847 resultados para EPISODES
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This study aimed at exploring and describing children s perceptions in threatened natural settings, specifically, the Rain Forest in Brazil. Several studies point to the significance of perceptions for people s pro-environmental attitudes and actions. We try to understand the person-environment interaction from an ecological perspective, and we present theoretical references for the understanding of how crucial nature is for psychological development and well-being. The children s drawings, individual interviews, discussion groups, photographies and informal and indirect sources, as teachers, brought material for the analysis. Participated in our study, carried on through a multi-method strategy, 209 children from six to eleven years old, living in the neighborhood of the Biological Reserve of Una, State of Bahia, created to protect Rain Forest fragments. The Rain Forest landscape is well portrayed in children s drawings, the vegetal elements prevailing over artificial and human elements. The figured plants and trees, however, are pointed with no precision as to their species. Most of the defined species are eatable. The children seem to be aware of the environment degradation, and of the importance of its conservation, but they describe episodes of hunting and feeding wild threatened animals. Our results indicate a utilitarian trend in the perception of living beings, in terms of their immediate usefulness for people. The multimethod approach seems to be appropriate to the complexity of the theme; the methodological strategies were well accepted by the children, offering them opportunities to express themselves. We observed how children, in different life phases, organize natural elements and processes in their drawings, and how these images relate to the local landscape. We discuss the results in the light of theoretical references of personenvironment studies and from previous investigations about children s perceptions of natural environment
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We herein report a case of a double aortic arch in a 10-week-old male dog of no defined race, which presented episodes of regurgitation at the time of weaning. This vascular malformation was Characterized by the persistence of two aortic arches, right and left, of varying dimensions. The right aortic arch was observed to be larger. During post mortem examination the vessels of the animal were injected with coloured latex bi-centrifuged CIS 1-4 polisopreno which revealed the patency of the two aortic arches. Concomitantly, dilation of the cranial oesophagus causing constriction was observed, indicating megaesophagus, Apart from the constriction, the oesophagus presented normal morphometric parameters in relation to its dimensions.
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JUSTIFICATIVA E OBJETIVOS: A sedação de dependentes de álcool e drogas em Unidades de Terapia Intensiva (UTI) é um desafio pela elevada incidência de tolerância às drogas sedativas e da elevada freqüência de síndromes de abstinência. O objetivo deste relato é mostrar um caso de paciente jovem admitido na UTI que desenvolveu síndrome de abstinência alcoólica e tolerância às drogas sedativas, solucionadas somente após o uso de clonidina. RELATO do CASO: Paciente do sexo masculino, 18 anos, dependente de álcool, tabaco, cocaína e maconha, vítima de acidente por arma de fogo, foi admitido na UTI no 1º dia de pós-operatório de enterectomia, após aspiração de conteúdo gástrico durante reintubação traqueal. Evolução clínica: drogas vasoativas até o 4º dia de internação e broncopneumonia bilateral com derrame pleural e necessidade de ventilação artificial até o 15º dia. O esquema de sedação inicial utilizado foi a associação de midazolam e fentanil. A partir do 4º dia, o paciente apresentou vários episódios de agitação psicomotora, mesmo com a associação de lorazepam no 6° dia. No 9° dia, o paciente recebeu as maiores doses dos fármacos, mas permanecia agitado. Optou-se pela associação de dexmedetomidina, que reduziu as doses das outras drogas em 35% e diminuiu a agitação. No 12° dia, o midazolam e a dexmedetomidina foram substituídos pela infusão de propofol, com piora do quadro. No 13° dia, foi associada clonidina ao esquema de sedação, com resolução do quadro de agitação. No 14° dia, o propofol foi suspenso, sendo mantida a infusão de fentanil e reintroduzida a infusão de midazolam, com doses respectivamente 75% e 65% menores em relação ao pico de uso destas drogas. No 15° dia, o paciente foi extubado e teve alta da UTI. CONCLUSÕES: A droga de escolha para o tratamento da síndrome de abstinência alcoólica é o benzodiazepínico. Entretanto, no presente relato, somente o uso adjuvante de clonidina conseguiu proporcionar tratamento adequado ao paciente.
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Background Venous ulcer is the most serious consequence of chronic venous insufficiency and is responsible for almost 70% of chronic leg ulcers. The main purpose of this research was to describe social, demographic and clinical characteristics of patients with venous ulcers and to identify some professional repercussions of this pathology.Subjects and methods We evaluated patients with a clinical picture compatible with venous ulcer. The sociodemographic characteristics of the patients, and the clinical characteristics and professional repercussions of the pathology were studied. We used the ankle-brachial index to identify associated arterial disease. The body mass index (BMI) was used for the classification of the nutritional condition of the patients.Results A total of 120 patients were included in the study (90 females and 30 males; 80.8% White; 44.2% > 60 years old). Ninety-one per cent of the patients had been in education for less than 4 years, and 89.7% were on the poverty line. Thirty-five per cent were retired, 2.5% were receiving government help due to disease and 4.2% were unemployed. About 16% of patients were out of work due to the disease, and 49.2% presented some degree of disability in terms of work tasks. The ulcer area was less than 30 cm(2) in 69.1% of patients. The first ulcer episode occurred in 13.4 years on average, and 64.2% of patients had recurrent episodes. Females presented on average 5.65 pregnancies, and 75.4% of patients were overweight.Conclusion Venous ulcer occurred mainly in the low-income population, who presented with little formal education. Generally, the ulcers were present for a long time and were recurrent, with repercussions for the capabilities of patients to work.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Peritoneal dialysis has a high acceptance rate in Latin America, thus the knowledge concerning complication patterns is of great relevance. This work reviews Latin American data on peritonitis, the most serious complication of peritoneal dialysis.The incidence of peritonitis has been reduced over time, concomitantly with the incorporation of safer exchange systems and the use of prophylactic measurements. Today, rates tower than 1 episode per 24 patient-months are commonly reported. Furthermore, changes in causative organisms have been observed, with predominance of Staphylococcus aureus up through the mid-1990s, as welt as increases in coagulase-negative staphylococcus and participation of gram negatives. However, the prevalence of S. aureus is still high, due possibly to climatic conditions and the elevated prevalence of carriers. Resolution rate varies from 55% to 78%, transfer to hemodialysis from 10.9% to 15.4%, and death in 3% to 9.9% of cases. Outcome is worse in S. aureus episodes compared to those with coagulase-negative staphylococcus, despite the higher percentage of oxacillin-resistant strains among the former. In general, despite socioeconomic or climatic conditions, our results are similar to those in developed countries, perhaps as a consequence of technological improvements and/or center expertise.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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This thesis presents the results of application of SWAN Simulating WAves Nearshore numerical model, OF third generation, which simulates the propagation and dissipation of energy from sea waves, on the north continental shelf at Rio Grande do Norte, to determine the wave climate, calibrate and validate the model, and assess their potential and limitations for the region of interest. After validation of the wave climate, the results were integrated with information from the submarine relief, and plant morphology of beaches and barrier islands systems. On the second phase, the objective was to analyze the evolution of the wave and its interaction with the shallow seabed, from three transverse profiles orientation from N to S, distributed according to the parallel longitudinal, X = 774000-W, 783000-W e 800000-W. Subsequently, it was were extracted the values of directional waves and winds through all the months between november 2010 to november 2012, to analyze the impact of these forces on the movement area, and then understand the behavior of the morphological variations according to temporal year variability. Based on the results of modeling and its integration with correlated data, and planimetric variations of Soledade and Minhoto beach systems and Ponta do Tubarão and Barra do Fernandes barrier islands systems, it was obtained the following conclusions: SWAN could reproduce and determine the wave climate on the north continental shelf at RN, the results show a similar trend for the measurements of temporal variations of significant height (HS, m) and the mean wave period (Tmed, s); however, the results of parametric statistics were low for the estimates of the maximum values in most of the analyzed periods compared data of PT 1 and PT 2 (measurement points), with alternation of significant wave heights, at times overrated with occasional overlap of swell episodes. By analyzing the spatial distribution of the wave climate and its interaction with the underwater compartmentalization, it was concluded that there is interaction of wave propagation with the seafloor, showing change in significant heights whenever it interacts with the seafloor features (beachrocks, symmetric and asymmetric longitudinal dunes, paleochannel, among others) in the regions of outer, middle and inner shelf. And finally, it is concluded that the study of the stability areas allows identifications of the most unstable regions, confirming that the greatest range of variation indicates greater instability and consequent sensitivity to hydrodynamic processes operating in the coastal region, with positive or negative variation, especially at Ponta do Tubarão and Barra do Fernandes barrier islands systems, where they are more susceptible to waves impacts, as evidenced in retreat of the shoreline
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OBJETIVO: Avaliar ocorrência de infecção em idosos de instituição de longa permanência (ILP) durante 13 meses consecutivos. MÉTODOS: Cinqüenta e cinco idosos foram avaliados segundo critérios de infecção e de comunicação padronizada. RESULTADOS: A idade mediana foi de 75 (66-81) anos. O conjunto de dados constituiu-se de 20.896 pacientes-dia (PD) durante o período, com um total de 76 infecções para uma taxa média de infecção de 3,2 por 1000 PD. A taxa de pacientes com infecção foi de 63,6%. As topografias prevalentes foram respiratória (50%), trato urinário (32%), pele e partes moles (12%) e gastrintestinal (7%), com taxa de infecção/1000 PD de 1,60; 1,01; 0,38; e 0,2, respectivamente. A taxa de mortalidade por infecção foi de 5%. Agentes microbiológicos foram isolados em 30,5% dos episódios infecciosos e Escherichia coli e Staphylococcus aureus foram os mais freqüentes. CONCLUSÃO: Infecção apresentou elevada incidência nos idosos institucionalizados, porém nenhum evento extraordinário foi observado.
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From the beginning of the AIDS epidemic, pneumocystis pneumonia ( PCP) has been distinguished as one of the most frequent opportunistic diseases with high morbid-mortality. As from 1996, the advent of the highly active antiretroviral therapy ( HAART) has changed the characteristics of such epidemic by reducing its related diseases and, as a result, AIDS-related mortality. With the purpose to estimate PCP occurrence and HAART interference, 376 HIV-infected or AIDS patients were studied from January 1992 to December 2002. Among them, 58 ( 15.5%) PCP cases were found. There was a higher occurrence of PCP in the group of patients in which HAART was not used, with 40 ( 69.0%) of the episodes. As regards the studied period, a tendency to a linear reduction in annual PCP incidence was observed. The mean of T CD4+ lymphocytes in the patients with PCP ( 117 cells/mm(3)) was significantly lower when compared to that of the other individuals ( 325 cells/mm(3)). Therefore, this study suggests a temporal reduction in PCP occurrence related to HAART use with higher T CD4+ lymphocyte counts. Nevertheless, this opportunistic infection still shows significant incidence in AIDS patients. ( NCT00516581).
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The region of the Senador Pompeu Shear Zone (SPSZ), in the North Tectonic Domain of the Borborema Province (BP), has its recent history associated with to South Atlantic Ocean formation event at the Jurassic. A lot of geologics models have discussed about crustal axis elevation in local scale and large scale (Borborema Province), relative to importants regionals tectonics directions of it. The identification and the relationship among this surfaces, stepped in many topographyc levels by tectonics mecanisms, is dificult because of the erosion process on it. Over there, sedimentary deposits is complex and it has not biostratigraphyc record in continental deposits. The analysis metodology on apatita fission-track, in the region of the SPSZ, purpose the more knowledge about morphotectonics mecanisms of the area and the impruvement of its morphotectonics models. For this, it was moleled the age and thermal history of the 11 apatites samples collected on both sides of this shear zone, taking relationships among other results of the thermochronology studies in the BP. Based on the thermal studies in this search, the region of the BP developed on two distint cooling events, separated for one period of relative stabilited. The first episode occur between 130 and 90 M.y., has been began when the samples cross the 120°C isoterm for last time and fineshed at 70°C. The second moment of the cooling process was began about 30 M.y., when the temperature was 90°C, from this to the equlibrium with present surface temperature at 30°C. Some evidences indicated a relacionship between thermal episodes and uplift events of the regional relief. The fundaments of the interpretation was based mainly on comparatives studies among results of the thermochronology analysis and geologics studies about BP. Nóbrega et al.(2005), e.g., on studies about the Portalegre Shear Zone, got similar results on SPSZ, with some details relative to local tectonic activity. Morais Neto et al. (2000) interpreted two importants cooling events in the BP based on their regional studies, that can be associated to regional uplift events. When Assine (1992) studied the stratigraphyc sequences of the Araripe Basin, in the south of Ceará state, conclude that the abrupt return to continentals condictions from the last sedimentar sequency (albiano-cenomaniane) indicate a regional uplift of the NE region of the Brazil at the 100 M.y., in the Albiano Intermediate/Superior. This ages are compatible to termal model of the SPSZ. This two periods of the thermal history of the BP are completely registered in the apatites samples just one age groups of the fission-track, that it is the most ancient age groups. This one suggest it has happened in response to heating before 75 M.y and it has erased the last report of the first moment relief evolution of the BP. The NNE-SSW and E-W structure reativation can have created ideal condictions for heating and local elevations of the geothermal gradients. The equilibrium between the apatites temperatures of this groups and the regionais temperatures took place about 50 M.y., when the samples of the two ages groups had a simillar evolution to present surfaces temperatures
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This study aimed to determine the frequency of Chlamydia trachomatis (CT) infection among high risk Brazilian women and evaluate its association with vaginal flora patterns.This was a cross-sectional study, performed in an outpatient clinic of Bauru State Hospital, So Paulo, Brazil. A total of 142 women were included from 2006 to 2008. Inclusion criteria was dyspareunia, pain during bimanual exam, presence of excessive cervical mucus, cervical ectopy or with three or more episodes of abnormal vaginal flora (AVF) in the previous year before enrollment. Endocervical CT testing was performed by PCR. Vaginal swabs were collected for microscopic assessment of the microbial flora pattern. Gram-stained smears were classified in normal, intermediate or bacterial vaginosis (BV), and recognition of Candida sp. morphotypes. Wet mount smears were used for detection of Trichomonas vaginalis and aerobic vaginitis (AV).Thirty-four of 142 women (23.9%) tested positive for CT. AVF was found in 50 (35.2%) cases. The most frequent type of AVF was BV (17.6%). CT was strongly associated with the presence of AV (n = 7, 4.9%, P = 0.018), but not BV (n = 25, 17.6%, P = 0.80) or intermediate flora (n = 18, 12.7%, P = 0.28).A high rate of chlamydial infection was found in this population. Chlamydia infection is associated with aerobic vaginitis.
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This study shows the results of a research developed in the coastal regions of the Maxaranguape and Touros municipalities, more specific in the mobile dune fields of the Rio Grande do Norte's eastern coast. Although the coastal zones, represent a small percentage of the earth's surface it concentrates a great part of the world's population. The Rio Grande do Norte's state coastal landscape mosaic composed by the dune fields suggest a dynamic scene of changes in the spatial and temporal arranges, with significant changes in the geometry of the sedimentary cover. Following this perspective this research has the objective to map the emerged coastal zone of the Rio Grande do Norte's eastern coast under the perspective of the time-space evolution of the mobile dune fields using geoprocessing techniques, which includes remote sensing, digital images processing and geographic information system (GIS). The results imply the issue of thematic maps: Geologic map; multitemporal evolution map of the mobile dune fields; quantification of the mobile dune fields differences map; temporal evolution of the mobile dune fields surrounds map. The El Niño episodes have directly affected the atmospheric circulation, what have enhanced the sedimentary input in the sand dune, what can justify the relative area growth between the years of 1993 and 2001. The dynamic of the landscape transition were higher than the stability of the spatial pattern of the dune and it's surrounds, as a result the Rio Grande do Norte eastern coast dune fields, specially the mobile dunes from Touros, Zumbi and Maracajau have shown a decrease on the sedimentary cover without vegetation area from 1970 to 2007. Therefore, the data acquired and the techniques used, can be, eventually applied to the mobile dune fields monitoring in order to preserve the dune ecosystems in the Rio Grande do Norte coast
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Objective. To report a case of cardiac arrhythmia related to a low dose of endovenous lanatoside C. Case report. A 23-year-old pregnant woman with mitral regurgitation complicated with preeclampsia and pulmonary edema presented 2 episodes of atrial tachycardia induced by a intravenous digitalis (2 mg, IV and 1 mg, IV, respectively). Conclusion. This case calls attention to the need for further studies analysing the security of digoxin use in preeclampsia.