921 resultados para BAIXO DÉBITO CARDÍACO


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The Kangaroo Program was implemented in Brazil in 2000 through the Unified Health System (Sistema Único de Saúde SUS) sustained with a humanized rethoric of health care assistance. This program adopts the skin-to-skin contact contributing to the mother-infant bond, breastfeeding and promoting security in mother s care. The users of SUS are encouraged to live in the maternity ward to follow the baby health improvement. However, it was verified in previous observations that mothers participation in the Kangaroo Program has been done through an imposed practice. Therefore, this study intended to understand the texts that permeate the kangaroo practice. This research was developed through two studies: 1) an historic exploration of motherhood concept and an analysis of how the motherhood is presented in the official document that orients the program; 2) an analysis of institutional dynamic of Kangaroo Program, emphasizing the study about the health workers everyday practice, the mothers view about their life in the maternity wards, and the attendance practice. It is highlighted that the relation between this two studies allowed the comprehension abouthow the official discourses can influence the health workers behaviors and how their viewpoint and position can shape the everyday work in a public health program. This research, supported by Institutional Ethnography, considers that people s practices and experiences are socially organized and shaped by broad social forces. The discourse method was used in the documental analysis and in the analysis of qualitative data from empiric research. The research showed that the kangaroo program has been an excellent way to save resources and to improve some baby s biologic and psychological aspects. However, this program has failed to consider the social, economic and cultural complexity of mothers and the structural limitation of the health care system. The official document uses the economic and medical approach, following the hegemonic biomedical model and the life style of the people that don t use the public health system. Consequently, the program has not been successful because it is planned without people participation. On the other hand, it was verified that although some professionals are committed with their work, the mainly does not consider mothers participation as an active process, using the institutional power as a social control to keep mothers uninformed about the possibility to leave the maternity wards. As a result, the research also showed that mothers perceive the program as mandatory and not as option that can improve pleasure moments. It is, therefore, necessary to consider the complex social determinants of health that can increase mothers participation in the Kangaroo Program. Bringing these issues into debate can be a reflective exercise on citizenship and governance, allowing spaces for the improvement of public health programs

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Background:Low birth weight(LBW) isa risk factor formorbidity, infant and child mortality. In Brazilthe highest percentages oflow birth weightoccur inregionsofbettersocio-economic status. Objective: to know the spatial distributionofrates of lowbirth weight andcorrelation withsocial indicatorsand service. Drawing: ecological, and Brazilian statesas units ofanalysis. Methodologyused thetechnique ofspatial analysis, data from 2009SINASC, IPEAandIBGE. Results:higher rates oflow birth weightare in the statesof the south/southeast,GlobalMoran: 0.267, p=0.02.Clustersofhigh-hightypein the Southeastandlow-lowstates ofthe Amazon region.Conclusion: Thespatial inequalityoflow birth weightreflectsthe socioeconomic conditionsof the states. More developed regionsholdhigher rates oflow birth weight, therefore,the presenceof the serviceandits usedodecrease infant mortalityandincrease theBPN

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Avaliou-se, sob duas densidades de plantio, um variante somaclonal de porte baixo de bananeira, comparando-o com a variedade Nanicão Jangada que lhe deu origem. Os materiais genéticos 'Nanicão Jangada'(controle) e o variante somaclonal representado pelas seleções 224 e 225 de um ensaio anterior, foram avaliados nos espaçamentos 2,0m X 2,0m (densidade 2500 plantas ha-1) e 3,0m X 2,0m (1666plantas ha-1), na Fazenda de Ensino e Pesquisa da Faculdade de Engenharia - UNESP, Campus de Ilha Solteira-SP. O ensaio foi conduzido em blocos ao acaso com cinco repetições, com utilização de mudas micropropagadas, sob irrigação por gotejamento, no período de dezembro de 1998 a março de 2001, com avaliação dos dois primeiros ciclos de produção. Constatou-se efeito da densidade e do ciclo sobre a produção estimada de frutos sendo que no cultivo mais denso, a média foi de 81,25 t.ha-1 no primeiro ciclo de produção e 67,93 t.ha-1 no segundo ciclo. No cultivo de menor densidade a produção estimada no primeiro ciclo foi de 51,35 t.ha-1 e 44,08 t.ha-1 no segundo. As seleções do variante de porte baixo apresentaram menor altura da planta e mostraram-se relativamente mais precoces e com produção semelhante a cv. Nanicão Jangada no primeiro ciclo. No segundo ciclo houve uma queda na produção do bananal, com maior intensidade para a seleção 225 do variante.

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OBJETIVO: Avaliar se existe correlação entre qualidade de vida e classe funcional em pacientes no pós-implante de marca-passo cardíaco, e sua relação com idade. MÉTODOS: Investigados 107 pacientes de ambos os sexos (49,5% do sexo feminino e 50,5% do sexo masculino), tempo médio de implante 6,36º ±2,99 meses e média de idade 69,3º ±12,6 anos. Para avaliação da classe funcional, foi utilizada escala proposta por Goldman e para qualidade de vida, questionário AQUAREL associado ao SF-36. Realizada análise estatística pela correlação de Spearman, com significância de 5%. RESULTADOS: Foram observadas correlações negativas entre qualidade de vida e classe funcional: AQUAREL nos três domínios, desconforto no peito (r=-0,197, P=0,042), dispneia (r=-0,508, P =0,000), arritmia (r=-0,271, P=0,005) e, no SF-36 nos oito domínios. em relação à idade, correlação negativa com Capacidade Funcional do SF-36 (r=-0,338, P=0,000) e não se observou correlação com AQUAREL. Entre idade e classe funcional observou-se correlação positiva (r=0,237, P=0,014). CONCLUSÃO: Neste estudo, encontrou-se correlação negativa entre qualidade de vida e classe funcional, evidenciando nesta amostra que os pacientes pertencentes a melhor classe funcional apresentaram melhor qualidade de vida. Conforme maior idade, pior a qualidade de vida em Capacidade Funcional e em classe funcional. Sugere-se, que idade e classe funcional influenciam qualidade de vida e as escalas de classificação funcional podem constituir um dos instrumentos que integram a avaliação e refletem a qualidade de vida em portadores de marca-passo.

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JUSTIFICATIVA E OBJETIVOS: em pacientes sob intubação traqueal ou traqueostomia, a umidificação e o aquecimento do gás inalado são necessários para a prevenção de lesões no sistema respiratório, conseqüentes ao contato do gás frio e seco com as vias aéreas. O objetivo da pesquisa foi avaliar o efeito do sistema respiratório circular com absorvedor de dióxido de carbono do aparelho de anestesia Cícero da Dräger, quanto à capacidade de aquecimento e umidificação dos gases inalados, utilizando-se fluxo baixo (1 L.min-1) ou mínimo (0,5 L.min-1) de gases frescos. MÉTODO: O estudo aleatório foi realizado em 24 pacientes, estado físico ASA I, com idades entre 18 e 65 anos, submetidos à anestesia geral, utilizando-se a Estação de Trabalho Cícero da Dräger (Alemanha), para realização de cirurgias abdominais, os quais foram distribuídos aleatoriamente em dois grupos: grupo de Baixo Fluxo (BF), no qual foi administrado 0,5 L.min-1 de oxigênio e 0,5 L.min-1 de óxido nitroso e fluxo mínimo (FM), administrando-se somente oxigênio a 0,5 L.min-1. Os atributos estudados foram temperatura, umidade relativa e absoluta da sala de operação e do gás no sistema inspiratório. RESULTADOS: Os valores da temperatura, umidade relativa e umidade absoluta no sistema inspiratório na saída do aparelho de anestesia e junto ao tubo traqueal não apresentaram diferença significante entre os grupos, mas aumentaram ao longo do tempo nos dois grupos (BF e FM), havendo influência da temperatura da sala de operação sobre a temperatura do gás inalado, nos dois grupos estudados. Níveis de umidade e temperatura próximos dos ideais foram alcançados, nos dois grupos, a partir de 90 minutos. CONCLUSÕES: Não há diferença significante da umidade e temperatura do gás inalado utilizando-se baixo fluxo e fluxo mínimo de gases frescos.

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

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FUNDAMENTO: A hipertrofia ventricular esquerda é potente preditor de mortalidade em renais crônicos. Estudo prévio de nosso grupo mostrou que renais crônicos com menor escolaridade têm hipertrofia ventricular mais intensa. OBJETIVO: Ampliar estudo prévio e verificar se a hipertrofia ventricular esquerda pode justificar a associação entre escolaridade e mortalidade cardiovascular de pacientes em hemodiálise. MÉTODOS: Foram avaliados 113 pacientes entre janeiro de 2005 e março de 2008 e seguidos até outubro de 2010. Foram traçadas curvas de sobrevida comparando a mortalidade cardiovascular, e por todas as causas dos pacientes com escolaridade de até três anos (mediana da escolaridade) e pacientes com escolaridade igual ou superior a quatro anos. Foram construídos modelos múltiplos de Cox ajustados para as variáveis de confusão. RESULTADOS: Observou-se associação entre nível de escolaridade e hipertrofia ventricular. A diferença estatística de mortalidade de origem cardiovascular e por todas as causas entre os diferentes níveis de escolaridade ocorreu aos cinco anos e meio de seguimento. No modelo de Cox, a hipertrofia ventricular e a proteína-C reativa associaram-se à mortalidade por todas as causas e de origem cardiovascular. A etiologia da insuficiência renal associou-se à mortalidade por todas as causas e a creatinina associou-se à mortalidade de origem cardiovascular. A associação entre escolaridade e mortalidade perdeu significância estatística no modelo ajustado. CONCLUSÃO: Os resultados do presente trabalho confirmam estudo prévio e demonstram, ademais, que a maior mortalidade cardiovascular observada nos pacientes com menor escolaridade pôde ser explicada por fatores de risco de ordem bioquímica e de morfologia cardíaca.

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OBJETIVO: Verificar a aterogenicidade do modelo de hipercolesterolemia por suplementação alimentar com gema de ovo em coelhos e seu uso como modelo de aterosclerose experimental de baixo custo. MATERIAL E MÉTODO: Foram utilizados 14 coelhos divididos em dois grupos de sete animais: grupo controle (G1), que recebeu ração comercial ad libitum, e grupo tratado (G2), que foi alimentado com dieta suplementada com gema de ovo. Ambos os grupos foram alimentados por 90 dias. Foram realizadas dosagens do perfil lipídico dos animais nos momentos 0, 30, 60 e 90 dias. Ao término do período experimental, os animais foram submetidos a eutanásia e retirada da aorta e de seus ramos diretos para realização de estudo anatomopatológico. RESULTADOS Apenas no grupo G2 houve aumento significativo nos níveis de colesterol total e frações. Ao exame macroscópico, foram observadas estrias gordurosas no arco aórtico e aorta abdominal e, à microscopia, acúmulos lipídicos discretos na íntima da aorta abdominal, renal, carótida, transição toracoabdominal e femoral. Portanto, a dieta com gema de ovo provocou aterosclerose leve no animal de experimentação e alterações equivalentes àquelas provocadas pelo colesterol purificado comercial quando fornecido em baixa dosagem. Assim sendo, a gema de ovo pode ser utilizada como fonte de colesterol alimentar de baixo custo em modelos de aterosclerose experimental.

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The research is developed in areas of horticulture in the city of Natal, in the neighborhoods of Lagoa Azul, Pajuçara and Redinha, along the Doce River, border area with Extremoz city, Rio Grande do Norte State. The region of the fluvial plain of Doce River is located in an Environmental Protection Zone (ZPA-9). This is one of the ZPA which is not under the regulatory marks and there are several environmental problems caused by use and land occupation, featuring an evident disregard of environmental laws and whose protection is hindered by the lack of specific legal mechanisms. This study aims to provide an overview of the use of pesticides in the lower course of the Doce River, in Natal, Rio Grande do Norte, and to assess environmental degradation in the area through chronic toxicity tests using the microcrustaceous Ceriodaphnia dubia Richard 1894 (Cladocera, Crustacea) as test organism. Visits were made to the area in 2009 and 2010. To obtain information a diagnosis of the local situation was accomplished based on personal observation and non-participatory photographic record, with the aim of assessing the environmental characteristics, population diversity and work processes of horticulturists. During the visits four different points of the Doce River were chosen to collect water for ecotoxicological tests and survey of physico-chemical parameters (dissolved oxygen, pH, chloride, turbidity, conductivity and temperature), which were measured in the field using Multiparameter Probe (TROLL 9500). The adverse effects of pesticide use in the lower course of the Doce River is a major problem for both the environmental and human health, since many of the substances and active principles that enter in the composition of the products are synthesized molecules whose effects can only be evaluated through different studies on their actions and behavior at short, medium or long term

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For many decades the problematic raised about the indiscriminate use of pesticides in modern agriculture has incited the interest of many researchers to discover the effects caused by such products in the environment and consequently in the life of the ones which use that products (farmers) and those people who live in places next to the agricultural areas. Facing these facts, this research had the intention of comprehend the environmental perception of habitants of the Distrito Irrigado do Baixo-Açu (DIBA), located in the semiarid of Rio Grande do Norte, by using agro toxics and its possible environmental effects, as well as evaluate the levels of toxicity of waters from agricultural runoff in this region by using eco-toxicological exams with Ceriodaphnia silvestii. Were done 86 interviews with dwellers and farmers from DIBA. With the results reached in the evaluation of the interviews it was possible to identify that one of major problems is the inappropriate discard of empty packs of the pesticides used at that place. The samples collected for eco-toxicological evaluation showed a variation in its toxicity, once that the point of collect which receives waters from different cultures presented in four out of five samples toxicity for the tested species. Therefore, it concludes that the indiscriminate use of pesticides agricultural practice presented a potential to pollute to the irrigation waters, and the absence of elucidation by the farmers about the manipulation of these products contribute to the risk of environmental contamination and the possible decrease of the quality of life of the dwellers of the region

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The lower course of Piranhas-Assu river, located in the north coast of Rio Grande do Norte, Brazil, arouses a keen interest as a study field, once it concentrates, besides petroleum and gas exploration, activities related to shrimp culture, salt and horticulture, factors that also deserve special attention. Thus, the awareness of the study field environmental stage demands studies from researchers and discernment from society, as a way of understanding the inter-relation between environment and men. Therefore, this work attempts at understanding and studying the dynamics of land use in the lower course of Piranhas-Assu river, through a multitemporal analysis of present and past, accomplishing future projections through simulation models. The work is divided in stages that include the research, analysis, interpretation of results, and the generation of simulation models, to analyze the landscape tendencies, making possible to identify indicators which cause such changes in the lower course of the river. From Geographical Database, the necessary exploratory analyses were accomplished to the following items: land use evolution, natural and environmental vulnerability, multiple geodiversity indexes, and preparation of the data to be used in the simulation model. Later, the construction of the landscape simulation model was conducted. Sequentially, simulations of future sceneries were accomplished through the execution of the model in a specific software environment. Last, the analyses of landscape tendencies in the study field were carried out. The lower course of Piranhas-Assu River didn't show any intense dynamics in landscape changing, once in the period taken into account (from 1988 to 2004) class stability proved to be superior to its transformations. Activities related to agriculture and livestock are the ones that influence, mostly, the landscape dynamics. The production of sea shrimp and petroleum also infers in the landscape, although in smaller proportion. INCRA s public policies excessively determined the dynamics of the landscape in the lower course of Piranhas-Assu River, RN. In respect to its natural vulnerability, the lower course of Piranhas-Assu River, RN, features more vulnerable than stable areas. The landscape simulation, in the first taken period (2004-2009), indicated considerable increases and decreases of antropic activities, if compared to its sequent periods (2009-2014, 2014-2019 and 2019-2024). The simulation, in a wider analysis, showed that the determining factors for the space mobility of antropic activities, in the focused area, are related to the pre-existence of communities with agricultural capability and to the existence of access routes and drainage. Considering the area that features fixed and mobile dunes, located in Porto do Mangue district, we recommend its conversion into a conservation area

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Baixo Vermelho area, situated on the northern portion of Umbuzeiro Graben (onshore Potiguar Basin), represents a typical example of a rift basin, characterized, in subsurface, by the sedimentary rift sequence, correlated to Pendência Formation (Valanginian-Barremian), and by the Carnaubais fault system. In this context, two main goals, the stratigraphic and the structural analysis, had guided the research. For this purpose, it was used the 3D seismic volume and eight wells located in the study area and adjacencies. The stratigraphic analysis of the Valanginian-Barremian interval was carried through in two distinct phases, 1D and 2D, in which the basic concepts of the sequence stratigraphy had been adapted. In these phases, the individual analysis of each well and the correlation between them, allowed to recognize the main lithofacies, to interpret the effective depositional systems and to identify the genetic units and key-surfaces of chronostratigraphic character. The analyzed lithofacies are represented predominantly by conglomerates, sandstones, siltites and shales, with carbonate rocks and marls occurring subordinately. According to these lithofacies associations, it is possible to interpret the following depositional systems: alluvial fan, fluvio-deltaic and lacustrine depositional systems. The alluvial fan system is mainly composed by conglomerates deposits, which had developed, preferentially in the south portion of the area, being directly associated to Carnaubais fault system. The fluvial-deltaic system, in turn, was mainly developed in the northwest portion of the area, at the flexural edge, being characterized by coarse sandstones with shales and siltites intercalated. On the other hand, the lacustrine system, the most dominant one in the study area, is formed mainly by shales that could occur intercalated with thin layers of fine to very fine sandstones, interpreted as turbidite deposits. The recognized sequence stratigraphy units in the wells are represented by parasequence sets, systems tracts and depositional sequences. The parasequence sets, which are progradational or retrogradational, had been grouped and related to the systems tracts. The predominance of the progradation parasequence sets (general trend with coarsening-upward) characterizes the Regressive Systems Tract, while the occurrence, more frequently, of the retrogradation parasequence sets (general trend with finning-upward) represents the Transgressive System Tract. In the seismic stratigraphic analysis, the lithofacies described in the wells had been related to chaotic, progradational and parallel/subparallel seismic facies, which are associated, frequently, to the alluvial fans, fluvial-deltaic and lacustrine depositional systems, respectively. In this analysis, it was possible to recognize fifteen seismic horizons that correspond to sequence boundaries and to maximum flooding surfaces, which separates Transgressive to Regressive systems tracts. The recognition of transgressive-regressive cycles allowed to identify nine, possibly, 3a order deposicional sequences, related to the tectonic-sedimentary cycles. The structural analysis, in turn, was done at Baixo Vermelho seismic volume, which shows, clearly, the structural complexity printed in the area, mainly related to Carnaubais fault system, acting as an important fault system of the rift edge. This fault system is characterized by a main arrangement of normal faults with trend NE-SO, where Carnaubais Fault represents the maximum expression of these lineations. Carnaubais Fault corresponds to a fault with typically listric geometry, with general trend N70°E, dipping to northwest. It is observed, throughout all the seismic volume, with variations in its surface, which had conditioned, in its evolutive stages, the formation of innumerable structural features that normally are identified in Pendencia Formation. In this unit, part of these features is related to the formation of longitudinal foldings (rollover structures and distentional folding associated), originated by the displacement of the main fault plan, propitiating variations in geometry and thickness of the adjacent layers, which had been deposited at the same time. Other structural features are related to the secondary faultings, which could be synthetic or antithetic to Carnaubais Fault. In a general way, these faults have limited lateral continuity, with listric planar format and, apparently, they play the role of the accomodation of the distentional deformation printed in the area. Thus, the interaction between the stratigraphic and structural analysis, based on an excellent quality of the used data, allowed to get one better agreement on the tectonicsedimentary evolution of the Valanginian-Barremian interval (Pendência Formation) in the studied area

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Objetivou-se identificar a prevalência das alterações de flora vaginal em gestantes de baixo risco, sua associação à sintomatologia referida e exame ginecológico. É estudo quantitativo, descritivo e transversal, desenvolvido no serviço público de atenção básica de Botucatu, SP, no período de 2006 a 2008, com 289 gestantes, amostradas de forma estratificada por unidade. Realizou-se exame do conteúdo vaginal, utilizando-se coloração pelo método de Gram e pesquisa de Trichomonas vaginalis em meio líquido de Diamond. Desconsiderando-se as associações, a prevalência de flora vaginal alterada foi de 49,5%, sendo as mais frequentes: vaginose bacteriana (20,7%), candidíase vaginal (11,8%) e flora intermediária (11,1%). Os dados apontam elevada prevalência das alterações de flora vaginal, com pouca associação à sintomatologia, mas associação com achados do exame ginecológico. Considerando-se as repercussões maternas e perinatais indesejáveis e a prática laboratorial exequível, sugere-se o estabelecimento de rotina para diagnóstico das alterações de flora vaginal em gestantes de baixo risco.

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O sucesso do transplante cardíaco com portadores da doença de Chagas está condicionado a cuidados especiais durante todas as fases do transplante, com necessidade de acompanhamento específico e rigoroso pela equipe de saúde. Os receptores devem estar conscientes da permanência do Trypanossoma no organismo, e das possibilidades de reativação da infecção após o transplante. Portanto, seu conhecimento dessa condição, e a sua participação ativa no próprio tratamento, têm importância fundamental. O objetivo do estudo foi investigar a experiência do transplante cardíaco vivenciada por pacientes portadores da doença de Chagas, para buscar compreender os significados que eles atribuem a esta experiência. Os procedimentos metodológicos abrangeram: a seleção dos pacientes; as entrevistas; a análise dos dados, indicando as unidades de significado e a análise individual; a busca de convergências dos discursos; e análise hermenêutica das convergências. da análise dos dados emergiram os seguintes temas: o tempo vivido pelo receptor, portador da Doença de Chagas; a concepção do TC apresentado pelo portador de Chagas; o cuidado na trajetória do TC.

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The present work is about the reproduction of the urban area of Nova Cruz RN, with the objective of analyzing the social and spatial implications of the relocation of the main street market in the city from 1991 on. Nowadays, the city of Nova Cruz takes over importance in the potiguar social and spatial scenario due to its condition of central city which is practiced for decades in Potiguar Agreste Microregion. Beginning with its formation process connected with traveler‟s hostel which assisted the activity of cattle transportation, further in time by the golden era of cotton production in its territory, it was noticed that its importance in relation with the nearby towns has been happening differently throughout time. From the year 1991 on, the town of Nova Cruz has gone through a territory restructuring of its urban area due to the relocation of the open market from Downtown neighborhood to São Sebastião neighborhood. Such territorial movement resulted in a reformation of the town‟s urban space, promoting in both neighborhoods urban growth and the expansion of commercial activity associated with the migration of the commercial center of the city. The transference of the commercial area has caused these processes through the new uses of the land towards the São Sebastião region, it has also caused a decrease in market value of the downtown area as a result of the breakdown of previous existing business activities, their service contribution and the citizen migration, establishing a space and socioeconomic portrait in the neighborhood. From this context, our analysis seeks to understand the social and spatial impacts occurred in Downtown neighborhood, the way in which the production and reproduction of the urban space in São Sebastião neighborhood and the implications resulted from the actions of the administrative power in restructuring of the urban space of Nova Cruz. In order to do so, a bibliographical research was used to compose our theoretic-conceptual mark, discussing the matter with authors such as Roberto Lobato Corrêa, Ana Fani, Milton Santos, Manuel Castells e Heri Lefvbre, among others, discussing on the subject of urban analysis, the concepts of urban space and the process of reproduction of the urban space. A field research was utilized in our area of study by means of primary data gathering through interviews, questionnaire and photographic register. Secondary data gathering was also obtained by means of bibliographical and documental research related to our study object. By these means, it was sought to contribute to the understanding of the urban space through its production and reproduction based upon the discovery of social and spatial practices