464 resultados para Emergencias medicas


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Pós-graduação em Enfermagem (mestrado profissional) - FMB

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En Chile, existen diversas In stituciones dedicads a la generación de información de carácter científico y técnico , útil para la realización de investigación y desarrollo de estudios de interés en el ámbito de los fenómenos naturales. Su examen , demuestra un desarrollo mayor en lo que se refiere a amenazas, especialmente en áreas como la meteorología o sismología, donde existe un importante número y cobertura de información disponible. La existencia de este tipo de información, no responde necesariamente a planes de gestión de riesgo, si no que, forma parte de las funciones habituales de los diferentes organismos, careciéndose de una política central que ordene y permita un aprovechamiento mejor de los datos que se disponen , resultando un alto grado de dispersión que limita el acceso a ésta. Otro aspecto que contribuye a un uso limitado de la información, es el costo que posee, restringiendo su acceso tanto a entidades públicas como privadas. A pesar de que los fenómenos naturales han sido recurrentes en el tiempo, no existen registros históricos a partir de los que sea posible obtener información integral de los efectos generados por éstos. La ausencia de registros válidos, agrega, por una parte, una dificultad a la hora de evaluar las consecuencias económicas de tales eventos. Por otra parte, en la mayoría de los casos los informes técnicos generados post-evento, contienen mayoritariamente información de la población afectada y sus viviendas, careciendo de referencias a las pérdidas de los sectores económicos. A partir del año 1997, la Oficina Nacional de Emergencia, ONEMI, sistematiza la información, elaborando un registro de todas las emergencias ocurridas a nivel país. Estos compendios están enfocados fundamentalmente a describir las características actuales de la emergencia, quedando por lo tanto sin desarrollo lo referente al análisis de las pérdidas económicas.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Engenharia Mecânica - FEG

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Accidents represent a major public health problem as they are frequent, preventable, and account for high morbidity and mortality rates. Children are the most vulnerable to accidents due to their inherent characteristics, and as a result of their physical, sensorial, psychomotor and cognitive limitations, which will only develop with time. Watchfulness and careful attention are of paramount importance, especially as children develop locomotor skills that are accompanied by curiosity about their surroundings. Child accidents, particularly those that could have been avoided, are the accidents most commonly seen in emergency and urgency departments. Urgency and emergency departments are the greatest allies in the attention to pediatric accidents as they offer adequate, immediate and specific high complexity care to patients at risk, viewing their vital stabilization. Investigating the causes and consequences of this insult is essential to establish a diagnosis and to contribute for the adoption of measures of prevention, control, and assistance. To identify the epidemiologic characteristics of the accidents involving children that received care at the pediatric emergency department of Botucatu Medical School Hospital and required hospitalization. This quantitative, retrospective, descriptiveanalytic epidemiologic study included all children aged 0-14 years who had had an accident and were seen at the Pediatric Emergency Department of Botucatu Medical School Hospital of São Paulo State University/UNESP between January 1/2008 and December 31/2009. A total of 227 medical charts were reviewed and 178 (78.4%) patients were included in this study. Of these, 116 (65.1%) were males and 62 (34.8%) were females. Children aged 5 - 9 years (38.9%) were the most affected, followed by those aged 10 - 14 years (37.5%). Fractures occurred in 138 (77.5%) of the cases, followed by foreign bodies... (Complete abstract click electronic access below)

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Presently, the dying process and death most often occur in hospitals and, particularly, in Intensive Care Units (ICU), where patients’ lives are prolonged thanks to advanced technological devices and highly efficient medicines. To learn about the opinion of health care professionals working at a Pediatric Intensive Care Unit in relation to the dying process and dying. This is a descriptive quantitative study. A questionnaire was applied to the unit’s staff members from June to August, 2011. Data were statistically analyzed. Twenty-five professionals answered the questionnaire, and 72% faced death as a natural life process. 60% felt compassion, but that feeling did not interfere with how they cared for patients. Concerning their professional training, 52% reported not to have received any concerning patients’ caregivers in the dying process or death; therefore, they experienced such situation when they were already working, and 76% reported to be interested in updating courses on that theme. Further discussion about this topic during academic education is necessary. It is also necessary to provide health care professionals with specialization courses, debates and experience exchange so that they can better understand and deal with their feelings and limitations in face of death and thus give better care to patients and relate to patients’ families during the dying process of a loved one

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Lymphocytic hypophysitis (LH) has been described previously in systemic lupus erythematosus (1.3%), Sjogren's syndrome (0.8%). Lymphocytic hypo physitis (LH) is rarely associated with rheumatic diseases, although three cases of pituitary disease associated with antiphospholipid syndrome (APS) have been described. Here, we report a possible association between APS and LH for the first time. A 34-yr-old woman with primary APS presented with polyuria, polydipsia, hypernatremia and impaired vision. Her hormone profile was compatible with panhypopituitarism, and sellar magnetic resonance imaging (MRI) depicted a normal pituitary gland with a thickened and displaced stalk and infundibulum portion. Hormone replacement was started, and the patient experienced a good clinical evolution.

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Introduction: Lupus erythematosus panniculitis (LEP) or lupus erythematosus profundus is a rare form of chronic cutaneous manifestation affecting both adults and pediatric patients. The prevalence of this manifestation was seldom reported in juvenile systemic lupus erythematosus (JSLE). Case reports: From January 1983 to December 2010, 5,506 patients were followed at the Pediatric Rheumatology Unit of our University Hospital and 278 (5%) of them met the American College of Rheumatology classification criteria for JSLE. Two (0.7%) of them had LEP at JSLE onset. These two cases had tender deep inflammatory subcutaneous nodules or plaques at the time of diagnosis, and the histopathologic pattern evidenced lobular or mixed panniculitis with lymphocytic inflammatory cells of the fat lobule. Treatments for LEP included mainly antimalarials, systemic corticosteroids and sunscreen protection. One male patient required thalidomide and immunosuppressive drugs, including mycophenolate mofetil, cyclosporin and intravenous cyclophosphamide. However, skin lesions improved only after rituximab treatment. Discussion: LEP was rarely observed in our cohort of JSLE patients as the first lupus manifestation. Anti-CD20 monoclonal antibody therapy may be an option for refractory LEP treatment in children.

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The application of immunobiologics for the rheumatoid arthritis treatment may present as a rare complication the development of inflammatory myopathy. Until this moment, there have been described in literature only seven cases of inhibitors of tumor necrosis factor induced-myositis. In this paper, we report the case of the patient with 39 years-old with eight years of arthritis rheumatoid and that due to refractory to various immunosuppressive drugs, the adalimumab was introduced, and evolved to dermatomyositis status.

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Introduction: Histoplasmosis is an infection caused by dimorphic fungus, Histoplasma capsulatum, and it has not been reported in juvenile systemic lupus erythematosus (JSLE) patients, particularly progressive disseminated histoplasmosis (PDH) subtype. Case report: We reported herein a 14-year old girl who was diagnosed with JSLE. Six months later, she had abdominal distension and received prednisone, hydroxychloroquine and azathioprine. Computer tomography evidenced hepatosplenomegaly and multiple mesenteric, mediastinal and retroperitoneal enlarged lymph nodes, forming large conglomerates at the mesentery, suggestive of lymphoproliferative disorder. After 10 days, she had acute surgical abdominal, and underwent a laparotomy and intestinal perforation and conglomerates of lymph nodes were observed. The jejunum biopsy showed perforated acute enteritis with hemorrhage and necrosis, and Grocott staining identified Histoplasma sp. and the culture showed a heavy growth of Histoplasma capsulatum. At that moment liposomal amphotericin B (1.0 mg/Kg/day) was introduced. Despite this treatment she died due to septic shock eight days later. Diffuse Histoplasma capsulatum was evidenced at autopsy. Conclusion: We reported a severe opportunistic infection in JSLE patient with adenopathy and multiple intestinal perforations. This study reinforces the importance of early diagnosis and antifungal therapy, especially in patients with these uncommon clinical manifestations.

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The association between autoimmune hepatitis and idiopathic inflammatory myopathies has been rarely described in literature. To our knowledge, there are only five reports of autoimmune hepatitis, all coursing with polymyositis. In the present work, we describe a female patient at the age of 58 with cutaneous lesions (heliotrope), progressive proximal muscle weakness of four limbs and constitutional symptoms for 12 months, and worsened two months ago. She had also been episodes of jaundice for five months. During hospitalization, after intense clinical investigation, the diagnosis of dermatomyositis and autoimmune hepatitis were defined, and the patient had a good clinical and laboratory response to corticosteroids and immunosuppressive.

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[ES] Actualmente el análisis de la producción científica es objeto de atención de estudiosos/as que, con las limitaciones propias de todo sistema de evaluación, proponen la utilización de unos indicadores para conocer la productividad de los/las científicos y el impacto de sus actividades. La productividad científica de un investigador/a se mide generalmente por el número de artículos originales de investigación que pública, el número de patentes o el desarrollo y aplicación de nuevas técnicas. Habrá que considerar con cautela que la cantidad no significativas calidad. La presión que el investigador/a sufre sobre todo en el ámbito académico, puede provocar distorsiones en el análisis. Sin embargo como mínimo la producción de un científico significa que éste cara a la investigación es activo. El por qué de este tipo de análisis y su implantación en la evaluación investigadora, viene determinado por intentar tener unos indicadores que midan e interpreten el conocimiento científico y su crecimiento. La información básica la ofrecen las publicaciones y la aplicación a éstas de técnicas bibliométricas. Los indicadores bibliométricos se dirigen a medir la cantidad, impacto y significado de la producción científica. Deben manejarse teniendo en cuenta siempre sus limitaciones. Un trabajo se considera más o menos importantes y tiene la posibilidad de ser difundido más o menos rápidamente en función de la revista donde se publique. El rigor más o menor exigente de los filtros de los manuscritos, hacen que la publicación un recursos con una calidad determinada. Un número alto de citas de los trabajos presuponen una contribución al conocimiento. Pero el simple recuento de publicaciones tiene defectos, no se tiene en cuenta la creatividad, la influencia y la calidad de los conocimientos que contienen.