Efeito da implementação de diretriz para profilaxia de tromboembolismo venoso em pacientes cirúrgicos

INTRODUÇÃO: Estratégias efetivas para profilaxia do tromboembolismo venoso (TEV) são amplamente disponíveis, mas são ainda subutilizadas, principalmente no nosso meio. OBJETIVO: Avaliar o efeito da implementação de diretriz para profilaxia do TEV, em pacientes cirúrgicos, sobre a conduta da equipe de saúde na prescrição dessa profilaxia. Método. Estudo retrospectivo pré-intervenção - pós-intervenção. Prontuários de 150 pacientes antes e 150 depois da implementação de uma diretriz para a profilaxia (AID e DID) foram sorteados dentre pacientes de mais de 40 anos internados para cirurgia maior abdominal ou ortopédica. Foram registrados dados demográficos, referência a risco de TEV no prontuário, prescrição de profilaxia para TEV e diagnóstico de TEV durante a internação. RESULTADOS: Não houve diferença entre os dois grupos, AID e DID, quanto aos dados demográficos e ao tempo de profilaxia (5,6 x 6,6 dias). A frequência de profilaxia AID x DID antes da cirurgia foi: profilaxia farmacológica (PF), 6% x 9%; meias de compressão graduada (MCG), 4% x 3%; compressão pneumática intermitente (CPI), 2% x 3%. Após cirurgia: PF 53% x 53%; MCG, 23% x 40% (P<0,05); CPI, 26% x 32% . No total, AP, foi prescrita profilaxia para 60,5% dos pacientes AID e para 66,5% DID, mas a profilaxia foi considerada adequada em 34% dos pacientes AID e em 32% DID. Conclusão. A adoção do protocolo, embora com maior a preocupação com a profilaxia, traduzida pelo aumento na prescrição de MCG, melhorou minimamente sua qualidade, indicando a necessidade de outras intervenções ativas e contínuas para aumentar a aderência ao mesmo.

Duffy blood group gene polymorphisms among malaria vivax patients in four areas of the Brazilian Amazon region

Background: Duffy blood group polymorphisms are important in areas where Plasmodium vivax predominates, because this molecule acts as a receptor for this protozoan. In the present study, Duffy blood group genotyping in P. vivax malaria patients from four different Brazilian endemic areas is reported, exploring significant associations between blood group variants and susceptibility or resistance to malaria.Methods: the P. vivax identification was determined by non-genotypic and genotypic screening tests. The Duffy blood group was genotyped by PCR/RFLP in 330 blood donors and 312 malaria patients from four Brazilian Amazon areas. In order to assess the variables significance and to obtain independence among the proportions, the Fisher's exact test was used.Results: the data show a high frequency of the FYA/FYB genotype, followed by FYB/FYB, FYA/FYA, FYA/FYB-33 and FYB/FYB-33. Low frequencies were detected for the FYA/FY(X), FYB/FY(X), FYX/FY(X) and FYB-33/FYB-33 genotypes. Negative Duffy genotype (FYB-33/FYB-33) was found in both groups: individuals infected and non-infected (blood donors). No individual carried the FY(X)/FYB-33 genotype. Some of the Duffy genotypes frequencies showed significant differences between donors and malaria patients.Conclusion: the obtained data suggest that individuals with the FYA/FYB genotype have higher susceptibility to malaria. The presence of the FYB-33 allele may be a selective advantage in the population, reducing the rate of infection by P. vivax in this region. Additional efforts may contribute to better elucidate the physiopathologic differences in this parasite/host relationship in regions endemic for P. vivax malaria, in particular the Brazilian Amazon region.

Approximate analytical states of a polynomial potential: an example of symmetry restoration

An approximate analytical expression for the first two eigenvalues of the Schrodinger equation for the potential V(x) = Ax(4) + Bx(2) is achieved by using the Symanzik scaling symmetry. A kind of symmetry restoration when one of the potential parameters changes conveniently is observed. (C) 2000 Published by Elsevier B.V. B.V. All rights reserved.

THE PARTITION-FUNCTION FOR AN ANYON-LIKE OSCILLATOR

We compute the partition function of an anyon-like harmonic oscillator. The well known results for both the bosonic and fermionic oscillators are then re-obtained as particular cases of our function. The technique we employ is a non-relativistic version of the Green function method used in the computation of one-loop effective actions of quantum field theory.

Classes of exact Klein-Gordon equations with spatially dependent masses: Regularizing the one-dimensional inversely linear potential

In this work we consider the effect of a spatially dependent mass over the solution of the Klein-Gordon equation in 1 + 1 dimensions, particularly the case of inversely linear scalar potential, which usually presents problems of divergence of the ground-state wave function at the origin, and possible nonexistence of the even-parity wave functions. Here we study this problem, showing that for a certain dependence of the mass with respect to the coordinate, this problem disappears. (c) 2006 Elsevier B.V. All rights reserved.

Remarks on supersymmetry of quantum systems with position-dependent effective masses

We apply the supersymmetry approach to one-dimensional quantum systems with spatially dependent mass, by including their ordering ambiguities dependence. In this way we extend the results recently reported in the literature. Furthermore, we point out a connection between these systems and others with constant masses. This is done through convenient transformations in the coordinates and wave functions.

Time-dependent non-Hermitian Hamiltonians with real energies

In this work we intend to study a class of time-dependent quantum systems with non-Hermitian Hamiltonians, particularly those whose Hermitian counterparts are important for the comprehension of posed problems in quantum optics and quantum chemistry. They consist of an oscillator with time-dependent mass and frequency under the action of a time-dependent imaginary potential. The wave functions are used to obtain the expectation value of the Hamiltonian. Although it is neither Hermitian nor PT symmetric, the Hamiltonian under study exhibits real values of energy.

Nonperturbative approach to potentials in impenetrable boxes based on quasi-exact solvability

In this work we develop an approach to obtain analytical expressions for potentials in an impenetrable box. In this kind of system the expression has the advantage of being valid for arbitrary values of the box length, and respect the correct quantum limits. The similarity of this kind of problem with the quasi exactly solvable potentials is explored in order to accomplish our goals. Problems related to the break of symmetries and simultaneous eigenfunctions of commuting operators are discussed.

Generalizing the soldering procedure

We start this work by revisiting the problem of the soldering of two chiral Schwinger models of opposite chiralities. We verify that, different from what one can conclude from the current literature, the usual sum of these models is, in fact, gauge invariant and corresponds to a composite model, where the component models are the vector and axial Schwinger models. As a consequence, we reinterpret this formalism as a kind of degree of freedom reduction mechanism. This result has led us to discover a second soldering possibility giving rise to the axial Schwinger model. This new result is seemingly rather general. We explore it here in the soldering of two Maxwell-Chern-Simons theories with different masses.

Approximate expression for the energy of a D-dimensional anharmonic oscillator

An approximate expression is constructed for the energy of an anharmonic potential with centrifugal barrier. In order to obtain such an analytical expression, the quasi-exact solvability is used and then a fitting of these exact solutions is done.

COMPARISON OF THE ANOMALOUS AND NONANOMALOUS GENERALIZED SCHWINGER MODELS VIA THE FUNCTIONAL FORMALISM

We calculate the Green functions of the two versions of the generalized Schwinger model, the anomalous and the nonanomalous one, in their higher order Lagrangian density form. Furthermore, it is shown through a sequence of transformations that the bosonized Lagrangian density is equivalent to the former, at least for the bosonic correlation functions. The introduction of the sources from the beginning, leading to a gauge-invariant source term, is also considered. It is verified that the two models have the same correlation functions only if the gauge-invariant sector is taken into account. Finally, there is presented a generalization of the Wess-Zumino term, and its physical consequences are studied, in particular the appearance of gauge-dependent massive excitations.

Ordering ambiguity versus representation

In this work we show that the ordering ambiguity on quantization depends on the representation choice. This property is then used to solve unambiguously some particular systems. Finally, we speculate on the consequences for more involved cases.

MAPPING CORRELATION-FUNCTIONS OF SCHWINGER AND AXIAL MODELS

We show that all Green's functions of the Schwinger and axial models can be obtained one from the other. In particular, we show that the two models have the same chiral anomaly. Finally it is demonstrated that the Schwinger model can keep gauge invariance for an arbitrary mass, dispensing with an additional gauge group integration.

BRST-BFV formalism for the generalized Schwinger model

We derive the Wess-Zumino scalar term of the generalized Schwinger model both in the singular and nonsingular cases by using BRST-BFV framework. The photon propagators are also computed in the extended Lorentz gauge.