Assuntos
Analgesia Epidural , Analgesia Obstétrica , Educação de Pacientes como Assunto , Terceiro Trimestre da Gravidez , Cuidado Pré-Natal , Adolescente , Adulto , Analgesia Epidural/psicologia , Analgesia Obstétrica/psicologia , Feminino , Humanos , Consentimento Livre e Esclarecido , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Gravidez de Alto Risco/psicologia , Avaliação de Programas e Projetos de Saúde , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: Our purpose was to evaluate the control of oral anticoagulant treatment (OAT) in capillary blood by the Coagucheck S System. PATIENTS AND METHOD: Descriptive cross-sectional study. 155 patients under treatment with oral anticoagulants were studied. The INR was determined in venous blood by the CA-6000 System (DADE-Behring Laboratories) and capillary blood was determined by the Coagulocheck S System (Roche Laboratories). RESULTS: Mean and standard deviation were: 2.64 (1.25) for the CA6000 System and 2.95 (1.58) for the Coagucheck S System. Pearson's correlation coefficient was r = 0.912. Intraclass correlation index was 0.86 (0.79-0.91) and the mean difference was 0.309 (0.202-0.417). The therapeutic attitude was the same in 80%. CONCLUSION: Both systems are interchangeable with regard to the INR measurement aimed at the control of oral anticoagulant therapy
Assuntos
Anticoagulantes/administração & dosagem , Coeficiente Internacional Normatizado , Estudos Transversais , Humanos , Coeficiente Internacional Normatizado/métodosRESUMO
BACKGROUND: The pathophysiology of renal impairments occurring in obstructive jaundice has been extensively studied, but the underlying mechanism of these derangements remains unclear. The aim of the present study was to investigate the time-related morphological and functional changes occurring in the kidneys of rats undergoing obstructive jaundice. METHODS: Histological examination, renal function assessment and determination of (Na + K)-ATPase activity were performed in the kidneys of rats 7, 14, and 21 days following bile duct ligation (BDL) or sham operation (sham). RESULTS: Glomerular filtration rate was unaffected by BDL throughout the period of the study. Tubular effects occurred at days 7 and 14, being more marked at day 7, and consisted of an increase of about twice in the fractional excretion of sodium and chloride, paralleled by a decreased proximal and distal tubular reabsorption of sodium of about 50 and 40%, respectively. Natriuresis was consistent with augmentation of osmolar clearance but it was not associated with changes in the activity of renal (Na+ + K+)-ATPase. The ability to dilute urine was impaired at days 14 and 21 after BDL. Additionally, these effects were accompanied by decreased tubulointerstitial fibrosis and vasodilation of inner medullary capillaries. At day 21, the parameters of tubular function in BDL and sham groups were not significantly different. CONCLUSIONS: These data support the view that raised natriuresis taking place in the initial 2 weeks following BDL is due mainly to tubular effects. The contribution of hemodynamic, paracrine and humoral mediators is discussed.