641 resultados para valvotomia percutânea por cateter balão


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A ascensão de Eduardo Cunha (PMDB) à presidência da Câmara dos Deputados reacendeu as discussões em torno da reforma política. Em rota de colisão com o Palácio do Planalto, Cunha oficializou a criação de uma comissão especial para debater o tema e garantiu ao oposicionista Rodrigo Maia (DEM-RJ) o comando dos trabalhos. A movimentação, entretanto, não é o primeiro balão de ensaio, sugerindo alterações nos itens da Constituição Federal que tratam do assunto. Desde a passagem de Fernando Henrique Cardoso (PSDB) pela cadeira de presidente até a sinalização de Dilma Rousseff (PT) – em resposta às manifestações de junho de 2013 -, propondo um plebiscito para debater as modificações, não faltaram esboços fracassados de alterações na legislação. As únicas mudanças observadas neste ínterim foram a emenda da reeleição – para muitos, casuística, já que garantiu a FHC mais quatro anos no poder – e a adoção da Lei da Ficha Limpa. Com a retomada das discussões, a Tribuna inicia hoje uma série para tentar jogar luz nos principais tópicos em debate no Congresso sobre a reforma.

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Objetivo: Avaliar o efeito da nicotina na cicatrização da camada musculoaponeurótica da parede abdominal. Métodos: Estudo experimental em que foram usados 16 ratos da raça Wistar pesando em média 210±8g, separados aleatoriamente em 2 grupos de 8. Nos animais do grupo A foi implantado disco de nicotina (Nicotinel Ò) na dose de 5mg/Kg de peso/dia no subcutâneo da região dorsal, trocado a cada dois dias, a partir do 5º dia antes da operação em que foi feita laparotomia mediana de 5 cm, até o 10o dia de observação. No grupo B (controle) foram usados discos de celulose com o mesmo diâmetro. Tubo de silicone multiperfurado foi implantado no subcutâneo a 1cm da lesão da parede abdominal. A camada musculoaponeurótica e a pele foram suturadas com fio de nylon 5-0. No 10º dia pós-operatório foi colhido 1ml de líquido seroso do tubo de silicone por punção percutânea para dosagem de pO2 e os animais receberam dose letal de anestésico. Foi ressecado um segmento da camada musculoaponeurótica com 2cm de largura para tensiometria, em seguida processado e corado em HE e tricrômico de Masson para análise quantitativa dos dados histopatológicos em sistema digitalizado. A análise estatística foi feita pelo ANOVA e teste Newman-Keuls, com significância 0,05. Resultados: No grupo A a pO2 do líquido tecidual atingiu o valor 17,75±3,4 mmHg e no grupo B (controle) a pO2 = 40,75±6,4 mmHg (p<0,01). A resistência à tensão apresentou o valor de 728,5±161,75gf no grupo A e 1241,6±232gf no grupo de controle (p<0,01), coincidindo com os achados da pO2. A densidade média dos elementos histopatológicos estudados foi de 105±17,1 nos animais do grupo A e 146,2±8,8 no grupo B (p<0,01). Conclusão: após avaliação da pO2 tecidual, tensiometria e histopatologia, concluiu-se que a nicotina por via subcutânea exerce efeito deletério sobre a cicatrização de lesões da parede abdominal de ratos

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Foam was developed as a novel vehicle for streptokinase with the purpose of increasing the contact time and area between the fibrinolytic and the target thrombus, which would lead to a greater therapeutic efficacy at lower doses, decreasing the drug s potential to cause bleeding. Fibrinolytic foams were prepared using CO2 and human albumin (at different v:v ratios), as the gas and liquid phases, respectively, and streptokinase at a low total dose (100,000 IU) was used as fibrinolytic agent conveyed in 1 mL of foam and in isotonic saline solution. The foams were characterized as foam stability and apparent viscosity. The thrombolytic effect of the streptokinase foam was determined in vitro as thrombus lysis and the results were compared to those of a fibrinolytic solution (prepared using the same dose of streptokinase) and foam without the fibrinolytic. In vitro tests were conducted using fresh clots were weighed and placed in test tubes kept at 37 ° C. All the samples were injected intrathrombus using a multiperforated catheter. The results showed that both foam stability and apparent viscosity increased with the increase in the CO2:albumin solution ratio and therefore, the ratio of 3:1 was used for the incorporation of streptokinase. The results of thrombus lysis showed that the streptokinase foam presented the highest thrombolytic activity (44.78 ± 9.97%) when compared to those of the streptokinase solution (32.07 ± 3.41%) and the foam without the drug (19.2 ± 7.19%). We conclude that fibrinolytic foam showed statistically significant results regarding the enhancement of the lytic activity of streptokinase compared to the effect of the prepared saline solution, thus it can be a promising alternative in the treatment of thrombosis. However, in vivo studies are needed in order to corroborate the results obtained in vitro

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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A laminite é uma doença podal grave que acomete os equídeos, sendo responsável por intenso sofrimento. Neste estudo foram pesquisadas a presença de calprotectina por meio da imunoistoquímica, e de lipocalina associada à gelatinase de neutrófilos (NGAL), por zimografia, no tecido laminar do casco de equinos após obstrução intestinal. Os animais foram divididos em quatro grupos: Grupo controle (Gc), contendo sete animais normais, sem procedimento cirúrgico; Grupo Instrumentado (Gi), contendo cinco animais, os quais passaram por todo o procedimento cirúrgico sem sofrerem obstrução intestinal; Grupo Não Tratado (Gnt), contendo quatro equinos submetidos a obstrução intestinal do jejuno por distensão de balão intraluminal, sem tratamento; e Grupo Tratado (Gt), contendo quatro equinos submetidos a obstrução intestinal, e tratados preventivamente com hidrocortisona. Houve imunomarcação de calprotectina em todos os grupos experimentais, com aumento nos equinos do grupo distendido em relação ao Gc. Com relação ao NGAL, houve aumento também do Gnt e do Gi em relação ao Gc. O Gt não diferiu dos demais. Conclui-se que a distensão do intestino delgado pode promover acúmulos de leucócitos nos cascos de equinos e que o NGAL é um método viável para se detectar infiltração neutrofílica em equinos. Novos estudos deverão ser realizados para se verificar possível benefício anti-inflamatório da hidrocortisona no casco de equinos com obstrução intestinal.

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Quasi-experimental study, prospective with quantitative approach, performed at the Hospital do Coração in Natal, aimed at verified the existence of difference between the care given by health professionals to the patients under mechanical ventilation (MV) in the Intensive Care Unit, before and after an educative intervention. The population was of 31 professionals, with data collected between november 05 of 2007 to march 27 of 2008. The results show a yong population, female gender, middle level of education, nursing technique, working between 05 and 09 years on nursing profession, and 01 to 04 years on Intensive Care Unit; almost all, never had an kind of training over prevent pneumonia associated to mechanical ventilation; from those that had training, occur on the work place with duration from 12 to 24 hours. About endotracheal intubation, the cuff was tested with a sterilized syringe had a positive change after a educative intervention, increased from 75,0% to 100,0%; the sterile guide was used on 75,0% before and 100,0% after an educative intervention. Regarding endotracheal suction procedure, was not informed to the patient on 72,7% before, however was informed on 56,7% after; the hands was not previously washed 68,5% before, however was 63,3% after the procedure; mask was used on 74,2 % opportunities before and 76,7% after; the aspiration catheter had adequated size on 98,9% observation before and 100,0% after; the gaze was sterilized on 95,7% before and 100,0% after; the ventilator was connected to the patient during the aspiration intervals on 94,4% observation before and 100,0% after; the ambu bag was clean and protected on 76,1% before and 85,7% after; the aspiration catheter was discarded after be used on 98,9% before and 100,0% after; FIO2 was turned to the begging value on 32,9% observation before and 12,0% after; before the procedure 71,9% professions washed their hands and 73,3% after; before, notes of aspiration results were performed on 70,8% observation and 86,7% after. Regarding devices used on respiratory tract, aspirator flasks were not swapped on 84,6% observations before and 71,0% after; daily látex extention change was not performed on 93,6% observation before and 87,1% after; the ambu bag change was not performed on 50,0% observation before even if was duty or unprotected and on 75,8% opportunities was changed, after; nebulization was not prepared with sterile fluids or manipulated aseptically on 65,2% observation before, perhaps was on 71,7% after; before nebulizers were not changed on 65,2% observations, perhaps were on 60,9% after. Concerning ventilator breathing circuits, condense fluids cumulated on circuits were removed on 55,0% opportunities before, and 64,0% after; moisturizer was not filled with sterile water when already had small amount of liquid inside on 78,4% observations before, and 90,2% after; MV circuits were changed on 97,0% observations on presence of visible duty or when presents some kind of failure, before and 98,4% after. About body position, on 51,3% observations the decubitus position change were done before and 78,2% after; fowler position was maitened on 95,5% observations before and 98,2% after; Regarding respiratory physiotherapy, enteral diet was not interrupted before respiratory physiotherapy on 94,9% before and 90,0% after; respiratory physiotherapy devices were not disinfected or sterile on 69,6% observations before but they re on 60,0% after; before the cateter was not tested before introduction enteral diet or medications on 100,0% but after was done on 15,2%. About enteral feeding, intestine motility and measure of stomach contents were not done on 100,0% observations before, but was 15,2% after. We conclude that 05 of 07 valuated procedures in relation to MV, had a significant improvement on quality of care given after educative intervention, when compared before intervention

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A descriptive, quantitative approach and non-participant observation study, which was aimed at analyzing the association between knowledge and practice of inclusion and maintenance of urinary catheter by nursing professionals in the occurrence of urinary tract infection, performed in the ICU of Onofre Lopes University Hospital in Natal / RN. The original sample was composed of 42 nursing staff professional, five (5) nurses and 37 nursing technicians, 27 of them were outsourced (FUNPEC and IEL fellows) and 10 servers UFRN. Data collection was performed using two instruments, the first observation procedures used in the insertion and manipulation of indwelling urinary catheter (IUC) and the second with a questionnaire that addressed the characterization data of respondents, knowledge and conduct the insertion and manipulation of the IUC. The results were tabulated in Microsoft Excel and analyzed using SPSS software, version 15.0. We found the prevalence of institutional staff members on outsourcing - IEL and FUNPEC - (64.3%) were female (69.0%), aged 21 to 35 years (59.5%) and with mid-level education (88.1%). As to knowledge, we found that the nurses had levels of good to excellent and the nursing technicians, to regulate the poor. The nurses made a mistake when choosing IUC (40.0%) and washing hands (30.0%) and technicians on hand washing (74.4%) and the contents of the tray (34.7%). In relation to the conduct of insertion of IUC, the nurses made a mistake when choosing SVD (66.7%) and washing hands (57.1%). Regarding the handling of IUC/drainage system, the technicians were wrong more about washing their hands (56.0%). Analyzing the misconduct to the categorization of knowledge, we saw that the nursing staff who had missed more had inadequate knowledge (ρ = 0.001). At the end we found the risk of a patient to acquire UTI is higher in two and a half times when there is a large number of mismatches, patient spends more time using the IUC and hospitalized in the ICU. As regards the study hypotheses, we accept the alternative hypothesis and reject the null hypothesis proposed at the start of this research, where the number of gaps in knowledge and behavior increases the incidence of urinary tract infection.