999 resultados para Insuficiencia venosa
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Magellania venosa, the largest recent brachiopod, occurs in clusters and banks in population densities of up to 416 ind/m**2 in Comau Fjord, Northern Chilean fjord region. Below 15 m, it co-occurs with the mytilid Aulacomya atra and it dominates the benthic community below 20 m. To determine the question of why M. venosa is a successful competitor, the in situ growth rate of the brachiopod was studied and its overall growth performance compared with that of other brachiopods and mussels. The growth in length was measured between February 2011 and March 2012 after mechanical tagging and calcein staining. Settlement and juvenile growth were determined from recruitment tiles installed in 2009 and from subsequent photocensus. Growth of M. venosa is best described by the general von Bertalanffy growth function, with a maximum shell length (Linf) of 71.53 mm and a Brody growth constant (K) of 0.336/year. The overall growth performance (OGP index = 5.1) is the highest recorded for a rynchonelliform brachiopod and in the range of that for Mytilus chilensis (4.8-5.27), but lower than that of A. atra (5.74). The maximal individual production (PInd) is 0.29 g AFDM/ind/year at 42 mm shell length and annual production ranges from 1.28 to 89.25 g AFDM/year/m**2 (1-57% of that of A. atra in the respective fjords). The high shell growth rate of M. venosa, together with its high overall growth performance may explain the locally high population density of this brachiopod in Comau Fjord. However, the production per biomass of the population (P/B-ratio) is low (0.535) and M. venosa may play only a minor role in the food chain. Settling dynamics indicates that M. venosa is a pioneer species with low juvenile mortality. The coexistence of the brachiopod and bivalve suggests that brachiopod survival is affected by neither the presence of potential brachiopod predators nor that of space competitors (i.e. mytilids).
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Introdução: O tratamento da Insuficiência Venosa Crônica (IVC) é baseado na correção dos refluxos e obstruções ao fluxo sanguíneo venoso. A detecção, a gravidade e o tratamento dessas obstruções venosas, responsáveis pelos sinais e sintomas da IVC, têm sido recentemente estudados e melhor compreendidos. Estes estudos não definem qual o grau de obstrução significativa nem os critérios ultrassonográficos para sua detecção. O objetivo deste estudo foi determinar critérios ultrassonográficos para o diagnóstico das obstruções venosas ilíacas, avaliando a concordância deste método com o ultrassom intravascular (UI) em pacientes portadores de IVC avançada. Métodos: Foram avaliados 15 pacientes (30 membros; 49,4 ± 10,7 anos; 1 homem) com IVC inicial (Classificação Clínica-Etiológica-Anatômica-Physiopatológica - CEAP C1-2) no grupo I (GI) e 51 pacientes (102 membros; 50,53 ± 14,5 anos; 6 homens) com IVC avançada (CEAP C3-6) no grupo II (GII) pareados por sexo, idade e etnia. Todos pacientes foram submetidos à entrevista clínica e à ultrassonografia vascular com Doppler (UV-D), sendo obtidas as medidas de fasicidade de fluxo, os índices de fluxo e velocidades venosas femorais, e as relações de velocidade e de diâmetro da obstrução ilíaca. Foi analisado o escore de refluxo multisegmentar. Os indivíduos do GI foram avaliados por 3 examinadores independentes. Os pacientes do GII foram submetidos ao UI, sendo obtidos a área dos segmentos venosos comprometidos e comparados com os resultados obtidos pelo UV-D, agrupados em 3 categorias: obstruções < 50%; obstruções entre 50-79% e obstruções >= 80%. Resultados: A classe de severidade clinica CEAP predominante no GI foi C1 em 24/30 (80%) membros, e C3 em 54/102 (52,9%) membros no GII. O refluxo foi severo (escore de refluxo multisegmentar >= 3) em 3/30 (10%) membros no grupo I, e em 45/102 (44,1%) membros no grupo II (p<0,001). Houve uma concordância moderadamente elevada entre o UV-D e o UI, quando agrupadas em 3 categorias (K=0,598; p<0,001), e uma concordância elevada quando agrupadas em 2 categorias (obstruções <50% e >= 50%) (K= 0,784; p<0,001). Os melhores pontos de corte e sua correlação com o UI foram: índice de velocidade (0,9; r=-0,634; p<0,001); índice de fluxo (0,7; r=-0,623; p<0,001); relação de obstrução (0,5; r=0,750; p<0,001); relação de velocidade (2,5; r= 0,790; p<0,001); A ausência de fasicidade de fluxo esteve presente em 88,2% dos pacientes com obstrução >=80% ao UV-D. Foi construído um algoritmo ultrassonográfico vascular, utilizando as medidas e os pontos de corte descritos obtendo-se uma acurácia de 79,6% para 3 categorias (K=0,655; p<0,001) e de 86,7% para 2 categorias (k=0,730; p<0,001). Conclusões: O UV-D apresentou uma concordância elevada com o UI na detecção de obstruções >= 50%. A relação de velocidade na obstrução >= 2,5 é o melhor critério para detecção de obstruções venosas significativas em veias ilíacas.
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Mode of access: Internet.
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Venous ulcers (UV) are the result of deep venous insufficiency or obstruction leading to venous hypertension in the lower limbs and lesions. Self-efficacy is the belief in the ability to successfully perform a given task or exhibit behavior that leads to a desirable outcome. Nursing needs to know and explore the influence of self-efficacy on quality of life (QOL) of people with UV, seeking to exercise holistic care. Thus, this study aimed to analyze the correlation of self-efficacy for pain control and functionality with the QOL of people with UV in primary health care. It is a cross-sectional, analytical, quantitative study with people with UV in family health strategy and mixed units in Natal / RN. We used the instruments: sociodemographic and health questionnaire, domains self-efficacy for pain control and self-efficacy for functionality of Scale of Self-Efficacy for Chronic Pain (SFCD) and the Charing Cross Venous Ulcer Questionnaire (CCVUQ). The sample included 101 people in the self-efficacy scale for functionality and 89 in self-efficacy for pain, for twelve patients reported no pain at the time of collection, and therefore were excluded from the application of the scale of selfefficacy for pain. The project was approved by the ethics committee of the Federal University of Rio Grande do Norte (CAAE No. 07556312.0.0000.5537), serving Resolution 466/12. Women predominated (66.3%), elderly (61.4%), married or in a stable relationship (63.4%), low income (90.1%) and education (85.1%), inactive (75.2%), associated chronic diseases (60.4%), more than six hours of sleep / day (82.2%), non-drinkers / smokers (80.2%), chronic injury (73.3%) and moderate to severe pain (76.2%). Self-efficacy for pain (mean 67.3, SD 26.6) was less committed to the self-efficacy for functionality (mean 59.4 SD 25.9), with statistical difference (pvalue = 0.011). No significant associations were found between self-efficacy for pain control and functionality with the sociodemographic and health characteristics. When considering the total mean CCVUQ (mean 52.1, SD 16.6), QOL of respondents tended to worsen, with the aesthetic domain the most committed (mean 57.6, SD 24.0), followed by emotional state (mean 57.0, SD 25.7), social interaction (mean 48.4, SD 21.4) and household activities (mean 43.6, SD 23.3) . We found negative and significant correlations between self-efficacy for pain and CCVUQ total score (r = -0,324; p = 0,001), the social interaction domain (r = -0,278; p = 0,008), household activities (r = - 0,285; p = 0,007) and state emotional (r = -0,247; p = 0,019). Likewise, between selfefficacy for functionality and the CCVUQ total score (r = -0,553; p < 0,001), the social interaction domain (r = -0,553; p < 0,001), household activities (r = -0,594; p < 0,001) and emotional status (r = -0,259; p = 0,009). The aesthetic domain showed negative correlation but weak and not significant with self-efficacy for pain (r = -0, 155; p = 0,147) and functionality (r = -0,189; p = 0,058). It became evident the correlation between self-efficacy for pain control and functionality and the domains social interaction, household activities and emotional state, the quality of life of people with UV
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The Chronic Venous insufficiency is characterized as a set of physical changes including how most serious complication of venous ulcers, characterized by irregular and progressive loss of continuity of the skin. The occurrence of venous ulcers in people with chronic venous insufficiency generates dependence on them with health services, with long-term treatments that cause limitations and high-impact changes, affecting their quality of life, affecting the physical, psychological, social, cultural and spiritual as an important public health problem. This study aimed to describe the experience of having a venous ulcer, in the scenario of primary health care services to Health, which includes Primary Care Units and Family Health Strategy in the city of Natal / RN, based on the life histories of users. This is a qualitative study, exploratory and descriptive, with the Oral History of Life as a methodological framework. From the ponto zero was the recruitment of participants who formed the network, totaling six employees, of both sexes and aged between 57 and 79 years. After approval by the Research Ethics Committee - UFRN under the Protocol 653 788/2014 and CAAE 30408014.0.0000.5537 was held data collection, between the months of July and August, through interviews, using identification and characterization of the instrument employees and open questions. Interviews were recorded, transcribed, transcriadas and returned to employees for a conference. The narratives were subjected to Content thematic analysis technique, according to Bardin, allowing the construction of three themes that encompass categories, namely: Axis I - Perspectives on the changes: the impact wound in social relations (changes with ulcer venous, venous ulcer and social and family relationships); Axis II - Brands in body and soul: the story of being hurt (conceptions of the body injured; therapeutic itinerary in primary care services); and Axis III - Reconstruction of being hurt: coping mechanisms (redefinition of the wounded body, resilience to chronic wound). The impact of having a chronic venous ulcer generates impact of physical, psychological and social order. As aspects related to changes after the appearance of venous ulcers, survey participants reported the presence of pain, physical limitations, psychological distress, social and emotional isolation, incapacity, aesthetic discomfort and dependency on health services; the family was the aspect thatshowed no significant change after the occurrence of wound for most participants, an ally in the therapeutic process as a support network. The redefinition of the body and the wound are the main coping mechanism of chronic condition. The services in the Primary Care Network play a fundamental role in the rehabilitation of patients with venous ulcers, although there are difficulties in accessing appropriate treatment and need for expanded services, with permanent professional training of health teams and providing the resources managers to strengthen the comprehensive care of people with venous ulcers in Health Primary Care.
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Traçar o perfil socioeconômico dos pacientes com úlcera venosa. Método: estudo quantitativo, transversal e descritivo, realizado com 50 pessoas no ambulatório de clínica cirúrgica do Hospital Universitário Onofre Lopes/HUOL, localizado no município de Natal/RN/Nordeste do Brasil, utilizando-se um roteiro de entrevista. Os dados coletados foram tabulados e armazenados numa planilha do software Excel e analisadas pela estatística descritiva. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, CAAE 0038.0.294.000-11. Resultados: idade média de 59,72 anos, 66% pertenciam ao sexo feminino, 60% possuíam companheiro, a média de estudos foi de 4,98 (±3,36) anos e a renda familiar 2,3 salários mínimos. Encontrou-se, portanto, o perfil de pessoas com úlcera venosa semelhante ao evidenciado na literatura. Conclusão: é imprescindível conhecer as características dessa clientela para desenvolver estratégias visando à melhoria de suas condições de saúde