Úlcera de pressão em pacientes internados em um hospital universitário em Natal/RN: condições predisponentes e fatores de risco

The pressure ulcers (PU), also known as decubitus ulcers, are defined as injuries caused by the constant pressure exerted on a particular point of the body, causing impairment of blood supply with a decrease or interruption of tissue irrigation, causing occlusion of blood vessels and capillaries, ischemia and cell death. This is a descriptive study with longitudinal design, and panel type, with quantitative approach that aimed to examine the association between predisposing conditions (PC), intrinsic factors (IF) and extrinsic factors (EF) with the occurrence of PU, in hospitalized patients in the Intensive Care Unit (ICU), pain clinical, surgical clinical and neurology wards of a university hospital. The study population was composed of all patients who were restricted to bed during the period from December 2007 to February 2008. The study was approved by the Ethics Committee of HUOL / UFRN (No 135/07). The data-collection took place through a structured formulary of observation, data from medical records and physical examination of patients skins. The results were organized in SPSS 15.0 software, tabulated, categorized and analyzed by descriptive and inferential statistics. Of the 30 patients studied, 43.3% had been hospitalized in the pain clinical and surgical clinic wards, 20.0% in the ICU, 20.0% in the ICU / ward and 16.7% in neurology, being the length of hospitalization in those units of 7 to 18 days (63.3%) and from 19 to 30 days (36.7%), predominantly female and aged ≥ 60 years (60.0%). 19 PU were diagnosed in 43.3% of patients monitored, being 38.5% with one PU between 7 to 18 days and 46.2% with two or more between 19 to 30 days of hospitalization, showing significant relationship (ρ-value = 0029) between length of hospital stay and the number of PU. Was found an association of 35.7% of the PC (cardio-respiratory, hematological, metabolic and psychogenic), IF (age group, oedema, skin changes in humidity and change of body temperature) and EF (type of mattress and strength of body pressure) for all patients studied, statistically significant (ρ-value = 0001), between the average scores in patients with and without PU, with reason chance to 12.0 for the development of PU and there was moderate correlation ( r = 0618) in the presence of this association. Results show the influence of the multiplicity of factors and conditions on the occurrence of PU, which brings us to reflect on the assistance focused on prevention and reduction of these injuries which will encourage the reduction of hospitalization length, physical and psychological suffering, and the possibility of improving the clinical condition of the patient.

Assistência de enfermagem e o risco para úlceras de pressão medido pela Escala de Braden em unidade de terapia intensiva

The problem facing the incidence of pressure ulcers (UP) in the hospital environment especially in the intensive care unit (ICU), although it is an old and frequent event in our professional practice, it is not notified in the researches as much as it should be. We observed a tendency to invest in therapeutical and in studies about the production of sophisticated new bandages. Few, however, are the investments in research on preventive measures in order to prevent or at least slow down the development of lesions. In this sense, the study aimed to analyze the correlation between nursing care and the risk of developing UP measured by the Braden scale in ICU patients. This is a descriptive study of longitudinal quantitative approach. The project obtained a favourable opinion from the Ethics Committee of HUOL (no 486/10). Data collection was carried out in the Hospital of Unimed in Natal during six months in 2011. The sample was of 32 patients hospitalized in ICU for over four days. The results were processed in SPSS 15.0 for descriptive statistics and inferential statistics. We identified that, only 9.4% of our sample developed UP, being predominantly male, elderly people aged above 60 years, Caucasian, with diagnostic hypothesis at the time of hospitalization of sepsis, were clinical patients, who presented hemodynamic instability, using orotracheal tube (TOT), enteral probe (SNE), vesical probe delay (SVD) and had values of albumin and hemoglobin levels below normal. In addition, these patients had a longer hospital stay, longer usage of TOT, SNE, SVD, increased use of sedation and drain than those who did not develop UP and were all at risk for developing these injuries second Braden scores. 66.7% of the lesions developed were located in the sacral region, limiting the degree I and all patients that developed were considered serious, 100.0% of them have evolved since the death. Small were the differences between the averages of Braden scores between patients with and without UP, 11,9+2,4 against 12,4+2,6 with p = 0.627. The clinical aspects of the patients in the study were instrumental in the development of UP, once, these findings were statistically significant through the Mann-Whitney test, and appropriateness of nursing conduct was decisive for the prevention of pressure ulcers in critical patients, since many were those classified as at risk (28) and few who have developed lesions (03)

Fatores associados à condição de saúde bucal de pacientes internados em hospitais públicos do município de Natal-RN

The hospitalization is an event that can attack any person, independent of gender, race, social and economical condition. Last year, the prevalence of hospitalization was 8.1 for 100 inhabitants and the average time of hospitalization was 8.5 days for each patient one in Natal city. Therefore, an important point is whether the attention to the patients during the permanence in these health establishments incorporates the health integral model suggested by the principles proposed by the National Health System in Brazil (SUS), with actions of promotion and protection by different kinds of professionals, beside those called convalescence. Then, the aim of this study was to evaluate the patient s oral health conditions hosted in public hospitals of the Natal city, looking for to establish its relationship with several risk factors by two dimensions: the characteristics of the hospitalization and the patient s general and economical conditions. We accomplished a cross-sectional study with 205 patients distributed among the hospitals Onofre Lopes, Giselda Trigueiro and Monsenhor Walfredo Gurgel, looking for to know the socio-demographic characteristics, the food habits and of oral hygiene and the conditions of oral health, through the Visible Plaque Index and Gingival Bleeding Index. We observed that the conditions of the patient s oral health interned at public hospitals of reference of the municipal district of Natal is bad, existing accumulation of dental plaque and, consequently, a great number of patients with gingival bleeding. However, the time of hospitalization and its reason, the type of medicine used in this time and the toothbrush frequency were not configured as risk factors for this oral health condition

Sobre o tempo

BONACCINI, J. A. . Sobre o tempo. Princípios: revista de filosofia. Natal((RN), v. 5, n. 6, p. 123-138, 1998. ISSN 1983-2109. Disponivel em: . Acesso em: 04 out. 2010.

Repercussões do tempo operatório em pulmões de ratos idosos

A duração das operações pode representar um fator importante para uma série de complicações pós-operatórias, especialmente para os indivíduos idosos. Objetivo: estudar a repercussão nos pulmões, de operações de diferentes tempos de duração. Métodos: Vinte ratos idosos (18 meses) e 20 jovens (3 meses) foram separados aleatoriamente em grupos A e B respectivamente. Os grupos foram divididos em A1, A2, A3, A4, B1, B2, B3 and B4, com cinco ratos cada. Os animais foram anestesiados com pentobarbital (20mg/Kg) intraperitoneal. No subgrupo A1 e B1 foi feita operação com duração de 30 minutos, nos grupos A2 and B2 60 minutos, em A3 and B3 a operação foi feita em 120 minuto e os animais A4 e B4 (controle) não foram operados. O procedimento consistiu de laparotomia xifopubiana que foi aberta e fechada tantas vezes quanto necessário para atingir os tempos estipulados. Após o quinto dia pós-operatório os animais foram mortos com superdose de anestésico e biópsias de ambos os pulmões foram realizadas. Os achados histopatológicos foram transformados em escores. Resultados: os grupos de ratos jovens atingiram os escores: A1= escore 6, A2=11; A3=28; A4=5. Os ratos idosos tiveram os escores: B1=12; B2=34; B3=51 e B4=6. A análise estatística revelou diferenças significantes entre os escores dos grupos A e B. Conclusões: O tempo prolongado nas operações realizadas em ratos idosos contribuiu para o aparecimento de alterações pulmonares de modo significante. Quanto maior o tempo operatório, mais intensas e mais freqüentes as complicações pulmonares

Repercussões do tempo operatório em pulmões de ratos idosos

A duração das operações pode representar um fator importante para uma série de complicações pós-operatórias, especialmente para os indivíduos idosos. Objetivo: estudar a repercussão nos pulmões, de operações de diferentes tempos de duração. Métodos: Vinte ratos idosos (18 meses) e 20 jovens (3 meses) foram separados aleatoriamente em grupos A e B respectivamente. Os grupos foram divididos em A1, A2, A3, A4, B1, B2, B3 and B4, com cinco ratos cada. Os animais foram anestesiados com pentobarbital (20mg/Kg) intraperitoneal. No subgrupo A1 e B1 foi feita operação com duração de 30 minutos, nos grupos A2 and B2 60 minutos, em A3 and B3 a operação foi feita em 120 minuto e os animais A4 e B4 (controle) não foram operados. O procedimento consistiu de laparotomia xifopubiana que foi aberta e fechada tantas vezes quanto necessário para atingir os tempos estipulados. Após o quinto dia pós-operatório os animais foram mortos com superdose de anestésico e biópsias de ambos os pulmões foram realizadas. Os achados histopatológicos foram transformados em escores. Resultados: os grupos de ratos jovens atingiram os escores: A1= escore 6, A2=11; A3=28; A4=5. Os ratos idosos tiveram os escores: B1=12; B2=34; B3=51 e B4=6. A análise estatística revelou diferenças significantes entre os escores dos grupos A e B. Conclusões: O tempo prolongado nas operações realizadas em ratos idosos contribuiu para o aparecimento de alterações pulmonares de modo significante. Quanto maior o tempo operatório, mais intensas e mais freqüentes as complicações pulmonares

Previsão do índice bovespa por meio de redes neurais artificiais: uma análise comparada aos métodos tradicionais de séries de tempo

Forecast is the basis for making strategic, tactical and operational business decisions. In financial economics, several techniques have been used to predict the behavior of assets over the past decades.Thus, there are several methods to assist in the task of time series forecasting, however, conventional modeling techniques such as statistical models and those based on theoretical mathematical models have produced unsatisfactory predictions, increasing the number of studies in more advanced methods of prediction. Among these, the Artificial Neural Networks (ANN) are a relatively new and promising method for predicting business that shows a technique that has caused much interest in the financial environment and has been used successfully in a wide variety of financial modeling systems applications, in many cases proving its superiority over the statistical models ARIMA-GARCH. In this context, this study aimed to examine whether the ANNs are a more appropriate method for predicting the behavior of Indices in Capital Markets than the traditional methods of time series analysis. For this purpose we developed an quantitative study, from financial economic indices, and developed two models of RNA-type feedfoward supervised learning, whose structures consisted of 20 data in the input layer, 90 neurons in one hidden layer and one given as the output layer (Ibovespa). These models used backpropagation, an input activation function based on the tangent sigmoid and a linear output function. Since the aim of analyzing the adherence of the Method of Artificial Neural Networks to carry out predictions of the Ibovespa, we chose to perform this analysis by comparing results between this and Time Series Predictive Model GARCH, developing a GARCH model (1.1).Once applied both methods (ANN and GARCH) we conducted the results' analysis by comparing the results of the forecast with the historical data and by studying the forecast errors by the MSE, RMSE, MAE, Standard Deviation, the Theil's U and forecasting encompassing tests. It was found that the models developed by means of ANNs had lower MSE, RMSE and MAE than the GARCH (1,1) model and Theil U test indicated that the three models have smaller errors than those of a naïve forecast. Although the ANN based on returns have lower precision indicator values than those of ANN based on prices, the forecast encompassing test rejected the hypothesis that this model is better than that, indicating that the ANN models have a similar level of accuracy . It was concluded that for the data series studied the ANN models show a more appropriate Ibovespa forecasting than the traditional models of time series, represented by the GARCH model

Influência do tempo e dose de heparina em modelo de peritonite aguda

In the last years, heparin has become target of many studies related to inflammation due its ability of biding to proteins involved on immune response. Recently, it was demonstrated, at our laboratory, using a thIoglycollate-induced peritonitis model, heparin s capacity of reduce cellular influx into the peritoneal cavity, 3 hours after the inflammatory stimulus. Once neutrophilic infiltration is highest around 8 hours after the inflammatory stimulus, at the present work, using the same peritonitis model, it was assessed heparin s ability of keeping the interference on leukocyte infiltration, 8 hours after inflammation induction. Moreover, using cellular differential count, it was evaluated how the cellular populations involved in the inflammatory process would be affected by the treatment. Eight hours after the inflammatory stimulus, only heparin dosage of 1 μg/Kg was able to reduce the cellular influx to peritoneum, 62.8% of reduction when compared to positive control (p < 0.001). Furthermore, heparin dosage of 15 μg/Kg presented a pro-inflammatory effect in whole blood verified by the increase of 60.9% (p < 0.001) and 117.8% (p < 0.001) on neutrophils and monocytes proportion, respectively, when compared to positive control. In addition, this dosage also presented a neutrophilic proportion on peritoneal fluid 27.3% higher than positive control (p < 0.05). This duality between anti- and pro-inflammatory effects at different times corroborates studies that attribute a pleiotropic immunomodulator role to heparin.

Cinemática de partículas em fluidos de viscosidade variável com o tempo e sua aplicação na construção de poços de petróleo: avaliação durante paradas operacionais

The new oil reservoirs discoveries in onshore and ultra deep water offshore fields and complex trajectories require the optimization of procedures to reduce the stops operation during the well drilling, especially because the platforms and equipment high cost, and risks which are inherent to the operation. Among the most important aspects stands out the drilling fluids project and their behavior against different situations that may occur during the process. By means of sedimentation experiments, a correlation has been validated to determe the sedimentation particles velocity in variable viscosity fluids over time, applying the correction due to effective viscosity that is a shear rate and time function. The viscosity evolution over time was obtained by carrying out rheologic tests using a fixed shear rate, small enough to not interfere in the fluid gelling process. With the sedimentation particles velocity and the fluid viscosity over time equations an iterative procedure was proposed to determine the particles displacement over time. These equations were implemented in a case study to simulate the cuttings sedimentation generated in the oil well drilling during stops operation, especially in the connections and tripping, allowing the drilling fluid project in order to maintain the cuttings in suspension, avoiding risks, such as stuck pipe and in more drastic conditions, the loss of the well

Metodologia para avaliação de cinemática de partículas gasosas em fluidos de viscosidade variável com o tempo e sua aplicação na construção de poços de petróleo

Many challenges have been presented in petroleum industry. One of them is the preventing of fluids influx during drilling and cementing. Gas migration can occur as result of pressure imbalance inside the well when well pressure becomes lower than gas zone pressure and in cementing operation this occurs during cement slurry transition period (solid to fluid). In this work it was developed a methodology to evaluate gas migration during drilling and cementing operations. It was considered gel strength concept and through experimental tests determined gas migration initial time. A mechanistic model was developed to obtain equation that evaluates bubble displacement through the fluid while it gels. Being a time-dependant behavior, dynamic rheological measurements were made to evaluate viscosity along the time. For drilling fluids analyzed it was verified that it is desirable fast and non-progressive gelation in order to reduce gas migration without affect operational window (difference between pore and fracture pressure). For cement slurries analyzed, the most appropriate is that remains fluid for more time below critical gel strength, maintaining hydrostatic pressure above gas zone pressure, and after that gels quickly, reducing gas migration. The model developed simulates previously operational conditions and allow changes in operational and fluids design to obtain a safer condition for well construction

Tempo livre de lazer e composição corporal de escolares do meio-oeste catarinense

The aim of this study was to investigate the relationship between free time for leisure and body composition of students in the crucial ninth year. (N = 228) of towns in the Midwest catarinense. We used the Adolescent Behavior Questionnaire of Santa Catarina (COMPAC) to assess lifestyle, considering that Active schoolchildren during the week, accumulated 300 or more minutes of moderate or vigorous physical activity (MVPA). Were used the time to 2 hours or more / day to determine the time of excessive use of TV and computer video game. To analyze body composition were used two criteria: the Body Mass Index (BMI) and sum of skinfolds (EDC). It was observed a proportion of 67.3% of girls and 68.7% of boys assets and more than 98% of students were using excessive TV time, computer and video game. In the classification by EDC, most of the boys showed great or low levels of body composition, while more than half of girls were classified at higher levels. As for BMI, most boys and girls had not overweight. Significant difference in the comparison of total minutes per week of MVPA reported between the groups, the second criterion of EDC and BMI for girls but not for BMI in boys. It is concluded that students with higher accumulation in minutes of MVPA showed better body composition indicators, but no significant difference was found when compared active groups with inactive, according to criteria used.

A influência do tempo de diálise e do paratormônio sobre as condições clínico-radiográficas bucais de indivíduos com insuficiência renal crônica em diálise

Universidade Estadual do Rio Grande do Norte

Um olhar sociológico sobre a criança e o brincar: espaço e tempo de construção, reinvenção e aprendizagem

This research I discuss the play, also talking with the other subjects that make up the universe in which the play is inserted, such as family, school and culture. The fundamental proposition of this dissertation assumes that the absence of play in children's lives affect their physical structure, psychological, biological, cultural, social, historical and theirs development. The initial questions were: What are the spacetimes reserved in the school for play? What is the importance of play in the development of children? Does the school recognize the importance of play in its social space? How the children perceive and use the spacetimes to play at school? Are there spacetimes at school to play? This is a theoretical and empirical research of exploratory study. The research‟s field was the Municipal School Professor Ulysses Góes, located in district of Nova Descoberta, in Natal, Rio Grande do Norte and, as research techniques, I used: participant observation, photography, structured interviews with students and questionnaires with teachers. The results indicate that for most of children, the school allows the play, few disagree with this preposition.Teachers recognize the importance of play in school, but for various reasons do not provide your practice. The dissertation points the possibility of new studies and developments for the theme.

Em busca do tempo partido: a consciência histórica e o MST

The work that follows is dedicated to the study of the historic time experience by the political militancy from our time. The political militant from the left-wing is the one that denies the state of current things, recovering a historic experience located far before its time and projecting a future beyond the incessant reproduction of the present relations. We chosen the Landless Workers Movement, not as study object, but as specific place where this consciousness is made and can be comprehended. The historic consciousness study of the landless militancy is, for us, the best starting point to understand the magnification of the historical time operated on the change of social relations lived inside an organization. The time division between before and after, as well as the history being understood as a progress isn t a natural given data, but a construction that obeys the contradictions of the present. It, therefore, must understand how the present lived by the militancy operates changes on the consciousness of time. From documents, reference books, formation notebooks and several materials produced by MST, we try to understand the way that the movement tells his history and lists with this wider experience of the struggle for the change of the current social order. Similarly, when we hear reports of history of several militants, we try to comprehend how this wider narrative re-orients the sight over history himself, over the experience of contradictions on before and after making the landless militant

Testemunhos de um tempo vivido : fragmentos e contextos de uma narrativa de Janduís-RN

Shows up the memory of the elderly, as a consistent experience in the in the construction of the social memory of Janduís, Rio Grande do Norte, where the research takes place. Through an autobiographic narrative, in a qualitative approaching, the intent is to stand up aspects about the individual history and collective memories, starting in a simple question: what did they remember? A question that turns into many others, as how the remember and under which circumstances. So, the lived and remembered moments are the subject of this paper, as these testimonials shows and reveals the citizens typical aspects, intending to telling (again) the city s history by the memories of this people. By oral statements and the analysis that followed, subjective aspects that made a social memory, highlight in violent episodes, that, now remembered, occurred in the historical sediment, which connects several social times, establishing a narrative standard. In Janduís, this standard is about the memory that sticks out their individual ways, and the collective life, in the past, standing out the fair and the events that occurred on it, as the most remembered place, where the memories go stronger. When they narrate are incorporated others facts, the story is reinvented, connecting the past to the future. The paper also revels builders subjects aspects of a social memory, as historical sediment that joins the social times. At the present moment, the fair, to them, is a place that doesn t exist anymore; for the city, is a place of enlargement of women s presence at the trending spaces, which means a place of social transformation. That being said, the fair, in both times, present and past, turns into a analysis object, with important elements to reference narrative s time and place. And how the narrative update the past recorded in the old citizen s memory. What was intended to do was articulate the memory and the history form temporal and special etching that define the place and the narrative context: the lived and the remembered at the group s day by day. In that way, were identify the collective memory s common elements, enunciating the memory and the narratives that update that history, influencing and being influenced, forming in memories in a collective phenomenon fueling the local imaginary