999 resultados para Complicações pós-Operatórias


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Como o Diabetes Mellitus (DM) é uma doença que necessita de mudanças que duram por toda a vida, torna-se necessária uma ação educativa para instruir e conscientizar o diabético da importância do seu conhecimento sobre a doença como parte integral do cuidado. O objetivo desse projeto foi elaborar um plano de intervenção com vistas a redução dos principais fatores de risco do diabetes mellitus e suas complicações em uma unidade da estratégia saúde da família na Unidade Básica Londrina no município Santa Luzia Minas Gerais. Trata-se de um estudo descritivo qualitativo realizado com pacientes atendidos em um ambulatório de uma unidade básica de saúde. participaram deste estudo 752 diabéticos selecionados por amostragem sistemática. Os dados foram obtidos por meio de entrevista semi-estruturada. as questões norteadoras à entrevista foram compostas por temas referentes aos conhecimentos adquiridos a respeito do Diabetes Mellitus, terapêutica, nutrição, automonitorização, atividade física e cuidados automonitorização, atividade física e cuidados com o corpo. Os entrevistados mostraram um precário conhecimento de Diabetes Mellitus, terapêutica medicamentosa, nutrição e importância da atividade física. A automonitorização foi referida como necessária para os cuidados com os pés já que foi um dos cuidados corporais a serem adotados.O conhecimento sobre a temática questionada foi superior após realização das atividades educativas.Concluiu-se que, após reformulação da atividade educativa, os pacientes assaram a conhecer mais sobre a sua doença, evidenciando a importância da educação em saúde no controle do Diabetes.

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Projeto de intervenção a ser aplicado na Unidade de Saúde da Família de Sobradinho - Araruama com objetivo de melhorar o auto cuidado dos pacientes portadores de Diabetes Mellitus, com ênfase na prevenção das complicações, principalmente em relação aos pés. As complicações acompanhadas e que dificultam o tratamento poderiam ser evitadas se os pacientes diabéticos tivessem informações adequadas e conhecimento a respeito de sua doença. Propõem-se realizar um ciclo de oficinas educativas para os pacientes buscamos aumentar o conhecimento da doença, melhorando o auto cuidado com os pés e identificando sinais e sintomas de possíveis complicações

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A diabetes mellitus é uma doença crônica que afeta um grande número de pessoas representando um problema pessoal, e de saúde pública de enormes proporções devido às suas complicações, dentre delas o pé diabético. A neuropatia diabética é uma complicação que constitui umas das principais causas de mobilidade e incapacidades com importante repercussão biológica psicológica e social pois afeta a qualidade de vida do paciente. Este estudo permite demostrar a falta de conhecimento quanto comportamento adequado dos pacientes diabéticos pertencente ao município de São Jose do vale do rio preto sobre os cuidados especiais que tem que ter os mesmos com seus pés e dos fatores de risco que propiciam a aparição do pé diabético. O objetivo es promover um plano de ensino aos pacientes e familiares dos mesmos sobre os principais fatores de risco do pé diabético. Este estudo é do tipo descritivo exploratório tendo como público alvo os pacientes diabéticos do município.Com esta investigação espera-se identificar o grau de conhecimento dos pacientes sobre a importância do cuidado dos pés, permitindo formular estratégias de promoção y prevenção para incrementar seus conhecimentos e diminuir o risco de aparição desta doença.

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BACKGROUND: Strictureplasty is an alternative surgical procedure for Crohn?s disease, particulary in patients with previous resections or many intestinal stenosis. AIM: To analyze surgical complications and clinical follow-up in patients submitted to strictureplasty secondary to Crohn?s disease. METHODS: Twenty-eight patients (57.1% male, mean age 33.3 years, range 16-54 years) with Crohn?s disease and intestinal stenosis (small bowel, ileocecal region and ileocolic anastomosis) were submitted to strictureplasty, at one institution, between September 1991 and May 2004. Thirteen patients had previous intestinal resections. The mean follow-up was 58.1 months. A total of 116 strictureplasties were done (94 Heineke-Mikulicz - 81%, 15 Finney - 13%, seven side-to-side ileocolic strictureplasty - 6%). Three patients were submitted to strictureplasty at two different surgical procedures and two in three procedures. RESULTS: Regarding to strictureplasty, postoperative complication rate was 25% and mortality was 3.6%. Early local complication rate was 57.1%, with three suture leaks (10.7%) and late complication was present in two patients, both with incisional hernial and enterocutaneous fistulas (28.6%). Patients remained hospitalized during a medium time of 12.4 days. Clinical and surgical recurrence rates were 63% and 41%, respectively. Among the patients submitted to another surgery, two patients had two more operations and one had three. Recurrence rate at strictureplasty site was observed in 3.5%, being Finney technique the commonest one. Presently, 19 patients had been asymptomatic with the majority of them under medical therapy. CONCLUSION: Strictureplasties have low complication rates, in spite of having been done at compromised site, with long term pain relief. Considering the clinical course of Crohn?s disease, with many patients being submitted to intestinal resections, strictureplasties should be considered as an effective surgical treatment to spare long intestinal resections.

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We studied 271 children under age of 15 with diagnosis of acute bacterial meningencephalitis treated at Medical School in Ribeirão Preto, University of São Paulo, between 1980 and 1990. The patients were divided in two groups: 1) those who had not received previous antibiotics treatment (NTP), with 153 cases; and 2), those who had received previous antibiotics treatment (PT), with 118 cases. The etiological agent was more frequently identified in NPT group, while ventriculitis was more frequent in PT group. Mortality rate accounted for 19,5% of all cases, and 29.7% of children under 12 months of age. Acute meningitis caused by Streptococcus pneumoniae was frequently followed by increased mortality. Convulsive disorders and hemiparesis predominante among children under 12 months of age. On the neurosurgical point of view, ventriculitis, subdural hygroma, hydrocephalus, subdural empyema and brain abscess were identified and treated

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Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA) and branches of the middle cerebral artery (MCA) are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA) is the treatment of choice in many cases. This procedure has however a high risk of brain infarction. Revascularization of the brain by extra-intracranial anastomosis between the superficial temporal artery (STA) and branches of the MCA is frequently performed. This procedure provides however a low flow bypass and brain infarction may occur. We report two cases of giant cavernous sinus aneurysms treated by high flow bypass and endovascular balloon occlusion of the ICA. Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.

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Tomato postharvest losses are very high in Brazil and the goal of this research was to evaluate the effect of handling and the transport of tomato fruits, cultivar Romana on the steps of harvesting, weight and transportation to the packinghouse, pointing some critical points. Tomatoes were harvested at plastic boxes, weighted and shipped to a packinghouse. Fruits taken directly from the plant were determined as reference. The parameters evaluated were weight loss and mechanical injury and tomato physical quality after storage during 21 days. It was observed an increasing on the weight loss, external damage, and postharvest losses, after storage. Handling and transportation were the cause of an increase in 6.6% in external damage and 1.93% of weight loss after storage, when comparing harvested fruits and fruits evaluated on the packing-house. The main reason for postharvest losses was due to mechanical injury caused during transportation mainly due to the compressure force among fruits and against the plastic boxes.

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The durability and postharvest quality of cut flowers are fundamental attributes in value along the production chain and in consumer satisfaction. The objective of this study was to evaluate the effect of chemical inhibitors of ethylene action on maintaining the postharvest quality of chrysanthemum stems (Chrysanthemum morifolium Ramat cv. Dragon). The experiment tested maintenance solutions with silver thiosulfate (STS) under five levels (distilled water, a 0.2 mM STS, the STS 0.2 mM + sucrose at 50 g L-1, STS at 0.4 mM; STS at 0.4 mM + sucrose at 50 g L-1), and date of sampling, for three levels (0, 3, 6 days). Three replications with two flower stems in each treatment were used in the experiment. Physical assessments were made: color, fresh mass and relative water content; chemical evaluations: reducing sugars and pigments, and qualitative assessments: turgidity, flower color, and number of buds, open flowers and partially open flowers. Treatment with 0.2 mM STS resulted in better maintenance of fresh mass of stems. The concentration of pigments and reducing sugar was higher in those treatments in which sucrose was associated. The color and relative water content were favored in treatments STS 0.2 mM and 0.4 mM. The concentration of 0.2 mM STS obtained the best results, prolonging the vase life the stems. The quality of these stems was higher, with the best assessments of water content, color and turgidity.

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The development and use of techniques that extend the life vase of the flowers, maintaining the quality of the product, is essential for reducing postharvest losses. The objective of this work was to evaluate different solutions for maintenance, associated or not to sucrose, in maintaining the postharvest quality of chrysanthemum stems. The treatments used distilled water, 8-HQC to 100 mg L-1, 8-HQC to 100 mg L-1 + sucrose 50 g L-1, 8-HQC to 200 mg L-1, 8-HQC to 200 mg L-1 + sucrose 50 g L-1. Physical assessments were made: color, fresh mass and relative water content; chemical evaluations: reducing sugars and pigments, and qualitative assessments: turgidity, color of the flowers, and number of buttons, open flowers and partially open flowers. The combination of 8-HQC 200 mg L-1 + sucrose 50 g L-1 was the best performance that made for maintaining the quality of flower stems, favoring the opening of buttons and turgidity of petals. Sucrose contributed to better maintenance of the reserve substances in the shaft, which had increased the flower vase life.

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One of the main objectives of applying edible coatings on fruits surface is to create a protective film to reduce weight loss due to evaporation and transpiration and also to decrease the risk of fruit rot caused by environmental contamination, in order to improve the visual aspect. Therefore, it is possible to increase shelf life, and decrease post harvest losses. Persimmon is a much appreciated fruit, with high potential for export, but sensitive to handling and storage. This study aimed to evaluate the effect of applying the edible coating Megh Wax ECF-124 (18% of active composts, consisting of emulsion of carnauba wax, anionic surfactant, preservative and water) produced by Megh Industry and Commerce Ltda in three different concentrations (25, 50 and 100%) on post harvest quality of 'Fuyu' persimmon stored for 14 days. The attributes evaluated for quality were: firmness, pH, acidity, soluble solids, weight loss and color. The results showed that application of carnauba wax in different concentrations was effective on decreasing weight loss of persimmon cv. Fuyu and maintenance of color aspects. Treatment at lower concentration, 25%, showed lower rate of discharge, but high concentrations showed lower values of mass loss. Carnauba wax application showed a high potential for use on postharvest conservation, and can be applied together with other technologies, helping to maintain quality for export.

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From December-1965 to November-1969, 95 hydrocephalic infants have been operated upon using ventriculoperitoneal shunt with valve (88 cases with a Spitz-Holter valve, 6 cases with a Hakim valve and one case with a Pudenz-Heyer valve). Up to the present time (December, 1970) a total of 54 children are alive with a compensated hydrocephalus and 9 patients died, being impossible to follow-up the 32 remaining cases. The use of the ventriculoperitoneal shunt has eliminated all cardiovascular-pulmonary complications and reduced the number for surgical revisions. Besides, infections involving the draining system are less severe and more easily controlled than those occurring in the ventriculoatrial shunts. After analysis of the surgical techniques as well as complications and results the following conclusions are stated: 1) the use of a valve in the ventriculoperitoneal shunt difficults the oclusion of the peritoneal end of the draining system; 2) good results can be expected without reoperations in about 42,35% of hydrocephalus cases treated by ventriculoperitoneal shunt with valve; 3) ventriculoperitoneal shunts with valve showed better results when compared to ventriculoatrial shunts. This statement is made comparing two groups of hydrocephalic infants submitted to surgery at the same Service and in the same conditions, with the same follow-up period; 4) the cases presented permit to state that at present time the ventriculoperitoneal shunt with valve is the most suitable surgical procedure for hydrocephalus.

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The computerized tomography (C.T.) of 18 pacients with sellar tumours were analysed. The C.T. made before surgery in 6 cases was positive in 3 and the type of tumour suggested by C.T. was confirmed in 3. Twelve pacients had a C.T. investigation after surgery and the examination suggest recurrent tumour in 5. Two of these were re-operated. One pacient with colesteatoma had the recurrent tumour verified by surgery and the other, with a pituitary adenoma during re-operation was noted only cicatricial tissue at sellar region.

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The authors present the study of four children with arteritis as vascular complication of acute bacterial meningitis. They report pathophysiological mechanisms involved in vascular lesions, and progress in the understanding of these complications.

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Universidade Estadual de Campinas . Faculdade de Educação Física