Determinantes da incapacidade funcional em doentes com AVC

Introdução- O Acidente Vascular Cerebral continua a ser a primeira causa de morte em Portugal, sendo também responsável pelo elevado índice de incapacidade e dependência funcional da população adulta portuguesa, afetando significativamente os aspetos da vida física, económica e social. Os processos de reabilitação continuados têm-se mostrado bastante eficazes na recuperação da independência funcional destes doentes. Assim sendo o objetivo geral deste estudo consiste em avaliar o nível de independência funcional e os fatores determinantes nesses níveis, em doentes sujeitos a programas de reabilitação continuados e doentes sem reabilitação. Métodos- O presente estudo é de carácter quantitativo, enquadrando-se num desenho de estudo descritivo transversal e analítico, no qual participaram 60 indivíduos que sofreram AVC, pertencendo 36 ao grupo experimental e 24 ao grupo de controle. A recolha de dados foi efetuada através de um questionário composto por questões de caracterização sociodemográfica, de caracterização clinica, uma escala de APGAR Familiar e uma Escala de Medida de Independência funcional (MIF). Resultados- A análise por grupos mostra que o grupo experimental é mais independente que o grupo de controle, ou seja, o nível de independência funcional é mais elevado na sua generalidade na amostra de indivíduos sujeitos a processos de reabilitação. As variáveis que influenciaram significativamente a independência funcional foram: o género (no comportamento social no G.cont),o estado civil (solteiros/viúvo mais independentes aos níveis dos cuidados pessoais, controle dos esfíncteres, mobilidade e locomoção no G. exp), habilitações académicas (maior escolaridade maior independência no G. exp) fatores de risco (doentes sem fatores de risco no G. cont são mais independentes nos cuidados pessoais, controle de esfíncteres e locomoção), indivíduos com AVC isquémico são mais independentes nos cuidados pessoais e locomoção, e os que realizaram trombólise são mais independentes nas diferentes dimensões nos dois grupos. Conclusão- As variáveis sociodemográficas e clinicas exercem influência apenas em algumas dimensões da independência funcional dos utentes após o AVC e a reabilitação desenvolvida de forma continuada, aumenta o grau de independência dos doentes diminuindo o grau de incapacidade. Palavras-chave- Acidente Vascular Cerebral, Incapacidade, Independência Funcional, Reabilitação.

Cuidados de enfermagem ao cliente internado na UCPA submetido a cateterização vesical

Relatório de Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Enfermagem Médico-Cirúrgica

Age models of sediment cores from the North-West African continental margin

A statistical analysis ol 15 deep sea cores in the eastern North Atlantic off NW Africa revealed the typical fluctuation pattern of distinct species proups as has been described from various parts of the world ocean. Only the "WBF-group" appears to be correlated with global climatic changes, i.e. warmer periods as the Eemian and the Atlanticum. A partly antagonistic "High Productivity group" (HPR-group) is in general not linked with global changes but times of increased fertility in the surface water and the resulting flux of organic matter reaching the bottom. The groups were extracted from cluster analysis of more than 150 surface samples (HPR-group) and a factor analysis of selected cores (WBF-group). In contrast to previous studies the observed fluctuations can not be explained by drastic changes in bottom water masses, but by the pulsation of a distinct "High Productivity Patch" in space and time. At present, this patch is located below the well known upwelling area between 22° and 12° northern latitude. It shifted to the north (up to 27 °N) during the latest glacial period ( 18 ky), indicating an equivalent shift of upwelling productivity caused by advection of nutrient rich upwelling SACW-waters, probably during most of isotopic stages 2 and 3.

Chemistry of Late Quaternary sediments and their interstitial waters of sediment cores from the Nort-West African continental margin

In the sediments of the NW African continental margin the mainly biogenic carbonate constituents become increasingly diluted with terrigenous material as one approaches the coast, as indicated by the carbonate-CO2 content, the Al2O3/SiO2-ratios, and the presence of ammonia fixed to alumino-silicates, predominantly to illites. In the norther area of the investigation - off Cape Blanc and Cape Bojador . the terrigenous constituents are mainly quartz from the Sahara Desert, whereas in the south - off Senegal - more alumino-silicates as clay minerals are admixed with the carbonate constituents. The organic carbon content of the continental slope sediments off Senegal is higher than in samples of the continental rise or of the preservation of organic matter as a result of high production and relatively rapid sedimentation. The zone of manganese-oxide enrichment follows the redox potential of + 330 mV from the surface (0-5 cm) into the sediments (20-30 cm deep) at 2000--3000 m and 3700 m of water depths, respectively. At shallower water depths, low redox potentials preclude deposition of manganese oxides and cause their mobilization from the sediments. About 1/3 of the total sedimentary Zn and 1/4 of the Cu is associated with the carbonate mineral fraction, probably in calcium phosphate overgrowths as a result of the mineralization of phosphorus-containing organic matter. Besides the precipitation of calcium phosphate, the mineralization of organic matter mediated by bacterial sulfate reduction also results in calcium carbonate precipitation and the exchange of ammonia for potassium on illites. Because of these simultaneous reactions, the depth distribution of all mineralization constituents in the interstitial water can be determined using the actual molar carbon-to-nitrogen-to phosphorus ratios of the sedimentary organic matter. The amount of sulfide sulfur in this process indicates the predominance of bacterial sulfate reduction in the sediments off NW Africa. This process also preferentially decomposes nitrogen- and phosphorus-containing organic compounds so organic matter deficient in these elements is characteristic for the rapidly accumulating sediments than today, indicating there was increased production of organic carbon compounds and more favorable conditions of their preservations. During the last interglacial times conditions were similar to those to today. This differentiation with time has also been observed in sediments from the Argentine Basin and from slope off South India indicating perhaps world-wide environmental changes throughout Late Quaternary times.

Erectile Dysfunction Drug Use, Risk Behavior, and Sexually Transmitted Diseases

Thesis (Master's)--University of Washington, 2016-06

Factors Affecting De Novo Urinary Retention after Holmium Laser Enucleation of the Prostate

Objective Patients can experience urinary retention (UR) after Holmium laser enucleation of the prostate (HoLEP) that requires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR after HoLEP. Materials and Methods 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between July 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after surgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal. Demographic and clinical parameters were compared between the UR (n = 37) and the non-urinary retention (non-UR; n = 299) groups. Results The mean age of patients was 68.3 (±6.5) years and the mean operative time was 75.3 (±37.4) min. Thirty seven patients (11.0%) experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (±1.7) days after UR. With regard to the causes of UR, 24 (7.1%) and 13 (3.9%) patients experienced a blood clot-related UR and a non-clot related UR respectively. Using multivariate analysis (p<0.05), we found significant differences between the UR and the non-UR groups with regard to a morcellation efficiency (OR 0.701, 95% CI 0.498–0.988) and a bleeding-related complication, such as, a reoperation for bleeding (OR 0.039, 95% CI 0.004–0.383) or a transfusion (OR 0.144, 95% CI 0.027–0.877). Age, history of diabetes, prostate volume, pre-operative post-void residual, bladder contractility index, learning curve, and operative time were not significantly associated with the UR (p>0.05). Conclusions De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age, diabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease the risk of UR after HoLEP.