No description available.

No description available.

No description available.

Orientador: Helio Jose Montassier / Resumo: As infecções do trato respiratório de aves têm-se constituído em problemas crescentes e com marcantes consequências negativas sobre a produção avícola em várias partes do mundo, notadamente onde a avicultura é mais desenvolvida como no Brasil. Dentre essas enfermidades, destacam-se as micoplasmoses aviárias e a pneumovirose aviária, que, apesar de suas relevâncias em sanidade avícola, não têm sido investigadas de forma sistematizada no Brasil, em especial no que concerne à interação entre esses agentes ou a ocorrência de co-infecção em frangos de corte. O presente estudo investigou a ocorrência de infecção por Mycoplasma gallisepticum (MG) e pelos subtipos A ou B de Metapneumovírus aviário (AMPV) em frangos de corte de plantéis avícolas comerciais mantidos em granjas mais tecnificadas localizadas nas regiões Sudeste e Centro-Oeste do Brasil. Para tanto, as técnicas de PCR e de RT-Nested-PCR foram usadas na detecção e/ou identificação, respectivamente de MG e AMPV em amostras de suabes nasais e traqueais colhidos de 87 lotes de frangos de corte com problemas respiratórios e oriundos de 15 granjas de produção comercial de frangos de corte. Dos lotes amostrados, dois deles em um total de 87 (2,3%) e de uma única granja da região Sudeste, mostraram-se positivos para MG, enquanto que nenhum dos lotes investigados revelou-se positivo para AMPV. A baixa ou nenhuma incidência desses agentes pode ser explicada pela utilização de medidas cada vez mais efetivas para o controle sanitário... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Respiratory infections of poultry may be an increasing and negative problem with poultry production in several parts of the world, especially when poultry farming is more widely used than in Brazil. These diseases include avian mycoplasmosis and avian pneumovirosis, which, despite their relevance in poultry health, have not been systematically investigated in Brazil, especially with regard to the interaction between these agents or the occurrence of co-infection in broilers. The present study investigated the occurrence of infection by Mycoplasma gallisepticum (MG) and A or B subtypes of avian Metapneumovirus (AMPV) in broiler commercial poultry farms located in the Southeast and Center-West regions of Brazil. For this, PCR and RT-Nested-PCR techniques were used in the detection and / or identification, respectively of MG and AMPV in nasal and tracheal swab samples collected from 87 lots of broilers with respiratory problems and from 15 commercial production of broilers. Of the sampled lots, two of them in 87 (2.3%) were positive for MG, whereas none of the lots were positive for AMPV. The low or no incidence of these agents can be explained by the use of increasingly effective measures for the sanitary control of these agents in the commercial farms of sampled broilers. Our findings also suggest, however, that other bacterial and viral infectious agents not investigated in this study may be involved in the etiology of the respiratory problems of these birds, since those that... (Complete abstract click electronic access below) / Mestre

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-12T10:24:12Z No. of bitstreams: 1 patriciadahan.pdf: 1472814 bytes, checksum: 1ac36b63c84d496db745b18dff845bc7 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T17:13:27Z (GMT) No. of bitstreams: 1 patriciadahan.pdf: 1472814 bytes, checksum: 1ac36b63c84d496db745b18dff845bc7 (MD5) / Made available in DSpace on 2016-01-25T17:13:27Z (GMT). No. of bitstreams: 1 patriciadahan.pdf: 1472814 bytes, checksum: 1ac36b63c84d496db745b18dff845bc7 (MD5) Previous issue date: 2015-08-05 / Introdução :A enurese, as doenças respiratórias do sono e a asma são condições que comprometem a qualidade do sono da criança e podem ocorrer isoladamente ou associadas. A enurese é considerada um dos distúrbios do sono mais comuns em pediatria perdendo apenas para insônia. As doenças respiratórias do sono (DRS) como a apneia obstrutiva do sono são alterações comuns na infância e a sua associação com enurese já foi demonstrada. Anormalidades das vias aéreas superiores e inferiores podem coexistir segundo a teoria da “Via aérea unificada”. Crianças sibilantes têm maior incidência de ronco e apneia noturna. Admitindo-se que a asma tem associação com as DRS e que essas já foram correlacionadas com a enurese, questiona-se a possibilidade de associação entre asma e enurese. Objetivo: Avaliar a associação entre asma e enurese em escolares de 6 a 14 anos de Juiz de Fora. Métodos: De agosto 2012 a março 2015, foram aplicados 523 questionários por telefone a responsáveis de escolares de 6 a 14 anos de 16 escolas de Juiz de Fora, sorteadas aleatoriamente. Foram excluídos do estudo, pacientes com incontinência diurna, doença neurológica ou qualquer outra situação que possa cursar com enurese. Foram utilizados os questionários sobre sintomas de DRS (Tucson) e ISAAC (Internacional Study of Asthma and Allergies in Childhood) para avaliação das DRS e asma e uma anamnese estruturada para avaliar a enurese e suas características. Resultados: A prevalência de história de enurese de 6 a 14 anos foi de 15,87%[12,98-19,26%] IC95%. A média de idade foi de 9,42 ± 2,46 e a razão sexo masculino/feminino de 283/240. Enurese está associada a apneia relatada pelos pais OR = 5,34 [2,19-13,03] IC95% (p = 0,0002), a história de ter tido sibilância em qualquer momento da vida OR = 1,63 [1,01-2,64] IC95% (p = 0,0465) e asma atual OR = 2,33 [1,37-3,95] IC95% (p = 0,0017). Conclusão: Os resultados sugerem que assim como a apneia, a asma também tem associação com a enurese. / Introduction: Enuresis, sleeping respiratory problems and asthma are diseases that compromises the quality of sleep in children and may occur isolate or in association with each other. Enuresis is considered one of the most common sleeping disorders in pediatrics. Sleeping respiratory disorders (SRD) such as obstructive sleep apnea are common problems in infancy and association with enuresis has been demonstrated. According to the United Airway Concept, abnormalities of both superior and inferior airways may coexist. A sibilant toddler has a greater chance of having snoring and nocturnal apnea. Since asthma and SRD may be associated and SRD has an association with enuresis, we questioned the possibility of the association between asthma and enuresis. Objective: to evaluate possibility of the association between asthma and enuresis in children 6 to 14 years of age. Methods: Between August 2012 and March 2015, parents of children between 6 to 14 years of age from 16 different schools in our region were randomly chosen for interview. Children with non-monosymptomatic enuresis, neurological diseases were not included. A specific questionnaire for SRD (Tucson) and the ISAAC questionnaire (Internacional Study of Asthma and Allergies in Childhood) were used for the evaluation of SRD and Asthma and a structured questionnaire was applied to evaluate enuresis and its characteristics. Results: We evaluated 524 children, 283 males and 240 females, with mean age in years of 9.42 ±2.46. The overall prevalence of enuresis in this sample was 15.87% [12.98-19.26%] 95%CI. Enuresis is associated to apnea reported by parents OR = 5.34 [2.19 to 13.03] 95% CI (p = 0.0002), to history of wheezing at any time of life OR = 1,63[1, 01 to 2.64] 95% CI (p = 0.0465) and to have current asthma OR = 2.33 [1.37 to 3.95] 95% CI (p = 0.0017) Conclusions: These findings demonstrate that asthma, as well with sleeping respiratory disorders, is associated with primary nocturnal enuresis.

L’objectif de cette thèse est de conceptualiser, à partir de l’exploitation des données de remboursement de soins de l’Assurance Maladie, les différentes trajectoires de recours aux soins relatives à la prise en charge d’une pathologie chronique (asthme), et d’étudier les déterminants de ces trajectoires du point de vue du profil et du comportement subséquent du prescripteur de soins. L’étude de la relation entre le comportement prescriptif et la trajectoire de soins est appréhendée par des techniques de modélisation et d’analyses multivariées. L’objectif sous-jacent est d’évaluer, d’un point de vue médico-économique, l’impact de la typologie des prescripteurs (caractéristiques des offreurs de soins) sur les différentes trajectoires de soins suivies par les patients atteints de la pathologie définie supra. Les caractéristiques susceptibles d’identifier une typologie de prescripteur correspondent aux variables influant sur le comportement prescriptif, au sens large, du médecin (âge, sexe, durée d’exercice, type d’exercice, etc.). La question principale de la thèse est celle de l’effet régulateur de l’incitation économique, instaurée par le parcours de soins coordonnés (réforme de l’Assurance Maladie, août 2004), sur les trajectoires de soins, réellement observées, de patients atteints de pathologies chroniques. Les corollaires sont : Le déremboursement des actes hors parcours de soins coordonnés peut-il avoir un impact significatif sur la trajectoire empirique de prise en charge du patient ? Le profil du prescripteur d’actes médicaux a-t-il, toutes choses égales par ailleurs, un effet sur le respect ou non de la trajectoire de soins référentielle admise par le parcours de soins coordonnés ? Quels sont les déterminants principaux du non respect de cette trajectoire référentielle, du point de vue de l’analyse des caractéristiques des couples « médecin – patient» ? / The objective of this thesis is to conceptualize, starting from the exploitation of the refunding data of cares from the Sickness insurance, the various trajectories of cares recourses introduced by chronic diseases as asthma, and to study their determinants by analysing the profile and the subsequent behavior of the general practitioner. The study of the relation between the prescriptive behavior and the trajectory of cares is carried out by different multivariate analyses. The other objective is to evaluate, from a pharmacoeconomic point of view, the impact of the general practitioner characteristics on the various trajectories of cares followed by the patients with chronic diseases. The characteristics likely to identify a typology of practitioners correspond to the variables influencing the prescriptive behavior (age, sex, duration of exercise, type of exercise, etc). The principal question of the thesis is that of the regulating effect of the economic incentive, rested on the coordinated care pathway (reform of the Sickness insurance, August 2004), on the trajectories of cares, really observed by the chronic patients. The corollaries are: Does the no-reimbursement of some medical acts, not considered in the coordinated care pathway, have a significant impact on the empirical recourse of the patient? Does the profile of the general practitioner have an effect on the respect or not of the allowed trajectory of cares classified by the French reform? Which are the principal determinants of disregarding this referential trajectory, by notably analysing the “practitioner - patient” characteristics?

Twenty publications are submitted. All deal with the issues of control of two ends of the spectrum of immune-mediated respiratory disorders in children, namely atopic (asthma and allergic rhinitis) and HIV-related lung disease. This submission summarises the research by the author into this spectrum of lung diseases of children in South Africa, highlighting the diversity of conditions that are not only clinically important, but also common. Understanding of all conditions is required to improve the health of children in this region. Management of chronic conditions requires two major end points - adequate and timely diagnosis and - management to control the condition. The author has a passion for improving the quality of life of children and firmly believes that the research findings will, and have, led to transformation in management of both these common disorders. This document follows the progression of the authors research work and highlights how interesting and important is the scope of two disorders which could be thought to have a central origin, namely in the T-cell. T-cells form the basis of cellular immunity and an excess of T-helper 2 cell activity promotes atopy, whilst the human immunodeficiency (HI) virus infects T-helper cells and promotes cellular immune deficiency and its attendant clinical disorders. The author’s research work is not based on the immunological basis of these conditions but does deal with the clinical implications and especially aspects relating to control of these two extremes of a clinical spectrum of disorders. To take the clarity of two diseases at the end of a spectrum to its natural conclusion these extremes are defined in aetiology or pathophysiological differences (excess versus suppression of the immune system), occurring in the affluent and poor alike versus just the poor, control being required to improve quality of life versus to save lives and finally that management requires anti-inflammatory therapy versus antibiotic and anti-infective therapy. For the eight publications based on atopic respiratory disease in children the themes are firstly that children with asthma and chronic rhinitis are diagnosed late, that most individuals with these conditions are not well controlled and finally that the reasons for lack of control are becoming obvious. For the first time, the significant lack of asthma and allergic rhinitis control in South Africa is documented. These studies suggest that, like surveys from the rest of the world, asthma control is seriously under-estimated and neglected in all asthmatics in South Africa, in both the privileged and the under-privileged. The research also defines reasons for poor asthma and allergic rhinitis control in this region. As in many studies published from around the world it is now evident that poor asthma and allergic rhinitis control cannot be blamed on any one source. A multitude of reasons underlie this phenomenon and each of the subsequent papers in this section illustrates attempts at defining these principles. The three most important reasons for poor control are probably that most asthmatics are managed in the wrong hands (by doctors who don’t understand adequate control and who aren’t empowered to use the correct therapy), that control may actually be a pipe dream and practically difficult to do or even impossible to achieve and lastly that the allergic basis of asthma is over emphasised and may not in fact determine all asthma. The subsequent papers summarise research work in the field of HV infection in children and exposes the opposite end of a spectrum of Paediatric respiratory disease and highlight research into the conditions common in HIV-infected children. Eleven papers are presented. For the diseases associated with the HI virus the major complications of inadequate diagnosis and prevention in children are acute pneumonia (especially severe pneumonia) and bronchiectasis. Bronchiolitis is not common in HIV infected children, despite epidemics of this condition in non-infected children. Passive smoking does not aggrevate or worsen disease progression in children. The complications of HIV related diseases in children require the same principles of adequate diagnosis and control as would apply to the chronic atopic conditions. Once the author delved into the disorders at the other end of the clinical spectrum, namely those associated with immune deficiency secondary to HIVinfection he faced the question of a possible relationship between the conditions. One submission explores that relationship. This research has a unique perspective, conferred by the fact that these two conditions do not occur to the same extent anywhere else in the world. Atopic respiratory conditions and HIV-related lung diseases occur side by side in abundance in this region. This perspective has created a clarity for research to address the two most important aims in clinical medicine, namely to diagnose correctly and then to manage the condition so that control is achieved. These must be universal principles of the successful practice of medicine. / Thesis (DSc)--University of Pretoria, 2013. / gm2013 / Paediatrics and Child Health / unrestricted

Made available in DSpace on 2014-07-29T15:04:32Z (GMT). No. of bitstreams: 1 Dissertacao Agueda Maria Ruiz Zimmer Cavalcante.pdf: 1035136 bytes, checksum: b4a1536a8353c2d355d3e8be5cf0bef5 (MD5) Previous issue date: 2009-06-19 / Upon the multiple ilnesses that aflict the elderly, respiratory problems stand out as cause of hospital admitance and re-admitance, and consequent worsening of funtional capacity. The nursing interventions directed to the human responses in evidence allow clinical improvement, visibility, and quality of nursing assistance to elderly patients with respiratory problems. The goal was to analyse the nursing interventions performed by the nursing staff to the nursing diagnosis ineffective breathing pattern in elderly patients. It is a descriptive study, developed in the internal medicine section of a scholl hospital in Goiânia, done in three stages, from July to December of 2008. The first stage consisted in the search of activities performed by the nursing staff to the ineffective breathing pattern in the elderly. The second consisted in the crossed mapping between the quoted activities and the interventions and activities priorized by the NIC to the ineffective breathing pattern diagnosis. And the third stage consisted in the new collection of data analyse the priorized NIC activities to ineffective breathing pattern in the elderly. If was adapted the descriptive statistic with distribution of the activities in simple frequence. 43 nursing workers took part in the study, after having read andsigned the form of free consent and understanding. Of the participants, 83,7% were women and 16,3% were men; 23,8% were between 36 and 40 years-old; 46,6% refered having completed high school, 11,6% had college education and 18,6% were in college, but not yet graduated; 18,6% had some complementary study after college and 2,3% had master degree; 60,5% were 1 to 5 years in the institution and 74,4% were 1 to 5 years in the same hospital section. From the 62 activities referred and mapped as NIC s interventions and activities, the ones witch presented a frequency higher than 50% were: Positioning (99,9%), Oxygen Therapy (99,8%) e Medication Administrantion (65,8%). Lower than 50%: Airway Manegement (45,0%), Anxiety Reduction (42,9%), Ventilation Assistance (40,8%), Respiratory Monitoring (36,8%), Vital Signs Monitoring (36,2%), Energy Management (31,6%), Emotional Support (27,2%), Pain Management (24,9%) e Surveillance (20,4%). Lower than 20%: Chest Physiotherapy (13,6%), Neurologic Monitoring (9,09%), Intravenous Therapy (6,8%), Airway Suctioning (6,8%), Intravenous Insertion (4,5%), Smoking Cessation Assistance (2,2%), Medication Management (2,2%), Fluid Monitoring (2,2%), Emergency Care (2,2%), Aspiration Precautions (2,2%) e Tube Care: Chest (2,2%).The drug administration activity present accordance as of the necessity of medical prescription; there was no accordance of the activities that are exclusive of the nurse. The activities concerning positioning, drug, administration, oxygen administration, aerosol administration and vital signs monitoring were referred as being frequently perfomed. The concerning monitoring of values of pulmonary function, fisioterapy and the ones that demanded, a physical exam evaluation were referred as not performed, and the main reason was being performed by another professional . The study made it possible to identify: the need to consider the interdisciplinarity in the interventions, the gaps in the assistance provided by the nursing staff, the abilities and skills required from the nurse to the assistance of the elderly patients that present ineffective breathing pattern , with focus a the prevention of disorders and on the integrality of the assistance, / Diante dos múltiplos agravos que acometem os idosos, destacam-se os problemas respiratórios como causa de internação e reinternação e consequente diminuição da capacidade funcional. As intervenções de enfermagem direcionadas às respostas humanas evidenciadas, possibilitam identificar a melhora clínica, tornando visível a qualidade da assistência de enfermagem à clientela idosa com problemas respiratórios. Objetivou-se analisar as intervenções de enfermagem realizadas pela equipe de enfermagem para o diagnóstico de enfermagem padrão respiratório ineficaz em idosos. Trata-se de um estudo descritivo realizado, nos meses de julho a dezembro de 2008, em três etapas, na Clínica Médica de um hospital escola de Goiânia. A primeira etapa consistiu na busca das atividades realizadas pela equipe de enfermagem para o padrão respiratório ineficaz em idosos. A segunda no mapeamento cruzado entre as atividades citadas e as intervenções e atividades prioritárias da NIC preconizadas para o padrão respiratório ineficaz . A terceira consistiu em uma nova coleta de dados para análise das atividades prioritárias da NIC preconizadas para o padrão respiratório ineficaz em idosos. Foi adotada a estatística descritiva com distribuição de frequência simples das atividades. Fizeram parte do estudo, 43 trabalhadores de enfermagem que atenderam os critérios de inclusão e exclusão. Dos participantes, 83,7% eram do sexo feminino e 16,3% masculino; 25,8% tinham entre 36 a 40 anos; 46,6% referiam ter o segundo grau completo, 11,6% tinham concluído e 18,6% estavam em processo de conclusão do terceiro grau; 18,6% eram pós-graduados e 2,3% mestres; 60,5% tinham de 1 a 5 anos de instituição e 74,4%, de 1 a 5 anos de atuação no setor. Das 62 atividades referidas pelos profissionais, foram mapeadas as intervenções e atividades da NIC. Apresentaram frequência maior que 50%: Posicionamento (99,9%), Oxigenoterapia (99,8%) e Administração de medicamentos (65,8%). As intervenções e atividades com frequência menor que 50% foram: Controle de Vias Aéreas (45,0%), Redução da Ansiedade (42,9%), Assistência Ventilatória (40,8%), Monitoração Respiratória (36,8%), Monitoração de Sinais Vitais (36,2%), Controle de Energia (31,6%), Suporte Emocional (27,2%), Controle da Dor (24,9%) e Supervisão (20,4%). Inferior a 20%: Fisioterapia Respiratória (13,6%), Monitoração Neurológica (9,09%), Terapia Endovenosa (6,8%), Aspiração de Vias Aéreas (6,8%), Punção venosa (4,5%), Assistência para parar de fumar (2,2%), Controle de Medicamentos (2,2%), Controle Hídrico (2,2%), Cuidados de Emergência (2,2%), Precauções contra Aspiração (2,2%) e Ventilação mecânica (2,2%). A atividade de administração de medicamentos apresentou concordância entre os profissionais quanto à necessidade da prescrição médica; não foi evidenciada concordância entre as atividades exclusivas do enfermeiro. As de posicionamento, de administração de medicamentos, de administração de oxigênio, de administração de aerossóis e de monitoração de sinais clínicos foram referidas por serem frequentemente realizadas. As atividades de monitoração de valores de função pulmonar, de realização de fisioterapia e aquelas que exigiam a propedêutica do exame físico foram referidas como não realizadas, cujo motivo principal foi ser realizada por outro profissional . O estudo possibilitou identificar: a necessidade de considerar a interdisciplinaridade nas intervenções, as lacunas na assistência prestada pela equipe de enfermagem, as habilidades e competências requeridas pelo enfermeiro para atendimento da clientela idosa que apresenta padrão respiratório ineficaz com foco na prevenção de agravos e na integralidade da assistência.