Parasitos e/ou comensais intestinais em pacientes neoplásicos submetidos à quimioterapia

The objective of this study was to verify the prevalence of intestinal parasites and/or commensals in the neoplastic patients undergoing chemotherapy. Stool samples were analyzed by the method of Lutz (1919) and Rugai (1954), in triplicate. This work was composed of three groups, the first one (GI) formed by neoplastic patients that are not undergoing chemotherapy, the second (GII) comprised patients who were undergoing chemotherapy, and the third group (GIII) consisting of patients who completed chemotherapy. A total of 30 patients (GI-5, GII-18 and GIII-7) were screened at the Assis Regional Hospital of the Unified Health System of Assis, São Paulo. Additional information on antiparasitic treatment and tumor type were obtained by questionnaire. The positivity was 66.7% (20 cases) for intestinal parasites and/or commensals. The helminths were Ascaris lumbricoides (36.7%), Hookworms (20%) and Hymenolepis diminuta (3.3%). Among the highlights are protozoan Giardia lamblia (46.7%), Entamoeba coli (6.7%), E. histolytica/dispar (3.3%), Endolimax nana (3.3%) and Iodameba butschlii (3.3%). The high frequency of intestinal parasites and/or commensals in the neoplastic patients can be attributed to poor personal hygiene and lack of immunity to reinfection and poor knowledge of the prophylaxis of infection by protozoa and helminths. The results indicate the necessity of adopting a new criterion for neoplastic patients undergoing chemotherapy, primarily performing parasitological diagnosis, treatment and monitoring of cure of intestinal parasitic infections in this risk group.

Acurácia da histerossonografia versus ultrassonografia transvaginal em mulheres inférteis candidatas às técnicas de reprodução assistida

PURPOSE: To compare the diagnostic accuracy of sonohysterography (HSN) and conventional transvaginal ultrasound (USG) in assessing the uterine cavity of infertile women candidate to assisted reproduction techniques (ART). METHODS: Comparative cross-sectional study with 120 infertile women candidate to ART, assisted at Centro de Reprodução Assistida (CRA) of Hospital Regional da Asa Sul (HRAS), Brasília-DF, from August 2009 to November 2010. Sonohysterography was performed with saline solution infusion in a close system. The sonohysterography finding was compared to previous USG results. The uterine cavity was considered abnormal whenthe endometrium was found to be thicker than expectedduring the menstrual cycle and whenan endometrial polyp, a submucous myoma and an abnormal shape of the uterine cavity were observed. The statistical analysis was doneusing absolute frequencies, percentage values and the χ 2, with the level of significance set at5%. RESULTS:HSN revealed that 92 (76.7%) infertile women candidate to ARThad anormal uterine cavity, while 28 (23.3%) had the following abnormalities: 15 polyps (12.5%).

Resultados perinatais de gêmeos com pesos discordantes ao nascer

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

A música enquanto instrumento terapêutico na resposta clínica da criança em unidade de terapia intensiva pediátrica

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Construção da rede de cuidado integral à pessoa em situação de violência sexual e apoio aos profissionais: narrativa de uma experiência

Pós-graduação em Psicologia - FCLAS

Análise da expressão do HER-2 no câncer de mama e sua correlação com outros fatores prognósticos

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Fatores associados e desfechos perinatais em gestação na adolescência em uma amostra de gestantes do Distrito Federal

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Síndrome hipertensivas gestacionais: identificação de fatores de risco e de complicações como subsídio para proposta de políticas públicas para a redução da morbimortalidade materna

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Perfil de sobrevida e alterações no ultrassom transfontanelar em prematuros menores que 32 semanas

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Medidas e índices antropométricos de recém-nascidos a termo com peso insuficiente

Pós-graduação em Pediatria - FMB

Parasitos e comensais intestinais em pacientes neoplásicos submetidos à quimioterapia

The objective of this study was to verify the prevalence of intestinal parasites and/or commensals in the neoplastic patients undergoing chemotherapy. Stool samples were analyzed by the method of Lutz (1919) and Rugai (1954), in triplicate. This work was composed of three groups, the first one (GI) formed by neoplastic patients that are not undergoing chemotherapy, the second (GII) comprised patients who were undergoing chemotherapy, and the third group (GIII) consisting of patients who completed chemotherapy. A total of 30 patients (GI-5, GII-18 and GIII-7) were screened at the Assis Regional Hospital of the Unified Health System of Assis, São Paulo.Additional information on antiparasitic treatment and tumor type were obtained by questionnaire. The positivity was 66.7% (20 cases) for intestinal parasites and/or commensals. The helminths were Ascaris lumbricoides (36.7%), Hookworms (20%) and Hymenolepis diminuta (3.3%). Among the highlights are protozoan Giardia lamblia (46.7%), Entamoeba coli (6.7%), E. histolytica /dispar (3.3%), Endolimax nana (3.3%) and Iodameba butschlii (3.3%). The high frequency of intestinal parasites and/or commensals in the neoplastic patients can be attributed to poor personal hygiene and lack of immunity to reinfection and poor knowledge of the prophylaxis of infection by protozoa and helminths. The results indicate the necessity of adopting a new criterion for neoplastic patients undergoing chemotherapy, primarily performing parasitological diagnosis, treatment and monitoring of cure of intestinal parasitic infections in this risk group.

Doppervelocimetria da artéria oftálmica em gestantes pré-eclâmpticas com recém-nascidos portadores de restrição de crescimento

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Doppervelocimetria da artéria oftálmica em gestantes pré-eclâmpticas com recém-nascidos portadores de restrição de crescimento

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Clima laboral en un organismo público

El propósito de este trabajo, Clima Laboral, es conocer el ambiente de una institución, en este caso el Hospital Regional Diego Paroissien, en un momento dado. Se trata de obtener el conocimiento interno del mismo y posibilitar a los empleados canalizar sus opiniones a través de las respuestas que manifiestan en la encuesta de clima. El mero hecho de permitir expresar las opiniones en cada una de las áreas y saber que éstas van a ser tenidas en cuenta genera expectativas en los empleados, por lo que es importante tomar medidas de mejora. El motivo por el cual se realizó esta investigación de clima laboral, se debe a la influencia que éste ejerce sobre el comportamiento de los empleados. El no contar con este conocimiento puede incidir negativamente en la productividad, motivación, satisfacción en el trabajo, etc. Se hace necesario reflexionar y priorizar la calidad de vida de la gente que trabaja en las organizaciones, ya que poco aporta un empleado frustrado, o que tenga resentimiento contra su jefe o lugar de trabajo. Un clima bien estructurado y con un perfil satisfactorio puede hacer que una organización sea exitosa. Ésta será valorada por los empleados que la conforman con agrado, compromiso y satisfacción.

Estudio teórico-experimental para la mejora de la resistencia estructural de autocares basado en el diseño de uniones y asientos

La presente tesis analiza la mejora de la resistencia estructural ante vuelco de autocares enfocando dos vías de actuación: análisis y propuestas de requisitos reglamentarios a nivel europeo y la generación de herramientas que ayuden al diseño y a la verificación de estos requisitos. Los requisitos reglamentarios de resistencia estructural a vuelco contemplan la superestructura de los vehículos pero no para los asientos y sistemas de retención. La influencia de los pasajeros retenidos es superior a la incluida en reglamentación (Reg. 66.01) debiendo considerarse unida al vehículo un porcentaje de la masa de los pasajeros del 91% para cinturón de tres puntos y del 52% para cinturón subabdominal frente al 50% reglamentario para todos los casos. Se ha determinado la cinemática y dinámica del vuelco normativo en sus diferentes fases, formulando las energías en las fases iniciales (hasta el impacto contra el suelo) y determinando la fase final de deformación a través del análisis secuencial de ensayos de módulos reales. Se han determinado los esfuerzos para los asientos que se dividen en dos fases diferenciadas temporalmente: una primera debida a la deformación estructural y una segunda debida al esfuerzo del pasajero retenido que se produce en sentido opuesto (con una deceleración del pasajero en torno a 3.3 g). Se ha caracterizado a través de ensayos cuasi.estáticos el comportamiento de perfiles a flexión y de las uniones estructurales de las principales zonas del vehículo (piso, ventana y techo) verificándose la validez del comportamiento plástico teórico Kecman.García para perfiles de hasta 4 mm de espesor y caracterizando la resistencia y rigidez en la zona elástica de las uniones en función del tipo de refuerzo, materiales y perfiles (análisis de más de 180 probetas). Se ha definido un método de ensayo cuasi.estático para asientos ante esfuerzos de vuelco, ensayándose 19 butacas y determinándose que son resistentes (salvo las uniones a vehículo con pinzas), que son capaces de absorber hasta más de un 17% de la energía absorbida, aunque algunos necesitan optimización para llegar a contribuir en el mecanismo de deformación estructural. Se han generado modelos simplificados para introducir en los modelos barra.rótula plástica: un modelo combinado unión+rótula plástica (que incluye la zona de rigidez determinada en función del tipo de unión) para la superestructura y un modelo simplificado de muelles no.lineales para los asientos. Igualmente se ha generado la metodología de diseño a través de ensayos virtuales con modelos de detalle de elementos finitos tanto de las uniones como de los asientos. Se ha propuesto una metodología de diseño basada en obtener el “mecanismo óptimo de deformación estructural” (elevando la zona de deformación lateral a nivel de ventana y en pilar o en costilla en techo). Para ello se abren dos vías: diseño de la superestructura (selección de perfiles y generación de uniones resistentes) o combinación con asientos (que en lugar de solo resistir las cargas pueden llegar a modificar el mecanismo de deformación). Se ha propuesto una metodología de verificación alternativa al vuelco de vehículo completo que contempla el cálculo cuasi.estático con modelos simplificados barra.rótula plástica más el ensayo de una sección representativa con asientos y utillajes antropomórficos retenidos que permite validar el diseño de las uniones, determinar el porcentaje de energía que debe absorberse por deformación estructural (factor C) y verificar el propio asiento como sistema de retención. ABSTRACT This research analyzes the improvement of the structural strength of buses and coaches under rollover from two perspectives: regulatory requirements at European level and generation of tools that will help to the design and to the verification of requirements. European Regulations about rollover structural strength includes requirements for the superstructure of the vehicles but not about seats, anchorages and restraint systems. The influence of the retained passengers is higher than the one included currently in the Regulations (Reg. 66.01), being needed to consider a 91% of the passenger mass as rigidly joint to the vehicle (for 3 points’ belt, a 52% for 2 points’ belt) instead of the 50% included in the Regulation. Kinematic and dynamic of the normative rollover has been determined from testing of different sections, formulating the energies of the first phases (up to the first impact with the ground) and determining the last deformation phase through sequential analysis of movements and deformations. The efforts due to rollover over the seats have been established, being divided in two different temporal phases: a first one due to the structural deformation of the vehicle and a second one due to the effort of the restrained passenger being this second one in opposite sense (with a passenger deceleration around 3.3 g). From quasi.static testing, the behavior of the structural tubes under flexural loads, including the principal joints in the vehicle (floor, window and roof), the validity of the theoretical plastic behavior according Kecman.García theories have been verified up to 4 mm of thickness. Strength of the joints as well as the stiffness of the elastic zone has been determined in function of main parameters: type of reinforcement, materials and section of the tubes (more than 180 test specimens). It has been defined a quasi.static testing methodology to characterize the seats and restrain system behavior under rollover, testing 19 double seats and concluding that they are resistant (excepting clamping joints), that they can absorb more than a 17 of the absorbed energy, and that some of them need optimization to contribute in the structural deformation mechanism. It has been generated simplified MEF models, to analyze in a beam.plastic hinge model: a combined model joint+plastic hinge (including the stiffness depending on the type of joint) for the superstructure and a simplified model with non.lineal springs to represent the seats. It has been detailed methodologies for detailed design of joints and seats from virtual testing (MEF models). A design methodology based in the “optimized structural deformation mechanism” (increasing the height of deformation of the lateral up to window level) is proposed. Two possibilities are analyzed: design of the superstructure based on the selection of profiles and design of strength joints (were seats only resist the efforts and contribute in the energy absorption) or combination structure.seats, were seats contributes in the deformation mechanism. An alternative methodology to the rollover of a vehicle that includes the quasi.static calculation with simplified models “beam.joint+plastic hinge” plus the testing of a representative section of the vehicle including seats and anthropomorphic ballast restrained by the safety belts is presented. The test of the section allows validate the design of the joints, determine the percentage of energy to be absorbed by structural deformation (factor C) and verify the seat as a retention system.