RESUMO
The objective of this study was to assess the impact of increasing levels of heat-treated soybean in the diet of crossbred cattle during the finishing phase on nutrient intake and digestibility, ruminal parameters, digesta passage rate, nitrogen balance, and microbial protein synthesis. Five steers, crossbred 7/8 Jersey x Zebu, fitted with rumen cannulas and with an average weight of 350 ± 50 kg, were utilized. The experimental treatments consisted of 0, 7, 14, 21, and 28% inclusion of heat-treated soybean in the total diet dry matter. The animals were randomly allocated in a 5 × 5 Latin square design. Evaluation of the animals took place over five experimental periods, each lasting 20 days. During each experimental period, the first 15 days were allocated for animal adaptation to the experimental diets, followed by five days of data collection. No significant differences were observed among the diets in terms of dry matter intake (average of 6.57 kg day-1; P = 0.615) and organic matter intake (average of 6.23 kg day-1; P = 0.832). However, heat-treated soybean had a significant impact on the digestibility of dry matter (P = 0.02), organic matter (P = 0.01), crude protein (P < 0.01), and neutral detergent fiber (P < 0.01). There was no observed change on microbial protein synthesis (average of 409.6 g day-1) in animals with the inclusion of heat-treated soybean in the diets. With each 1% inclusion of heat-treated soybean in the cattle diet, there was an increase of 0.00754 units in ruminal pH values and a reduction of 0.75839 mg dL-1 in ruminal ammoniacal nitrogen values. This study suggests that heat-treated soybean can be included in up to 15% of the dry matter in diets for finishing feedlot cattle.
Assuntos
Farinha , Glycine max , Bovinos , Animais , Temperatura Alta , Digestão , Dieta/veterinária , Nitrogênio/metabolismo , Rúmen/metabolismo , Fermentação , Ração Animal/análise , Fibras na Dieta/metabolismoRESUMO
Qualitative study developed in a public university of São Paulo State, Brazil, to identify the conception of quality of hospital nursing care under the perspective of last year undergraduate nursing students. Semi-structured interviews with 24 students were performed to collect the data and the speeches were analyzed according to Bardin's conceptual framework. The central ideas of the speeches were divided into six categories: holism, humanization, technically and scientifically trained team, promotion of self-care, appropriate management of the units and respecting the safety principles in care. It is concluded that students' view regarding the theme is wide; however it is necessary to incorporate important issues to the concept of quality of hospital care, such as the valorization of team work, the systematization of care and the satisfaction of all actors involved in nursing care.
Assuntos
Serviço Hospitalar de Enfermagem/normas , Qualidade da Assistência à Saúde , Estudantes de Enfermagem , Adulto , Feminino , Humanos , Masculino , Adulto JovemRESUMO
ABSTRACT: The aim of this study was to evaluate the histological changes in the liver of thirty-five Gymnotusspp. parasitized by endohelminths collected between April 2012 to October 2013 in commercial bait fish farming of Pantanal basin. Histological cuts of 7µm were stained with hematoxylin-eosin for parasites research and liver changes and have also been submitted to the Perls histochemical method for evaluation of hemosiderosis (Fe+++) based on the incidence degree and severity of change (Grade I, II and III) and tests for the presence of central melanomacrophages. Parasites identified were: Brevimulticaecumsp. with a prevalence of 22,9%, Eustrongylidessp 17,1%, Contracaecumtype I 68,7%, Contracaecumtype II 5,7%, Contracaecumtype III 5,7% and larvae of Anisakidae11,4%. Histological analysis showed intense disorganization of hepatic parenchyma with degenerate hepatocytes due to high parasitic infection, changes that can be deleterious and compromise the organism functioning, being harmful to the health of evaluated animals. Also evidencing normal tissue interleaved with different stages of Fe+++ deposit in grades II and III, injuring or destroing the cell. Histopathological changes in the tuvira's liver suggested a chronic response and the development of a balance relation between tuvira and parasitism by endohelminth identified in this study. There are also a testimony to the health condition of commercial bait fish farming on current ecosystem conditions.
RESUMO: O objetivo deste estudo foi avaliar as alterações histológicas do fígado de trinta e cinco Gymnotusspp. parasitados por endohelmintos, coletados entre abril de 2012 a outubro de 2013, em isqueiros da bacia do Pantanal. Cortes histológicos de 7µm foram corados com hematoxilina-eosina para pesquisa de parasitos e de alterações hepáticas; também foram submetidos ao método histoquímico de Perls para avaliação de hemossiderose (Fe+++) com base no grau de incidência e severidade da alteração (Grau I, II e III) e pesquisa da presença de centro de melanomacrófagos. Os parasitos identificados foram: Brevimulticaecumsp., com prevalência de 22,9%, Eustrongylidessp. 17,1%, Contracaecumtipo I 68,7%, Contracaecumtipo II 5,7%, Contracaecumtipo III 5,7% e larvas de Anisakidae11,4%. A análise histológica revelou intensa desorganização do parênquima hepático, com hepatócitos degenerados devido à alta infecção parasitária. Essas alterações podem ser deletérias e comprometer o funcionamento do organismo, sendo prejudicial à saúde dos animais avaliados; também evidenciou tecido normal intercalado com estágios diferenciados de depósito de Fe+++ nos Graus II e III, podendo lesionar ou destruir a célula. As alterações histopatológicas do fígado das tuviras sugerem uma resposta crônica e o desenvolvimento de uma relação de equilíbrio entre a tuvira e o parasitismo pelos endohelmintos identificados neste estudo. Elas também são um testemunho da condição de saúde dos peixes dos isqueiros nas condições atuais do ecossistema.
RESUMO
BACKGROUND: Continuous positive airway pressure is a noninvasive respiratory support technique that may prevent pulmonary complications following cardiac surgery. This study was conducted to determine the efficacy of prophylactic nasal continuous positive airway pressure (nCPAP) compared with standard treatment. The primary end points were pulmonary adverse effects defined as hypoxemia (Pao(2)/fraction of inspired oxygen [Fio(2)] <100), pneumonia, and reintubation. The secondary end point was the readmission rate to the ICU or intermediate care unit (IMCU). METHODS: We prospectively randomized 500 patients scheduled for elective cardiac surgery. Following extubation either in the operating room (early) or in the ICU (late), patients were allocated to standard treatment (control) including 10 min of intermittent nCPAP at 10 cm H(2)O every 4 h or prophylactic nCPAP (study) at an airway pressure of 10 cm H(2)O for at least 6 h. RESULTS: Prophylactic nCPAP significantly improved arterial oxygenation (Pao(2)/Fio(2)) without altering heart rate and mean arterial BP. Pulmonary complications including hypoxemia (defined as Pao(2)/Fio(2) <100), pneumonia, and reintubation rate were reduced in study patients compared to controls (12 of 232 patients vs 25 of 236 patients, respectively; p = 0.03). The readmission rate to the ICU or IMCU was significantly lower in nCPAP-treated patients (7 of 232 patients vs 14 of 236 patients, respectively; p = 0.03). CONCLUSIONS: The long-term administration of prophylactic nCPAP following cardiac surgery improved arterial oxygenation, reduced the incidence of pulmonary complications including pneumonia and reintubation rate, and reduced readmission rate to the ICU or IMCU. Thus noninvasive respiratory support with nCPAP is a useful tool to reduce pulmonary morbidity following elective cardiac surgery.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Pressão Positiva Contínua nas Vias Aéreas , Hipóxia/prevenção & controle , Pneumopatias/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Idoso , Ponte de Artéria Coronária , Cuidados Críticos/métodos , Feminino , Implante de Prótese de Valva Cardíaca , Humanos , Intubação Intratraqueal , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Readmissão do Paciente/estatística & dados numéricos , Pneumonia/prevenção & controle , Estudos Prospectivos , Insuficiência Respiratória/prevenção & controle , RetratamentoRESUMO
Estudo com abordagem qualitativa, desenvolvido em universidade pública do interior do Estado de São Paulo com o objetivo de identificar o conceito de qualidade na assistência de enfermagem hospitalar na perspectiva de alunos do último ano do curso de Bacharelado em Enfermagem. Foram realizadas entrevistas semi-estruturadas com 24 alunos, sendo as falas analisadas segundo o referencial de Bardin. Os núcleos de sentido das falas foram divididos em seis categorias: holismo, humanização, equipe capacitada técnica e cientificamente, promoção do autocuidado, gerenciamento adequado das unidades e respeito aos princípios de segurança na assistência. Os resultados nos permitiram concluir que a visão dos alunos acerca do tema é ampla, sendo necessário, no entanto, incorporar pontos importantes ao conceito de qualidade na assistência de enfermagem, tais como valorização do trabalho em equipe, sistematização da assistência e questões relacionadas à satisfação dos diversos atores envolvidos na assistência em saúde no ambiente hospitalar.
Estudio cualitativo desarrollado en una universidad pública en el Estado de Sao Paulo, Brasil, con el objetivo de identificar el concepto de calidad en la atención de enfermería hospitalaria en la perspectiva de estudiantes del último año del curso de bachillerato en enfermería. Para la recolección de los datos, fueron realizadas entrevistas semi-estructuradas con 24 alumnos y las declaraciones fueron analizadas según el referencial de Bardin. Las ideas principales se dividían en seis categorías: holismo, humanización, equipo capacitado técnica y científicamente, promoción del auto cuidado, gerenciamiento adecuado de las unidades y respecto a los principios de seguridad en la atención. La visión de los alumnos acerca del tema es amplia pero aún es necesario que identifiquen temas importantes como la valoración del trabajo en equipo, sistematización de la atención y la satisfacción de los atores involucrados en la atención de enfermería hospitalaria.
Qualitative study developed in a public university of São Paulo State, Brazil, to identify the conception of quality of hospital nursing care under the perspective of last year undergraduate nursing students. Semi-structured interviews with 24 students were performed to collect the data and the speeches were analyzed according to Bardin's conceptual framework. The central ideas of the speeches were divided into six categories: holism, humanization, technically and scientifically trained team, promotion of self-care, appropriate management of the units and respecting the safety principles in care. It is concluded that students' view regarding the theme is wide; however, it is necessary to incorporate important issues to the concept of quality of hospital care, such as the valorization of team work, the systematization of care and the satisfaction of all actors involved in nursing care.
Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Serviço Hospitalar de Enfermagem/normas , Qualidade da Assistência à Saúde , Estudantes de EnfermagemRESUMO
OBJECTIVE: The aim of the study was to determine pre- and intraoperative risk factors for the development of postoperative delirium among patients undergoing aortic, carotid, and peripheral vascular surgery to predict the risk for postoperative delirium. SUMMARY BACKGROUND DATA: Although postoperative delirium after vascular surgery is a frequent complication and is associated with the need for more inpatient hospital care and longer length of hospital stay, little is known about risk factors for delirium in patients undergoing vascular surgery. METHODS: Pre-, intra-, and postoperative data were prospectively collected, including the first 7 postoperative days with daily follow-up by a surgeon and a psychiatrist of 153 patients undergoing elective vascular surgery. Delirium (Diagnostic and statistical Manual of Mental Disorders IV) was diagnosed by the psychiatrist. Multivariate linear logistic regression and a cross validation analysis were performed to find a set of parameters to predict postoperative delirium. RESULTS: Sixty patients (39.2%) developed postoperative delirium. The best set of predictors included the absence of supraaortic occlusive disease and hypercholesterinemia, history of a major amputation, age over 65 years, a body size of less than 170 cm, preoperative psychiatric parameters and intraoperative parameters correlated to increased blood loss. The combination of these parameters allows the estimation of an individual patients' risk for postoperative delirium already at the end of vascular surgery with an overall accuracy of 69.9%. CONCLUSIONS: Postoperative delirium after vascular surgery is a frequent complication. A model based on pre- and intraoperative somatic and psychiatric risk factors allows prediction of the patient's risk for developing postoperative delirium.
Assuntos
Delírio/etiologia , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Valor Preditivo dos Testes , Curva ROC , Fatores de RiscoRESUMO
Analisou-se a performance produtiva de vacas mestiças das raças Holandesa (H) e Gir (G) de um rebanho localizado emltaguaí, Rio de Janeiro (latitude 22" 45"S e longitude 43 41" W) utilizando-se dados de 1.178 lactações, abrangendo um períodode dez anos (1982 a 1991 ). A média estimada para produção de leite por dia de intervalo de partos (PRLIP) foi 11,90 ± 0,08 kg.A PRLIP foi influenciado, de forma significativa (P 0,01 ), pelo ano de parto, ordem de parto, grupo genético e período delactação, não sendo, contudo, influenciada (P>0,05) pela estação de parto. Os grupos de animais 314 HG, 718 HG e 15116 HGapresentaram maiores índices de PRLIP em relação ao 112 HG. Observou-se efeito linear do período de lactação sobre aPRLIP (b = 0,011 kg I dia).