Beta-bloqueadores em anestesiologia: aspectos farmacológicos e clínicos

JUSTIFICATIVA E OBJETIVOS: Informações experimentais e clínicas têm sugerido que os b-bloqueadores apresentam efeitos hemodinâmicos importantes e protetores durante o ato anestésico-cirúrgico. O objetivo deste trabalho é revisar as informações farmacológicas e clínicas dos b-bloqueadores para sua utilização adequada na medicina per-operatória. CONTEÚDO: Os b-bloqueadores seletivos inibem preferencialmente os b1-receptores reduzindo a freqüência e inotropismo cardíacos e determinando redução no consumo de oxigênio do miocárdio. Os b-bloqueadores não seletivos inibem também os b2-receptores, aumentando a resistência bronquiolar e vascular periférica. Alguns b-bloqueadores são, também, vasodilatadores. O tratamento prolongado com os b-bloqueadores aumenta a densidade dos b-receptores na membrana celular, o que pode explicar a hiperatividade simpática que pode ocorrer durante a parada do tratamento desses medicamentos. em cirurgia não cardíaca, os efeitos benéficos do b-bloqueadores em pacientes hipertensos ou nos que apresentam doença coronariana têm sido demonstrados, com redução da incidência de isquemia miocárdica no pós-operatório e da mortalidade durante o período de dois anos que se segue à operação. CONCLUSÕES: O tratamento com b-bloqueadores deve ser mantido até o período da manhã da operação, exceto nos pacientes com sinais de intolerância à droga, como hipotensão ou bradicardia importante. Os b-bloqueadores exercem efeito benéfico na recuperação pós-operatória de pacientes com doenças cardiovasculares ou nos que apresentam fatores de risco. Por isso, o emprego desses medicamentos é importante na medicina per-operatória e deve ser ampliado.

Grupos sanguíneos e lúpus eritematoso crônico discoide

FUNDAMENTOS: Lesão discoide é a manifestação cutânea mais comum do lúpus eritematoso, e formas cutâneas crônicas apresentam características imunológicas próprias, direcionadas ao polo Th1. Diversas doenças possuem associação com grupos sanguíneos, o que não foi ainda estudado no lúpus discoide. OBJETIVO: Investigar a associação entre tipos sanguíneos (ABO e Rh) e lúpus eritematoso discoide. MÉTODOS: Estudo prospectivo tipo transversal envolvendo tipagem sanguínea ABO e Rh, inquérito de dados clínicos e dosagem de FAN e C4 de portadores de lúpus discoide sem critérios de doença sistêmica, atendidos em hospital universitário. RESULTADOS: Foram incluídos no estudo 69 pacientes, sendo 71,0% do sexo feminino (p 1:160, em 31,9%; e níveis baixos de C4, em 8,7%. Não houve diferença significativa entre as frequências dos grupos sanguíneos dos pacientes e da população local; entretanto, o grupo A foi associado às formas disseminadas da doença (OR 4,1 e p < 0,05). CONCLUSÕES: Grupos sanguíneos de pacientes com lúpus discoide apresentam frequência semelhante à da população; porém, formas clínicas disseminadas foram mais prevalentes entre portadores do grupo A.

Respiratory pressures and expiratory peak flow rate of patients undergoing coronary artery bypass graft surgery

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Chromosome 22q a frequent site of allele loss in head and neck carcinoma

Background. Loss of heterozygosity (LOH) correlates with inactivated tumor suppressor genes. LOH at chromosome arm 22q has been found in a variety of human neoplasms, suggesting that this region contains a tumor suppressor gene(s) other than NF2 important to tumorigenesis. The aim of this study was to evaluate the presence of LOH on chromosome 22q11.2-13 and determine whether there was a relationship between loss in this genomic region and tumor histologic parameters, anatomic site, and survival in patients with squamous cell carcinoma of the head and neck (HNSCC).Methods. Fifty matched blood and HNSCC tumor samples taken at the time of surgical treatment were evaluated for LOH by use of four microsatellite markers mapping to 22q11.2-q13. Clinical information was available for all patients. The frequency and distribution of LOH was correlated with clinical (age, sex, use of tobacco and alcohol, site of primary tumor, clinical stage, adjuvant therapy and overall survival) and histologic parameters (histopathologic stage, tumor differentiation).Results. LOH at 22q was found in 19 of 50 (38%) informative tumors. The respective incidence of allelic loss for the patients was as follows: 28% at D22S421, 10% at D22S277, 8% at D22S44S, and 4% at D22S280. No statistical differences were apparent with a mean follow-up of 30 months. Laryngeal tumors showed a higher incidence of LOH compared with oral tumors.Conclusions. These results suggest that the D22S277 locus may be closely linked to a tumor suppressor gene (TSG) and involved in upper aerodigestive tract carcinogenesis. In particular, laryngeal tumors may harbor another putative TSG on 22q11.2-q12.3 that may play a role in aggressive stage III/IV disease. (C) 2000 John Wiley & Sons, Inc.

Information for the diagnosis and treatment of root resorption due to tooth replantation.

A favorable prognosis after tooth avulsion depends on some variables, such as the extra-alveolar period and storage medium. Vitality of the periodontal ligament cells is considered a critical factor for a successful outcome without root resorption. The dental surgeon is provided with clinical information and radiographic findings to establish a diagnosis and may rely on current available guidelines. Once trauma has occurred, treatment must be quick and effective, and periodic follow-up must be performed. Clinical, radiographic, and histologic characteristics for each type of root resorption due to tooth replantation are presented, with the aim to provide information for the diagnosis and treatment of healing complications.

Comportamento informacional de cirugiões-dentistas: um estudo junto a ortodontistas da cidade de São Paulo

Pós-graduação em Ciência da Informação - FFC

Intraoperative Cardiac Arrest and Mortality in Trauma Patients. A 14-Yr Survey from a Brazilian Tertiary Teaching Hospital

Background: Little information on the factors influencing intraoperative cardiac arrest and its outcomes in trauma patients is available. This survey evaluated the associated factors and outcomes of intraoperative cardiac arrest in trauma patients in a Brazilian teaching hospital between 1996 and 2009.Methods: Cardiac arrest during anesthesia in trauma patients was identified from an anesthesia database. The data collected included patient demographics, ASA physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All intraoperative cardiac arrests and deaths in trauma patients were reviewed and grouped by associated factors and also analyzed as totally anesthesia-related, partially anesthesia-related, totally surgery-related or totally trauma patient condition-related.Findings: Fifty-one cardiac arrests and 42 deaths occurred during anesthesia in trauma patients. They were associated with male patients (P<0.001) and young adults (18-35 years) (P = 0.04) with ASA physical status IV or V (P<0.001) undergoing gastroenterological or multiclinical surgeries (P<0.001). Motor vehicle crashes and violence were the main causes of trauma (P<0.001). Uncontrolled hemorrhage or head injury were the most significant associated factors of intraoperative cardiac arrest and mortality (P<0.001). All cardiac arrests and deaths reported were totally related to trauma patient condition.Conclusions: Intraoperative cardiac arrest and mortality incidence was highest in male trauma patients at a younger age with poor clinical condition, mainly related to uncontrolled hemorrhage and head injury, resulted from motor vehicle accidents and violence.

O desempenho terminológico dos descritores em Ciência da Informação do Vocabulário Controlado do SIBi/USP nos processos de indexação manual, automática e semi-automática

The terminological performance of the descriptors representing the Information Science domain in the SIBI/USP Controlled Vocabulary was evaluated in manual, automatic and semi-automatic indexing processes. It can be concluded that, in order to have a better performance (i.e., to adequately represent the content of the corpus), current Information Science descriptors of the SIBi/USP Controlled Vocabulary must be extended and put into context by means of terminological definitions so that information needs of users are fulfilled.

Perioperative cardiac arrest: a study of 53718 anaesthetics over 9 yr from a Brazilian teaching hospital

Background. Little information exists regarding factors influencing perioperative cardiac arrests and their outcome. This survey evaluated the incidence, causes and outcome of perioperative cardiac arrests in a Brazilian tertiary general teaching hospital between April 1996 and March 2005.Methods. The incidence of cardiac arrest during anaesthesia was prospectively identified from an anaesthesia database. There were 53 718 anaesthetics during the study period. Data collected included patient characteristics, surgical procedures (elective, urgent or emergency), ASA physical status classification, anaesthesia provider information, type of surgery, surgical areas and outcome. All cardiac arrests were retrospectively reviewed and grouped by cause of arrest and death into one of four groups: totally anaesthesia related, partially anaesthesia related, totally surgery related or totally patient disease or condition related.Results. One hundred and eighty-six cardiac arrests (34.6:10 000) and 118 deaths (21.97:10 000) were found. Major risk factors for cardiac arrest were neonates, children under 1 yr and the elderly (P < 0.05), male patients with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05) and under general anaesthesia (P < 0.05). Patient disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were 18 anaesthesia-related cardiac arrests (3.35:10 000)-10 totally attributed (1.86:10 000) and 8 partially related to anaesthesia (1.49:10 000). There were 6 anaesthesia-related deaths (1.12:10 000)-3 totally attributable and 3 partially related to anaesthesia (0.56:10 000 in both cases). The main causes of anaesthesia-related cardiac arrest were respiratory events (55.5%) and medication-related events (44.5%).Conclusions. Perioperative cardiac arrests were relatively higher in neonates, infants, the elderly and in males with severe underlying disease and under emergency surgery. All anaesthesia-related cardiac arrests were related to airway management and medication administration which is important for prevention strategies.

Knowledge extraction using visualization of hemoglobin parameters to identify thalassemia

The analysis of large amounts of data is better performed by humans when represented in a graphical format. Therefore, a new research area called the Visual Data Mining is being developed endeavoring to use the number crunching power of computers to prepare data for visualization, allied to the ability of humans to interpret data presented graphically.This work presents the results of applying a visual data mining tool, called FastMapDB to detect the behavioral pattern exhibited by a dataset of clinical information about hemoglobinopathies known as thalassemia. FastMapDB is a visual data mining tool that get tabular data stored in a relational database such as dates, numbers and texts, and by considering them as points in a multidimensional space, maps them to a three-dimensional space. The intuitive three-dimensional representation of objects enables a data analyst to see the behavior of the characteristics from abnormal forms of hemoglobin, highlighting the differences when compared to data from a group without alteration.

Temporal trends in incidence of Type 1 diabetes between 1986 and 2006 in Brazil

Background: Scarce information is available about the variation in the incidence of Type 1 diabetes in the Brazilian population in the last decades. Aim: The objective of this study was to assess the long-term trends (1986-2006) in the incidence of Type 1 diabetes in Bauru, São Paulo State, Brazil. Subjects and methods: The annual incidence of Type 1 diabetes (per 100,000 per yr) from 1986 to 2006 was determined in children yr of age, using the capture and recapture method. Results: A total of 176 cases were diagnosed in the study population. The overall incidence was 10.4/100,000 with a range of 2.82/100,000 in 1987 to 18.49/100,000 in 2002 representing a 6.56-fold increase within the same population. The estimated incidence, using the capture and recapture method varied from 2.82/100,000 per yr in 1987 to 27.20/100,000 per yr in 2002, representing a 9.6-fold variation. The global pattern of incidence variation was categorized as high (10-19.99/100,000 per yr), and very high (20/100,000 per yr) in 71.43% of the study-years. Incidence was slightly higher among females, Caucasians, children in the 5-9 yr of age range and belonging to lower socio-economic classes. Most diagnoses were established during the colder months and/or with higher pluviometric indexes. Conclusions: The incidence of Type 1 diabetes in children is increasing in Bauru, São Paulo State, Brazil, and the global pattern of incidence was classified as high or very high, mainly in the last 10 yr. All Brazilian regions should be involved in the study. (J. Endocrinol. Invest. 33: 373-377, 2010) (C)2010, Editrice Kurtis

Impacto das tecnologias de informação e comunicação: cultura digital e mudanças sócio-culturais

The contemporaneous culture presents new con ditions of interaction with the information flows in the knowledge construction. Multidimensional codifications stimulate the brain and impress meaning to concepts initially empty. Culture is redefined as mosaic-culture, composed by a diversity of media and by immersion in the messages' sphere. In emerge nt countries like Brazil that propose to capacitate citizens for action and for interaction, the aims should imply the respect to the cultural specificities and in the real improvement of the citizens welfare. Information Science in this context must seek theorizations and practices that contribute to social improvements, capacitating and a better understanding of the challenges of Social Web. If the PISA examination demonstrates the County's frailness relating to the information, the 2011 Unicef report point to opportunities. The Universities have an essential role in the capacitating and in the creation of professional contingents, developing their own potentialities in the study, research and knowledge production for a better use of the Information and Communication Technologies. The man-machinery interfaces offer new problems to be dealt together with the literacy lags in Brazil: if information needs to be communicated to re-elaborate in knowledge, its representational supports need to be learnt as technological processes. Implementing informational ambiences studies will produce material for analyses, for the understanding and for the cultural practices importation, converting them to the contextualization of the Country's needs.

A competência informacional de graduandos de biblioteconomia da região sudeste: um enfoque nos processos de busca e uso ético da informação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prospecção e monitoramento informacional no contexto da inteligência competitiva em microempresas do ramo óptico da região de Marília - SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Representação das necessidades de informação na organização da informação: uma análise de modelos teóricos de busca

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)