Literatura académica sobre el tema "Hospital Real de S"

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-28T12:14:02Z No. of bitstreams: 1 469458 - Texto Completo.pdf: 15561298 bytes, checksum: 3e2aef91e88f708205203abd85b8f44c (MD5)<br>Made available in DSpace on 2015-05-28T12:14:02Z (GMT). No. of bitstreams: 1 469458 - Texto Completo.pdf: 15561298 bytes, checksum: 3e2aef91e88f708205203abd85b8f44c (MD5) Previous issue date: 2015-03-18<br>This is a retrospective study reporting 35 years of kidney transplantation at Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. An historical approach of the origins and development of the Nephrology Unit over the years was performed. Data were separated into different eras, based on the type of immunosuppression, and the patient?s characteristics before, during and after transplantation were assessed. There were significant differences between each era, mainly on the characteristics of the recipients and donors, but also in the rates of complications and technical aspects of surgery. A total of 1231 transplants were performed until 2013, April 30. Of these, 55.8% were male, white (86.9%) and 76.6% from deceased donors. Most recipients aged between 19 and 59 years (77.5%), and 1.9% over 70 years. Significant differences were observed between the characteristics of each era, especially in relation to recipients and donors. Through the eras, an increased number of patients are being transplanted, with grafts from older donors (p<0.001) subjected to longer cold ischemia times (p<0.001) transplanted in an increasing proportion of elderly recipients (p<0.001), maintained in a longer period on the waiting list (p<0.001). Fewer episodes of rejection were observed (p<0.001), lower incidence of some clinical complications such as myocardial infarction (p<0.001), strokes (p=0.02) and post-??transplant diabetes (p<0.001), along of the time. In the present era, survival of patients at 1, 3 and 5 years were 98.3%, 94.6% and 90.5% for living donors and 92.4%, 87.2% and 80.7% for deceased donors, respectively. Survival of grafts were, for living donors, 92.2%, 88.7% and 82.4% and deceased donors 80.4%, 71.1% and 63.7%. Transplants with acute pyelonephritis in the first 30 days after transplantation, had significantly worse graft and patients survivals, compared to patients without pyelonephritis in the first 30 days. In addition, age, use of ureteral stents, thymoglobulin induction and longer hospital stays increased the risk of this infection. Recipients of expanded criteria donors transplants induced with thymoglobulin may be at a 25.75 fold increase in risk for death 24 hours after diagnosis of CRAB septicemia, a severe complication occurring in 10 recipients between January 2000 and April 2013, of 807 transplants patients. In recent years, our study showed a low incidence of cytomegalovirus (CMV) infection, despite the increased use of Thymoglobulin. We found that the use of low thymoglobulin doses reduces the risk of cytomegalovirus and, the use of oral ganciclovir had a protective effect on CMV, in the first year of transplantation. Finally, patients with a positive polyomavirus urinary cytology had worse renal function and graft survival in a seven years follow-??up period, compared with the patients without the presence of decoy cells in urine. The analysis of the 35 years of transplantation at the Renal Unit of Hospital S?o Lucas da PUCRS depicts the evolution and development of a program that is a reference in South Brazil, and the different management and results through the different eras. There were changes in donor and recipient?s characteristics, inclusion selection, compatibility assessment and immunosuppression protocols, among others.<br>Este trabalho consiste em um estudo retrospectivo que abordou a hist?ria dos 35 anos de transplantes renais no Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Foi realizado um levantamento da hist?ria das origens do servi?o de nefrologia e sua evolu??o ao longo dos anos. Os dados foram separados em diferentes eras, com base no tipo de imunossupress?o, sendo avaliadas as caracter?sticas dos pacientes antes, durante e ap?s o transplante. Encontramos diferen?as significativas entre cada era, principalmente nas caracter?sticas dos receptores e doadores, mas tamb?m na ocorr?ncia de complica??es e nos aspectos cir?rgicos. Foram realizados 1231 transplantes at? 30 de abril de 2013, sendo 55,8% do sexo masculino, ra?a branca (86,9%) e com 76,6% de doadores falecidos. A maioria dos receptores com idade entre 19 e 59 anos (77,5%), sendo 1,9% acima de 70 anos. Diferen?as significativas entre as caracter?sticas de cada era, principalmente em rela??o aos receptores e doadores. Estamos transplantando um n?mero progressivamente maior de pacientes, significativamente mais idosos (p<0,001), com maior tempo em lista de espera (p<0,001), com doadores mais idosos (p<0,001) e tempos mais longos de isquemia (p<0,001). Foram verificados menos epis?dios de rejei??o (p<0,001), menor ocorr?ncia de algumas complica??es cl?nicas, tais como infarto de mioc?rdio (p<0,001), AVE (p=0,02) e diabete p?s transplante (p<0,001), ao longo do tempo. Na era atual, sobrevida de pacientes foram em 1, 3 e 5 anos de 98,3%, 94,6% e 90,5% para doadores vivos e de 92,4%, 87,2% e 80,7% para doadores falecidos, respectivamente. Sobrevida de enxertos foram para doadores vivos de 92,2%, 88,7% e 82,4% e doadores falecidos de 80,4%, 71,1% e 63,7%. Foi encontrado que transplantados que apresentaram pielonefrite aguda nos primeiros 30 dias ap?s o transplante, apresentavam significativamente pior sobrevida de enxertos e pacientes, comparado com os que n?o apresentavam pielonefrite nos primeiros 30 dias. Al?m disto, idade, uso de cateteres de duplo J, indu??o com timoglobulina e tempo maior de hospitaliza??o aumentam o risco desta infec??o. Pacientes que receberam rins com doadores com crit?rios expandidos e induzidos com timoglobulina podem apresentar risco maior para morte ap?s 24 horas do diagn?stico de septicemia por Acinetobacter baumannii resistentes a carbapen?micos, complica??o grave que ocorreu em 10 pacientes transplantados, dentre os 807 transplantados entre janeiro de 2000 e abril de 2013. Ocorreu baixa incid?ncia de citomegalov?rus nos ?ltimos anos, apesar do aumento do uso de timoglobulina. Verificamos que o uso de timoglobulina em doses menores diminui o risco de citomegalov?rus e que o uso de ganciclovir oral tem efeito protetor para o desenvolvimento de citomegalov?rus no primeiro ano do transplante. E por fim, verificamos que pacientes que apresentavam presen?a de citologia urin?ria positiva para poliomav?rus apresentaram pior fun??o renal e pior sobrevida de enxerto, em acompanhamento de 7 anos, comparado com grupo de pacientes que n?o tinha presen?a de c?lulas decoy na urina. A an?lise de 35 anos de transplante do Servi?o de Nefrologia da PUCRS, mostra a evolu??o de um programa de refer?ncia no nosso meio e as diferentes condutas e resultados nas diversas ?pocas. Ocorreram mudan?as nas caracter?sticas dos doadores e receptores, crit?rios de sele??o, avalia??o de compatibilidade e protocolos de imunossupress?o, entre outros.

Staphylococcus aureus (S. aureus) catheter-related bloodstream infection (CRBSI) remains a leading cause of nosocomial (hospital acquired) infection worldwide. Early detection of S. aureus as a causative organism and appropriate antibiotic therapy is crucial in reducing patient morbidity and mortality rates. Current diagnosis of S. aureus intravascular catheter (IVC) colonisation relies on the use of conventional culture-dependent methods. However, many fastidious bacteria are difficult to be recovered in current laboratory conditions. Furthermore, a definitive diagnosis following a positive culture may take up to seven days and is therefore not useful in directing early antibiotic therapy in patients with CRBSI. A real-time polymerase chain reaction (PCR) assay, using primers specific to the thermonuclease (nuc) gene, targeting the S. aureus genome has the potential to address these limitations.<br>Thesis (Masters)<br>Master of Science (MSc)<br>School of Natural Sciences<br>Science, Environment, Engineering and Technology<br>Full Text

Made available in DSpace on 2015-04-14T13:33:05Z (GMT). No. of bitstreams: 1 448602.pdf: 5444949 bytes, checksum: 5f077f7aa23c0ec642d7726b401ada78 (MD5) Previous issue date: 2013-03-04<br>OBJECTIVE: To calculate the frequencies of acute pyelonephritis and renal scarring in youngers than two years old through scintigraphy with 99mTcDMSA with first episode of UTI in a Brazilian university hospital and comparing with international literature. MATERIALS AND METHODS: We reviewed reports scintigraphy of youngers than two years old who underwent scintigraphy with 99mTcDMSA in a university hospital in Rio Grande do Sul, between 2006 and 2009 to search for APN and renal scarring. It was also revised the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities that were recorded in e lectronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. We excluded patients with no electronic record. RESULTS: 157 children met the inclusion criteria, where 48 had APN and 8 of these had renal scars. There was no statistical difference in the association of VUR and APN (p=1.0) as well as among all comorbidities (p=0.470). There was no significance relation to early use of antibiotics and APN (p=0.130) and renal scarring (p=0.720). CONCLUSION: The frequency of renal scarring and APN obtained agree with the results of most studies.<br>OBJETIVO: Calcular as frequ?ncias de pielonefrite aguda (PNA) e cicatriz renal em pacientes menores de dois anos com cintilografia renal com 99mTcDMSA com primeiro quadro de ITU em hospital universit?rio brasileiro comparando com dados da literatura internacional. MATERIAIS E M?TODOS: Foram revisados laudos cintilogr?ficos de crian?as menores de dois anos de idade que realizaram cintilografia renal com 99mTcDMSA em um hospital universit?rio de no Rio Grande do Sul, entre 2006 e 2009 para pesquisa de PNA/cicatriz renal. Revisouse a presen?a de refluxo v?sicoureteral (RVU), uso precoce de antibi?tico, e presen?a de comorbidades que constassem nos prontu?rios eletr?nicos. Calculouse a amostra baseado num estudo de revis?o sistem?tica e obtevese um m?nimo de 147 pacientes. Excluiu-se pacientes sem registro eletr?nico. RESULTADOS: 157 crian?as preencheram crit?rios de inclus?o do estudo, 48 tiveram PNA e 8 destes apresentaram cicatriz renal. Nem a idade e g?nero dos pacientes apresentaram associa??o significativa com PNA (p=0,405&#894; p=0,124 respectivamente). N?o houve diferen?a estat?stica nas associa??es de RVU e PNA (p=1,0) e outras comorbidades (p=0,470)&#894; e em rela??o ao uso precoce de antibi?tico com PNA (p=0,130) e cicatriz renal (p=0,720). CONCLUS?O: As frequ?ncias de PNA e cicatriz renal obtidas concordam com os resultados da maioria dos estudos publicados

Made available in DSpace on 2014-12-17T15:38:46Z (GMT). No. of bitstreams: 1 EtienneAMD.pdf: 633997 bytes, checksum: a1c6aef8df161229449aa5c834ae4cee (MD5) Previous issue date: 2003-11-26<br>Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior<br>We studied about the organizational health and the syndrome of burnout in professionals of the education and health field, with the objective of establishing a connection between those two constructs. This research was realized in three public schools and in three hospitals, two publics and one from the military. We obtained 168 valid questionnaires for investigation about the syndrome of burnout, being 83 in the hospitals and 85 in the schools, among the questionnaires given in those two organizations. Worked with accidental sample, although it was decided the professional proportions, with the objective of reproducing the population characteristics. In the schools the sample was planned with the teachers. In the hospitals the sample was planned with doctors, nurses and nurse assistants, nutritionists, psychologists, dentists and social assistants. To assure the syndrome of burnout, it was used the Maslach Burnout Inventory (MBI), followed with social demographic information. We used semi-structured interviews, based in the indicators, with the organizations key persons, directors, coordinators, and people involved in the human resources department, for research about the organizational health. Only among the hospitals were found significant statistics differences between the scores of factors and the incidence of burnout. Besides that, it was observed as well that it is possible to establish a connection between the organizational health and the syndrome of burnout, this research main objective<br>Estudamos sobre a sa?de organizacional e a s?ndrome de burnout em profissionais de educa??o e sa?de, objetivando estabelecer uma rela??o entre esses dois construtos te?ricos. A pesquisa foi realizada em tr?s escolas p?blicas de ensino m?dio e em tr?s hospitais, dois p?blicos e um hospital militar. Dos question?rios aplicados nos dois tipos de organiza??es, obtivemos 168 question?rios v?lidos para investiga??o da incid?ncia da s?ndrome de burnout, sendo que 83 nos hospitais e 85 nas escolas. Trabalhamos com amostras acidentais, embora tenha sido planejada a propor??o de profissionais, visando reproduzir as caracter?sticas da popula??o. Nas escolas as amostras foram planejadas com professores. Nos hospitais, com m?dicos, enfermeiros, auxiliares de enfermagem, nutricionistas, psic?logos, odont?logos e assistentes sociais. Para aferi??o da s?ndrome de burnout, utilizamos o Invent?rio de Burnout de Maslach (MBI), acrescido de uma ficha sociodemogr?fica. Para an?lise de sa?de organizacional, utilizamos entrevistas semi-estruturadas com pessoas-chave das organiza??es, diretores, coordenadores pedag?gicos e pessoas envolvidas com o setor de recursos humanos, utilizando um roteiro baseado nos indicadores. Somente entre os hospitais encontramos diferen?as estatisticamente significavas em rela??o aos escores dos fatores e a incid?ncia de burnout. Al?m disso, observamos tamb?m que ? vi?vel estabelecer a rela??o entre a sa?de organizacional e a s?ndrome de burnout, principal objetivo da pesquisa

This thesis is focused on the risks arising from the data recorded in the cadastre of real estate and legislation related to the cadastre. Introductory chapters are devoted to the definition of risk for the purposes of this work and of basic terms in response to the changes brought by the new Civil Code. A brief historical overview coupled to the cadastre and description of the basic principles of the cadastre is complemented by context resulting from the integration with information systems of public administration. The merit of the work is dedicated to risks arising from the principles of the cadastre, historical circumstances, the importance and obligatory force of the registered data and their accuracy. Among the major factors influencing the risks associated with trade in real estate can be classified in particular, the evidence of ownership of itself and fulfilling the principle of publicity material, the question of the acreage recorded in cadastre, providing access to the property or existence of the simplified register. The work is enriched by concrete examples from practice that show errors and possible solutions.

This work deals with an artificial intelligence problematics in real-time computer games. Goal of this project is a creation of an intelligent computer opponent in a real-time enviroment of a multiagent systems.

The sound environment in hospitals is complex. While there have been several studies that address the acoustic environment in hospitals, there is a limited amount of research done concerning the effect that noise has on staff. This thesis describes two related studies: 1) analysis of the relationships between acoustics and perceptual staff outcomes using an existing data set collected in real hospitals; 2) development of methodologies to test the relationships between acoustics and hospital staff task performance in a simulated laboratory setting. In the first study it was found that mental health and perception of noisiness were occupational factors that were related to the sound environment using a variety of acoustic metrics. Only a few acoustic metrics were shown to be statistically significant related to dependent variables in a direct correlation (e.g., as the acoustic conditions worsened the dependent variable also decreased). However, almost all acoustic metrics tested had a statistically significant relationship with mental health once subjective job strain was considered as a moderating factor. This means that while the direct impact of sound may not be immediately observable, sound may play a more significant role once subjective job strain is taken into account. In the second study, a new methodology was developed to directly relate staff task performance to noise and beta-tested on a single group of subjects. The methodology development included synthesizing a signal that was acoustically comparable to those heard in real hospitals in order to simulate a realistic noise exposure in a controlled environment. Additionally, objective methods of measuring performance and perception were devised by utilizing task performance scripts already validated in other studies and developing new surveys that could be administered to subjects to garner their perceived task performance and perceptions of the simulation room environment, including noise.

This diploma thesis focus on transmiting multimedia over computer network. There are detailed informations about protocols RTP and RTPC in a first part because a transmition over a network is realized by using these protocols. Some basic multimedia terms, FFmpeg codecs and SDL library are described in next chapters. A multimedia player using FFmpeg and SDL is implemented in a second part of thesis. The player is console application and it has basic user interface. The player reproduces video and audio from a given file. RTP communication is described in next chapters of the second part. RTP server and client are implemented there too. They are console aplications and they use data coded by Theora or Vorbis. There are summarized results in a conclusion.

A presente dissertação pretende contribuir para o conhecimento da história da vida corporativa e assistencial na cidade do Porto através da Confraria dos Sapateiros nos sécs. XIV e XV. Limita-se a uma abordagem sobre as origens das confrarias e como se desenvolveram em Portuga. A Confraria dos Sapateiros aparece-nos com uma relevante vertente assistencial através do seu hospital aos peregrinos de S. Tiago. Na assistência prestada transparece toda a esfera religiosa que envolvia o homem medieval e o medo perante a morte, o que leva a praticar todo o bem que lhe possa sufragar a alma. De salientar a organização, o brio e o bom desempenho na administração do Hospital pelos confrades sapateiros, cativando a simpatia real, levando ao embargue da ordem régia da anexação à Misericórdia.