957 resultados para Unidade Pediátrica de Terapia Itensiva
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Trata-se de um caso clínico que teve como objetivo traçar diagnósticos, intervenções e resultados de enfermagem em um paciente com Síndrome de Marfan internado na unidade de terapia intensiva no pós-operatório de correção de aneurisma de aorta. Foi desenvolvido em um Hospital Universitário, localizado no município de Natal-Brasil, em abril de 2011. Entre os principais diagnósticos de enfermagem identificados, destaca-se: Débito Cardíaco Diminuído; Risco de Infecção; Dor Aguda; Risco de Glicemia Instável; Integridade da Pele Prejudicada e Ansiedade. Percebeu-se que a aplicação do processo de enfermagem neste paciente contribuiu para delimitar o campo de atuação específico da enfermagem, bem como identificar os cuidados prioritários, contribuindo para uma melhoria na qualidade da assistência
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The evaluation of public policies that promote Food Security and Nutrition (FSN) it s a multidisciplinary activity extremely relevant to the effectiveness of actions to legitimize the Human Right to Adequate Food (HRAF). This study aimed at assessing the effectiveness of the unit project Natal-RN Café do Trabalhador in promoting SAN to its users. The theoretical framework is based on the public and political and on the dimensions of the concept of FSN (quantity and quality-regularity). Through a qualitative approach, methodologically this was the work of an evaluation of efficiency of the unit Natal-RN of Café do Trabalhador project in light of the assumptions of the concept of SAN. Data collection was conducted through retrospective archival research in official documents of the project, semi-structured interviews with managers involved in its implementation (representative of the Secretary of State for Employment, Housing and Care of RN SETHAS and third party), socioeconomic questionnaire applied to the users of the unit, check the amount, regularity and quality of meals offered for 15 days (menu routine) using the descriptive form menu and form filling type checklist for verification of compliance with good practices . Methods of analysis, we used content analysis, descriptive statistics and compared to previously established parameters for the project. As categories of analysis were defined organizational arrangement, access, user, food quantity-regularity and food quality. The results show that, it was found in the category arrangement that will implement the project dismissed technical criteria for choosing the districts and the quantitative distribution of meals for each location. It was found that the valuation of the shares of the company outsources technical SETHA has not been performed. We observed in the access category, the unit has a strategic location, but lack of space in the refectory. The main obstacle to economic access for users is the lack of a register for the beneficiaries. In the category of users, it was identified that the clientele of the project it is predominantly men, with more than 51 years, low education, earning wages less 1 obtained through informal employment, which they move up through the unit transport collective, go to all days of operation due primarily to price. About the meals category quantity-regularity of food showed that the menu serves 95% of the desired needs, and that holidays and weekends are periods of disrupting the regularity of supply of meals. Regarding the category of food quality, it was found that the nutritional aspect on the menu are food sources rich in sodium, nitrates and low in fiber. In the aspect of hygiene and sanitation are the main limitations related to waste management, lack of exposure controls of food prepared and inadequacies of the physical structure. The results showed that in general and the institutional arrangement of the organs attached to the project should establish a systematic evaluation project is to establish as a promoter of and FSN overcome these obstacles
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Standardization and sustainability: these two apparently antagonistic words find the challenge of uniting in a flexible architectonic proposal. This was the idea that motivated the proposal of this assignment, whose appearing is bound up with the necessity of thinking about standardized spaces that attend on functional criterias and environmental sustainability, in reply to an existing real demand. The assignment consists of an architectonic proposal for a flexible standard of a Basic Unit of Health for the bioclimatic zone 7 of RN (UBS RN-7), with emphasis in the environmental sustainability. The project contemplates innumerable involved variables, such as: obedience to the current law of the Health Ministry for the UBSs; formal/aesthetic aspects; criterias of expansiveness of the UBS I for the UBS II; relative aspects to the constructive rationality and, mainly, sustainability aspects. With the intention to unite the variables and, also, glimpsing a proposal that could reach a good functional performance, aesthetic, of environment comfort and energetic efficiency, it was also necessary to consider concepts about the flexibility of the envelopment. The elaboration of the architecture first draft was based on bibliographical research, conceptual studies and references, elaboration of the architectonic program and the draft development for the UBS port I and the UBS port II. To the end, an implantation data sheet for the project is proposed for the UBS standard project, where strategies of thermal isolation, shadowing and thermal inertia are adopted and combined to three possible types of lot, resulting in 24 possibilities of implantation
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Gene therapy is one of the major challenges of the post-genomic research and it is based on the transfer of genetic material into a cell, tissue or organ in order to cure or improve the patient s clinical status. In general, gene therapy consists in the insertion of functional genes aiming substitute, complement or inhibit defective genes. The achievement of a foreigner DNA expression into a population of cells requires its transfer to the target. Therefore, a key issue is to create systems, vectors, able to transfer and protect the DNA until it reaches the target. The disadvantages related to the use of viral vectors have encouraged efforts to develop emulsions as non-viral vectors. In fact, they are easy to produce, present suitable stability and enable transfection. The aim of this work was to evaluate two different non-viral vectors, cationic liposomes and nanoemulsions, and the possibility of their use in gene therapy. For the two systems, cationic lipids and helper lipids were used. Nanoemulsions were prepared using sonication method and were composed of Captex® 355; Tween® 80; Spam® 80; cationic lipid, Stearylamine (SA) or 1,2-dioleoyl-3-trimethylammoniumpropane (DOTAP) and water (Milli-Q®). These systems were characterized by average droplet size, Polidispersion Index (PI) and Zeta Potential. The stability of the systems; as well as the DNA compaction capacity; their cytotoxicity and the cytotoxicity of the isolated components; and their transfection capacity; were also evaluated. Liposomes were made by hydration film method and were composed of DOTAP; 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE), containing or not Rhodaminephosphatidylethanolamine (PE- Rhodamine) and the conjugate Hyaluronic Acid DOPE (HA-DOPE). These systems were also characterized as nanoemulsions. Stability of the systems and the influence of time, size of plasmid and presence or absence of endotoxin in the formation of lipoplexes were also analyzed. Besides, the ophthalmic biodistribution of PE-Rhodamine containing liposomes was studied after intravitreal injection. The obtained results show that these systems are promising non-viral vector for further utilization in gene therapy and that this field seems to be very important in the clinical practice in this century. However, from the possibility to the practice, there is still a long way
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The demand for alternative sources of energy drives the technological development so that many fuels and energy conversion processes before judged as inadequate or even non-viable, are now competing fuels and so-called traditional processes. Thus, biomass plays an important role and is considered one of the sources of renewable energy most important of our planet. Biomass accounts for 29.2% of all renewable energy sources. The share of biomass energy from Brazil in the OIE is 13.6%, well above the world average of participation. Various types of pyrolysis processes have been studied in recent years, highlighting the process of fast pyrolysis of biomass to obtain bio-oil. The continuous fast pyrolysis, the most investigated and improved are the fluidized bed and ablative, but is being studied and developed other types in order to obtain Bio-oil a better quality, higher productivity, lower energy consumption, increased stability and process reliability and lower production cost. The stability of the product bio-oil is fundamental to designing consumer devices such as burners, engines and turbines. This study was motivated to produce Bio-oil, through the conversion of plant biomass or the use of its industrial and agricultural waste, presenting an alternative proposal for thermochemical pyrolysis process, taking advantage of particle dynamics in the rotating bed that favors the right gas-solid contact and heat transfer and mass. The pyrolyser designed to operate in a continuous process, a feeder containing two stages, a divisive system of biomass integrated with a tab of coal fines and a system of condensing steam pyrolytic. The prototype has been tested with sawdust, using a complete experimental design on two levels to investigate the sensitivity of factors: the process temperature, gas flow drag and spin speed compared to the mass yield of bio-oil. The best result was obtained in the condition of 570 oC, 25 Hz and 200 cm3/min, temperature being the parameter of greatest significance. The mass balance of the elementary stages presented in the order of 20% and 37% liquid pyrolytic carbon. We determined the properties of liquid and solid products of pyrolysis as density, viscosity, pH, PCI, and the composition characterized by chemical analysis, revealing the composition and properties of a Bio-oil.
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The inter-subjectivity is the answer in the search for the solution of complex problems, which concerns interfaces of knowledge, respecting their borders. This paradigm is essential in the author's work. So, the search on screen is based on this perspective, by using inter-subject groups of work conduced by professionals of Computer Science, Social Communication, Architecture and Urbanism, Pedagogy, Psicopegagogy, Nutritional Science, Endocrinology, Occupational Therapy and Nursing, it was also part of this group an 8 year old child, daughter of one of the professional who took part of the group. This thesis aims to present the course of investigation developed, analyzing the action of inter-subject Occupational Therapy and Nutrition on the promotion of learning nutritional concepts through educative-nutritional games in order to prevent child's obesity in an educative context. The research was analytic, interventionist and almost experimental. It took place in a public school in Fortaleza, Ceará, Brazil, between August and December 2004. It was selected a sample non-probabilistic, by convenience, of 200 children, born from 1994 to 1996. It was selected almost nonprobabilistically, by convenience, 200 children born between 1994 and 1996. To analyze the results it was used a triangulation, associated by quantitative and qualitative approaches. The basis collect happened through games specially manufactured to these research- video-games, board games, memory games, puzzles, scramble, searching words and iterative basics. There were semi-structured interviews, direct and structured observations and focus in-groups. It was noticed the efficiency of educativenutritional games in the learning process, which lead to a changing of attitude towards the eating choices. These games gave similar results in relation to the compared variations preferences, experience and attitudes, theses attitudes were observed through the game; and the categories to compare the possibility of learning by playing, the fantasy in the learning process, learning concepts of nutritional education and the need of help in the learning process (mediation). It was proved that educativenutritional games could be used to teach nutritional concepts, in an inter-subjective action of Occupational Therapy and Nutrition in schools. The simultaneous application of these games lead to the optimization of child s learning process. It should be emphasized the need of studies about the adaptation of tools used in a child s Nutritional Education, with the help of inter-subjective action. Because just one subject, in a fractionated way can give an answer to complex problems and help to a change of the reality with effectiveness and resolution
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Hypertensive syndromes in pregnancy (HSP) are configured as one of the major complications in the pregnancy and postpartum period and can lead premature newborn and subsequent hospitalization of the newborn to the Neonatal Intensive Care Unit (NICU). This study aimed to analyze the perceptions, meanings and feelings of mothers on the hypertensive syndromes in pregnancy and premature obstetric labor. The research was qualitative and has a theoretical methodological the Social Representations Theory(SRT) in the approach to the Central Nucleus Theory. The study included 70 women, mean age 29 years, predominantly school to high school, most of them married or in consensual union, primiparous and prevalence of cesarean delivery occurred between 32 and 37 weeks of pregnancy.The data were collected from may to december 2008 in the Maternity School Januário Cicco in Natal , and obtained through the following instruments for data collection: questionnaire including questions about socio-demographic status; the Free Words Association Test (FWAT) and and verbalized mental image construction used three stimuli: such as pregnancy with high blood pressure, preterm birth and NICU, and interview with the following guiding question: what it meant for you to have a pregnancy with high blood pressure and consequently the birth of a premature baby? Data analysis was performed using multi-method obtained from the data processing by EVOC (Ensemble Programmes Permettant L 'Analyze des Évocations) and ALCESTE (Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte) and thematic analysis in categories. The results will be presented in four thematic units under the following representative universes: HSP, prematurity as a result of HSP, NICU and the social representations of mothers on the hypertensive disorder of pregnancy sequenced premature birth and hospitalization of the child in the NICU. The results obtained by multimethod analyses showed similar constructions and point to death as the central nucleus and negative aspects, coping strategies, need of care, knowledge about the disease, fragility and meanings of the NICU as peripheral elements. It is considered that the perceptions, meanings and feelings of puerperal women in relation to HSPs and to premature delivery are a negative social representation, with representational elements that may have influenced the adverse effects on the disease and its consequences. We suggest action on the peripheral elements of this representation, with adequate orientation, early diagnosis, effective conduct, receptive attitude on the part of the team, health promotion measures and effective public policies, in order to improve the care provided to puerperal women, making them feel welcome and minimizing their suffering
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Investigate intrahospital and neonatal determinants associated to the weaning of very low birth weight (VLBW) infants. Methods: 119 VLBW (<1500g) infants 81 were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Results: Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB) and 66 (75%) were weaned (partial breastfeeding or formula feeding). Univariate analysis found an association between weaning and lower birth weight, longer stays in the NICU and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. Conclusion: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants
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A busca por um modelo democrático de saúde despertou a atenção do governo brasileiro para o estabelecimento de prioridades e estratégias, que impulsionaram a implantação do Programa de Saúde da Família (PSF), atualmente denominada Estratégia Saúde da Família (ESF), a fim de aproximar a equipe de saúde da comunidade e, assim, implementar ações de promoção da saúde e de prevenção do adoecimento. Nessa perspectiva a Terapia Comunitária (TC) emerge como uma tecnologia de cuidado voltada à saúde mental na Atenção Básica de Saúde. Desde 2007, a TC vem sendo desenvolvida no município de João Pessoa/PB por profissionais da ESF: enfermeiras, agentes comunitários de saúde, médicos, odontólogos, fisioterapeutas, nutricionistas, psicólogos, entre outros. O estudo teve como objetivos: avaliar a satisfação dos usuários em relação à TC na Atenção Básica no município de João Pessoa/PB; medir o nível de satisfação dos participantes da TC em relação a essa ferramenta do cuidado; identificar elementos importantes para a satisfação em relação à TC por parte dos usuários. Trata-se de um estudo avaliativo, transversal e observacional, realizado no período de maio a agosto de 2009. Utilizou-se como instrumento de coleta de dados a Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental Satis-BR, bem como um instrumento de perguntas complementares utilizado pelos terapeutas comunitários. Os resultados revelaram que dos 198 (100%) entrevistados, 105 (53%) verbalizaram satisfação e 93 (47%) muita satisfação nos encontros de TC, o que evidencia que a totalidade da amostra está satisfeita com a terapia. Os elementos importantes que concorreram para a satisfação dos usuários da TC foram: respeito, dignidade, escuta, compreensão, acolhimento, apoio nas necessidades e boas instalações dos locais onde ocorre a terapia. A TC vem fortalecendo o cuidado à saúde mental, por se constituir como uma tecnologia de prevenção e fortalecendo a porta de entrada para a rede de saúde mental e de apoio psicossocial. Conclui-se, portanto, que a TC vem se destacando como instrumento de inclusão da saúde mental na Atenção Básica no atendimento aos usuários do Sistema Único de Saúde
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A venous ulcer is the most serious clinical manifestation of chronic venous failure, and the most frequent in lower limbs, accounting for 70% of all ulcers. Patients may suffer from this infirmity for several years without healing of the lesion if treatment is inadequate. The aim of this investigation was to verify the effectiveness of decongestive physical therapy in the healing of venous ulcers. This is a quasi-experimental, interventionist study, with paired, non-probabilistic sampling, composed of 50 patients divided into two groups: control and intervention, each composed of 25 patients. Both groups were identically treated for six months with daily dressings and the latter also underwent complex physical therapy consisting of a combination of the following techniques: manual lymphatic drainage, compression bandaging, lower limb elevation, myolymphokinetic exercises and skin care. The study was approved (Protocol no. 59/2007) by the Ethics Committee of the State University of Southeast Bahia. The Mann-Whitney and Chi-square tests were applied for data analysis. After statistical analysis the patients who underwent therapy showed a statistically significant difference with respect to wound contraction starting in the second month of treatment. Compared to the control, the intervention group showed a greater reduction in both pain and edema starting in the third and fourth month of therapy, respectively. To reinforce these findings, the mean percentage of tissue present at the base of the ulcer (granulation/fibrin ratio) was calculated. The intervention group showed greater granulation at the base of the ulcer compared to the control, significant from the second month of treatment on. It was observed in this study that lymphotherapy, when compared between the intervention and control groups, accelerated the healing process, and reduced pain and edema in the affected limbs. It is expected, therefore, that these results widen scientific knowledge and we suggest that this therapy be used 78 not only to reduce lymphedema, but also as a treatment option for venous ulcers, given its easy application and low cost. The data, therefore, demonstrated the importance of basic care on the part of a multiprofessional and transdisciplinary health team involved in the healing process of these infirmities, thereby contributing to better quality of life in these individuals
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Universidade Federal do Rio Grande do Norte
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Nas últimas décadas, houve grande aumento da prevalência de obesidade, inclusive na faixa etária pediátrica. Com isso, aumentou o número de crianças e adolescentes afetados por síndrome metabólica (SM), diabetes tipo 2 (DM2) e doenças cardiovasculares (DCV), doenças anteriormente consideradas quase exclusivas de adultos. Os objetivos do estudo foram identificar e correlacionar marcadores antropométricos (IMC- índice de massa corpórea, CA- circunferência abdominal, RCQ- razão cintura/quadril, RCArazão cintura altura e PSE- prega subescapular), PAS e PAD- pressão arterial sistólica e diastólica, respectivamente, e laboratoriais (CT- colesterol total, HDL, LDL, TGL- triglicérides, I/G- razão insulina glicose, HOMA- homeostatic model assessment for insulin resistance) de risco para o desenvolvimento de SM e observar a sua prevalência em crianças e adolescentes com excesso de peso. Foi conduzido estudo transversal, em amostra aleatória, de conveniência, onde foram avaliadas 60 crianças e adolescentes com excesso de peso, atendidas no ambulatório de endocrinologia pediátrica do Hospital de Pediatria da Universidade Federal do Rio Grande do Norte (UFRN) com idade mínima e máxima de 7 e 15 anos, de maio de 2009 a abril de 2010. Foram admitidos os indivíduos que apresentavam sobrepeso (IMC P > 85 e < 95) ou obesidade (IMC P > 95) (CDC, 2000) e história familiar positiva para DM2 em parentes de primeiro ou segundo grau ou algum dos sinais de resistência insulínica (acantose, hipertensão arterial, dislipidemia, síndrome de ovários policísticos). 2 O componente individual para SM mais prevalente foi o percentil da CA ≥ 90 (58,3%), seguido de HDL ≤ 40 mg/dl (36,6%). Na regressão linear simples, observaram-se as variações para mais nos parâmetros laboratoriais e de PA para cada unidade de aumento de IMC, CA, RCA, RCQ e PSE, sendo significantes as seguintes correlações: CA com TGL, HOMA IR, I/G, PAS e PAD; RCQ com TGL, HOMA, I/G, LDL e glicemia; RCA com TGL; PSE com TGL, HOMA-IR, I/G e PAS; e IMC com HOMA IR, I/G, PAS e PAD. De acordo com os critérios da IDF (Federação Internacional de Diabetes International Diabetes Federation) 2007, o diagnóstico de SM foi encontrado em seis indivíduos (10%). Do total, oito (13,3%), estavam em situação de sobrepeso e 52 (86,6%), obesos. As evidências de correlação CA e RCQ, medidas de obesidade centrípeta, com vários marcadores como TGL e HOMA, já sabidamente relacionados à SM, chamam atenção para a necessidade de utilização dessas medidas de forma mais rotineira na prática pediátrica, por serem de fácil obtenção, baixo custo e método não invasivo. Os valores de CA, RCQ, RCA e PSE, quando elevados devem justificar maior detalhamento na avaliação laboratorial de possível resistência insulínica. É importante a identificação de crianças e adolescentes que preencham os requisitos para o diagnóstico da SM, pois são indivíduos de maior risco metabólico e devem ser adequadamente acompanhados.
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O objetivo do nosso projeto foi determinar as características dos recém nascidos com crises convulsivas internados em unidades de terapia intensiva. Foi realizada uma pesquisa multicêntrica, observacional, prospectiva, cuja população alvo foi os recém nascidos com crises convulsivas internados em unidades de terapia intensiva, envolvendo equipe multidisciplinar constituída por neurologista infantil, neonatologistas, intensivistas pediátricos, enfermeiros, técnicos de enfermagem e fisioterapêutas. As crises foram definidas pelo critério clínico, com classificação de Volpe. Variáveis relacionadas à gestação, ao parto, características dos recém nascidos, aspectos das crises convulsivas e mortalidade foram analisadas. Estatística: descritiva (freqüências, medidas de tendência central e dispersão) e análise (teste de probabilidade, teste de risco e de acurácia). Comparamos as crises clínicas entre os recém nascidos de termo e pretermo e observamos diferenças com significância estatística na idade de início das crises, mais tardia nos prematuros, na etiologia predominante: hemorragia peri-intraventricular no prematuro e encefalopatia hipóxico-isquêmica no termo e tipo clínico de crise, clônica no pretermo e sutil no termo. Os testes de acurácia utilizados para determinar se o tipo clínico de crise convulsiva é predictor da etiologia da mesma não revelaram resultados positivos. Quanto às características associadas à mortalidade de prematuros com crise convulsiva, observamos associação entre ventilação mecânica e pneumonia com a mortalidade. Existem diferenças clínicas quando comparamos os recém nascidos pretermo e de termo com crises convulsivas, confirmando dados da literatura
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Verificou-se o efeito de diferentes densidades de insetos por unidade de criação sobre o potencial reprodutivo de Chrysoperla externa. Utilizaram-se adultos da geração F4 mantidos a 25 ± 1ºC, 70 ± 10% de UR e fotofase de 12 horas. Foram utilizadas as seguintes densidades por unidade de criação (10 cm de diâmetro por 23 cm de altura e volume de 1650 cm³): um macho e três fêmeas, dois machos e seis fêmeas, três machos e nove fêmeas e quatro machos e doze fêmeas. Avaliou-se o período de pré-oviposição, a oviposição diária e total por fêmea e por unidade de criação, as porcentagens de ovos viáveis e inférteis e o índice de aproveitamento, calculado por fêmea e por unidade de criação. A densidade quatro machos e doze fêmeas apresentou melhor aproveitamento da unidade de criação, compensando as reduções observadas nos valores de postura média e total por fêmea.
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It is a descriptive study with a qualitative approach, and an action-research type, which aimed to analyze the changes of knowledge about contraceptive methods invested to a teenager group attended in Igapó Family Healthcare Unit, in the city of Natal/RN, after consent and institutional assent of Ethics Committee of Rio Grande do Norte Federal University (Protocol No. 131/07). It were researched 16 teenagers of both sexes, with age ranging from 11 to 16 years. We used two structured questionnaires, one in the initial diagnosis and another during the seven meetings of the focus group, in addition to the field notes and the meetings discussions transcriptions. The data-collection was performed in the period of two months by a team composed by a nurse the research coordinator, a dentist, a nursing assistant, a community-based healthcare worker and a nursing academic. The quantitative and qualitative data were organized, tagged and categorized into spreadsheet in Microsoft Excel, being held a thematic analysis of speeches performed by the study participants. The results were presented as tables, graphics, photos, drawings and word clippings. The educational strategy developed in focus group allowed adolescents to discuss, exchange ideas and opinions on several contraceptive methods, providing expansion in knowledge of all contraceptives discussed, especially those natural and surgical, which were less mentioned at the beginning of the study. Among the advantages of the contraceptive methods listed by teenagers, was highlighted avoiding pregnancy and STDs in use of the barrier method of condom. As for the disadvantages more frequently noted by the survey with the misuse of barrier methods, was highlighted get pregnant, acquire STD's and do not prevent STD's in hormonal, natural and surgical methods. Adolescents showed consistency between the advantages and disadvantages and types of contraceptive methods, showing a widening in knowledge among them. It may be said that, in general, those surveyed had a good understanding about the use of the various contraceptive methods. Thus, the study participants had positively evaluated all the criteria used to qualify the meetings in the focus group. The action strategy of the focus group should be encouraged by professionals who work with teenagers, since they prefer to live in groups, one characteristic of adolescence.