999 resultados para Posicionamento do paciente
Resumo:
The present experiment aimed to study the influence of point positioning in an irradiated field to produce a planialtimetric plant. A planialtimetric evaluation was carried out in a 14-acre experimental area with well-defined topographic variations. Planialtimetric maps were designed using manual procedures, Datageosis and Topoesalq. Datageosis built all the curves after numerical surface modeling. Topoesalq provided only height reports and the drawing of curves was done manually. The third method was a manual procedure. Because there were planialtimetry representation differences, longitudinal profiles were used in the sites where there was a great divergence among plants. When obtained profiles and plants were compared, it was verified that the one produced by Datageosis represented the relief plant better. Later, only the irradiated field points were evaluated and each point presented positioned readings before and after each relief map variation. The processing through the three methods resulted in significant plants of the local planialtimetry, according to the control profiles. It was concluded that the planning of the field procedure should be suitable to the posterior treatment method of obtained data in order to make a planialtimetric plant to accord to the evaluated local topography.
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The patient with anophthalmia may present feelings of inferiority and rejection. Knowing his/her needs and expectations contribute to a better technical intervention. Purpose: To elaborate a questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis. Methods: An exploratory research was used to elaborate the questionnaire, by means of a guided interview followed by writing down what was said by the interviewees, who were adult patients of the Bucco-Maxillo-Facial Prosthesis Center of FOSJC - UNESP. The guided interview was made up of 14 items directly related to the future outline of the profile. Each item of the interview resulted in questions of the questionnaire, which was pretested twice before reaching its final version. Results: The patients reported, in the exploratory research, unpleasant feelings with the loss of the eye; relationship shyness; expectations regarding surgery and prosthesis use; a wish to receive explanations and to hold their opinion about the treatment. The questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis is, therefore, made of 43 questions divided into 5 blocks in order to aid the comprehension of the inquired aspects and to facilitate both the computation of data and discussion, and also to improve the selection of questions according to the objective of the researcher or professional. Conclusions: It was concluded that the questionnaire was viable, can be used in full or by selecting blocks and provide a panorama of the patient's history related to the problem he/she faces, from the loss of the ocular globe to the confection of the prosthesis.
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The error associated with the ionosphere depends on Total Electron Content (TEC) of the ionosphere. The geomagnetic field exerts strong influence in the TEC variation, because it controls the movement of the electrons. After solar events the magnetic lines of force can be compressed, characterizing the geomagnetic storm. The aim of this paper is to present to geodesic community the effects of a geomagnetic storm in the relative positioning. The processing of the data was accomplished with an interval of two hours, with a 430 km baseline. The analyze of the obtained results have been carried out from the discrepancies between the true coordinates and corresponding ones obtained in the processing of the baseline. The used data in this paper include the period of 30/03/2001 up to 02/04/2001. In March 31 a strong geomagnetic storm happened. One day after, that it corresponds to main phase of the storm, the values of the discrepancies decreased significantly. For instance, in 01:00-03:00 UT period, the value of the planimetric discrepancy reached 20 m in the storm day. However, in the main phase of the storm, the planimetric discrepancy decreased to 0.1 m.
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BACKGROUND AND OBJECTIVES: Psoas muscle abscess is a rare complication of epidural analgesia. The adequate approach to this complication is fundamental for a good resolution. The objective of this report was to discuss the diagnosis and treatment of psoas muscle abscess. CASE REPORT: A female patient, 65 years old, with neuropathic pain in the lower limbs, difficult to control with systemic drugs. The patient was treated with epidural opioid and local anesthetic as an alternate treatment. Twenty days after the continuous epidural administration, the patient complained of lumbar pain, headache, and fever. A CT scan of the pelvis showed an abscess of the psoas muscle, thus, closed drainage and antibiotics were indicated. CONCLUSIONS: An adequate, continuous supervision of the patient is necessary when an epidural catheter is placed, and it should continue after its removal. © Sociedade Brasileira de Anestesiologia, 2007.
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Acute myelopathy are characterized by spinal cord dysfunction, developing sensitive, motor and autonomic signs and symptons. Since they are relatively rare, there are some difficulties to early diagnosis and to the beginning of the treatment. So, literature was reviewed to describe the main aetiologies of acute non compressive myelopathy: 1) demyelinating diseases; 2) systemic disease; 3) parainfectious; 4) delayed radiation myelopathy; 5) vascular myelopathy; 6) idiopatic and 7) vitamin B12 deficiency. Besides, we suggest an algorithm to initial approach of these patients and further aethiologic investigation. © Copyright Morelra Jr. Editora.
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This exploratory descriptive study, of qualitative nature had the purpose to study how the nurses from a hospital school see the family as care participants. Six nurses from clinics of chronically ill patients were interviewed. The data analysis allowed to infer that the nurses had only little knowledge of the family's thematic during graduation, making the relationship with the accompanying families very difficult. Daily care during hospitalization period is marked by easy moments when members are willing to participate in the process, and by difficulties when they attempt to break institutional rules. It was suggested that new nurses have theoretical foundation to attend the family in several scenarios of care. It was considered the need of investments in professional training, and that the advance of humanization of services implies in exchange and integration of knowledge among patients, family members, health professionals, support staff and managers beyond the science field.
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One of the main drawbacks of the GPS accuracy for L1 users is the error due to ionosphere. This error depends on the total electron content presents in the ionosphere, as well as of the carrier frequency. Some models have been developed to correct GPS observables of the systematic error due to the ionosphere. The model more known and used is the Klobuchar model, which corrected 50-60% of the ionospheric error approximately. Alternatively, IGS (International GNSS Service) also has developed a model called Global Ionospheric Map (GIM). These maps, in format IONEX, are available in the site of the IGS, and one of the applications of them is to correct the GPS observables of the error due to ionosphere. This work aims at evaluating the quality of GPS point positioning using the IGS ionospheric model in the Brazilian region. Tests carried out had shown an average improvement in the horizontal and vertical determination of 72% and 26%, respectively, when GIM is used in the point positioning.
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Hospitals are very important for the health system. The objective of this quali-quantitative research was to visualize patients' social representation, which profited of the interaction between public universities and hospitals. 105 patients in the waiting rooms at the Integrated Clinic at FOA _ UNESP in the first semester 2005 answered to the question: How did you know about the service at FOA? - in opened interviews, recorded or written. A collective speech of the subject represented the field that allouds a society to speak as one. Twenty three of all patients have been sent to FOA by Health Assistance Centers in Araçatuba (7) and region (16) and twenty one patients assisted in Araçatuba by emergency. We can observe that the interaction between the public universities and general hospitals is a reality.
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BACKGROUND AND OBJECTIVES: Due to the high incidence of technical and neurological complications, continuous spinal blocks were not performed for several years. With the advent of intermediate catheters the technique has been used more often and gaining acceptance among anesthesiologists. The objective of this report was to demonstrate the usefulness of the technique as a viable alternative for medium and major size surgeries. CASE REPORT: This is a 58 years old female patient, weighing 62 kg, physical status ASA I, with a history of migraines, low back pain, and prior surgeries under spinal block without intercurrence. The patient was scheduled for exploratory laparotomy for a probable pelvic tumor. After venoclysis with an 18G catheter, monitoring with cardioscope, non-invasive blood pressure and pulse oximetry was instituted; she was sedated with 2 mg of midazolam and 100 μg of fentanyl, and placed in left lateral decubitus. The patient underwent continuous spinal block through the median approach in L 3-L 4; 9 mg of 0.5% hyperbaric bupivacaine and 120 μ g of morphine sulfate were administered. Inspection of the abdominal cavity revealed a gastric stromal tumor that required an increase in the incision for a partial gastrectomy. A small dose of hyperbaric solution was required for the entire procedure, which was associated with complete hemodynamic stability. Postoperative admission to the ICU was not necessary; the patient presented a good evolution without complaints and with a high degree of satisfaction. She was discharged from the hospital after 72 hours without intercurrence. CONCLUSIONS: Intermediate catheters used in continuous spinal blocks have shown the potential to turn it an attractive and useful technique in medium and large size surgeries and it can even be an effective alternative in the management of critical patients to whom hemodynamic repercussions can be harmful.
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BACKGROUND AND OBJECTIVES: Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. CASE REPORT: This is a 39-year old patient with DM1 who underwent general anesthesia for videolaparoscopic cholecystectomy. Total intravenous anesthesia with propofol, remifentanil, and rocuronium was the technique chosen. Intercurrences were not observed in the 90-minute surgical procedure, but after extubation, the patient developed respiratory failure and myotonia, which made tracheal intubation impossible. A laryngeal mask was used, allowing adequate oxygenation, and mechanical ventilation was maintained until full recovery of the respiratory function. The patient did not develop further complications. CONCLUSIONS: Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.
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Original en inglés: Perkin, Gordon W., Measuring clinic performance. Publicado en Perspectives, vol. 1, 1969
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The efficiency of monitoring fertigation by means of porous capsule extractors is directly related to its correct placement, since the nutrients applied through fertigation have different mobility throughout the soil profile. The objective of this study was to evaluate the distributions of NO3, P, and K in the soil solution, when applied in citrus in sandy soil through drip fertigation systems, aiming to define the proper placement of the solution extractors. In order to measure the concentration of ions in the soil solution, the extractors were installed at four different distances (5, 15, 25, and 35 cm) and depths (15, 30, 60, and 90 cm) with an emitter located under the projection of the tree canopy. The experiment was conducted in a Valencia orange orchard on citrumelo Swingle rootstock, in Reginópolis/SP. The experimental design was randomized blocks and the treatment arrangement was a 4 x 4 factorial design with five repetitions. Sixteen soil solution extractors were installed per block, with a total of 80 extractors in the experiment. According to the obtained results, to determine P and K, it is recommended to install the solution extractor at 15 cm horizontal and 30 cm depth from the emitter. For NO3, the extractor recommended placement is 25 cm horizontal and 30 cm depth. The soil solution extractor proved to be a sensitive tool, capable of determining the ions mobility in the wet bulb.
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The authors report a case of bilateral Tinea nigra plantaris treated through a double-blind study with the topical antifungal agents Isoconazole and Terbinafine. The objective of the study was to clinically compare the efficacy of these two topical antifungal agents on days 10, 20 and 30 of the treatment. No significant clinical differences were found, as all the plantar lesions regressed completely by the end of the treatment. Our conclusion was that in the case reported, the topical antifungal agents Isoconazole and Terbinafine demonstrated identical efficacy as a clinical cure. We also suggest the inclusion of injuries caused by arthropods of the Diplopoda Class in the differential diagnosis of Tinea nigra plantaris, due to the persistent acral hyperpigmentation.
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The natural co-infection with dengue virus can occur in highly endemic areas where different serotypes have been observed for many years. We report one case of DENV-1/DENV-4 co-infection in human serum detected by molecular tests. Phylogenetic analysis of the sequences obtained indicated the presence of genotype V and II for DENV-1 and DENV-4, respectively.