35 research outputs found
Tempo de demora intra-hospitalar das síndromes coronárias agudas
TITULO: Tempo de Demora Intra-hospitalar das Síndromes Coronárias Agudas.
ENQUADRAMENTO: A doença coronária, por si só, mantém-se no primeiro lugar das
causas de morte na União Europeia. O enfarte agudo do miocárdio (EAM) constitui uma
importante causa de morbilidade e mortalidade, sobretudo ao nível dos países
industrializados, e resulta, habitualmente, de um processo progressivo de aterosclerose
coronária. Todos os anos em Portugal ocorrem cerca de 10.000 EAM. Em doentes com
enfarte do miocárdio com supradesnivelamento do segmento ST, a reperfusão precoce
é o tratamento de eleição. Manter o menor intervalo de tempo desde o início dos
sintomas até à reperfusão é realçado nas guidelines atuais como uma prioridade.
OBJECTIVOS: Determinar o tempo de demora intra-hospitalar das Síndromes
Coronárias Agudas e analisar a influência de determinadas variáveis no tempo de
demora intra-hospitalar, como a idade, o sexo, a forma de admissão (proveniência e tipo
de transporte), a prioridade do Sistema de Triagem de Manchester (STM), a dor
torácica, o tipo de Síndrome Coronária Aguda (SCA) e a Via Verde Coronária (VVC).
MÉTODOS: É um estudo quantitativo e transversal. Amostra constituída por 204
indivíduos com diagnóstico médico de SCA, internados na UCIC do CHTV, EPE, no
período compreendido de 1 de Janeiro de 2010 a 30 de Setembro de 2010. A recolha de
dados teve por base o registo informático do Sistema ALERT®.
RESULTADOS: Os doentes são maioritariamente do sexo masculino (70,1%) com uma
média de idades de 69,75 anos (dp=12,74). 63,2% são provenientes do domicílio, 34,8%
foram referenciados pelo centro de saúde/SUB. A ambulância sem médico e os meios
próprios são o tipo de transporte mais utilizado (44,1% e 42,6% respetivamente). 96,1%
dos indivíduos apresentaram dor torácica. 49,0% dos indivíduos foi diagnosticado EAM
sem Supra-ST, 32,4% dos indivíduos foi diagnosticado EAM com Supra-ST e 18,6% dos
indivíduos foi diagnosticado angina instável. O tempo médio de demora pré-hospitalar
(DPH) foi de 1043,11 minutos e o tempo médio entre o início da dor torácica e a
admissão no Serviço de Urgência (TDH) foi de 1044,13 minutos; o tempo médio entre a
admissão e a realização de triagem (DAT) foi de 8,60 minutos; o tempo médio entre a
triagem e a realização do eletrocardiograma (DT-ECG) foi de 34,09 minutos; o tempo
médio entre a realização do eletrocardiograma e a primeira observação médica (D-ECGMédico)
foi de 20,48 minutos; o tempo médio entre a primeira observação médica e a
administração da primeira terapêutica (D-Médico-Terapêutica) foi de 20,25 minutos; o
tempo médio entre a admissão e a alta/internamento do doente (DIH-SU) foi de 281,91
minutos, com um tempo mínimo de 6 minutos e máximo de 1500 minutos. 64,7% dos
indivíduos fizeram o 1.º ECG no SU num tempo superior a 10 minutos e apenas 35,3% dos indivíduos fizeram o 1.º ECG no SU num tempo 10 minutos. 74,5% dos indivíduos
foram triados através do fluxograma Dor Torácica, 70,6% dos indivíduos foram triados
com a prioridade laranja e 72,7% dos indivíduos do sexo masculino e 70,5% dos
indivíduos do sexo feminino entraram pela VVC. Relativamente ao DIH-SU, o tempo
médio foi de 126,71 minutos (dp=141,023) nos indivíduos com EAM com Supra-ST,
340,76 minutos (dp=246,71) nos indivíduos com EAM sem Supra-ST e 396,61 minutos
(dp=324,50) nos indivíduos com angina instável.
CONCLUSÃO: Os indivíduos do sexo masculino têm um tempo de demora intrahospitalar
inferior aos indivíduos do sexo feminino (p> 0,05). Os indivíduos do grupo
etário <55 anos apresentam melhores valores médios do tempo entre a admissão e a
alta/internamento (p> 0,05). Os indivíduos transferidos do domicílio apresentam
melhores valores médios no tempo de demora intra-hospitalar que os indivíduos que
são referenciados por outra Instituição de Saúde (p> 0,05). Os indivíduos transportados
em ambulância com médico apresentam melhores tempos médios de demora intrahospitalar
(p< 0,05). Os indivíduos com dor torácica apresentam piores tempos médios
de demora intra-hospitalar que os indivíduos sem dor torácica, à exceção do tempo
entre a triagem e o ECG (p< 0,05). Os indivíduos com EAM com Supra-ST são os
indivíduos que apresentam melhores tempos médios de demora intra-hospitalar (p<
0,001). Os indivíduos que entraram na VVC são os indivíduos que apresentam melhores
tempos médios de demora intra-hospitalar (p< 0,001).
PALAVRAS-CHAVE: Síndrome coronária aguda, Tempo de demora intra-hospitalar,
Triagem de Manchester, Dor torácica, Tipo de SCA, Via Verde Coronária, ECG.ABSTRACT
TITLE: In-hospital delay time in Acute Coronary Syndrome
FRAMEWORK: Coronary heart disease alone remains in the first cause of death in the
European Union. The acute myocardial infarction (AMI) is an important cause of
morbidity and mortality, especially at the level of industrialized countries, and usually
results of a progressive process of coronary atherosclerosis. Every year in Portugal
occur, about 10000 AMI. In patients with ST-segment elevation myocardial infarction, the
early reperfusion therapy is the treatment of choice. Keep the shortest time interval from
symptom onset to reperfusion is emphasized in current guidelines as a priority.
OBJECTIVES: Determining the time delay of thein-hospital management of Acute
Coronary Syndromes and analyze the influence of certain variables in the in-hospital
delay time, such as age, sex, the form of admission (provenance and type of transport),
the priority of the Manchester Triage System, chest pain, the type of Acute Coronary
Syndrome (ACS) and VVC.
METHODS: It is a quantitative cross-sectional, retrospective study. Sample of
204individuals, with diagnosis of acute coronary syndrome (ACS), hospitalized in the
Coronary Care Unit of CHTV, EPE from the period 1 January 2010 to 30 September
2010. Data collection was based on the computer record ALERT ®System.
RESULTS: Patients are mostly male (70.1%) with average age of 69,75. 63.2% came
from home, 34.8% were referred by a health center. The type of transport used were,
ambulance without doctor and by own means (44.1% and 42.6% respectively).
96.1%ofindividuals had chest pain. 49.0% of individuals were diagnosed with Non-STsegment
elevation myocardial infarction, 32.4% of individuals were diagnosed with STsegment
elevation myocardial infarction and 18.6%of individuals diagnosed unstable
angina. The pre-hospital delay time average was 1043.11 minutes and the time of the
beginning of chest pain and admission to hospital average was 1044.13 minutes; time
average between admission and triage was 8.60 minutes; time between triage and
application of ECG averaged 34.09 minutes; time between execution of ECG and the
first medical observation averaged 20.48 minutes; time between the first observation and
the first medical therapeutic averaged 20.25 minutes. The average time between
admission and discharge/hospitalization was 281.91 minutes, with a minimum time of 6
minutes and a maximum of 1500 minutes. 64.7%of individual shad the first ECG in the
emergency room at a time over 10 minutes and only 35.3% of individual shad the first
ECG in the emergency room at a time 10 minutes. 74.5% of individuals were triaged
through the flowchart chest pain, 70.6% of individuals were triaged with the priority orange and 72.7% of males and 70.5% of females entered the VVC. For the time
between admission and discharge/hospitalization, the average time was 126.71 minutes
(sd = 141.03) in individuals with ST-segment elevation myocardial infarction, 340.76
minutes (sd = 246.71) in individuals with Non-ST-segment elevation myocardial infarction
and 396.61 minutes (sd = 324.50) in patients with unstable angina.
CONCLUSION: The males have a lower in-hospital delay time than females (p>0.05).
Individuals in the age group <55 year shave better average time between admission and
discharge/hospitalization (p>0.05). Individuals transferred from home show better
average in-hospital delay time than individuals that are referenced by other Health
Institutions (p>0.05). Individuals transported by ambulance with a doctor have better
average in-hospital delay time (p<0.05). Individuals with chest pain have worse average
in-hospital delay time than individuals without chest pain, except for the time between
triage and ECG (p <0.05). Individuals with ST-segment elevation myocardial infarction
are the individuals with the best average in-hospital delay time (p <0.001). Individuals
who entered the VVC are individuals who have better average in-hospital delay time (p
<0.001).
KEY WORDS: Acute coronary syndrome, in- hospital delay time, Manchester Triage
system, chest pain, type of ACS, via verde coronária.
Sd= standard deviation
Enhanced ferromagnetism in CuO nanowires on the top of CuO nanograins.
In the past few years, a considerable effort has been devoted in order to grow magnetoelectric nanostructured materials. Besides fundamental science, they are very attractive in the electronic/spintronic industry as well as magnetic storage media, solar energy conversion due to their nanometer scale. It is believed that CuO is a magnetoelectric multiferroic system where a ferroelectric order is induced by the onset of a magnetic coupling at low temperatures. Furthermore, its simplest composition is the bases of cuprates which bring about the well-known high-temperature superconductivity. Bulk samples of CuO (which has an unpaired electron in the d-shell) show two antiferromagnetic phase transitions – a commensurate collinear state with the magnetic moments along the monoclinic b axis at TN ~ 213 K and an incommensurate spiral state with half of the magnetic moments in the ac plane at TN ~ 230 K
Characterization of the physical properties of NdNiO3 nanotubes.
Neodymium nickelate (NdNiO3) is a correlated oxide that exhibits a metal–insulator transition (MIT) close to 200K and is of interest for advanced electronics and optoelectronics. In this work, we have synthesized NdNiO3 nanotubes using a template-assisted method. For this, precursor solution with stoichiometric amounts of Nd-Ni was prepared by polymeric precursor route, than this solution was deposited in commercial anodized aluminum mesoporous membranes. All samples were heat treated at temperatures ranging from 350 to 750°C under oxygen pressure of 1 and 100 bar. The samples were characterized by X-ray diffraction, scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and magnetization as a function of temperature (M(T)).FAPESPCAPESUFAB
Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial
<p>Abstract</p> <p>Background</p> <p>Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage.</p> <p>Methods</p> <p>This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.</p> <p>Discussion</p> <p>The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.</p> <p>Trial Registration</p> <p>Clinical Trials <a href="http://www.clinicaltrials.gov/ct2/show/NCT00970931">NCT00970931</a>.</p
Do Folclorismo à História da Cultura na Amazônia: o percurso construído por Vicente Salles
Electrical transport in disordered and ordered magnetic domains under pressures and magnetic fields
Magnetic M( T, H, P) and electrical transport.( T, H, P) measurements in a strong spin-lattice-charge coupled La(0.7)Ca(0.3)MnO(3) system have been conducted. The application of H and P leads to the formation of different magnetic domain structures in the vicinity and below the polaronic-to-ferromagnetic transition temperature. The charge mobility is more sensitive to the variation of the spatial wave function overlap between Mn(3+) eg and O(2-) 2p orbitals due to the applied compacting pressure rather than the relative spin orientation between neighbouring Mn ions when the magnetic field is applied. In spite of the presence of different magnetic domain structures due to the sample history, the effect of magnetic field and pressure is less pronounced at lower temperatures on electrical transport properties.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Brazilian agencies FAPESP[05/53241-9]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Brazilian agencies FAPESP[07/01039-7]CNPq[473932/2007-5]Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq
Effect of weak dipolar interaction on the magnetic properties of Ni nanoparticles assembly analyzed with different protocols
The effect of weak dipolar interactions (DIs) between Ni nanoparticles (NPs) in samples with different Ni concentrations was investigated by performing a detailed characterization of their structural and magnetic properties. From the determination of several physical parameters of Ni NP assemblies, it was found that the ac and dc magnetic susceptibility measurements are valuable for identifying the DIs between NPs while hysteresis loops measurements showed to be very insensitive, provided that the strength of the DI field is much smaller than the maximum coercive field. Therefore, the sensitivity of the observed static and dynamical magnetic properties to the effect of weak DI depends on the measurement protocols used. (C) 2011 American Institute of Physics. [doi:10.1063/1.3556767
Flux-Line-Lattice Melting and Upper Critical Field of Bi1.65Pb0.35Sr2Ca2Cu3O10+delta Ceramic Samples
We have conducted magnetoresistance measurements rho(T,H) in applied magnetic fields up to 18 T in Bi1.65Pb0.35Sr2Ca2Cu3O10+delta ceramic samples which were subjected to different uniaxial compacting pressures. The anisotropic upper critical fields H (c2)(T) were extracted from the rho(T,H) data, yielding and the out-of-plane superconducting coherence length xi (c) (0)similar to 3 . We have also estimated and xi (ab) (0) similar to 90 . In addition to this, a flux-line-lattice (FLL) melting temperature T (m) has been identified as a second peak in the derivative of the magnetoresistance d rho/dT data close to the superconducting transition temperature. An H (m) vs. T phase diagram was constructed and the FLL boundary lines were found to obey a temperature dependence H (m) ae(T (c) /T-1) (alpha) , where alpha similar to 2 for the sample subjected to the higher compacting pressure. A reasonable value of the Lindemann parameter c (L) similar to 0.29 has been found for all samples studied.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2010/52545-2]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [304112/2010-0]Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES
Spin-wave fluctuations in ferrimagnetic Mg(x)Fe(3-x)O(4) nanoparticles
We have performed a systematic study of the magnetic properties of a series of ferrimagnetic nanoparticles of Mg(x)Fe(3-x)O(4) (0.8 <= x <= 1.5) prepared by the combustion reaction method. The magnetization data can be well fitted by Bloch's law with T(3/2). Bloch's constant B determined from the fitting procedure was found to increase with Mg content x from similar to 3.09 X 10(-5) K(-3/2) for x = 0.8 to 6.27 X 10(-5) K(-3/2) for x=1.5. The exchange integral J(AB) and the spin-wave stiffness constant D of Mg(x)Fe(3-x)O(4) nanoparticles were also determined as similar to 0.842 and 0.574 meV and 296 and 202 meV angstrom(2) for specimens with x=0.8 and 1.5, respectively. These results are discussed in terms of cation redistribution among A and B sites on these nanostructured spinel ferrites. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3359709]FUNAPE-UFGCNPq[308706/2007-2]National Science Foundation NSFDepartment of Energy (DOE)State of FloridaFAPES