Efeitos adversos a medicamentos em hospital público: estudo piloto

The results from implementing a strategy for monitoring adverse effects from drugs in a public hospital in the municipality of Rio de Janeiro, Southeastern Brazil, in 2007, were analyzed. Based on retrospective analysis of 32 medical files, adverse effects were found in 16%. To identify these effects, 38 tracking criteria were needed. Among these, the main ones were the use of antiemetics, abrupt cessation of medication and over-sedation. Despite the difficulties, especially in relation to access to information and the record quality, application of these tracking criteria seems to be viable. To improve the implementation of the method, it is suggested that the data collection should be computerized and risk adjustment indicators should be sought.Fueron analizados los resultados de la implantación de estrategia de monitoreo de efectos adversos a los medicamentos en hospital público en Rio de Janeiro, Sureste de Brasil, en 2007. Con base en análisis retrospectivo de 32 prontuarios fueron encontrados efectos adversos en 16%. Para identificarlos, fueron necesarios 38 criterios rastreadores, de los cuales los principales fueron: uso de antieméticos, interrupción abrupta de medicamentos y sedación excesiva. A pesar de las dificultades, sobre todo relacionadas con el acceso a las informaciones y a la calidad de los registros, la aplicación de los criterios rastreadores parece ser viable. Para perfeccionar la implantación del método, se sugiere informatizar la colecta de datos y buscar indicadores de ajuste del riesgo.Foram analisados os resultados da implantação de estratégia de monitoramento de efeitos adversos aos medicamentos em hospital público no Rio de Janeiro, RJ, em 2007. Com base em análise retrospectiva de 32 prontuários foram encontrados efeitos adversos em 16%. Para identificá-los, foram precisos 38 critérios rastreadores, dos quais os principais foram: uso de antieméticos, interrupção abrupta de medicamentos e sedação excessiva. Apesar das dificuldades, sobretudo relacionadas ao acesso às informações e à qualidade dos registros, a aplicação dos critérios rastreadores parece ser viável. Para aprimorar a implantação do método, sugere-se informatizar a coleta de informações e buscar indicadores de ajuste de risco

Prediction of the Occurrence of Lameness in Dairy Cows using a Fuzzy-Logic Based Expert System. - Part I

Rosana G. Moreira, Editor-in-Chief; Texas A&M UniversityThis is a paper from International Commission of Agricultural Engineering (CIGR, Commission Internationale du Genie Rural) E-Journal Volume 7 (2005): Prediction of the Occurrence of Lameness in Dairy Cows using a Fuzzy-Logic Based Expert System. ? Part I by Carvalho, V., I. A. Naas, Mollo, M., and V. Massafera Jr

Dairy Cattle Linear and Angular Kinematics during the Stance Phase

Rosana G. Moreira, Editor-in-Chief; Texas A&M UniversityThis is a paper from International Commission of Agricultural Engineering (CIGR, Commission Internationale du Genie Rural) E-Journal Volume 9 (2007): Dairy Cattle Linear and Angular Kinematics during the Stance Phase. Manuscript BC 06 006. Vol. IX. June, 2007

Assessment Of Dairy Cattle Carbohydrate Feeding Limitations For A Lameness Preventive Diagnosis Expert System Input

Claw lameness in dairy cows can be triggered by biomechanical factors caused by imbalances of the pressure distribution under the hooves when cows are confined in dairy operations with hard concrete flooring. Clinically, the earliest diagnosis of claw lameness is only possible by visually observing faulty locomotion. Unfortunately, the earliest pathological gait signs are characteristics of mild to severe degrees of lameness requiring veterinary intervention and causing economic losses. The results obtained, using a plantar pressure measurement system, yielded a preliminary database on claw pressure distribution, which correlated to claw length and nutritional factors (carbohydrate and fiber available for digestion) formed a preliminary knowledge base used in a Fuzzy Inference System (IRISK) for providing a method to help prevent claw lameness. In order to create the system's UI (IRISK's user interface) nutritional carbohydrate and fiber concentrations, provided by farm mixed and commercial premixed rations, had to be translated mathematically in terms of total rumen available NDF and NFC (Neutral Detergent Fiber and Non Fibrous Carbohydrate respectively) levels. A program was coded in Visual Basic, containing calculations of total DMI (dry matter intake) and accounted for live weight of the cows, lactation phase, production and environmental temperature. The total DMI was then used together with nutrition facts from raw ingredients from farm mixed rations to calculate the total rumen available levels of NDF and NFC. The First module (IRISK) uses the NDF and NFC obtained and together with claw dimensions estimates the total risk level of developing claw lesions.288293Amendola, M., Castanho, M.J., Nääs, I.A., Souza, A.L., Análise Matemática de Condições de Conforto Térmico para Avicultura Usando a Teoria dos Conjuntos Fuzzy. (2004) Biomatemática, 14, pp. 87-92Carvalho, V.R.C., Bucklin, R.A., Shearer, J.K., Shearer, L., 2005(a). Effects of Trimming on Dairy Cattle Hoof Weight Bearing and Pressure Distributions during the Stance Phase Transactions of the ASAE, 48 (4), pp. 1653-1659. , St. Joseph, MI, vCarvalho, V. R. CI. A. NääsM. Mollo NetoV. Massafera Jr. 2005(b). Prediction of Lameness Occurrences in Dairy Cows using a Fuzzy-Logic Based Expert's System. - Part I. International Commission of Agricultural Engineering, Bonn - Germany, v. 7, p. 1-15Nutrient Requirement of Dairy Cattle National Academic Press, W. DC. 381 p. 2001, , NRC, National Research Concil, seventh revised editionRaven, E.T., (1989) Cattle Foot Care and Claw Trimming, pp. 19-33. , Farming Press, UKStone, W.C., Nutritional Approaches to Minimize Subacute Ruminal Acidoses and Laminitis in Dairy Cattle (2004) J. Dairy Sci, 87 (E. SUPPL.), pp. E13-E26Warren, J., Beliakov, G, Van der Zwaag, B. 2000. Fuzzy Logic in Clinical Practice Decision Support Systems. In Proc. of the 33rdHawaii International Conference on System Sciences. IEEE0-7695-0493- 0/0

Effects Of Trimming On Dairy Cattle Hoof Weight Bearing Surfaces And Pressure Distributions [efeito Do Casqueamento Na Distribuição De Pressões E Suporte De Peso Na Superfície Dos Cascos De Vacas Leiteiras]

Claw lameness can be associated to biomechanical factors caused by unbalanced pressure distribution under the hooves when cows are confined in modern dairy operations with hard concrete flooring. In the present study, an original claw subdivision 4 was slightly modified to differentiate between the anterior (typical sole lesion spot) and posterior portions of the medial sole, and to emphasize the maximum pressures applied only on the area of contact without including the total area within these regions during midstance. The results, obtained showed significance (p < 0.044) for the interaction among Group, Leg and region (G*L*R). It was observed that the rear portion of the claws (heels) on the hind limb of untrimmed cows, are more stressed than the heel region on trimmed cows (23 % versus 16.72% of total pressure applied on the claw for untrimmed and trimmed respectively). The typical sole lesion spot pressures were increased slightly on trimmed cows as compared to untrimmed (20.20% versus 15.9%). The front feet presented differences in pressure concentration on the lateral sole between both groups (29% versus 23.25% for untrimmed versus trimmed respectively). It was concluded that, although the differences were small (5%) changes in pressure concentration, untrimmed cows stress more the sole lateral as compared to trimmed on the front feet, and on the rear feet, they stress more the heel region whereas trimmed cows tend to have a slight better balance among regions. Conversely, when cows are trimmed, the typical sole lesion spot concentrates more pressure than the heel itself (20.20% versus 16.72% respectively) and may favor the occurrence of sole ulcers.434518525Raven, E.T., (1989) Cattle foot care and claw trimming, pp. 19-33. , Ipswich, UK: Farming PressShearer, J.K., Van Amstel, S.R., (2000) Manual for the master hoof care technician program, pp. 6-14. , University of Florida-Gainesville, FL: Department of Large Animal Clinical Sciences-College of Veterinary MedicineShearer, J.K., (2003) Large animal clinical sciences, , Veterinary Medicine School, University of Florida. Gainesville, FL, personal communicationCarvalho, V.R.C., (2004) Effects of trimming on dairy cattle hoof weight bearing surfaces and pressure distributions during the stance phase, , Tese (Doutorado)-University of Florida, Gainesville, FL, 2004Manske, T., Hultgren, J., Bergsten, C., The effect of claw trimming on the hoof health of swedish dairy cattle (2002) Preventive Veterinary Medicine, 54, pp. 113-12

Efeitos adversos a medicamentos em hospital público: estudo piloto Efectos adversos a medicamentos en hospital público: estudio piloto Adverse effects from drugs in a public hospital: pilot study

Foram analisados os resultados da implantação de estratégia de monitoramento de efeitos adversos aos medicamentos em hospital público no Rio de Janeiro, RJ, em 2007. Com base em análise retrospectiva de 32 prontuários foram encontrados efeitos adversos em 16%. Para identificá-los, foram precisos 38 critérios rastreadores, dos quais os principais foram: uso de antieméticos, interrupção abrupta de medicamentos e sedação excessiva. Apesar das dificuldades, sobretudo relacionadas ao acesso às informações e à qualidade dos registros, a aplicação dos critérios rastreadores parece ser viável. Para aprimorar a implantação do método, sugere-se informatizar a coleta de informações e buscar indicadores de ajuste de risco.<br>Fueron analizados los resultados de la implantación de estrategia de monitoreo de efectos adversos a los medicamentos en hospital público en Rio de Janeiro, Sureste de Brasil, en 2007. Con base en análisis retrospectivo de 32 prontuarios fueron encontrados efectos adversos en 16%. Para identificarlos, fueron necesarios 38 criterios rastreadores, de los cuales los principales fueron: uso de antieméticos, interrupción abrupta de medicamentos y sedación excesiva. A pesar de las dificultades, sobre todo relacionadas con el acceso a las informaciones y a la calidad de los registros, la aplicación de los criterios rastreadores parece ser viable. Para perfeccionar la implantación del método, se sugiere informatizar la colecta de datos y buscar indicadores de ajuste del riesgo.<br>The results from implementing a strategy for monitoring adverse effects from drugs in a public hospital in the municipality of Rio de Janeiro, Southeastern Brazil, in 2007, were analyzed. Based on retrospective analysis of 32 medical files, adverse effects were found in 16%. To identify these effects, 38 tracking criteria were needed. Among these, the main ones were the use of antiemetics, abrupt cessation of medication and over-sedation. Despite the difficulties, especially in relation to access to information and the record quality, application of these tracking criteria seems to be viable. To improve the implementation of the method, it is suggested that the data collection should be computerized and risk adjustment indicators should be sought