RESUMO
OBJECTIVE: To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients. METHODS: The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods. RESULTS: Hyponatremia was present in 63.33% of the patients, particularly on the first postoperative day. Natriuresis was present in 93.33% of the patients, particularly on the second postoperative day. Plasma atrial natriuretic factor was increased in 92.60% of the patients in at least one of the postoperative days; however, there was no statistically significant association between the atrial natriuretic factor and plasma sodium and between the atrial natriuretic factor and urinary sodium. CONCLUSION: Hyponatremia and natriuresis were present in most patients after neurosurgery; however, the atrial natriuretic factor cannot be considered to be directly responsible for these alterations in neurosurgery patients. Other natriuretic factors are likely to be involved.
Assuntos
Fator Natriurético Atrial/sangue , Hiponatremia/epidemiologia , Natriurese/fisiologia , Procedimentos Neurocirúrgicos/métodos , Adulto , Neoplasias Encefálicas/cirurgia , Feminino , Humanos , Aneurisma Intracraniano/cirurgia , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Período Pré-Operatório , Estudos Prospectivos , Sódio/urinaRESUMO
RESUMO Objetivo: Avaliar a presença de hiponatremia e natriurese, bem como suas associações com o fator natriurético atrial em pacientes de neurocirurgia. Métodos: Foram incluídos 30 pacientes submetidos à ressecção de tumor intracraniano e à clipagem de aneurisma cerebral. Os níveis plasmáticos e urinários de fator natriurético atrial foram medidos durante os períodos pré e pós-operatório. Resultados: Hiponatremia esteve presente em 63,33% dos pacientes, particularmente no primeiro dia pós-operatório. Observou-se natriurese em 93,33% dos pacientes, principalmente no segundo dia pós-operatório. Os níveis plasmáticos de fator natriurético atrial estavam aumentados em 92,60% dos pacientes em pelo menos um dos dias pós-operatórios, mas não houve associação estatisticamente significante entre fator natriurético atrial e sódio plasmático, e entre fator natriurético atrial e sódio urinário. Conclusão: Após neurocirurgia, na maior parte dos pacientes, estiveram presentes hiponatremia e natriurese; contudo, o fator natriurético atrial não pôde ser considerado diretamente responsável por tais alterações nos pacientes neurocirúrgicos. Provavelmente, há o envolvimento de outros fatores natriuréticos.
ABSTRACT Objective: To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients. Methods: The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods. Results: Hyponatremia was present in 63.33% of the patients, particularly on the first postoperative day. Natriuresis was present in 93.33% of the patients, particularly on the second postoperative day. Plasma atrial natriuretic factor was increased in 92.60% of the patients in at least one of the postoperative days; however, there was no statistically significant association between the atrial natriuretic factor and plasma sodium and between the atrial natriuretic factor and urinary sodium. Conclusion: Hyponatremia and natriuresis were present in most patients after neurosurgery; however, the atrial natriuretic factor cannot be considered to be directly responsible for these alterations in neurosurgery patients. Other natriuretic factors are likely to be involved.
Assuntos
Humanos , Masculino , Feminino , Adulto , Fator Natriurético Atrial/sangue , Procedimentos Neurocirúrgicos/métodos , Hiponatremia/epidemiologia , Natriurese/fisiologia , Período Pós-Operatório , Sódio/urina , Neoplasias Encefálicas/cirurgia , Aneurisma Intracraniano/cirurgia , Estudos Prospectivos , Período Pré-Operatório , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To characterize the profile of effective organ and tissue donors and to understand which organs and tissues were donated for transplantation. METHODS: This was a quantitative, descriptive, exploratory, retrospective study that analyzed clinical data from 305 donors between January 2006 to December 2010. The data were then analyzed using descriptive analyses, generating frequency tables, measures of position (mean, minimum and maximum) and measures of dispersion (standard deviation) for data that was social and clinical in nature. RESULTS: There was an overall predominance of white (72%) and male (55%) individuals between the ages of 41 and 60 years (44%). The primary cause of brain death was cerebrovascular accident (55%). In the patient history, 31% of the patients were classified as overweight, 27% as hypertensive and only 4.3% as having diabetes mellitus. Vasoactive drugs were used in 92.7% of the donors, and the main drug of choice was noradrenaline (81.6%). Hyperglycemia and hypernatremia were diagnosed in 78% and 71% of the donors, respectively. CONCLUSION: Significant hemodynamic changes were found, and the results indicate that the use of vasoactive drugs was the main strategy used to control these changes. Furthermore, most donors presented with hyperglycemia and hypernatremia, which were frequently reported in association with brain death. The persistent nature of these findings suggests that the organ donors were inadequately maintained.
Assuntos
Morte Encefálica , Hiperglicemia/epidemiologia , Hipernatremia/epidemiologia , Doadores de Tecidos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto JovemRESUMO
Objetivo: Caracterizar o perfil dos doadores efetivos de órgãos e tecidos além de conhecer quais órgãos e tecidos foram doados para transplantes. Métodos: Estudo quantitativo, descritivo, exploratório e retrospectivo, analisando-se os dados de prontuários de 305 doadores, entre janeiro de 2006 a dezembro de 2010, os quais foram submetidos à análise descritiva com confecção de tabelas de frequência, medidas de posição (média, mínimo e máximo) e dispersão (desvio-padrão) para os dados de caráter social e clínico. Resultados: Houve predomínio de indivíduos brancos (72%), do gênero masculino (55%), idade entre 41 e 60 anos (44%), sendo a principal causa de morte encefálica o acidente vascular encefálico (55%). Quanto aos antecedentes, 31% foram classificados na categoria de sobrepeso, seguidos de hipertensão arterial sistêmica (27%) e o diabetes mellitus encontrado em apenas 4,3% dos doadores. O uso de drogas vasoativas esteve presente em 92,7% dos doadores, e a principal droga utilizada foi a noradrenalina (81,6%). A hiperglicemia e a hipernatremia foram encontradas em 78% e em 71% dos doadores, respectivamente. Conclusão: Foram encontradas importantes alterações hemodinâmicas, e os resultados mostram o uso de drogas vasoativas como a principal estratégia para seu controle. Ademais, a maioria dos doadores apresentou hiperglicemia e hipernatremia, achados frequentes no quadro de morte encefálica, e que, por sua persistência, sugerem manutenção inadequada do doador de órgãos. .
Objective: To characterize the profile of effective organ and tissue donors and to understand which organs and tissues were donated for transplantation. Methods: This was a quantitative, descriptive, exploratory, retrospective study that analyzed clinical data from 305 donors between January 2006 to December 2010. The data were then analyzed using descriptive analyses, generating frequency tables, measures of position (mean, minimum and maximum) and measures of dispersion (standard deviation) for data that was social and clinical in nature. Results: There was an overall predominance of white (72%) and male (55%) individuals between the ages of 41 and 60 years (44%). The primary cause of brain death was cerebrovascular accident (55%). In the patient history, 31% of the patients were classified as overweight, 27% as hypertensive and only 4.3% as having diabetes mellitus. Vasoactive drugs were used in 92.7% of the donors, and the main drug of choice was noradrenaline (81.6%). Hyperglycemia and hypernatremia were diagnosed in 78% and 71% of the donors, respectively. Conclusion: Significant hemodynamic changes were found, and the results indicate that the use of vasoactive drugs was the main strategy used to control these changes. Furthermore, most donors presented with hyperglycemia and hypernatremia, which were frequently reported in association with brain death. The persistent nature of these findings suggests that the organ donors were inadequately maintained. .
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Morte Encefálica , Hiperglicemia/epidemiologia , Hipernatremia/epidemiologia , Doadores de Tecidos/estatística & dados numéricos , Causas de Morte , Estudos Retrospectivos , Obtenção de Tecidos e Órgãos/estatística & dados numéricosRESUMO
BACKGROUND: Dermatophytes represent a group of keratinophilic fungi capable of invading the superficial layer of the skin, hair, and nails of humans and animals. There is a high prevalence of dermatomycosis in tropical regions, and military personnel are susceptible to this kind of infection due to the type of occupational activities. OBJECTIVE: This study was to investigate dermatophytosis in military, in addition to predisposing factors to such infections. METHODS: The direct examination of the 221 samples obtained was conducted by preparing fresh slides, clarified with KOH. The clinical materials were seeded in duplicate in SDA and in Mycosel agar medium. The identification of the etiologic agents was performed according to the Riddell technique. RESULTS: 99/221 (44.8 %) of the dermatophyte infection agents distributed in the three taxonomic genera that cause Tinea were recovered. The Trichophyton genus was the most representative and T. rubrum species 33 (33.3 %), the most prevalent. The other species found were as follows: T. tonsurans 13 (13.1 %), T. verrucosum 11 (11.1 %), T. interdigitale 9 (9.1 %), and T. mentagrophytes 6 (6.1 %). Among the most affected anatomical sites were skin 83 (83.8 %) and nails 17 (17.2 %). CONCLUSIONS: Dermatophyte infections are common disorders in tropical countries. These infections lead to a variety of clinical manifestations. This study reports the incidence of dermatophytosis in the military personnel in the Central-West Region of Brazil. The occupational activities of the military individuals, in addition to the hot and humid climate of the region, can predispose them to infection by these fungal entities.
Assuntos
Arthrodermataceae/classificação , Tinha/epidemiologia , Tinha/microbiologia , Adolescente , Adulto , Arthrodermataceae/isolamento & purificação , Brasil/epidemiologia , Dermatoses do Pé/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Militares , Técnicas de Tipagem Micológica , Unhas/microbiologia , Infecções do Sistema Genital/microbiologia , Pele/microbiologia , Adulto JovemRESUMO
Despite advances related to the prevention and treatment in the past few years, many lives are lost to cardiac arrest and cardiovascular events in general in Brazil every year. Basic Life Support involves cardiovascular emergency treatment mainly in the pre-hospital environment, with emphasis on the early recognition and delivery of cardiopulmonary resuscitation maneuvers focused on high-quality thoracic compressions and rapid defibrillation by means of the implementation of public access-to-defibrillation programs. These aspects are of the utmost importance and may make the difference on the patient's outcomes, such as on hospital survival with no permanent neurological damage. Early initiation of the Advanced Cardiology Life Support also plays an essential role by keeping the quality of thoracic compressions; adequate airway management; specific treatment for the different arrest rhythms; defibrillation; and assessment and treatment of the possible causes during all the assistance. More recently, emphasis has been given to post-resuscitation care, with the purpose of reducing mortality by means of early recognition and treatment of the post-cardiac arrest syndrome. Therapeutic hypothermia has provided significant improvement of neurological damage and should be performed in comatose individuals post-cardiac arrest. For physicians working in the emergency department or intensive care unit, it is extremely important to improve the treatment given to these patients by means of specific training, thus giving them the chance of higher success and of better survival rates.
Assuntos
Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Adulto , Brasil , Desfibriladores , Serviços Médicos de Emergência , Humanos , Parada Cardíaca Extra-Hospitalar/terapia , Respiração Artificial/métodos , Taquicardia Ventricular/terapia , Fibrilação Ventricular/terapiaRESUMO
Apesar de avanços nos últimos anos relacionados à prevenção e a tratamento, muitas são as vidas perdidas anualmente no Brasil relacionado à parada cardíaca e a eventos cardiovasculares em geral. O Suporte Básico de Vida envolve o atendimento às emergências cardiovasculares principalmente em ambiente pré-hospitalar, enfatizando reconhecimento e realização precoces das manobras de ressuscitação cardiopulmonar com foco na realização de compressões torácicas de boa qualidade, assim como na rápida desfibrilação, por meio da implementação dos programas de acesso público à desfibrilação. Esses aspectos são de fundamental importância e podem fazer diferença no desfecho dos casos como sobrevida hospitalar sem sequelas neurológicas. O início precoce do Suporte Avançado de Vida em Cardiologia também possui papel essencial, mantendo, durante todo o atendimento, a qualidade das compressões torácicas, adequado manejo da via aérea, tratamento específico dos diferentes ritmos de parada, desfibrilação, avaliação e tratamento das possíveis causas. Mais recentemente dá-se ênfase a cuidados pós-ressuscitação, visando reduzir a mortalidade por meio do reconhecimento precoce e tratamento da síndrome pós-parada cardíaca. A hipotermia terapêutica tem demonstrado melhora significativa da lesão neurológica e deve ser realizada em indivíduos comatosos pós-parada cardíaca. Para os médicos que trabalham na emergência ou unidade de terapia intensiva é de grande importância o aperfeiçoamento no tratamento desses pacientes por meio de treinamentos específicos, possibilitando maiores chances de sucesso e maior sobrevida.
Despite advances related to the prevention and treatment in the past few years, many lives are lost to cardiac arrest and cardiovascular events in general in Brazil every year. Basic Life Support involves cardiovascular emergency treatment mainly in the pre-hospital environment, with emphasis on the early recognition and delivery of cardiopulmonary resuscitation maneuvers focused on high-quality thoracic compressions and rapid defibrillation by means of the implementation of public access-to-defibrillation programs. These aspects are of the utmost importance and may make the difference on the patient's outcomes, such as on hospital survival with no permanent neurological damage. Early initiation of the Advanced Cardiology Life Support also plays an essential role by keeping the quality of thoracic compressions; adequate airway management; specific treatment for the different arrest rhythms; defibrillation; and assessment and treatment of the possible causes during all the assistance. More recently, emphasis has been given to post-resuscitation care, with the purpose of reducing mortality by means of early recognition and treatment of the post-cardiac arrest syndrome. Therapeutic hypothermia has provided significant improvement of neurological damage and should be performed in comatose individuals post-cardiac arrest. For physicians working in the emergency department or intensive care unit, it is extremely important to improve the treatment given to these patients by means of specific training, thus giving them the chance of higher success and of better survival rates.
Assuntos
Adulto , Humanos , Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Brasil , Desfibriladores , Serviços Médicos de Emergência , Parada Cardíaca Extra-Hospitalar/terapia , Respiração Artificial/métodos , Taquicardia Ventricular/terapia , Fibrilação Ventricular/terapiaRESUMO
The purpose of this study is to characterize native bee plants regarding their capacity to extract and accumulate trace elements from the soil and its consequences to the sanity of the produced pollen. The trace elements Cu, Mn, Pb and Zn were analyzed in soil, plants and bee pollen from Teresina region (PI), Brazil, by flame atomic absorption spectrophotometer. Considering the studied plant species, Cu and Pb metals presented in the highest levels in the roots of B. platypetala with 47.35 and 32.71 µg.mL(-1) and H. suaveolens with 39.69 and 17.06 µg.mL(-1), respectively, while in the aerial parts Mn and Zn metals presented the highest levels in S. verticillata with 199.18 and 85.73 µg.mL(-1). In the pollen, the levels of Cu, Mn, Pb and Zn vary from 5.44 to 11.75 µg.mL(-1); 34.31 to 85.75 µg.mL(-1); 13.98 to 18.19 µg.mL(-1) and 50.19 to 90.35 µg.mL(-1), respectively. These results indicate that in the apicultural pasture the translocation (from soil to pollen) of Mn and Zn was more effective than in case of Cu and Pb, therefore, the bee pollen can be used as food supplement without causing risks to human health.