Validação das diretrizes gerais de comunicação do enfermeiro com o cego / Validation of the general guidelines of communication between the nurse and the blind / Validación de las directrices generales de la comunicación entre la enfermera y el ciego

Objetivou-se validar as diretrizes gerais da comunicação do enfermeiro com o cego. Estudo quantitativo, realizado entre abril de 2008 e março de 2009 em Fortaleza-CE. Participaram 30 enfermeiros e 30 cegos divididos em grupo controle e experimental. Realizaram-se 30 consultas de enfermagem filmadas e analisadas por especialistas. O grupo experimental apresentou desempenho bom e excelente em todas as diretrizes para a comunicação verbal e não verbal com o cego, contrariamente ao grupo controle. Os resultados do estudo apontam para a urgência da adoção do ensino destas diretrizes gerais de comunicação com cegos nos cursos de enfermagem, além de capacitar enfermeiros no cuidado a pessoas cegas.

This quantitative study, conducted between 2008 April and 2009 March in Fortaleza-CE, Brazil, aimed to validate the general guidelines of the communication of the nurse with the blind. Thirty nurses and 30 blinds, divided into control and experimental groups, participated in the study. Thirty nursing consultations were videotaped and analyzed by experts. In contrast to the control group, the experimental group showed good and excellent performance in all guidelines for verbal and non-verbal communication with the blinds. The study results point to the urgency of adopting the teaching of these general guidelines for communicating with the blind in nursing courses, in addition to training nurses in caring for the blind people.

Estudio cuantitativo, realizado entre abril de 2008 y marzo de 2009, en Fortaleza-CE, Brasil, que tuvo como objetivo validar los lineamientos generales de la comunicación del enfermero con los ciegos. Los participantes fueron 30 enfermeros y 30 ciegos, divididos en grupos control y experimental. Fueran realizadas 30 consultas de enfermería, registradas y analizadas por expertos. El grupo experimental mostró un buen y excelente rendimiento en todas las directrices para comunicación verbal y no verbal con los ciegos, en contraste con el grupo de control. Los resultados del estudio apuntan a la urgencia de la adopción de la enseñanza de estas directrices generales para la comunicación con los ciegos en los cursos de enfermería, además de la formación de enfermeras en el cuidado de las personas ciegas.

Hepatic Arterioportal Shunts: Dynamic CT and MR Features

With the increased temporal resolution available in dynamic computed tomography (CT) and magnetic resonance imaging (MRI), hepatic arterioportal shunts are now more frequently encountered than in the past. The condition occurs in various hepatic diseases in which portal or hepatic venous flow is compromised. The underlying mechanism and the degree of shunt affect its appearance at dynamic imaging. The dynamic CT and MRI findings have been summarized as early enhancement of peripheral portal veins, and wedge-shaped transient parenchymal enhancement during the hepatic arterial phase. Recognition of arterioportal shunt can suggest the presence of a previously unsuspected disorder and avoids false-positive diagnosis or overestimation of a hepatic disease. Familiarity with the pathophysiology of arterioportal shunt also allows investigation of the hepatic hemodynamic changes occurring in various hepatic diseases.

Splenectomy associated with ligature of the left gastric vein in children with surgical schistosomiasis: analysis of the hepatic functional reserve

Foram submetidas 40 crianças, portadoras de esquistosomíase mansônica hepatoesplenica e sangramento de varizes esofágicas, à esplenectomia e ligadura da veia gástrica esquerda. Foram acompanhadas durante 48 meses de pós-operatório, determinando-se a reserva funcional hepática durane esse período. Antes do tratamento cirúrgico, 13 crianças foram classificadas como grau A de Child's e 27 como grau B. A concentraçäo média da albumina sérica era 3.16g/dl mais ou menos 0.62g/dl. Apenas em 1 paciente a concentraçäo de bilirubina sérica era pouco maior do que 2 mg/dl. Após a intervençäo operatória, 15 pacientes foram diagnosticados como grau A de Child's e 25 como grau B. A concentraçäo média de bilirrubina sérica foi de 3.25g/dl mais ou menos 0.50g/dl. Um paciente apresentava ainda na evoluçäo pós-operatória concentraçäo de bilirrubina sérica maior que 2mg/dl mais ou menos 0.050g/dl. Um paciente apresentava ainda na evoluçäo pós-operatória concentraçäo de bilirrubina sérica maior que 2mb/dl. Houve melhora significante após operaçäo dos níveis de protrombina plasmática. Conclui-se que näo houve deterioraçäo da reserva funcional hepática nos pacientes operados

Sonographic evaluation of spleen and portal venous system before and after complete eradication of oesophageal varices by injection sclerotherapy

The spleen size, portal vein diameter and splenic vein diameter were measured sonographically in fifteen patients before and after complete eradication of oesophageal varices by injection sclerotherapy. Significant increases in splenic size from 1202.39 +/- 509.39 cm[3] to 1514.37 +/- 550.9 cm[3], and portal vein diameter from 1.59 +/- 0.36 cms to 1.67 +/- 0.35 cms, and splenic vein diameter from 1.28 +/- 0.31 cms to 1.48 +/- 0.31 cms were observed. These findings denote definite effects of injection sclerotherapy on the spleen size and portal venous system

Hipertensión portal / Portal hypertension

Esta revisión trata sobre los recientes conocimientos de la anatomía, fisiología, etiología, clínica, exámenes auxiliares y tratamiento del síndrome de hipertensión portal. En fisiopatología se destaca que además de los factores clásicos considerados en la hipertensión portal de origen cirrótico, habría otro, dado por el incremento en la sensibilidad de los receptores S2 de serotonina a nivel de la circulación portal. Se hace una actualización de los métodos diagnósticos no invasivos, y se comentan algunas pruebas de laboratorio de utilidad clínica. En relación al tratamiento se ha puesto énfasis en el uso de fármacos, especialmente vasodilatadores, que actúan modificando la magnitud de la presión portal

Functional modifications evoked by physical training in rats

Se investigaron los efectos del entrenamiento físico (natación, 5 veces/semana durante lapsos de 2 a 60 min, durante 4 meses) sobre la actividad funcional de segmentos vasculares aislados, peso corporal y presión arterial sistólica en ratas macho. Después de 75 días, el peso corporal del grupo entrenado (E) fue significativamente menor que el del grupo control (C). La presión arterial sistólica decayó significativamente en E (p < 0.001 vs. C) a los 60 días. La tensión contráctil isométrica de la vena porta aislada al final del período de entrenamiento e incubada en medio de Krebs-Ringer-bicarbonato fue similar en ambos grupos (E: 15.36ñ0.82 mN, n=15; C:16.15ñ1.9 mN, n=10). Los componentes fásico y tónico de las contracturas inducidas por norepinefrina fueron mayores en E y la EC50 menor en C. No hubo, en cambio, diferenciais significativas en las respuestas contráctiles a ClK. La reactividad farmacológica de la arteria caudal ventral a los mismos agentes fue significativamente mayor en E. Nuestros hallazgos indican que el entrenamiento físico en ratas induce cambios funcionales adaptativos que incluyen modificaciones del peso corporal y la presión arterial sistólica. Los resultados obtenidos en músculo liso vascular aislado pueden ser explicados por incremento en la población de receptores adrenérgicos con disminución simultánea de su afinidad, como lo sugieren los valores de la EC50. Otros fenómenos adaptativos celulares (modificaciones en la fosforilación de proteínas, metabolismo...

Differential diagnosis of ascitic fluid: evaluation and comparison of various biochemical criteria with a special reference to serum ascites albumin concentration gradient and its relation to portal pressure.

Among various biochemical indices measured in 93 patients with ascites, ascitic LDH estimation was proved to be indiscreminatory, while ascites/serum LDH ratio has shown a diagnostic accuracy of 85 per cent. Ascitic total protein levels and ascites/serum total protein ratio (accuracy rates of 72 and 77% respectively) were limited, especially in differentiating the ascites due to heart failure. Serum ascites albumin gradient, showed a strong correlation to portal pressure (r, + 0.83 + 0.88), and was found to be the best diagnostic index (with an overall accuracy of 97 per cent) in distinguishing the 'transudative' from 'exudative' ascites. However, no index could discreminate the 'mixed' cases and provide the etiological diagnosis of the ascites.

Portal flow and mitochondrial function during extrahepatic cholestasis

This study was designed to determine portal blood flow and mitochondrial and hepatic function during extrahepatic obstruction. Twenty-two male Wistar rats which had undergone bile duct ligation were compared 7 days later to 20 sham-operated controls. Portal flow and mitochondrial respiratory control ratio were reduced by 50% and 35%, respectively (P < 0.01), and serum alanine-aminotransferase levels increased significantly (P < 0.01) in the extrahepatic cholestatic group. These results suggest that cholestasis may cause an imbalance between the energy supply and the high demand of the liver leading to a state of partial ischemia

Urinary fructose excretion in health after fructose test.

Urinary excretion of fructose during three hours following the ingestion of 100 g of hydrolysed sucrose (in 200 ml) was studied in 85 normal men. This solution was better tolerated than a solution of 50 g of pure fructose and gave higher urinary excretion of fructose than with 100 g of unhydrolysed sucrose. The mean fructose excretion was 54.0 mg (S.D. 40.6 MG). The majority of subjects (63) excreted between 1 and 75 mg and the highest value was 187mg. This suggests a relatively inexpensive method for assessing the existence of porta-systemic shunts beyond normal.