1000 resultados para Unidades hospitalares de hemodiálise
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Wireless sensor networks are reality nowadays. The growing necessity of connectivity between existing industrial plant equipments pushes the research and development of several technologies. The IEEE 802.15.4 LR-WPAN comes as a low-cost and powersaving viable solution, which are important concerns while making decisions on remote sensoring projects. This study intends to propose a wireless communication system which makes possible the monitoring of analogic and/or digital variables (i. e., the pressure studied) involved on the artificial methods for oil and gas lifting. The main issues are: To develop a software based on SMAC Standard in order to create a wireless network to monitoring analogic and/or digital variables; To evaluate the communication link based on the number of lost packets tested in different environments (indoor and outdoor) and To propose an instrumentation system consisting of wireless devices
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This thesis studied the motivation to work among health professionals of the Basic Unities (BUH) in the health network of the city of Natal (RN). It was understood that the work motivation is a process. Then, the expectation theory was applied and motivation components (results of work, expectative, valence, instrumentality, and motivational force) were used to analyses. It s understanding the motivation as multifaceted phenomenon, the psycho sociological perspective was adopted. The research was developed in two phases: one with application of Work Motivation and Meaning Inventory (WMMI), and another with interview. In the first phases, the analysis of results revealed that the major factors contributing to increase the motivational force to health professionals in the BUH´s are: in valence, Self Expression and Personal Realization (VF2), Personal and Family Survival (VF3); in expectative, Self Expression and Work Justice (EF1), Safety and Dignity (EF2) and Responsibility (EF4); in instrumentality, Involvement (IF1) and Recognition and Economic Independence (IF4). In opposition, the factors that more contribute to reduce the motivational force are Wear and Dehumanization factors in valence (VF4), in expectative (EF3), and in instrumentality (IF4), behind the Work Justice Factor (IF2). Basing in content analysis of interviews, it was possible to associate by equivalence, the senses presented by health professionals with obtained results of first phase, indicating that the results of second phase corroborated and complemented those of first one. This possibility broadened the comprehension of the studied phenomenon. In speaking of the respondents, it was visible the presence of contents showing that they perceive the Health System and BUH´s in degradation. In the first phase, the participants´ instruction also predict the results in motivation, and in the interviews can be saw that the instruction is associated with the opportunities in outside of system. As work motivation is a process, the impact of personal and occupational characteristics tend to interact with contextual aspects. It was concluded the majority of health professionals present the moderated motivational force, but it was falling because they experience and perceive a degrading context with work condition increasingly unfavorable.
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RESUMO A fístula arteriovenosa com bom fluxo sangüíneo é de fundamental importância para os pacientes portadores de insuficiência renal crônica em tratamento hemodialítico. Uma das complicações da fístula arteriovenosa é a síndrome do roubo, mas esta é de ocorrência incomum, e o seu tratamento está diretamente indicado quando há sintomas manifestos. Vários métodos foram propostos para sua correção nos membros superiores, sendo considerada a revascularização distal com ligadura arterial o procedimento de escolha. Neste relato de caso inédito, descreve-se o tratamento da síndrome do roubo de uma fístula arteriovenosa realizada em membro inferior, tratada com sucesso por meio da mesma técnica indicada para os membros superiores.
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FUNDAMENTO: A hipertrofia ventricular esquerda é potente preditor de mortalidade em renais crônicos. Estudo prévio de nosso grupo mostrou que renais crônicos com menor escolaridade têm hipertrofia ventricular mais intensa. OBJETIVO: Ampliar estudo prévio e verificar se a hipertrofia ventricular esquerda pode justificar a associação entre escolaridade e mortalidade cardiovascular de pacientes em hemodiálise. MÉTODOS: Foram avaliados 113 pacientes entre janeiro de 2005 e março de 2008 e seguidos até outubro de 2010. Foram traçadas curvas de sobrevida comparando a mortalidade cardiovascular, e por todas as causas dos pacientes com escolaridade de até três anos (mediana da escolaridade) e pacientes com escolaridade igual ou superior a quatro anos. Foram construídos modelos múltiplos de Cox ajustados para as variáveis de confusão. RESULTADOS: Observou-se associação entre nível de escolaridade e hipertrofia ventricular. A diferença estatística de mortalidade de origem cardiovascular e por todas as causas entre os diferentes níveis de escolaridade ocorreu aos cinco anos e meio de seguimento. No modelo de Cox, a hipertrofia ventricular e a proteína-C reativa associaram-se à mortalidade por todas as causas e de origem cardiovascular. A etiologia da insuficiência renal associou-se à mortalidade por todas as causas e a creatinina associou-se à mortalidade de origem cardiovascular. A associação entre escolaridade e mortalidade perdeu significância estatística no modelo ajustado. CONCLUSÃO: Os resultados do presente trabalho confirmam estudo prévio e demonstram, ademais, que a maior mortalidade cardiovascular observada nos pacientes com menor escolaridade pôde ser explicada por fatores de risco de ordem bioquímica e de morfologia cardíaca.
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Ecotourism, in face to environmental demands and discussions, has achieved prominence in the tourism market and wide global development, occasioning a concern about the need for a scientific deepening through a critical approach of the dynamics of consumption and conservation that permeate this practice. This study addresses the ecotourism under aegis of consumer society, in which is perceived that it constitutes a contester practice of society in which it is embedded, nevertheless has been subjected to the logic of capital through commodification of nature. In order to comprehend the reality presented, this study had as geographical cutting two Conservation Units of Sustainable Use in Rio Grande do Norte state: the Jenipabu Environmental Protection Area (APAJ) and Ponta do Tubarão State Sustainable Development Reserve (RDSEPT). The research sought to investigate the relationship between conservation and consumption and their influences on ecotourism held in the Conservation Units (UCs) of sustainable use selected for this study. To this aim it was made a critical reflection about the relationship conservation versus consumption constant in the practice of ecotourism in UCs in the context of current society, analyzing the historical process of formation of UCs of sustainable use in RN state under the light of the contradictory pair conservation-consumption, as well as looking to apprehend the perception of ecotourism of the actors involved with this practice. It was adopted a qualitative approach under a critical perspective based on bibliographical and documentary research and realization of semi-structured interviews with three groups of actors, namely managers/technician, community and ectourists involved with ecotourism in the selected UCs. The analysis was made using two basic units of analysis (consumption and maintenance) and twelve categories. For definition of units of analysis and categories were taken as reference the authors Santos (1987; 1988; 1994; 2001; 2006), Guerreiro Ramos (1989) and A. B. Rodrigues (1996; 2003), which perform critical to society of consumption and describe the key characteristics of the technical-scientific-informational predominant means, and Diegues (1998; 2000), A. B. Rodrigues (2001), Pires (2002) and Neiman and Rabinovici (2010), which discusse historic and scientifically about the emphasis on conservation present in origins and discourse of ecotourism, describing also its founding characteristics. The main results show that the marketing use of the prefix eco has acted as a new dress for what in reality is in fact ancient, ie, the conservation is used as a justification for another new type of consumption. The results also show that despite the coexistence of commercial and symbolic intentions in both UCs, one can observe the predominance consumer society characteristics in the process of creation and the production activities of APAJ, while in RDSEPT we note the predominance of the conservationist characteristics proclaimed by ecotourism. It can be inferred therefore that tourism held in the APAJ can not be called ecotourism, while the practice found in RDSEPT show an alignment with the guidelines of ecotourism
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INTRODUÇÃO: Pacientes com doença renal crônica (DRC) apresentam menor tolerância ao exercício e baixa capacidade funcional, o que os torna, via de regra, sedentários. Outra alteração importante encontrada na DRC é a disfunção cognitiva. O sedentarismo tem sido associado à disfunção cognitiva na população geral, porém, poucos estudos avaliaram essa associação na DRC. OBJETIVOS: Verificar associação entre o nível de atividade física e a função cognitiva de pacientes com DRC que realizam hemodiálise (HD). MÉTODOS: Foram avaliados 102 pacientes que realizam HD. Os participantes responderam o Questionário Internacional de Atividade Física, que avalia o nível de atividade física e o Mini Exame do Estado Mental, utilizado para o rastreamento cognitivo. Os pacientes foram divididos em três grupos conforme a classificação do nível de atividade física (GI: ativos/GII: irregularmente ativos/GIII: sedentários). Foi aplicada análise de regressão logística adotando-se como variável desfecho a presença de disfunção cognitiva e preservando como variáveis independentes aquelas com probabilidade estatística de diferença entre os grupos inferior a 0,1. Foi considerado estatisticamente significante o valor de p inferior a 0,05. RESULTADOS: Os grupos foram semelhantes quanto à idade, tempo de HD, escolaridade e tabagismo. Apresentaram diferença estatisticamente significante quanto à raça, índice de massa corporal, presença de diabetes mellitus, doença de base e grau de déficit cognitivo. Quanto aos dados laboratoriais, os grupos diferiram quanto à creatinina, glicemia, hemoglobina e hematócrito. Houve associação entre o nível de atividade física e função cognitiva, mesmo ajustando-se para as variáveis de confusão. CONCLUSÃO: O maior nível de atividade física associou-se a melhor função cognitiva em renais crônicos em HD, independentemente das variáveis de confusão avaliadas.
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A hemodiálise é uma modalidade terapêutica que pode sustentar a vida do paciente com insuficiência renal aguda (IRA), enquanto este recupera a função renal. Para sua realização, é necessário estabelecer circulação extracorpórea, para que seja realizada a filtração do sangue, impondo a necessidade de um acesso vascular viável e eficiente. O objetivo deste estudo foi avaliar a eficiência e as complicações do acesso vascular para hemodiálise (HD), com cateter temporário de duplo lúmen inserido na veia jugular externa. Foram estudados 10 cães com IRA induzida por gentamicina, submetidos a sessões diárias de HD, com duração de uma hora, até a recuperação da função renal ou óbito. Foram realizadas 104 sessões de HD nos animais estudados, observando-se necessidade de troca do cateter em sete sessões (6,7%), devido à obstrução do lúmen do cateter em seis sessões (5,8%) ou por saída acidental do mesmo em uma sessão (1,0%). Não se observou migração do cateter, infecção, hemorragia ou hematoma no local de entrada do cateter na pele, obtendo-se fluxo sanguíneo patente em 90,4% das sessões. Concluiu-se que o acesso vascular na veia jugular externa com cateter temporário de duplo-lúmen mostrou-se viável, com ocorrência de poucas complicações, sendo, portanto, indicado como forma de acesso para a circulação extracorpórea para HD em cães com IRA.
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The area studied forms a thin NNE-directed belt situated south of Recife town (Pernambuco state), northeastern Brazil. Geologically, it comprises the Pernambuco Basin (PB), which is limited by the Pernambuco Lineament to the north, the Maragogi high to the south and the Pernambuco Alagoas massif to the west, all of them with Precambrian age. This thesis reports the results obtained for the Cabo Magmatic Province (CMP), aiming the characterization of the geology, stratigraphy, geochronology, geochemistry and petrogenesis of the Cretaceous igneous rocks presented in the PB. The PB is composed of the Cabo Formation (rift phase) at the base (polymictic conglomerates, sandstones, shales), an intermediate unit, the Estiva Formation (marbles and argillites), and, at the top, the Algodoais Formation (monomictic conglomerates, sandstones, shales). The CMP is represented by trachytes, rhyolites, pyroclastics (ignimbrites), basalts / trachy-andesites, monzonites and alkali-feldspar granite, which occur as dykes, flows, sills, laccoliths and plugs. Field observations and well descriptions show that the majority of the magmatic rocks have intrusive contacts with the Cabo Formation, although some occurrences are also suggestive of synchronism between volcanism and siliciclastic sedimentation. 40Ar/39Ar and zircon fission tracks for the magmatic rocks indicate an average age of 102 r 1 Ma for the CMP. This age represents an expressive event in the province and is detected in all igneous dated materials. It is considered as a minimum age (Albian) for the magmatic episode and the peak of the rift phase in the PB. The 40Ar/39Ar dates are about 10-14 Ma younger than published palynologic ages for this basin. Geochemically, the CMP may be divided in two major groups; i) a transitional to alkaline suite, constituted by basalts to trachy-andesites (types with fine-grained textures and phenocrysts of sanidine and plagioclase), trachytes (porphyrytic texture, with phenocrysts of sanidine and plagioclase) and monzonites; ii) a alkaline suite, highly fractionated, acidic volcano-plutonic association, formed by four subtypes (pyroclastic flows ignimbrites, fine-to medium-grained rhyolites, a high level granite, and later rhyolites). These four types are distinguished essentially by field aspects and petrographic and textural features. Compatible versus incompatible trace element concentrations and geochemical modeling based on both major and trace elements suggest the evolution through low pressure fractional crystallization for trachytes and other acidic rocks, whereas basalts / trachy-andesites and monzonites evolved by partial melting from a mantle source. Sr and Nd isotopes reveal two distinct sources for the rocks of the CMP. Concerning the acidic ones, the high initial Sr ratios (ISr = 0.7064-1.2295) and the negative HNd (-0.43 to -3.67) indicate a crustal source with mesoproterozoic model ages (TDM from 0.92 to 1.04 Ga). On the other hand, the basic to intermediate rocks have low ISr (0.7031-0.7042) and positive HNd (+1.28 to +1.98), which requires the depleted mantle as the most probable source; their model ages are in the range 0.61-0.66 Ga. However, the light rare earth enrichment of these rocks and partial melting modeling point to an incompatible-enriched lherzolitic mantle with very low quantity of garnet (1-3%). This apparent difference between geochemical and Nd isotopes may be resolved by assuming that the metasomatizing agent did not obliterate the original isotopic characteristics of the magmas. A 2 to 5% partial melting of this mantle at approximately 14 kbar and 1269oC account very well the basalts and trachy-andesites studied. By using these pressure and temperatures estimates for the generation of the basaltic to trachy-andesitic magma, it is determined a lithospheric stretching (E) of 2.5. This E value is an appropriated estimate for the sub-crustal stretching (astenospheric or the base of the lithosphere?) region under the Pernambuco Basin, the crustal stretching probably being lower. The integration of all data obtained in this thesis permits to interpret the magmatic evolution of the PB as follows; 1st) the partial melting of a garnet-bearing lherzolite generates incompatible-enriched basaltic, trachy-andesitic and monzonitic magmas; 2nd) the underplating of these basaltic magmas at the base of the continental crust triggers the partial melting of this crust, and thus originating the acidic magmas; 3rd) concomitantly with the previous stage, trachytic magmas were produced by fractionation from a monzonitic to trachy-andesitic liquid; 4th) the emplacement of the several magmas in superficial (e.g. flows) or sub-superficial (e.g. dykes, sills, domes, laccoliths) depths was almost synchronically, at about 102 r 1 Ma, and usually crosscutting the sedimentary rocks of the Cabo Formation. The presence of garnet in the lherzolitic mantle does not agree with pressures of about 14 kbar for the generation of the basaltic magma, as calculated based on chemical parameters. This can be resolved by admitting the astenospheric uplifting under the rift, which would place deep and hot material (mantle plume?) at sub-crustal depths. The generation of the magmas and their subsequent emplacement would be coupled with the crustal rifting of the PB, the border (NNE-SSW directed) and transfer (NW-SE directed) faults serving as conduits for the magma emplacement. Based on the E parameter and the integration of 40Ar/39Ar and palynologic data it is interpreted a maximum duration of 10-14 Ma for the rift phase (Cabo Formation clastic sedimentation and basic to acidic magmatism) of the PB
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico