recollection concerning the period of hospitalization. The study was carried out in the Head Injury Outpatient Clinic at the Central Institute of the FMUSP Hospital including 45 conscious patients able to sustain an interview. Most patients were male, young adults with the major cause of trauma such as traffic accidents and falls. Most patients (86%) reported unconsciousness state of different time duration in their hospitalization period and were unable to remember anything related to that period. The predominant recollection reported by the patients who never had consciousness decreased after the trauma and that ones who had it but awoke during the hospitalization were: seeing, feeling, hearing, and reacting either to sounds and procedures.

Adolescent↗

[Traumatic brain injury: differences among pedestrians and motor vehicle occupants].

OBJECTIVE: The purpose of this study was to discover the differences among victims who had traumatic brain injury due to traffic accidents. METHODS: Medical record of the head injury patients were analyzed according to their classification as traffic accident victims (pedestrian, motorcyclist or passenger and other motor vehicle deriver or passenger), age, gender, admission type (admitted from scene of the injury or from another hospital), duration of hospitalization, type of head injury, types of lesions present in other body segments and mortality. Patient's injury severity was measured by Injury Severity Score and head injury severity was analyzed using the ranking on the Glasgow Coma Scale, recorded by neurosurgeons during their first neuro assessment. All head injured patients admitted to a trauma center in S. Paulo city over a four-month period from March through June 1993, were included in the study. The sample was of 156 victims, with subsets of 80 pedestrians, 26 occupants of motorcycles and 50 occupants of other motor vehicles. RESULTS AND CONCLUSION: The results of this study showed that the mortality rate was higher in the pedestrian subset (25.0%) than among other victims and higher for motorcycle occupants (19.2%) than for motor vehicle victims (8.0%). Statistical differences between the subsets were established when the head injury severity variable was analyzed using the Glasgow Coma Scale. On the other hand, the differences between the three subsets was not statistically significant when the measurement used was the Injury Severity Score. Analyses of other variables showed important differences among subset distributions.

Accidents, Traffic↗

[Nature and severity of injuries in traffic accident victims].

The objective of this retrospective study is to characterize the nature and severity of injuries of hospitalized traffic accident victims using the "Abbreviated Injury Scale" (AIS). Two-hundred and twenty such patients in a trauma reference hospital in Sao Paulo, Brazil were assessed. One-hundred and eleven of them were pedestrians, eighty-three vehicular passengers and twenty-six motorcyclists. The most common injuries were of the limbs, pelvic girdle and head/neck. Injury severity in all these patients was AIS = 3. Two-thirds of the forty-five victims who died were pedestrians.

Abbreviated Injury Scale↗

[Head injury victims and their return to work after 6 months to 1 year].

A prospective and longitudinal study about head injury victims was carried out in order to identify their return to productivity after 6 months and 1 year post-trauma and to analyze the relationship between their return to work and their educational level as well as to determine the relationship between their return to work and their type of job before the onset of the injury. Of the 72 patients who were students or employees pre-injury, or housewives at the time of injury, the majority (73.6%) had returned to productivity 6 months after onset of injury. Of the victims who had returned to productivity, 25.0% had changed their original occupations or reported significant problems when returning to productivity. Baseline return was achieved in 48.6% of the victims at 6 months. Return to productivity was higher at 1 year after injury than at 6 months. When the relationship between return to work and educational level and job type was analyzed, return to work was not related to educational level or job type.

Adolescent↗

[Measurements of the gravity of injuries in patients with head injuries by the AIS/90 manual and the CAIS/85 chart].

This study was developed in order to compare the use of the ABBREVIATED INJURY SCALE (AIS) and the CONDENSED ABBREVIATED INJURY SCALE (CAIS) as basis to calculate INJURY SEVERITY SCORE (ISS) in head injured patients. The results showed that the ISS value was equivalent in the majority of the patients (58.51%) codified by both scales. Also no statistic differences between the scales were perceived when we compared the severity levels as severe, moderate and minor, 61.38% of the lesions scored by AIS/90 were scored by CAIS/85, too.

Abbreviated Injury Scale↗

[Continuing education of the intensive care units nursing staff in the city of Sao Paulo].

This study is part of a project about ICU's characteristics in São Paulo city. This article describes the continuing education programs for nursing staff. 43 ICUs were analysed and the questionnaire answered by the ICU nurse coordinator was used to collect data. Results showed that 34 (79.1%) of the ICUs have initial program for training each nursing staff category and 18 (41.9%) had regular continuing education program focusing primarily on nursing procedures and routines and the update in pathologies. Continuing education programs are developed primarily by ICU's nurses. 50.2% of the nurses answered that they attended specialisation/extension courses too, in Medical Surgical Nursing or in other areas or in both areas. Due to this result and the development of the ICU's nurses as specialists, some suggestions are presented to improve the continuing education program in these Units.

Brazil↗

[Pain, depression, and cultural concepts].

The influence of personal, cultural and affective factors and of the characteristics of the neoplastic diseases in the occurrence of pain and pain intensity in 92 patients presenting advanced cancer was evaluated. Pain usually moderate or severe during past week before the interview occurred in 62.0% of the patients. The duration of pain symptomatology lasted 10 months as an average. There was a higher proportion of patients with head and neck tumors in the group with pain than without pain. Cultural misconceptions about cancer pain control and the idea that doctors prescribe excessive amount of analgesics were correlated with higher intensities of pain (p < 0.05). Patients with pain presented higher depression scores than patient without pain (p < 0.05). Higher pain scores were correlated with higher depressive scores (p < 0.05).

Adolescent↗

[Characteristics of intensive care units in Sao Paulo].

This study is the first part in a series of the articles reporting results of a project conducted to analyse the structural resources of ICUs in São Paulo city. This article describes the characteristics of those Units, considering the quantity and geographic location, bed number, maintainer entity, type of assistance, type of client, as well the percentage of beds usage and length of stay. Forty three ICUs were analysed and a questionnaire answered by the ICU nurse coordinator was used to collect data. The results showed that the number of ICUs in the hospital varied from 1 to 4, being more frequently those with only one ICU (68.8%). 79.2% of the Units were in private hospitals, located in the central area of the city. ICU beds represented 8.0% of the total hospital beds and there was an average of 10 beds per Unit. There was a predominance of general ICUs (60.5%), destined only for adult patients (51.2%) and for clinical-surgical treatment (95.3%). The percentage of beds usage in majority of ICU was between 80 to 100% and the length of stay was 4,5 days.

Adult↗

[Evaluation of the severity of head injuries using anatomical and physiological indices].

The purpose of this study was the analysis of head injury severity based on physiologic and anatomic indexes, shown by hospitalized patients from the Intensive Care Unit. The study was characterized according to patients' age, gender, external cause and remaining time at the Intensive Care Unit, and it was verified that from the total of admitted patients the most of them were young adult males with a remaining time percentage of 6.28 days, Most frequent external cause was traffic motor vehicle accidents (65.72%). The study also considers the lesions and trauma severity according to the Abbreviated Injury Scale/ Injury Severity Score (AIS/ISS), reporting that the lesions were classified as severe lesions non-life threatening (AIS-3) and severe lesions life threatening (AIS-4). It was verified that the body region most affected was head and neck (57.65%). In relation to the trauma severity (ISS), most of the patients reached ISS 16. The study also presents the head injury severity by determining the consciousness level using the Glasgow Coma Scale (GCS); most of the patients showed severe head injury or GCS from 3 to 8. Analysis regarding a possible relation between the GCS and the AIS/ISS was performed to evaluate the head injury severity, considering the fact that the patient was victim of head injury or head injury and other body lesions. No meaning statistical element was observed regarding the relation between the GCS-1 and the AIS from the head region, except when analyzed by groups of severity, or GCS-1 3 to 8 and AIS-head 4 to 5; GCS-1 9 to 12 and AIS-head 2 to 3. Similarly, no meaning statistical relation between the GCS-1 and the ISS, isolated head injury or head injury and other body lesions and the ISS or the GCS. It is expected that this study may contribute with new data for the continuous assistance improvement of patients, with head injury severity either related to other lesions or not, offered both by the Nursing and Health teams.

Adult↗

[Recovery of patients with traumatic brain injuries one year after the trauma].

A prospective longitudinal study of traumatic brain injury (TBI) patients was conducted to identify the recovery pattern 1 year after trauma. Patients with all levels of injury and age between 12 and 60 years were observed. They were analyzed using the eight-point Glasgow Outcome Scale (GOS) as well as their return to productivity in that period. The majority of victims (77.2%) made good recovery, that is (GOS = 0 or 1) and complete recovery or GOS 0 was achieved in 38.6% of then. However at the 1 year mark, 22.8% of the victims showed disabilities. Overall, victims had returned to productivity in that period (83.3%) but 19.4% of them have had changes in their productivity and 16.7% didn't return to your job.).

Activities of Daily Living↗

[Determination of the trauma severity level].

The severity of traumas in hospitalized patients was characterized by means of the Injury Severity Score (ISS) was studied prospectively. One hundred trauma patients hospitalized in a trauma referral health facility located in S. Paulo, Brazil, were analyzed. Of the total number of patients, 68 had blunt trauma and 32 penetrating trauma. As to ISS, it was discovered that 53.0% of the blunt trauma patients had mild trauma (ISS 1-15), 29.4% moderate trauma (ISS 16-24), and 17.6% showed severe trauma (ISS 25); 34.4% of the penetrating trauma patients had mild trauma, 18.7% moderate trauma and 46.9% severe trauma. The mean and standard deviations relating to the ISS of blut and penetrating trauma patients were, respectively, 14.9 +/- 8.1 and 20.8 +/- 11.0; the respective mortality rates were of 11.8% and 12.5%.

Adolescent↗

[Teaching and learning in the physical exam: an analysis of the process by an exam of the pupils].

The goal of this study was to analyse the teaching-learning process of the pupil examination, in two aspects: the pupil diameter (DP), obtained by measurement and photomotor reflex (RFM), by subjective judgement. The sample was composed by 46 students of 4th semester in Nursing Undergraduate Course of University of São Paulo. The study was developed in two phases: the first was at nursing laboratory and the second, at clinical practice. The findings seemed to indicate that the learning was done because there was high level of agreement among students in their observation, development of an ability and a specific knowledge. The major difficulties was at clinical practice.

Adult↗

[A method of analysing the reasoning applied in nursing in neuroscience].

It is a preliminary study testing the applicability of a method for knowledge characterization based on graphs theory. 11 (eleven) nurses working in a medical surgical intensive care unit including neurological patients constructed graphs to explain the diagnostic process. The results show that: the knowledge structure is in a developing stage; there is agreement regarding to diagnosis formulation and the data base on which it is founded is diversified and link to a specified form of related causes. The method demonstrated to be feasible and should be reapplied on a larger population.

Adult↗

[The measurement of the psychomotor capacities involved in the technic of the intramuscular injection].

This study is to verify the psychomotor skill using psychomotor capacity measure. The authors describe two tests that will be used by nurses denominated "electronic psychomotor" and "perferation". Those tests are applied in the first stage of this study to analyse the teaching-learning process of intramuscular injection. Three groups of undergraduate nursing students in different stages of evolution of the course, were analysed and were verified that there was homogeneity among groups in relation to psychomotor capacity.

Analysis of Variance↗

[Analgesia in cancer: beliefs and an update].

Cancer pain relief is not yet adequate, but there are resources for this. Professional's misconception and the tabu about that pain in cancer is inevitable have been contributing to this problem. Important nurses' knowledge lacuna about pain relief in cancer was found by this study. The WHO program about pain relief in cancer is presented too.

Analgesia↗