Oxidative stress has been associated with many disease conditions in adults and neonates based on clinical and post mortem studies. Trauma is the commonest cause of oxidative stress. However a gap in knowledge of the natural history of oxidative stress in humans was identified as most studies have been post mortem or in animals. <p>The aim of this research is to understand treat and oxidative stress in trauma and surgical patients. The study involved three components including: the development and evaluation of the novel oxistress assay; study of clinical trauma and oxidative stress; and clinical trial of alanyl-glutamine supplementation following major surgery. The novel oxistress assay was used on urine samples in the normal population to determine reference values and subsequently on hospital patients to determine sensitivity and specificity. The study of clinical trauma and oxidative stress evaluated plasma antioxidants (FRAP assay), red cell glutathione (Asensis method), plasma and urine protein carbonyl (Levines method) and total oxidants in plasma and urine (oxistress assay) over 7 day period following trauma. The clinical trial was a double blind study of 69 major surgery patients evaluating biochemical and clinical parameters over 7 day period in comparison with pre-operative status. <p>The novel oxistress assay proves to be a sensitive and accurate bedside diagnostic tool for oxidative stress. It can also be used in the laboratory setting. Oxidative stress is associated with increased trauma severity resulting in antioxidant depletion, strong oxidant production and protein degradation. The presence of pre-morbid medical factors also increased oxidative stress in trauma patients. Oral alanyl-glutamine supplementation (0.3 g/kg) increased plasma glutamine and antioxidant levels while decreasing urine oxidant levels. It significantly reduced hospital stay in non-cancer and higher disease complexity patients. The intervention also reduced the resource intensity weighting (RIW) score. <p>Oxidative stress is a clinical problem in surgery and trauma patients that can now be easily diagnosed at the bedside using the novel oxistress assay. Treatment with alanyl-glutamine is effective in reducing oxidative stress and improving clinical outcome. It is highly recommended probably at a higher dose in order to achieve optimal results.

Oxidative stress has been associated with many disease conditions in adults and neonates based on clinical and post mortem studies. Trauma is the commonest cause of oxidative stress. However a gap in knowledge of the natural history of oxidative stress in humans was identified as most studies have been post mortem or in animals. <p>The aim of this research is to understand treat and oxidative stress in trauma and surgical patients. The study involved three components including: the development and evaluation of the novel oxistress assay; study of clinical trauma and oxidative stress; and clinical trial of alanyl-glutamine supplementation following major surgery. The novel oxistress assay was used on urine samples in the normal population to determine reference values and subsequently on hospital patients to determine sensitivity and specificity. The study of clinical trauma and oxidative stress evaluated plasma antioxidants (FRAP assay), red cell glutathione (Asensis method), plasma and urine protein carbonyl (Levines method) and total oxidants in plasma and urine (oxistress assay) over 7 day period following trauma. The clinical trial was a double blind study of 69 major surgery patients evaluating biochemical and clinical parameters over 7 day period in comparison with pre-operative status. <p>The novel oxistress assay proves to be a sensitive and accurate bedside diagnostic tool for oxidative stress. It can also be used in the laboratory setting. Oxidative stress is associated with increased trauma severity resulting in antioxidant depletion, strong oxidant production and protein degradation. The presence of pre-morbid medical factors also increased oxidative stress in trauma patients. Oral alanyl-glutamine supplementation (0.3 g/kg) increased plasma glutamine and antioxidant levels while decreasing urine oxidant levels. It significantly reduced hospital stay in non-cancer and higher disease complexity patients. The intervention also reduced the resource intensity weighting (RIW) score. <p>Oxidative stress is a clinical problem in surgery and trauma patients that can now be easily diagnosed at the bedside using the novel oxistress assay. Treatment with alanyl-glutamine is effective in reducing oxidative stress and improving clinical outcome. It is highly recommended probably at a higher dose in order to achieve optimal results.

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Purpose: Restoring Effective Sleep Time in Post Cardiac Surgery Patients: A Quality Improvement Project Brooke Watts, BSN, RN, DNP Student, Murray State University Dr. Kristin Reid, DNP, APRN, ACNS-BC, DNP Program Director/Assistant Professor Murray State University Aims: This quality improvement project was developed using DNP project guidelines provided through Murray State University and was designed to improve sleep in hospitalized cardiac surgery patients. Processes: IRB approval was obtained from the healthcare institution and academic institution. This two-phase quality improvement project was designed to analyze the effects of a change in normalized hospital routines on self-reported sleep in post-cardiac surgery patients. Phase one involved no change in unit nursing routines to draw baseline data. Phase two involved the quality improvement intervention where routine patient assessments and vital signs were executed at 11:00 p.m., and at 04:00 a.m. Any non-timed lab work or routine radiological studies were postponed until after 04:00am. Patient participation for both phase one (n=4) and phase two (n=3) were determined by exclusion criteria. The Richards Campbell Sleep Questionnaire (RCSQ) was utilized for data collection and patients were asked to complete the questionnaire daily. Results: Comparison of mean patient-reported sleep scores between the pre-intervention and intervention groups showed a positive association between the quality improvement intervention and patient reported sleep. Limitations: Limitations for this project included a small sample size in both phases. IRB stipulations required a low-risk profile which limited eligible participants. There was a limited timeframe for project execution due to time required for IRB approval and to meet course-related timelines. The project was further limited by lack of on-site dedicated project staff overseeing qualifying patient enrollment. Conclusions: Key findings were in alignment with sleep-related findings in comparable studies and projects where unit routines were adjusted. Execution of similar projects should occur to provide more substantial evidence supporting this quality change. With evidence of this project in mind, providers and nurses can practice mindfully and incorporate creative approaches to safely care for patients and improve sleep.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-05-31T13:39:32Z No. of bitstreams: 1 liviafabianasaco.pdf: 1876242 bytes, checksum: ce10c4b3fb80afca690072dcda3c42d6 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-02T12:29:25Z (GMT) No. of bitstreams: 1 liviafabianasaco.pdf: 1876242 bytes, checksum: ce10c4b3fb80afca690072dcda3c42d6 (MD5) / Made available in DSpace on 2016-07-02T12:29:25Z (GMT). No. of bitstreams: 1 liviafabianasaco.pdf: 1876242 bytes, checksum: ce10c4b3fb80afca690072dcda3c42d6 (MD5) Previous issue date: 2012-03-29 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Multiplicadas desordenadamente, as células cancerosas transformam-se e transformam o ser habitável – o câncer de mama é uma patologia que cada vez mais invade nosso tempo e nossos sentidos. O investimento, nesta pesquisa, refere-se à constituição físico-funcional/social e simbólica da mulher pós-diagnóstico de câncer à terapêutica e a produção de seus efeitos de sentidos do/no funcionamento físico discursivo do ser com câncer de mama. A partir da análise de materiais orais e funcionais, buscamos compreender a constituição do sujeito por meio da relação linguagem/câncer, ou seja, entender, discursivamente, de que maneira esse sujeito envolvido com a doença se significa e/ou é significado; em que medida a passagem pela doença produz novas formas de significação, novas organizações do dizer, novos processos de identificação, outras modalidades de subjetivação. A partir do contexto teórico da Análise de Discurso, situamos esta pesquisa em duas (principais) reflexões. A primeira versa sobre o que é o câncer e o processo de transformação físico-funcional que a clínica do tratamento pressupõe. A segunda reflexão diz respeito ao processo discursivo nas etapas do diagnóstico à terapêutica. Os resultados demonstram alterações físico-funcionais (limitação de movimentos e de força muscular) pós-procedimento cirúrgico, influenciando diretamente no processo de identificação e subjetivação na constituição dessa outra mulher, agora afetada pelo câncer de mama. Depreendemos também, nos discursos, o reconhecimento dos exercícios físicos como proposta de apoio terapêutico e mecanismo de reinserção social. O conhecimento reunido neste trabalho reforça a importância do entendimento das peculiaridades do tratamento representativo em cada mulher, necessário para a condução das atividades pela equipe dos profissionais que estão inseridos nesse contexto. / Randomly multiplicated, the cancer cells change themselves and change the habitable being – the breast cancer is a pathology that is growing bigger and getting more space in our time and on our senses. The goal in this paper refers to the physical-functional, social and symbolical constitution of the post-diagnostic women, until the treatment and the production of its effects on the breast cancer patients and their physical functions’ senses. Starting from the analysis of oral and functional materials, we try to understand the constitution of the subject through the relation language/cancer, that is, to understand discursively how this subject, involved with the disease, signifies and/or is signified; in which way the disease diagnostic produces new ways of signifying, new organizations of saying, new identification processes and other subjectivation modalities. From the historical context of Discourse Analysis, we situate our paper with two (main) reflections. The first one, on how the cancer acts and the physical-functional transformation process that the clinical treatment suggests. The second reflection is about the discursive process in the phases of the diagnosis to the treatment. The results demonstrate post-surgical procedure’s physical-functional alterations (such as low mobility and loss of muscular strength), which directly influences identification and subjectivation processes in this new woman, now affected by the disease. We also comprehend in these discourses the recognition of physical exercises as support proposal for the treatment and social reintegration mechanism. The knowledge reunited in this paper reinforces the meaning of understanding the peculiarities on each representative treatment for every woman, which is necessary for the professional team to conduct their activities in this context.