997 resultados para 530405 Seguros


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Different environmental disasters registered around the world and their consequences to nature and to the biodiversity, including the human beings, lead us to deal with nature’s mysteries and with our limits In controlling technological apparatus that make us proud enough to think that we can control nature’s processes. These kinds of experiences, considered as a real “being-event”, make us experiment processes of disillusion related to the possibilities of science and technology. Considering this frame and the historical human experiences, one fundamental question is related to our position, our professional and ethical commitments and our responsibilities facing this reality. How can we deal with these facts that are continuously announcing the limits of nature, of science, technologies and our self-limits? As researchers involved with environmental education, it seems plausible for us to ask about the ethical commitments related to our “acts” of investigation. So, considering different and stimulating possibilities opened by intellectual and philosophers who are adding significant contributions to these debates, my proposal for this essay is to invite environmental education researchers to carry on a dialog involving these questions with some perspectives proposed specially by Bakhtin (1895 – 1975) and some other authors affiliated or not to his approach. This seems to be an opportunity which allows us to realize that our commitments as environmental education researchers would be identified with our commitments with life

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Pós-graduação em Educação Matemática - IGCE

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

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Certain medicines are considered potentially inappropriate (PIM) for elderly people as they increase the risk of adverse drug events (ADE) and because safer alternative therapies are available on the market. In this context, in order to identify the instruments that assess the quality of medical prescriptions for elderly and to determine which drugs are considered PIM, a bibliographic survey was conducted in PUBMED, LILACS and PAHO databases, in February and March/2010. The search strategy included the use of health descriptors and a manual search in the references cited by selected papers. During the period of data collection, 15 instruments were identified. In 2012, with the publication of the update of Beers criteria, this instrument was included in the study. We identified 163 PIM of 25 therapeutic classes, of which 125 (76.7%) are marketed in Brazil. Of these, 31 (24.8%) are essential medicines (RENAME 2012), of which 13 have safer therapeutic equivalents and 19 (15.2%) are over-the-counter drugs. Data suggest the need for inclusion of safer alternatives for the elderly in the national list of essential medicines and the pharmaceutical care for early detection of ADE in this age group, in order to contribute to the safe use of medicines.

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A laparoscopia ainda é pouco utilizada como ferramenta para técnicas de reprodução assistida em cervídeos sul-americanos, não havendo informações sobre seus efeitos e protocolos anestésicos seguros para sua realização. Objetivaramse avaliar as possíveis alterações na freqüência cardíaca (FC), respiratória (FR), saturação de oxihemoglobina (SpO2) e temperatura retal (TR) durante a laparoscopia para visualização dos órgãos reprodutivos de seis fêmeas de veado-catingueiro (Mazama gouazoubira) anestesiadas com a associação cetamina (5mg/kg), xilazina (0,3mg/kg), midazolam (0,5mg/kg) e isofluorano. Cada animal, após anestesiado, foi posicionado em decúbito dorsal para realização de duas laparoscopias com insuflação abdominal de CO2 (14,2 ± 2,39mmHg; M ± EPM) com intervalo de 40 dias. Para avaliar os principais eventos da laparoscopia, esta foi dividida em três períodos: animal sem insuflação abdominal (P1), com insuflação abdominal (P2) e insuflação abdominal com os quadris elevados a 45º (P3). O controle foi realizado após 40 dias da última laparoscopia, para isto, cada animal foi novamente anestesiado e mantido em decúbito dorsal por um período de tempo igual ao tempo médio de duração das anestesias realizadas nas laparoscopias, sem que o procedimento laparoscópico fosse realizado. O tempo de anestesia dos controles foi também dividido em P1, P2 e P3, respeitando o tempo médio de duração de cada um destes períodos das laparoscopias. Para análise dos dados foi usado o teste de análise de variância (ANOVA) seguido do teste de Tukey e valores de P<0,05 considerados significativos. Não houve diferença significativa nos parâmetros estudados em nenhum dos períodos estabelecidos para o controle e laparoscopia. Porém, a FR média entre P1 (38,8 ± 4,42) e P3 (32,7 ± 4,81) e a TR média entre P1 (38,2ºC ± 0,17), P2 (37,6ºC ± 0,19) e P3 (37,0ºC ± 0,21) variaram significativamente, independente da laparoscopia. Tais dados permitiram concluir que a laparoscopia não promoveu alterações significativas nos parâmetros avaliados, embora o protocolo anestésico utilizado tenha contribuído para redução da temperatura retal resultando em risco de hipotermia durante a anestesia.

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

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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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The use of computers in dental clinics has brought many benefits to dentist, helping them in various technical, administrative and legal. This study aimed to verify whether dentist, students of the post-graduate course in Orthodontics and Implantodontia of the Brazilian Association of Dentistry (ABO), regional Araçatuba-SP, using computers and digital documentation in clinical practice. They were invited to participate in the study all 60 students enrolled in courses of Orthodontics and Implantodontia of those institutions, in the year 2007 and those who consented (n = 52) answered a questionnaire containing questions open and closed on the subject . As the profile of the participants, 64.5% are male, 51.9% are between 30-39 years of age and 48.1% completed the graduation in the 90th. A 69.3% said they didn't receive any notion of computing during graduation and 67.3% use the computer in the office, mainly for management of the same (34.3%). Regarding the use of electronic record 55.8% reported using this technology, while 44.2% denied. 32.7% do not believe that electronic records that can serve as proof of judicial and 35.7% believe that the electronic records should be archived for 20 years. It follows that most professionals use the computer in the office and also the digital records, but does not feel secure about the legal validity of such documents, unknown, including the appropriate time of its filing.

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Introdução: a ausência ou alterações da estrutura dentária, principalmente em áreas estéticas, compromete a aparência, as relações sociais, a autoestima e, consequentemente, a qualidade de vida do indivíduo. Atualmente, avanços tecnológicos e científicos na Odontologia têm possibilitado várias opções de tratamentos reabilitadores e restauradores que oferecem resultados cada vez mais seguros e confiáveis. Objetivo: relatar, por meio de um caso clínico, a recuperação da harmonia dos dentes anteriores com a utilização de laminados de cerâmica e prótese sobre implante associada a recursos para recuperar a estética gengival. Conclusão: o planejamento adequado, associado aos conhecimentos de uma Odontologia integrada, possibilita resultados extremamente satisfatórios, resgatando a função e a estética, tanto dentária quanto gengival, proporcionando um sorriso harmonioso e o bem-estar social do paciente.

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The diagnosis of head and neck infections constitutes relevant step in their treatment. However, in spite of the fact that most of diseases in head and neck region are infectious in nature, several reasons collaborated for dentists do not ask laboratory tests in order to help clinical diagnosis. By mean of this review literature, based on research articles about the newest and most reliable methods of diagnosis for clinical laboratories, the authors discuss the advantages and disadvantages of each selected method and the relevant aspects in transportation of the specimens to the laboratory. Saliva, biofilm, pus, and blood are the most frequent specimens for microbial diagnosis, being that the most used methods are culture and those based on detection of deoxyribonucleic acid by polymerase chain reaction method. Whereas, the culture depends on cellular viability, and has reduced sensitivity, as well as needs favorable conditions in the sample collection and transportation, PCR shows high sensitivity and specificity, but it does not allow the determination of antibiogram, what reduces its usefulness. In addition, few laboratories possess conditions to perform cultivation of obligate anaerobes or have experience in the molecular detection of these microorganisms.

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Each year individuals have sought a better quality of life and work, in this case, the science of Bio-insurance needs to keep up with technological advances and the needs of society to minimize or eliminate the risks of accidents. This study evaluated the most common accidents involving health staff from 2007 to 2011 in Araçatuba-SP. 478 accidents were recorded, and 78.7% with percutaneous involvement, 9% with intact skin, 4% with no skin intact, with 7.3 mucous and 1.05% other types of exposures. Most accidents were caused by needles with lumen (68.0%), followed by other agents (14.1%), accidents with blades (8.5%) or needles without lumen (5.5%); 3.7% did not answer and 0.2% were accidents with glasses. When checking the condition in which the accident occurred, 26.0% did not specify, 25.1% occurred in the disposal and / or handling sharp objects, 12.0% at the time of drug administration, 6.9% puncture, 3.7% occurred during recapping the needle. These data show that the most common accidents are those involving needles with lumen and / or sharp objects and due to these factors, the industry of health materials have sought alternatives to minimize such accidents as needles with protective, vacuum collection . Thus, it appears that reporting accidents is important for the development of technical and / or safer materials for patients and health workers.

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The ageing process can change the pharmacodynamics and pharmacokinetics parameters. Therefore, some medications are considered potentially inappropriate (PIM) for the elderly people, since they can increase the likelihood of occurrence of adverse drug events. The objectives are to estimate the frequency of use of PIM in the elderly people, with potentially hazardous drug interactions (PHDI) and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. A cross-sectional study was performed in a Health Family Strategy (region of Araraquara, SP), between January and February/2012. The medical records of patients aged ≥60 years, that use at least one drug, were consulted for identification of PIM, according to the Beers criteria. The MPI identified were classified considering the Anatomical Therapeutic Chemical Classification System (ATC) and the essentiality of the drug (safety, effectiveness, quality and cost parameters) The inclusion criteria were met by 358 elderly, being that 93 of them (26%) had taken at least one PIM. Of the 114 different drugs prescribed for elderly, ten were classified as PIM, of which four of them act on the central nervous system, four on cardiovascular system and two on the digestive tract. Seven MPI are essential medicines, belonging to national list of essential drugs (RENAME-2010). Fourteen drug interactions were identified, of which two are PHDI (fluoxetine/amitriptyline and digoxin/hydrochlorothiazide).After the PI, there was no change in medical prescriptions of patients with PIM use or with DI. Medical prescriptions of elderly attended in the Health Family Strategy show pharmacotherapeutic safety problems, of which may be responsible for health hazardous for this age group. Although the intervention carried out by letter had been ineffective for the adherence of doctors in prescribing safe alternatives, wide dissemination of the lists that contain PIM and PHDI is need, as well as the inclusion of safer equivalents in RENAME, in order to contribute for rational use of drugs.

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The status epilepticus (SE) is characterized by a series of crises which occur without recovery of consciousness or a single seizure lasting more than 30 minutes and can damage the central nervous system and systemic. The duration and frequency of attacks are directly related to patient prognosis. Whether seizures occur often and are longer, increase the risk of neurological and systemic complications. Child population has a higher frequency of seizures and it is associated with a lower threshold of immature brain to trigger these episodes. Aim: To determine the safest drugs prescribed for children in SE, their doses and schedules. A bibliographic survey was performed in electronic databases. Methods: The scientific health descriptors used for search was: “status epilecticus” and “anticonvulsivants” and “child”. Results: This strategy identified 396 manuscripts, of whom four were considered eligible for the study, after the assessment by floating reading and criteria. Of these, two were randomized trials and two descriptive. The studies address the use of oral midazolam, rectal diazepam and intravenous lorazepam. Conclusions: All investigated drugs were effective in treat in status epilepticus. Lorazepam is highlight, since it has fewer secondary effects and, as an alternative to the intravenous, oral midazolam. However, there is a need for further studies to demonstrate the efficacy and safety in the use of drugs in children.

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There is no vaccine available against leishmaniasis. Drug resistance, variable efficacy, toxicity, parenteral administration, and requirement for long courses of administration are the main drawbacks of current leishmanicidal drugs. Infections by protozoans of the genus Leishmania are the major worldwide health problem, with high endemicity in developing countries. The drugs of choice for the treatment of leishmaniasis are the pentavalent antimonials, which exert renal and cardiac toxicity, thus, there is a strong need for safer and more effective treatments against leishmaniasis.