Avaliação dos custos da assistência de recém-nascidos de mães hipertensas no Hospital das Clínicas - UNESP - Botucatu

The Hypertension Arterial Gestationis is a of largest complications to the pregnant women, a time that is associated with to high risk of morbimortalidade fetal and maternal ;the term If referred the levels pressure equal or above of 140mmhg to the pressure systolic and of 90mmhg to the pressure diastolic (1).Hypertension in pregnancy can be classified into gestational hypertension, chronic hypertension, preeclampsia and eclampsia(3). This study aimed to calculate and analyze the cost of care of newborns of hypertensive mothers hospitalized in rooming, nursery and the neonatal intensive care unit (Neonatal UTI). It’s a study of exploratory, descriptive and quantitative data analysis, in newborns of mothers with hypertension, who underwent prenatal care in HCFMB, from January 1 to 31 in December 2010. The data analysis showed that the cost of care for newborn in rooming was R$ 38.62 for the control group and groups of hypertensive mothers were R$ 19.93 to R$ 37.38. The costs of care to the newborn in the nursery were R$ 1,781.81 for the control group and groups of hypertensive mothers were R$ 680.03 to 7544.10. The costs for the newborn who Neonatal UTI were R$ 7,468.60 for the control group and groups of hypertensive mothers were R$ 5,228.02 to R $ 18,372.75. The total costs of care for newborn in rooming, nursery and Neonatal UTI were R$ 916.15 for the control group, R$ 1,385.98 for the HAC group, R$ 327.23 for the group HAS, R$ 3,896.57 for the group of preeclampsia and R$ 6,326.54 for the group of eclampsia. Considerations It can be concluded that the costs of mothers with preeclampsia and eclampsia were higher, being conditions with increased risk of maternal-fetal morbidity / mortality, requiring care in intensive care unit and longer stay in hospital

Influência dos polimorfismos para o gene da sintase do óxido nitrico endotelial (eNOS) na pressão arterial e perfil lipídico em resposta ao treinamento físico em mulheres no climatério

A incidência de doenças cardiovasculares tem se constituído na maior causa de morbimortalidade em todo mundo, especialmente após os 50 anos de idade, e têm sido associadas à presença de polimorfismos em alguns genes, especialmente o gene da eNOS. Apesar das mulheres compartilharem com os homens os diversos fatores de risco para o desenvolvimento das doenças cardiovasculares, entre elas hipertensão arterial e dislipidemia, estudos epidemiológicos mostram que as mesmas, antes da menopausa, apresentam menor risco cardiovascular quando comparadas aos homens. Entretanto, após o período da menopausa há um aumento significativo na incidência de hipertensão arterial e suas complicações. Este fato parece estar relacionado a uma possível ação protetora exercida pelos hormônios sexuais femininos, sobretudo os estrogênios que apresentam queda abrupta no período da menopausa. O óxido nítrico (NO), produzido pelas células endoteliais através da enzima eNOS, desempenha importante papel no sistema cardiovascular, participando na regulação do fluxo sanguíneo, do remodelamento vascular e na atividade plaquetária. Assim, estudos envolvendo o gene responsável pela síntese da enzima eNOS, tem sido foco de várias pesquisas na tentativa de avaliar se a presença dos polimorfismos poderia predispor os indivíduos a maior incidência de doenças cardiovasculares. O polimorfismo do gene da eNOS na posição G894T/Glu298Asp localizado no éxon 7, implica na alteração da sequência protéica, tornando a proteína mais suscetível à clivagem, tendo consequências funcionais como a redução do NO demonstrando assim sua provável contribuição para a disfunção endotelial e consequente aumento da pressão arterial. Com relação ao Íntron 4 caracterizado por um Número Variável de Repetições em Tandem... (Resumo completo, clicar acesso eletrônico abaixo)

A influência da mídia no conceito de corpo

Esta monografia teve como objetivo demonstrar as diferentes concepções culturais do corpo ao longo de diferentes épocas e como os padrões sociais estabelecidos influenciam diretamente a maneira de visualizar esse corpo. Os meios de comunicação do século XX se desenvolveram de maneira vertiginosa, ficando mais acessíveis a população e aumentando a influência sobre esta. A geração fitness do início da década de 1980, que tinha como objetivo incentivar a prática de exercícios físicos para a população, acabou sendo amplamente divulgada pela mídia e exercendo grande influencia na sociedade. O padrão de corpo, bastante divulgado na sociedade atual, consiste em mulheres jovens, magras, e com o corpo bem delineado e homens fortes e musculosos. O corpo ficou banalizado. A mídia impõem o corpo ideal para toda a sociedade utilizando de inúmeras propagandas, com pessoas famosas e bem sucedidas relacionando muitas vezes o sucesso delas com o seu corpo. Várias pessoas acabam utilizando métodos nada saudáveis para a obtenção desse corpo ideal. Porém, isso pode causar inúmeras complicações de saúde e em alguns casos, a morte. O corpo perfeito, que deveria significar saúde, está virando sinônimo de doença e obsessão.

Subluxação atlantoaxial canina

The atlantoaxial subluxation or luxation is an instability of this articulation that produces excessive flexion of this joint causing the cranial aspect of the axis to rotate dorsally into the vertebral channel with subsequent spinal cord compression. This disorder is most commonly found in young small breed dogs. The diagnosis of this disease is done by survey radiographs, where there is a larger distance between the atlas dorsal arch and the axis spinal process characterize the atlantoaxial subluxation. Surgical stabilization is the treatment of choice and multiple implants show the best results to stabilize the atlantoaxial joint. The main complications are sudden death or implant failure. The sudden death happens because of cardiorespiratory arrest and it is most likely caused by brainstem iatrogenic trauma. However, a larger study comparing different surgical stabilization techniques should be performed to evaluate relative success rates in dogs that have the same initial neurologic status

Caracterização morfo-anatômica de beressol [Trimezia juncifolia (Klatt.) Benth]

A Trimezia juncifolia (Iridaceae) é encontrada nas regiões tropicais e subtropicais e possui características muito próximas das plantas do mesmo gênero e família. Ela é utilizada pela população de Botucatu, São Paulo, para a depuração do sangue, para feridas intermitentes e como antiinflamatório. Por possuir interesse econômico primordialmente ornamental, são raros os estudos que a caracteriza, facilitando as complicações que podem ocorrer por trocas de espécies. Por causa disso, este trabalho tem como objetivos descrever a morfologia externa da Trimezia juncifolia, visando a caracterização da droga vegetal, e a anatomia das raízes, bulbo, caule aéreo e escamas do bulbo, visando uma descrição microscópica farmacopeica. A caracterização morfológica da planta foi feita com o auxílio de estereomicroscópio binocular. Para o estudo anatômico de Trimezia juncifolia (beressol), foram selecionados exemplares que contenham raízes, caule subterrâneo, e caule aéreo. Os catafilos, bulbo, raízes e caule aéreo foram divididos em terço apical, médio e basal. Com ênfase no caule subterrâneo, o bulbo e as raízes tiveram as três frações analisadas, e o catafilo, as frações média e basal. Somente o terço médio do caule aéreo foi analisado.O material foi fixado em solução de glutaraldeído e formaldeído. Em seguida o material foi conduzido às etapas de inclusão em resina (metacrilato). O material incluído foi seccionado em micrótomo de rotação. As secções dispostas em lâminas foram coradas com azul de toluidina pH 6,8. Mesmo com a descrição das frações medianas da raiz, bulbo, catafilos e caule aéreo, ou escapo, na discussão deste trabalho foi dada ênfase à análise do caule subterrâneo e raízes. Mesmo que popularmente a fração utilizada da planta seja o bulbo, essa análise se faz necessária para auxiliar o controle de qualidade... (Resumo completo, clicar acesso eletrônico abaixo)

Tromboembolismo na aorta abdominal terminal em felinos

Clinical manifestations of arterial thromboembolism in cats depends on the location of embolization, the severity and duration of occlusion, the functionality of the collateral circulation and the development of complications. In case of location in the terminal abdominal aorta usually presents animal paresis/paralysis, pulses are weak or nonpalpable, pain, cold limbs. Gastrocnemius and tibialis muscles generally have become bulbous, swollen and sore because of ischemic neuromyopathy. The nail beds become pale or very dark (purple to black), and do not bleed when cut. Due to the small number of researches in the area it’s until not possible to determine which medication, dosage and frequency of administration are more suitable for the treatment of arterial thromboembolism in cats. Among the options currently available the cheapest, easiest to administer and which requires no periodic monitoring is the low-dose aspirin

Desenvolvimento de um modelo de atenção farmacêutica para pacientes portadores de anemia falciforme

A Atenção Farmacêutica (ATENFAR) nasceu oficialmente a partir do Consenso Brasileiro de Atenção Farmacêutica em 2002. Este define a prática de ATENFAR como um elemento da Assistência Farmacêutica. A Anemia Falciforme (AF) é a doença hereditária hematológica de maior prevalência no mundo, e os pacientes requerem Atenção Integral e cuidados especiais para melhor efetividade da farmacoterapia e melhoria de sua qualidade de vida. As complicações da doença são decorrentes da vaso-oclusão e abrangem diversos sistemas do organismo, incluindo baço, coração, encéfalo, pulmões e sangue, tais como as crises álgicas e infecções pneumocócicas. Medidas não-farmacológicas são eficazes na prevenção e tratamento das complicações menos intensas. Nesse contexto, a Educação Sanitária é ferramenta essencial para conscientizar os pacientes a respeito das características da doença e da promoção do uso correto de medicamentos. A complexidade do quadro clínico do paciente portador de AF e as dificuldades enfrentadas pelos mesmos no acesso a informações e tratamentos justificam a necessidade de um método de Atenção Farmacêutica específico para esses indivíduos. A metodologia desenvolvida consiste em um Questionário de Acompanhamento Farmacoterapêutico e abrange todos os aspectos pertinentes à saúde do paciente, à qualidade de vida e à farmacoterapia. Neste estudo piloto foram acompanhados seis pacientes portadores de AF; houve a identificação de 12 RNMs e foram efetuadas 39 intervenções farmacêuticas. As respostas do Questionário de Acompanhamento Farmacoterapêutico foram pontuadas e cada paciente foi classificado quanto à qualidade do seu estado de saúde, farmacoterapia e qualidade de vida. Houve avaliação de indicadores... (Resumo completo, clicar acesso eletrônico abaixo)

Polimorfismo do gene IL6 candidato à predisposição à rotura prematura de membranas pré-termo e ao trabalho de parto pré-termo

Introduction: Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) cause severe complications for both mother and fetus. Among the risk factors associated with preterm labor and PPROM, genetic predisposition has been gaining importance. However, the association between polymorphic genes and the pathogenesis of PTL and PPROM remains elusive. A better understanding of the genetic mechanisms underlying these adverse pregnancy outcomes may enable the identification of high risk patients and allow new approaches to minimize the deleterious effects of prematurity. Aim: To determine the association between maternal IL-6 polymorphism gene and the occurrence of PTL and PPROM. Patients and Methods: The study included 109 patients with prior history of PL and/or PPROM that delivered prematurely at the Obstetrical Unit Care of Botucatu Medical School, UNESP between 2003 and 2012. The control group consisted of 68 patients that delivered at term, matched to the case group by age, ethnicity, and sex of the newborn. Oral swabs (Cath-AllTM – Epicentre Biotechnologies) were collected for analysis of genetic polymorphisms by PCR. Statistical tests were performed to compare genotype, clinical and socio-demographic data from the groups. A p-value of <0.05 was considered significant. Results: The sociodemographic characteristics in both groups were homogeneously distributed. The frequency of the polymorphic allele C, associated with less production of IL-6, and therefore thought to be protective against PTL and PPROM, was 32,5% in the study group and 30,9% in the control group, without statistically significant differences. Conclusion: Considering the sample size included in this study, the frequency of the mutated allele is similar in pregnant women who delivered at term and gestational complications as PTL and PPROM

Avaliação dos fatores de virulência de cepas de Staphylococcus aureus isoladas de pacientes submetidos à diálise peritoneal e correlação com a evolução clínica dos episódios de peritonite

10 A diálise peritoneal (DP) é uma terapia de substituição renal utilizada em pacientes renais crônicos. A peritonite é uma das suas principais complicações; sendo o Staphylococcus aureus causador de episódios mais graves e reincidentes. Os fatores de virulência desta bactéria são responsáveis por essa alta patogenicidade. Esse estudo objetivou avaliar esses fatores e a presença do gene mecA em amostras de S.aureus obtidas de episódios de peritonites de pacientes tratados com DP. Foram estudadas 73 amostras de peritonites ocorridas entre janeiro de 1996 e setembro de 2008. O estudo dos fatores de patogenicidade consistiu na detecção da produção de biofilme, de enzimas hemolisinas α e β, lipase, lecitinase e nucleases; e das enterotoxinas A, B, C, D e da Toxina 1 da Síndrome do Choque Tóxico (TSST-1). Ainda foi verificado o perfil de sensibilidade dos isolados à oxacilina pelo Etest® e detecção do gene mecA por PCR. Dentre todos os resultados, a produção de toxina B e a resistência à oxacilina foram os dois fatores que influenciaram a evolução dos casos de nova infecção. Quanto aos casos recorrentes, características dos pacientes como idade, raça e presença de diabetes foram mais determinantes para a não resolução dos surtos de peritonite

Aspectos gerais da síndrome anorexia caquexia do câncer em pequenos animais

The cancer anorexia-cachexia syndrome is the most common paraneoplastic syndrome in Veterinary Medicine. It is characterized by severe loss of muscle mass and adipose tissue resulting in severe unintentional weight loss, anemia, fatigue, negative nitrogen balance, immune dysfuntion and other metabolic disturbances. The SAC is not only a result of inadequate intake of nutrients. The tumor requires large amounts of nutrients to allow growth and causes changes in pacient metabolism to get this energy. Recent studies suggest that the metabolic changes by cancer can be measured by hormones and cytokines produced or by the patient or the tumor, but this not completely understood. Animals with SAC have lower survival time, the greater chance of complications during treatment and lower quality of life. With the increase in the number of cancer cases in domestic animals and longer lifespan after diagnosis of malignant disease through the use of antineoplastics drugs, diagnosis and treatment of cancer anorexia-cachexia syndrome has shown great importance in that patients may have higher survival then better quality of life. This paper aims to provide information about this complex and multifunctional syndrome and its possible treatments

Avaliação da proliferação celular na próstata de gerbilos vasectomizados, após indução química pela injeção intraperitoneal do carcinógeno N-metil-N-nitrosuréia (MNU)

Prostate cancer is the second leading cause of cancer death in the country. Due to this factor, the interest of showing what relationship exists between vasectomy surgery and the incidence of prostate carcinoma has started. Some epidemiological studies showed an increased risk of prostate cancer in vasectomized men (Emard et al., 2001). On the other hand other authors have argued that there is no correlation (Patel et al., 2005) and there are those who said that vasectomy is linked to reduced risk of prostate cancer (Ross, 1983). Faced with an analysis of published works, such discussion remains today. The vasectomy, or deferentectomia, is a contraceptive male method, which is the section of the vas deferens of man by preventing the sperm from being expelled along with the seminal fluid during ejaculation, and is one of the most simple, economical, uncomplicated post- operative. This study aims to evaluate the process of cell proliferation and to evaluate immuno-histochemically the expression of specific markers of PCNA (Proliferating Cell Nuclear Antigen) and Ki-67, in the prostate of the gerbil after chemical induction by intraperitoneal injection of the carcinogen N-methyl -N-nitrosourea (MNU), because the regulation of the functional balance between cell proliferation and apoptosis is associated with hyperplasia and prostatic carcinoma. The experimental procedure was performed at the Laboratory of the Department of Anatomy, along with collecting the data for later analysis

Checklist de cirurgias da OMS: análise da segurança e comunicação da equipe cirúrgica de um hospital escola

WHO has launched the “Safe Surgery Saves Lives” program with the purpose to reduce damage to surgical patients and define safety standards specifically in order to reduce such patients’ morbi-mortality by providing surgery teams and hospital managers with orientation about the standards of safe surgery and a uniform service evaluation instrument for national and international surveillance. Hence, this study aimed at applying the WHO safe-surgery checklist to the surgical specialties of a university hospital and evaluating the team’s opinion about the influence of its application on the safety of surgical process and on the team’s interpersonal communication. It was a descriptive, analytical, qualitative field study conducted in the surgery facilities of a university hospital in a public establishment in São Paulo state. The checklist was applied to eight surgical specialties, resulting in a total number of 30 surgeries. Its application was conducted by the researcher in three phases: Sign in, Time out, Sign Out. Next, one member of the surgery team was invited to voluntarily participate in the study by signing an informed consent form and answering guiding questions. Thirty members of the surgery team participated in the study. Bardin’s Content Analysis Method was used to organize and analyze the data. As regards the safety provided by the checklist, the following thematic categories emerged: “It reduces risk and possible complications”; “It standardizes conducts and reviews safety steps”; “It allows for better understanding of the process”; and “It provides safety to the team as a whole”. The category “It is not included in the institution’s routine” emerged from the subjects’ statements when they understood that, in this form, the checklist does not provide safety to surgical procedures. As regards communication, two thematic categories emerged: ...(Complete abstract click electronic access below)

Equilíbrio, funções executivas e quedas de idosos com demência de Alzheimer: um estudo longitudinal

Falls among older people is a major clinical problem due to its high incidence, with consequent implications for the health and care costs. Elderly patients with dementia of Alzheimer type (AD) are more susceptible to falls due to the impairment of executive functions and gait, with the risk of falls 3 times higher than non-demented elderly. This study used a longitudinal design and aimed to analyze the effects of a regular and systematized physical activity program on the frequency of falls in patients with AD. Additionally, we aimed to correlate the frequency of falls with the executive functions and equilibrium, after and before the physical activity program. The study included 21 patients with clinical diagnosis of AD, divided into two groups: control group (CG), composed of 11 subjects not engaged in any systematized physical activity and training group (TG): 10 seniors who participated in the Cinesioterapia Functional and Cognitive in Elderly with Alzheimer's disease program (PRO-CDA). The physical activity program lasted four months, with weekly frequency of three times, with each session lasting 60 minutes. Were administered the Mini-Mental State Examination (MMSE) to assess cognitive functioning and global score of the Clinical Dementia Rating (CDR) to classify the severity of dementia. For the evaluation of executive functions were used the Clock Drawing Test (TDR) and Frontal Assessment Battery (FAB). In addition, we used the Functional Balance Scale, Berg test (EEFB) and Timed Up-and-Go (TUG) to assess the equilibrium and risk of falls. Falls were recorded by means of a questionnaire, which included the number of falls in the last four months. Analyzing the results, it was observed that TG obtained significant improvements in equilibrium and in executive functions, highlighting the beneficial effects of physical activity in these variables... (Complete abstract click electronic access below)

Patogenias e tratamentos da insuficiência hepática em cães

The liver has many biological functions that contribute to the proper functioning of the organism. Liver failure is the loss of these functions, leading to the appearance of complications that worsen the general clinical condition of the patient. This review shows the main complications of liver failure, explaining their pathogenesis and the possible forms of treatment in an attempt to improve the quality of life of patients during treatment of the disease that causes liver failure

Participação da família no tratamento de paciente em diálise peritoneal

Dramatic changes occur in the lives of patients on peritoneal dialysis and his family life, changing lifestyle, professional and social activities. Considering the important role of family in treatment, is crucial for nurses to know how these families perceive their role as caregivers and their difficulties and needs, in the process of peritoneal dialysis. The approach chosen for the study was the phenomenological method, based on Merleau-Ponty, who proposes to understand the human experience, from the description of those who lived it. The study findings show that in the beginning of treatment, family members, feel impacted with the disease severity and eager to become responsible for maintenance treatment, fearing not match the expectations.Guided by staff, appear confident in taking care and deal with the difficulties and complications of treatment, supported by professionals. However, resent the great changes in their social activities and work, his life turns out to be quite limited, due to the dedication to a sick family member. Many feel overwhelmed because they are not supported by other family members. Some envision a future outlook for renal transplant, others seem skeptical, given the long waiting list, especially when advanced age of the sick family member. These results suggest the need for individualized attention to family caregivers, and to encourage the family to organize itself and develop a joint work. In this sense, the design of health care, taking care with the focus of the family, it seems highly appropriate in preparing the plan of family orientation, this is defined as a dynamic unity, which, working in harmony, can contribute positively in the treatment of health a sick member