Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-03-30T17:02:31Z No. of bitstreams: 1 TES_MARISA_REGINATTO_VIEIRA_COMPLETO.pdf: 3906952 bytes, checksum: 0346741513899775dc5b6837169dfdfd (MD5) / Made available in DSpace on 2016-03-30T17:02:31Z (GMT). No. of bitstreams: 1 TES_MARISA_REGINATTO_VIEIRA_COMPLETO.pdf: 3906952 bytes, checksum: 0346741513899775dc5b6837169dfdfd (MD5) Previous issue date: 2015-09-29 / Objective: To analyze the behaviour of blood pressure at the first 8 hours of emergency care in pregnant women who arrive with hypertension in an obstetric unit. Methods: Blood pressure was measured at an Obstetric Unit in a cohort of 415 pregnant women with high blood pressure at the initial evaluation. Data of the first 8 hours of blood pressure readings were analyzed by Generalized Estimated Equations test. Results: At baseline the means(+SD) were 154.3?16.5 mmHg and 98.0?12.1 mmHg for systolic and diastolic blood pressure, respectively. There was a significant reduction in blood pressure during follow-up (p<0.001). Blood pressure means (SD) were: 1st hour: 146.6+19.1 and 89.7+15.6, 2nd: 139.0+17.8 and 83.2+14.2, 3rd: 137.2+15.6 and 78.7+12.2, 4th: 136.9+14.7 and 78.8+14.5, 5th: 135.9+16.6 and 78.2+14.1, 6th: 135.6+16.3 and 77.9+13.5, 7th: 133.3+14.2 and 75.7+11.9, and 8th hour 133,8+15.6 and 76.9+12.9 mmHg for systolic and diastolic blood pressure, respectively. Blood pressure stabilized after the third hour. Conclusion: The study provides evidence that an interval of at least three hours between measurements is adequate to establish the diagnosis of gestational hypertension in pregnant women presenting with high blood pressure at an obstetric unit. / Objetivo: Analisar o comportamento da press?o arterial nas primeiras 8 horas de cuidados de emerg?ncia em mulheres gr?vidas com mais de 20 semanas de idade gestacional que chegam com hipertens?o em uma unidade obst?trica. M?todos: A press?o arterial foi medida numa Unidade Obst?trica em uma coorte de 415 mulheres gr?vidas com press?o arterial elevada na avalia??o inicial. Dados das primeiras 8 horas de leituras de press?o arterial foram analisadas por teste de Equa??es de Estimativas Generalizadas. Resultados: No momento da chegada ? Unidade Obst?trica, a m?dia foi 154,3 ? 16,5 mmHg e 98,0 ? 12,1 mmHg para a press?o arterial sist?lica e diast?lica, respectivamente. At? 8 horas todas as m?dias das aferi??es diminu?ram a cada hora (p <0,001). As medidas da primeira hora foram 146,6+19,1 e 89,7+15,6, na segunda hora: 139,0+17,8 e 83,2+14,2, 3?: 137,2+15,6 e 78,7+12,2, 4?: 136,9+14,7 e 78,8+14,5, 5?: 135.9+16,6 e 78,2+14,1, 6?: 135,6+16,3 e 77,9+13,5, 7?: 133,3+14,2 e 75,7+11,9 e na 8? hora 133,8+15,6 e 76,9+12.9 mmHg para a press?o arterial sist?lica e diast?lica respectivamente. No tempo de tr?s horas 55,3% das pacientes tiveram a press?o arterial estabilizada e abaixo de 140/90mmHg. A idade gestacional foi maior em gestantes que atingiram a estabiliza??o em tr?s horas (36,4+4,4 versus 34,3+4,9 semanas; p = 0,007). Conclus?o: O estudo fornece evid?ncias de que um intervalo de pelo menos tr?s horas entre as medidas seja suficiente para estabelecer o diagn?stico de hipertens?o gestacional em mulheres gr?vidas que apresentam press?o alta em uma unidade de obstetr?cia.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-18T20:24:43Z No. of bitstreams: 1 YaskaraYgaraMenescalPintoFernandes_TESE.pdf: 2632244 bytes, checksum: a599e082c85a496e5b7fd4d617b18831 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-19T22:59:23Z (GMT) No. of bitstreams: 1 YaskaraYgaraMenescalPintoFernandes_TESE.pdf: 2632244 bytes, checksum: a599e082c85a496e5b7fd4d617b18831 (MD5) / Made available in DSpace on 2017-10-19T22:59:23Z (GMT). No. of bitstreams: 1 YaskaraYgaraMenescalPintoFernandes_TESE.pdf: 2632244 bytes, checksum: a599e082c85a496e5b7fd4d617b18831 (MD5) Previous issue date: 2017-09-06 / De acordo com a Organiza??o Mundial da Sa?de, cerca de 9,2% dos 28 milh?es dos rec?m-nascidos em todo o mundo s?o natimortos. Al?m disso, cerca de 358 mil mulheres morreram devido a complica??es com a gravidez em 2015. Parte dessas mortes poderiam ter sido evitadas com a melhoria na assist?ncia pr?-natal e agilidade no reconhecimento de problemas na gesta??o. Assim, esfor?os t?m sido realizados para disponibilizar os servi?os de sa?de com tecnologias que possam contribuir para o melhor acesso ? informa??o e aux?lio ? tomada de decis?o. ? neste contexto que a presente tese apresenta uma arquitetura para automatizar o processo classifica??o e encaminhamento de gestantes entre as unidades b?sica de sa?de e o hospital de refer?ncia atrav?s da plataforma de Telessa?de. A arquitetura de Telessa?de foi desenvolvida atrav?s de tr?s componentes: componente de aquisi??o de dados, respons?vel pela coleta e inser??o de dados; componente de processamento, ? o n?cleo da arquitetura, implementada atrav?s de sistemas especialistas para a classificar o risco gestacional; e o componente de p?s-processamento, respons?vel pela entrega e an?lise dos casos. Foram realizados os testes de aceita??o, teste de precis?o do sistema baseado em regras e teste de desempenho. Para a realiza??o dos testes foram utilizados 1380 formul?rios de encaminhamentos de situa??es reais. Diante dos resultados obtidos com a an?lise de dados reais, a arquitetura desenvolvida, chamada Eileithyia, atende aos requisitos de auxiliar especialistas m?dicos na classifica??o do risco gestacional, diminuindo os custos de transporte e o inconveniente do deslocamento das mulheres gr?vidas pelo Estado. / According to the World Health Organization, about 9.2% of the 28 million newborns worldwide are stillborn. Besides, about 358,000 women died due to complications related to pregnancy in 2015. Part of these deaths could have been avoided with improving prenatal care agility to recognize problems during pregnancy. Based on that, many efforts have been made to provide technologies that can contribute to offer better access to information and assist in decision-making. In this context, this work presents an architecture to automate the classification and referral process of pregnant women between the basic health units and the referral hospital through a Telehealth platform. The Telehealth architecture was developed in three components: The data acquisition component, responsible for collecting and inserting data; the data processing component, which is the core of the architecture implemented using expert systems to classify gestational risk; and the post-processing component, in charge of the delivery and analysis of cases. Acceptance test, system accuracy test based on rules and performance test were realized. For the tests, 1,380 referral forms of real situations were used. On the results obtained with real data analysis, the developed architecture, called Eileithyia, meets the requirements to assist medical specialists on gestational risk classification which decreases the inconvenience of pregnant women displacement and the resulting costs.