998 resultados para Escalonamento de exames médicos


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Fil: Galvani, Iván Horacio. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

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Basándonos en 18 entrevistas en profundidad con médicos que han incorporado en su práctica clínica la acupuntura, en este trabajo analizamos cómo ellos definen la medicina que practican y de qué modo la diferencian de la práctica biomédica convencional o alopática. El trabajo de campo se realizó en las ciudades de Buenos Aires y Tucumán durante los años 2005 y 2006. El estudio se centra en los significados y estilos terapéuticos desarrollados por los médicos, y más específicamente en sus perspectivas de cómo el ejercicio de la acupuntura en la atención primaria de la salud les ha permitido mantenerse próximos a la "esencia" de lo que debería ser la medicina. Los médicos construyen dicha esencia a partir de la crítica de la biomedicina actual hiper especializada y altamente tecnologizada, y de la recuperación de valores y prácticas perdidas de la medicina occidental moderna (el enfoque holístico y centrado en el paciente) así como de la posibilidades que abren las medicinas no convencionales de brindar tratamientos que no producen iatrogenia y de facilitar una relación terapéutica menos paternalista

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Fil: Galvani, Iván Horacio. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

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The continuous evolution of integrated circuit technology has allowed integrating thousands of transistors on a single chip. This is due to the miniaturization process, which reduces the diameter of wires and transistors. One drawback of this process is that the circuit becomes more fragile and susceptible to break, making the circuit more susceptible to permanent faults during the manufacturing process as well as during their lifetime. Coarse Grained Reconfigurable Architectures (CGRAs) have been used as an alternative to traditional architectures in an attempt to tolerate such faults due to its intrinsic hardware redundancy and high performance. This work proposes a fault tolerance mechanism in a CGRA in order to increase the architecture fault tolerance even considering a high fault rate. The proposed mechanism was added to the scheduler, which is the mechanism responsible for mapping instructions onto the architecture. The instruction mapping occurs at runtime, translating binary code without the need for recompilation. Furthermore, to allow faster implementation, instruction mapping is performed using a greedy module scheduling algorithm, which consists of a software pipeline technique for loop acceleration. The results show that, even with the proposed mechanism, the time for mapping instructions is still in order of microseconds. This result allows that instruction mapping process remains at runtime. In addition, a study was also carried out mapping scheduler rate. The results demonstrate that even at fault rates over 50% in functional units and interconnection components, the scheduler was able to map instructions onto the architecture in most of the tested applications.

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Currently, the diagnostic ultrasound is inserted in various areas of medical action and carried out by many medical professionals, from which militate directly in the image area, such as radiologists and sonographers, but also by gynecologists, pediatricians, neurologists, general practitioners, endocrinologists, angiologists, orthopedists, rheumatologists, urologists, general and vascular surgeons. It is well known that the medical professional, for the exercise of its mission, requires a broad set of skills, competencies and attitudes developed and exercised during their training period. Living with medical students over nearly 20 years in hospital environment, I noticed gaps in the learning process by the students about what is diagnostic ultrasound and its applications, demonstrating failures as understanding the basic acoustic ultrasound, difficulties in identifying of anatomical structures in ultrasound images and inability in requests examinations and interpretations of images and reports. Based on these findings, it was developed in this Professional Masters a multimedia digital book that exposes what the ultrasound as a diagnostic modality imaging, dealing with its historiography and its physical/acoustic concepts, relating the process of formation of the ultrasound image, discussing about the features of sonographic equipments and their embedded technologies and highlighting its diagnostic applications , the latter presented through videos which will be described aspects of captured ultrasound images. This book will be available for access in digital format, serving as a teaching tool in medical education since the beginning of the course, so that can be used in conjunction with the discipline of Gross Anatomy, offered in the basic cycle of the Medicine Undergraduate Course of the Federal University of Rio Grande do Norte (UFRN).

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Lung cancer is one of the most common types of cancer and has the highest mortality rate. Patient survival is highly correlated with early detection. Computed Tomography technology services the early detection of lung cancer tremendously by offering aminimally invasive medical diagnostic tool. However, the large amount of data per examination makes the interpretation difficult. This leads to omission of nodules by human radiologist. This thesis presents a development of a computer-aided diagnosis system (CADe) tool for the detection of lung nodules in Computed Tomography study. The system, called LCD-OpenPACS (Lung Cancer Detection - OpenPACS) should be integrated into the OpenPACS system and have all the requirements for use in the workflow of health facilities belonging to the SUS (Brazilian health system). The LCD-OpenPACS made use of image processing techniques (Region Growing and Watershed), feature extraction (Histogram of Gradient Oriented), dimensionality reduction (Principal Component Analysis) and classifier (Support Vector Machine). System was tested on 220 cases, totaling 296 pulmonary nodules, with sensitivity of 94.4% and 7.04 false positives per case. The total time for processing was approximately 10 minutes per case. The system has detected pulmonary nodules (solitary, juxtavascular, ground-glass opacity and juxtapleural) between 3 mm and 30 mm.

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INTRODUCTION: Chronic kidney disease (CKD) is a global health problem, with increasing prevalence in its terminal stage and one of the factors that can contribute is the failure to recognize the disease and its risk factors. OBJECTIVE: To evaluate the knowledge of medical residents (MR) and medical preceptors (MP) in hospitals in the Federal University of Rio Grande do Norte in Natal-RN - Brazil, on the DRC, based on the policy of the Kidney Disease Improving Global Outcomes (KDIGO ). METHODS: Cross-sectional study where 64 MR (R1 = 32; R2 = 15; R3 = 17) and 63 MP answered a questionnaire divided into seven sessions that addressed aspects of the DRC since the setting up referral to a nephrologist. RESULTS: Only 20 participants (15.7%) reported using any guidelines for the management of CKD. The scores obtained by session were: Definition and classification (46.1 ± 47.8); Risk factors (70.5 ± 27.9); Laboratory evaluation (58.2 ± 8.8); Clinical action plan (57.6 ± 19.9); Reduction in proteinuria (68.3 ± 15.0); Complications (64.8 ± 19.9); Referral to a nephrologist (73.0 ± 44.6). There was a statistically significant difference between the knowledge of MR and MP in the sessions: Laboratory evaluation (MR 61.5 ± 8.4 vs 54.8 ± 7.9 MP; p <0.001); Reduction in proteinuria (73.1 ± 11.4 vs MR MP 63.5 ± 16.7; p <0.001) and Referral to a nephrologist (MR 81.2 ± 39.3 vs 64.5 ± 48.2 MP; p = 0.035). Among the MR, the R2 obtained the best score (63.9 ± 22.6 vs R1 R2 R3 71.9 ± 17.2 vs 63.5 ± 22.5, p = 0.445). It identified a low percentage of success of the doctors on the definition of CKD (MP = 46%; R1 = 40.6%; R2 = 60%; R3 = 52.9%; p = 0.623) and classification (MP = 34.9%; R1 = 53.1%, R2 = 60%; R3 = 52.9%; p = 0.158). CONCLUSION: The study showed that most doctors do not use any guidelines for clinical management of CKD and that there are gaps in knowledge on the subject, even among physicians who work in the university environment. In this sense, we propose the realization of mini-workshops for participants and students from boarding UFRN, using Case-Based Learning Strategy (CBL), with small group discussion, to strengthen the incorporation of CKD guidelines in undergraduate teaching and in clinical medical practice in general.