884 resultados para Pancreatic insufficiency


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

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The aim of the study was to determine the effect of clenbuterol on the anaerobic-threshold of horses on a tread-mill with increasing physical stress, measuring heart rate (HR) and blood levels of lactate, glucose, and insulin. Twelve Arabian horses. were submitted to two physical tests separated by a 10-day interval. Clenbuterol (CL) at 0.8 mu g/kg or saline (control-C) was administered intravenously 30 minutes, before the test. The treadmill exercise test consisted of an initial warmup followed by a gradually increasing effort. There was no statistical difference in either V-2 or V-4 (velocity at which plasma lactate concentration reached 4 and 2 mmol/L, respectively) between the two-experimental groups. For the CL group, V-200, V-180, V-160, and V-140 (velocity at which the rate heart is 140, 160, 180, and 200 beats/minute, respectively) decreased significantly. At rest as well as times 4, 6, and 10 minutes, insulin levels were higher in the group that recieved clenbuterol (P < .05). Contrary to what was expected, apparently, there was no improvement in aerobic metabolism in animals when given a therapeutic dose of the bronchodilator. The elevated heart rate observed could have been attributable to the stimulation of cardiac beta(1) adrenoceptors and the increased insulin levels to the stimulation of pancreatic beta(2) receptors.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Estudou-se o comportamento do sistema portal hepático em 30 patos domésticos, adultos, machos e fêmeas. O sistema apresenta-se constituído por duas veias portais hepáticas: direita e esquerda. A veia portal hepática esquerda é formada por veias gástricas esquerdas (em número de 1 a 2), veias da margem ventral do ventrículo, veia pilórica e veia proventricular caudal. A veia portal hepática direita é formada pela veia mesentérica caudal, veia mesentérica cranial, veia proventrículo-esplênica e veia gastropancreaticoduodenal. A veia mesentérica caudal recebe tributárias do mesorreto, cloaca e junção ileocecocólica. A veia mesentérica cranial recebe tributárias jejunais (em número de 12 a 21) e se anastomosa com a veia mesentérica caudal, formando a veia mesentérica comum. A veia pancreaticoduodenal recebe duas veias gástricas direitas, constituindo assim a veia gastropancreaticoduodenal. A veia proventrículo-esplênica é formada pelas veias proventriculares dorsal e direita e pelas veias esplênicas.

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This work is a research about the policy of initial education of teachers made by the federal government, in the Brazilian educational view in the 1990 s. It is based on that the procedures to the initial education of teachers are in a much bigger context of the productive rearrangement and of the reconstruction of the State and they have in the international institutions, like the CEPAL, UNESCO and the World Bank, their main mediators. The dissertation aims to analyze the implementation of the policy of initial education of educators, having as empirical field the CEFET RN institution, and as reference the undergraduate course of Geography, more specifically the subject vocational practice. This study is advised by the theoretical and methodological fundamentals of the qualitative research, and it is being characterized by a case study. Among the methodological procedures which were used, some of them can be pointed out such as, the bibliographic research, the documental analysis, the application of questionnaires and the carrying out of interviews. The studies show up CEFETs and the Superior Education Institutes were considered by the Brazilian government suitable for the introduction of the initial education of vocational training, related to teaching, a proposed model by updated principles of international organizations. However, in the CEFET RN reality, although the difficulties listed by the teachers and students in the introduction of the subject vocational practice, the initial background in the undergraduate course of Geography got one point which is getting close to the teaching that is carried out in universities, privileging teaching, research and extension. For the people who have participated of researches, the subject vocational practice is relevant for the curriculum of teaching education because it makes the articulation between theory and practice possible, aspects considered essential ones for a teaching education of quality. Also, the studies show that one of the big obstacles faced in the introduction of the subject in question, was the lack of assistance to the students who are in a period of training and in the execution of research and extension projects caused by the insufficiency of educators to perform in the undergraduate course, as well as the lack of time of the teachers due to a large number of activities that they develop in their workplace (CEFET RN). This fact reveals the way how the policy of education of teachers came to educational institutions, imposed by MEC, without considering their structure conditions. Although the difficulties, the innovator character of the experience stood out, as in relation to the locus of education as because of being an educational model which involves theory and practice and the different kinds of knowledge, pretty necessary ones for the teaching education, as well as coming beyond a pragmatic education coherent with the immediate interests of the world of work

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Descriptive study aimed to analyze the quality of life (QOL) of patients with venous ulcers (UV) outpatient clinic of a university hospital in Natal / RN. The aim of the study population was composed of 50 patients with UV treated at the cardiology clinic of a university teaching hospital at the tertiary level. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol 279/09). Data collection was performed over a period of two months by the very a masters degree and an academic nursing through the application of a form concerning the socio-demographic, clinical, and health care, and the instruments WHOQOL and WHOQOL - old. The data were analyzed with SPSS 15.0, using descriptive and inferential statistics presented in the form of tables, charts and graphs. Of the surveyed, female predominance, age range 59 years, Catholic, low education, married, with up to 03 children, not working, retired, or with occupations requiring long periods in one position, wage income of up to 02 minimum wages, inadequate sleep, patients with chronic venous insufficiency and other chronic diseases such as diabetes and hypertension, were taking medications for treatment, being a minority to IVC. In patients with predominant only one injury, time of injury up to five years, inadequate rest, pain, edema and lesions colonized. The assistance the UV patients began treatment of the injury until four months after the onset of the ulcer, and services primary health care most wanted, access to angiologist by reference form, commuted by public transportation, received support regarding the treatment of injuries. The topical product most used in the lesion was healing, and few were using compression therapy. respondents suffer discrimination in society, showed changes in quality of life after the occurrence of ulcer in relation to leisure, pain, restriction of social / school / transportation; barring employment / financial / social ladder; Physical appearance / discrimination and restriction of domestic activity. These changes were related to the time of injury and found that the more chronic injury is the most negative changes occur in their QV (ρ = 0.000). Analyzing the characteristics of QV measured by the WHOQOL-bref, we found for the two general questions they are dissatisfied with their health (ρ = 0.023) and all areas have significant difference compared with the worst QV have the injury of more than 5 years (ρ = 0.000). The QV measured by the WHOQOL-old, we found that these patients had no changes from the time of injury. We conclude that the QV of patients with UV was considered unsatisfactory when compared to the time of injury on more than 5 years which shows that the quality of life worsens with time the chronic UV.

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Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequié/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K ≥ 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference

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Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

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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

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Este trabalho foi realizado para avaliar o efeito da adição de enzima e/ou probiótico, bem como do estresse calórico sobre a atividade de enzimas digestivas de frangos de corte aos 7, 14, 28 e 42 dias de idade. O delineamento experimental utilizado foi o inteiramente casualizado em parcelas subdivididas com 6 tratamentos primários, constituindo um esquema fatorial 6x2 (rações x temperatura) e 4 tratamentos secundários (idades de amostragem), com 2 repetições. Não foi verificado efeito significativo dos tratamentos sobre a atividade específica das enzimas, exceto para as atividades de amilase aos 14 dias e tripsina aos 28 dias de idade, nas quais a adição de enzima proporcionou maiores atividades. Já a idade de criação afetou significativamente todas as enzimas quantificadas, sendo que a atividade específica de lipase diminuiu e as atividades específicas de amilase, tripsina e quimotripsina aumentaram com a idade das aves. A temperatura ambiente (calor) também afetou a produção enzimática de acordo com a idade dos frangos de corte, com um aumento na atividade de lipase e redução na tripsina e amilase.

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Objetivou-se neste trabalho analisar os efeitos do uso de hidrolisado protéico do conteúdo celular de levedura (HPCCL), da proteína isolada de soja (PIS), do hidrolisado protéico de mucosa intestinal de suínos (HPMIS) e do leite em pó integral em substituição parcial ao farelo de soja sobre a morfologia do intestino delgado e o desenvolvimento pancreático de leitões aos 7 e 14 dias pós-desmame. Foram utilizados 44 leitões desmamados aos 21 dias de idade, com peso de 5,5 ± 0,6 kg, alimentados desde o desmame com as seguintes dietas isonutritivas: FS - ração à base de milho e farelo de soja; LPI - ração FS + leite em pó integral; LPI+HPMIS - ração LPI mais HPMIS; LPI+PIS - ração LPI mais PIS; LPI+HPCCL- ração LPI mais HPCCL. Os tratamentos não influenciaram a morfologia intestinal dos leitões, evidenciando que nenhuma das fontes protéicas utilizadas foi capaz de minimizar os efeitos deletérios da mudança da alimentação sobre a vilosidade intestinal. Os animais alimentados com LPI+PIS e LPI+HPMIS apresentaram, aos sete dias pós-desmame, o maior desenvolvimento pancreático. Concluiu-se, portanto, que todas as fontes protéicas estudadas foram igualmente adequadas para a formulação de dietas de desmame.

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CONTEXTO E OBJETIVO: Portadores de insuficiência renal crônica em diálise apresentam alta prevalência de desnutrição proteico-energética. Não existe ainda um método uniforme para avaliar o estado nutricional desses pacientes. Recomenda-se a aplicação de um conjunto de métodos subjetivos e objetivos para se chegar aos diagnósticos nutricionais adequados. O objetivo deste estudo é traçar o perfil nutricional de pacientes submetidos a hemodiálise. TIPO DE ESTUDO E LOCAL: Estudo transversal descritivo realizado na Unidade de Tratamento Dialítico de Araraquara, São Paulo, Brasil, em 2008. MÉTODOS: 48 pacientes tiveram seus indicadores antropométricos e bioquímicos caracterizados, sendo também submetidos ao questionário Avaliação Global Subjetiva modificada (SGAm), verificando-se possíveis correlações entre esses indicadores. RESULTADOS: A frequência de desnutrição moderada e grave variou de 22% a 54%, de acordo com o parâmetro utilizado. Com relação à adequação do peso ideal, 29% da amostra estavam com porcentagem de adequação abaixo do percentil 75, classificados como portadores de desnutrição moderada e grave. As correlações mais significativas foram observadas entre índice de massa corporal (IMC) e adequações de prega triciptal (PCT), circunferência do braço (CB) e circunferência muscular do braço (CMB); e entre o SGAm e adequações de CB e CMB. CONCLUSÃO: A desnutrição apresentou grande variabilidade de frequência entre os pacientes de acordo com o critério escolhido para avaliação. O acompanhamento nutricional de rotina e a validação de métodos que avaliem a composição corporal desses pacientes são de extrema importância para diagnosticar precocemente a desnutrição e assim prevenir complicações e reduzir as taxas de morbimortalidade nesta população.

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The microbiological monitoring of the water used for hemodialysis is extremely important, especially because of the debilitated immune system of patients suffering from chronic renal insufficiency. To investigate the occurrence and species diversity of bacteria in waters, water samples were collected monthly from a hemodialysis center in upstate São Paulo and tap water samples at the terminal sites of the distribution system was sampled repeatedly (22 times) at each of five points in the distribution system; a further 36 samples were taken from cannulae in 19 hemodialysis machines that were ready for the next patient, four samples from the reuse system and 13 from the water storage system. To identify bacteria, samples were filtered through 0.22 mu m-pore membranes; for mycobacteria, 0.45 mu m pores were used. Conventional microbiological and molecular methods were used in the analysis. Bacteria were isolated from the distribution system (128 isolates), kidney machine water (43) and reuse system (3). Among these isolates, 32 were Gram-positive rods, 120 Gram-negative rods, 20 Gram-positive cocci and 11 mycobacteria. We propose the continual monitoring of the water supplies in hemodialysis centers and the adoption of effective prophylactic measures that minimize the exposure of these immunodeficient patients to contaminated sources of water.

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Extracts and decoctions of Eugenia jambolana Lam., Eugenia uniflora L., and Eugenia punicifolia (Humb., Bonpl. & Kunt) DC. are used in traditional medicine to treat diabetes mellitus. Although there have been reports that Eugenia jambolana and Eugenia uniflora have antidiabetic effects, no study has yet been made on Eugenia punicifolia . We investigated the effects of aqueous, butanol, and methanol extracts of Eugenia punicifolia leaves administered by gavage to streptozotocin-diabetic rats for 26 to 29 days. Body weight, food and fluid intake, urine volume, and urinary glucose and urea were evaluated every 7 days. At the end of the experiment, we measured serum cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides and bilirubin, hepatic glycogen and serum marker-enzymes (alanine and aspartate aminotransferases, alkaline phosphatase, gamma-glutamyltransferase, L-lactate dehydrogenase, creatine kinase, alpha-amylase, and angiotensin I converting enzyme). We found that in rats treated with the aqueous extracts, food and liquid intake, urinary volume, and body weight were all reduced, while for rats treated with the methanol extract, not only were liquid intake, urinary volume and body weight reduced, but urinary glucose and urea also decreased. Rats treated with the butanol extract showed no significant alterations in any of the parameters measured. Chronic treatment with extracts had no effect on the marker enzymes nor on serum bilirubin levels. The results indicate that aqueous extracts of Eugenia punicifolia leaves produced an anorexic effect and that methanol extracts had a beneficial effect on the diabetic state by improving carbohydrate and protein metabolism without provoking hepatobiliary, microvascular, muscular, or pancreatic toxic effects.

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This dissertation examines the Kantian moral in a teleological perspective. It consists of a reconstruction of philosophy practice that departs from the investigation of the categorical imperative, the concepts of duty, will, good will, as well as an approach on the ways of investigation of nature, which will enable the foundation to engage in the teleological argument, investigating the organized human beings, the harmonious system, its relationship with the ultimate and most important purpose, always flexing the analysis of these concepts the idea of purpose. Subsequently we will establish an argument about the end terminal and the implication of this concept to think about the real idea of the system in Kant and his relationship or support for moral theory. In essence this paper approaches the moral point of view of ethics, outlining the insufficiency of this field for the foundation of architectural moral, which will enable the final touch or the indispensability or the teleological argument as fundamental to the Kantian moral Theory