Implantação do Serviço de Avaliação Pré-Anestésica em Hospital Universitário: dificuldades e resultados

JUSTIFICATIVA E OBJETIVOS: A avaliação pré-operatória é a chave principal para um bom preparo pré-operatório e manuseio intra-operatório. Quando realizada em nível ambulatorial permite uma análise melhor, possibilitando investigações adicionais, melhorando a qualidade do preparo e diminuindo os custos hospitalares. O objetivo deste estudo foi analisar a implantação e o desenvolvimento do Serviço de Avaliação Pré-Anestésica (SAPAN) em Hospital Universitário, verificando quais foram as dificuldades e os resultados positivos encontrados. MÉTODO: Foram avaliados os dados relativos aos pacientes atendidos no ambulatório do SAPAN, pelos médicos em especialização com supervisão de um docente, nos primeiros nove meses de instalação. A consulta era feita seguindo uma ficha padronizada. Ao término, os pacientes eram liberados para o procedimento cirúrgico ou encaminhados para consulta com outros especialistas para controle de doenças específicas. Analisou-se o número de pacientes avaliados e o número de procedimentos cirúrgicos eletivos realizados nesse período e as diversas especialidades cirúrgicas, porcentagem de pacientes com intervenção cirúrgica suspensa por necessidade de controle de doenças, e as especialidades clínicas mais solicitadas. RESULTADOS: Realizaram-se 913 consultas ambulatoriais e 5.409 intervenções cirúrgicas eletivas. Várias clínicas não encaminharam seus pacientes para a avaliação. Por necessidade clínica, 11,9% dos pacientes tiveram o procedimento cirúrgico suspenso, e as clínicas envolvidas foram cardiologia (43,08%), pneumologia (25,74%), hematologia (21,65%) e endocrinologia (9,52%). CONCLUSÕES: Embora grande parte dos pacientes não tenha sido encaminhada pelas especialidades cirúrgicas, os dados iniciais do SAPAN permitiram demonstrar os benefícios de um serviço de preparo ambulatorial dos pacientes.

On the relationship between a 2 x 2 matrix and second-order scalar spectral problems for integrable equations

A simple proof is given that a 2 x 2 matrix scheme for an inverse scattering transform method for integrable equations can be converted into the standard form of the second-order scalar spectral problem associated with the same equations. Simple formulae relating these two kinds of representation of integrable equations are established.

A Hodge dual for soldered bundles

In order to account for all possible contractions allowed by the presence of the solder form, a generalized Hodge dual is defined for the case of soldered bundles. Although for curvature the generalized dual coincides with the usual one, for torsion it gives a completely new dual definition. Starting from the standard form of a gauge Lagrangian for the translation group, the generalized Hodge dual yields precisely the Lagrangian of the teleparallel equivalent of general relativity, and consequently also the Einstein-Hilbert Lagrangian of general relativity.

Variação intraoperatória do sódio sérico e complicações neurológicas pós-operatórias em cirurgia cardíaca pediátrica

Pós-graduação em Anestesiologia - FMB

Estudo termoanalítico e caracterização no estado sólido dos anti-hipertensivos: atenolol, besilato de anlodipino e maleato de enalapril

Pós-graduação em Ciência e Tecnologia de Materiais - FC

Association between sleep quality and quality of life in nursing professionals working rotating shifts

Objective: To analyze the association between sleep quality and quality of life of nursing professionals according to their work schedules. Methods: A prospective, cross-sectional, observational study was conducted between January and December 2010, with 264 nursing professionals, drawn from 989 subjects at Botucatu General Hospital and stratified by professional category. The Pittsburg Sleep Quality Index and the WHOQOL-bref were administered to evaluate sleep quality and quality of life, respectively. Self-reported demographic data were collected with a standard form. Continuous variables were reported as means and standard deviations, and categorical variables were expressed as proportions. Associations were evaluated using Spearman's correlation coefficient. The association of night-shift work and gender with sleep disturbance was evaluated by logistic regression analysis using a model adjusted for age and considering sleep disturbance the dependent variable. The level of significance was p < 0.05. Results: Night-shift work was associated with severe worsening of at least one component of sleep quality in the model adjusted for age (OR = 1.91; 95% CI 1.04; 3.50; p = 0.036). Female gender was associated with sleep disturbance (OR = 3.40; 95% CI 1.37; 8.40; p = 0.008). Quality of life and quality of sleep were closely correlated (R = -0.56; p < 0.001). Conclusions: Characteristics of the nursing profession affect sleep quality and quality of life, and these two variables are associated.

The International Physical Activity Questionnaire-long form overestimates self-reported physical activity of Brazilian adults

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Crystallization, preliminary X-ray analysis and molecular-replacement solution of the carboxy form of haemoglobin I from the fish Brycon cephalus

Haemoglobin, the 'honorary enzyme' [Brunori (1999), Trends Biochem. Sci. 24, 158-161], constitutes a prime prototype for allosteric models. Here, the crystallization and preliminary X-ray analysis of haemoglobin I from the South American fish Brycon cephalus are reported. X-ray diffraction data have been collected to 2.5 Angstrom resolution using synchrotron radiation (LNLS). Crystals were determined to belong to the space group P6(1)22 and preliminary structural analysis revealed the presence of one dimer (alpha beta) in the asymmetric unit. The structure was determined using standard molecular-replacement techniques.

Optimal contract pricing of distributed generation under a competitive framework

A bilevel programming approach for the optimal contract pricing of distributed generation (DG) in distribution networks is presented. The outer optimization problem corresponds to the owner of the DG who must decide the contract price that would maximize his profits. The inner optimization problem corresponds to the distribution company (DisCo), which procures the minimization of the payments incurred in attending the expected demand while satisfying network constraints. The meet the expected demand the DisCo can purchase energy either form the transmission network through the substations or form the DG units within its network. The inner optimization problem is substituted by its Karush- Kuhn-Tucker optimality conditions, turning the bilevel programming problem into an equivalent single-level nonlinear programming problem which is solved using commercially available software. © 2010 IEEE.

Internal standard for amorphous pharmaceuticals products quantification and an application of Parametric Rietveld refinement using time, temperature and relative humidity as 'non-crystallographic' parameters

Pós-graduação em Química - IQ