A utilização do cateter central de inserção periférica (CCIP) no ambiente hospitalar

El estudio objetivó analizar el histórico de la utilización del catéter central de inserción periférica en pacientes adultos e internados en ambiente hospitalario de 2000 a 2007. Tuvo abordaje de cohorte histórico con recolección de datos retrospectivo en fichas del Grupo de Catéteres de la Asociación Hospitalaria Molinos de Viento en Porto Alegre, RS, totalizando 229 catéteres inseridos. La curva de crecimiento en la utilización del CCIP fue de 1 catéter inserido en 2000 a 57 inseridos en 2007. La prevalencia inherente a la patología fue oncológica (17,9%, n=41). En relación a las indicaciones de uso prevaleció la terapia con antibióticos (54,1%, n=124). En la confirmación radiológica la vena cava fue prevalente (68,1%, n=156). La utilización del CCIP en el ambiente hospitalario está en expansión y la enfermería tiene un papel fundamental en la inserción, manutención y remoción.O estudo objetivou analisar o histórico da utilização do cateter central de inserção periférica em pacientes adultos e internados, em ambiente hospitalar, de 2000 a 2007. Teve abordagem de coorte histórica, com coleta de dados retrospectiva em prontuários do Grupo de Cateteres da Associação Hospitalar Moinhos de Vento, em Porto Alegre, RS, totalizando 229 cateteres inseridos. A curva de crescimento na utilização do cateter central de inserção periférica (CCIP) foi de 1 cateter inserido em 2000 a 57 inseridos em 2007. A prevalência inerente à patologia foi a oncológica (17,9%, n=41). Em relação às indicações ao uso, prevaleceu a antibioticoterapia (54,1%, n=124). Na confirmação radiológica, a veia cava foi prevalente (68,1%, n=156). Pode-se concluir que a utilização do CCIP no ambiente hospitalar está em expansão e a enfermagem tem papel fundamental na inserção, manutenção e sua remoção.The study aimed to analyze the history of the use of the peripherally inserted central catheters in adult patients admitted to hospital from 2000 to 2007. The historical cohort approach was used with retrospective data collection from medical records of the Catheter Group of the Moinhos de Vento Hospital Association in Porto Alegre, RS, totaling 229 catheters inserted. The growth curve in the use of the PICC was from 1 catheter inserted in 2000 to 57 in 2007. The most prevalent pathology was oncology (17.9%, n=41). In relation to the indications of use, antibiotic use prevailed (54.1%, n=124). In the radiological confirmation the vena cava was prevalent (68.1%, n=156). The use of the PICC in the hospital environment is expanding and nursing has a fundamental role in its insertion, maintenance and removal

Solving DCOPs with Distributed Large Neighborhood Search

The field of Distributed Constraint Optimization has gained momentum in recent years, thanks to its ability to address various applications related to multi-agent cooperation. Nevertheless, solving Distributed Constraint Optimization Problems (DCOPs) optimally is NP-hard. Therefore, in large-scale, complex applications, incomplete DCOP algorithms are necessary. Current incomplete DCOP algorithms suffer of one or more of the following limitations: they (a) find local minima without providing quality guarantees; (b) provide loose quality assessment; or (c) are unable to benefit from the structure of the problem, such as domain-dependent knowledge and hard constraints. Therefore, capitalizing on strategies from the centralized constraint solving community, we propose a Distributed Large Neighborhood Search (D-LNS) framework to solve DCOPs. The proposed framework (with its novel repair phase) provides guarantees on solution quality, refining upper and lower bounds during the iterative process, and can exploit domain-dependent structures. Our experimental results show that D-LNS outperforms other incomplete DCOP algorithms on both structured and unstructured problem instances

A gastrocnemius heterotopical transplant model with end-to-side neurorraphy

PURPOSE: To present an animal model to assess the effects of end-to-side innervation in the heterotopically transplanted model with reduced chances of neural contamination.METHODS:The medial portion of the gastrocnemius muscle in wistar male rats was isolated and its pedicle dissected and performed a flap in the abdominal portion. To prevent neural contamination in the abdominal region, the muscle was wrapped with a Goretex(r) sheet. The specimens were divided into 2 groups (G). In G1 was performed an end-to-end suture between tibial nerve of the gastrocnemius and femoral motor nerve and between the saphenous sensory nerve and the motor nerve. In G2 was performed a end-to-side suture between the tibial nerve and the motor femoral and between the tibial nerve and saphenous motor nerve. The specimens were evaluated 60 days later to check the structure of the neurorraphy. Sections were obtained proximal and distal to the coaptation site.RESULTS:The medial gastrocnemius muscle had the advantage of maintaining visible mass after 60 days. No disruption of the coaptation site was found. No major injury to the donor nerve was seen in group 2.CONCLUSION: The proposed model is simple, reproduciple and prevent the neural contamination in the flap in end-to-side suture.Federal University of São Paulo Paulista School of MedicinePontifícia Universidade Católica do Rio Grande do Sul Hospital São LucasMcMaster UniversityFederal University of Health ScienceFederal University of Pelotas Departament of SurgeryUNIFESPUNIFESP, EPMSciEL

Experimental model of spinal cord injury in rats with a device for local therapeutic agents access

An experimental model of spinal cord injury at a precise and reproducible site is an extremely important tool for studying new therapies in spinal cord injuries. OBJECTIVES: To develop an experimental model of spinal cord injury in rats that is able to produce a complete injury (paraplegia) and placing a system enabling agents access close to injury site in order to test local therapeutic agents. METHODS: Fifteen Wistar rats were submitted to surgical transection of the spine, performed by using scissors at the level of T-13 to L-3 vertebral bodies, and, at the end of the procedure, to the insertion of a subdermal catheter intended to enable local therapeutic agents access to injury site. RESULTS: An experimental model of paraplegia was consistently developed by adding a supplementary catheter for local therapeutic agents access to injury site. CONCLUSION: An animal model of spinal cord injury and a system for local therapeutic agents access can be reproduced for the study of different modifiers of the regenerative response in a model of rats with spinal cord injury.Um modelo experimental de lesão raquimedular com localização precisa e reproduzível é uma ferramenta extremamente importante para o estudo de novas terapias em lesões raquimedulares. OBJETIVOS: Desenvolver um modelo experimental de lesão raquimedular em ratos que produza lesão completa (paraplegia) com o posicionamento de um sistema que permita o acesso de agentes próximo ao local da lesão para testar agentes terapêuticos locais. MÉTODOS: Quinze ratos Wistar foram submetidos à transecção cirúrgica da medula espinhal, realizada com o uso de tesoura ao nível dos corpos vertebrais de T-13 a L-3 e, ao final do procedimento, à implantação de um cateter subcutâneo para o acesso de agentes terapêuticos locais ao local da lesão. RESULTADOS: Um modelo experimental de paraplegia foi consistentemente desenvolvido com a adição suplementar de um cateter para o acesso de agentes terapêuticos locais ao local da lesão. CONCLUSÃO: Um modelo animal de lesão raquimedular e um sistema para o acesso de agentes terapêuticos locais pode ser reproduzido para o estudo de diferentes modificadores da resposta regenerativa em um modelo de ratos com lesão raquimedular.UNIFESPUNIFESPSciEL

VIABILITY OF VASCULARIZED BONE GRAFT FROM THE ILIAC CREST USING THE ILIAC BRANCH OF THE ILIOLUMBAR ARTERY: EXPERIMENTAL STUDY ON RATS

ABSTRACTObjective: Through an experimental model, our aim was to create inferences about the viability of vascularized bone grafts from the iliac crest in rats and investigate their histological features. Methods: Twenty-one rats were used, divided into two groups: the first consisted of animals that were subjected to the technique of vascularized bone graft pedicled onto the iliac branch of the iliolumbar artery; the second (control group) underwent the same procedure as performed on the first group, with the addition of ligation of the vascular pedicle. The viability of the bone grafts was observed for three weeks, by means of direct observation of the graft, histology and immunohistochemistry. Results: All the vascularized grafts evaluated in the first week showed viability according to direct observation, histology and immunohistochemistry. However, in the second and third weeks, direct observation showed that 75% of the grafts were unviable, while histological analysis and immunohistochemistry showed that 50% were unviable. Conclusions: Some grafts that are designed to be vascularized became unviable and began to behave like non-vascularized grafts under direct observation and histology. Despite the possibility of failure, use of vascularized bone grafts should be encouraged, because descriptive histology shows greater cell density in the medullary bone portion, and osteocytes that function better regarding deposition of bone matrix, with preservation of the intraosseous vascular network

Obtenção de plasma rico em plaquetas: avaliação do efeito da centrifugação sobre a concentração de plaquetas através da comparação entre protocolos

The most different areas of health sciences seek to find new biotechnologies, in order to use them in tissue bioengineering. In this context, is inserted the platelet-rich plasma, who consists in high platelet concentration in a small volume of plasma, which is a potential method to provide a complex of growth factors that leads to repair of different tissues in medicine regenerative. The aim of this study was to assess the centrifugation effect (spin x time) on the platelet concentration, through comparison of three different protocols for producing platelet-rich plasma. Whole blood was drawn into tubes containing acid citrate dextrose as anticoagulant from ten healthy volunteers. The blood was divided into four aliquots for producing platelet-rich plasma by three different protocols and baseline platelet counts. All the protocols used were effective to concentrate platelets at least three times more than baseline values, however there was no statistically significant difference in the results of platelet concentration between the protocols for analysis of variance (p < 0,445). Regression analysis performed was able to predict the relationships between variables with significant positive correlation between the increases in the number of platelets. Protocols that used longer centrifugation time had a positive correlation between the number of baseline platelets count and the increases in platelets count after obtaining PRP.Diferentes áreas das ciências da saúde buscam encontrar novas biotecnologias, a fim de empregá-las na bioengenharia tecidual. Nesse contexto, está inserido o plasma rico em plaquetas, que consiste em um pequeno volume de plasma contendo alta concentração de plaquetas, e se trata de um método potencial para fornecer um complexo de fatores de crescimento que favorecem o reparo de diferentes tecidos no âmbito da medicina regenerativa. O objetivo do estudo foi avaliar o efeito da centrifugação (velocidade x tempo) sobre a concentração de plaquetas, através da comparação de três diferentes protocolos de obtenção de plasma rico em plaquetas. Foi coletado sangue total em tubos contendo o anticoagulante ácido citrato dextrose (ACD) de dez indivíduos voluntários. O sangue foi separado em quatro alíquotas, destinadas ao processamento do plasma rico em plaquetas por três diferentes protocolos e à contagem basal de plaquetas. Todos os protocolos testados foram eficazes para concentrar as plaquetas em pelo menos três vezes mais do que os valores basais, porém não houve diferença estatisticamente significante entre os resultados de concentração de plaquetas entre os protocolos por análise de variância (p < 0,445). A análise de regressão realizada foi capaz de predizer as relações entre as variáveis com correlação positiva significativa entre o aumento do número de plaquetas. Os protocolos que utilizaram maior tempo de centrifugação obtiveram correlação positiva entre o número basal de plaquetas e o aumento do número de plaquetas após a obtenção do PRP.

Evaluation and depreciation analisys of the immobile market value in the city of CODÓ-MA.

Due to the heterogeneity of the real estate market and its peculiarities, it is not always possible to develop a single model that is totally faithful and representative of the market reality, thus, the Evaluation Engineering is increasingly developing, with the use of increasingly advanced processes in the determination of the value of the good, such as the application of statistical inference and the use of physical depreciation. This study aims to determine the value of a property in the city of Codó-MA, using statistical inference through multiple linear regression and, later, to verify physical depreciation. The data were collected in the city of Codó,MA, in real estate, construction companies that work with the sale of houses, ads and, its statistical treatment was performed by the Sisdea software. After the statistical treatment some models were generated and the most effective one was used and the one that best met the requirements foreseen by NBR 14653-2 (2011) and, after the physical depreciation was verified by two different methods: survey of the cost of recovering the good and Ross Heidecke’s method. Finally, it was possible to determine the market value of the property and to make a critical analysis among the values found of physical depreciation by each method performed

Modelo experimental em ratos no reparo ósseo do fêmur utilizando células mononucleares no plasma rico em plaquetas

As células mononucleares da medula óssea têm sido utilizadas em diversas afecções na tentativa de regeneração tecidual. (O objetivo deste estudo foi o de avaliar a adesão das células mononucleares sobre defeito crítico, com a adição do plasma rico em plaquetas (PRP) e / ou TGF-β1 (Fator de crescimento transformador Beta 1), e, por fim, verificar o reparo ósseo dos sítios defeituosos dos fêmures dos ratos. Foi criado um defeito bilateral critico nos fêmures de 33 Wistar-Kyoto ratos. Células mononucleares de medula óssea, TGF-β e PRP foram adicionadas no lado tratado da lesão e soro fisiológico no lado contralateral. Determinou-se a adesão de células mononucleares sobre o defeito crítico e reparo ósseo. A presença e consequente adesão das células mononucleares administradas nos animais tratados não foi evidenciada através da técnica de PCR. As análises radiológicas evidenciam fechamento da lesão, porém, nós não podemos afirmar que foi pelos tratamentos administrados ou pela própria regeneração óssea, quando analisadas em seis e 10 semanas pós-operatórias, haja visto não apresentarem diferenças significantes entre os grupos. Conclusões: a) As células mononucleares não aderiram ao defeito crítico criado no fêmur do rato; b) Não foi possível avaliar a eficiência dos tratamentos propostos para o reparo ósseo, por não apresentarem diferenças significativas entre os grupos.Mononuclear cells from bone marrow have been used in various treatments of diseases in an attempt to regenerate tissues. The objective of this study was to evaluate the accession and proliferation of mononuclear cells in a critical defect, with the addition of platelet-rich plasma (PRP) and / or TGF-β1 (transforming growth factor beta 1), and then to evaluate bone repair at defective sites on the femurs of rats. We created a critical defect on the bilateral femurs of 33 Wistar-Kyoto rats. Mononuclear bone marrow cells, TGF-β and PRP were added to the lesion on the treated side and saline on the contralateral side. We determined the adhesion of mononuclear cells at the critical defect and bone repair. The presence and consequent adhesion of the mononuclear cells administered to the treated animals was not demonstrated by PCR. Radiographic analysis showed closure of the lesion, but we could not affirm that this resulted from the treatments administered or by normal bone regeneration itself, when the lesion was evaluated at 6 and 10 weeks postoperative, seeing that there were no significant differences between the groups. Conclusions: a)Bone marrow mononuclear cells did not adhere at the critical defect created in the rat femur; b) It was not possible to determine the efficiency of the bone repair treatments studied, as the results did not show significant differences between the groups

FACTORS RELATED TO HOPELESSNESS IN COLLEGE STUDENTS

Objective: To identify factors related to hopelessness in college students.Method: cross-sectional study conducted in a Higher Education Institution in the state of Piauí - Brazil, in 2017, with 142 students from the health courses. The Beck Hopelessness Scale, Beck Suicidal Intent Scale, and socioeconomic and academic questionnaire were used. The data were analyzed using Fisher’s exact test, Mann-Whitney test, and Kruskall-Wallis test.Results: Of the students with suicidal ideation, 24 (77.4%) presented a severe level of hopelessness. Higher mean scores on the Hopelessness Scale were observed in male students, who did not attend the desired course, with reports of insecurity about their professional future, users of alcohol and other drugs, with a history of suicide attempts, bullying and depressed mood.Conclusion: Hopelessness correlates with the presence of suicidal ideation and low academic performance, highlighting the importance of physical, mental, and academic health support actions.Objetivo: identificar los factores relacionados con la desesperanza en los estudiantes universitarios. Método: estudio transversal, realizado en una Institución de Educación Superior del estado de Piauí, Brasil, en 2017, con 142 estudiantes de los cursos de salud. Se utilizó la escala de desesperanza de Beck, la escala de ideación suicida de Beck y un cuestionario socioeconómico y académico. Los datos se analizaron mediante las pruebas exactas de Fisher, Mann-Whitney y Kruskall-Wallis. Resultados: De los estudiantes con ideación suicida, 24 (77,4%) presentaban un nivel severo de desesperanza. Se observaron puntuaciones medias más altas en la escala de desesperanza en los estudiantes varones, que no asistieron al curso deseado, con informes de inseguridad sobre su futuro profesional, consumidores de alcohol y otras drogas, con antecedentes de intento de suicidio, acoso escolar y estado de ánimo deprimido. Conclusión: La desesperanza se correlaciona con la presencia de ideación suicida y el bajo rendimiento académico, destacando la importancia de las acciones de apoyo a la salud física, mental y académica.Objetivo: identificar fatores relacionados à desesperança em universitários.Método: estudo transversal, realizado em uma Instituição de Ensino Superior no estado do Piauí - Brasil, em 2017, com 142 estudantes dos cursos de saúde. Utilizou-se a Escala de Desesperança de Beck, Escala de Ideação Suicida de Beck e questionário socioeconômico e acadêmico. Os dados foram analisados utilizando os testes exato de Fisher, Mann-Whitney e Kruskall-Wallis.Resultados: dos estudantes com ideação suicida, 24 (77,4%) apresentaram nível de desesperança severa. Maiores médias na Escala de Desesperança foram observadas em estudantes do sexo masculino, que não frequentavam o curso desejado, com relato de insegurança quanto ao futuro profissional, usuários de álcool e outras drogas, com histórico de tentativa de suicídio, bullying e de humor deprimido.Conclusão: A desesperança correlaciona-se com a presença de ideação suicida e baixo rendimento acadêmico, destacando a importância de ações de apoio físico, mental e de saúde acadêmica