937 resultados para non-pharmacological intervention


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Caloric restriction is the most effective non-genetic intervention to enhance lifespan known to date. A major research interest has been the development of therapeutic strategies capable of promoting the beneficial results of this dietary regimen. In this sense, we propose that compounds that decrease the efficiency of energy conversion, such as mitochondrial uncouplers, can be caloric restriction mimetics. Treatment of mice with low doses of the protonophore 2,4-dinitrophenol promotes enhanced tissue respiratory rates, improved serological glucose, triglyceride and insulin levels, decrease of reactive oxygen species levels and tissue DNA and protein oxidation, as well as reduced body weight. Importantly, 2,4-dinitrophenol-treated animals also presented enhanced longevity. Our results demonstrate that mild mitochondrial uncoupling is a highly effective in vivo antioxidant strategy, and describe the first therapeutic intervention capable of effectively reproducing the physiological, metabolic and lifespan effects of caloric restriction in healthy mammals.

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Syftet var att beskriva vilka icke farmakologiska omvårdnadsåtgärder en sjuksköterska kan användaför att lindra agitation hos äldre personer med demens. Metod Designen som har använts, är enlitteraturöversikt. Artiklar söktes via Cinahl och PubMed, med sökorden dementia, nonpharmacological,nursing och agitation. Sammanställning av sökord, antal träffar, urval,inklusionskriterier och exklusionskriterier återgavs genom text och tabeller. Till resultatsdelenvaldes 11 artiklar ut efter att granskats med granskningsmallar för kvalitetsbedömning. Bådekvantitativa och kvalitativa artiklar valdes ut i resultatet.Resultatet visade att de icke farmakologiska omvårdnadsåtgärderna, har en positiv verkan påpersoner med demens agitation. Litteraturöversiktns slutsats är att speciellt musik och beröringfungerar bra som icke farmakologisk omvårdnadsåtgärd. Den positiva effekten är dock kortvarig.Slutsats Det behövs lite nytänkande kring de icke farmakologiska omvårdnadsåtgärderna.Metoderna är bra. Det som behövs, är att komma på hur man får en långvarig effekt av dessa.

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Objective: To determine the clinical maternal and neonatal outcomes in HELLP syndrome patients treated with dexamethasone who either developed renal injury or renal insufficiency and to identify predictive values of urea and creatinine for the identification of subjects with HELLP syndrome at risk of developing renal insufficiency. Methods: Non-radomized intervention study of dexamethasone use in HELLP syndrome. A total of 62 patients were enrolled at Maternidade Escola Januário Cicco (MEJC). Patients received a total of 30 mg of dexamethasone IV, in three doses of 10 mg every 12 hours. A clinical and laboratory follow up were performed at 24, 48 and 72 hours. Patients were followed up to 6 months after delivery. Patients were grouped in accordance to renal function, i.e, normal and some type of renal lesion. Renal lesion was considered when creatinine was equal or greater than 1.3 mg/dl and diuresis less than 100 ml in 4 hours period and renal insufficiency was defined when dialysis was needed. Results: A total of 1230 patients with preeclampsia were admitted at MEJC. Of those 62 (5%) developed HELLP syndrome. There was no statistical difference in the groups with renal involvement or normal renal function with respect to the demographics, type of anesthesia used and delivery, and weight of the newborn. An improvement in the AST, ALT, LDH, haptoglobine, antithrombine, fibrinogenen and platelets was observed within 72 hours after dexamethosone use. There was a significant increase in the diuresis within the interval of 6 hours before the delivery and 24 hours after it. Of the 62 patients, 46 (74. 2%) had normal renal function and 16 (25.8%) evolved with renal lesion, with 5 (8.1%) needing dialysis. These 5 patients who received dialysis recovered the xi renal function. The delay in administering dexamethasone increased in 4.6% the risk of development of renal insufficiency. Patients with renal insufficiency had received significantly more blood products than subjects without renal lesion (p=0.03). Diuresis, leukocytes, uric acid, urea, creatinine were significantly different between the groups with normal renal function, renal lesion and renal insufficiency. The levels of creatinine 1.2mg/dl and uric acid 51mg/dl, at admission are predictive of subjects who will evolve with renal lesion (p<0.001). Maternal mortality was 3.2%. None of the subjects with renal insufficiency evolved with chronic renal disease. Conclusions: Dexamethasone in patients with HELLP syndrome seems to reduce significantly the hepatic microthrombosis and normalize hemostasis as seen by improvement of liver function. Renal injury can be considered, in HELLP syndrome, when creatinine levels are greater than 1.3 mg/dl and diuresis less than 100 ml/h in interval of 4 hours. The level of creatinine greater than 1.2 mg/dl and urea greater than 51mg/dl are predictive of subjects with HELLP syndrome who will develop renal injury. Patients who receive more red cell packs develop renal insufficiency. Finally, the delay in administering dexamethasone increases the risk of developing renal insufficiency

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The Liberal Constitutionalism emerged from the late eighteenth century, a period of major revolutions (French and American), fruit of the struggle for libertarian rights. Although the time of the first written constitutions, these were linked to mere political letters, did not provide for fundamental human rights, as it is, so only on the state organization, structure of powers, division of powers of the state and some relations between state and individuals. There was a clear division between the civil codes and constitutions, those governing private relations and acted as barriers to non-state intervention. After the Second World War, the constitutions are no longer Letters political order to establish how the human person, in order to enshrine the fundamental rights, the primacy of constitutional principles and take their normative function against ordinary legislator. Constitutional evolution gave the name of contemporary constitutionalism, based on repersonalization or despatrimonialização of Private Law, ceasing the separation of legislative civil codes and constitutions, in favor of the protection of fundamental rights of the human person. And this tendency to the Brazilian Federal Constitution of 1988 brought higher ground the dignity of the human person, the epicenter axiological legal to govern private relations, including family law. The constitutionalization of family law motivates the adoption of desjudicialização family issues, so as to respect the direio intimacy, privacy, private autonomy and access to justice. Conflictual family relationships require special treatment, given the diversity and dynamism of their new compositions. The break in the family relationship is guided in varied feelings among its members in order to hinder an end harmonic. Thus, the judiciary, through performances impositive, not to honor the power of decision of the parties, as also on the structural problems faced to operate on these cases, the environment is not the most appropriate to offer answers to the end of family quarrels. Situation that causes future demands on the dissatisfaction of the parties with the result. Before the development of the Family Law comes the need to adopt legal institutions, which monitor the socio-cultural, and that promote an effective assistance to people involved in this kind of conflict. In obedience to the private autonomy, before manifestations of volunteers involved in family mediation, among autocompositivos instruments of conflict resolution, is indicated as the most shaped the treatment of family quarrels. Remaining, then the state a minimal intervention to prevent excessive intrusion into private life and personal privacy

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The pain is a sensuous and emotional experience unpleasant associated or related to real injury or potencial of the tissues. It is considered an individual and subjective experience generally has been described in the literature about in the neonatal stage a lot. This study has descriptive and exploratory character with a qualitative approach. The study has with objectives to analyze the performance of the nursing technicians working with newborns admitted in the ITUN, seeking to describe the perception of the nursing technicians about the pain, identify the parameters used for the detection and evaluation of pain in them, trying to describe the ons of this team about the pain in the newborns in ITUN. The subjects are nine nursing technicians of the ITU of the Parenting School Januário Cicco in Natal-RN, engaged in direct assistance to newborns in the ITU, on the turn of the morning, which was prepared to participate in the search. The collection of the data was conducted through a structured interview with tree questions; through a non-participatory observation with a structured roadmap and were used to record and pass on call was also as a way of obtaining data. The start of the collection made after the assent of the Ethics Committee / UFRN in November, 2007. The speakings have been transcribed and data read extensively to obtain categories.The analysis of the content made in terms of Bardin. Emerged three main categories of significance: Perceptioning of pain in newborns; Caring for the newborns with pain; Registering the pain in the newborns. A nursing technicians identifies the pain in the newborns, for the most part, so empirical, using signs of behavioral or physiological changes in isolation, giving little emphasis to the environment and to respect that the newborns is inserted. It was found that the attitudes cited by subjects of the search before the newborns with pain, are for the most part non-pharmacological actions such as sucking nutrient not, a proper positioning and measures of comfort, however pharmacological actions have also been reported.These is also the absence of records of nursing records in the report of pain and actions to minimize them and, in records and for the passage of call. With this study we understand the role of the nursing technicians, and seek to contribute to subsidies for the practice of professionals involved in caring for this age group, and also in the search for a humane assistance to the newborns

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Neuroscience is on a rise of discoveries. Its wide interdisciplinary approach facilitates a more complex understanding of the brain, covering various areas in depth. However, many phenomena that fascinate human kind are far from being fully elucidated, such as the formation of memories and sleep. In this study we investigated the role of the dopaminergic system in the process of memory consolidation and modulation of the phases of sleep-wake cycle. We used two groups of animals: wildtype mice and hiperdopaminergic mice, heterozygous for the gene encoding the dopamine transporter protein. We observed in wild-type mice that the partial blockade of the D2 dopamine receptor by the drug haloperidol caused deficits in memory consolidation for object recognition, as well as a significant reduction in the duration of rapid eye movement sleep (REM). We also found a mnemonic deficit without pharmacological intervention in hiperdopaminergic animals; this deficit was reversed with haloperidol. The results suggest that dopamine plays a key role in memory consolidation for object recognition. The data also support a functional relationship between the dopaminergic system and the modulation of REM sleep

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JUSTIFICATIVA E OBJETIVOS: A ansiedade pré-operatória na criança é caracterizada por tensão, apreensão, nervosismo e preocupação e pode ser expressa de diversas formas. Alterações de comportamento no pós-operatório como enurese noturna, distúrbios alimentares, apatia, insônia, pesadelos e sono agitado podem ser resultado desta ansiedade. em algumas crianças, estas alterações persistem por até um ano. O objetivo deste trabalho é avaliar os aspectos envolvidos com a ansiedade que afeta a criança e os pais durante o período que antecede a cirurgia, bem como as intervenções, farmacológicas ou não, para reduzi-la. CONTEÚDO: O artigo aborda a ligação entre a ansiedade pré-operatória em crianças e as alterações de comportamento que podem ocorrer no período pós-operatório, bem como a influência de variáveis como idade, temperamento, experiência hospitalar prévia e dor. Medidas para reduzir a ansiedade pré-operatória na criança como a presença dos pais durante a indução da anestesia ou programas de informação e a utilização de medicação pré-anestésica também são revisadas. CONCLUSÕES: O período que antecede a cirurgia acompanha-se de grande carga emocional para toda família, sobretudo para a criança. Um pré-operatório turbulento significa, para muitas crianças, alterações de comportamento que se manifestam de forma variada e por períodos prolongados em algumas vezes. A presença dos pais durante a indução da anestesia e programas de preparação pré-operatórios para a criança e para os pais podem ser úteis para casos selecionados, levando em conta a idade, temperamento e experiência hospitalar prévia. A medicação pré-anestésica com benzodiazepínicos, em especial o midazolam, é claramente o método mais eficaz para redução da ansiedade pré-operatória em crianças e das alterações de comportamento por ela induzidas.

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O estudo teve como objetivo avaliar a produção científica publicada entre 1991 e 1995, para identificar como o assunto adesão ao tratamento anti-hipertensivo vem sendo abordado. Foram analisados 107 artigos científicos. Os resultados mostraram que a adesão foi abordada da seguinte maneira: 68% relacionaram ao paciente, 63% ao tratamento farmacológico, 62% a aspectos gerais, 39% ao tratamento não farmacológico, 34% a fatores institucionais, e 8% relativos à, doença. A adesão ao tratamento anti-hipertensivo tem sido um desafio no controle da hipertensão arterial e conhecer como este assunto está sendo enfocado na literatura pode contribuir para aumentar adesão ao tratamento na hipertensão arterial.

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

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A obesidade é atualmente um problema de saúde pública que provoca sérias conseqüências sociais, físicas e psicológicas. A etiologia da obesidade não é de fácil identificação, uma vez que a mesma é caracterizada como doença multifatorial de complexa interação entre fatores comportamentais, culturais, genéticos, fisiológicos e psicológicos. Recentes avanços na área de endocrinologia e metabolismo mostram que, diferentemente do que se acreditava há alguns anos, o adipócito sintetiza e libera diversas substâncias, não sendo apenas uma célula armazenadora de energia. Entre as substâncias liberadas pelo adipócito incluem-se a adiponectina, o fator de necrose tumoral-alfa, a interleucina-6 e a leptina. Especificamente, a leptina desempenha importante papel no controle da ingestão alimentar e no controle do peso corporal em mamíferos. Além disso, o hormônio ghrelina, recentemente descoberto, também parece influenciar o metabolismo energético e a obesidade. As alterações que o exercício físico provoca na fisiologia endócrino-metabólica podem contribuir sobremaneira para a prática clínica. Assim, essa revisão abordará os conhecimentos mais recentes sobre a leptina, a ghrelina e o papel dos diferentes tipos de exercício físico sobre estes hormônios. Os trabalhos mostram que a relação entre o exercício físico e a concentração plasmática desses peptídeos ainda não está clara. As razões para isso poderiam ser devidas aos diferentes protocolos de treinamento físico empregados nos estudos. Além disso, diferenças genéticas também podem explicar as discrepâncias entre os resultados obtidos em seres humanos, pois a existência de polimorfismo em alguns genes pode acarretar respostas celulares diferentes frente ao exercício físico.

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The Brazilian Sleep Association brought together specialists in sleep medicine, in order to develop new guidelines on the diagnosis and treatment of insomnias. The following subjects were discussed: concepts, clinical and psychosocial evaluations, recommendations for polysomnography, pharmacological treatment, behavioral and cognitive therapy, comorbidities and insomnia in children. Four levels of evidence were envisaged: standard, recommended, optional and not recommended. For diagnosing of insomnia, psychosocial and polysomnographic investigation were recommended. For non-pharmacological treatment, cognitive behavioral treatment was considered to be standard, while for pharmacological treatment, zolpidem was indicated as the standard drug because of its hypnotic profile, while zopiclone, trazodone and doxepin were recommended.

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Background: There is increasing interest in non-pharmacological control of cholesterol and triglyceride levels in the plasma and diet-drug association represent an important area of studies. The objective of this study was to observe the hypocholesterolemic effect of soybean β-conglycinin (7S protein) alone and combined with fenofibrate and rosuvastatin, two hypolipidemic drugs. Methods. The protein and drugs were administered orally once a day to rats and the effects were evaluated after 28 days. Wistar rats were divided into six groups (n = 9): hypercholesterolemic diet (HC), HC+7S protein (300 mg.kg-1 day-1) (HC-7S), HC+fenofibrate (30 mg.kg-1 day-1)(HC-FF), HC+rosuvastatin (10 mg.kg-1 day-1)(HC-RO), HC+7S+fenofibrate (HC-7S-FF) and HC+7S+rosuvastatin (HC-7S-RO). Results: Animals in HC-7S, HC-FF and HC-RO exhibited reductions of 22.9, 35.8 and 18.8% in total plasma cholesterol, respectively. In HC-7S-FF, animals did not show significant alteration of the level in HC+FF while the group HC-7S-RO showed a negative effect in comparison with groups taking only protein (HC-7S) or drug (HC-RO). The administration of the protein, fenofibrate and rosuvastatin alone caused increases in the plasma HDL-C of the animals, while the protein-drug combinations led to an increase compared to HC-FF and HC-RO. The plasma concentration of triacylgycerides was significantly reduced in the groups without association, while HC-7S-FF showed no alteration and HC-7S-RO a little reduction. Conclusion: The results of our study indicate that conglycinin has effects comparable to fenofibrate and rosuvastatin on the control of plasma cholesterol, HDL-C and triacylglycerides, when given to hypercholesterolemic rats, and suggests that the association of this protein with rosuvastatin alters the action of drug in the homeostasis of cholesterol. © 2012 Ferreira et al; licensee BioMed Central Ltd.

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The issue of this article concerned the discussion about tools frequently used tools for assessing neuropsychiatric symptoms of patients with dementia, particularly Alzheimer's disease. The aims were to discuss the main tools for evaluating behavioral disturbances, and particularly the accuracy of the Neuropsychiatric Inventory - Clinician Rating Scale (NPI-C). The clinical approach to and diagnosis of neuropsychiatric syndromes in dementia require suitable accuracy. Advances in the recognition and early accurate diagnosis of psychopathological symptoms help guide appropriate pharmacological and non-pharmacological interventions. In addition, recommended standardized and validated measurements contribute to both scientific research and clinical practice. Emotional distress, caregiver burden, and cognitive impairment often experienced by elderly caregivers, may affect the quality of caregiver reports. The clinician rating approach helps attenuate these misinterpretations. In this scenario, the NPI-C is a promising and versatile tool for assessing neuropsychiatric syndromes in dementia, offering good accuracy and high reliability, mainly based on the diagnostic impression of the clinician. This tool can provide both strategies: a comprehensive assessment of neuropsychiatric symptoms in dementia or the investigation of specific psychopathological syndromes such as agitation, depression, anxiety, apathy, sleep disorders, and aberrant motor disorders, among others.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)