Instituto da Criança - HC/ICr

URI Permanente desta comunidade

https://observatorio.fm.usp.br/handle/OPI/84
O Instituto da Criança (ICr) é parte do Sistema Faculdade de Medicina da Universidade de São Paulo - Hospital das Clínicas (FMUSP-HC), atende a pacientes de 0 a 19 anos de todo o Brasil e da América Latina em 21 especialidades médicas, incluindo assistência ambulatorial, internação clínica e cirúrgica. Inaugurado em 1976, o hospital foi preparado para atender doenças de alta complexidade como síndromes raras, Câncer, AIDS, além de realizar transplantes de fígado e de medula óssea.

O ICr possui o Serviço de Diagnóstico por Imagem (SDI) e dispensa atenção especial às necessidades da criança e do adolescente, integrando a estrutura biológica, psicológica e social de cada paciente. O atendimento é realizado por equipes multiprofissionais compostas por assistentes sociais, educadores, enfermeiros, fisioterapeutas, médicos, nutricionistas, psicólogos e terapeutas ocupacionais. Essa atuação conjunta torna o atendimento completo e eficaz, num ambiente que remete ao mundo infantil, utilizando brincadeiras, desenhos, cores e muita diversão. Os profissionais do ICr são orientados pelos pilares fundamentais de um hospital-escola: Assistência, Ensino, Pesquisa e contam com o apoio do Departamento de Pediatria da FMUSP.

Site oficial: http://www.icr.usp.br/

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article
Physical rehabilitation in Brazilian pediatric intensive care units: a multicenter point prevalence study
(2023) REDIVO, Juliana; KANNAN, Harini; SOUZA, Andreia Aparecida Freitas; COLLETI JUNIOR, José; KUDCHADKAR, Sapna Ravi; HORIGOSHI, Nelson Kazunobu; COSTA, Graziela de Araújo; CASTILHO, Taísa Roberta Ramos de; PERON, Paula Peres Domingues; SCARANTO, Walter Perez; MEDEIROS, Daniela Nasu Monteiro; MATSUMOTO, Toshio; ALMEIDA, Carlos Gustavo de; OLIVEIRA, Felipe Rezende Caino de; BRANDÃO, Marcelo Barciela; LIMA-SETTA, Fernanda; PRATA-BARBOSA, Arnaldo; XAVIER, Glaciele Nascimento; ANDRADE, Livia Barbosa de; AGUIAR, Agda Ultra de; COUTINHO, Marcos Paulo Galdino; CASTRO, Roberta Esteves Viera de; LANDY, Glazia André; BALANIUC, Suzana Lopes Bonfim; YAMAGUCHI, Ricardo Silveira
ABSTRACT Objective: To determine the prevalence and factors associated with the physical rehabilitation of critically ill children in Brazilian pediatric intensive care units. Methods: A 2-day, cross-sectional, multicenter point prevalence study comprising 27 pediatric intensive care units (out of 738) was conducted in Brazil in April and June 2019. This Brazilian study was part of a large multinational study called Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). The primary outcome was the prevalence of mobility provided by physical therapy or occupational therapy. Clinical data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥ 72 hours. Results: Children under the age of 3 years comprised 68% of the patient population. The prevalence of therapist-provided mobility was 74%, or 277 out of the 375 patient-days. Out-of-bed mobility was most positively associated with family presence (adjusted odds ratios 3.31;95%CI 1.70 - 6.43) and most negatively associated with arterial lines (adjusted odds ratios 0.16; 95%CI 0.05 - 0.57). Barriers to mobilization were reported on 27% of patient-days, the most common being lack of physician order (n = 18). Potential safety events occurred in 3% of all mobilization events. Conclusion: Therapist-provided mobility in Brazilian pediatric intensive care units is frequent. Family presence was high and positively associated with out-of-bed mobility. The presence of physiotherapists 24 hours a day in Brazilian pediatric intensive care units may have a substantial impact on the mobilization of critically ill children.
article
Performance and labor conditions of physiotherapists in Brazilian intensive care units during the COVID-19 pandemic. What did we learn?
(2023) RESENDE, Andressa Sabrina de Oliveira; BACCI, Suzi Laine Longo dos Santos; PAULA, Ítalo Ribeiro; PEREIRA, Leandro Alves; JOHNSTON, Cíntia; LUSZCZYNSKI, Valéria Cabral Neves; AZEVEDO, Vívian Mara Gonçalves de Oliveira
ABSTRACT Objective: To describe the role of physiotherapists in assisting patients suspected to have or diagnosed with COVID-19 hospitalized in intensive care units in Brazil regarding technical training, working time, care practice, labor conditions and remuneration. Methods: An analytical cross-sectional survey was carried out through an electronic questionnaire distributed to physiotherapists who worked in the care of patients with COVID-19 in Brazilian intensive care units. Results: A total of 657 questionnaires were completed by physiotherapists from the five regions of the country, with 85.3% working in adult, 5.4% in neonatal, 5.3% in pediatric and 3.8% in mixed intensive care units (pediatric and neonatal). In intensive care units with a physiotherapists available 24 hours/day, physiotherapists worked more frequently (90.6%) in the assembly, titration, and monitoring of noninvasive ventilation (p = 0.001). Most intensive care units with 12-hour/day physiotherapists (25.8%) did not apply any protocol compared to intensive care units with 18-hour/day physiotherapy (9.9%) versus 24 hours/day (10.2%) (p = 0.032). Most of the respondents (51.0%) received remuneration 2 or 3 times the minimum wage, and only 25.1% received an additional payment for working with patients suspected to have or diagnosed with COVID-19; 85.7% of them did not experience a lack of personal protective equipment. Conclusion: Intensive care units with 24-hour/day physiotherapists had higher percentages of protocols and noninvasive ventilation for patients with COVID-19. The use of specific resources varied between the types of intensive care units and hospitals and in relation to the physiotherapists’ labor conditions. This study showed that most professionals had little experience in intensive care and low wages.
article
OCCULT AND SEMI-OCCULT CONSTIPATION IN CHILDREN WITH MONOSYMPTOMATIC OR NON MONOSYMPTOMATIC ENURESIS
(2023) MAFFEI, Helga Verena L; VIDOLIN, Eliana; REIS, Joceara Neves dos; FREITAS, Marcia de; CABRAL, Beatriz Helena; TRIGO-ROCHA, Flavio
ABSTRACT Background: Functional constipation and enuresis frequently coexist. Constipation treatment often results in resolution or improvement of the enuresis. However, besides the classical presentation, patients can present with occult constipation (OC) diagnosed in complementary evaluation; in addition, semi-occult constipation (SOC) can be detected by means of a detailed questionnaire. Objective: To quantify OC and SOC frequency in children with monosymptomatic or non monosymptomatic enuresis (MNE or NMNE). Methods: Otherwise healthy children/adolescents, with enuresis refractory to behavioral therapy and denying constipation after simple questions, answered a structured bowel habit questionnaire and were submitted to a plain abdominal radiological exam. Constipation was classified considering the Boston diagnostic criteria (to allow diagnosis at initial stages), and fecal loading in the X-ray quantified ≥10 by the Barr score. Children with constipation received a standardized treatment (except 26 “pilot” children). Results: Out of 81 children, 80 aged 9.34±2.07 years, 52.5% male, were diagnosed with constipation: 30 OC, 50 SOC; 63.75% had MNE, 36.25% NMNE (six NMNE without behavioral therapy). Demographic data and the Barr score were similar for OC and SOC, but SOC children experienced significantly more constipation complications (retentive fecal incontinence and/or recurrent abdominal pain). Not showing the Bristol Stool Scale (BSS) to 24 “pilot” children, or absence of constipation symptoms accompanying BSS predominantly type 3, in 13 children, did not significantly impact the detection of constipation by the Barr score. Children identifying BSS 3 or ≤2 had similar results. Twenty-eight children, with adequate follow-up after treatment, improved or recovered from constipation at 44 of their 52 follow-up visits. Conclusion: In patients with MNE or NMNE refractory to behavioral therapy, and who initially denied constipation after simple questions, a detailed questionnaire based on the Boston diagnostic criteria detected SOC in 61.7%, and the radiological Barr score revealed fecal loading (OC) in 37.0% of them.
bookPart
Nutrologia e incongruência de gênero na infância
(2024) SKIBELSKI, Clara Igel; NOVO, Ana Carolina de Albuquerque Cavalcanti Ferreira
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Intervenção de terapia ocupacional em unidade de terapia intensiva pediátrica
(2018) FRANCO, Mariana de Paiva; KUDO, Aide Mitie
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Pediatria e incongruência de gênero
(2024) NOVO, Ana Carolina de Albuquerque Cavalcanti Ferreira
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Desenvolvimento hormonal
(2024) STEINMETZ, Leandra; DAMIANI, Durval
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Terapia ocupacional em contextos hospitalar e cuidados paliativos: histórias e desafios
(2018) CARLO, Marysia Mara Rodrigues do Prado De; KUDO, Aide Mitie
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Terapeuta ocupacional na unidade de transplante de medula óssea
(2018) BITTENCOURT, Renata Sloboda; SANTOS, Dayane Regina dos