998 resultados para Protocolos de encaminhamento


Relevância:

20.00% 20.00%

Publicador:

Resumo:

OBJETIVO: Avaliar a função renal de cães sadios, sob dois protocolos para administração de cisplatina. MÉTODOS: Todos os animais foram submetidos a três sessões de quimioterapia com cisplatina (60mg/m², iv) a intervalos de 21 dias. Foi realizada fluidoterapia com solução de cloreto de sódio a 0,9%, (25mL/kg/hora,iv), durante duas horas e, após administração de cisplatina, por mais uma hora. Os animais do grupo 2 receberam furosemida (2mg/kg, iv) 20 minutos antes da administração da cisplatina. A avaliação da função renal foi feita por exame clinico, urinálise, concentrações séricas de uréia e creatinina, clearance de creatinina, excreção fracionada de sódio e de potássio e razão proteína: creatinina urinária. As avaliações foram feitas imediatamente antes e 1, 2, 5, e 21 dias após cada uma das três sessões de quimioterapia. RESULTADOS: Mantiveram-se dentro da normalidade, não sendo detectados sinais de lesões ou insuficiência renal. Os animais que não receberam furosemida sofreram aumento gradativo nas concentrações séricas de creatinina e diminuição no clearance da mesma. CONCLUSÃO: O regime de fluidoterapia empregado mostra ser efetivo em minimizar a ação nefrotóxica da cisplatina e benefício adicional importante é obtido pela administração de furosemida.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

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

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The advent of the Internet stimulated the appearance of several services. An example is the communication ones present in the users day-by-day. Services as chat and e-mail reach an increasing number of users. This fact is turning the Net a powerful communication medium. The following work explores the use of communication conventional services into the Net infrastructure. We introduce the concept of communication social protocols applied to a shared virtual environment. We argue that communication tools have to be adapted to the Internet potentialities. To do that, we approach some theories of the Communication area and its applicability in a virtual environment context. We define multi-agent architecture to support the offer of these services, as well as, a software and hardware platform to support the accomplishment of experiments using Mixed Reality. Finally, we present the obtained results, experiments and products

Relevância:

20.00% 20.00%

Publicador:

Resumo:

This work presents a packet manipulation tool developed to realize tests in industrial devices that implements TCP/IP-based communication protocols. The tool was developed in Python programming language, as a Scapy extension. This tool, named IndPM- Industrial Packet Manipulator, can realize vulnerability tests in devices of industrial networks, industrial protocol compliance tests, receive server replies and utilize the Python interpreter to build tests. The Modbus/TCP protocol was implemented as proof-of-concept. The DNP3 over TCP protocol was also implemented but tests could not be realized because of the lack of resources. The IndPM results with Modbus/TCP protocol show some implementation faults in a Programmable Logic Controller communication module frequently utilized in automation companies

Relevância:

20.00% 20.00%

Publicador:

Resumo:

RFID (Radio Frequency Identification) identifies object by using the radio frequency which is a non-contact automatic identification technique. This technology has shown its powerful practical value and potential in the field of manufacturing, retailing, logistics and hospital automation. Unfortunately, the key problem that impacts the application of RFID system is the security of the information. Recently, researchers have demonstrated solutions to security threats in RFID technology. Among these solutions are several key management protocols. This master dissertations presents a performance evaluation of Neural Cryptography and Diffie-Hellman protocols in RFID systems. For this, we measure the processing time inherent in these protocols. The tests was developed on FPGA (Field-Programmable Gate Array) platform with Nios IIr embedded processor. The research methodology is based on the aggregation of knowledge to development of new RFID systems through a comparative analysis between these two protocols. The main contributions of this work are: performance evaluation of protocols (Diffie-Hellman encryption and Neural) on embedded platform and a survey on RFID security threats. According to the results the Diffie-Hellman key agreement protocol is more suitable for RFID systems

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The public illumination system of Natal/RN city presents some recurring problems in the aspect of monitoring, since currently is not possible to detect in real time the light bulbs which are on throughout the day, or those which are off or burned out, at night. These factors depreciate the efficiency of the services provided, as well as, the use of energetic resources, because there is energetic waste and, consequently, financial resources that could be applied at the own public system illumination. The purpose of the work is create a prototype in substitution to the currently photoelectric relays used at public illumination, that have the same function, as well others: turn on or off the light bulbs remotely (control flexibility by the use of specifics algorithms supervisory), checking the light bulbs status (on or off) and wireless communication with the system through the ZigBee® protocol. The development steps of this product and the tests carried out are related as a way to validate and justify its use at the public illumination

Relevância:

20.00% 20.00%

Publicador:

Resumo:

INTRODUÇÃO: O artigo compara os protocolos Davison-Caprini (americano) e Sandri (brasileiro) para profilaxia da trombose venosa profunda (TVP), buscando a elaboração de um novo protocolo, mais abrangente e aplicável. MÉTODO: Foi realizado um estudo prospectivo, durante um ano, abrangendo 212 pacientes, comparando os protocolos quanto à estratificação de risco de TVP, e ao tipo de profilaxia indicado. Um novo protocolo foi proposto, aplicado e comparado aos anteriores. RESULTADOS: Obteve-se um novo protocolo, denominado Sandri modificado, que restringe a heparina a um grupo seleto de pacientes, semelhante ao americano, mantendo-se adequado tanto para cirurgias estéticas quanto reparadoras. CONCLUSÕES: A baixa adesão, por parte dos cirurgiões plásticos, ao uso rotineiro da profilaxia de TVP, espelha a escassez de informação sobre o tema. O protocolo Sandri modificado busca melhorar a compreensão e a aplicabilidade da profilaxia da TVP na cirurgia plástica.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

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

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Utilizaram-se 12 cães, machos, distribuídos em quatro grupos (G) experimentais, selecionados de acordo com o tempo de fluidoterapia com solução fisiológica 0,9%: G1 (sem fluidoterapia), G2 (uma hora de fluidoterapia antes da cisplatina), G3 (uma hora de fluidoterapia antes da cisplatina e uma hora após) e G4 (duas horas de fluidoterapia antes da cisplatina e uma após). Todos os animais receberam a cisplatina (70mg/m²), pela via intravenosa, sendo os ciclos de quimioterapia realizados em intervalos de três semanas, num total de três ciclos. O ondansetron (0,4mg/kg) foi administrado pela via intravenosa, a cada oito horas, no dia da quimioterapia e, a seguir, a cada 12 horas, por dois dias. O methimazole (40mg/kg) foi pela via oral, 30 minutos antes da cisplatina e quatro horas após. Avaliaram-se os parâmetros hematológicos, bioquímicos, urinários e dosagem de tiroxina e triiodotironina a cada sete dias até o término do experimento. Esse protocolo foi eficaz e seguro em cães que permaneceram sob fluidoterapia durante duas a três horas. Os animais que não receberam fluidoterapia e os que ficaram somente uma hora sob infusão intravenosa de solução fisiológica apresentaram alterações que resultaram em não-recomendação do protocolo.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Los efectos de la prostaglandina (PGF2α) vs CIDR y eCG (gonadotrofina coriónica equina) en la dinámica de la población folicular y su relación con las concentraciones plasmáticas de P4 fueron investigadas en ovejas cíclicas. Fueron utilizadas 14 hembras ovinas de la raza Bergamascia; el Grupo 1 (Gl) se sometió a dos aplicaciones de PGF2α, y, el Grupo 2 (G2) tratado con CIDR durante 14 días siendo que, en el momento de su retirada, se administraron 500 UI de eCG. La dinámica folicular ovárica fue monitoreada por medio de ecógrafo. Se monitorearon todos los folículos ≥ mm y se gráfico su posición diariamente, observándose el desarrollo individual folicular. Desde el día anterior a la aplicación de la segunda dosis de PGF2α, (Gl) y desde la administración de eCG (G2) hasta el décimo día del ciclo estral se colectaron muestras de sangre para el análisis de P4. Hubo diferencia significativa (P<0,001) en las concentraciones plasmáticas de P4 entre los tratamientos. La sincronización del estro y ovulación utilizando CIDR + 500 UI de eCG, incrementó la cantidad de folículos reclutados, además de aumentar el diámetro máximo y la tasa de crecimiento de los folículos grandes en la primera onda folicular. En consideración a los resultados se puede concluir que la sincronización del estro y de la ovulación en hembras ovinas, utilizando el CIDR y 500 UI de eCG, incrementa la cantidad de folículos reclutados, además de aumentar el diámetro máximo y la tasa de crecimiento de los folículos grandes. La asociación CIDR+500 UI de eCG provoca aumentos significativos en las concentraciones plasmáticas de progesterona (P4) al inicio de la fase luteal en hembras ovinas.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The purpose of this review was to assess the efficacy of recombinant LH (r-LH) supplementation for controlled ovarian stimulation in recombinant FSH (r-FSH) and GnRH-agonist (GnRH-a) protocol for IVF/ICSI cycles. Search strategies included on-line surveys of databases from 1990 to 2006. Four trials fulfilled the inclusion criteria (Lisi et al. 2002, Humaidan et al. 2004, Marrs et al. 2004, Tarlatzis et al. 2006). When the review was carried out advantages were observed for the r-LH supplementation protocol with respect to a fewer days of stimulation, a fewer total amount of r-FSH administered and a higher serum estradiol levels on the day of hCG administration. However, these differences were not observed in number of oocyte retrieved, number of mature oocytes, clinical pregnancy per oocyte retrieval, implantation and miscarriage rates. Nevertheless, more randomized controlled trials are necessary before evidence-based recommendations regarding exogenous r-LH supplementation in ovarian stimulation protocols with r-FSH and GnRH-a for assisted reproduction treatment can be provided.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The purpose of this investigation was to verify the efficacy of recombinant LH supplementation for controlled ovarian stimulation in GnRH-antagonist protocol for assisted reproductive technologies cycles. Search strategies included on-line surveys of databases from 1990 to 2006. In this review and meta-analysis, the observed advantages for the LH supplementation protocol were a higher serum estradiol levels on the day of hCG administration and a higher number of mature oocytes. However, there were no differences observed in the total amount of r-FSH administered, days of stimulation, number of oocyte retrieved, the clinical pregnancy rate per oocyte retrieval, the implantation rate and miscarriage rate. This result demonstrates that the association of r-LH with r-FSH may prevent any decrease in estradiol after antagonist administration and a significant higher number of mature oocytes was obtained. Nevertheless, additional randomized controlled trials are needed confirm these observations.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The objective of this study was to evaluate the LH surge after last hormonal injection of synchronization of ovulation protocols in buffalo. Fifteen multiparous buffaloes received 25 mg of Lecirelin in Day 0, and 150 mg of D-Cloprostenol on Day 7. On Day 8, estradiol benzoate was injected in Group 1 (0.5 mg, n = 5) and Group 2 (1.0 mg, n = 5). On Day 9, five buffaloes received 25 mg of Lecirelin (Control). Blood samples were collected for measure the LH concentrations on Day 7 and then every 3 hours until 72 hours after the PGF 2a injection. For evaluation of LH surge were compared the interval between PGF 2a injection to LH surge, duration, amplitude and area under the LH peak. The LH surge occurred 51.0 + 0.0 hours, 47.3 + 2.7 hours and 47.0 + 3.8 hours after PGF 2a injection for Control, Group 1 and Group 2, respectively (P > 0.05). The duration of LH peak in Control (7.8 + 1.5 hours) was shorter than Groups 1 and 2 (10.5 + 1.5 hours vs. 10.8 + 2.4 hours, respectively; P < 0.05). The amplitudes of LH peak were 4.5 + 0.4 ng/mL, 4.0 + 0.4 ng/mL and 4.3 + 0.8 ng/mL for Control, Group 1 and Group 2, respectively (P > 0.05). The area under LH peak for Control (4.8 ± 0.7) was smaller than the areas of the Groups 1 and 2 (8.8 ± 2.5 vs. 8.7 2.2, respectively; P < 0.05). In summary, the estradiol benzoate injection provided higher duration and area of LH peak than GnRH injection in Ovsynch protocol in buffalo.