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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
41

O transplante de células tronco hematopoéticas alogênico e autogênico na leucemia mielóide aguda em primeira remissão completa: análise de 62 pacientes / The allogeneic and autologous hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission: analyses of 62 patients

Nadjanara Dorna Bueno 03 April 2008 (has links)
O transplante de células tronco hematopoéticas alogênico e autogênico na leucemia mielóide aguda em primeira remissão completa: analise de 62 pacientes. Os pacientes foram submetidos a transplante de células tronco hematopoéticas alogênico e autogênico. Ao final do estudo estavam vivos no alogênico 43,3% e no autogênico 62,5%. Consolidação intensiva teve melhor sobrevida no alogênico. Os pacientes com DECH aguda grau II tiveram melhor sobrevida. Dois pacientes com DECH crônica extensa morreram. Óbito por infecção ocorreu com maior freqüência no alogênico seguido de recidiva. No autogênico a recidiva foi a principal causa de óbito. Morte por toxicidade ocorreu em 47% dos pacientes que foram a óbito no alogênico e em 8,3% no autogênico. Na analise múltipla de Cox a consolidação intensiva e DECH crônica, tiveram significância. / The allogeneic and autologous hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission: analyses of 62 patients. The patients were submitted to allogeneic and autologous hematopoietic stem cell transplantation. The end of the study were kept alive in allogeneic 43,3% and in autologous 65,2%. Patient in allogeneic who were consolidated had better survival. Patients with acute GVHD grade II had better survival. Two patients with chronic GVHD in intense, died. Infection was the most frequent dead cause in allogeneic following relapse. In autologous the relapse was the principal cause of death. Toxicity occurred in 47% of patients who died in allogeneic and 8,3% in autologous. In cox multiple analyses intensive consolidation and chronic GVHD had significance.
42

"Prática de exames de rastreamento em profissionais de saúde de um hospítal terciário" / Screening behaviors among health professionals of a terciary hospital

Ana Claudia Camargo Gonçalves da Silva 11 January 2005 (has links)
A prática de 18 procedimentos de rastreamento foi avaliada em profissionais de saúde de um hospital terciário, com idade entre 40 e 69 anos. Dos 364 profissionais elegíveis sorteados, foram entrevistados 333 (91%): 170 auxiliares de enfermagem, 137 médicos e 26 enfermeiras. A realização de procedimentos de rastreamento não recomendados, ou com evidência insuficiente para recomendação, foi relatada por expressiva proporção dos profissionais: eletrocardiograma - 48%, RX de tórax - 57%, dosagem de PSA - 66%, hemograma - 74%. Por outro lado, quase um terço (29%) não havia medido a Pressão Arterial como rastreamento, e apenas quatro (1%) haviam realizado pesquisa de sangue oculto nas fezes. Esses resultados mostram a necessidade de melhor divulgação entre profissionais de saúde das diretrizes sobre rastreamento / The use of 18 screeming procedure was evaluated in health professionals of a terciary hospital, aged 40-69 years. Of the 364 drafted eligible professionals, 333 (91%) had been interviewed: 170 nurses assistant, 137 physician and 26 nurses. The realization of not recommended screening procedure, or with insufficient evidence to recomendation, was related by expressive proportion of the professionals: electrocardiogram - 48%, chest x-ray - 57%, PSA - 66%, hemogram - 74%. On the other hand, almost one third (29%) hadn't measured the blood pressure as screening, and only four (1%) had realized fecal occult blood tests. These results shows the necessity of a better divulgation among health professionals about the screening guidelines
43

Is the Association of Diabetes With Uncontrolled Blood Pressure Stronger in Mexican Americans and Blacks Than in Whites Among Diagnosed Hypertensive Patients?

Liu, Xuefeng, Song, Ping 01 November 2013 (has links)
BACKGROUND: Clinical evidence shows that diabetes may provoke uncontrolled blood pressure (BP) in hypertensive patients. However, racial differences in the associations of diabetes with uncontrolled BP outcomes among diagnosed hypertensive patients have not been evaluated. METHODS: A total of 6,134 diagnosed hypertensive subjects aged ≥ 20 years were collected from the National Health and Nutrition Examination Survey 1999-2008 with a stratified multistage design. Odds ratios (ORs) and relative ORs of uncontrolled BP and effect differences in continuous BP for diabetes over race/ethnicity were derived using weighted logistic regression and linear regression models. RESULTS: Compared with participants who did not have diabetes, non-Hispanic black participants with diabetes had a 138% higher chance of having uncontrolled BP, Mexican participants with diabetes had a 60% higher chance of having uncontrolled BP, and non-Hispanic white participants with diabetes had a 161% higher chances of having uncontrolled BP. The association of diabetes with uncontrolled BP was lower in Mexican Americans than in non-Hispanic blacks and whites (Mexican Americans vs. non-Hispanic blacks: relative OR = 0.55, 95% confidence interval (CI) = 0.37-0.82; Mexican Americans vs. non-Hispanic whites: relative OR = 0.53, 95% CI = 0.35-0.80) and the association of diabetes with isolated uncontrolled systolic BP was lower in Mexican Americans than in non-Hispanic whites (Mexican Americans vs. non-Hispanic whites: relative OR = 0.62, 95% CI = 0.40-0.96). Mexican Americans have a stronger association of diabetes with decreased systolic BP and diastolic BP than non-Hispanic whites, and a stronger association of diabetes with decreased diastolic BP than non-Hispanic blacks. CONCLUSIONS: The association of diabetes with uncontrolled BP outcomes is lower despite higher prevalence of diabetes in Mexican Americans than in non-Hispanic whites. The stronger association of diabetes with BP outcomes in whites should be of clinical concern, considering they account for the majority of the hypertensive population in the United States.
44

Increased Prevalence of Helicobacter Pylori Antibodies Among Nurses

Wilhoite, S L., Ferguson, D A., Soike, D R., Kalbfleisch, J. H., Thomas, E. 22 March 1993 (has links)
BACKGROUND: Numerous studies have suggested that Helicobacter pylori infection in asymptomatic subjects is transmitted from person to person. Its prevalence is higher in the institutionalized setting. If that is the case, persons involved in patient care should have a higher prevalence of the infection. METHODS: We estimated the prevalence of H pylori antibodies among groups of asymptomatic medical and nursing staff and compared them with volunteer blood donors of similar age and sex. RESULTS: One hundred fifty-eight nurses and aides, 59 residents, 46 senior medical students, and 22 senior nursing students were enrolled in this study. Serum samples were tested for IgG antibodies against H pylori by enzyme-linked immunosorbent assay. Sixty-two (39%) of 158 nurses were found to be positive for antibodies to H pylori compared with 114 (26%) of 441 specimens from the blood donor group. Within the youngest age group (20 to 34 years), 13 (25%) of 51 nurses were positive for H pylori antibodies compared with 19 (13%) of 143 age-matched serum samples from the blood donor group. Within the middle age group (35 to 49 years), 32 (39%) of 83 nurses were positive for H pylori antibodies vs 43 (26%) of 167 age-matched blood donors. In the oldest age group (> 50 years), 17 (71%) of 24 nurses were positive for H pylori antibodies compared with 52 (40%) of 131 age-matched blood donors. Twenty-three (27%) of 86 nurses with 1 to 15 years of occupational exposure were positive for H pylori antibodies compared with 40 (56%) of 72 nurses with more than 15 years of occupational exposure. CONCLUSIONS: Nurses have an increased prevalence of H pylori antibodies that is significantly higher than the comparable prevalence of volunteer blood donors and is evident in the youngest age group. In addition, the increased prevalence is related to a longer duration of patient exposure in the nursing group.
45

ePrescribing : Studies in Pharmacoinformatics

Åstrand, Bengt January 2007 (has links)
Det övergripande syftet med den här avhandlingen har varit att, inom området läkemedelsinformatik, studera utvecklingen av elektroniska stöd inom läkemedelsförskrivning; för klinisk praxis, uppföljning och forskning. Under århundraden har det handskrivna receptet varit det sätt, med vilket läkare förmedlat sina läkemedelsordinationer till apotekare, vilket också för patienten blivit en informationskälla för hur läkemedel ska användas för att göra bästa nytta. Nu genomgår receptet en förändring från pappersbaserat till elektroniskt meddelande och att anpassa en traditionell process till en ny elektronisk era innebär både möjligheter och utmaningar. Studierna som ingår i avhandlingen har visat att exponeringen av förskrivna läkemedel i en allmän befolkning har ökat under de senaste tre decennierna. Risken för potentiella interaktioner mellan läkemedel, varmed avses den risk som finns att olika läkemedel kan påverka varandras effekter och biverkningar, har också visat sig öka starkt desto fler läkemedel som används av en individ. Denna ökade samtidiga användning av flera olika läkemedel, så kallad polyfarmaci, medför att det finns en större anledning för förskrivare och farmacevter att uppmärksamma risken för potentiella interaktioner mellan läkemedel. De nyinrättade nationella receptregistren över uthämtad receptförskriven medicin bör användas bland annat för att upptäcka potentiella läkemedelsinteraktioner, såväl i vårdens utövning som inom läkemedelsepidemiologisk forskning. Den svenska läkemedelsförteckningen, som omfattar information om uthämtade receptförskrivna läkemedel för huvuddelen av den svenska befolkningen, bedöms ha en stor klinisk potential. Den enskilde individens historiska information om uthämtade läkemedel är tillgänglig för individen på Internet med hjälp av e-legitimation; även förskrivare och farmacevter på apotek kan ta del av informationen med den enskildes samtycke. Brist på tillgång till enhetliga och säkra autenticeringsmetoder inom hälso- och sjukvården kan dock fördröja tillgången på individuell läkemedelsinformation för förskrivare. I och med att de flesta recepten i Sverige nu skrivs och överförs elektroniskt är det viktigt att kvalitetsmässiga aspekter tas tillvara så att en iakttagen ökad risk för receptförskrivningsfel inte överförs i informationskedjan. Avhandlingens slutsats är att e-förskrivning, med kommunikation och användning av lagrad information om receptexpeditioner, möjliggör att läkemedelsbehandling som process kan följas och studeras på ett helt nytt / The thesis aimed to study the developments, in the area of pharmacoinformatics, of the electronic prescribing and dispensing processes of drugs - in medical praxis, follow-up, and research. For hundreds of years, the written prescription has been the method of choice for physicians to communicate decisions on drug therapy and for pharmacists to dispense medication. Successively the prescription has also become a source of information for the patient about how to use the medication to maximize its benefit. Currently, the medical prescription is at a transitional stage between paper and web, and to adapt a traditional process to the new electronic era offers both opportunities and challenges The studies in the thesis have shown that the exposure of prescribed drugs in the general population has increased considerably over three decades. The risk of receiving potentially interacting drugs was also strongly correlated to the concomitant use of multiple drugs, polypharmacy. The pronounced increase in polypharmacy over time constitutes a growing reason for prescribers and pharmacists to be aware of drug interactions. Still, there were relatively few severe potential drug interactions. Recently established national prescription registers should be evaluated for drug interaction vigilance, both clinically and epidemiologically. The Swedish National Pharmacy Register provides prescription dispensing information for the majority of the population. The medication history in the register may be accessed online to improve drug utilization, by registered individuals, prescribers, and pharmacists in a safe and secure way. Lack of widespread secure digital signatures in healthcare may delay general availability. With a relatively high prevalence of dispensed drugs in the population, the National Pharmacy Register seems justified in evaluating individual medication history. With a majority of prescriptions transferred as ePrescriptions, the detected increased risk for prescription errors warrants quality improvement, if the full potential of ePrescriptions is to be fulfilled. The main conclusion of the studies was that ePrescribing with communication of prescribed drug information, storing and retrieving dispensed drug information, offers new opportunities for clinical and scientific
46

Panorama da produção científica da Faculdade de Medicina da Universidade de São Paulo no período 2001-2006 / The scientific production of Faculdade de Medicina da Universidade de São Paulo: a view of the period of 2001-2006

Cardoso, Suely Campos 02 July 2009 (has links)
A comunicação escrita consiste, ainda hoje, no principal veículo de divulgação das pesquisas científicas, sendo feita basicamente por meio de documentos convencionais, como livros e artigos de revistas. A mensuração da produção científica de determinada Entidade de Ensino Superior pode contribuir para um melhor direcionamento de verbas ou mesmo de ações acadêmicas. Este trabalho teve por objetivo traçar um panorama da produção científica da Faculdade de Medicina da Universidade de São Paulo (FMUSP), de seus professores titulares (MS-6), ativos entre 2001-2006, usando como referência a base de dados Medline/PubMed. Dos registros encontrados, foram identificadas as revistas científicas, seu fator de impacto e as citações dos artigos. Após identificação dos 66 docentes (MS-6) foram recuperados 1.960 artigos científicos em 630 títulos de revistas científicas, sendo 3,8% em revistas nacionais e 96,2% em internacionais. Nas revistas internacionais o fator de impacto variou de 0.062 a 51.296 (JCR/2006). As citações foram pesquisadas na base de dados Web of Science/ISI Thomson, sendo que 45% dos artigos foram citados por outros pesquisadores, totalizando 9.335 citações. Os resultados desta pesquisa parecem indicar ser possível a análise da produção científica dos professores titulares de uma Instituição, não somente pela posição na carreira acadêmica como também pela chance maior de esses docentes agregarem em seus projetos membros do mesmo departamento ou de outros da Instituição. O elevado número de artigos publicados em revistas científicas nacionais e internacionais com penetração na comunidade científica contribui para a repercussão e visibilidade das publicações e pesquisas desenvolvidas nesta Instituição. / The Scientific production of higher education schools/institutions as well as its dissemination and use by peer institutions are measured by means of quantitative and qualitative measurements, which may also contribute to serving other academic purposes. Variables such as type of evaluation, number of faculty members, whether to include researchers that are not professors are frequently difficult to measure when comparing diverse schools/institutions. The purpose of this study was to assess the 2001-2006 scientific production of tenured faculty from the Universidade de ou São Paulo University Medical School indexed at Medline/PubMed database. The articles found were sorted out according to the journals in which they had been published, their impact factor, and how many times they had been cited. This study identified 66 professors/researchers and 1,960 articles, which were registered on an Excell spreadsheet. There were 630 journals found, 24 of which were national and 606 international. The impact factor of the international journals ranged from 0.062 to 51.296 (JCR/2006). As verified at Web of Science/ISI Thomson database, 45% of these articles were cited by peer researchers, totaling 9,335 citations. The results of this study suggest that it is possible to evaluate the scientific production of a school/institution by means of the production of its tenured faculty, not only because of their academic standing, but also because their projects tend to bring together other faculty members from the same school/department or other schools/departments at the same institution. The large number of articles published in international journals contributes to making this institutions scientific production known to the international academic community.
47

"Desempenho visual na correção de miopia com óculos e lentes de contato gelatinosas" / Visual performance in myopic correction with spectacles and soft contact lenses

Andrade, Breno Barth Amaral de 24 September 2004 (has links)
Objetivos: Avaliar o desempenho visual(DV), por meio da AV logMAR de alto contraste, sensibilidade ao contaste(SC) e análise de frentes de onda(AFO), em míopes, com óculos e três LCG. Métodos: Estudo clínico e prospectivo, em 40 indivíduos míopes(-1,00D e -4,50D). Exames: AV logMAR de alto contraste, avaliação de SC e AFO. Resultados: A AFO detectou diferença na aberração de terceira ordem sem e com as LCG.. Em relação ao nível trifoil houve diferença entre com e sem LCG. Conclusões: Na avaliação do DV com óculos e com LCG, a AFO é uma medida mais sensível da função visual que a AV LogMAR de alto contraste e a SC. / Objective: to evaluate the visual performance(VP) by Visual acuity(VA)Logmar of high contrast, sensibility of contrast(SC) and wavefront (WF) in myopic patients correct with spectacles and 3 SCL Methods: prospective clinical trial was performed in 40 myopic patients(-1,00 D and -4,50 D). Exams: VA, WF and CS. Results: The WF analysis detected a significant difference in a third order aberration with and without SCL. There was significant difference related to trefoil coefficient in VP between with and without SCL. Conclusion: In VP evaluation with spectacles and SCL the wavefront analysis was more sensible measure of VP when compared with high contrast VA Logmar and CS.
48

Avaliação urodinâmica em pacientes com sintomas do trato urinário inferior e volume prostático menor que 40 centímetros cúbicos / Urodynamic evaluation of patients with lower urinary tract symptoms and prostate volumes less than 40cc

Araujo, Rogério Matos 26 March 2004 (has links)
INTRODUÇÃO - As manifestações clínicas da hiperplasia prostática benigna envolvem a interação entre três fatores: sintomas miccionais, aumento do volume prostático e obstrução infravesical. A relação entre estes fatores é complexa e parcialmente entendida. O objetivo do presente estudo foi avaliar os achados urodinâmicos de pacientes com sintomas do trato urinário inferior e volume prostático menor que 40cm3, com ênfase nos parâmetros obstrução infravesical, hiperatividade detrusora e contratilidade detrusora. CASUÍSTICA E MÉTODOS - Os prontuários e exames urodinâmicos de 33 pacientes foram analisados retrospectivamente. A média de idade dos pacientes foi de 60,3 ± 9,3 anos, variando de 40 a 78 anos. Os sintomas do trato urinário inferior foram avaliados com o escore internacional de sintomas prostáticos (IPSS). O volume prostático e os seguintes parâmetros urodinâmicos foram analisados: fluxo máximo, capacidade cistométrica máxima, complacência, presença de hiperatividade detrusora, fluxo máximo no estudo fluxo/pressão, pressão detrusora no fluxo máximo, contratilidade detrusora e resíduo miccional. Analisou-se, também, o impacto da obstrução infravesical, hiperatividade detrusora e volume prostático nos sintomas miccionais e parâmetros urodinâmicos. RESULTADOS - As médias do volume prostático e IPSS foram 26,5 ± 6,9cm3 e 16,8 ± 5,0, respectivamente. Anormalidades urodinâmicas foram encontradas em 30 (90,9%) pacientes, sendo obstrução infravesical e hiperatividade detrusora os achados mais freqüentes, cada qual acometendo 16 (48,5%) pacientes. A prevalência da hiperatividade detrusora foi de 50,0% entre os pacientes obstruídos e de 47,0% nos pacientes sem obstrução infravesical (p = 0,99). Hipocontratilidade detrusora foi observada em 18,8% dos obstruídos e 64,7% dos pacientes sem obstrução (p = 0,013). O índice de contratilidade detrusora foi de 111,7 ± 20,8 nos pacientes obstruídos e de 92,9 ± 17,3 nos pacientes sem obstrução (p = 0,008). Nos pacientes com e sem hiperatividade detrusora, encontrou-se diferença estatisticamente significativa na complacência vesical, que foi de 15,4 ± 9,6ml/cmH2O nos pacientes com hiperatividade detrusora e de 28,8 ± 10,8ml/cmH2O nos pacientes sem hiperatividade detrusora (p = 0,007). CONCLUSÕES - O estudo urodinâmico identifica anormalidades vesicais na maioria dos pacientes com sintomas do trato urinário inferior e volume prostático menor que 40cm3. Embora a obstrução infravesical seja um achado comum, mais da metade dos pacientes tiveram outras alterações vesicais responsáveis pelos seus sintomas, principalmente hiperatividade detrusora e diminuição da contratilidade detrusora, reforçando o valor dos exames urodinâmicos nesta população. / INTRODUCTION - The clinical manifestations of benign prostatic hyperplasia involve the correlation of three elements: voiding symptoms, prostate enlargement and bladder outlet obstruction. The interaction between these factors is complex and incompletely understood. The objective of this study was to evaluate the urodynamic findings in patients with lower urinary tract symptoms and prostate volumes less than 40cc, focusing on the parameters bladder outlet obstruction, detrusor overactivity and detrusor hypocontractility. PATIENTS AND METHODS - The records and urodynamic studies of 33 patients with lower urinary tract symptoms and prostate volumes less than 40cc were reviewed. Average age of the patients was 60.3 ± 9.3 years (range 40 to 78 years). Lower urinary tract symptoms were evaluated with the International Prostate Symptom Score (IPSS). Prostate volume and the following urodynamic parameters were analyzed: maximum flow rate, maximum cystometric capacity, compliance, presence of detrusor overactivity, maximum flow rate during pressure/flow studies, detrusor pressure at maximum flow rate, detrusor contractility e post void residual volume. We also evaluated the impact of bladder outlet obstruction, detrusor overactivity and prostate volume on the voiding symptoms and urodynamic parameters. RESULTS -Mean prostate volume and IPSS were 26.5 ± 6.9 cc and 16.8 ± 5.0, respectively. Urodynamic abnormalities were found in 30 (90.9%) patients, with a preponderance of bladder outlet obstruction and detrusor overactivity, each affecting 16 (48.5%) patients. The prevalence of detrusor overactivity was 50.0% in the obstructed patients and 47.0% in patients without bladder outlet obstruction (p = 0.99). Detrusor hypocontractility was present in 18.8% of the obstructed patients and 64.7% of the non-obstructed patients (p = 0.013). The detrusor contractility index was 111.7 ± 20.8 in the obstructed patients and 92.9 ± 17.3 in those without bladder outlet obstruction (p = 0.008). In the patients with and without detrusor overactivity there was a statistically significant difference in bladder compliance, which was 15.4 ± 9.6 ml/cmH2O in the patients with detrusor overactivity and 28.8 ± 10.8 ml/cmH2O in those without detrusor overactivity (p = 0.007). CONCLUSIONS - Urodynamic studies identify bladder abnormalities in most patients with lower urinary tract symptoms and prostate volumes less than 40cc. Although bladder outlet obstruction is a common diagnosis, more than half of the patients had other types of bladder dysfunction as the basis for their voiding symptoms, predominantly detrusor overactivity and decreased detrusor contractility, emphasizing the value of urodynamic studies in this population.
49

"Falência do desmame: risco, fatores associados e prognóstico de pacientes sob ventilação mecânica prolongada" / Weaning failure : rate, risk factors and outcomes of prolonged mechanically ventilated patient

Yamauchi, Liria Yuri 31 May 2005 (has links)
OBJETIVOS: Estimar a taxa de falência de desmame, identificar fatores de risco para a falência, estimar a taxa de mortalidade na unidade de terapia intensiva e hospitalar em um grupo heterogêneo de pacientes com ventilação mecânica prolongada. MÉTODOS: Trata-se de um estudo de coorte prospectivo de pacientes adultos consecutivamente internados em 11 unidades de terapia intensiva e que receberam ventilação mecânica por 3 dias ou mais. As variáveis de desfecho incluíram o resultado do desmame (falência ou sucesso) e o desfecho da UTI (alta ou óbito).RESULTADOS: Dos 189 pacientes incluídos, 149 (79%) foram desmamados com sucesso e 40 (21%) necessitaram de reintubação dentro de 48 horas, constituindo o grupo falência.Através da análise de regressão logística, o sexo feminino foi identificado como fator independentemente associado com a falência do desmame. Os pacientes com falência permaneceram por mais tempo na UTI (p < 0,01). A freqüência de traqueostomia foi maior no grupo com falência (p < 0,01). A taxa de mortalidade na UTI foi de 21%; IC de 95%: 15-27%. O modelo de regressão de Cox ajustado para a gravidade à admissão na UTI identificou que a falência do desmame aumentou o risco de morte na UTI (RR: 3,08; p < 0,01). CONCLUSÔES: Após o controle para variáveis clínicas e gravidade à internação na UTI, o sexo feminino apresentou associação independente com a falência do desmame. Pacientes com falência apresentaram maior tempo de internação na UTI, maior taxa de traqueostomia e maior risco de morte na UTI / OBJECTIVE: To determine the rate of weaning failure, risk factors, intensive care unit (ICU) and hospital outcomes in a number of heterogeneous patients with prolonged MV. DESIGN, SETTING, AND SUBJECTS: Prospective cohort of consecutive adult patients admitted to 11 ICU who received MV (³ 72 hours). Study endpoints included weaning failure vs success and ICU death vs survival. RESULTS: Of 189 intubated patients, 149 (79%) were succesfully extubated, and 40 (21%) required reintubation within 48 hours.Using multiple logistic regression, female gender was an independent predictor of weaning failure. The mean ICU length of stay was significantly longer in weaning failure group (p < 0.01). The rate of tracheostomy was higher in the failure group (p < 0.01). The ICU mortality rate was 21%; 95% CI, 15 - 27%. In a Cox model adjusting on severity at ICU admission, weaning failure increased the risk of death in the ICU (RR: 3.08; p < 0,01). CONCLUSION: After adjusting for severity of ilness and medical conditions, female gender had a significant independent association with increased risk of weaning failure (WF). WF had association with prolonged ICU stay and higher rate of tracheostomy. Patients with weaning failure were 3 times more likely to die in the ICU
50

Álcool em vítimas fatais de acidentes de trânsito no município de São Paulo, ano 2005 / Alcohol in fatal victims of traffic accidents in the city of São Paulo, 2005

Ponce, Julio de Carvalho 23 March 2010 (has links)
Os acidentes de trânsito constituem a 13ª causa mais freqüente de morte no Brasil, ocupando o primeiro lugar na faixa de 10 a 14 anos, e o segundo na faixa dos 15 aos 29 anos. Estudos indicam que do total do custo dos acidentes de trânsito, mais de 20% deve-se diretamente ao uso indevido de álcool. Estudos internacionais que relacionam o consumo de álcool com fatalidades no trânsito são freqüentes, mas carecemos de dados epidemiológicos confiáveis e de abrangência nacional que sinalizem a atual e real situação. Portanto, o objetivo do presente estudo é realizar uma análise retrospectiva de dados de vítimas fatais de acidentes de trânsito ocorridos no Município de São Paulo no ano de 2005, para estabelecer a relação do uso do álcool e a morte no trânsito. Nas 907 vítimas avaliadas, notou-se uma associação com o uso de etanol, com 39,4% de casos positivos. Para condutores de veículos, essa porcentagem atinge 55,8%, todos acima do limite máximo permitido para condução à época, de 0,6 g/l. Acidentes em geral, e aqueles relacionados ao álcool, ocorreram com maior frequência aos sábados e domingos, e nos horários das 18hs às 6hs da manhã Os resultados demonstram uma associação do etanol com a ocorrência de vítimas fatais, e devem servir como alerta para o desenvolvimento de políticas públicas visando diminuir este grave problema. / Traffic accidents, in Brazil, account for the 13th most frequent cause of death, being the 1st most frequent among 10 to 14 year olds, and second for those aged 15 to 29. Studies indicate that form the total cost of traffic accidents, over 20% are directly due to the harmful consumption of alcohol. International studies that relate alcohol consumption to traffic fatalities are frequent, but we lack nationwide epidemiological data that present the current and real situation. Thus, the objective of the present study is to carry out a retrospective analysis of data from fatal traffic accident victims, in the city of Sao Paulo, in the year 2005, to establish the relationship between alcohol consumption and traffic deaths. In the 907 evaluated victims, an association with ethanol use was found, with 39.4% of cases being positive. For automobile drivers, this percentage reached 55.8%, all of them above the maximum level allowed at the time, 0.6 g/l. Accidents in general, and those related to alcohol happened in greater frequency on Saturdays and Sunday, and from 6PM to 6AM. The results show an association of alcohol consumption with fatal victims in traffic accidents, and should be a cause for concern. The data present can help in implementing and developing public policies aiming to diminish this grave issue.

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