International Journal of Health Management Review 2022-10-10T21:00:09-03:00 Altieres de Oliveira Silva [email protected] Open Journal Systems <p>The <strong>International Journal of Health Management Review - IJHMReview</strong> arose from an in-depth reflection regarding the challenges for the management of healthcare systems both in Brazil and globally, since resources for healthcare are becoming increasingly scarce, which poses a challenge for both public and private sectors.</p><p>The Journal was created as a non-profit entity by the Brazilian Institute for Training, Development and Professional Management, a private sector organization, the activities of which focus primarily on teaching, research, development, and projects that involve the management of professional and academic education in the many fields of healthcare and administration.</p><p>To achieve its objectives, the Brazilian Institute for Training, Development and Professional Management has at its disposal a team of highly qualified professionals with extensive experience in the fields of teaching and research, as well as an organizational structure suitable for: </p><ul><li>supporting the dissemination of knowledge in economics and related fields by means of technical publications, periodicals, essays, the Internet and other communications media;</li></ul><ul><li>collaborating with public and private sector institutions, both national and foreign, whether academic or otherwise, in the creation, management, and evaluation of programs in the field of healthcare management;</li></ul><ul><li>Promoting courses, symposiums, seminars, conferences, and studies that foster education and debate regarding healthcare systems, promoting the improvement of professionals, whether in the public or private sector, in partnership with a broad range of healthcare and educational institutions.</li></ul><ul><li>Conducting research required by the public and private sectors, pursuant to the highest academic standards, which simultaneously enable the production of knowledge and the training of specialized personnel. </li></ul><p>The changes that occur in the political, social, cultural, environmental, technological and economic environments in various countries around the world are reflected in the way resources are managed, whether in the healthcare sector or in other sectors, all of which require practical, clear, and objective solutions which can be applied to the daily operations of the administrators which manage these different systems. </p><p>In this context, <strong>I</strong><strong>JHMReview</strong> seeks to contribute with research on these practical issues, providing knowledge and scientific understanding regarding how to improve healthcare management, increase the quality of the care, optimize the use of healthcare resources and, consequently, improve the quality of life of the citizens. Thus, the topics of interest are: </p><ul><li>Healthcare Management in the daily operations of the hospital administrator: strategic, tactical and operational aspects thereof;</li><li>Formal and informal organization of healthcare services: leadership, negotiation, communication, culture;</li><li>Challenges, trends and strategic aspects of the management of healthcare systems;</li><li>Quality management in healthcare services;</li><li>Cost management in healthcare services;</li><li>Aspects and trends of Public Health Policies, Women's Health, Men’s Health, Sexually Transmitted Diseases, Epidemiological and Public Health Surveillance, among others;</li><li>Entrepreneurship and innovation in the healthcare sector;</li><li>Technology management in the healthcare sector;</li><li>Operational management in the healthcare sector;</li><li>Knowledge management in the healthcare sector;</li><li>Sustainability in the healthcare sector;</li><li>Crisis Management in healthcare systems;</li><li>Operational logistics in the healthcare sector; </li></ul><p>As a scientific publication, <strong>I</strong><strong>JHMReview</strong> prioritizes scientific research, both empirical and theoretical, as well as technical reports (practical/technical in nature) of actual cases occurring in healthcare services and systems. </p><p><strong>IJHMReview</strong> will publish articles in Portuguese, English, and Spanish. </p><p>Articles will be submitted only via this website, and will be evaluated by peers using the blind review system.</p><p> </p><p><strong>Indexer:</strong></p><p><a href=";gclid=CjwKCAjw27jnBRBuEiwAdjQXDP24oNJFCbRXJVwmyaznIcbUg1tcvKYeyOngiMHTqraaPT4M9qeVThoCwU4QAvD_BwE" target="_blank"><img src="/public/site/images/chennyferpaim/150_capessó.jpg" alt="" /></a></p><p><strong><br /></strong></p> Agreement in the neer classification of proximal humerus fracture 2022-09-19T19:12:50-03:00 Francielly Teles Silva [email protected] Luiz Carlos Bedin Filho [email protected] Sávio Machado Torres [email protected] Marcelo Wiltemburg Alves [email protected] <p><strong>Background:</strong> Proximal humerus fractures account for approximately 4 to 5% of all fractures, affecting more elderly females. As a treatment method, whether surgical or conservative, it is necessary to classify it to know the prognosis of the fracture. Despite being widely used, there are dissociations of evaluation and radiographic reproducibility among examiners.</p> <p><strong>Aim:</strong> To assess the inter- and intra-observational agreement of Neer's classification for fractures of the proximal humerus in adults.</p> <p><strong>Method:</strong> Radiographs of 20 cases of proximal humerus fracture were selected and made available to 35 examiners (Orthopedists, including specialists in shoulder and elbow surgery), who classified them according to Neer's classification, over a period of 60 days. Results: Initially evaluating the 35 evaluators with different levels of experience, at two different times, with a common interval of 60 days between one evaluation and another, the intra-evaluator reliability, considering the median, was excellent 0.923 (95% CI [0.610 - 1.237]), as well as the mode 0.925 (95% CI [0.626 – 1.224]). In the evaluation of the 20 evaluators with the highest intra-evaluator reliability (k&gt;0.5), the intra-evaluator reliability, considering the median among the 20 evaluators, was excellent 0.923 (95% CI [0.610 - 1.237]), as well as considering the mode 0.855 (95% CI [0.569 - 1.141]). Finally, considering the 20 evaluators with the highest individual intra-evaluator reliability, the inter-evaluator reliability in the first evaluation (test) was light 0.259 (95% CI [0.239 - 0.280]), as well as in the second evaluation (retest) 0.289 (95% CI [ 0.269 - 0.310]).</p> <p><strong>Conclusion:</strong> This study evidences that the classification system proposed by Neer, following the Kappa index, presents as a final result a poor categorization of agreement, both intraobservational and interobservational, of fractures of the proximal humerus extremity. A lower reliability (mild to negligible) was also observed in the interobserver analysis. Thus, it is evident the importance of using other classification systems and complementary diagnostic methods, such as computed tomography, for better assessment and management of patients with fractures of the proximal humerus, aiming at optimizing the treatment and rehabilitation of these cases.</p> 2022-09-19T00:00:00-03:00 Copyright (c) 2022 Proximal femur fractures: incidence before and during the COVID-19 pandemic 2022-09-19T19:12:47-03:00 Thiago Henrique Abrão Bertholini [email protected] José Eduardo Sousa Prado [email protected] Maurício Ferraz Moreira [email protected] Daniel Novais Guedes [email protected] <p><strong>Background:</strong> Fracture of the proximal femur is a common and important cause of mortality and functional loss. The incidence of this type of fracture increases with age, mainly due to the increase in the number of falls associated with a higher prevalence of osteoporosis. It is more commonly related to elderly people living in urban areas, female and institutionalized. Fracture of the proximal femur can be intracapsular or extracapsular. In the first type are femoral neck fractures, and in the second, transtrochanteric fractures, both of which result from low-energy trauma, such as falls. The treatment of most of these fractures is surgical, aiming at the reduction and stable fixation of the fracture, using the most varied methods of osteosynthesis or arthroplasty, especially in the case of fractures of the femoral neck with displacement.</p> <p><strong>Aim:</strong> To assess the incidence of proximal femur fractures before and during the COVID-19 pandemic.</p> <p><strong>Method:</strong> This is a retrospective study, with a systematic review of data regarding the number of surgical procedures for proximal femur fractures in the years 2019 to 2021, corresponding to the period before and during the COVID19 pandemic, and to demonstrate its incidence and need of care, in a private hospital in the interior of the state of São Paulo.</p> <p><strong>Results:</strong> During the study period, 1,203 procedures were performed. It was possible to notice the gradual increase in cases during the pandemic years, and a high rate of proximal femur fractures in women, reaching a difference of 62% in relation to men in 2022. The mortality rate during hospitalization was 2.39% in 2019, 2.78% in 2021, and 2.83% in 2022. The factors positively correlated with mortality, most frequently indicated, were advanced age, presence of associated diseases, significant cognitive impairment and female gender.</p> <p><strong>Conclusion:</strong> Recent literature, even within the context of a pandemic and its restrictions, has identified four major factors directly related to mortality in proximal femur fractures in the elderly, namely the patient's advanced age, the presence of associated diseases, the female sex and the existence of cognitive deficiencies.</p> 2022-09-19T00:00:00-03:00 Copyright (c) 2022 Patients' perception of the percutaneous coronary intervention benefits in stable coronary artery disease 2022-09-19T19:12:43-03:00 Stefany Casarin Moura [email protected] Murillo de Oliveira Antunes [email protected] <p><strong>Background:</strong> Percutaneous coronary intervention (PCI) is a common procedure to relieve obstruction of a stenotic coronary artery. Patients' beliefs about the need for the procedure and its effectiveness are shaped by interaction with attending physicians. Therefore, every decision involving the procedure must be taken jointly between the patient and the physician, and the physician must help the subject to understand the probability of the expected benefits and the risks to be faced in the intervention, acting as an experienced partner.</p> <p><strong>Aim:</strong> To assess patients' perception of the benefits and risks of PCI based on information provided by the attending physician. Method: Through a descriptive longitudinal study carried out with patients diagnosed with coronary insufficiency admitted to the HUSF.</p> <p><strong>Results:</strong> When analyzing the expected benefits, in a fraction of the sample, through the performance of PCI, 26% of patients would like to avoid acute myocardial infarction, 26% wanted to reduce their possibility of dying, 10% sought to live longer, 40% wanted to reduce chest pain, 5% would like to take less medication, 25% wanted to decrease dyspnea and 15% did not know how to respond. All patients said that the risks of the procedure were not addressed in the conversation, and only one patient was able to inform possible risks due to prior knowledge.</p> <p><strong>Conclusion:</strong> It was noted the existence of failures in communication between the doctor and the patient, evidenced by the overestimation of benefits and underestimation of risks in performing PCI.</p> 2022-09-19T00:00:00-03:00 Copyright (c) 2022 Academic League of Urgency and Emergency, Pre-Hospital and Emergency Care (LUEPPA) – Medical School of São Bernardo do Campo, SP - Brazil: 2022-2023 management experience report 2022-10-10T17:30:36-03:00 Giulia Veneziani Zogaib [email protected] Maria Fernanda Marques Moncorvo [email protected] Roberto Nogueira Santana [email protected] Júlia Rugoni Perez [email protected] Karoline Barbosa da Silva [email protected] Beatriz Tesoni Marchiori [email protected] Lethicia de Almeida Bigollo [email protected] Maicon Ataide da Silva [email protected] Renato Ribeiro Nogueira Ferraz [email protected] Renato de Lima Rozenowicz [email protected] <p>The aim of the present study was to report the experience of the Academic League of Urgency and Pre-Hospital Emergency and Emergency Care (LUEPPA) of the Faculdade de Medicina Nove de Julho - São Bernardo do Campo, SP, Brazil. The classes took place during the first semester of the year 2022, and were taught by experienced professionals, mostly doctors, who work in specific areas related to each of the lectures. Most of the meetings took place weekly, via Google meet, at night. The assembly of the classes was at the discretion of each speaker, as well as the conduction of the presentation, which ranged from the lecture to the dialogued lecture, encouraging the participation of those present. At the end of the presentations, doubts were resolved, creating an environment of interaction between the speaker and those present. In conclusion, it is understood that the work of Academic Leagues should be encouraged by Faculties and Universities, since it is a learning environment of enormous contribution, especially for medical students.</p> 2022-09-19T00:00:00-03:00 Copyright (c) 2022 Perineal reconstruction after Fournier's syndrome: three-year experience at the Hospital do Servidor Público Municipal (São Paulo city) 2022-10-10T21:00:09-03:00 Sheila Cover [email protected] Pedro Henrique de Paula Nunes Pinto [email protected] Lucas Strufaldi Nunes [email protected] Guilherme Baptista Rosalém Fraga [email protected] <p>Fournier's syndrome is a multi bacterial infectious disease with an insidious onset and rapid progression in the perineal region. Its treatment includes debridement and broad-spectrum antibiotic therapy. Debridement results in loss of skin coverage in the perineal region. There are several possible techniques for reconstruction of the open area, such as skin grafts, myofasciocutaneous and fasciocutaneous flaps, in addition to primary closure of the lesion.</p> <p>The study analyzed six patients who underwent coverage of the open areas with reconstructive procedures, which ranged from the approximation of the edges with simple suture to the use of flaps and grafts in larger lesions. Cutaneous repair techniques presented good evolution with resolution of the raw area, obtaining satisfactory results.</p> 2022-10-10T00:00:00-03:00 Copyright (c) 2022