Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation

Background:Primary graft dysfunction is the main cause of early mortality after heart transplantation. Mechanical circulatory support has been used to treat this syndrome.Objective:Describe the experience with extracorporeal membrane oxygenation to treat post-transplant primary cardiac graft dysfunction.Methods:Between January 2007 and December 2013, a total of 71 orthotopic heart transplantations were performed in patients with advanced heart failure. Eleven (15.5%) of these patients who presented primary graft dysfunction constituted the population of this study. Primary graft dysfunction manifested in our population as failure to wean from cardiopulmonary bypass in six (54.5%) patients, severe hemodynamic instability in the immediate postoperative period with severe cardiac dysfunction in three (27.3%), and cardiac arrest (18.2%). The average ischemia time was 151 ± 82 minutes. Once the diagnosis of primary graft dysfunction was established, we installed a mechanical circulatory support to stabilize the severe hemodynamic condition of the patients and followed their progression longitudinally.Results:The average duration of extracorporeal membrane oxygenation support was 76 ± 47.4 hours (range 32 to 144 hours). Weaning with cardiac recovery was successful in nine (81.8%) patients. However, two patients who presented cardiac recovery did not survive to hospital discharge.Conclusion:Mechanical circulatory support with central extracorporeal membrane oxygenation promoted cardiac recovery within a few days in most patients.

Formação das castas no gênero Melípona (Illiger, 1806)

The present work is destinated to prove that the castes : workers and queens, in Melipona bees are due to genetic factors and not to differences in food. 2) Material used: Hives of Melipona quadri-fasciata anthidioides (Lep. 1836), M. schenki schenki (Gribodo, 1893), M. fasciata rufiventris (Lep. 1836), M. quadri-fasciata vicina (Lep. 1836), M. marginata marginata (Lep. 1836), Apis mellifera (L. 1758). 3) It should be pointed out that in Melipona bees there are no royal cells for the queens, but all the cells are of the same size independently of being destinated for workers, queens or drones. The numerous queens which are born are killed soon after emerging from their cells. 4) Changes of feeding in quality and in quantity caused no variation of castes. The only variable factor is the size, which becomes bigger when the bee is well nourished. 5) The offsprings of 5 hives were examined : 3 of M. quadri-fasciata anthidioides (n.o 1, n.o 2 and n.o 3), 1 of M. quadri-fasciata vicina (n.o 4) and 1 of M. marginata marginata (n.o 5). Combs of about 40 cells were taken into laboratory and the type of bee registered immediately after emerging. The results of the counts were: BOX COMB WORKER QUEEN PERCENTAGE Σ X2 to 12,5% Nº 1 1th 69 8 10,4% 0, 3139 " 1 2nd 144 18 11,1% 0, 2856 " 2 1th 52 8 13,3% 0, 0384 " 3 1th 45 10 18,2% 1, 6736 " 4 1th 56 4 6,7% 1, 8686 " 4 2nd 29 4 12,1% 0,00432 Σ X2 to 25% " 5 1th 34 14 29,2% 0,44444 "5 2nd 83 27 24,5% 0, 0121 In the 4 first boxes there is a percentage of 11,63% queens and in the last there is a percentage of 25,95%. 6) These percentages are very near two genetical ratios: 12,5% or 7:1, and 25% or 3:1, which correspond to a trifactorial and a bifactorial back-cross. Carrying out a X² test no significant deviations were found ( X² to 12,5% and to 25% and table 1 to 4). 7) We suppose that the formula for the queen in the first case (11,65%) is: AaBbCc. Since the Melipona bees are arrhenotokous hymenopteres, the drones are haploid and may have any one of the following eight formulas, corresponding to the gonic segregation of the queem : ABC, ABc, Abc, Abc, AbC, aBC, aBc, abC, abc. Anyone combination of these males with the queen will give a segregation of 7 workers to 1 queen, since there is always only one triple heterozygote among the eight possible segregates (table 5). 8) In order to explain the second case, it is suffient to assume that in this species there are only two pairs of factors, the queen being the double heterozygote : AaBb, while the drones may have any one of the following constitutions: AB, Ab, aB and ab. Workers are again all diploids which are homozygous for one or both factors, for instance: AABB, AABb, AaBB, aaBb, AAbb, etc. (table 6). 9) It is suggested that the genus Melipona is an intermediary type between the solitary bees, where all females are fertile independently of their feeding, and the genera Apis and Trigona, where without special feeding all females are born sterile, while only specially fed females develop into fertile queens. 10) No speculations are put forward with regards to the evolutionary mechanism which may have been responsible for the development of the genetical determination of castes in Melipona, since it seems advisable point to extend the studies to other insects with complicated caste systems.

Fatôres que afetam a determinação da vitamina C na goiaba (Psidium guajava L.)

In the present paper the authors deal with the content of ascorbic acid in guavas (Psidium guajava L.) and the methods of sampling used. Ascorbic acid was determined directly in the photoeletric colorimeter (EEL), after extraction with a 4 per cent solution of oxalic acid. Guavas from various parts of State of S.Paulo were used and the general mean found was around 100 mgm of ascorbic acid per 100 gm fresh weight of the material used for extraction. It was found that there is great variation in the ascorbic acid content according to the condition of the fruit: Ascorbic acid Condition content in Mean mgm/100 gm Green and hard 93,36 - 119,54 102,43 Small green 57,34 - 92,30 83,40 Firm ripe 71,28 - 115,98 90,32 Overripe 63,22 - 85,98 77,36 Of the diferent parts of the fruit, the skin has the highest content; the pulp between the skin and the parts containing the seeds, the "inner pulp" contains little and finallw the central parts, formed by the pulp between seeds, the "inter pulp" a engligible amount. The proportion of ascorbic acid found in the skin, inner pulp and inter pulp may be as high as 1.6: 1: 0. Furthermore, the section near the peduncule and the sepals are richer than equatorial crossections. It was proved that the amount and intensity of sun-light is at least one important factant factor determining differences in the ascorbic acid content of the fruit, which is higer in the parts which have received more light. A sharp decrease was found in the vitamin C content of ripe fruite stored in a home refrigerator. The periods of the preservation were 12-24-48-96 hours and the decrease of the ascorbic acid content m per cent was 23.4 - 42.0 - 66.8 - 76.4 of the initial content of 144.28 mgm/100 gm. The following five different methods of sampling in the determination of the amount of vitamin C were tested, with extraction in a Waring blendor: 1) whole fruit; 2,) sample taken form fruits cut into many small pieces; 3) half of a fruit divided by a crossection at equal distance from both ends; 4) half of fruit divided lenghtwise; 5) a transversal slice of about 1 cm. It was found that the two first methods geve the most reliable results.

Estudo comparativo entre métodos de contrôle quantitativo da produção leiteira

This paper deals with the estimation of milk production by means of weekly, biweekly, bimonthly observations and also by method known as 6-5-8, where one observation is taken at the 6th week of lactation, another at 5th month and a third one at the 8th month. The data studied were obtained from 72 lactations of the Holstein Friesian breed of the "Escola Superior de Agricultura "Luiz de Queiroz" (Piracicaba), S. Paulo, Brazil), being 6 calvings on each month of year and also 12 first calvings, 12 second calvings, and so on, up to the sixth. The authors criticize the use of "maximum error" to be found in papers dealing with this subject, and also the use of mean deviation. The former is completely supersed and unadvisable and latter, although equivalent, to a certain extent, to the usual standard deviation, has only 87,6% of its efficiency, according to KENDALL (9, pp. 130-131, 10, pp. 6-7). The data obtained were compared with the actual production, obtained by daily control and the deviations observed were studied. Their means and standard deviations are given on the table IV. Inspite of BOX's recent results (11) showing that with equal numbers in all classes a certain inequality of varinces is not important, the autors separated the methods, before carrying out the analysis of variance, thus avoiding to put together methods with too different standard deviations. We compared the three first methods, to begin with (Table VI). Then we carried out the analysis with the four first methods. (Table VII). Finally we compared the two last methods. (Table VIII). These analysis of variance compare the arithmetic means of the deviations by the methods studied, and this is equivalent to compare their biases. So we conclude tht season of calving and order of calving do not effect the biases, and the methods themselves do not differ from this view point, with the exception of method 6-5-8. Another method of attack, maybe preferrable, would be to compare the estimates of the biases with their expected mean under the null hypothesis (zero) by the t-test. We have: 1) Weekley control: t = x - 0/c(x) = 8,59 - 0/ = 1,56 2) Biweekly control: t = 11,20 - 0/6,21= 1,80 3) Monthly control: t = 7,17 - 0/9,48 = 0,76 4) Bimonthly control: t = - 4,66 - 0/17,56 = -0,26 5) Method 6-5-8 t = 144,89 - 0/22,41 = 6,46*** We denote above by three asterisks, significance the 0,1% level of probability. In this way we should conclude that the weekly, biweekly, monthly and bimonthly methods of control may be assumed to be unbiased. The 6-5-8 method is proved to be positively biased, and here the bias equals 5,9% of the mean milk production. The precision of the methods studied may be judged by their standard deviations, or by intervals covering, with a certain probability (95% for example), the deviation x corresponding to an estimate obtained by cne of the methods studied. Since the difference x - x, where x is the mean of the 72 deviations obtained for each method, has a t distribution with mean zero and estimate of standard deviation. s(x - x) = √1+ 1/72 . s = 1.007. s , and the limit of t for the 5% probability, level with 71 degrees of freedom is 1.99, then the interval to be considered is given by x ± 1.99 x 1.007 s = x ± 2.00. s The intervals thus calculated are given on the table IX.

Formas de ocorrência do fósforo no solo latosólico roxo

O presente trabalho apresenta os resultados obtidos sôbre um estudo de fracionamento do fósforo em oito amostras constituidas do horizonte Ap de solo latosólico roxo do Estado de São Paulo e do Paraná. Nessas amostras procederam-se as determinações do fósforo solúvel em água e fração fracamente ligada aos colóides, extraídos com solução de cloreto de amônio 0,5 N; fósforo ligado ao alumínio, extraido com solução 0,5 N de fluoreto de amônio com pH = 8,5; fósforo ligado ao ferro, extraído com solução 0,1 N de NaOH; fósforo ligado ao cálcio, extraido com solução 0,5 N de ácido sulfúrico; fósforo ocluido nas formas de fosfatos de ferro e de alumínio. Além disso foram determinados o fósforo orgânico e o fósforo total. Os dados obtidos evidenciaram que os solos estudados apresentaram uma quantidade razoável, 45,3 a 162,5 ppra, de fósforo ligado ao cálcio, o que é explicável tendo em vista o teor de cálcio trocável nas amostras, que variou de 7,71 a 19,40 e.mg por 100 g de solo, e o pH que variou de 6,30 a 7,50. 0 teor de fósforo ligado ao alumínio variou de 35,0 a 265,7 ppm de P; o de fósforo ligado ao ferro, de 74,2 a 144,9 ppm de P; e o de fósforo ocluido de 470,8 a 850,8 ppm de P. O teor de fósforo orgânico e o total variaram, respectivamente, de 347,2 a 511,0 e de 741,0 a 1493,0 ppm de P.

Fontes e doses de adubos fosfatados na cultura da soja, em solo de cerrado

O presente trabalho foi realizado em um LE da Fazenda Experimental da UNESP-Campus de Ilha Solteira, município de Selvíria, MS. No 1° cultivo os tratamentos foram três fontes fosfatadas (superfosfato triplo, termofosfato Mg e fosfato de Araxá) e quatro níveis (145-290-435-58O kg/ha de P2O5 total) aplicados a lanço seguido de incorporação ao solo. Houve um tratamento que não recebeu P. No 2° cultivo estudou-se o efeito residual dos adubos do 1° cultivo e de mais cinco níveis de fósforo (superfosfato triplo) em manutenção (0-36-72-108 - 144 kg/ha de P2O5), no sulco de plantio. A planta teste utilizada foi a soja 'UFV-1'. Foi observado uma resposta significativa da cultura à adubação fosfatada. Otermofosfato Mg apresentou comportamento semelhante ao superfosfato triplo no 1° cultivo, e foi superior a ele quanto aos efeitos residuais. Ofosfato de Araxá, comparado ao superfosfato triplo, apresentou eficiência superior a 80% com ou sem adubação de manutenção, possuindo, portanto, condições de ser empregado na adubação corretiva em solos de baixa fertilidade.

Relative growth and morphological sexual maturity of Chasmagnathus granulatus (Crustacea, Varunidae) from a mangrove area in southeastern Brazilian coast

The relative growth and morphological sexual maturity of Chasmagnathus granulatus Dana, 1851 are presented for the first time to a mangrove population. The crabs were obtained during low tide periods, in the mangrove of Jabaquara Beach, Paraty, Rio de Janeiro, Brazil. All crabs in intermolt stage were sexed and had their body parts measured as follows: body height (BH), carapace length (CL) and width (CW), major cheliped propodus height (PH) and length (PL) for each sex, gonopod length (GL) and abdomen width (AW) for males and females, respectively. The relative growth was described using the allometric equation y=ax b and the size at onset sexual maturity was achieved using the software Mature I. The size of specimens ranged from 4.1 mm to 39.5 mm CW. The growth pattern was different between sexes in the cheliped relationships; the relationships BH vs. CW evidenced positive allometry for juveniles; PL vs. CW and PH vs. CW positive allometry for most crabs except juvenile females; AW vs. CW and GL vs. CW evidenced positive allometry for juveniles and isometry for adults. The relationships that best indicated the change from the juvenile to the adult phase were PH vs. CW for males and AW vs. CW for females. The size in which 50% of males from this population are mature is at 19.7 mm of CW (F=144.14; p<0.05) and for females it is at 19.2 mm of CW (F=166.54; p<0.05). The sizes obtained in this mangrove population are larger than those from previous studies, that could be attributed to a species plasticity concerning the habitat structure.

Febre maculosa das Montanhas Rochosas: ensaios negativos de transmissão experimental do virus por Triatomideos

1. - As seguintes especies de Triatomideos não puderam transmitir pela picada o virus da febre maculosa das Montanhas Rochosas a cobayas normaes, nos seguintes prazos após a sucção de animal infectado: Eutriatoma uhleri, 33, 47, 75 e 141 dias (1 exemplar); Triatoma protracta, 15 e 37 dias (1 exemplar), Triatoma infestans, 8 dias (15 exemplares), e Rhodnius prolixus, 2 dias (1 exemplar). Foi demonstrado por inoculaçao que o ultimo insecto ainda continha o virus vivo. 2. - Experiencias de transmissão mechanica, por picada interrompida em animal infectado e continuada immediatamente em animal são, foram tambem negativas, com as especies T. protracta e R. prolixus. Um unico insecto da primeira especie picou 2 vezes cada animal, emquanto que 22 exemplares da segunda especie picaram de 1 a 3 vezes cada cobaya. 3. - A inoculação de gottas de dejecções de um R. prolixus eliminadas 2 dias depois de sugar animal infectado, não produziu a infecção em cobaya normal, não obstante ter sido demonstrada a presença do virus no organismo do barbeiro, por inoculação do conteúdo estomacal em outra cobaya. 4. - Foram feitas experiencias para determinar o tempo de sobrevivencia do virus nos barbeiros, inoculando-se conteúdo intestinal a diversos intervallos depois da sucção de cobayas infectadas, com os seguintes resultados: T. infestans: positivo 1 vez em 24 horas e 2 vezes em 48 horas; negativo 2 vezes em 72. 96, 120 e 192 horas. P. megistus: positivo 3 vezes em 24 horas, 2 vezes em 48 horas e 1 vez em 72 horas; negativo 1 vez em 72 e 96 horas; resultado duvidoso ou sem valor (infecção intercorrente) 1 vez em 48 horas e 2 vezes a 72, 96 e 144 horas cada um. R. prolixus: positivo 1 vez em 24, 48 e 72 horas e negativo em 96 horas. 5. - Em vista dos resultados destas experiencias, feitas com 5 especies pertecentes a 4 generos de Triatomideos, torna-se muito pouco provavel que estes Hemipteros possam transmitir pela picada o virus da febre maculosa das Montanhas Rochosas, ou retel-o em seu organismo, em estado virulento, por mais de 2 a 4 dias.

Prolongada persistência do vírus da gripe em hamsters inoculados por vias parenterais e nasal

As experiências relatadas no presente trabalho visaram observar a persistência do vírus da gripe em hamsters inoculados pelas vias subcutânea, peritoneal e nasal. Usaram-se 53 hamsters na verificação da persistência do vírus nos seus organismos a qual atingiu até um ano e cinco meses, pelo menos, numa das séries de experiências. A outra parte do trabalho consistiu em verificar a passagem do vírus, em série, de hamster a hamster. Observamo-la até o máximo de nove vezes, o que foi excepcional, notando-se passagens, na série, com resultados negativos intercalados. Para esta última parte forma usados 91 hamsters, perfazendo o total de 144 em todas as experiências realizadas.

Prevention of transfusional Trypanosoma cruzi infection in Latin America

Trypanosoma cruzi is a protozoan infection widely spread in Latin America, from Mexico in the north to Argentina and Chile in the south. The second most important way of acquiring the infection is by blood transfusion. Even if most countries of Latin America have law/decree/norms, that make mandatory the screening of blood donors for infectious diseases, including T. cruzi (El Salvador and Nicaragua do not have laws on the subject), there is usually no enforcement or it is very lax. Analysis of published serologic surveys of T. cruzi antibodies in blood donors done in 1993, indicating the number of donors and screening coverage for T. cruzi in ten countries of Central and South America indicated that the probability of receiving a potentially infected transfusion unit in each country varied from 1,096 per 10,000 transfusions in Bolivia, the highest, to 13.02 or 13.86 per 10,000 transfusions in Honduras and Venezuela respectively, where screening coverage was 100%. On the other hand the probability of transmitting a T. cruzi infected unit was 219/10,000 in Bolivia, 24/10,000 in Colombia, 17/10,000 in El Salvador, and around 2-12/10,000 for the seven other countries. Infectivity risks defined as the likelihood of being infected when receiving an infected transfusion unit were assumed to be 20% for T. cruzi. Based on this, estimates of the absolute number of infections induced by transfusion indicated that they were 832, 236, and 875 in Bolivia, Chile and Colombia respectively. In all the other countries varied from seven in Honduras to 85 in El Salvador. Since 1993, the situation has improved. At that time only Honduras and Venezuela screened 100% of donors, while seven countries, Argentina, Colombia, El Salvador, Honduras, Paraguay, Uruguay and Venezuela, did the same in 1996. In Central America, without information from Guatemala, the screening of donors for T. cruzi prevented the transfusion of 1,481 infected units and the potential infection of 300 individuals in 1996. In the same year, in seven countries of South America, the screening prevented the transfusion of 36,017 infected units and 7, 201 potential cases of transfusional infection.

Subclinical form of the American visceral leishmaniasis

The subclinical form of visceral leishmaniasis (VL) shows nonspecific clinical manifestations, with difficulties being frequently met in its clinical characterization and diagnostic confirmation. Thus, the objective of the present study was to define the clinical-laboratory profile of this clinical form. A cohort study was conducted in the state of Maranhão, Brazil, from January/1998 to December/2000, with monthly follow-up of 784 children aged 0-5 years. Based on the clinical-laboratory parameters reported in the literature, four categories were established, with the children being classified (according to their clinical-evolutive behavior) as asymptomatic (N = 144), as having the subclinical form (N = 33) or the acute form (N = 12) or as subjects "without VL" (N = 595). Multiple discriminant analysis demonstrated that the combination of fever, hepatomegaly, hyperglobulinemia, and increased blood sedimentation rate (BSR) can predict the subclinical form of VL as long as it is not associated with splenomegaly or leukopenia. Subjects with the subclinical form did not show prolonged or intermittent evolution or progression to the acute form of VL. Subclinical cases have a profile differing from the remaining clinical forms of VL, being best characterized by the combination of fever, hepatomegaly, hyperglobulinemia, and increased BSR.

Dispersal and survival of Nyssomyia intermedia and Nyssomyia neivai (Diptera: Psychodidae: Phlebotominae) in a cutaneous leishmaniasis endemic area of the speleological province of the Ribeira Valley, state of São Paulo, Brazil

The dispersal and survival of the phlebotomines Nyssomyia intermedia and Nyssomyia neivai (both implicated as vectors of the cutaneous leishmaniasis agent) in an endemic area was investigated using a capture-mark-release technique in five experiments from August-December 2003 in municipality of Iporanga, state of São Paulo, Brazil. A total of 1,749 males and 1,262 females of Ny. intermedia and 915 males and 411 females of Ny. neivai were marked and released during the five experiments. Recapture attempts were made using automatic light traps, aspiration in natural resting places and domestic animal shelters and Shannon traps. A total of 153 specimens (3.48%) were recaptured: 2.59% (78/3,011) for Ny. intermedia and 5.35% (71/1,326) for Ny. neivai. Both species were recaptured up to 144 h post-release, with the larger part of them recaptured within 48 h. The median dispersion distances for Ny. intermedia and Ny. neivai, respectively, were 109 m and 100 m. The greatest dispersal range of Ny. intermedia was 180 m, while for Ny. neivai one female was recaptured in a pasture at 250 m and another in a pigsty at 520 m, showing a tendency to disperse to more open areas. The daily survival rates calculated based on regressions of the numbers of marked insects recaptured on the six successive days after release were 0.746 for males and 0.575 for females of Ny. intermedia and 0.649 for both sexes of Ny. neivai. The size of the populations in the five months ranged from 8,332-725,085 for Ny. intermedia males, 2,193-104,490 for Ny. intermedia females, 1,687-350,122 for Ny. neivai males and 254-49,705 for Ny. neivai females.

Histopathological examination of nerve samples from pure neural leprosy patients: obtaining maximum information to improve diagnostic efficiency

Nerve biopsy examination is an important auxiliary procedure for diagnosing pure neural leprosy (PNL). When acid-fast bacilli (AFB) are not detected in the nerve sample, the value of other nonspecific histological alterations should be considered along with pertinent clinical, electroneuromyographical and laboratory data (the detection of Mycobacterium leprae DNA with polymerase chain reaction and the detection of serum anti-phenolic glycolipid 1 antibodies) to support a possible or probable PNL diagnosis. Three hundred forty nerve samples [144 from PNL patients and 196 from patients with non-leprosy peripheral neuropathies (NLN)] were examined. Both AFB-negative and AFB-positive PNL samples had more frequent histopathological alterations (epithelioid granulomas, mononuclear infiltrates, fibrosis, perineurial and subperineurial oedema and decreased numbers of myelinated fibres) than the NLN group. Multivariate analysis revealed that independently, mononuclear infiltrate and perineurial fibrosis were more common in the PNL group and were able to correctly classify AFB-negative PNL samples. These results indicate that even in the absence of AFB, these histopathological nerve alterations may justify a PNL diagnosis when observed in conjunction with pertinent clinical, epidemiological and laboratory data.

Atenuantes do efeito do compartilhamento da informação na decisão grupal: foco na familiaridade e na discordância entre os decisores

Neste trabalho, objetiva-se identificar o efeito da familiaridade entre os membros de um grupo e a discordância deles na tomada de decisão sob condição de compartilhamento irregular da informação. Como metodologia de investigação, realizou-se um quase-experimento em laboratório. A tarefa decisória passou por processo de tradução reversa, adaptação cultural e duas validações. Para a aplicação do experimento, foi desenvolvido um sistema de coleta de dados específico. Além disso, as discussões dos grupos foram acompanhadas por observadores previamente treinados e gravadas para posterior análise. Participaram do experimento 144 colegas de faculdade, divididos em grupos de três pessoas. Dentre os resultados, identificou-se que a familiaridade existente entre os participantes contribuiu para que tomassem melhores decisões, sob condições de compartilhamento irregular da informação. Também, a partir de uma análise quantitativa e qualitativa das discussões dos grupos, percebeu-se que havia uma troca substancial das informações, bem como a discordância entre os membros acerca das alternativas, o que fez com que o grupo obtivesse melhor qualidade na decisão. De modo geral, percebe-se que o compartilhamento irregular da informação não afeta a qualidade da decisão do grupo, desde que haja a troca intensiva de informações por parte dos integrantes.

Diagnósticos de enfermagem documentados para pacientes de clínica médica

Este artigo relata estudo descritivo, de análise de registros, dos diagnósticos de enfermagem documentados após três meses da implementação da classificação da NANDA-I no HU-USP e propõe resultados e intervenções para os três diagnósticos mais freqüentes. A amostra de conveniência, de 34% das internações no mês, constituiu-se de 30 prontuários de pacientes internados na Clínica Médica em agosto de 2004 (60% mulheres; idade média 60,9±23,1 anos; média de internação=5,8±2,7 dias). Os diagnósticos documentados nos prontuários, no primeiro dia de internação, foram manualmente transcritos e analisados segundo freqüências. Foram documentados 144 diagnósticos (31 categorias diagnósticas); com média de 4,8(± 4,0) diagnósticos por paciente (variação = 1 a 10) e os mais freqüentes foram: Dor aguda (66,7%), Integridade tissular prejudicada (63,3%), Desobstrução ineficaz de vias aéreas (43,3%), Risco para integridade da pele prejudicada (36,7%) e Integridade da pele prejudicada (33,3%). São apresentadas propostas de resultados e intervenções para os três mais freqüentes.