Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-21T00:25:24Z No. of bitstreams: 1 MarianaCarmemApolinarioVieira_DISSERT.pdf: 1712134 bytes, checksum: 88ad1bdccb2c21827752124eedb04a6c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-03T23:34:52Z (GMT) No. of bitstreams: 1 MarianaCarmemApolinarioVieira_DISSERT.pdf: 1712134 bytes, checksum: 88ad1bdccb2c21827752124eedb04a6c (MD5) / Made available in DSpace on 2017-03-03T23:34:52Z (GMT). No. of bitstreams: 1 MarianaCarmemApolinarioVieira_DISSERT.pdf: 1712134 bytes, checksum: 88ad1bdccb2c21827752124eedb04a6c (MD5) Previous issue date: 2016-01-26 / Introdu??o: As mulheres apresentam maior decl?nio f?sico e incapacidade durante o envelhecimento em rela??o aos homens. Com isso, diversas explica??es biol?gicas v?m sendo propostas para explicar a raz?o pela qual as mulheres apresentam piores resultados de sa?de. Dentre elas, sabe-se que a hist?ria reprodutiva e poss?veis altera??es gineco-obstetricias vem sendo associada a limita??es na fun??o f?sica. Entretanto, sabe-se pouco sobre a rela??o entre a incontin?ncia urin?ria, o prolapso de ?rg?os p?lvicos e o desempenho f?sico. Objetivo: Verificar a rela??o entre incontin?ncia urin?ria, prolapso de ?rg?os p?lvicos e desempenho f?sico em mulheres de meia-idade.Metodologia: Trata-se de um estudo observacional anal?tico, de car?ter transversal, realizado com mulheres (40 a 65 anos), residentes em Parnamirim/RN. Todas as participantes foram avaliadas atrav?s de um question?rio estruturado, sendo coletados dados socioecon?micos, demogr?ficos, altera??es ginecol?gicas e desempenho f?sico. Na an?lise estat?stica, a normalidade dos dados foi verificada utilizando o teste Kolmogorov-Smirnov. Para avaliar a rela??o entre as vari?veis independentes e as de desempenho f?sico foram utilizados o test t e a ANOVA. An?lises de regress?o linear foram realizadas para observar a rela??o entre incontin?ncia urin?ria, prolapso de ?rg?os p?lvicos e o desempenho, ajustadas pelas covari?veis. Resultados: Foram avaliadas 361 mulheres, com m?dia de idade 53,0 (?5,6) anos. As mulheres que apresentavam incontin?ncia urin?ria mostraram pior desempenho no teste de sentar e levantar (p=0,04) e aquelas com prolapso de ?rg?os p?lvicos, pior equil?brio de olhos abertos (p=0,04). Ap?s as an?lises de regress?o linear m?ltipla, as altera??es ginecol?gicas permaneceram relacionadas ao teste sentar e levantar (incontin?ncia urin?ria: ? = 0,923; IC: 0,016 : 1,830) e ao equil?brio de olhos abertos (prolapso p?lvico: ? = -2,467; IC: -4,706 : -0,228). Conclus?o: As mulheres com incontin?ncia urin?ria apresentaram pior desempenho f?sico no teste de sentar e levantar da cadeira e aquelas com prolapso de ?rg?os p?lvicos apresentaram pior desempenho f?sico no teste de equil?brio com olhos abertos. / Introduction: Women have presented higher charge of physical decline and disability during aging compared to men. Consequently, several biological explanations have been proposed to explain the reason why women have worse health outcomes. Among them, has knowledge that the reproductive history and possible urogynecological changes has been associated with limitations in physical function. However, little is known about the relationship between urinary incontinence, pelvic organ prolapse and physical performance. Objective: To verify the relationship between urinary incontinence, pelvic organ prolapse and physical performance in middle-aged women. Methodology: A cross-sectional study, accomplished with women (40-65 years), living in Parnamirim-RN, between September of 2014 and July of 2015, with a sample of 361 women. All participants were assessed using a structured questionnaire, being collected socioeconomic and demographic data, urogynecological changes and physical performance. In the statistical analysis, the normality of the data was verified using the Kolmogorov-Smirnov test. To evaluate the relationship between independent variables and physical performance variables were used test t and ANOVA. Linear regression analysis was performed to observe the relationship between urinary incontinence, pelvic organ prolapse and physical performance, adjusted for covariates. Results: A total of 361 women were assessed with mean of age 52.0 (? 5.6) years. Women who had urinary incontinence showed worse performance in the chair stand test (p = 0.04) and those with pelvic organ prolapse, worse balance with open eyes (p = 0.04). After multiple linear regression analysis, urogynecological changes related to the test remained related chair stand test (urinary incontinence: ? = 0.923; CI: 0.016 : 1.830) and balance with open eyes (pelvic prolapse: ? = -2.467; CI: -4.706 : -0.228). Conclusion: Women who had urinary incontinence showed worse performance in the chair stand test and those with pelvic organ prolapse, worse balance with open eyes.

There have only been few investigations comparing total fluoride intake and the fluoride proportion excreted in urine in pre–school children. In addition, the results of available studies are conflicting. Total fluoride intake was assessed in 11 healthy children aged 3–6 years on 2 consecutive days and urinary fluoride excretion was determined. The duplicate–diet approach was used for the assessment of fluoride intake from solid and liquid foods. Fluoride intake from toothbrushing was calculated as the difference between the amount of fluoride in the paste put on the toothbrush and the drinking water (fluoride concentration 0.25 mg/l) used for rinsing vs. the fluoride amounts recovered in the toothpaste spat out and in the rinsing water. Use of fluoridated domestic salt and/or fluoride tablets was recorded. The children’s intake of fluoride from food averaged 202.5±116.2 μg F/day. They swallowed an average amount of 273.9±175.6 μg F/day when brushing their teeth. Daily fluoride ingestion from all sources totalled 930.7±391.5 μg or 53.0±21.4 μg/kg body weight. On average 51.5% of the fluoride ingested was excreted in urine. The wide interindividual variation makes it necessary to evaluate the urinary excretion rate for fluoride in larger study populations with varied fluoride exposure. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Studier har tidigare visat surgörning urinprover inför analys av kalcium, fosfat och magnesium inte är nödvändigt. Dessa analyter är viktiga att analysera vid njursjukdomar och det görs med instrumentet Advia Chemistry XPT (Siemens AG, München, Tyskland) på Universitetssjukhuset Örebro. Syftet med arbetet var att se om samma resultat erhölls för kalcium, fosfat och magnesium beroende på om urinen var surgjord eller inte inför analys. Tre metoder utvärderades beträffande behov av surgörning av urin: Metod 1; den nuvarande metoden, urinen surgjordes till pH 3-4. Metod 2; utan surgörning, urinen rumstempererades i 30 min före mätning. Metod 3; utan surgörning, urinen värmdes till 36ºC före varje mätning för att lösa upp eventuella saltkristaller. Alla metoderna utfördes på 30 prover och testades efter 0h, 24h, 3 dagar och 7 dagar. Resultaten sammanställdes i ett linjärt regressionsdiagram och ett Bland Altmann-diagram. Ett förutbestämt acceptansmål var att de genomsnittliga analysresultaten inte skulle ha en större skillnad än 10% vid jämförelse mellan metod 1 och metod 2 respektive metod 1 och metod 3, samt att eventuella avvikande enskilda prover skulle undersökas närmare. Fem av proverna höll inte den förutbestämda 10%-gränsen och mikroskoperades för att se om saltkristaller förekom och surgjordes för att se om provsvaren skulle förändras. I tre av fem prover kunde saltkristaller observeras. Detta gav slutsatsen att alla prover fortsatt måste surgöras eftersom det inte går att avgöra i förväg om provet måste surgöras eller inte eftersom ett tydligt samband inte kunde ses mellan proverna som inte höll 10%-gränsen och de som gjorde det. / Studies have previously shown that acidification of urine samples before analysis for calcium, phosphate and magnesium may not be necessary. These analytes are important to monitor during kidney disease and are, at USÖ, detected using the instrument Advia Chemistry XPT (Siemens AG, München, Germany). The aim of this study was to examine whether the results from analyzing previously mentioned mineral levels would differ depending on whether the urine had been acidified prior to analysis or not. To examine this, three methods were used. Method 1; the current method, where urine is acidified to pH 3-4. Method 2; without acidification, the urine was warmed at room temperature before analysis. Method 3; without acidification, the urine was heated to 36°C before analysis. All methods were assayed on 30 samples which were all examined after 0h, 24h, 3 days and 7 days. Results were compiled using a linear regression diagram and a Bland Altmann diagram. The predetermined acceptance criterion was a maximum 10% difference between mean analyte levels found using methods 2 or 3, in comparison to using method 1. Five samples deviated from the remainder by breaking the 10% limit and were therefore scrutinized under microscope to search for salt crystals, before acidification and reanalysis. Crystals were detected in three of the five samples. As there was no clear connection between the deviating samples, there is no way of knowing prior to analysis whether acidification will be necessary or not, and it is therefore deemed a necessity to acidify all urine samples.

Akut- och psykiatriska avdelningar på länssjukhuset Ryhov i Jönköping använder sig av snabbtest för drogscreening med varierande kvalitet under de tider då analysinstrumentet Konelab Prime 30i inte är bemannat. Syftet med studien var att utvärdera sensitivitet och specificitet hos Multitest 15 från tillverkaren Acro Biotech, och jämföra resultat från två olika avläsningstider. Antalet urinprover som samlades in för analys uppgick till 272. Positiva och negativa urinprover med drogkoncentrationer inom ±50% från varje drogs gränsvärde insamlades. Senare inkluderades drogkoncentrationer utanför detta intervall. Proverna testades med Multitest 15 vid laboratoriet för klinisk kemi på Ryhov efter utförd analys med Konelab Prime 30i, vars analysresultat utgjorde referens. De droger som testades var amfetamin, metamfetamin, ecstasy, bensodiazepiner, buprenorfin, kokain, metadon, morfin, THC, oxykodon och tramadol. För alla droger sammantaget var sensitiviteten 86,7% - 100%, specificiteten 33,3% - 100% och träffsäkerheten 71,4% - 94,7%. Provurvalet inom intervallet ±50% från gränsvärdet var begränsat, vilket avsevärt påverkat dessa beräkningar, och Konelab Prime 30i använder semikvantitativ metod vilken endast ger approximativa koncentrationsvärden som referens. / The emergency and psychiatric wards on the county hospital Ryhov in Jönköping utilize onsite drug testing with varying quality during evenings and night-time when no staff are operating the chemistry analyzer Konelab Prime 30i. The aim of the study is to evaluate the performance of sensitivity and specificity of Acro Biotech Multitest 15 and comparing results from two different reading-times. The number of urine samples collected for analysis was 272. Positive and negative urine samples with drug concentrations within ± 50% from cut-off were collected. Later, concentrations outside of this range was included. The samples were tested with Multitest 15 at the laboratory for clinical chemistry at Ryhov after analysis with Konelab Prime 30i providing reference results. The drugs tested were amphetamine, methamphetamine, ecstasy, benzodiazepines, buprenorphine, cocaine, methadone, morphine, THC, oxycodone and tramadol. All drugs included, the sensitivity was 86.7% - 100%, the specificity 33% - 100% and the accuracy 71.4% - 94.7%. The sample selection within the range ±50% from the cut-off value was limited, which significantly affected these calculations, and Konelab Prime 30i uses a semi-quantitative method only providing approximate concentration values for reference.

Made available in DSpace on 2015-04-14T13:53:27Z (GMT). No. of bitstreams: 1 413472.pdf: 860824 bytes, checksum: 3d6cfadeb503ae060681a77379e7d4ec (MD5) Previous issue date: 2009-03-23 / A freq??ncia de incontin?ncia urin?ria feminina aumenta com a idade. Devido ? incapacidade que provoca e os riscos e complica??es do tratamento cir?rgico, ? de grande import?ncia o desenvolvimento de estrat?gias terap?uticas n?o-invasivas, especialmente para a popula??o idosa. O objetivo deste estudo foi examinar a efic?cia da eletroestimula??o transcut?nea do nervo tibial para o tratamento de incontin?ncia urin?ria de urg?ncia em idosas. Foi realizado um ensaio cl?nico randomizado com 51 mulheres idosas (> 60 anos) com incontin?ncia urin?ria por urg?ncia. Todas foram tratadas com 12 semanas de retreinamento vesical e exerc?cios de refor?o da musculatura do assoalho p?lvico, sendo que 25 foram selecionados aleatoriamente para receber tamb?m a estimula??o el?trica. Os casos foram avaliados pelo di?rio miccional de 3 dias, o Kings Health Questionnaire (escala de qualidade de vida relacionada a incontin?ncia), o International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) e dados cl?nicos. A popula??o em estudo tinha uma idade m?dia de 68 anos, cerca de metade tinha parceiro, 61% tiveram tratamento pr?vio e 76,5% tinham incontin?ncia aos esfor?os associada. As caracter?sticas cl?nicas, o n?mero de perdas urin?rias e a qualidade de vida antes do tratamento foram semelhantes entre os grupos. Ambos os grupos apresentaram melhora significativa no ICIQ-SF, na maioria dos dom?nios do Kings Health Questionnaire, e na urge-incontin?ncia relatada no di?rio miccional. No entanto, houve melhora significativamente superior no grupo tratado com eletroestimula??o. Os dom?nios do Kings Health Questionnaire que apresentaram diferen?as significativas entre os grupos foram: impacto da incontin?ncia, limita??es nas atividades di?rias, limita??es f?sicas, emo??es, sono/energia, e medidas de gravidade. Foi observado em nosso estudo que a eletroestimula??o transcut?nea do nervo tibial ? eficaz no tratamento da incontin?ncia urin?ria de urg?ncia em mulheres idosas. Esta terap?utica deve ser considerada uma boa alternativa no tratamento de idosas.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-12-12T19:38:30Z No. of bitstreams: 1 ReginaCarmenEsposito_TESE.pdf: 1609404 bytes, checksum: bbff08f10f8b71c6162cfba459bc5243 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-12-14T19:40:52Z (GMT) No. of bitstreams: 1 ReginaCarmenEsposito_TESE.pdf: 1609404 bytes, checksum: bbff08f10f8b71c6162cfba459bc5243 (MD5) / Made available in DSpace on 2017-12-14T19:40:52Z (GMT). No. of bitstreams: 1 ReginaCarmenEsposito_TESE.pdf: 1609404 bytes, checksum: bbff08f10f8b71c6162cfba459bc5243 (MD5) Previous issue date: 2017-09-29 / O aumento benigno da pr?stata, mais conhecido como hiperplasia benigna da pr?stata (HBP), leva a sintomas do trato urin?rio inferior (STUI), que contribuem para diminuir a qualidade de vida dos homens acima da quarta d?cada. O mesmo vem sendo tratado, na sua maioria, por medicamentos alop?ticos do grupo dos inibidores da 5-alfa-redutase e/ou alfa-bloqueadores e/ou fitoter?picos. A literatura cient?fica apresenta uma escassez de ensaios cl?nicos randomizados, controlados com cegamento sobre a efic?cia de medicamentos homeop?ticos que j? tenham mat?ria m?dica para esta doen?a, bem como de novos rem?dios homeop?ticos. O presente estudo visou a avaliar a efic?cia do produto homeop?tico, contendo Momordica charantia 12CH, no controle dos STUI, devido ? HBP em ensaio cl?nico, randomizado, duplo cego e placebo controlado. Foram aleatorizados 81 pacientes em grupo A - Placebo e grupo B - Momordica charantia 12CH e avaliados a cada consulta pela anamnese, com o Escore Internacional de Sintomas Prost?ticos (IPSS), pelos exames de imagem com mensura??o do Volume Prost?tico (PV) e do Volume de Urina Residual P?s-esvaziamento (PVR) e laboratoriais pelo Ant?geno Prost?tico Espec?fico (PSA), Prote?na C Reativa quantitativa (PCR) e Interleucina-6 (IL-6). Em 72 amostras, foram realizados imunofenotipagem de linf?citos e subpopula??es por citometria de fluxo. Tanto a vari?vel principal (IPSS) quanto as vari?veis secund?rias (PSA, PV, PVR e PCR) e acess?rias (IL-6, linf?citos totais, linf?citos B, linf?citos T, linf?citos T helper, linf?citos T citot?xico e rela??o CD4/CD8 e c?lulas Natural Killer) n?o apresentaram signific?ncia estat?stica nas m?dias entre os grupos tratado e Placebo. Quanto ?s vari?veis de seguran?a, o uso da medica??o homeop?tica, pelos pacientes, n?o trouxe interfer?ncia durante os seis meses do experimento, seja na taxa de glicemia de jejum, seja nas dosagens de alanina aminotransferase, aspartato aminotransferase, fosfatase alcalina, bilirrubinas totais e fra??es e creatinina, usadas para avalia??o hep?tica e da fun??o renal respectivamente. A aus?ncia de infec??o urin?ria, confirmada pelo sum?rio de urina dos pacientes, predominou em ambos os grupos A e B durante todo o per?odo do ensaio cl?nico. Pode-se concluir que o tratamento com a Momordica charantia 12CH n?o apresentou diferen?a significativa para o placebo, quanto ? efic?cia no controle dos STUI, por HBP, por?m mostrou-se seguro. Pesquisas de alta qualidade, que permitam a prescri??o, a partir da individualiza??o dos sintomas e com diferentes dinamiza??es, devem ser realizadas, para possibilitar uma interpreta??o mais decisiva. / The benign enlargement of the prostate, better known as benign prostatic hyperplasia (BPH) results in symptoms of the lower urinary tract (LUTS) that contributes to lower quality of life of men over the fourth decade, and is mostly treated by allopathic drugs of the group of 5-alpha-reductase inhibitors and / or alpha-blockers, and / or phytotherapics. The scientific literature shows lack research from randomised and doubleblind clinical trials on the efficacy of homeopathic medicinal products that already have homeopathic medical materia and new homeopathic medicinal for BPH.The present study aimed to evaluate the effectiveness of the homeopathic product containing Momordica charantia 12CH in the LUTS control caused by BPH in a clinical, randomized, double-blind and placebo-controlled trial.A total of 81 patients were randomized to group A - Placebo and group B - Momordica charantia 12CH and evaluated at each visit by anamnesis with the International Prostate Symptom Score (IPSS), by imaging tests measured prostate volume (PV) and post-void residual (PVR) and laboratory tests for prostate specific antigen (PSA), quantitative C-reactive protein (CRP) and interleukin-6 (IL-6), and in 72 samples, lymphocyte and subpopulation immunophenotyping were performed by flow cytometry.Both the main variable (IPSS) and the secondary variables (PSA, PV, PVR and CRP) and accessory variables (IL-6, total lymphocytes, B lymphocytes, T lymphocytes, T helper cells, cytotoxic T lymphocytes and CD4 / CD8 ratio and Natural Killer cells) did not present statistical significance in the means between the groups treated and Placebo.About the safety variables, the use of homeopathic medication by the patients did not interfere during the six months of research, either in the fasting glucose level, as well as in the dosages of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubins and fractions and creatinine levels used for hepatic evaluation and renal function respectively.The absence of urinary infection confirmed by urinalysis of patients predominated in both groups A and B throughout the clinical trial period. It can be concluded that treatment with Momordica charantia 12CH did not show a significant difference for placebo in the efficacy in the control of STUI by BPH, but it demostrated to be safe. High quality researchs, which allows prescription, from the individualization of symptoms and with different dynamizations, must be performed, to enable more decisiveinterpretation of its effectiveness.

Made available in DSpace on 2014-12-17T14:46:39Z (GMT). No. of bitstreams: 1 ParticiaCBF_DISSERT.pdf: 926078 bytes, checksum: 9ea88765b5e731681c2629ed4e7288ec (MD5) Previous issue date: 2009-09-29 / A descriptive, quantitative approach and non-participant observation study, which was aimed at analyzing the association between knowledge and practice of inclusion and maintenance of urinary catheter by nursing professionals in the occurrence of urinary tract infection, performed in the ICU of Onofre Lopes University Hospital in Natal / RN. The original sample was composed of 42 nursing staff professional, five (5) nurses and 37 nursing technicians, 27 of them were outsourced (FUNPEC and IEL fellows) and 10 servers UFRN. Data collection was performed using two instruments, the first observation procedures used in the insertion and manipulation of indwelling urinary catheter (IUC) and the second with a questionnaire that addressed the characterization data of respondents, knowledge and conduct the insertion and manipulation of the IUC. The results were tabulated in Microsoft Excel and analyzed using SPSS software, version 15.0. We found the prevalence of institutional staff members on outsourcing - IEL and FUNPEC - (64.3%) were female (69.0%), aged 21 to 35 years (59.5%) and with mid-level education (88.1%). As to knowledge, we found that the nurses had levels of good to excellent and the nursing technicians, to regulate the poor. The nurses made a mistake when choosing IUC (40.0%) and washing hands (30.0%) and technicians on hand washing (74.4%) and the contents of the tray (34.7%). In relation to the conduct of insertion of IUC, the nurses made a mistake when choosing SVD (66.7%) and washing hands (57.1%). Regarding the handling of IUC/drainage system, the technicians were wrong more about washing their hands (56.0%). Analyzing the misconduct to the categorization of knowledge, we saw that the nursing staff who had missed more had inadequate knowledge (ρ = 0.001). At the end we found the risk of a patient to acquire UTI is higher in two and a half times when there is a large number of mismatches, patient spends more time using the IUC and hospitalized in the ICU. As regards the study hypotheses, we accept the alternative hypothesis and reject the null hypothesis proposed at the start of this research, where the number of gaps in knowledge and behavior increases the incidence of urinary tract infection. / Estudo descritivo, de abordagem quantitativa e observacional n?o participante, que teve como objetivo geral analisar a associa??o do conhecimento e conduta de inser??o e manuten??o da sonda vesical de demora pelos profissionais de enfermagem na ocorr?ncia de infec??o do trato urin?rio, realizado na UTI do Hospital Universit?rio Onofre Lopes em Natal/RN. A amostra pesquisada foi composta por 42 profissionais da equipe de enfermagem, sendo cinco (5) enfermeiros e 37 t?cnicos de enfermagem, deles 27 eram terceirizados (FUNPEC e bolsistas do IEL) e 10 servidores da UFRN. A coleta de dados foi realizada atrav?s de dois instrumentos, o primeiro utilizado na observa??o procedimentos de inser??o e de manipula??o da Sonda Vesical de Demora (SVD) e o segundo, com a aplica??o de um question?rio que abordou dados de caracteriza??o dos pesquisados, conhecimentos e conduta na inser??o e manipula??o da SVD. Os resultados foram tabulados no Excel e analisados atrav?s do programa estat?stico SPSS, vers?o 15.0. Encontramos a predomin?ncia de funcion?rios com v?nculo institucional terceirizado IEL e FUNPEC - (64,3%), do sexo feminino (69,0%), na faixa et?ria de 21 a 35 anos (59,5%) e com n?vel m?dio de escolaridade (88,1%). Quanto aos conhecimentos, verificamos que os enfermeiros apresentaram n?vel de bom a ?timo e os t?cnicos de enfermagem, de regular a ruim. Os enfermeiros erraram mais na escolha da SVD (40,0%) e na lavagem das m?os (30,0%) e os t?cnicos, na lavagem das m?os (74,4%) e no conte?do da bandeja (34,7%). Em rela??o ?s condutas de inser??o da SVD, os enfermeiros erraram mais na escolha da SVD (66,7%) e na lavagem das m?os (57,1%). Em rela??o ? manipula??o da SVD/sistema de drenagem, os t?cnicos erraram mais ao lavar as m?os (56,0%). Ao analisarmos as condutas inadequadas com a categoriza??o do conhecimento, vimos que os t?cnicos de enfermagem que erraram mais apresentaram conhecimentos inadequados (ρ = 0,001). Ao final, vimos que o risco de um paciente adquirir ITU est? maior em duas vezes e meia quando ocorre um n?mero grande de inadequa??es, paciente passa mais tempo usando a SVD e internado na UTI. Quanto ?s hip?teses do estudo, aceitamos a Hip?tese alternativa e rejeitamos a hip?tese nula proposta no in?cio desta pesquisa, onde a quantidade de inadequa??es no conhecimento e conduta aumenta a ocorr?ncia de infec??o do trato urin?rio.

Made available in DSpace on 2014-12-17T14:47:00Z (GMT). No. of bitstreams: 1 LiviaSCB_DISSERT.pdf: 1773815 bytes, checksum: b1a18f6fd70697b2b1ff4d4416245742 (MD5) Previous issue date: 2013-02-21 / That study had the aim to validate an instrument to evaluate the knowledge about the Urinary Catheterization (UC) in males. Cross-sectional, descriptive, quantitative and methodological study, accomplished in Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) and a private university from Rio Grande do Norte. Sample of 27 judges selected from the inclusion criteria: registered nurses, discipline of semiology and/or semiotics teachers, with at least 1 year of experience in the disciplines, to work at UFRN, UERN or in private university and agree to participate voluntarily with the signing of the Consent Form. Study developed in three stages: a) elaboration of twos instruments based on the scientific literature, resulting in a structured observation script type checklist consisting of 36 items and a knowledge questionnaire with 12 questions; b) submission of instruments to judges from June to September 2012, which should evaluate each item in "adequate," "adequate with changes" and "inappropriate", and make an overall evaluation of each instrument based on 10 requirements; c) and validation with a verification of the agreement level among the judges, through the application of Kappa Index (K) and Content Validity Index (CVI). It was used the consensus level higher than 0.60 (good) for Kappa Index and higher than 0.70 for CVI. The research project had favorable opinion from the Ethics in Research/HUOL (CAAE n. 0002.0.294.000-10). After being coded and tabulated, the data were analyzed using descriptive statistics. Of the 27 judges who evaluated the instrument, 77.8% are female, with a mean age of 36.6 (? 9.0) years, 63.0% worked in UFRN, 74.1% had master degree and 63.0% worked exclusively on teaching. The experience time mean in teaching was 7.9 (? 8.0) years and in the disciplines of semiology and/or semiotics in nursing was 5.5 (? 6.7) years. In judgment of the checklist and knowledge questionnaire, no step/question was considered inappropriate, since all achieved level of agreement within the established values. All the checklist steps obtained good to excellent K (between 0.60 and 1.00). Of the 36 items, 25 had excellent K (0.75 &#8804; K <1.00) and excellent total K (K = 0.83). Regarding the IVC, all steps reached levels above 0.70 (between 0.74 and 1.00) and CVI total was 0.90. All questionnaire questions evaluated separately (K from 0.60 to 0.93 and CVI from 0.74 to 0.96) and generally (K from 0.79 to 1.00 and CVI from 0.89 to 1.00) had evaluation levels of content validity within the established values. The instruments were reformulated based on the agreement levels between judges and international guidelines, dissertations and scientific articles. Both instruments proved to be valid regarding to their content, allowing a clear and objective evaluation of knowledge and skills about UC, both nursing students as well as other students and health professionals, since the use of valid measures seeking the reduction of the risk of the results distorted / Este estudo teve como objetivo validar instrumentos para avalia??o da habilidade e do conhecimento acerca da sondagem vesical de demora (SVD). Estudo transversal, descritivo, quantitativo e metodol?gico realizado na Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) e em uma universidade privada do Rio Grande do Norte. Amostra composta por 27 ju?zes selecionados a partir dos crit?rios de inclus?o: enfermeiros, docentes da disciplina de Semiologia e/ou Semiot?cnica, com m?nimo de um ano de experi?ncia nas disciplinas, ser da UFRN, UERN ou da universidade privada do estado e aceitar participar voluntariamente assinando o Termo de Consentimento Livre Esclarecido. A pesquisa foi desenvolvida em tr?s etapas: a) constru??o de dois instrumentos com base na literatura cient?fica, resultando em um roteiro de observa??o estruturado tipo checklist composto por 36 itens e um question?rio do conhecimento com 12 quest?es; b) submiss?o dos instrumentos aos ju?zes, no per?odo de junho a setembro de 2012, os quais deveriam avaliar cada item em adequado , adequado com altera??es e inadequado , al?m de fazer uma avalia??o geral de cada instrumento baseada em 10 requisitos; c) e valida??o com a verifica??o do n?vel de concord?ncia entre os ju?zes, atrav?s da aplica??o do ?ndice Kappa (K) e do ?ndice de Validade de conte?do (IVC). Utilizou-se o n?vel de consenso maior que 0,60 (bom) para o ?ndice Kappa e maior que 0,70 para o IVC. O projeto de pesquisa obteve parecer favor?vel do Comit? de ?tica em Pesquisa/HUOL (CAAE n? 0002.0.294.000-10). Ap?s serem codificados e tabulados, os dados foram analisados por meio de estat?stica descritiva. Dos 27 ju?zes que avaliaram o instrumento, 77,8% eram do sexo feminino, com m?dia de idade de 36,6 (? 9,0) anos, 63,0% atuavam na UFRN, 74,1% possu?am mestrado acad?mico e 63,0% atuavam exclusivamente na doc?ncia. A m?dia de tempo de experi?ncia na doc?ncia foi de 7,9 (? 8,0) anos e nas disciplinas de semiologia e/ou semiot?cnica da enfermagem foi de 5,5 (? 6,7) anos. No julgamento do checklist e question?rio do conhecimento, nenhuma etapa/quest?o foi considerada inadequada, uma vez que todas obtiveram n?vel de concord?ncia dentro dos ?ndices estabelecidos. Todas as etapas do checklist obtiveram K de bom a excelente (entre 0,60 e 1,00). Dos 36 itens, 25 tiveram K excelente (0,75 &#8804; K < 1,00) e K total excelente (K = 0,83). Em rela??o ao IVC, todas as etapas atingiram n?veis acima de 0,70 (entre 0,74 e 1,00) e o IVC total foi de 0,90. Todas as quest?es do question?rio avaliadas separadamente (K de 0,60 a 0,93 e IVC de 0,74 a 0,96) e de forma geral (K de 0,79 a 1,00 e IVC de 0,89 a 1,00) obtiveram n?veis de avalia??o da validade de conte?do dentro dos valores estabelecidos. Os instrumentos foram reformulados baseando-se nos n?veis de concord?ncia entre os ju?zes e em diretrizes internacionais, disserta??es e artigos cient?ficos. Os dois instrumentos mostraram-se v?lidos quanto ao seu conte?do, permitindo avalia??o objetiva e clara dos conhecimentos e habilidades acerca SVD, seja dos graduandos de enfermagem como tamb?m de outros estudantes e profissionais da sa?de, uma vez que a utiliza??o de medidas v?lidas busca a redu??o do risco de distor??o dos resultados

Made available in DSpace on 2014-12-17T14:13:36Z (GMT). No. of bitstreams: 1 SilviaRS_TESE.pdf: 1377136 bytes, checksum: 8255e0cbf50a79a12b6f6b0f3965241e (MD5) Previous issue date: 2010-10-08 / Lithiasis is considered a public health issue due to its high prevalence and rates of recurrence. Objective: To identify risk factors for lithiasis in kidney stone patients from Fortaleza, Brazil. In the first stage of the study, the medical records of 197 patients with urinary lithiasis covering the period 1996 2006 were analyzed with regard to clinical and metabolic data. In the second stage, 340 kidney stones were submitted to morphological examination under 10x magnification. According to the external morphology and the cut surface, the stones were classified as pure or mixed, and major and minor components were identified. In addition, the stone fragments of 25 patients treated with lithotripsy were submitted to morphological analysis. In the third stage, a subsample of 50 stones was used in a double-blind comparison of morphological and chemical findings. Results were expressed as concordant, partly concordant (discordant for minor components) or discordant (discordant for major components). The average age of first symptoms was 35.8?13.3 years, with no significant difference between the genders. The male/female ratio was 1:1.7. Recurrence was reported in 53.3% of cases. The main metabolic changes observed were hypernatriuria (80.7%), hypercalciuria (48.7%), low urine volume (43.7%), hyperoxaluria (30.5%) and hyperuricosuria (17.3%). Pure stones represented 34.7% of the total sample of 340 stones. The most common route of elimination was spontaneous for pure stones (49.1%) and surgical for mixed stones (50.5%). Pure stones consisted most frequently of calcium oxalate (OxCa) (59.3%) and uric acid (UA) (23.7%), the former prevalent in women, the latter prevalent in men. The most frequently observed component in mixed stones was OxCa (67.1%), followed by carbapatite (11.2%) and struvite (7.9%). The main components were OxCa and UA for men, and carbapatite and struvite for women. Nearly half (48%) the 25 analyzed fragments were pure, consisting of calcium oxalate dihydrate (COD) (56%), calcium oxalate monohydrate (COM) (48%), phosphate (32%) and UA (20%). Four patients (16%) had infectious stones. In the chemical analysis of the subsample of 50 stones, the most 64 frequently observed major components were calcium (70%), oxalate (66%), ammonium (56%), urate (28%) and carbonate (24%). In the morphological analysis, the main components were calcium and magnesium phosphate (32%), COM (24%), UA (20%), COD (18%) and cystine (6%). Morphological and chemical findings were totally concordant for 38% of the stones, partly concordant in 52% and discordant in 10%. Conclusion: The risk factors for lithiasis in kidney stone patients from Fortaleza (Brazil) were hyperoxaluria, hypercalciuria with or without hypernatriuria, hyperuricosuria and low urine volume / A lit?ase urin?ria ? um problema de sa?de p?blica pela elevada preval?ncia e recorr?ncia. Objetivo: O objetivo do presente estudo foi determinar os fatores litog?nicos em pacientes com lit?ase urin?ria de Fortaleza, Cear?. O estudo foi dividido em tr?s fases: na primeira, realizouse estudo documental de prontu?rios de 197 pacientes com lit?ase urin?ria atendidos entre 1996 e 2006, para a an?lise de dados cl?nicos e avalia??o metab?lica. Na segunda fase foi realizada uma avalia??o morfol?gica de 340 c?lculos urin?rios, classificando-os como puro ou misto e os componentes em majorit?rios ou minorit?rios. Foi tamb?m avaliado fragmentos de c?lculos de 25 pacientes tratados com litotripsia. Na terceira fase utilizou-se uma amostra de 50 c?lculos para um estudo duplo-cego comparando a an?lise morfol?gica e a an?lise qu?mica. Os resultados foram considerados como concordantes, parcialmente concordantes (componentes minorit?rios discordantes) ou discordantes (componentes majorit?rios discordantes). A m?dia de idade dos 197 pacientes no primeiro sintoma foi 35,8 ? 13,3 anos, n?o houve diferen?a entre os g?neros. A rela??o homem:mulher foi de 1:1,7, 53,3% eram recorrentes. As principais altera??es metab?licas foram hipernatri?ria (80,7%), hipercalci?ria (48,7%), volume urin?rio baixo (43,7%), hiperoxal?ria (30,5%) e hiperuricos?ria (17,3%). Entre os 340 c?lculos analisados, 34,7% foram puros. A via de elimina??o mais comum dos c?lculos puros foi a espont?nea (49,1%) e a dos mistos foi a cir?rgica (50,5%). Os c?lculos mais freq?entes foram o oxalato de c?lcio (OxCa=59,3%) e ?cido ?rico (AU=23,7%), sendo o primeiro mais comum nas mulheres e o segundo nos homens. Entre os c?lculos mistos, o OxCa foi o principal componente (67,1%), seguido da carbapatita (11,2%) e estruvita (7,9%). Os principais componentes nos homens foram o OxCa e AU, enquanto que nas mulheres foram a carbapatita e estruvita. Entre os 25 fragmentos de c?lculos analisados, 48% foram puros. Os componentes encontrados foram: OxCa dihidratado-COD (56%), OxCa monohidratado-COM (48%), fosfato (32%), AU (20%). Quatro pacientes (16%) apresentaram c?lculo de infec??o. Na an?lise qu?mica dos 50 c?lculos urin?rios os principais componentes majorit?rios foram c?lcio (70%), xvi oxalato (66%), am?nio (56%), urato (28%) e carbonato (24%), enquanto que na morfol?gica foram fosfato de c?lcio e magnesiano (32%), COM (24%), AU (20%), COD (18%) e cistina (6%). Concord?ncia total foi observada em 38%, parcial em 52% e discord?ncia em 10%. Conclus?o: Os fatores de risco litog?nicos na regi?o de Fortaleza foram hiperoxal?ria, hipercalci?ria com ou sem hipernatri?ria, hiperuricos?ria e volume urin?rio reduzido

Made available in DSpace on 2014-12-17T14:13:49Z (GMT). No. of bitstreams: 1 MariaTABCM_DISSERT.pdf: 247939 bytes, checksum: cb096019e991f8f3059823ed5c01ce36 (MD5) Previous issue date: 2010-10-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Stress urinary incontinence (SUI) is defined as "involuntary loss of urine" due to several processes that alter the ability of the bladder to hold urine properly, regarded as a social and hygienic problem that adversely affects quality of life. In postmenopausal women, IU is associated with atrophy and weakness of the pelvic floor muscles. The objective this study was investigate, using the onehour pad test, stress urinary leakage (SUI), evaluate and compare their results in postmenopausal and premenopausal women. The survey was characterized as a cross-sectional study. The study consisted of 60 postmenopausal women were divided into GIU - consisting of 34 volunteers complaining of involuntary loss of urine during stress - and GSIU - consisting of 26 volunteers without complaints of loss of urine during stress, and 15 women, during the premenopausal (GPM), and ovulatory with normal menstrual cycle. All volunteers were evaluated clinically, subjected to one-hour pad test, after the biochemical evaluation of blood and sex hormones. Statistical analysis was performed by descriptive analysis, ANOVA, Turkey?s post-test and Pearson correlation. The results showed that 100% of postmenopausal patients had involuntary loss of urine during one hour pad test (GIU: 4.0 g; GSIU: 4.5 g). GPM remained continent after an hour pad test (GPM: 0.4 g). In addition, Pearson showed a strong correlation between urine loss with time since menopause (r = 0.8, p <0.01) and body mass index - BMI (r = 0.7; p = 0.01). These data suggest that the one-hour pad test is a useful test to assess and quantify urinary leakage, including those volunteers who had no previous complaint of SUI / A incontin?ncia urin?ria (IU) ? definida como perda involunt?ria de urina decorrente de diversos processos que alteram a capacidade da bexiga de reter a urina adequadamente. A IU surge com o avan?ar da idade e m mulheres na p?s-menopausa, seu aparecimento associa-se a atrofia e a fraqueza da musculatura do assoalho p?lvico. O objetivo deste estudo foi investigar, com o uso do pad test de uma hora, as perdas urin?rias aos esfor?os (IUE), avaliar e comparar seus resultados em mulheres na p?s-menopausa e na pr?menopausa. A pesquisa foi caracterizada como um estudo transversal. O estudo foi composto por 60 mulheres na p?s-menopausa, divididas em GIU constitu?do por 34 volunt?rias com queixa de perda involunt?ria de urina aos esfor?os e GSIU constitu?do por 26 volunt?rias sem queixa de perda de urina aos esfor?os, e 15 mulheres, no per?odo da pr?-menopausa (GPM), ovulat?rias e com ciclo menstrual normal. Todas as volunt?rias foram avaliadas clinicamente, submetidas ao pad test de uma hora, ap?s avalia??o bioqu?mica do sangue e dos horm?nios sexuais. A estat?stica foi feita atrav?s da an?lise descritiva, o teste param?trico ANOVA, o p?s-teste de Turkey e a correla??o de Pearson. Os resultados mostraram que 100% das pacientes na p?smenopausa apresentaram perda involunt?ria de urina durante o pad test de uma hora (GIU:4,0g; GSIU:4,5g). O GPM manteve-se continente ap?s o pad test de uma hora (GPM:0,4g). Al?m disso, a correla??o de Pearson mostrou um forte rela??o entre as perdas de urina com o tempo de menopausa (r=0,8;p<0,01) e com o ?ndice de massa corporal IMC (r=0,7;p=0,01). Os dados obtidos sugerem que o pad test de uma hora ? um exame ?til para avaliar e quantificar as perdas urin?rias, inclusive daquelas volunt?rias que n?o apresentavam queixa pr?via de IUE