999 resultados para Terapia intensiva


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The objective of this research was to study the basic aspects of bullfrog reproduction in Anfigranja system from June 1989 to July 1990. For the 1493 animals involved in this experiment (657 males and 836 females) biometrical data were obtained (weight, length and tympanum diameter) and developmental stages of gonads were determined. Female sizes at first maturation were 10,33 cm and 109,78 g and for males it was around 8,09 cm; all males above 45 g were already in the maturation process. The relationship between tympanum diameter and body length (RTC) was considered a good index for male maturation.

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The objective of this work was to caracterize the morphological characterization of the development stages of female reproduction apparel of bullfrog Rana catesbeiana from intensive Anfigranja system. During the period of one year, 836 bullfrog females were removed from regrowing and reproduction sections of the Anfigranja system to study the basic aspects of the reproduction of this specie. The collections were realized monthly and, in that occasion, the body and ovary weights for each animal were recorded and their macroscopic gonadal characteristics, registred. The ovaries from 303 females were removed and histologically examined. From the macro and microscopic characteristics analysis set of the ovary, five stages of gonadal maturation for the female of Rana catesbeiana were determined: juvenile, beginning of maturation, intermediate maturation, advance maturation and spent.

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Thirty 3/4 Canchim + 1/4 Nelore young bulls with 417 kg of body weight and 15 months of age, were confined during 84 days. The animals were fed with diets composed with corn silage, corn grain, cottonseed meal, soybean meal, whole soybean and mineral mix, adjusted in agreement with the recommendations of the Metabolizable Protein System (MP), Cornell Net Carbohydrate and Protein System (CNCPS) and Intestine Digestible Protein System (PDI), for predicted body weight gain of 1.3 kg/head/day. The daily body weight gain did not differ among treatments CNCPS, MP and PDI, with 1.51; 1.48; and 1.13 kg/head, respectively. The economic analysis revealed net profit of R$116.25; R$148.30; and R$108.51/head for CNCPS, MP and PDI systems, respectively. The diets adjusted by CNCPS and MP systems provided superior animal performance than that expected, while the diet adjusted by PDI system did not allow the predicted body weight gain.

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Patients under treatment with oral anticoagulants present specific needs for which nursing care plays an important role, especially to prevent complications. The present review was carried out aiming at discussing nursing diagnoses for these patients by using the system of the North American Nursing Diagnoses Association--NANDA. Diagnoses for such patients depict the risk of bleeding and rethrombosis almost always due to the ineffective control of the therapeutic regimen and the deficit in the volume of fluids during active bleeding. Also, nursing interventions and assessment criteria are proposed for such conditions. The authors see the team's preparation to deal with such therapy as relevant for successful assistance.

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The first option for the treatment of UC is both: salicylates or corticoids. Recently, in late November of 2006, the Brazilian Ministry of Health has approved infliximab (Remicade c, Mantecorp, Brazil) to treat ulcerative colitis. We report the use of infliximab as a first option for the treatment of two patients with severe ulcerative colitis. Case report: Patient 1: AZF, 52 years-old, female, was first diagnosed with UC after history and clinical examination; colonoscopy showed pancolitis with positive biopsy (crypt microabscess). Her Mayo score was 10 (range: 0 to 12/asymptomatic to severe colitis). She received intra venous infusion of infliximab at a dose of 5mg/Kg of body weigh at week 0, 2, 6 and 14. Then, patient was given mesalazine 4.5 g/day for maintenance therapy. Clinical response was defined as a decreased from baseline in the total Mayo score of at least 3 points. At present, patient is asymptomatic with Mayo score of 3 one moth after the last dose of infliximab. Patient 2: MLA, 45 years-old, female was first diagnosed with bloody diarrhea; colonoscopy showed left colitis and the biopsy was positive for ulcerative colitis. Her Mayo score was 9. She was offered and accepted the step down treatment. She was given infliximab 5mg/Kg of body weight at week 0, 2, 6 and 14. After initial treatment with infliximab, she received mesalazine 4.2 g/day. At present, she is asymptomatic with Mayo score of 2 eighteen days after the last dose of infliximab. At our knowledge, this is the first Brazilian report of the use of infliximab as fist-line therapy in ulcerative colitis. Few days after the begging of the infusion, an impressive clinical and colonoscopy improvement was seen in these two patients. Recently, it has been reported the use of infliximab as first-line therapy in pediatric Crohn disease. Infliximab could be a good option in cases of moderate and severe UC to avoid the side effects of the use of high doses of corticoids in patients with moderate and severe UC. However, the question if step-down therapy in ulcerative colitis is better then conventional therapy with salicylates and corticoids needs to be answered by randomized trials.

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Objective: evaluating the adequacy, prescription and energy supply of enteral nutrition therapy in hospitalized patients. Methods: was performed a retrospective survey of the evolution of TNE protocol of 59 patients hospitalized in a general hospital in Marília / SP / BR. Data collected included gender, age, clinical diagnosis, anthropometric and dietary data related to the prescribed dietary formula, route and method of administration of the enteral nutrition, the daily volume prescribed and administered, the daily amount of energy required and offered in the diet, as well as possible complications. Body mass index (BMI), triceps skinfold (TSF) and arm muscle circumference (AMC) were used to establish the nutritional status of the patients. The adequacy of ENT was done according to the daily energy requirement compared to the average energy received during the daily use of ENT. Results: The average found to the BMI was 21.4 kg/m 2, and no differences were found comparing male and female. The data for TSF and AMC were different between genders (p<0.05) and suggest a more severe muscle mass in relation to adipose tissue. The averaged to the energy requirements was 1642 kcal/day but the average of energy prescribed was 1045 kcal/day and the amount offered was 1035 kcal/day. There was a significant difference between the necessity and the supplied energy offered through enteral nutrition (p=0.00) as well between the energy required and prescribed (p =0.00), both were shorter than the necessity. There was no significant difference (p>0.05) in energy supply, volume of enteral nutrition prescribed and administered among eutrophic, underweight or overweight patients. Conclusion: The results of this study indicate that the prescription and energy supply were not based on the needs of these patients, causing a significant energy deficit, which can lead to worsening of the nutritional status of the same. In hospitalized patients in use of ENT, the energy requirement must be made by a qualified professional within the multidisciplinary team, based on the needs of each patient.

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Considering that the cutaneous flap can be affected by isquemic complications the extra corporeal shock wave therapy (ESWT) was described as rescue techniques. The present study was developed to analyze histological and with morfometry, twenty one skin samples treated or not with the shock wave therapy, obtained from flap's distal border, used in this study to repair eyelids' experimental defects in dogs. The flap with or without ESWT did not show any histological sign of inflammatory or atrophic alterations. Both group treated showed similar morphometrical characteristics. The ESWT with the protocol used in this study (2500 impulses at 0,15 mJ/mm 2) did not demonstrate significant clinical outcomes as a rescue technique when applied over the oris angularis flap, however results showed no signals of collateral deleterious effects.

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Context - Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. Objective - To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. Methods - A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. Results - Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. Conclusion - As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.

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This study evaluated the influence of intensive farming of tilapia on physical and chemical parameters and on the occurrence of Streptococcus spp. in the water of the lake and of cages. Throughout a year, monthly samplings were taken in the rainy and dry seasons for a year, at two sampling sites, lake and net cages. For the determination of water quality, physical and chemical water parameters were evaluated and compared to the standards established by Conama Resolution no. 357/2005. The presence of Streptococcus spp. in the water was determined by plating on blood Agar and biochemical screening. Mean values of water parameters were tested using the Kruskal-Wallis test comparing sampling sites and seasons. Ammoniacal nitrogen (ammoniacal-N), total phosphorus (total-P) levels and occurrence of Streptococcus spp. have increased in the water of the net cages. The mean values of several parameters have decreased during the rainy period, except for pH, temperature and ammoniacal-N. Total-P and dissolved oxygen levels, during dry and rainy periods, respectively, exceeded the standard established for freshwater class 2, recommended for aquaculture, which can be harmful to the fish. Therefore, constant monitoring of the physical,chemical and microbiological water parameters is recommended since the Juara lake is also used for recreational purposes.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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