ResumoOBJETIVOS: Identificar e analisar as causas da mortalidade materna, segundo os níveis de complexidade hospitalar. MÉTODOS: Estudo quantitativo, descritivo e de corte transversal das mortes maternas hospitalares ocorridas no Paraná, Brasil, nos triênios de 2005-2007 e 2008-2010. Foram utilizados dados dos estudos de casos de óbitos maternos, que foram elaborados pelo Comitê Estadual de Prevenção da Mortalidade Materna. As variáveis estudadas foram o local e as causas dos óbitos, a transferência hospitalar e a evitabilidade. Foram calculadas a razão de mortalidade materna, a proporção e a taxa de letalidade hospitalar, segundo os subgrupos hospitais de referência para gestações de alto e baixo risco. RESULTADOS: A razão de mortalidade materna, incluindo os óbitos maternos tardios, foi 65,9/100.000 nascidos vivos (de 2008 a 2010). O local do óbito foi o hospital em cerca de 90% dos casos, em ambos os períodos. No primeiro triênio, nos hospitais de referência para gestação de alto risco, a taxa de letalidade hospitalar foi de 158,4/100.000 partos e, no segundo, 132,5/100.000 e as principais causas foram: pré-eclampsia/eclampsia, infecção urinária, infecção puerperal e causas indiretas. Nos hospitais de referência para gestação de baixo risco, as taxas de letalidade hospitalar foram: 76,2/100.000 e 80,0/100.000, e como principais causas: hemorragias, embolias e complicações anestésicas. Em 64 (2005Em 64 ( -2007 e 71% (2008)(2009)(2010) dos casos, o óbito ocorreu no hospital do internamento inicial. Foram considerados evitáveis 90% dos óbitos no segundo triênio. CONCLUSÕES: Há dificuldades no atendimento das complicações obstétricas em ambos os níveis de atenção de baixa e alta complexidade. A capacitação dos profissionais para o atendimento às emergências obstétricas e o monitoramento do uso dos protocolos em todos os níveis hospitalares deve ser priorizada para a redução das mortes maternas evitáveis. Abstract PURPOSES:To identify and to analyze maternal mortality causes, according to hospital complexity levels. METHODS: A descriptive-quantitative cross-sectional study of maternal deaths that occurred in hospitals in Paraná, Brazil, during the periods from 2005 to 2007 and from 2008 to 2010. Data from case studies of maternal mortality, obtained by the State Committee for Maternal Mortality Prevention, were utilized. The study focused on variables such as site and causes of death, hospital transfer, and avoidability. Maternal mortality rate, proportions, and hospital lethality ratio were calculated according to subgroups of low and high-risk pregnancy reference hospitals. RESULTS: Maternal mortality rate, including late maternal deaths, was 65.9 per 100.000 live-borns (from 2008 to 2010). Almost 90% of all maternal deaths occurred in the hospital environment, in both periods. The hospital lethality ratio at the high-risk pregnancy reference hospital was 158.4 deaths per 100,000 deliveries during the first period and 132.5/100,000 during the second, and the main causes were pre-eclampsia/eclampsia, puerperal in...
BACKGROUND Herpes simplex virus (HSV) infection is an endemic disease and it is estimated that 6095% of the adult population are infected with symptoms that are usually self-limiting, though they can be serious, extensive and prolonged in immunocompromised individuals, highlighted by the emergence of drug-resistant strains. The study of the wild-type HSV strains based on the cytopathogenic features and its antiviral sensitivity are important in the establishment of an antivirogram for controlling the infection.OBJECTIVE This study sought to isolate and examine the cytopathological characteristics of circulating strains of the Herpes simplex virus, from clinical specimens and their sensitivity to commercially available antiherpesvirus drugs, acyclovir, phosphonophormic acid and trifluridine.METHODS Herpes simplex virus isolation, cytopathological features and antiviral sensitivity assays were performed in cell culture by tissue culture infectious dose or plaque forming unit assay.RESULTS From twenty-two clinical specimens, we isolated and adapted nine strains. Overall, the cytopathic effect was detected 24 h post-infection (p.i.) and the presence of syncytia was remarkable 48 h p.i., observed after cell staining. Out of eight isolates, four developed plaques of varying sizes. All the isolates were sensitive to acyclovir, phosphonophormic and trifluridine, with the percentage of virus inhibition (%VI) ranging from 49.7-100%.CONCLUSIONSThe methodology for HSV isolation and characterization is a straightforward approach, but the drug sensitivity test, regarded as being of great practical importance, needs to be better understood.
Porque e como racionalizar o uso de sangue alogênico em cirurgia 87 Semina: Ciências Biológicas e da Saúde, Londrina, v. 23, p. 87-92, jan./dez. 2002 Porque e como racionalizar o uso de sangue alogênico em cirurgia Why and how to rationalize allogeneic blood in surgery Elbens M. M. de Azevedo¹; Aryeh Shander ² ResumoOs autores avaliam a utilização do sangue alogênico em procedimentos cirúrgicos e suas repercurssões em centros médicos norte-americanos. Evidenciam aspectos fisiológicos e fisiopatológicos na prática transfusional, como a ocorrência de processos infecciosos e imunológicos, salientando a atual intercorrência denominada "Lesão Pulmonar Agúda Relacionada a Transfusões" (TRALI), que têm preocupado a comunidade científica por ser subdiagnosticada e subnotificada. Os autores mostram ainda, que existem alternativas ao uso de sangue alogênico que são seguras, efetivas e simples, as quais tem sido difundidas e possivelmente tornar-se-ão a conduta padrão em centros médicos de excelência. Palavras-Chave: Medicina e Cirurgia sem Sangue, Alternativas Hemotransfusionais. AbstractThe authors have assessed the use of allogeneic blood in surgery procedures and its influence on American Medical Centers. Physiology and physiopathology in transfusion surgery are evaluated, alerting to the possibility of occurring some risks such as infection and immunological diseases, mainly the "Transfusion Related Acute Lung Injury" (TRALI), that has concerned the scientific community as it is misdiagnosed and underreported. The authors point out safe, effective and simple alternatives for the use of allogeneic blood that will shortly be the standard conduct in surgeries in the best medical centers.
The purpose of the present study was to evaluate the sexual transmission of GBV-C/HGV, through RNA detection in cervicovaginal smears. Therefore the GBV-C/HGV RNA in cervicovaginal smears from apparently healthy women was investigated using routine proceedings for prophylactic screening to cervical cancer. GBV-C/HGV RNA was detected by reverse transcriptase and polymerase chain reaction (RT-PCR). Only one woman presented co-infection with human papilloma virus (HPV). The GBV-C/HGV
ResumoOs vários fatores que precipitam uma transfusão sanguínea nos hospitais são chamados de "gatilho da transfusão". O objetivo da reposição de sangue no perioperatório é manter níveis satisfatórios de hemoglobina e de volume sanguíneo para uma adequada oxigenação tecidual. Os fatores de coagulação são importantes nas disfunções de coagulação. O ideal é evitar-se ou promover-se uma melhor transfusão em pequenas quantidades e com menor risco. Trabalhos recentes questionam os padrões previamente considerados aceitáveis para a transfusão sanguínea. Produtos substitutivos para o tratamento do choque hemorrágico, bioprodutos do sangue e as indicações baseadas em parâmetros laboratoriais e clínicos são analisadas e discutidas nesta revisão. Palavras-chave: Transfusão. Sangue. Choque hemorrágico. AbstractThe several factors which precipitate blood transfusion in hospitals are called "transfusion trigger". The goal of perioperative blood replacement is to maintain satisfactory levels of haemoglobin and blood volume in order to have a better tissue oxygenation. The coagulation factors are used in the coagulations dysfunctions. The ideal is to avoid or to carry out a better blood transfusion in small quantities at a lower risk. Recent reports question the standards previously considered acceptable for blood transfusion. Blood substitute products for the treatment of haemorrhagic shock, blood bioproducts, and the indications for transfusions based on laboratory and clinical parameters, are analysed and discussed in this review.
Cervicography may be used as a complementary screening method to the Pap test for cervical cancer.
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