833 resultados para observational study


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Objectives: The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. Patients and methods: A prospective observational study was conducted in the period from January 2010 to March 2011 in the Intensive Care Units (ICUs) of the University Hospital of Botucatu Medical School, UNESP. Consecutive patients undergoing abdominal surgery were included in the study. Initial evaluation, at admission in ICU, was performed in order to obtain demographic, clinical surgical and therapeutic data. Evaluation of IAP was obtained by the intravesical method, four times per day, and renal function was evaluated during the patient's stay in the ICU until discharge, death or occurrence of AKI. Results: A total of 60 patients were evaluated, 16 patients developed intra-abdominal hypertension (IAH), 45 developed an abnormal IAP (>7 mmHg) and 26 developed AKI. The first IAP at the time of admission to the ICU was able to predict the occurrence of AKI (area under the receiver-operating characteristic curve was 0.669; p=0.029) with the best cutoff point (by Youden index method) >= 7.68 mmHg, sensitivity of 87%, specificity of 46% at this point. The serial assessment of this parameter did not added prognostic value to initial evaluation. Conclusion: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.

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

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Introduction : The aging is characterized by a reduction in the effectiveness of skills, among them the loss of the flexibility. The hamstring muscles may be affected by the decreased flexibility occurs when elderly can present limitation of gait, low back problems and osteomuscular. Among the techniques used to evaluate the flexibility of the hamstring muscles are the Sit and Reach Test and Computerized Photogrammetry evaluation of the popliteal angle . However, the scientific literature doesn’t provide consistent data on the correlation of these forms of evaluation. Objective: To analyze the correlation between the sit and reach test and Computerized Photogrammetry evaluation of the popliteal angle used to assess the flexibility of the hamstring muscles in elderly women. Method: This was a cross-sectional, observational study, consisting of 39 elderly, healthy. The evaluation was composed by forms with personal details and physical examination (body weight, height and body mass index), and the evaluation of tests to measure the flexibility of the hamstring muscles (Sit and reach test and Computerized Photogrammetry evaluation of the popliteal angle). The correlation of the data was done by using the Spearmam’s rank correlation coefficient, with a significance level of 5% (p<0.05). Results: The data showed a positive correlation between Sit and Reach Test Computerized Photogrammetry and the popliteal angle of the right leg (r=0.4690, p=0.0026) and the left leg (r=0.3604, p=0.0241). Conclusion: The data from this study allow conclude that the tests for assessing hamstring flexibility in elderly women, the Sit and Reach Test and Computerized Photogrammetry evaluation of the popliteal angle are complementary because it doesn’t correlate strongly.

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Background: Acute viral bronchiolitis is a respiratory disease with high morbidity that affects newborn in the first two years of life. Its treatment with physiotherapy has been highlighted as an important tool, however, there is no consensus regarding its effects on patients improvement. We aimed to evaluate the physiological parameters before and after the procedure respiratory therapy in newborn with acute viral bronchiolitis. Method: This was a cross sectional observational study in 30 newborns with acute viral bronchiolitis and indicated for physiotherapy care in a hospitalized Urgency and Emergency Unit. It was collected the clinical data of newborn through evaluation form, and we measured heart rate (HR), oxygen saturation (SpO2) and respiratory rate (RR). We measured the variables before physiotherapy treatment, 3, 6 and 9 minutes after the physiotherapy treatment. Results: There has been no change in HR, however, we observed a decrease in RR at 6 and 9 min compared to 3 min and increase in SpO2 at 3, 6 and 9 min compared to before physiotherapy. Conclusion: Respiratory physiotherapy may be an effective therapy for the treatment of newborn with Acute Viral Bronchitis.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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OBJECTIVE: The objective of this study was to perform a nutritional assessment of acute kidney injury patients and to identify the relationship between nutritional markers and outcomes.METHOD: This was a prospective and observational study. Patients who were hospitalized at the Hospital of Botucatu School of Medicine were evaluated between January 2009 and December 2011. We evaluated a total of 133 patients with a clinical diagnosis of acute kidney injury and a clinical presentation suggestive of acute tubular necrosis. We explored the associations between clinical, laboratory and nutritional markers and in hospital mortality. Multivariable logistic regression was used to adjust for confounding and selection bias.RESULTS: Non-survivor patients were older (67 +/- 14 vs. 59 +/- 16 years) and exhibited a higher prevalence of sepsis (57.1 vs. 21.4%) and higher Acute Tubular Necrosis-Individual Severity Scores (0.60 +/- 0.22 vs. 0.41 +/- 0.21) than did survivor patients. Based on the multivariable analysis, laboratorial parameters such as blood urea nitrogen and C-reactive protein were associated with a higher risk of death (OR: 1.013, p = 0.0052; OR: 1.050, p = 0.01, respectively), and nutritional parameters such as low calorie intake, higher levels of edema, lower resistance based on bioelectrical impedance analysis and a more negative nitrogen balance were significantly associated with a higher risk of death (OR: 0.950, p = 0.01; OR: 1.138, p = 0.03; OR: 0.995, p = 0.03; OR: 0.934, p = 0.04, respectively).CONCLUSIONS: In acute kidney injury patients, a nutritional assessment seems to identify nutritional markers that are associated with outcome. In this study, a low caloric intake, higher C-reactive protein levels, the presence of edema, a lower resistance measured during a bioelectrical impedance analysis and a lower nitrogen balance were significantly associated with risk of death in acute kidney injury patients.

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Pós-graduação em Fisioterapia - FCT

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Pós-graduação em Fisiopatologia em Clínica Médica - FMB

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Pós-graduação em Fisioterapia - FCT