957 resultados para anos 60


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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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A neoplasia gástrica é doença heterogênea e multifatorial, com incidência e mortalidade variando geograficamente. Aproximadamente 60% dos diagnósticos em pacientes de países ocidentais ocorrem nos estádios III ou IV. Nestes doentes, o melhor tratamento consiste na realização de procedimento cirúrgico. OBJETIVO: Identificar os aspectos epidemiológicos de pacientes diagnosticados com adenocarcinoma gástrico T4b. MÉTODOS: Estudo observacional, transversal, retrospectivo, de fonte secundária, dos pacientes diagnosticados com adenocarcinoma gástrico T4b através de estadiamento patológico. Foram analisados 815 prontuários, sendo 27 pacientes estudados. As variáveis investigadas foram: aspectos demográficos, principais queixas, fatores de risco, acesso ao serviço de saúde, aspectos cirúrgicos, morbidade, mortalidade e sobrevida. RESULTADOS: Vinte e dois eram homens (81,5%) e cinco mulheres (18,5%) com idade variando de 38 a 87 e média de 58,78 anos. O tempo de acesso ao serviço, em meses, variou de 1 a 120, com média de 12,5. Os sinais e sintomas mais prevalentes foram: perda de peso 23 (85,2%), epigastralgia 22 (81,5%), vômitos 16 (59,3%) e plenitude gástrica 12 (44,4%). A frequência de acometimento das estruturas adjacentes foi: pâncreas oito (29,6%), fígado sete (25,9%), cólon transverso seis (22,2%), intestino delgado seis (22,2%), mesocólon três (11,1%), baço um (3,7%) e vesícula biliar um (3,7%). Morbidades pós-operatórias ocorreram em 51,85% dos pacientes. Houve associação significativa entre mortalidade cirúrgica e ocorrência de fístula/deiscência, choque séptico e sangramento. A sobrevida ao final de seis meses foi de 63,27%. CONCLUSÃO: A média do tempo entre início dos sintomas e acesso ao serviço de saúde especializado foi elevada. Mais da metade dos pacientes apresentaram morbidades pós-operatórias. Os pacientes que apresentaram fístula/deiscência, sangramentos e choque séptico tiveram associação significativa com mortalidade cirúrgica. A sobrevida ao final de seis meses foi de 63,27%.

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The arterial hypertension is a chronic disease, which can be controlled by changing the way of life, as well as by drug treatment, which demand specific Health Care sequence. The lack of adherence to sequence/treatment is one of the main obstacles the disease control. Characterize and analyze the profile of Health Care usage by a 192 patient cohort diagnosed with arterial hypertension in 1995, between the period of 2001 – 2005 and 2006 – 2010. It is a longitudinal study, retrospective and descriptive developed on School Health Center(SHC) which belongs to School of Medicine Botucatu –UNESP, in continuity of the previous research which has analyzed the sequence of the referred sample between the period of 1995 – 1999. The database was obtained from the patients records by using structured adapted forms appointed in the previous study phase. In the case there were transfers to other Health Care facilities, the database was obtained by the records either, while the patients attended the CSE. The database was analyzed by means of descriptive statistics. Predominated the patients in the age from 50 – 69 (47,9%), whites (93,2%), female (56,7%) with low level of education (72,7%). In the period of 2001 - 2005, 76 (39,5%) of the patients remained under sequence, and that 44 (22,9%) belonged to adherence group (GAD), 17 belonged to abandonment/adherent group (GAB/GAD) and 15 to the abandonment group (GAB), groups which were already identified by the study which has analyzed the period of 1995 – 1999. At the end of the third period of the sample sequence (2006 – 2010), 60 (31,2%) of the patients kept under medical sequence. The cohort’s mortality rate in the period reached 15,1% and 21,9% were transferred to other Municipal Health Care facilities. We conclude that the Health Care service usage by the 192 sample’s integrants kept the same model already identified in the previous analysis... (Complete abstract click electronic access below)

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Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.

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This work aim to show that the reach to the limits of capital accumulation, which is showing its first signs since the 60 s, has and still is exercising great importance in Brazilian economic policies. In the first chapter, we establish a reference to what is understood as the limit of capital accumulation after World War II and how the accumulation process drives itself to its own limits. In the following chapters, we detach the importance of the reached limit to the most relevant moments of Brazilian economic policy. Since the IIPND, when the first signs of influence raise in Brazilian economy, passing through the stabilizing attempts during the 80 s and 90 s and the emergence of the pro-market State in Brazil, until the 00 s, when macroeconomic prudence took shape and delimited the conduction of the country s economic policy, we will show how the limit of capital accumulation has played an important role.

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Preterm birth is a public health problem worldwide. It holds growing global incidence rates, high mortality rates and a risk of the long-term sequelae in the newborn. It is also poses burden on the family and society. Mothers of very low birth weight (VLBW) preterm infants may develop psychological disorders, and impaired quality of life (QoL). Factors related to mothers and children in the postpartum period may be negatively associated with the QoL of these mothers. The aim of this study was to assess factors possibly associated with the QoL of mothers of VLBW preterm newborns during the first three years after birth. Mothers of VLBW preterm answered the World Health Organization Quality of Life (WHOQOL)-bref and the Beck Depression Inventory (BDI) in five time points up to 36 months postpartum, totalizing 260 observations. The WHOQOL–bref scores were compared and correlated with sociodemographic and clinical variables of mothers and children at discharge (T0) and at six (T1), twelve (T2), 24 (T3) and 36 (T4) months after the delivery. We used the Kruskal Wallis test to compared scores across different time points and correlated WHOQOL-bref scores with the sociodemographic and clinical variables of mothers and preterm infants. Multiple linear regression models were used to evaluate the contribution of these variables for the QoL of mothers. The WHOQOL–bref scores at T1 and T2 were higher when compared to scores in T0 in the physical health dimension (p = 0.013). BDI scores were also higher at T1 and T2 than those at T0 (p = 0.027). Among the maternal variables that contributed most to the QoL of mothers, there were: at T0, stable marital union (b= 13.60; p= 0.000) on the social relationships dimension, gestational age (b= 2.38; p= 0.010) in the physical health dimension; post-hemorrhagic hydrocephalus (b= -10.05; p= 0.010; b= -12.18; p= 0.013, respectively) in the psychological dimension; at T1 and T2, Bronchopulmonary dysplasia (b= -7.41; p= 0.005) and female sex (b= 8,094; p= 0.011) in the physical health dimension and environment, respectively. At T3, family income (b= -12.75’ p= 0.001) in the environment dimension, the SNAPPE neonatal severity score (b= -0.23; p= 0.027) on the social relationships dimension; at the T4, evangelical religion (b= 8.11; p= 0.019) and post-hemorrhagic hydrocephalus (b: -18.84 p: 0.001) on the social relationships dimension. The BDI scores were negatively associated with WHOQOL scores in all dimensions and at all times points: (-1.42 ≤ b ≤ -0.36; T0, T1, T2, T3 and T4). We conclude that mothers of preterm infants VLBW tend to have a transient improvement in the physical well-being during the first postpartum year. Their quality of life seems to return to levels at discharge between two and three years after delivery. The presence of maternal depressive symptoms and diagnosis of post-hemorrhagic hydrocephalus or BDP are factors negatively associated with the QoL of mothers. Social, religious and economic variables are positively associated with the QoL of mothers of VLBW preterm.

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Due to the high supply and its attractive cost, the poultry litter has been used in the southwestern region of Parana to the improvement of soil fertility seeking greater production of grains and pastures. However, the use without technical knowledge can minimize the benefits of poultry litter or even cause undesirable effects on soil, environmental pollution and also productivity losses in the used crops. The objective of this study was to evaluate the influence of different times of poultry litter application, predating the winter crop, associated with increasing levels, about soil chemical properties, release of nutrients and crop performances in four consecutive years (2011-2014). In the first three years the experimental design was randomized blocks with a split plot system and four replications. In the main plots were tested four poultry litter application times preceding the wheat production: 0, 15, 30 and 45 days before sowing (DAS); in the subplots were applied four poultry litter levels (wet basis): 0, 4, 8 and 12 Mg ha-1. Last year one more subdivision of plots was done, evaluating the use or not of nitrogen in coverage in wheat, at a dose of 100 kg N ha-1. The wheat cultivar used in the four years was the BRS 220. In three years it was evaluated the residual effect on soybean production (cultivar - BMX Turbo RR) and in one year on the beans. The chemical soil attributes were evaluated at four depths 0-2,5cm, 2,5-5cm, 5-10cm and 10-20cm, and also the rate of decomposition and nutrient release of poultry litter and the crop productivity. The different times of application concerning the poultry litter had little influence on the studied variables, demonstrating that the producer does not need to have a specific date (before planting) to the application of poultry litter. Potassium was fully released 60 days after the allocation of litter bags into the field; for nitrogen and phosphorus the release was slower. The use of increasing levels of poultry litter increased the levels of various soil elements, highlighting the potassium which reached 20 cm deep in the second year of evaluation. The increase in pH and in the base saturation occurred only in the upper layers, while the phosphorus reached 10 cm deep in the third year of the study. It was observed increased pH and base saturation. The use of increasing doses of poultry litter contributed to the wheat plant nutrition, significantly increasing the weight of a thousand grains, and the grain yield of wheat in all the evaluated years; the nitrogen fertilization in coverage also had significant effect for the fourth evaluated year. Also there was a significant response from the residual effect of poultry litter for crops planted in summer for both soybeans and beans.

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As abelhas pertencem à família dos Apídeos, existem em torno de vinte mil espécies distintas, porém são as da espécie Apis mellifera que são as maiores responsáveis pela polinização, colaborando assim para a agricultura com a produção da cera, do mel, própolis, geléia real e o pólen. A nosema spp. é uma doença causada por fungos formando microesporos que podem contaminar abelhas adultas, e é considerado um parasita do trato digestivo das abelhas adultas a que podem ocasionar a morte. Este estudo objetivou avaliar morfologicamente os esporos de nosema spp. e verificar se existe diferença em relação a área de coleta e o ano que foram coletadas as amostras. O presente trabalho foi executado no laboratório de patologia apícola pertencente ao Instituto Politécnico de Bragança em Portugal, em atividades de intercâmbio pelo programa 'Minas Mundi' no primeiro semestre de 2016. As amostras foram processadas de acordo com a metodologia estabelecida pela organização mundial de saúde animal (O.I.E.) e adotada pelo laboratório de referência nacional, utilizando técnicas de microscopia óptica, baseadas em exames microscópicos e macroscópicos do material biológico. As amostras tiveram origem na associação de apicultores da região de Leiria (AARL), sendo estas de diferentes distritos (Guarda, Santarém, Viseu, Leiria e Évora) em Portugal. Foram coletadas um total de 96 amostras de abelhas adultas dos diferentes distritos. Para verificar a presença de nosema spp. foram retirada a traqueIa de todas as abelhas da amostra (total de 60 abelhas por amostra) o tórax e o abdomen foram colocados em um vasilhame com 10ml de água destilada onde foi realizada a compreensão das abelhas maceradando-as até atingir o liquido com cor amarelada. Após a realização desde procedimento, 1ml deste líquido foi transferido para um tubo de ensaio devidamente identificado com a codificação da amostra e com 9ml de água destilada. Uma alíquota foi depositada em câmara de Neubauer para pesquisa de nosema spp.. Com auxilio do software VisicamImageAnalyser 7 pôde-se visualizar os esporos e posteriormente, por meio de fotografias, avaliou-se o comprimento e largura dos mesmos. Para análise estatística foram realizados análise de variância (ANOVA). Das 96 amostras analisadas, 68 obtiveram resultado positivo para nosema spp., sendo que após verificar as amostras positivas em relação ao distrito não se notou diferença significativa (p<0,05) do tamanho dos esporos sendo estes comprimento e largura em relação a origem distintas. Em relação ao ano, ao comparar a morfologia dos esporos de nosema spp. nos anos de 2014 e 2015 destes distritos verificou-se que não houve diferença significativa (p<0,05). Com os resultados obtidos conclui-se que as amostras positivas na região centro de Portugal são homogéneas em relação à morfologia dos esporos. Além disso, o conhecimento de amostras positivas, auxiliou os produtores na melhoria da produção dos apiários e na redução da incidência da nosema nas colmeias prevenindo que este patogeno passasse para outros apiários ou colmeias.