Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients

Persistência na lactação para vacas da raça Holandesa criadas no Estado do Rio Grande do Sul via modelos de regressão aleatória

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dogs can detect scat samples more efficiently than humans: an experiment in a continuous Atlantic Forest remnant

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Modelagem de dados de falhas de equipamentos de sub-superfície em poços de petróleo da Bacia Potiguar

This master´s thesis presents a reliability study conducted among onshore oil fields in the Potiguar Basin (RN/CE) of Petrobras company, Brazil. The main study objective was to build a regression model to predict the risk of failures that impede production wells to function properly using the information of explanatory variables related to wells such as the elevation method, the amount of water produced in the well (BSW), the ratio gas-oil (RGO), the depth of the production bomb, the operational unit of the oil field, among others. The study was based on a retrospective sample of 603 oil columns from all that were functioning between 2000 and 2006. Statistical hypothesis tests under a Weibull regression model fitted to the failure data allowed the selection of some significant predictors in the set considered to explain the first failure time in the wells

Predição de valores genéticos para a produção de leite no dia do controle e para a produção acumulada até 305 dias

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Qualidade em serviços de saúde: uma contribuição à definição de um modelo paramétrico e padrão de qualidade do tempo agendado para consulta ambulatorial

This work presents a study in quality of health care, with focus on consulting appointment. The main purpose is to define a statistical model and propose a quality grade of the consulting appointment time. The time considered is that from the day the patient get the appointment done to the day the consulting is realized. It is used reliability techniques and functions that has as main characteristic the analysis of data regarding the time of occurrence certain event. It is gathered a random sample of 1743 patients in the appointment system of a University Hospital - the Hospital Universitário Onofre Lopes - of the Federal University of Rio Grande do Norte, Brazil. The sample is randomly stratified in terms on clinical specialty. The data were analyzed against the parametric methods of the reliability statistics and the adjustment of the regression model resulted in the Weibull distribution being best fit to data. The quality grade proposed is based in the PAHO criteria for a consulting appointment and result that no clinic got the PAHO quality grade. The quality grade proposed could be used to define priority for improvement and as criteria to quality control

Exigências de triptofano e padrão de recuperação do desempenho de poedeiras comerciais após alimentação com rações deficientes em triptofano

Este experimento foi conduzido para avaliar as exigências de triptofano e o padrão de recuperação do desempenho de poedeiras alimentadas com rações deficientes em triptofano. Foram utilizadas 160 poedeiras comerciais da linhagem Hisex White distribuídas em um delineamento inteiramente casualizado com cinco níveis de triptofano nas dietas (0,13; 0,15; 0,17; 0,19 e 0,21%), com oito repetições de quatro aves. As poedeiras permaneceram por duas semanas em adaptação (51 a 52 semanas), por seis semanas para avaliação da exigência de triptofano (53 a 58 semanas) e por quatro semanas para determinação do padrão de recuperação do desempenho (59 a 62 semanas). A produção e a massa de ovos foram prejudicadas quando as poedeiras foram alimentadas com rações contendo 0,13% de triptofano, no entanto, o desempenho foi recuperado após uma semana de alimentação com ração contendo 0,21% desse aminoácido. A qualidade interna dos ovos não foi influenciada pelos níveis de triptofano estudados (ingestão de 137,1 a 228,0 mg triptofano/dia). As exigências de triptofano foram estabelecidas entre 161 e 188 mg/dia, dependendo da característica avaliada (produção ou massa de ovos) e do modelo de regressão aplicado (polinomial, exponencial ou segmentado).

Períodos de interferência de uma comunidade de plantas daninhas na cultura da batata

Objetivou-se neste trabalho avaliar diferentes períodos de controle e de convivência de uma comunidade de plantas daninhas na cultura da batata 'Atlantic'. O experimento foi realizado no município de Botucatu-SP, e o delineamento experimental utilizado foi de blocos ao acaso com quatro repetições. Os tratamentos constituíram-se de seis períodos de controle, nos quais a cultura foi mantida livre da comunidade de plantas daninhas e após cada período, as plantas daninhas foram deixadas crescer livremente; e de seis períodos de convivência, nos quais a cultura foi mantida na presença da comunidade de plantas daninhas e após cada período, as plantas daninhas foram eliminadas até a colheita. Os períodos foram de 7, 14, 21, 28, 35 e 42 dias após o plantio dos tubérculos, além de uma testemunha mantida sempre livre de plantas daninhas e outra mantida sempre na presença dessas plantas. Foram identificadas 9 famílias e 15 espécies de plantas daninhas, com destaque para Bidens pilosa, Galinsoga parviflora,Brachiaria plantaginea,Commelina benghalensis e Digitaria horizontalis. Os resultados de produção de tubérculos ajustaram-se ao modelo de regressão não-linear: y = 8,907+(17,722/[1+(x/16,865)-8,412]), (R² = 0,963*) - equação para os períodos de controle e y = 5,728+(24,789/[1+(x/39,292)2,247 ]), (R² = 0,947*) - equação para os períodos de convivência. Assim, considerando perda de 5% na produtividade como aceitável, foram determinados o período anterior à interferência (PAI), que foi de 20 dias; o período total de prevenção à interferência (PTPI), de 21 dias; e o período crítico de prevenção da interferência (PCPI), de apenas de um dia, dos 20 aos 21 dias após o plantio dos tubérculos.

Períodos de interferência de plantas daninhas na cultura do sorgo

Objetivou-se com este trabalho estimar os períodos de interferência das plantas daninhas na cultura do sorgo granífero BRS 310. O experimento foi realizado no município de Botucatu/SP, em delineamento experimental de blocos ao acaso, com quatro repetições. Os tratamentos constituíram-se de oito períodos de controle, nos quais a cultura foi mantida livre da comunidade de plantas daninhas, e de oito períodos de convivência, nos quais a cultura foi mantida na presença da comunidade infestante. Os períodos foram: 7, 14, 21, 28, 35, 42, 49 e 56 dias após a semeadura (DAS), além de uma testemunha mantida livre da interferência das plantas daninhas e outra mantida na presença destas. Foram identificadas 11 famílias e 17 espécies de plantas daninhas, destacando-se as famílias Asteraceae e Poaceae, com o maior número de espécies. Para determinação dos períodos de interferência, os dados de produtividade de grãos, comprimento da panícula e massa seca da parte aérea das plantas de sorgo obtidos foram ajustados ao modelo de regressão não linear: y = a/[1+(x/b)c]. Considerando como aceitável perda de 5% para a produtividade de grãos, o comprimento da panícula e a massa seca da parte aérea das plantas de sorgo, determinou-se o período anterior à interferência (PAI) de 42, 72 e 15 DAS e o período total de prevenção à interferência (PTPI) de 26, 17 e 12 DAS, respectivamente. Não houve período crítico de prevenção da interferência (PCPI) para os parâmetros avaliados.

Estimation of Maximal Work Rate Based on the 6-Minute Walk Test and Fat-Free Mass in Chronic Obstructive Pulmonary Disease

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

Prognostic significance of beta-2 adrenergic receptor in oral squamous cell carcinoma

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Sono e síndrome da fragilidade em idosos residentes em instituições de longa permanência

Introduction: The aging process causes quantitative and qualitative changes in sleeping. Such changes affects more than half of the adults above 65 years old, that live in the community and 70% of the institutionalized, a great negative impact in their quality of life. One of the pathological displays of aging, that share some characteristics with sleeping disorders and predict similar results, is the Frailty Syndrome, that characterize the most weakened and vulnerable elderly. The way sleeping disorders play a role in the frailty pathogeneses remains uncertain. Objective: Evaluate the relation between the sleeping and the frailty syndrome on institutionalized elderly. Methodology: A transversal study was performed with 69 elderly in institutions in the city of João Pessoa PB. Were used the Pittsburgh Sleeping Quality Index and actigraphy to subjective and objective variables, respectively, and questionnaires and specific tests to frailty phenotype variant (Fried Frailty Criteria). In the statistic analysis were used the Pearson correlation test, Chi Square and One-way ANOVA test, with Tukey-Krammer posttest. Subsequently, a Simple Linear Regression model was built. On every statistical analysis were considered a confidence interval of 95% and a p < 0,05. Results: The sample was characterized by the prevalence of the frail (49,3%), women (62,3%), single (50,7%) and 77,52 (±7,82).The frail elderly obtained the worst sleeping quality 10,37 (±4,31) (f = 4,15, p = 0,02), when compared with the non-frail. The sleep latency influenced more the frailty (R2 = 0,13, β standard = 1,76, β = 0,41, p = 0,001). Weren t found differences between the standard resting-activity variable and the frailty phenotype categories. Conclusion: Sleeping alterations, including bad sleeping quality, prolonged sleep latency, low sleep efficiency and day drowsiness, influenced the frailty in institutionalized elderly

Apoio social e síndrome da fragilidade em idosos residentes na comunidade

Introduction: The frailty in the elderly is the result of a complex interplay between many social and clinical factors involved in its genesis. Although there is an understanding of its association with increased risk of adverse clinical outcomes, still it is unclear whether this syndrome can be aggravated due to lack of social support. So, the objective of this study was to analyze the association between social support and frailty syndrome in elderly community residents. Materials and methods: Observational analytical cross-sectional study, with a sample of 300 elderly living in the city of Natal-RN. Were collected informations about socialdemographic, economics and physical health data. The Social support was assessed by the status of cohabitation; marital status; contact frequency and diversity rate; received and given attendance frequency rate; and Map Minimum Relations of the Elderly. The frailty was assessed using the following criteria: unintentional weight loss, weakness, low physical activity, exhaustion and Slowness. To observe any possible associations, we performed the Pearson chi-square test, the Student t test and multivariate analysis using binary logistic regression, adopting a significance level of 5%. Results: It was observed that there were no associations of frailty with the social support variables, except for housekeeping mode (p = 0.046) of the MMRI. For the sociodemographic, economic, physical health and social support data, only age (p <0.001), sedentary lifestyle (p = 0.002) and poor perceived health (p = 0.001) were the ones that remained in the logistic regression model, with strong association for the presence of frailty. Conclusion: Among the variables related to social support, only to help with housekeeping was significantly associated with frailty. However, more studies need to be developed to characterize the social vulnerability, as well as health services need to recognize the importance of social support as an integral part of care for the elderly

Validação da escala de fatigabilidade percebida para avaliação da fadiga em idosas

The term fatigability concerns the degree of fatigue associated with performing an activity of any type (physical, mental, emotional and / or social). Recently scales for assessing fatigue in the English language were created, however, gaps exist regarding the validity of these scales in relation to oxygen consumption and levels of perceived fatigue. Objective: To investigate the validity of perceived fatigability scale in older women frail and non-frail by the expired gases kinetics. Methods: This is a study of type validation, where were evaluated 48 elderly. The evaluation was conducted at two different sessions. In the first, data were collected demographic partners, as well as assessment of cognitive function, physical health, and the phenotype of frailty. The second was composed by the test 6-minute walk (6MWT) associated the expired gases kinects and assessment of perceived fatigability. Statistical analysis was performed a descriptive analysis and then we used the Pearson correlation test to evaluate the relationship between the measure of perceived fatigue and variables oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (RER)before and after 6MWT. We used a linear regression model initially considering the following explanatory variable: age, Body Mass Index (BMI), presence of frailty, comorbidities, level of physical activity, distance covered in the 6MWT , the energy cost of walking and severity of fatigability on performance. Results: The final sample consisted of 44 elderly women, 4 elderly were excluded because they didn t complete all phases of this study. The mean age obtained was 75 years (± 7.2 years). There was no significant correlation between fatigability measures and the values of VO2 ( r = .09 , p = .56 ) , VCO2 ( r = .173 , p = .26 ) , RER ( r = - .121 , p = .43 ). The final linear regression model showed that the energy cost of walking, the usual level of physical activity and the performance severity of fatigability explained 83.5 % (R2 = 0.835, p < 0.01) of the variation in the perceived fatigability. Conclusion: Our findings indicate a relationship between greater severity of fatigability and lower levels of physical activity and increased energy cost in walking, suggesting that the fatigability analyses using a simple numeric scale is valid and viable for assessment of fatigue in older women

Comparison of a sidestream capnograph and a mainstream capnograph in mechanically ventilated dogs

Objective-To compare the ability of a sidestream capnograph and a mainstream capnograph to measure end-tidal CO2 (ETCO2) and provide accurate estimates of Paco(2) in mechanically ventilated dogs.Design-Randomized, double Latin square.Animals-6 healthy adult dogs.Procedure-Anesthesia was induced and neuromuscular blockade achieved by IV administration of pancuronium bromide. Mechanical ventilation was used to induce conditions of standard ventilation, hyperventilation, and hypoventilation. While tidal volume was held constant, changes in minute volume ventilation and Paco(2) were made by changing the respiratory rate. Arterial blood gas analysis was performed and ETCO2 measurements were obtained by use of either a mainstream or a sidestream capnographic analyzer.Results-A linear regression model and bias analysis were used to compare Paco(2) and ETCO2 measurements; ETCO2 measurements obtained by both capnographs correlated well with Paco(2). Compared with Paco(2), mainstream ETCO2 values differed by 3.15 +/- 4.89 mm Hg (mean bias +/- SD), whereas the bias observed with the sidestream ETCO2 system was significantly higher (5.65 +/- 5.57 mm Hg). Regardless of the device used to measure ETCO2, bias increased as Paco(2) exceeded 60 mm Hg.Conclusions and Clinical Relevance-Although the mainstream capnograph was slightly more accurate, both methods of ETCO2 measurement correlated well with Paco(2) and reflected changes in the ventilatory status. However, ETCO2 values > 45 mm Hg may inaccurately reflect the severity of hypoventilation as Paco(2) may be underestimated during conditions of hypercapnia (Paco(2) > 60 mm Hg).