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Influência da fisioterapia respiratória sobre a função cardiopulmonar em recém-nascidos de muito baixo peso; Effects of respiratory physiotherapy on the cardiopulmonary function of very low birth weight newborn infants

NICOLAU, Carla Marques; FALCÃO, Mário Cícero
Fonte: Sociedade de Pediatria de São Paulo Publicador: Sociedade de Pediatria de São Paulo
Tipo: Artigo de Revista Científica
POR
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OBJETIVO: Avaliar as repercussões da fisioterapia respiratória sobre a função cardiopulmonar em recém-nascidos pré-termo (RNPT) submetidos à ventilação mecânica. MÉTODOS: Estudo prospectivo de RNPT com peso de nascimento menor que 1500g, sendo verificados os valores de frequência cardíaca (FC), saturação de oxigênio (SatO2), frequência respiratória (FR) e pressão arterial sistêmica (PA) antes e após a fisioterapia respiratória e a aspiração endotraqueal. Os RNPT incluídos foram avaliados em sessões sequenciais entre o 3º-7º dias de vida por dois fisioterapeutas da unidade neonatal. Os valores de FC, SatO2 e PA foram coletados por monitorização eletrônica e a FR, por cronômetro. Na análise estatística, foi utilizado o teste de ANOVA para medidas repetidas, sendo significante p<0,05. RESULTADOS: Foram estudados 42 recém-nascidos, 57% do sexo feminino, com peso de nascimento médio de 1024g e idade gestacional média de 29,5 semanas. Somente 3 RNPT apresentaram Apgar de 5º minuto menor que 5 e a Doença das Membranas Hialinas foi o principal diagnóstico respiratório (88%). Foram realizadas 252 sessões de fisioterapia. A FC, FR, SatO2 e PA atingiram valores considerados fisiológicos após os procedimentos fisioterapêuticos e a aspiração endotraqueal. CONCLUSÕES: Os procedimentos de fisioterapia respiratória e de aspiração endotraqueal não apresentaram influências significativas na função cardiopulmonar...

Monitorização de eletrólitos urinários em pacientes críticos: estudo preliminar observacional; Urinary electrolyte monitoring in critically ill patients: a preliminary observational study

Maciel, Alexandre Toledo; Park, Marcelo; Macedo, Etienne
Fonte: Associação de Medicina Intensiva Brasileira - AMIB Publicador: Associação de Medicina Intensiva Brasileira - AMIB
Tipo: Artigo de Revista Científica
POR
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OBJETIVO: Sobreviventes e não sobreviventes da unidade de terapia intensiva apresentam perfis ácido-básicos distintos. A regulação renal de eletrólitos urinários e a diferença de íons fortes urinários têm papéis principais na homeostase ácido- básica. O objetivo deste estudo foi avaliar a potencial utilidade da mensuração diária dos eletrólitos urinários na monitorização ácido-básica e da função renal. MÉTODOS: Foram registrados, prospectivamente e diariamente, parâmetros ácido-básicos plasmáticos e marcadores tradicionais da função renal, em paralelo à medição dos eletrólitos urinários em pacientes com sonda vesical internados na unidade de terapia intensiva. Os pacientes que permaneceram na unidade de terapia intensiva com sonda vesical por pelo menos 4 dias foram incluídos neste estudo. RESULTADOS: Dos 50 pacientes incluídos neste estudo, 22% vieram a óbito durante a internação na unidade de terapia intensiva. A incidência de lesão renal aguda foi significativamente maior nos não sobreviventes, durante os 4 dias de observação (64% versus 18% em sobreviventes). O cloreto e o sódio urinário foram mais baixos, e a diferença de íons fortes urinários mais alta, no 1º dia, em pacientes que desenvolveram lesão renal aguda tanto nos sobreviventes como nos não sobreviventes. Ambos os grupos tiveram débito urinário semelhante...

Part II : monitorização hemodinâmica básica e cateter de artéria pulmonar; Part II : basic hemodynamic monitoring and the use of pulmonary artery catheter

Dias, Fernando Suparregui; Rezende, Ederlon Alves de Carvalho; Mendes, Ciro Leite; Réa Neto, Álvaro; David, Cid Marcos; Schettino, Guilherme de Paula Pinto; Lobo, Suzana Margareth; Barros, Alberto; Silva, Eliezer; Friedman, Gilberto; Amaral, José Luiz
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
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JUSTIFICATIVA E OBJETIVOS: A monitorização de funções vitais é uma das mais importantes e essenciais ferramentas no manuseio de pacientes críticos na UTI. Hoje é possível detectar e analisar uma grande variedade de sinais fisiológicos através de diferentes técnicas, invasivas e não-invasivas. O intensivista deve ser capaz de selecionar e executar o método de monitorização mais apropriado de acordo com as necessidades individuais do paciente, considerando a relação risco-benefício da técnica. Apesar do rápido desenvolvimento de técnicas de monitorização não-invasiva, a monitorização hemodinâmica invasiva com o uso do cateter de artéria pulmonar (CAP) ainda é um dos procedimentos fundamentais em UTI. O objetivo destas recomendações é estabelecer diretrizes para o uso adequado dos métodos básicos de monitorização hemodinâmica e CAP. MÉTODO: O processo de desenvolvimento de recomendações utilizou o método Delphi modificado para criar e quantificar o consenso entre os participantes. A AMIB determinou um coordenador para o consenso, o qual escolheu seis especialistas para comporem o comitê consultivo. Outros 18 peritos de diferentes regiões do país foram selecionados para completar o painel de 25 especialistas...

Predomínio de manifestações respiratórias na indicação de pHmetria esofágica prolongada em crianças; Predominant respiratory symptoms in indications for prolonged esophageal pH-monitoring in children

Goldani, Helena Ayako Sueno; Silveira, Themis Reverbel da; Rocha, Renata Gonçalves; Célia, Luciana dos Santos; Dalle Molle, Lucas; Barros, Sergio Gabriel Silva de
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
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Racional - Observa-se um aumento na prevalência de complicações extra-esofágicas do refluxo gastroesofágico. A avaliação do perfil de pacientes submetidos a pHmetria esofágica prolongada poderia auxiliar na identificação de pacientes que poderiam se beneficiar do diagnóstico precoce de refluxo gastroesofágico. Objetivo - Avaliar a população de demanda, indicações e resultados dos exames de pHmetria esofágica prolongada na avaliação de refluxo gastroesofágico em um Serviço de Gastroenterologia Pediátrica. Pacientes e Métodos – Analisaram-se os dados de 190 crianças e adolescentes que realizaram pHmetria esofágica. Realizou-se análise descritiva da população de estudo. As crianças foram categorizadas em cinco grupos conforme a idade. Utilizou-se o aparelho Digitrapper MKIII (Synetics) e software EsopHogram versão 5.7. O parâmetro do exame considerado para análise foi o índice de refluxo. Resultados - As indicações mais freqüentes para o exame foram: asma (26,8%), apnéia/cianose (20%), pneumonias de repetição (18,4%), síndrome do bebê chiador (15,8%) e tosse crônica/rouquidão (11%). Os grupos etários mais freqüentes nas indicações respiratórias foram: asma - maior de 5 anos (92,2%); apnéia/cianose - menor de 3 meses (55...

Cerebral hemometabolism: from isolated measurements to monitoring and therapy

Cruz,Julio
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/1993 EN
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An overview is presented on historical and multivariate aspects of cerebral hemometabolism. This involves a full multivariate approach, from blood pressure to cerebral metabolism. From isolated measurements, to monitoring and management, a comprehensive overview of cerebral hemometabolism is addressed, from its inception to current days, up to a new concept, the cerebral hemodynamic reserve. A multivariate functional diagram is proposed, to summarize the multivariate interrelationships of cerebral hemometabolism. A generic proposition is mode for studies of truly normal cerebral hemometabolism in children, for subsequent clinical applications. Another proposition is made for multivariate cerebral hemometabolic monitoring, in a broad variety of circumstances of predominantly global changes in intracranial dynamics, both in animal and clinical research.

The use of external event monitoring (web-loop) in the elucidation of symptoms associated with arrhythmias in a general population

Epifanio,Hindalis Ballesteros; Katz,Marcelo; Borges,Melania Aparecida; Corrêa,Alessandra da Graça; Cintra,Fátima Dumas; Grinberg,Rodrigo Leandro; Ludovice,Ana Cristina Pinotti Pedro; Valdigem,Bruno Pereira; Silva,Nilton José Carneiro da; Fenelon,Guilh
Fonte: Instituto Israelita de Ensino e Pesquisa Albert Einstein Publicador: Instituto Israelita de Ensino e Pesquisa Albert Einstein
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2014 EN
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Objective To correlate arrhythmic symptoms with the presence of significant arrhythmias through the external event monitoring (web-loop). Methods Between January and December 2011, the web-loop was connected to 112 patients (46% of them were women, mean age 52±21 years old). Specific arrhythmic symptoms were defined as palpitations, pre-syncope and syncope observed during the monitoring. Supraventricular tachycardia, atrial flutter or fibrillation, ventricular tachycardia, pauses greater than 2 seconds or advanced atrioventricular block were classified as significant arrhythmia. The association between symptoms and significant arrhythmias were analyzed. Results The web-loop recorded arrhythmic symptoms in 74 (66%) patients. Of these, in only 14 (19%) patients the association between symptoms and significant cardiac arrhythmia was detected. Moreover, significant arrhythmia was found in 11 (9.8%) asymptomatic patients. There was no association between presence of major symptoms and significant cardiac arrhythmia (OR=0.57, CI95%: 0.21-1.57; p=0.23). Conclusion We found no association between major symptoms and significant cardiac arrhythmia in patients submitted to event recorder monitoring. Event loop recorder was useful to elucidate cases of palpitations and syncope in symptomatic patients.

Physiologic Trend Detection and Artifact Rejection: A Parallel Implementation of a Multi-state Kalman Filtering Algorithm

Sittig, Dean F.; Factor, Michael
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 08/11/1989 EN
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Using a parallel implementation of the multi-state Kalman filtering algorithm, we have developed an accurate method of reliably detecting and identifying trends, abrupt changes, and artifacts from multiple physiologic data streams in real-time. The Kalman filter algorithm was implemented within an innovative software architecture for parallel computation: a parallel process trellis. Examples, processed in real-time, of both simulated and actual data serve to illustrate the potential value of the Kalman filter as a tool in physiologic monitoring.

Impact of endoscopic suturing of the gastroesophageal junction on lower esophageal sphincter function and gastroesophageal reflux in patients with reflux disease

Tam, W.; Holloway, R.; Dent, J.; Tippett, R.; Schoeman, M.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
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OBJECTIVES: Plication of the gastroesophageal junction by endoscopic suturing has been reported to improve symptoms and reduce acid exposure in patients with gastroesophageal reflux disease (GERD). The mechanisms underlying these effects are not well defined. The aims of our study were to determine the impact of endoscopic suturing of the gastroesophageal junction on lower esophageal sphincter (LES) function in patients with GERD. METHODS: In 15 patients (7 males) with GERD (heartburn, % time esophageal pH < 4 greater than 4%, +/- history of erosive esophagitis within 6 months), two plications were performed circumferentially 1 cm below the gastroesophageal junction. Endoscopy and combined postprandial esophageal manometry and pH monitoring were performed before and 6 months after treatment; 24-h ambulatory pH monitoring and symptom assessment were also performed before, and at 6 and 12 months after treatment. RESULTS: Six months after treatment, the rate of transient LES relaxations (tLESRs) was decreased by 37% (p < 0.05) and basal LES pressure had increased from 4.3 +/- 2.2 mmHg to 6.2 +/- 2.1 mmHg (p < 0.05). The rate of postprandial reflux events and acid exposure time were not altered. Endoscopic suturing significantly reduced 24-h esophageal acid exposure from 9.6% (9.0-12.1) to 7.4% (3.9-10.1) at 6 months...

Multichannel intraluminal impedance monitoring in the evaluation of patients with non-obstructive dysphagia

Conchillo, J.; Nguyen, Q.; Samsom, M.; Holloway, R.; Smout, A.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
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BACKGROUND: Non-obstructive dysphagia (NOD) often poses diagnostic problems. The aim of this study was to evaluate the value of the addition of multichannel intraluminal impedance (MII) recording to esophageal manometry in the work-up of patients with NOD. METHODS: A total of 40 consecutive patients with NOD underwent combined esophageal MII recording and perfusion manometry. Ten liquid and 10 viscous boluses were tested in each patient. Values for bolus presence time (BPT) at each of the four recording sites and total bolus transit time (TBTT) were calculated. Bolus transit (BT) was considered to be normal when BPT at all sites and TBTT were within the normal limits defined in 42 healthy subjects. Patients were judged to have normal transit if >or=80% of liquid and >or=70% of viscous swallows showed normal transit. RESULTS: The following manometric diagnoses were made: normal motility (20), ineffective esophageal motility (IEM) (13), diffuse esophageal spasm (DES) (4), and achalasia (3). Abnormal transit for liquid and/or viscous boluses was found in 35.3% of patients with normal motility, in 66.7% of DES patients, and in 100% of achalasia patients. In patients with achalasia quantification of BT was often made impossible by low initial impedance baseline. Two IEM patients (15.4%) showed normal liquid and viscous transit. Swallows showing normal transit had significantly longer duration of LES relaxation in patients with normal manometry and IEM (p < 0.05). CONCLUSIONS: MII recording identifies esophageal function abnormalities in NOD patients with normal manometry...

Reflux in children

Davidson, G.; Omari, T.
Fonte: Bailliere Tindall Publicador: Bailliere Tindall
Tipo: Artigo de Revista Científica
Publicado em //2000 EN
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Gastro-oesophageal reflux (GOR) is an extremely common paediatric problem that often runs a harmless and self-limited course. Physiological GOR however can lead to marked parental anxiety, many unnecessary investigations and often unwarranted and potentially harmful therapeutic interventions. Our ability to better define GOR and gastro-oesophageal reflux disease (GORD) has improved in the past 15 years with a better understanding of the pathophysiology in infants and children due to the development and wider use of flexible endoscopy, 24-hour oesophageal pH monitoring and, more recently, the use of micromanometric methods for studying oesophageal motility. This will be further enhanced in the future with the development of non-invasive breath testing to study gastrointestinal motility and the use of electrical impedance to study fluid movement. Our therapeutic interventions have also improved particularly in the areas of acid suppression, improved surgical techniques and most recently laparoscopic fundoplication. This chapter reviews these advances in the paediatric area especially with regard to pathophysiology, diagnostic testing and therapeutic intervention.

Apnea-Associated Reduction in Lower Esophageal Sphincter Tone in Premature Infants

Omari, T.
Fonte: Mosby Inc Publicador: Mosby Inc
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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OBJECTIVE: To characterize esophageal motility during episodes of prolonged apnea in premature infants. STUDY DESIGN: We retrospectively reviewed combined manometric and physiological monitoring studies performed in tube-fed premature infants from 1994 to 2002. Apnea was defined as a respiratory pause of >20 seconds. For each apneic event, pharyngeal swallowing, esophageal motility, and lower esophageal sphincter (LES) pressure were assessed before, during, and after apneic episodes. RESULTS: Twelve episodes of apnea (duration, 20 to 120 seconds) were identified in 7 infants (34 to 37 weeks postmenstrual age (PMA); study weight, 1950 to 2380 g). During the apneic episodes, swallowing increased (median[interquartile range], 0[0,0], 5[4,7], and 1[0,2] swallows/minute before, during, and after apnea, respectively; P < .05), esophageal pressure wave sequences (PWS) increased (1[0,2], 5[3,6], and 2[1,3] PWS/minute before, during, and after apnea, respectively; P < .05) and LES pressure decreased (16[12,21], 6[5,8], and 27[12,32] mmHg before, during, and after apnea, respectively; P < .05). CONCLUSION: In premature infants, apnea is associated with reduced LES tone, potentially increasing the likelihood of reflux occurring after the onset of apnea.; Taher I. Omari

The minimum frequency of glucose measurements from which glycemic variation can be consistently assessed

Baghurst, P.; Rodbard, D.; Cameron, F.
Fonte: Diabetes Technology Society Publicador: Diabetes Technology Society
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
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Aims: While there has been much debate about the clinical importance of glycemic variation (GV), little attention has been directed to the properties of data sets from which it is measured. The purpose of this study is to assess the minimum frequency of glucose measurements from which GV can be consistently and meaningfully measured. Methods: Forty-eight 72 h continuous glucose monitoring traces from children with type 1 diabetes were assessed. Measures of GV included standard deviation (SD), mean amplitude of glycemic excursion (MAGE), and continuous overlapping net glycemic action (CONGA1–4). Measures of GV calculated using 5 min sampling were designated as the 100% or “best estimate” value. Calculations were then repeated for each patient using glucose values spaced at increasing intervals. For each of the specified sampling frequencies, the ratio (%) of the between-subject SD based on the reduced subset of data to the estimate of the SD based on the full 5 min sampling data set was calculated. Results: As the interval between observations increased, so did the variability of the estimators of GV. Standard deviation exhibited the least systematic change at all measurement intervals, and MAGE exhibited the greatest systematic change. Conclusions: In patients with type 1 diabetes...

Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device

Bignold, J.; Mercer, J.; Antic, N.; McEvoy, R.; Catcheside, P.
Fonte: The American Academy of Sleep Medicine Publicador: The American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
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Study Objectives: Approximately 30% of obstructive sleep apnea (OSA) patients have supine-predominant OSA, and simply avoiding supine sleep should normalise respiratory disturbance event rates. However, traditional supine-avoidance therapies are inherently uncomfortable, and treatment adherence is poor and difficult to monitor objectively. This study evaluated the efficacy of a novel, potentially more acceptable position monitor and supine-avoidance device for managing supine-predominant OSA and snoring. Design and Setting: In-laboratory evaluation of position recording accuracy versus video recordings (validation study), and randomized controlled crossover trial of active versus inactive supine-avoidance therapy in the home setting (efficacy study). Patients: 17 patients undergoing in-laboratory sleep studies (validation) and 15 patients with supine-predominant OSA (efficacy). Interventions: Efficacy study: 1 week of inactive and 1 week of active treatment in randomized order, separated by 1 week. Measurements and Results: Agreement between 30-sec epoch-based posture classifications from device versus video records was high (median κ 0.95, interquartile range: 0.88-1.00), and there was good supine time agreement (bias 0.3%, 95%CI: −4.0% to 4.6%). In the efficacy study...

University of Queensland vital signs dataset: development of an accessible repository of anesthesia patient monitoring data for research

Liu, D.; Gorges, M.; Jenkins, S.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
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46.16%
BACKGROUND: Data recorded from the devices used to monitor a patient’s vital signs are often used in the development of displays, alarms, and information systems, but high-resolution, multiple-parameter datasets of anesthesia monitoring data from patients during anesthesia are often difficult to obtain. Existing databases have typically been collected from patients in intensive care units. However, the physical state of intensive care patients is dissimilar to those undergoing surgery, more frequent and marked changes to cardiovascular and respiratory variables are seen in operating room patients, and additional and highly relevant information to anesthesia (e.g., end-tidal agent monitoring, etc.) is omitted from these intensive care databases. We collected a set of high-quality, high-resolution, multiple-parameter monitoring data suitable for anesthesia monitoring research. METHODS: Vital signs data were recorded from patients undergoing anesthesia at the Royal Adelaide Hospital. Software was developed to capture, time synchronize, and interpolate vital signs data from Philips IntelliVue MP70 and MP30 patient monitors and Datex-Ohmeda Aestiva/5 anesthesia machines into 10 millisecond resolution samples. The recorded data were saved in a variety of accessible file formats. RESULTS: Monitoring data were recorded from 32 cases (25 general anesthetics...

Continuous glucose monitoring and cognitive performance in type 2 diabetes

Pearce, K.; Noakes, M.; Wilson, C.; Clifton, P.
Fonte: Mary Ann Liebert, Inc Publishers Publicador: Mary Ann Liebert, Inc Publishers
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
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46.07%
BACKGROUND: Type 2 diabetes is associated with reductions in cognitive function that are associated with glycated hemoglobin (HbA1c) levels, but there is no information on whether cognition is related to postmeal glucose spikes. We explored the relationship of cognition to glucose levels measured by a continuous glucose monitoring system (CGMS) both before and after a weight loss diet. SUBJECTS AND METHODS: Forty-four white subjects with type 2 diabetes (59.0±6.2 years old; body mass index, 32.8±4.2 kg/m2; HbA1c, 6.9±1.0%) completed an 8-week energy-restricted (approximately 6–7 MJ, 30% deficit) diet. Cognitive functioning (short-term memory, working memory, speed of processing [inspection time], psychomotor speed, and executive function) was assessed during four practice sessions, baseline, and Week 8. Parallel glucose levels were attained using the CGMS in 27 subjects. Outcomes were assessed by fasting blood glucose (FBG), postprandial peak glucose (Gmax), time spent >12 mmol/L (T>12), and 24-h area under the glucose curve (AUC24). RESULTS: Despite a fall in FBG of 0.65 mmol/L after 8 weeks, digits backward results correlated with FBG at both Week 0 and Week 8 (r=−0.43, P<0.01 and r=−0.32, P<0.01, respectively). Digits forward results correlated with FBG (r=−0.39...

Efficacy and safety of once-daily esomeprazole for the treatment of gastroesophageal reflux disease in neonatal patients

Davidson, G.; Wenzl, T.; Thomson, M.; Omari, T.; Barker, P.; Lundborg, P.; Illueca, M.
Fonte: Mosby Inc Publicador: Mosby Inc
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
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36.07%
OBJECTIVE: To evaluate the efficacy and safety of proton pump inhibitors in infants aged <1 year with gastroesophageal reflux disease (GERD). STUDY DESIGN: In this randomized, double-blind, placebo-controlled multicenter study, neonates (premature to 1 month corrected age; n = 52) with signs and symptoms of GERD received esomeprazole 0.5 mg/kg or placebo once daily for up to 14 days. Change from baseline in the total number of GERD symptoms (from video monitoring) and GERD-related signs (from cardiorespiratory monitoring) was assessed with simultaneous esophageal pH, impedance, cardiorespiratory, and 8-hour video monitoring. RESULTS: There were no significant differences between the esomeprazole and placebo groups in the percentage change from baseline in the total number of GERD-related signs and symptoms (-14.7% vs -14.1%, respectively). Mean change from baseline in total number of reflux episodes was not significantly different between esomeprazole and placebo (-7.43 vs -0.2, respectively); however, the percentage of time pH was <4.0 and the number of acidic reflux episodes >5 minutes in duration was significantly decreased with esomeprazole vs placebo (-10.7 vs 2.2 and -5.5 vs 1.0, respectively; P ≤ .0017). The number of patients with adverse events was similar between treatment groups. CONCLUSIONS: Signs and symptoms of GERD traditionally attributed to acidic reflux in neonates were not significantly altered by esomeprazole treatment. Esomeprazole was well tolerated and reduced esophageal acid exposure and the number of acidic reflux events in neonates.; Geoffrey Davidson...

Bipolar disorder and medication: adherence, patients' knowledge and serum monitoring of lithium carbonate

Souza,Camila de; Vedana,Kelly Graziani Giacchero; Mercedes,Bruna Paiva do Carmo; Miasso,Adriana Inocenti
Fonte: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Publicador: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 EN
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46.03%
OBJECTIVES: this study featured patients with affective bipolar disorder who were making use of lithium and received care at an outpatient care center located in a country town in the state of Sao Paulo in 2009; it assessed the adherence and knowledge of these patients in relation to the medication prescribed to them and verified the proportion of blood tests performed per year in the service, for each individual, to measure lithium levels in the blood. METHOD: descriptive study with quantitative approach, involving 36 participants. Structured interviews and review of medical records were used for data collection and descriptive statistics for data analysis. RESULTS: difficulties in reporting the dosage of the medication prescribed and a high rate of non-adherence were identified among the participants. None of the participants in the study was submitted to two tests a year to measure lithium levels in the blood, which is the minimum proportion of tests recommended by the literature for maintenance treatment using lithium carbonate. CONCLUSION: this study highlights the critical factors for the promotion of patients' safety in monitoring lithium drug therapy.

Pre-discharge "car seat challenge" for preventing morbidity and mortality in preterm infants

Pilley, Elizabeth P; McGuire, William
Fonte: The Cochrane Library Publicador: The Cochrane Library
Tipo: Artigo de Revista Científica
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BACKGROUND: Physiological monitoring studies indicate that some preterm infants experience episodes of oxygen desaturation, apnoea, or bradycardia when seated in standard car safety seats. The American Academy of Pediatrics recommends that all preterm inf

MONITORIZAÇÃO DA RESPOSTA ORGÂNICA AO TRAUMA E À SEPSE; TRAUMA AND SEPSIS METABOLIC RESPONSE MONITORING

Basile-Filho, Anibal; Suen, Vivian Marques Miguel; Martins, Maria Auxiliadora; Coletto, Francisco Antonio; Marson, Flavio
Fonte: Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto Publicador: Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 30/03/2001 POR
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O hipermetabolismo causado pela sepse, pelo trauma, pela síndrome da resposta inflamatória sistêmica e pela síndrome da disfunção de múltiplos órgãos é o responsável pela alta mortalidade dos pacientes internados nas unidades de terapia intensiva. O desenvolvimento do hipermetabolismo, fator provavelmente associado ou, até mesmo, secundário à liberação de mediadores e subprodutos, tem, como resultante final, a alteração do metabolismo de vários órgãos. Por essas razões, dada a suma importância de compreender-se o metabolismo dos pacientes críticos, este artigo de revisão analisa os diversos aspectos envolvidos na monitorização dos parâmetros fisiológicos do paciente em estresse metabólico, tais como o consumo de oxigênio, o grau de perfusão esplâncnica e sua relação com o lactato sérico e a cinética protéica corpórea total, através da administração intravenosa de 13C-leucina.; Sepsis, trauma, systemic inflammatory response syndrome and multiple organ dysfunction syndrome cause hypermetabolism, which is the principal factor for high mortality in critical ill intensive care unit patients. The hypermetabolism evolution, probably connected to the release of the mediators and metabolites, ends up impairing the metabolism of several organs. By the reasons mentioned above...

Monitorização hemodinâmica invasiva a beira do leito: avaliação e protocolo de cuidados de enfermagem; Monitorización hemodinámica invasiva a la cabecera del paciente: evaluación y protocolo del cuidado de enfermeria; Invasive hemodynamic monitoring at bedside: nursing evaluation and nursing care protocol

Ramos, Carla Cristina de Souza; Dal Sasso, Grace Teresinha Marcon; Martins, Cleusa Rios; Nascimento, Eliane Regina; Barbosa, Sayonara de Fátima Faria; Martins, Josiane de Jesus; Sardo, Pedro Miguel Garcez; Kuerten, Patrícia
Fonte: Universidade de São Paulo. Escola de Enfermagem Publicador: Universidade de São Paulo. Escola de Enfermagem
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Artigo Avaliado pelos Pares Formato: application/pdf; application/pdf
Publicado em 01/09/2008 POR; ENG
Relevância na Pesquisa
46.07%
Pesquisa-ação que objetivou estabelecer os parâmetros de avaliação clínica necessários ao paciente submetido à monitorização hemodinâmica pelo Cateter de Artéria Pulmonar (CAP) e construir um Protocolo de Cuidados de Enfermagem ao paciente grave e de risco em uso do cateter com os enfermeiros da UTI geral de um hospital público de Santa Catarina. A população se constituiu em uma amostra não probabilística intencional de 5 enfermeiros e utilizou para coleta de dados reuniões de grupo e questionário. O estudo é apresentado mediante estatística descritiva e análises qualitativas das questões subjetivas. Conclui-se que os critérios de avaliação clínica necessários ao paciente submetido à monitorização hemodinâmica se constituem em parâmetros invasivos e não invasivos e que o protocolo fundamenta a tomada de decisão clínica para o cuidado do paciente em uso do Cateter de Artéria Pulmonar.; Se trata de una Investigación-acción que tuvo como objetivo establecer los parámetros de evaluación clínica necesarios para el paciente sometido a monitorización hemodinámica por el Catéter de Arteria Pulmonar (CAP) y construir un Protocolo de Cuidados de Enfermería para el paciente grave y de riesgo en el uso del catéter...