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1.
Ann Oper Res ; : 1-31, 2023 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-37361087

RESUMO

The relationship between efficiency, quality, and access in healthcare is far from being well defined. In particular, there is no consensus on whether there is a trade-off between hospital performance and its social dimensions, such as the care appropriateness, safety, and access to proper health care. This study proposes a new approach based on the Network Data Envelopment Analysis (NDEA) to evaluate the existence of potential trade-offs between efficiency, quality, and access. The aim is to contribute for the heated debate around this topic with a novel approach. The suggested methodology combines a NDEA model with the weak disposability of outputs to handle with undesirable outputs related to the poor quality of care or the lack of access to appropriate and safe care. This combination results in a more realistic approach that has not yet been used to investigate this topic. We utilised data of the Portuguese National Health Service from 2016 to 2019, with four models and nineteen variables selected to quantify the efficiency, quality, and access to public hospital care in Portugal. A baseline efficiency score was calculated and compared with the performance scores obtained under two hypothetical scenarios to quantify the impact of each quality/access-related dimension on efficiency. The first scenario considers that each variable, individually, is at its best situation (for example, absence of septicaemia cases), and the second one, at its worst (e.g., all seen inpatients had a septicaemia case). The findings suggest that there might exist meaningful trade-offs between efficiency, quality, and access. Most variables exhibited a considerable and negative impact on the overall hospital efficiency. That is, we may expect a trade-off between efficiency and quality/access.

3.
Allergol Immunopathol (Madr) ; 47(5): 437-448, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31371133

RESUMO

INTRODUCTION AND OBJECTIVES: Primary immunodeficiency diseases (PIDs) are disorders associated mainly with recurrent and severe infection and an increase in susceptibility to autoimmune conditions and cancer. In Venezuela, PIDs are underdiagnosed and there is usually a delay in their diagnosis. Hence there are no data concerning the frequency and type of PIDs that occur. The aim of this study was to identify and quantify the types of PIDs that occur in Merida, a population within Venezuela. PATIENTS OR MATERIALS AND METHODS: Following an informative program designed to alert local health professionals to the warning signs for PIDs, patients with a history of recurrent infections were referred to the Instituto de Inmunologia Clinica, Universidad de Los Andes. RESULTS AND CONCLUSIONS: During the three-year period January 2014 to January 2017, thirty-two cases of PIDs were identified in pediatric patients, and 17 different types of PIDs, were identified. Predominantly antibody deficiencies were most frequent (40.6%), followed by immunodeficiencies affecting cellular and humoral immunity (21.8%), congenital defects of phagocyte (18.7%), CID with associated or syndromic features (9.3%), defects in intrinsic and innate immunity (6.4%) and diseases of immune dysregulation (3.2%). These results have important implications not only to the future approach for management of patients in our regions, but add important knowledge concerning PIDs in Latin America and worldwide.


Assuntos
Infecções/imunologia , Doenças da Imunodeficiência Primária/imunologia , Adolescente , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Progressão da Doença , Feminino , Humanos , Lactente , Recém-Nascido , Infecções/epidemiologia , Masculino , Doenças da Imunodeficiência Primária/epidemiologia , Recidiva , Venezuela/epidemiologia
5.
Plant Biol (Stuttg) ; 19(4): 592-598, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28244194

RESUMO

Some parasitic plants are capable of vegetative propagation, which allows them access to new hosts and improves nutrient availability. We aimed to determine what factors positively influence this propagation in the xylem-tapping Struthanthus flexicaulis, focusing on the use of directed foraging as a means of optimising access to resources. The study site was a rupicolous plant community in southeast Brazil. We evaluated how the success of branch propagation (by contagion) of the mistletoe is influenced by the crown height and density of its main host, the legume Mimosa calodendron. Oriented foraging was tested through comparing the response of mistletoe branches toward a potential host (resources) or a plastic net (no resources). Successful contagion was related to high density and the departure height of a branch from a host crown. In a high-density area, 89% of branches reached a new host versus 21% in a low-density area. Formation of an appressorium on either the plastic nets or hosts elicited branch growth reorientation towards it, as well as development of new branches. These responses were significantly stronger towards hosts than nets, and attributed to effective xylem tapping. The foraging strategy of S. flexicaulis benefits from branch response (growth and reorientation) to the development of appressoria and their resulting haustoria. The growth of appressoria on non-resource substrates and the ensuing response optimises the mistletoe spread by allowing these substrates to act as physical support for spreading branches and to infect a host that was previously out of reach.


Assuntos
Loranthaceae/crescimento & desenvolvimento , Loranthaceae/fisiologia , Brasil , Fabaceae/parasitologia , Xilema/fisiologia
6.
Braz J Biol ; 75(2): 451-4, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26132031

RESUMO

Around forty bird species habitually reproduce in the Northern Hemisphere during summer, and migrate to the Southern Hemisphere during northern winter. These migrating birds fly together in large or small groups until they have reached the Caribbean, Central American, or Brazilian shores. Charadrius semipalmatus, Bonaparte 1825, is one of these migrating species that uses resting and feeding areas along eastern and western coasts of North and South America, with several records for the Brazilian coast, and very few for the inland country. On November 24, 2011, an individual of this species was observed on the banks of one of the lakes that compose a complex of about 40 temporary lakes within the Karst of Lagoa Santa Environmental Protection Area. On October 29 and 30, 2012 a single individual of Gelochelidon nilotica, Gmelin 1789, was also observed in Sumidouro State Park. We suggest that these specimens have used the Atlantic Ocean migration route, following the São Francisco River Basin, until the karst area. Although highly impacted, the temporary lakes within the Karst of Lagoa Santa still harbor a significant number of bird species, and serve as resting and feeding places for migratory or errant species that are still eliciting new records.


Assuntos
Migração Animal , Aves/classificação , Animais , Brasil , Estações do Ano
7.
Arq. bras. med. vet. zootec ; 67(1): 109-118, 2/2015. tab
Artigo em Português | LILACS | ID: lil-741108

RESUMO

Avaliaram-se as características quantitativas e qualitativas do sêmen de coelhos alimentados com uma ração referência e outra ração formulada com 79,83% de subprodutos de mandioca. Utilizaram-se 20 reprodutores da raça Nova Zelândia Branco, com idade média inicial de sete meses, alojados individualmente em gaiolas e distribuídos em delineamento experimental inteiramente ao acaso, com duas dietas e dez repetições. Realizaram-se dez colheitas de sêmen por animal durante seis meses. Avaliaram-se o volume de sêmen sem gel e volume de gel, cor do sêmen, pH, motilidade espermática progressiva, vigor espermático, concentração espermática, número de espermatozoides no ejaculado, espermatozoides normais, anormais e anormalidades primárias e secundárias. O volume de sêmen sem gel, o índice de normalidade, as anormalidades primárias e secundárias foram iguais (P>0,05) para os animais alimentados com a ração referência e a com subprodutos de mandioca. Os demais parâmetros do sêmen foram melhores (P<0,05) nos animais tratados com a ração com subprodutos de mandioca. Os resultados das características quali-quantitativas do sêmen dos coelhos da Raça Nova Zelândia Branco demonstram que é possível utilizar ração com 79,83% do volume da formulação com subprodutos de mandioca, na dieta de reprodutores, sem prejuízos nas características do sêmen, desde que observados os níveis reduzidos de taninos e ácido cianídrico.


The quantitative and qualitative rabbit semen characteristics fed with a reference diet and a diet formulated with 79.83% of cassava by-products were evaluated. 20 New Zealand White rabbit bucks, with initial average age of seven months were used, individually allocated and distributed in a completely ramdomized design, with two diets (treatments) and ten replications. The ten semen collections per animal were taken during six months. The evaluated parameters were: semen volume without gel and gel volume, color of semen, pH, spermatic progressive motility, spermatic vigor, spermatic concentration, spermatozoa number in the ejaculation, normal spermatozoa, abnormal and primary and secondary abnormalities spermatozoa. The semen volume without gel, the normal spermatozoa, primary and secondary abnormalities spermatozoa were similar (P>0.05) to the animals fed with cassava by-products diet and reference diet. Other semen parameters were better (P<0.05) in the animals fed with the cassava by-products diet. The results of the quali-quantitative characteristics of the semen from New Zealand White rabbits showed that it is possible to use diets containing 79.83% of inclusion of cassava by-products in the diet of rabbit bucks, without affecting semen characteristics, since we observed the reduced level of tannins and hydrocyanic acid.


Assuntos
Animais , Masculino , Coelhos , Análise do Sêmen/estatística & dados numéricos , Análise do Sêmen/veterinária , Ração Animal/análise , Coelhos , Manihot/química
8.
Braz J Biol ; 74(3): 560-8, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25296203

RESUMO

Ungulates, large primates and caviomorfs are cited by Amazonian hunters as preferred species. In this research, paca (Cuniculus paca) hunting was investigated in relation to water levels and the lunar cycle. In eight years of monitoring in the Amanã Sustainable Development Reserve, the killing of 625 pacas was registered in five monitored communities. Paca hunting took place mainly at night and the most commonly used method is "spotlighting". A positive correlation between the number of pacas killed and water level (rs=0.890; p<0.0001) was found. At least 37% of the pacas were hunted when moon illumination level was less than 10%, before moonrise or after moonset. In the Boa Esperança community, capture of paca tended to decrease on nights with high moon illumination (rs= -0.663; p=0.067). At the same time, an expressive catch-per-unity-effort decrease was also observed in this community (r2= -0.881; p<0.001), allowing us to predict unsustainable hunting levels for the next decade. The stock of animals in these areas could be continuously replaced if surrounding areas consisted of continuous forests. However, continuous hunting and deforestation force local hunters to travel longer distances to kill prey such as pacas. The confirmation of the relation between paca habits and lunar illumination and water level, a pattern described by local hunters, demonstrates the potential value of participatory research and the possibility of integrating traditional knowledge into scientific knowledge.


Assuntos
Comportamento Animal/fisiologia , Cuniculidae , Atividades Humanas/estatística & dados numéricos , Animais , Animais Selvagens , Brasil , Conservação dos Recursos Naturais , Cuniculidae/fisiologia , Humanos , Densidade Demográfica , Estações do Ano
9.
Value Health ; 17(7): A413, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27201026
10.
Braz J Biol ; 74(4): 828-36, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25627592

RESUMO

In this study, we hypothesized that the life history traits of Leiothrix spiralis and L. vivipara would be linked to soil factors of the rupestrian grasslands and that rosette size would be influenced by soil moisture. Soil analyses were performed from five populations of L. spiralis and four populations of L. vivipara. In each area, three replicates were employed in 19 areas of occurrence of Leiothrix species, and we quantified the life history attributes. The microhabitats of these species show low favorability regarding to soil factors. During the dry season, their rosettes decreased in diameter due the loss of its most outlying leaves. The absence of seedlings indicated the low fecundity of both species. However, both species showed rapid population growth by pseudovivipary. Both L. spiralis and L. vivipara exhibit a kind of parental care that was quantified by the presence of connections between parental-rosettes and ramets. The findings of the present study show that the life history traits are linked to soil factors.


Assuntos
Eriocaulaceae/crescimento & desenvolvimento , Solo , Brasil , Eriocaulaceae/classificação , Umidade , Estações do Ano
11.
Intensive Care Med ; 39(4): 693-702, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23344833

RESUMO

PURPOSE: To determine whether macrolide-based treatment is associated with mortality in critically ill H1N1 patients with primary viral pneumonia. METHODS: Secondary analysis of a prospective, observational, multicenter study conducted across 148 Intensive Care Units (ICU) in Spain. RESULTS: Primary viral pneumonia was present in 733 ICU patients with pandemic influenza A (H1N1) virus infection with severe respiratory failure. Macrolide-based treatment was administered to 190 (25.9 %) patients. Patients who received macrolides had chronic obstructive pulmonary disease more often, lower severity on admission (APACHE II score on ICU admission (13.1 ± 6.8 vs. 14.4 ± 7.4 points, p < 0.05), and multiple organ dysfunction syndrome less often (23.4 vs. 30.1 %, p < 0.05). Length of ICU stay in survivors was not significantly different in patients who received macrolides compared to patients who did not (10 (IQR 4-20) vs. 10 (IQR 5-20), p = 0.9). ICU mortality was 24.1 % (n = 177). Patients with macrolide-based treatment had lower ICU mortality in the univariate analysis (19.2 vs. 28.1 %, p = 0.02); however, a propensity score analysis showed no effect of macrolide-based treatment on ICU mortality (OR = 0.87; 95 % CI 0.55-1.37, p = 0.5). Moreover, the sensitivity analysis revealed very similar results (OR = 0.91; 95 % CI 0.58-1.44, p = 0.7). A separate analysis of patients under mechanical ventilation yielded similar results (OR = 0.77; 95 % CI 0.44-1.35, p = 0.4). CONCLUSION: Our results suggest that macrolide-based treatment was not associated with improved survival in critically ill H1N1 patients with primary viral pneumonia.


Assuntos
Mortalidade Hospitalar , Influenza Humana/tratamento farmacológico , Macrolídeos/uso terapêutico , Pneumonia Viral/tratamento farmacológico , APACHE , Adulto , Coinfecção , Comorbidade , Feminino , Humanos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/mortalidade , Influenza Humana/terapia , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Pontuação de Propensão , Estudos Prospectivos , Insuficiência Respiratória/tratamento farmacológico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/mortalidade , Espanha/epidemiologia , Resultado do Tratamento
12.
Int J Med Inform ; 80(4): 262-73, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21295515

RESUMO

OBJECTIVE: The aim of this paper is to apply an informatics tool for dealing with a medical decision aiding problem to help infertile couples to become parents, when using assisted reproduction. METHODS: A multiple criteria decision aiding method for sorting or ordinal classification problems, called Electre Tri-C, was chosen in order to assign each couple to an embryo-transfer category. The set of categories puts in evidence a way for increasing the single pregnancy rate, while minimizing multiple pregnancies. The decision aiding sorting model was co-constructed through an interaction process between the decision aiding analysts and the medical experts. RESULTS: According to the sample used in this study, the Electre Tri-C method provides a unique category in 86% of the cases and it achieves a sorting accuracy of 61%. Retrospectively, the medical experts do agree that some of their judgments concerning the number of embryos to transfer back to the uterus of the woman could be different according to these results. The current ART methodology achieves a single pregnancy rate of 47% and a twin pregnancy rate of 14%. Thus, this informatics tools may play an important role for supporting ART medical decisions, aiming to increase the single pregnancy rate, while minimizing multiple pregnancies. LIMITATIONS: Building the set of criteria comprises a part of arbitrariness and imperfect knowledge, which require time and expertise to be refined. Among them, three criteria are modeled by means of a holistic classification procedure by the medical experts.


Assuntos
Algoritmos , Sistemas de Apoio a Decisões Clínicas , Infertilidade/reabilitação , Educação de Pacientes como Assunto , Técnicas de Reprodução Assistida , Software , França , Humanos
13.
Arq. Inst. Biol. (Online) ; 77(3): 471-476, jul.-set. 2010. tab
Artigo em Português | VETINDEX, LILACS | ID: biblio-1391604

RESUMO

O ácaro-plano-vermelho-da-seringueira, Tenuipalpus heveae Baker é uma importante praga de Hevea brasiliensis (Willd. ex. Adr. de Juss.) Müell. Arg. Entre os ácaros predadores, Euseius citrifolius Denmark & Muma tem sido frequentemente registrado nessa cultura. Este trabalho teve por objetivo determinar a atividade predatória de E. citrifolius sobre as fases de ovo, larva, ninfa e adulto de T. heveae. Os experimentos foram realizados em placas de Petri de 9 cm de diâmetro, contendo uma camada de algodão umedecido e sobre ela um disco de folha de seringueira de 2,5 cm de diâmetro, obtido de folhas naturalmente infestadas no campo. Em cada disco foram deixados vinte espécimes da fase biológica de T. heveae a ser testada, eliminando-se o restante com um estilete. Cada placa recebeu um exemplar do predador (larva, ninfa ou fêmea), proveniente de uma criação de laboratório. Para cada fase de E. citrifolius testada, foram considerados quatro tratamentos (fases de T. heveae) e vinte repetições em um delineamento inteiramente casualizado. As avaliações foram realizadas após 24 horas para larvas e ninfas do predador e após 24, 48 e 72 horas para as fêmeas. Larvas e ninfas de E. citrifolius tiveram preferência por larvas de T. heveae, seguida por ninfas, ovos e adultos. Em 72 horas, cada fêmea do predador consumiu 15,0 larvas, 14,5 ninfas, 7,4 adultos ou 2,2 ovos de T. heveae. Assim, pode-se concluir que o ácaro-plano-vermelho é uma presa aceita por E. citrifolius, que apresenta preferência pelas fases de larva e ninfa.


The rubber tree red false spider mite, Tenuipalpus heveae Baker, is an important pest of Hevea brasiliensis (Willd. ex. Adr. de Juss.) Müell. Arg. The phytoseiid mite Euseius citrifolius Dennmark & Muma has frequently been recorded on rubber tree crops. The objective of this work was to determine the predatory activity of E. citrifolius on the different life stages (egg, larva, nymph and adult) of T. heveae. The experiments were carried out in Petri dishes (9-cm diameter) containing a layer of wet cotton inside, onto which a disk of rubber tree leaf (2.5-cm diameter) was laid. The disks were taken from naturally infested leaves. Twenty specimens in the life stage that was to be tested were left on the disk and the others were eliminated; a predator life stage (larva, nymph or female) was obtained from a laboratory stock colony and put into each dish. For each tested life stage of E. citrifolius, 4 treatments (T. heveae life stages) and 20 replications were considered in a randomized block design. The observations were made after 24 hours for larvae and nymphs of the predator, and after 24, 48 and 72 hours for the females. E. citrifolius larvae and nymphs had a higher preference for T. heveae larvae followed by nymphs, eggs and adults. Within 72 hours, each predator female consumed 15.0 larvae, 14.5 nymphs, 7.4 adults or 2.2 eggs of T. heveae. It is concluded that E. citrifolius can feed on red false spider mites, the larva and nymph being the preferred stages.


Assuntos
Comportamento Predatório , Ácaros/parasitologia , Hevea/parasitologia , Agentes de Controle Biológico
14.
Med. intensiva (Madr., Ed. impr.) ; 34(2): 87-94, mar. 2010. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-81252

RESUMO

Introducción: La pandemia de gripe A (H1N1)v es la primera pandemia en la que las unidades de cuidados intensivos (UCI) desempeñan un papel fundamental. Su evolución ha sido muy rápida desde los primeros casos diagnosticados en México y la afectación posterior de países del cono sur hasta su llegada a Europa durante la época estival. Objetivo: Comparar las características clínicas y de evolución de los pacientes críticos ingresados hasta el 31 de julio de 2009 en España con algunas series de Latinoamérica. Material y método: Se consideraron 6 series de pacientes ingresados en la UCI. Se realizaron comparaciones de las características clínicas, complicaciones y evolución entre las series. Resultados: Los datos evidencian una población joven (35-45 años) con predominio de ingresos por neumonía viral con grave insuficiencia respiratoria y una elevada necesidad de ventilación mecánica (60-100%). Si bien algunas determinadas poblaciones, como los obesos, las embarazadas y los pacientes con enfermedad pulmonar crónica, parecen estar expuestas a un riesgo más elevado, la ausencia de comorbilidades alcanza un porcentaje considerable en casi todas las series (40-50%). La mortalidad superior en Latinoamérica osciló entre el 25 y el 50%, y demostró el particular potencial patogénico del nuevo virus. El uso del tratamiento antiviral es tardío (entre 3 y 6 días) y poco generalizado, con mayor retraso en Latinoamérica respecto de España. Conclusiones: Estos datos indican que una estrategia de tratamiento más intensivo con un acceso más precoz y fácil al antiviral podría reducir el número de pacientes que requieren UCI y su mortalidad (AU)


Introduction: Pandemic Influenza A (H1N1)v infection is the first pandemic in which intensive care units (ICU) play a fundamental role. It has spread very rapidly since the first cases were diagnosed in Mexico with the subsequent spread of the virus throughout the Southern Cone and Europe during the summer season. Objective: This study has aimed to compare the clinical presentation and outcome among the critical patients admitted to the ICU until July 31, 2009 in Spain with some series from Latin America. Material and method: Six series of critically ill patients admitted to the ICU were considered. Clinical characteristics, complications and outcome were compared between series. Results: Young patients (35-45 years) with viral pneumonia as a predominant ICU admission cause with severe respiratory failure and a high need of mechanical ventilation (60-100%) were affected. Obesity, pregnancy and chronic lung disease were risk factors associated with a worse outcome, however there was a high number of patients without comorbidities (40-50%). Mortality rate was between 25-50% and higher in the Latin America series, demonstrating the specific potential pathogenesis of the new virus. The use of antiviral treatment was delayed (between 3 and 6 days) and not generalized, with greater delay in Latin America in regards to Spain. Conclusions: These data suggest that a more aggressive treatment strategy, with earlier and easier access to the antiviral treatment might reduce the number of ICU admissions and mortality (AU)


Assuntos
Humanos , Masculino , Feminino , Gravidez , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Surtos de Doenças , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/epidemiologia , Antivirais/uso terapêutico , Mortalidade Hospitalar , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Influenza Humana/virologia , Unidades de Terapia Intensiva/estatística & dados numéricos , América Latina/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Índice de Gravidade de Doença , Espanha/epidemiologia
15.
Med Intensiva ; 34(2): 87-94, 2010 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-20061066

RESUMO

INTRODUCTION: Pandemic Influenza A (H1N1)v infection is the first pandemic in which intensive care units (ICU) play a fundamental role. It has spread very rapidly since the first cases were diagnosed in Mexico with the subsequent spread of the virus throughout the Southern Cone and Europe during the summer season. OBJECTIVE: This study has aimed to compare the clinical presentation and outcome among the critical patients admitted to the ICU until July 31, 2009 in Spain with some series from Latin America. MATERIAL AND METHOD: Six series of critically ill patients admitted to the ICU were considered. Clinical characteristics, complications and outcome were compared between series. RESULTS: Young patients (35-45 years) with viral pneumonia as a predominant ICU admission cause with severe respiratory failure and a high need of mechanical ventilation (60-100%) were affected. Obesity, pregnancy and chronic lung disease were risk factors associated with a worse outcome, however there was a high number of patients without comorbidities (40-50%). Mortality rate was between 25-50% and higher in the Latin America series, demonstrating the specific potential pathogenesis of the new virus. The use of antiviral treatment was delayed (between 3 and 6 days) and not generalized, with greater delay in Latin America in regards to Spain. CONCLUSIONS: These data suggest that a more aggressive treatment strategy, with earlier and easier access to the antiviral treatment might reduce the number of ICU admissions and mortality.


Assuntos
Surtos de Doenças , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Comorbidade , Feminino , Mortalidade Hospitalar , Humanos , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Influenza Humana/virologia , Unidades de Terapia Intensiva/estatística & dados numéricos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Oseltamivir/uso terapêutico , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Sistema de Registros , Respiração Artificial/estatística & dados numéricos , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Índice de Gravidade de Doença , Choque/etiologia , Espanha/epidemiologia , Adulto Jovem
16.
Br J Ophthalmol ; 93(10): 1341-4, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19054831

RESUMO

AIM: The study was a prospective randomised controlled double-masked trial performed in two centres to compare sub-threshold micropulse diode laser photocoagulation (MPDL) with conventional green laser photocoagulation (CGL) in the treatment of clinically significant diabetic macular oedema (CSMO). METHODS: Fifty-three patients (84 eyes) with diabetic CSMO were randomly assigned to MPDL (n = 44) or CGL (n = 40) according to the modified Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Treatments were performed after baseline and re-treatments were allowed at or after the 4 month visit if necessary. Parameters noted included the best corrected visual acuity (BCVA), colour fundus photographs, central retinal thickness using optical coherence tomography (OCT), vision contrast sensitivity with Pelli-Robson charts and presence of visible laser scars at baseline and at 4 and 12 months. The primary outcome was BCVA at 12 months. RESULTS: All patients completed 12 months of follow-up after treatment at baseline. There were no statistically significant differences in BCVA, contrast sensitivity and retinal thickness between the two laser modalities at 0, 4 and 12 months. We found that laser scarring was much more apparent with CGL than with the sub-threshold approach (MPDL). Laser scars were identified at the 12 month visits in 13.9% of the MPDL-treated eyes compared with 59.0% of the CGL-treated eyes (p<0.001). CONCLUSION: Sub-threshold micropulse diode laser photocoagulation is equally as effective as CGL treatment for CSMO. TRIAL REGISTRATION NUMBER: ISTRN 90646644.


Assuntos
Retinopatia Diabética/cirurgia , Fotocoagulação a Laser/métodos , Edema Macular/cirurgia , Adulto , Idoso , Cicatriz/etiologia , Sensibilidades de Contraste , Retinopatia Diabética/patologia , Retinopatia Diabética/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Fotocoagulação a Laser/efeitos adversos , Macula Lutea/patologia , Edema Macular/patologia , Edema Macular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Acuidade Visual
17.
Acta Med Port ; 20(3): 193-200, 2007.
Artigo em Português | MEDLINE | ID: mdl-17868527

RESUMO

Breastfeeding is the best way of feeding the baby for the first six months of life. However, in Portugal the abandonment rate of breastfeeding is very high during the baby first's months of life. The aim of this study was to assess prevalence of breastfeeding and to identify related factors during the six months after delivery, as socio demographic variables and life styles. We conducted a cohort study at the Maternity of the Hospital Santa Maria. A standard questionnaire was applied to 475 women after delivery, at three and six months postpartum. We studied socio demographics aspects, life styles and the way of feeding during the six months after delivery. Multivariate analysis was performed. The women studied (mean age of 29.8 +/- 5,4 years), 52.2% were primiparous, 86.1% were Caucasian, 40% had a high school degree and 33% had a University degree. Four hundred and sixty (96.8%) received prenatal care. The mean gestational age was 38.8 +/- 2 weeks and the birth weight was 3198.3 +/- 545.3 g. At the discharge 91% were breastfeeding (77% exclusively), 54.7% at third month and 34.1% at sixth month. The main causes pointed for abandoning breastfeeding were insufficient milk production, bad sucking and return to work. The milk formula introduction was in 68.6% cases by medical recommendation. The decision in maintenance breastfeeding at third and sixth months was correlated with a previous positive breastfeed experience, high educational level, healthy lifestyles, as non-smoking, regular physical activity, and information about advantage of breastfeed for mother health. Information about breastfeeding was received by media, friends, family and only 9% by health professionals. Fifty (13%) women had no information about breastfeeding. Although breastfeeding rate at discharge was high, there was an important rate of abandonment at third and sixth month. Healthy lifestyles, high educational level, a previous positive breastfeed experience had a positive influence in breastfeeding. Understanding attitudes towards pregnancy and breastfeeding can lead to new strategies for its promotion and maintenance.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Estilo de Vida , Fatores Socioeconômicos , Inquéritos e Questionários
18.
Braz J Biol ; 66(2A): 393-404, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16862292

RESUMO

Analysis of a three-year bird survey in the pantanal of Poconé revealed that most of the resident and seasonal birds are habitat generalists, using two or more habitats. In this study, previously sampled habitats were ranked in relation to species richness and stability (as measured by the ratio of seasonal to resident species). In all, nine habitats were grouped into three categories; results are as follows: 1) forests: more species-rich and more stable; 2) cerrado: intermediate levels; and 3) aquatic: less species-rich and less stable. The number of seasonal species remained relatively constant in forests throughout the year, while increasing in the other habitats during the dry season. The abundance of resident species seems to be related to species use of multiple habitats. Although many species were found to be habitat generalists, we discuss possible consequences of habitat loss and other human impacts on efforts to conserve this important bird community.


Assuntos
Biodiversidade , Aves/classificação , Animais , Aves/fisiologia , Brasil , Densidade Demográfica , Dinâmica Populacional , Estações do Ano
19.
Braz. j. biol ; 66(2a): 393-404, May 2006. tab, graf
Artigo em Inglês | LILACS | ID: lil-431525

RESUMO

Análises de um levantamento de três anos da avifauna do Pantanal de Poconé indicam que a maioria das espécies residentes e estacionais utiliza dois ou mais tipos de habitats. Estes habitats podem ser ordenados num gradiente de riqueza de espécies e estabilidade (medida pela proporção de espécies estacionais): 1) matas - mais ricas e estáveis; 2) cerrados e pastos – intermediários; e 3) campos inundáveis/aquáticos – menos ricos e menos estáveis. Enquanto a proporção de espécies estacionais nas matas permanece relativamente constante ao longo do ano, há aumento significativo destas espécies nos outros habitats durante a estação seca. A abundância das espécies residentes parece ligada ao uso de maior variedade de habitats. São discutidas possíveis implicações decorrentes da destruição de habitats e perturbações antrópicas na conservação desta comunidade de aves.


Assuntos
Animais , Biodiversidade , Aves/classificação , Brasil , Aves/fisiologia , Densidade Demográfica , Dinâmica Populacional , Estações do Ano
20.
Braz. j. biol ; 66(2)2006.
Artigo em Inglês | LILACS-Express | LILACS, VETINDEX | ID: biblio-1467818

RESUMO

Analysis of a three-year bird survey in the pantanal of Poconé revealed that most of the resident and seasonal birds are habitat generalists, using two or more habitats. In this study, previously sampled habitats were ranked in relation to species richness and stability (as measured by the ratio of seasonal to resident species). In all, nine habitats were grouped into three categories; results are as follows: 1) forests: more species-rich and more stable; 2) cerrado: intermediate levels; and 3) aquatic: less species-rich and less stable. The number of seasonal species remained relatively constant in forests throughout the year, while increasing in the other habitats during the dry season. The abundance of resident species seems to be related to species use of multiple habitats. Although many species were found to be habitat generalists, we discuss possible consequences of habitat loss and other human impacts on efforts to conserve this important bird community.


Análises de um levantamento de três anos da avifauna do Pantanal de Poconé indicam que a maioria das espécies residentes e estacionais utiliza dois ou mais tipos de habitats. Estes habitats podem ser ordenados num gradiente de riqueza de espécies e estabilidade (medida pela proporção de espécies estacionais): 1) matas - mais ricas e estáveis; 2) cerrados e pastos - intermediários; e 3) campos inundáveis/aquáticos - menos ricos e menos estáveis. Enquanto a proporção de espécies estacionais nas matas permanece relativamente constante ao longo do ano, há aumento significativo destas espécies nos outros habitats durante a estação seca. A abundância das espécies residentes parece ligada ao uso de maior variedade de habitats. São discutidas possíveis implicações decorrentes da destruição de habitats e perturbações antrópicas na conservação desta comunidade de aves.

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