945 resultados para Medicamentos - Controle de custo
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Load transportation in brazilian territory is made difficult by a deficient highway network, result of low maintenance and lack of government supervision. The problem aggravates when we consider the transportation of indivisible loads, mainly because the brazilian highways are not prepared for such task and few companies in Brazil have the necessary equipment suited for this kind of transport. In this dissertation it will be shown the analysis of a specific equipment to transport overweight indivisible loads, called hydraulic modular multi axle trailer. From an existing project (RB.04LE-01), manufactured and homologated in Brazil, it has been studied how the components in this trailer work so it could have been possible to elaborate a new model (RB.04LE-02), with two main objectives: reduction of costs and weight with subsequent increase in the liquid load for roadway transportation. The trailer’s components analyses were made utilizing the theory of fatigue strength of materials and finite element method with the von Misses criteria for a more safety when realizing the calculations
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O captopril foi o primeiro agente desenvolvido para o tratamento da hipertensão, doença que acomete grande parte da população adulta mundial, a qual requer cuidados especiais quanto à farmacoterapia e ajuste de doses. Assim sendo, este trabalho tem como objetivo avaliar a qualidade de comprimidos de captopril 50 mg comercializados no Brasil através da realização da equivalência farmacêutica entre duas marcas de comprimidos não revestidos de captopril 50 mg (um genérico G e um similar S) em relação ao medicamento referência (R) Capoten® Bristol Myers Squibb 50 mg, utilizando os requisitos descritos na monografia individual do fármaco da Farmacopeia Brasileira e da Farmacopeia Americana. Medicamentos referência são produtos inovadores, cuja eficácia, segurança e qualidade foram comprovadas cientificamente; os chamados similares são os que contêm as mesmas substâncias ativas, mesma concentração, forma farmacêutica, via de administração, posologia e indicação terapêutica do medicamento de referência e são identificados por nome comercial ou por sua marca; os medicamentos genéricos são intercambiáveis com o produto referência e, geralmente, são produzido após a expiração ou renúncia da proteção patentária do mesmo, ele deve ser designado pela DCB (Denominação Comum Brasileira) ou, na ausência desta, pela DCI (Denominação Comum Internacional). Os dois medicamentos analisados, medicamento similar e medicamento genérico, apresentaram resultados satisfatórios quanto à determinação de peso médio, resistência mecânica e tempo de desintegração dos comprimidos, identificação, doseamento, limite de dissulfeto de captopril, uniformidade de doses unitárias, teste de dissolução e perfil de dissolução do fármaco, com relação ao seu medicamento referência correspondente, ou seja, estes são equivalentes farmacêuticos e apresentam qualidade... (Resumo completo, clicar acesso eletrônico abaixo)
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The search for energy efficiency improvement is a common concern in many companies. Cogeneration is a well known technique but not so spread in Brazil, despite its potential for energy costs reduction through heat recovery from prime movers. In this work, a preliminary technical and economic study is carried out for a cogeneration plant application in an automotive industry of São Paulo. Though mathematics modeling, three 2435 kW internal combustion engines are selected. When compared to the current status (no cogeneration), annual savings of about 2,2 MR$ are obtained, resulting a almost 3 years payback
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This work has a focus on project execution DMAIC ( Define Measure Analyze Implement Control) , using the statistical and quality tools to identify , analyze and implement improvements in a given process in order to reduce costs telephony transport of a multinational consumer goods . The multinational consumer goods to be studied has outsourced carriers who perform the distribution of its products , which may lead them straight to their factories or one of its distribution centers to the points of sale ( supermarkets , bakeries , gas stations , convenience cafeterias , among others ) . Whenever there is an unexpected situation or some problem at the time of delivery of the goods to the customer opens an occurrence , ie , the carrier responsible for contacts ( 0800 ) with the contact center company of consumer goods which in turn registers the occurrence, analyzes and sends a response action to the carrier . This work will study the problem with a high number of connections to handle occurrence , through analysis and data collection , identify improvement opportunities, implement them and monitor the results to ensure that the gain and loss reduction are sustainable
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Objectives: conduct a systematic review of national and international literature, to classify the types of production, comparing the two literatures and synthesize knowledge in the area. Method: Systematic Review of Literature, in the databases LILACS, CINAHL and MEDLINE for selection of articles in their entirety, the data extracted from the articles selected were: the study of bibliographic information (title, author, journal, place of study and year of publication), and general information (multidisciplinary production or specific area, language, type of study, type of population and contributions of the study). The categories established for classification of publications were: raising the cost of procedures/ interventions, economic evaluation of specific intervention, inclusion of nursing in the economic context, using cost as an important variable in the study. Results: The study included 39 publications, with 31% of national production and the remaining 69%, internationally. Most publications were classified according to category of economic evaluation of specific intervention, followed by the category of raising the cost of procedure / intervention, which fits the majority of national production. Human resources is shaped as an important variable for obtaining cost studies that proposed to make this calculation. Conclusion: The production of literature in nursing cost management is relevant in number of publications within the proposed period and is directed to different areas within this theme. There are significant differences in national and international literature: these last use more accurate methods, have more content theorized, use more the economic evaluation tools and related more costs with a amplified context. The production of such knowledge should continue as far as possible and putting that knowledge relating the current reality, in order to amplify the field of nursing and add value
Validation of analytical methodology for quantification of cefazolin sodium by liquid chromatography
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A reversed-phase high performance liquid chromatography method was validated for the determination of cefazolin sodium in lyophilized powder for solution for injection to be applied for quality control in pharmaceutical industry. The liquid chromatography method was conducted on a Zorbax Eclipse Plus C18 column (250 x 4.6 mm, 5 μm), maintained at room temperature. The mobile phase consisted of purified water: acetonitrile (60: 40 v/v), adjusted to pH 8 with triethylamine. The flow rate was of 0.5 mL min-1 and effluents were monitored at 270 nm. The retention time for cefazolin sodium was 3.6 min. The method proved to be linear (r2 =0.9999) over the concentration range of 30-80 µg mL-1. The selectivity of the method was proven through degradation studies. The method demonstrated satisfactory results for precision, accuracy, limits of detection and quantitation. The robustness of this method was evaluated using the Plackett–Burman fractional factorial experimental design with a matrix of 15 experiments and the statistical treatment proposed by Youden and Steiner. Finally, the proposed method could be also an advantageous option for the analysis of cefazolin sodium, contributing to improve the quality control and to assure the therapeutic efficacy
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The competition for markets have created extreme challenges for companies that need an efficient management system. The transformational system involve all the employees in the task of eliminating waste, add value to products, reduce variations in processes, increase reliability and discover customer needs. The collaborative management is one of the focuses of this research. It was based on the analysis of the Fleury's suggestion program called Central de Ideias, The Fleury Group is one of the most traditional organizations of medical and health in the country. We pointed out the evolution of the program and we also showed the results of the changed of the management tool ideas. An extensive theoretical study was conducted in order to enhance the benefits that a suggestion system provides to the organizations. The Programa Central de Ideias has saved millions for Fleury and it has been made processes more efficient. The increasing of employees participation, the improvement of the internal communication and the refinement of the quality services are one of the suggestion system benefits
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The competition for markets have created extreme challenges for companies that need an efficient management system. The transformational system involve all the employees in the task of eliminating waste, add value to products, reduce variations in processes, increase reliability and discover customer needs. The collaborative management is one of the focuses of this research. It was based on the analysis of the Fleury's suggestion program called Central de Ideias, The Fleury Group is one of the most traditional organizations of medical and health in the country. We pointed out the evolution of the program and we also showed the results of the changed of the management tool ideas. An extensive theoretical study was conducted in order to enhance the benefits that a suggestion system provides to the organizations. The Programa Central de Ideias has saved millions for Fleury and it has been made processes more efficient. The increasing of employees participation, the improvement of the internal communication and the refinement of the quality services are one of the suggestion system benefits
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Dissertação (mestrado)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Civil e Ambiental, 2016.
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As emissões atmosféricas têm sido consideradas por especialistas, poder público, iniciativa privada e organizações ambientalistas, um dos maiores impactos ambientais que o planeta vem enfrentando. Neste contexto estão tanto as fontes estacionárias quanto as fontes móveis. Ao mesmo tempo em que se lançam na atmosfera milhões de toneladas de poluentes a cada ano através da indústria, o homem procura soluções alternativas através de fontes de energia limpa. Adicionalmente, procura-se ao diminuir as emissões das fontes fixas exercer melhor controle e tratamento. Apresenta-se nesse trabalho, a possibilidade da implementação de ações que visem minimizar o impacto causado pelas caldeiras geradoras de energia, em especial as que operam com queimadores convencionais. Experimentou-se um procedimento capaz de ser utilizado de imediato pelas indústrias, antes mesmo de se implementar inovações tecnológicas, que demandam tempo e recursos. Desta forma, pode-se reduzir, de maneira imediata, o volume de poluentes lançados diariamente na atmosfera, em especial o monóxido de carbono, CO, os óxidos de nitrogênio, NOx, e o material particulado, MP. Objetivou-se atingir um nível de emissões capaz de minimizar o custo do dano, sem perder a eficiência da combustão. Apresenta-se ainda a base metodológica de um modelo, utilizando-se a lógica difusa, como forma de se obter um controle e confiabilidade na gestão das emissões.
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Medidas restritivas de controle de antimicrobianos têm sido propostas para controlar surtos epidêmicos de infecção por germes multirresistentes em hospitais, mas são escassas as publicações a respeito de sua eficácia. Em um estudo quaseexperimental com controles históricos, avaliou-se a efetividade de uma intervenção restritiva ao uso de antimicrobianos para controlar a emergência de germes multirresistentes em uma unidade de cuidados intensivos (UTI) de um hospital geral. Os Serviços de Controle de Infecção e Comissão de Medicamentos restringiu o uso de drogas antimicrobianas em pacientes hospitalizados na UTI a não mais que dois agentes simultaneamente, exceto em casos autorizados por aqueles serviços. A incidência de eventos clínicos e bacteriológicos foi comparada entre o ano que precedeu a intervenção e o ano que a seguiu. No total, 225 pacientes com idade igual ou maior de 15 anos , com infecção, internados na UTI por pelo menos 48 horas, foram estudados no ano precedente a intervenção e 263 no ano seguinte a ela. No ano seguinte à intervenção, um percentual menor de pacientes foi tratado simultaneamente com mais de dois antimicrobianos, mas não houve modificação no número total de antimicrobianos prescritos, na duração e no custo do tratamento. Mortalidade e tempo de internação foram similares nos dois períodos de observação. O número de culturas positivas aumentou depois da intervenção, tanto para germes Gram positivos, quanto para germes Gram negativos, principalmente devido ao aumento do número de isolados do trato respiratório. A maioria dos isolados foi Staphylococcus aureus dentre os Gram positivos e Acinetobacter sp dentre os germes Gram negativos. No ano seguinte à intervenção, a sensibilidade dos microorganismos Gram negativos para carbenicilina, ceftazidima e ceftriaxona aumentou, e para o imipenem diminuiu. A ausência de resposta dessa intervenção sobre desfechos clínicos pode ser em conseqüência da insuficiente aderência ou a sua relativa ineficácia. A melhora da sensibilidade microbiana de alguns germes, semaumento de custos ou a incidência de efeitos adversos, encoraja o uso de protocolos similares de restrição de drogas antimicrobianas para reduzir a taxa de resistência bacteriana na UTI.
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A introdução da Análise Custo-Efetividade na área da Saúde decorre desta preocupação de aperfeiçoamento dos métodos gerenciais em geral, e de escolha de alternativas de ação que levem ao melhor resultado em relação ao custo. Derivada das técnicas econômicas de análise de investimentos em uso no setor empresarial, a ACE pode ser de grande utilidade na montagem de programas e planos de saúde, na escolha entre diversos programas alternativos, e na sua avaliação. Consiste basicamente em confrontar os custos (esperados ou realizados a) de um programa, com seus resultados ou impactos (esperados ou realizados). A aplicação da Análise Custo-Efetividade é ainda recente, e restringe-se aos Estados Unidos e a alguns países europeus. No Brasil, embora comece a ser divulgada, ainda não foi utilizada em programas reais. Seus princípios e sua metodologia são relativamente simples, mas sua utilização em casos concretos esbarra em algumas dificuldades. Assim, a aplicação da análise a um dos programas desenvolvidos na Secretaria da Saúde poderá, além de divulgar a ACE na instituição, estabelecer claramente seu potencial e suas limitações no contexto da saúde pública brasileira. Um dos programas mais problemáticos da Secretaria é o Sub-programa de Controle da Hanseníase. Em vigência há vários anos, seus resultados estão aquém do esperado, em que pesem as características de uma doença endêmica e complexa e as falhas do próprio sub-programa. O interesse em se avaliar um programa cujos resultados são reconhecidamente insatisfatórios, e nosso conhecimento e experiência pessoal na área da hanseníase, justificam a escolha deste Sub-programa para a aplicação da Análise Custo-Efetividade.
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Analytical study of therapeutic nonrandomized intervention type, intra-group controlled, with the aim of analyzing the cost-effectiveness of compression therapy with manipulated Unna boot in relation to conventional therapy in the healing of venous ulcers (VU) of patients treated in ambulatory clinic. The study population was composed by patients with VU treated by angiologists in Surgical Clinic Ambulatory of the Onofre Lopes University Hospital (HUOL) with a sample of 18 patients. It obtained the assent of the HUOL Ethics in Research Committee (Protocol 276/09). Data collection was performed over a period of four months by the own master's student and 34 nursing students, through the application of the research instrument in the admission of patients to the study and in the ten subsequent evaluations, performed at the time of changing Unna boot, weekly, for a maximum period of 10 weeks. The data were analyzed with SPSS 15.0 software, using descriptive and inferential statistics, and presented as tables, charts and graphs. Among those surveyed, prevailed: females, mean age 57.6 years, low education and income levels, most retired, unemployed or off work, with the standing position more than six hours per day and up to eight hours daily of domestic or occupational activities. In health status profile of respondents there were predominantly sleep, rest and inadequate elevation of the lower limbs, no smoking and/or alcohol use, presence of hypertension and no use of drugs. Most presented the first VU for over 10 years, recurrences, present VU for more than five years, involvement of left leg, in malleolar and / or distal leg region, mild edema, hyperpigmentation, lipodermatosclerosis, telangiectasies, reticular and varicose veins, mild pain, serous exudate in moderate quantity, small lesions (up to 50cm2), with predominance of granulation tissue and / or epithelialization and demarcated, elevated and irregular borders, with crusts and macerated. Most patients reported that in the 10 weeks prior to admission, made bandages at home and / or Basic Health Unit and / or ambulatory, with nursing aides or technicians, daily, and on weekends or holidays, performed by patients themselves, using healing ointment on the lesion, being observed granulation / epithelialization and increase in VU prevalent in the 10 weeks of traditional treatment. After follow up with manipulated Unna boot, was observed a decrease of lesions in all study patients, with complete healing in 27.8% of those between 1 and 5 weeks of treatment, with satisfactory evolution of the lesions, pain and ankle and calf circumferences, and unsatisfactory development of the borders of ulcers, edema, sleep, rest and elevation of the lower limbs, especially in more chronic patients. Furthermore, patients who achieved total healing and exhibited the greatest percentage reduction of lesions had a higher number of wound healing factors (ρ = 0.01 and ρ = 0.027, respectively). The manipulated Unna boot showed better results in those patients with shorter duration of injury, leading them to a satisfactory outcome within a short period of treatment. After the cost-effectiveness analysis, we conclude that the manipulated Unna boot is more effective than conventional therapy in the healing process of VU and is more cost-effective in patients with shorter lesions (ρ = 0.001), shorter treatment (ρ = 0.000) and greater number of wound healing factors (ρ = 0.005).