: Evidence-based medicine in QoHC is limited. It is concluded that optimizing QoHC by "information"; "education", "benchmarking" and "psychological analysis" helps the patient to understand the disease and comply with its therapy, increasing QoL, reducing depression and anxiety. Future aspects regarding more evidence-based science and optimization of QoHC in IBD throughout Europe have been proposed.
Valve replacement is a common cardiovascular procedure for the treatment of a variety of congenital and acquired defects. Many surgical programs rely on cryopreserved heart valves from regional tissue bank programs to meet clinical demands. Current cryopreservation strategies for heart valves are empirically derived. The aim of this study was to use proton nuclear magnetic resonance spectroscopy (NMR) to monitor changes in cryoprotectant concentration in isolated heart valve leaflets. Porcine aortic valves were locally obtained, freshly isolated, and allowed to equilibrate at various experimental temperatures (22°C, 10°C, 4°C) for 1 h prior to immersion in 1 M Me 2 SO solution. At defined intervals (0, 0.25, 0.5, 1, 2, 6, and 24 h) the valves were removed from the Me 2 SO and the leaflets were rapidly dissected and equilibrated in deuterium oxide (D 2 O). Using previously described techniques the Me 2 SO concentration in the heart valve leaflets was determined by NMR and the diffusion coefficient was calculated as a function of time and temperature. Heart valve leaflets were fully equilibrated with Me 2 SO after approximately 2 h of exposure at 22°C while equilibrium was not reached >6 h or more at 10°C and 4°C. These results indicate that that permeation of Me 2 SO in heart valves is strongly temperature dependent. Furthermore, this study provides a quantitative measure of Me 2 SO permeation and cryoprotectant at equilibration in heart valve leaflets. The clinical applications of these findings may help to optimize the balance between the protective and toxic effects of cryoprotectants and lead to improved methods of preservation of heart valves.Key words: Cryopreservation; Heart valve; Me 2 SO; Cryoprotectant permeation; Proton NMR spectroscopy INTRODUCTIONthe tissue for a minimal exposure to decrease the effect of toxicity. All cryoprotectants are toxic and increase in toxicity with concentration, time, and temperature of Heart valve replacement is a common cardiovascular procedure for the treatment of a variety of congenital diffusion. Overexposure to cryoprotectants may not only affect tissue viability in the short term, but over an exand acquired defects, but is limited by the supply of tissue for transplantation. As a result, many surgical protended period of time the cryoprotectant may have adverse toxic effects on tissue biological function. grams rely on cryopreserved heart valves from regional tissue banks to meet clinical demands (23). The use of Cryoinjury during cooling is associated with the presence of intracellular ice (12), but the probability of intraMe 2 SO as a cryoprotectant has been shown to be useful in preventing the damage associated with the freezing cellular ice formation can be reduced by increasing the concentration of intracellular solutes. Slow cooling, in process in heart valves and other tissues, and the use of cryopreserved valves for transplantation has been shown the presence of external ice, may allow this as solutes concentrate in the diminishing unfrozen fraction of wain s...
RESUMOObjetivo: analisar as características dos atendimentos e o perfil das vítimas socorridas pelo Serviço de Atendimento Móvel de Urgência/SAMU. Método: trata-se de estudo bibliográfico, descritivo, tipo revisão de literatura, em que se buscaram artigos, sem delimitação do tempo, na BVS, LILACS, SciELO, BDENF, MEDLINE. Selecionaram-se dez artigos que atenderam aos critérios de inclusão. Resultados: evidenciaram-se divergências sobre as características dos atendimentos, o que dificulta o planejamento de ações específicas e resolutivas. Destaca-se a falta de estudos realizados sobre esta temática nos três Estados da região Sul do Brasil. Conclusão: sugerem-se pesquisas na área, bem como produções pelos profissionais da Enfermagem, contribuindo, assim, para a organização e a gestão eficiente deste serviço, além de um redirecionamento dos profissionais para cursos de atualização e aperfeiçoamento compatíveis com o perfil de morbidade prevalente. Descritores: Serviços Médicos de Emergência; Enfermagem de Emergência; Assistência pré-hospitalar; SAMU; Urgências; Emergências.ABSTRACT Objective: to analyze the characteristics of care and the profile of the victims rescued by the Mobile Emergency Care Service/SAMU. Method: this is a descriptive bibliographical study, a literature review, in which articles were searched, without time delimitation, in the VHL, LILACS, SciELO, BDENF, MEDLINE. Ten articles were selected that met the inclusion criteria. Results: there were evidences about the characteristics of the attendance, which makes it difficult to plan specific and resolute actions. It is worth noting the lack of studies carried out on this subject in the three States of the southern region of Brazil. Conclusion: research in this area and nursing professionals' productions are suggested, thus contributing to the organization and efficient management of this service, as well as a redirection of professionals for refresher courses that are compatible with the prevalent morbidity profile. Descriptors: Emergency Medical Services; Emergency Nursing; Prehospital Care; SAMU; Urgencies. Emergency.RESUMEN Objetivo: analizar las características de las atenciones y perfil de las víctimas socorridas por el Servicio de Atención Móvil de Urgencia / SAMU. Método: se trata de un estudio bibliográfico, descriptivo, tipo revisión de literatura, en que se buscó artículos sin delimitación del tiempo, en la BVS, LILACS, SciELO, BDENF, MEDLINE, se seleccionaron diez artículos que atendieron a los criterios de inclusión. Resultados: el análisis evidenció divergencias sobre las características de las atenciones, lo que dificulta en la planificación de acciones específicas y resolutivas. Se destaca la falta de estudios realizados sobre esta temática en los tres estados de la región Sur de Brasil. Conclusión: se sugiere investigaciones en el área, así como producciones por los profesionales de enfermería, contribuyendo así a la organización y gestión eficiente de este servicio. Además de sugerir una redirección de los profesionales para cursos de actualización y perfeccionamiento compatibles con el perfil de morbilidad prevalente. Descriptores: Servicios Médicos de Emergencia; Enfermería de Emergencia; Asistencia Pre Hospitalaria; SAMU; Urgencia; Emergencia.
Objetivo: Verificar o conhecimento dos profissionais de enfermagem no que concerne à segurança do paciente na Sala de Recuperação Pós-Anestésica (SRPA), após a implantação de um protocolo assistencial no referido setor. Método: Trata-se de um estudo descritivo, exploratório, com abordagem qualitativa, do tipo convergente assistencial, envolvendo sete profissionais da equipe de enfermagem, atuantes na SRPA de um hospital do oeste catarinense. Resultados: Com base nos achados, surgiram duas categorias: “Segurança do paciente na sala de recuperação pós-anestésica” e “Protocolos Assistenciais” (PA), que proporcionaram efetividade de tais protocolos na sistematização do processo de cuidar, considerando, tanto a segurança do paciente, quanto a do profissional. Conclusão: A aplicação do protocolo, por meio de checklist, além de nortear as ações da equipe, possibilitou que estas ocorressem de forma sistemática e rápida, levando-se em conta a complexidade do atendimento na SRPA.
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