Fatores associados à efetividade da doação de órgãos e tecidos para transplantes

The transplantation of organs and tissues presents itself as an important therapeutic option, both from a medical standpoint, the social or economic. Thus, the identification of variables that can interfere in the effectiveness of organs and tissues donation for transplantation needs to be investigated adequately, because it stands before increasing index of chronic and degenerative diseases in the population, what makes the waiting list for transplantation grow disproportionately and patients come to death without the opportunity of realization the treatment due to a lack of donors. In this context, has defined as objective of this study evaluate the factors associated with the effectiveness of organs and tissues donation for transplantation. It is a evaluative research, quantitative, prospective, with longitudinal design, developed at Central of Catchment, Notification and organ donation for transplant, Organ Procurement Organization and in six accredited hospitals to collect and transplantation of organs and tissues, in Natal/RN, between august 2010 and february 2011, after the approval of the Research Ethics Committee, under No. 414/10 and CAAE 007.0.294.000-10. The probabilistic sample without replacement was composed of 65 potential donors. It was used as an instrument of data collection a structured script non-participant observation of checklist type. Data were analyzed using descriptive statistics and presented in tables, charts, graphs and figures. For this, was used Microsoft Excel 2007 and statistical program SPSS version 20.0. To check the level of significance was chosen by applying the chi-square test (χ2) and Mann Whitney and caselas for less than five, it is considered the Fisher exact test. It was adopted as the significance level p-value <0.05. Among the surveyed it was observed that most of the individuals were male (50,8%), in the age group 45 years (53,8%), mean age of 42,3 years, minimum 5 and maximum 73 years (± 17,32 years). Single / widowers / divorced (56,9%), with up to completed elementary school (60,0%) in the exercise of professional activity (86,2%), catholic (83,1%) and residents in metropolitan region of Natal (52,3%). Was obtained donation effectiveness of 27,7%. There was no statistical significance between structure and effectiveness of the donation, but were observed inadequacies in physical resources (36,9%), materials (30,8%), organizational structure (29,2%) and human resources (18,5%). In the process, the maintenance phase (p= 0.004), diagnosis of brain death (p= 0.032), family interview (p≤ 0.001) and documentation (p= 0.001) presented statistical significance with effectiveness. Thus, it is accepts the alternative hypothesis of the study, in which is evidenced that the adequacy of the factors related to structure and process is associated to effectiveness of organs and tissues donation for transplantation. In this way, the effectiveness of organ and tissue donation ends in an essential way the rapidity and accuracy with which the donation process is conducted, requiring appropriate structure, with appropriate physical and material resources and skilled human resources to optimize the reduction of time and the suffering of those waiting for an organ or tissue transplant queued in Brazil

Cuidado de enfermagem ao potencial doador de órgãos em morte encefálica: uma reflexão sobre a prática

Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing

Atuação e o conhecimento dos profissionais de enfermagem quanto a morte encefálica e manutenção do potencial doador de órgãos e tecidos para transplantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Crescimento e deposição de nutrientes nos órgãos de frangos de corte de duas linhagens comerciais

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

Biometria da carcaça e peso de vísceras e de órgãos internos de bovinos mestiços alimentados com diferentes volumosos e fontes protéicas

Quarenta bovinos machos, com peso médio de 371 kg, foram distribuídos em um delineamento em blocos casualizado com esquema fatorial 3x3, dos quais quatro foram abatidos no início do experimento como referência, para avaliar a biometria das carcaças e o peso de vísceras e órgãos internos quando alimentados com diferentes fontes protéicas (uréia, Amiferm e farelo de soja) e volumosos (cana-de-açúcar e a silagem de milho e pastagem de capim Brachiaria brizantha). Não houve interação significativa volumosos x fontes protéicas e não houve diferença significativa entre as fontes protéicas para os parâmetros estudados. Para os volumosos, os pesos (em porcentagem do peso do corpo vazio - % PCV) do conteúdo estomacal (CRROA) e do conteúdo gastrintestinal (CGI) foram significativamente maiores para os animais alimentados com cana-de-açúcar (7,52 e 8,59% PCV, respectivamente) e não diferiram entre os alimentados com silagem de milho e capim, com médias de 5,10% PCV, para CRROA, e 5,89% PCV para CGI. Os animais mantidos em pastagem não apresentaram compacidade das carcaças diferente dos animais alimentados com os outros volumosos, enquanto os alimentados com cana-de-açúcar mostraram ser menos compactos que os alimentados com silagem de milho. As fontes protéicas também influenciaram a compacidade, que foi menor nos animais que receberam Amiferm e iguais para os que receberam uréia e farelo de soja. Conclui-se que os animais alimentados com cana-de-açúcar apresentam maior enchimento dos compartimentos digestivos e carcaças menos compactas.

Fotointerpretação comparativa de fotografias pancromáticas coloridas e infravermelhas coloridas através da drenagem

O presente trabalho teve por objetivo avaliar quantitativamente as informações obtidas por diferentes tipos de fotografias. Os estudos basearam-se em fotografias pancromáticas, coloridas e infravermelhas coloridas de uma área teste localizada no município de Campinas - SP. A cobertura fotográfica denominada Missão 96 resultou da colaboração científica entre INPE - Instituto de Pesquisas Espaciais, NASA - National Aeronautics and Space Administration e IAC - Instituto Agronômico do Estado de São Paulo. A rede de drenagem foi o elemento de comparação tendo sido estudados dois parâmetros: número de segmentos de rios e comprimentos de rios. A rede de drenagem foi estudada em monoscopia e em estereoscopia, onde as medições foram efetuadas em amostras circulares de 10 km² (parcelas), sendo que o delineamento experimental foi o de parcelas inteiramente casualizadas. Os dados obtidos foram utilizados para avaliar a eficiência de cada tipo de fotografia, para; os parâmetros considerados. Para as condições estudadas, obteve-se as seguintes conclusões principais: a) a fotografia infravermelha forneceu maior número de informações comparativamente às fotografias pancromáticas e coloridas, as quais ofereceram resultados semelhantes; b) os resultados obtidos pela análise monoscópica da fotografia infravermelha foram semelhantes aos resultados obtidos pela análise estereoscópica da fotografia pancromática, o que pode facilitar bastante o processo fotointerpretativo.

Estudo da recuperação de óleo por drenagem gravitacional assistida por injeção de vapor

Steam assisted gravity drainage process (SAGD) involves two parallel horizontal wells located in a same vertical plane, where the top well is used as steam injector and the bottom well as producer. The dominant force in this process is gravitational. This improved oil recovery method has been demonstrated to be economically viable in commercial projects of oil recovery for heavy and extra heavy oil, but it is not yet implemented in Brazil. The study of this technology in reservoirs with characteristics of regional basins is necessary in order to analyze if this process can be used, minimizing the steam rate demand and improving the process profitability. In this study, a homogeneous reservoir was modeled with characteristics of Brazilian Northeast reservoirs. Simulations were accomplished with STARS , a commercial software from Computer Modelling Group, which is used to simulate improved oil recovery process in oil reservoirs. In this work, a steam optimization was accomplished in reservoirs with different physical characteristics and in different cases, through a technical-economic analysis. It was also studied a semi-continuous steam injection or with injection stops. Results showed that it is possible to use a simplified equation of the net present value, which incorporates earnings and expenses on oil production and expenses in steam requirement, in order to optimize steam rate and obtaining a higher net present value in the process. It was observed that SAGD process can be or not profitable depending on reservoirs characteristics. It was also obtained that steam demand can still be reduced injecting in a non continuous form, alternating steam injection with stops at several time intervals. The optimization of these intervals allowed to minimize heat losses and to improve oil recovery

Variação da qualidade da água do escoamento superficial de duas bacias de drenagem de Natal/RN - Brasil

The urban drainage is one of the powers of environmental sanitation and its scope is the quantitative and qualitative aspects. In decision making of managers and the engineering aspects of design are almost always taken into account only the quantitative aspects. However, the waters of the runoff have the highest concentrations of pollutants at the beginning of precipitation. Thus, if the plot pollution removed, the remaining portion can be used for other purposes. This work has aimed to present the variation of water quality of two drainage basins in the city of Natal / RN-Brazil to support the implementation of drainage to consider the qualitative aspect, and identify potential for the use of water. The basins (M and C) are analyzed closed-type, are in the urban area, are predominantly residential occupation and its waters are used for detention ponds and infiltration. The samples were divided into three phases, the first two direct to final points in a basin and the third in traps distributed over the surface drainage. The parameters had been analyzed were pH, conductivity, dissolved oxygen, Color, Turbidity, COD, Ammonia, nitrite, nitrate, total phosphorus, orthophosphate, Sediments solids, total solids, chloride, sulfate, alkalinity, calcium, magnesium, sodium, potassium, Heavy Metals (Chromium, Cadmium, Lead, Zinc and Copper), Eschichia coli and total coliforms. The parameters studied showed high initial pollution load, events and located in different proportions, except nitrite, heavy metals and biological indicators. The size of the surface drainage and topographic its features influence the quality of water. However, the form of sampling is crucial in the qualitative study in the basin. The samplers developed at work, were generated economic and representative results. The urban rainwater presents organic faecal indicators. The runoff of water from both basins shows no risk of salinity and sodicity for use in irrigation, should be noted the content of chloride in the choice of method of irrigation

Distribuição de macroalgas lóticas de uma bacia de drenagem no Parque Nacional da Serra da Canastra, Minas Gerais, Brasil

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

Distribuição ecológica das comunidades de macroalgas da bacia de drenagem do Rio das Pedras, região Centro-Sul do Estado do Paraná, Sul do Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Uso urbano não potável de água de lagoas do sistema de drenagem de Natal

The detention and infiltration ponds of urban drainage system has function to protect the population from undesirable effects of floods. In general these ponds are not completly used and it potential is wasted. As it are disseminated at different places at cities it can reduce costs with water transport and permit water preservation of best quality. Some it utilities includes use in green areas irrigation, industrial among than cooling towers and boiler, soil compaction, cleaning urban road, pisciculture and fire fighting system. The quality these water is influenced by anauthorized sewage in the drainage system. This study was performed in six detention and infiltration ponds at drainage system of Natal, which aim was to verify the non-portable use these ponds on urban environment. As indirect aim would to incentive the water utilization these ponds as a water source to another uses in urban environment. These ponds represents the characteristics of detention and infiltration of Natal city and consequently of Brazil. As the water quality, the ponds presents following characteristics: three has apparently good quality, other showed intermediate condition and two had water polluted. Were performed twenty sample in each ponds and the following parameters assessed: pH, temperature, dissolved oxygen, turbidity, electrical conductivity, coliform thermotolerant, ammonia, organic nitrogen, TKN, nitrate, total phosphorus and alkalinity, bicarbonate, chloride, total hardness, calcium and magnesium hardness, total solids, TSS, TDS, COD and SAR°. To utilization on pisciculture we recommend use in ponds which presents the best quality. Only one pond presented higher pollutants and it not being appropriated for use in cooling tower. The content of solids suspension restricted the water use in all ponds in boilers. As water use in soil compaction, cleaning urban road and fire fighting system the water from these ponds are not appropriated. However, the recommended limits from literature are to domestic sewage, due to this, the parameters are restrictive to diminish the sanitary risk that could be offered with it utilization. The infiltration velocity of water these assessed ponds restrict a moderato use, however the effects are potentiated only in soil less sandy, which not occur in Natal. It is recommend the unrestricted irrigation utilization in ponds with best quality of water, and a restricted irrigation to ponds with worst quality of water. As load of pollutants, it is recommended a complementary treatment in those ponds whit higher load to diminish sanitary risks. In only one pond was found one helminth eggs and due to the convention formula of results, it was found for all ponds less than 1 helminth/liter eggs.

Análise da salubridade do meio urbano com base na utilização de índices ambientais: aplicação na bacia de drenagem XII da cidade do Natal-RN

The growing accumulation of people in urban centers caused chronic problems of the cities to begin to take an increasingly unsustainable. Primarily related to lack of infrastructure coupled with sanitation and lack of investment in critical sectors such as health, education, housing and transportation, these problems start to deteriorate markedly the quality of life of city dwellers and put into test management policies of the spaces urbanized. To reverse this situation, shows is essential to the use of tools (highlighting this harvest rates and environmental indicators) that help in assessing the current conditions and may assist in predicting future scenarios. From the information listed above, now put the research seeks to present an index called ISBA Environmental (Sanitation Index) which looks at the four urban systems (water, sewer, solid waste and urban drainage) from the viewpoint of application in a geographical cutout specific - in this case the Drainage Basin XII, defined by the Plan of Urban Drainage Stormwater in the city of Natal, capital of Rio Grande do Norte. This index, together with analysis of other factors sought to trace the current conditions of the basin and thus, assist in proposing the best solutions. For the preparation of the index was applied a questionnaire with a sample of 384 (three hundred eighty-four) households that aimed to study two variables: access to services and satisfaction of the population in relation to these. The ISBA has shown that the system is the most deficient collection and disposal of effluents (ICE = 47.66%), followed by the drainage of rainwater (IDAP = 54.17%), water supply (AAI = 61, 36) and solid waste collection (IRS = 78.28). With the ISBA was possible to verify that the qualitative data shows whose subjectivity is evident (as is the case of user satisfaction) can be of great importance when an assessment, since we obtained the correlation coefficient between the variables "Access" and " Satisfaction "equal to 0.8234, showing a strong correlation between the existence / quality of service offered and the impressions of the population that receives them

Percepção do corpo, medo da morte, religião e doação de órgãos

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

Doação de órgãos: meu corpo, minha sociedade

A doação de órgãos é um problema de relevância social e científica, pois envolve as formas como a vida é perpetuada através do corpo de outra pessoa, especificamente por meio de seus órgãos. Quais são os fatores de resistência e de facilitação à doação de órgãos? Este artigo propõe um fator de resistência e um de facilitação. O primeiro, o narcisismo pelo próprio corpo; o segundo, o desejo de perpetuar-se a si mesmo e a vida.

Estudo da ação do extrato de Ginkgo biloba e amido hidroxietílico hipertônico na atenuação de alterações decorrentes de isquemia e reperfusão de órgãos esplâncnicos em ratos

A oclusão e reperfusão das artérias esplâncnicas ocasiona choque circulatório, causado principalmente pelo aumento de permeabilidade vascular e pela agressão celular provocada por radicais livres derivados do oxigênio. Este estudo tem por finalidade verificar a ação do extrato de Ginkgo biloba (Egb-761) e do amido hidroxietílico (AHH) na prevenção do choque circulatório produzido pela isquemia e reperfusão de órgãos esplâncnicos. O Egb-761 tem propriedades antioxidantes relatadas na literatura. O AHH, tem sido utilizado como recurso terapêutico do choque hipovolêmico. Ratos anestesiados receberam infusão contínua de Egb-761 ou AHH, sendo submetidos à isquemia (oclusão do tronco celíaco, artéria mesentérica superior e artéria mesentérica inferior por 30 minutos) e reperfusão (por 90 minutos) dos órgãos esplâncnicos. Foram feitas: análise histopatológica ileal, dosagem de malondialdeído ileal e determinação contínua da pressão arterial média (PAM). A PAM ao final do período de reperfusão foi significativamente mais elevada nos animais tratados com Egb-761 e AHH, que no grupo controle (F=18,29; p<0,001). Não houve diferença entre os grupos tratados e controle quanto à dosagem de MDA (H=4,61; p>0,10) e quanto às alterações histológicas (H=6,003; p>0,10). em conclusão, houve melhora nas condições hemodinâmicas, com atenuação do choque nos ratos que receberam Egb-761 ou AHH. Novos estudos serão necessários para se avaliar melhor as alterações histológicas e para esclarecer a formação de produtos finais da peroxidação lipídica.