225 resultados para Erro clínico
Resumo:
Este trabalho foi realizado com o objetivo de se investigar o gerenciamento do erro em aulas de inglês como língua estrangeira e suas implicações para o processo de ensino e aprendizagem. em sua primeira etapa, a investigação buscou (a) verificar como os participantes da pesquisa vivenciavam o erro e a correção, (b) descrever as principais características das interlínguas dos aprendizes naquele momento. Na segunda etapa do trabalho, desenvolveu-se uma proposta de intervenção e tratamento dos erros mais recorrentes, por meio da qual se pretendia implementar ações pedagógicas com foco na forma (FonF) que promovessem a negociação de determinados aspectos lingüísticos. Os dados foram coletados por meio de entrevistas, questionários, gravações audiovisuais, observações das aulas, notas de campo transformadas em diários, sessões de visionamento com os aprendizes e de discussão com a professora participante, num processo cíclico e contínuo, a fim de se embasarem as decisões referentes ao processo interventivo. Verificou-se que os movimentos corretivos empregados para promover momentos de negociação da forma se mostraram uma importante ferramenta no tratamento dos erros por ajudarem os aprendizes a perceberem lacunas em suas interlínguas e a se esforçarem para refazer suas produções consideradas imprecisas. Nesse esforço, observou-se a importância do papel do professor ao fornecer os andaimes necessários para que cada aprendiz pudesse se monitorar. Considerou-se, também, a relevância do aspecto complementar entre os dois focos - foco na forma x foco na mensagem para o processo de ensino e aprendizagem de língua estrangeira por instrução.
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Avaliaram-se as alterações clínicas e radiográficas em nove cães adultos, após a transecção do ligamento cruzado cranial (LCCr) seguida da substituição ligamentar por retalho de fáscia lata, associada ou não à incisuroplastia troclear (ITR). O joelho direito (GI) foi submetido à ITR e posterior estabilização articular, e o esquerdo somente à substituição ligamentar (GC). Os animais foram avaliados nos períodos pré-operatório, pós-operatório (po) imediato e aos 30, 90 e 180 dias de po, período coincidente com o momento de eutanásia de subgrupos de três cães. A instabilidade articular e o grau de claudicação diminuíram significativamente durante o período de avaliação, apesar da instabilidade persistir durante a flexão articular. Observou-se decréscimo significativo do perímetro muscular da coxa aos 30 e 90 dias p.o. em ambos os grupos. Não foram evidenciadas alterações nos graus de extensão e flexão articulares, na rotação interna da tíbia, na amplitude de movimento articular ou de doença articular degenerativa (DAD) durante o período de avaliação em ambos os grupos. Conclui-se que a ITR, associada à técnica de estabilização articular, não produz alterações em nenhuma das variáveis estudadas em cães, quando comparada à estabilização intra-articular, isoladamente.
Resumo:
A doença de Chagas causada pelo T. cruzi é transmitida, principalmente, por insetos vetores e está distribuída na Argentina, no Chile, na Venezuela e no Brasil. O cão, além de ser um importante reservatório, também é vítima da doença e a única espécie capaz de desenvolver manifestações clínicas iguais a do homem. O presente trabalho teve como objetivo descrever as alterações clínicas encontradas em quatro cães infectados naturalmente pelo T. cruzi e alertar para a possibilidade de que a ocorrência dessa enfermidade em cães de Mato Grosso do Sul possa estar sendo subestimada. Os animais foram selecionados a partir de exames sorológicos de reação de imunofluorescência indireta (RIFI), ensaio imunossorvente ligado à enzima (ELISA) e immunoblotting com antígeno secretado e excretado da forma tripomastigota do T. cruzi (TESA-blot) e submetidos a xenodiagnóstico, exame físico, radiografia torácica, eletrocardiografia, ecocardiografia e bioquímica sérica. As alterações encontradas foram aumento de ventrículo direito, presença de arritmias do tipo bloqueio átrio ventricular, sinus arrest e bloqueio de ramo direito, além de disfunção sistólica e diastólica. Três animais apresentaram hiperproteinemia e as dosagens das enzimas CK e CK-MB revelaram valores indicativos de uma miocardite ativa. Esses são os primeiros casos descritos de cães com evidências consistentes de infecção natural pelo T. cruzi em Mato Grosso do Sul e ressalta-se o alerta aos médicos veterinários para a importância clínica e o papel dessa espécie como reservatório da doença.
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Acute renal failure (ARF) is a frequent complication in hospitalized patients, and is strongly related to increase of mortality. PURPOSE: To analyze the clinical outcome and the prognostic factors in hospital acquired AFR. METHOD: A prospective study was performed. Data from 200 patients with established ARF admitted during the period of January, 1987 and July, 1990 were collected. RESULTS: The incidence of ARF was 4.9/1000 admissions. Renal ischemia (50%) and nephrotoxic drugs (21%) were the main etiologic factors. The histologic study done in 43 patients showed: acute tubular necrosis (53%), tubular hydrophic degeneration (16%), glomerulopathies (16%) and other lesions (15%). Dialysis therapy was performed in 101 patients and the main indications were: uremia (67%), hypervolemia (22%) and hyperkalemia (9%). The mortality rate was 46.5% and the most important causes of death were: sepsis (38%), respiratory failure (19%) and multiple organs failure (11%). Treatment withdraw was the cause of death in 2 patients. Higher mortality was observed in oliguric patients (62.9%) than non-oliguric (34.5%) (p < 0.05) and in ischemic renal failure (56.7%) when compared to nephrotoxic renal failure (14.7%) (p < 0.05). This difference was maintained when the comparison was done only between dialyzed patients. CONCLUSION: As primary cause of death was not associated to the acute renal failure, we conclude that acute renal failure is an important marker of the gravity of the underlying disease and not the cause of death.
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In order to investigate epidemiological and clinical aspects of beef cattle mortalities caused by botulism, a syndrome popularly known as doença da vaca caída, studies were carried out in 32 naturally affected 4 to 9 year old cows, 27 belonging to the Nellore breed and 5 to crossbred Nellore, all from 27 farms located in municipalities near Botucatu, State of São Paulo. The epidemiological and clinical features were based, respectively, on the farm and herd managements, and on the general physical examination of the cows. Mouse bioassay and complement microfixation tests were performed to detect the presence of botulinum toxins in liver samples. The results showed that the disease occurs in beef cattle of range breeding systems, reared under inadequate mineral nutrition and deficient health management. Pregnant and milking cows represented the group at risk, and the incidence was higher during the rainy season (December to March), with morbidity and mortality rates of 3,2 ± 3,6%. Clinical examination revealed cows with no alterations of vital signs, behavior, visual and auditory acuities and skin sensation; but revealed ruminal hypomotility, anorexia, dehydration, flaccid para or tetraparesis with permanent recumbency, and a paretic or paralytic tongue. The diagnosis of botulism, involving type C and D toxins, was consistent with the epidemiological and clinical findings.
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Single frequency GPS receivers have been many used in GPS surveys. Among the several applications, one can mention those that are to obtain the receiver's antenna coordinates in real time. One of the main error sources to these applications is the ionosphere systematic error. In the FCT/UNESP a regional ionosphere model (Mod_Ion) was developed. It has been implemented to execute after collecting of GPS data. At real time application two improvements in the Mod_Ion were introduced, consisting of an alteration of the function of modeling and implementation of the Kalman Filter. The results of the experiments showed that the modifications were the most effective in the ionosphere systematic effect's corrections, providing a improvement in the accuracy of point positioning, of 90,75%, in period of the highest ionosphere activity.
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PURPOSE: to evaluate the insulin therapy protocol and its maternal and perinatal outcome in patients with clinical or gestational diabetes in a high risk reference service. METHODS: descriptive and prospective study including 103 pregnant women with gestational or clinical diabetes treated with insulin and attended by the reference service from October 2003 to December 2005. Gemellarity, miscarriages, unfinished prenatal care and deliveries not attended by the service were excluded. The gestational age at the beginning of the treatment, dosage, doses/day, increment of insulin (UI/kg), glycemic index (GI) and perinatal outcomes were compared. ANOVA, Fisher's exact test and Goodman's test considering p<0.05 were used. RESULTS: multiparity (92 versus 67.9%), pre-gestational body mass index (BMI) >25 kg/m 2 (88 versus 58.5%), weight gain (WG) <8 kg (36 versus 17%) and a high increment of insulin characterized the gestational diabetes. For the patients with clinical diabetes, despite the highest GI (120 mg/dL (39.2 versus 24%)) at the end of the gestational period, insulin therapy started earlier (47.2 versus 4%), lasted longer (56.6 versus 6%) and higher doses of insulin (92 versus 43 UI/day) were administered up to three times a day (54.7 versus 16%). Macrosomia was higher among newborns from the cohort of patients with gestational diabetes (16 versus 3.8%), being the only significant neonatal outcome. There were no neonatal deaths, except for one fetal death in the cohort of patients with clinical diabetes. There were no differences in the other neonatal complications in both cohorts, and most of the newborns were discharged from hospital up to seven days after delivery (46% versus 55.8%). CONCLUSIONS: the analysis of these two cohorts has shown differences in the insulin therapy protocol in quantity (UI/day), dosage (UI/kg weight) and number of doses/day, higher for the clinical diabetes cohort, and in the increment of insulin, higher for the gestational diabetes cohort. Indirectly, the quality of maternal glycemic control and the satisfactory perinatal outcome have proven that the treatment protocol was adequate and did not depend on the type of diabetes.
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This study correlated the solid preoperative fasting periods with plasma glycemia, serum cortisol, condition clinic and acid-base balance in dogs submitted to inhalation of general anaesthesia. Eight adults, animals were distributed into three groups in accordance with solid preoperative fasting: group 1 (12 hours), group 2 (18 hours) and group 3 (24 hours). Gastric emptying was observed and following this animals were submitted to the same anesthetic procedure. Heart and respiratory rate, rectal temperature, capillary refill time, percent hydration and noninvasive arterial pressure determined before and after Acepromazine and every 10 minutes during anaesthesia, included ETCO 2; values blood gas (pH, PaCO 2, PaO 2, HCO 3, TCO 2, SaO 2, BE), glycemic and serum cortisol were analyzed before MPA and each 30 minutes during anaesthesia. In recovery anaesthetic, glycemia and serum cortisol were repeated. During anaesthesia there were little cardiovascular and respiratory alteration not having interference of the preoperative fasting periods. Animals with 12 hours of the preoperative fasting showed a higher rise in glycemia levels than others groups in recovery anaesthetic. Serum cortisol wasn't influenced by fasting. Solid preoperative fasting independent of the duration describe a discreet respiratory alkalosis. All animals showed good clinical condition in all three groups. Solid preoperative fasting of the 18 hours is recommended to ensure a complete absence of the solid food contents in stomach.
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Aim of present paper is to describe and to assess the Clinicoradiological findings of the temporomandibular joint (TMJ) in a group of patients diagnosed with rheumatoid arthritis (RA). Sample included 61 patients with a mean age of 54 years and 5 months. All of them were interrogated and clinically examined and then underwent to a radiographic examination of both TMJs, using the transcranial projection technique, with the closed mouth and in maximal opening. Study includes the TMJ syndrome founded such as pain, tumefaction, luxation, clicking, and a limited oral opening. The study of radiographic features showed the presence of changes in condyle surface and temporal fossa, in condylar motility, and articulation space. We conclude that in patients presenting with rheumatoid arthritis is frequent the presence of clinicoradiological findings in the TMJ, and that patient's age and gender and the activity level and the RA course time, are factors influencing in TMJs general status.
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Alzheimer's dementia (AD) is a neurodegenerative disorder that causes motor and cognitive decline. The aim of this study was to analyze the influence of a specific physical activity program on the cognitive, depressive symptoms and functional capacity of patients with diagnosis of probable AD. The subject, a 79-year old woman, participated in this program for three months, with 50 min sessions three times a week. The instruments used were the Cambridge Cognitive Examination; the Geriatric Depression Scale; and the Battery of the American Alliance for Health Physical Education, Recreation and Dance. The results in relationship with the depressive symptoms and functional capacity were significantly positive. There were no changes in regards to the patient's cognitive functions. In conclusion, this physical activity program seems to be an important part of the treatment for patients with AD, as it improves the functional capacity and also stimulates cognitive tasks. © 2008 Asociación Española de Fisioterapeutas.
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Aim: This study aimed to evaluate the efficacy of a new topical drug (EF028) in two separate presentations (aerosol and cream) in a comparative way with the already registered medication, Andolba® (benzocaine, benzoxiquina chloride benzeconio, menthol) and the negative control (hygiene), in the analgesic efficacy after episiotomy wound, reducing the requirement for systemic medication. Methods: 60 patients were voluntary post normal vaginal childbirth with episiotomy, were divided into four groups to comparatively assess the action of the product EF028 (cream and aerosol), Andolba® and soap, the efficacy of decreasing painful symptoms from daily use for 2 times a day for seven days. Clinical assessments and subjective pain occurred daily until the third postoperative day and on the 7th postoperative day. Results: The results showed that the drugs promoted a reduction of painful symptoms and there was no statistically significant difference (p <0.05) between presentations of drug EF028 (cream and aerosol) and Andolba® and the three products were significantly higher (p <0.05) to the control. Conclusions: The evaluated drugs EF028 aerosol, EF028 cream and Andolba® had similar efficacy in relieving the painful symptoms of the perineal region in postoperative episiotomy can be considered as indication for postoperative episiotomies. © Copyright Moreira Jr. Editora.
Resumo:
Aim: This study aimed to compare the safety and analgesic efficacy of a new topical drug (in two different presentations: cream and aerosol) consisting of benzocaine, menthol and triclosan, in the curettage of molluscum contagiosum. Method: The study included 296 volunteers in different stages: 256 healthy adult volunteers for the safety evaluation, and 40 volunteers between 2 and 12 years old who presented Molluscum contagiosum, for the evaluation of tolerability and efficacy. Each volunteer represented two experimental units (left and right) where it was applied randomly the tested products (cream or aerosol) 30 minutes before the dermatological curettage, immediately after and twice a day during 7 days. Dermatological evaluations of safety and efficacy were performed immediately after the procedure, 3 and 7 days after the curettage. Results: During safety evaluation, the tested products showed no irritant, sensitizing, phototoxic or photosensitizing potential. Both presentations, cream and aerosol, were considered safe with no statistically significant differences between them. With respect to analgesic efficacy, the results showed that the medication promoted the reduction of painful symptoms and there was no statistically significant difference (p <0.05) between the two presentations. Conclusion: The tested product, in two different presentations, was considered safe and effective in controlling pain symptoms during and after the curettage of molluscum contagiosum. © Copyright Moreira Jr. Editora.
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This paper proposes a solution to improve the performance of the first order Early Error Sensing (EES) Adaptive Time Delay Tanlock Loops (ATDTL) presented in (Al-Zaabi, Al-Qutayri e Al-Araji, 2005), regarding to frequency estimation and tracking time. The EES-ATDTL are phaselocked-loops (PLL) used to hardware implementations, due to their simple structure. Fixed-points theorems are used to determine conditions for rapid convergence of the estimation process and a estimative of the frecuency input is obtained with a Gaussian filter that improves the gain adaptation. The mathematical models are the presented by (Al-Araji, Al-Qutayri e Al-Zaabi, 2006). Simulations have been performed to evaluate the theoretical results.
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Pós-graduação em Bases Gerais da Cirurgia - FMB