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TEMA: a tecnologia ecologicamente mais adequada como uma estratégia preventiva a ser perseguida
Porto, Marcelo Firpo de Souza;Mattos, Ubirajara Aluizio de Oliveira;
Produ??o , 1994, DOI: 10.1590/S0103-65131994000300003
Abstract: a preven??o técnica dos riscos industriais pode envolver cinco níveis de atua??o: os níveis do indivíduo/trabalhador, do posto de trabalho, do setor de trabalho, da fábrica como um todo, e do meio ambiente em geral. historicamente, tais níveis tenderam a serem analisados por disciplinas, métodos e institui??es frequentemente dissociados uns dos outros. transpassando todos os níveis, a discuss?o sobre a base tecnológica de um dado setor industrial pode fornecer luzes importantes para entendermos a dinamica dos riscos presentes e evitáveis numa determinada fábrica ou setor industrial, em articula??o com as estratégias de investimentos produtivos e mudan?as tecnológicas. neste contexto, a busca da tecnologia ecologicamente mais adequada - tema - pode ser um importante conceito preventivo, servindo para nortear os critérios dos investimentos produtivos em curso nos diferentes setores industriais do país. a partir de um exemplo em andamento no rio de janeiro, envolvendo uma mudan?a negociada de tecnologia numa empresa de cloro-soda, este trabalho pretende apresentar alguns dos elementos que comp?em a intrincada rede de interesses e possibilidades que est?o por detrás da implementa??o da tema, envolvendo as dimens?es social, econ?mica e tecnológica do problema
ECLAMPSIA
TASNEEM ASHRAF
The Professional Medical Journal , 2004,
Abstract: Objective: To evaluate incidence, morbidity andmortality associated with Eclampsia. Design: Prospective study of 98 cases of eclampsia. Setting: departmentof obstetrics and gynaecology unit II Bolan Medical Collage Complex Quetta. Patients: 98 cases were admittedwith eclampsia during two years and six months period from 1st June 2001 to December 2003. Results: Totalno of admissions were 6952. 98 patients presented with eclampsia making a frequency of 1.40%. Of these 98cases of eclampsia 58 % were primigravidas, mean age of eclamptic patients was 34 years. Gestational age atadmission was less than 35 weeks in 80(78.4%) cases. 54(55%) patients had intrapartum eclampsia.64 (66.7%)patients received diazepam and rest received Magnesium sulphate as anticonvulsant. Caesarean section was donein 10 (11.49%) cases rest delivered vaginally. Fetal loss was seen in 72(82.75%) patients, while 7(7.14%) mothersdied of eclampsia. Conclusion: Maternal and perinatal mortality and morbidity is very high in eclempticpatients. Magnesium sulphate is good anticonvulsant, helpful in reducing maternal morbidity and mortalityconsiderably. Good antenatal practices, maternal education and awareness, provision of better health facilitiesand their utilization will definitely improve maternal and fetal outcome.
Dopplerfluxometria de artérias oftálmicas e avalia??o da fun??o endotelial nas formas precoce e tardia da pré-eclampsia
Brand?o, Augusto Henriques Fulgêncio;Barbosa, Alexandre Sim?o;Lopes, Ana Paula Brum Miranda;Leite, Henrique Vitor;Cabral, Ant?nio Carlos Vieira;
Radiologia Brasileira , 2012, DOI: 10.1590/S0100-39842012000100006
Abstract: objective: to identify possible differences between endothelial dysfunction evaluated by brachial artery flow-mediated dilation and central hyperperfusion evaluated by dopplerfluxometry of ophthalmic artery in women with early- and late-onset preeclampsia. materials and methods: flow-mediated dilation testing and dopplerfluxometry of ophthalmic artery were performed in 81 patients (26 with early preeclampsia, 30 with late preeclampsia, and 25 normotensive pregnant women - control group). results: as compared with the control group, patients with preeclampsia presented lower values of flow-mediated dilation, both in cases of early preeclampsia (7.62 ± 5.42% × 14.12 ± 6.14%; p = 0.02) and in cases of late preeclampsia (5.83 ± 4.12% × 14.12 ± 6.14%; p = 0.00). no statistically significant difference was observed between early- and late-onset preeclampsia (7.62 ± 5.42% × 5.83 ± 4.12%; p = 0.09). values for dopplerfluxometry of ophthalmic artery were significant lower in patients with preeclampsia as compared with the control group, both in cases of early preeclampsia (0.631 ± 0.024 × 0.737 ± 0.032; p = 0.01) and in cases of late preeclampsia (0.653 ± 0.019 × 0.737 ± 0.032; p = 0.03). again, no statistically significant difference was observed between early- and late-onset preeclampsia (0.631 ± 0.024 × 0.653 ± 0.019; p = 0.12). basically, the results demonstrate a decrease in values for dopplerfluxometry of ophthalmic artery in patients with early and late presentations of preeclampsia as compared with the control group, although with no statistically significant difference between the two presentations of the disease. conclusion: the present results indicate the presence of endothelial dysfunction and central hyperperfusion in patients with early- and late-onset preeclampsia.
ECLAMPSIA
SHAHIDA SHERAZ
The Professional Medical Journal , 2006,
Abstract: Objective: To evaluate incidence, morbidity and mortalityassociated with eclampsia. Design: A prospective study. Place and Duration: The study which was carried out at PAFHospital Rafiqui, Shorkot spanned over a period of 2 years from Jun 2002-Dec 2004. Patients and Methods: Thestudy comprises of 55 eclamptic cases diagnosed out of 3391 consecutive deliveries, carried out in our hospital.Results: The incidence of eclampsia, in this study, was found to be 1.62%. Out of 55 cases 38(69.1%) patients wereprimigravida. Forty three (78.2%) of the patients were between the ages of 21 to 30 years. In 50(90.9%) patientsgestational age was less than 35 weeks. Thirty seven (67.3%) cases had antepartum eclampsia. Forty four (80%)patients received diazepam while the remaining 11(20%) received magnesium sulphate (MgSO4) as anticonvulsant.Commonest mode of delivery was spontaneous vaginal delivery (31 cases, 56.4%) followed by lower caesareansection (21 cases, 38.2%). Fetal loss was seen in 12(20.7%) cases. Two patients died of eclampsia, maternal mortalityrate being 3.6%. Conclusion: Eclampsia is a life threatening complication of pregnancy. However an improvement inantenatal care, upgrading the neonatal facilities and early delivery by cesarean section can improve the perinataloutcome.
Colecistite aguda n o-complicada: colecistectomia laparoscópica precoce ou tardia? Uncomplicated acute cholecystitis: early or delayed laparoscopic cholecystectomy?  [cached]
Ajith Sankarankutty,Luis Teodoro da Luz,Tercio De Campos,Sandro Rizoli
Revista do Colégio Brasileiro de Cirurgi?es , 2012, DOI: 10.1590/s0100-69912012000500017
Abstract: Metanálises recentes sugerem que a colecistectomia laparoscópica precoce (dentro de uma semana do início dos sintomas) para a doen a aguda, n o complicada, da vesícula biliar é segura e viável. No entanto, enquetes sobre as práticas cirúrgicas indicam que a colecistectomia laparoscópica precoce é realizada por apenas uma minoria dos cirurgi es. Além disso, o melhor momento para realiza o deste procedimento, bem como sua rela o custo-eficácia continuam sendo uma quest o de debate. A reuni o de revista TBE - CiTE realizou uma avalia o crítica dos artigos mais relevantes, publicados recentemente, sobre o momento da colecistectomia laparoscópica e sua rela o custo-eficácia para o tratamento da colecistite aguda n o complicada e fornece recomenda es baseadas em evidências sobre o tema. A literatura engloba pequenos ensaios com alto risco para vieses. Ela sugere que colecistectomia laparoscópica precoce é segura e encurta o período de interna o. Há uma escassez de estudos bem desenhados e de grandes séries analisando custo-utilidade. As seguintes recomenda es foram geradas: (1) a colecistectomia laparoscópica precoce deve ser tentada como o tratamento de primeira linha dentro de uma semana do início dos sintomas, e (2) O custo-efetividade da colecistectomia laparoscópica precoce deve ser avaliada em cada local, levando-se em considera o os recursos, tais como a disponibilidade de pessoal treinado e de equipamentos laparoscópicos. Recent meta-analyses suggested that early laparoscopic cholecystectomy (within 1 week of symptom onset) for uncomplicated acute gallbladder disease is safe and feasible. However, surveys on surgical practices indicated that early laparoscopic cholecystectomy is performed by only a minority of surgeons. Furthermore, the exact time-point for performing this procedure as well as its cost-effectiveness remain a matter of debate. The TBE - CiTE Journal Club performed a critical appraisal of the most relevant evidence recently published on timing of laparoscopic cholecystectomy and its cost-effectiveness for the management of uncomplicated acute cholecystitis and provides evidence-based recommendations on the topic. The literature encompasses small trials with high risk of biases. It suggests that early laparoscopic cholecystectomy is safe and shortens hospital stay. There is scarcity of well-designed and large cost-utility analyses. The following main recommendations were generated: (1) Early laparoscopic cholecystectomy should be attempted as the first-line treatment within one week of symptoms onset; and (2) The cost-effectivene
Eclampsia: Morbilidad y mortalidad materna y perinatal
Valarino,Gabriela; Mora,Adriana; Cabrera,Carlos; Durán,Isbelly; Díaz,Yazmín; González,Samantha; Meléndez,Marianna;
Revista de Obstetricia y Ginecología de Venezuela , 2009,
Abstract: objective: to evaluate the impact of eclampsia on maternal and fetal morbidity and mortality. methods: retrospective, descriptive and longitudinal study, that included 102 patients with diagnostic hypertensive distress of pregnancy eclampsia?s type during 2006-2007. a record sheet containing the variables of the study was used. setting: unidad de medicina materno fetal, maternidad "concepcion palacios", caracas. results: during the study period 28 617 deliveries were attended, from which 102 (0.35 %) presented eclampsia. the main symtoms were headache (57.84 %) and hypertension (85.29 %), seizure appreas before delivery in 63.72 %, the main complication was hellp syndrome in 38.23 %. the 80-48 % of the neonates were born alive and perinatal mortality was 18.75 %. conclusion: eclampsia is an important cause of maternal and perinatal morbi-mortaliy.
Eclampsia: Morbilidad y mortalidad materna y perinatal
Gabriela Valarino,Adriana Mora,Carlos Cabrera,Isbelly Durán
Revista de Obstetricia y Ginecología de Venezuela , 2009,
Abstract: Objetivo: Evaluar el impacto de la eclampsia sobre la morbilidad y mortalidad materno fetal. Métodos: Estudio retrospectivo, descriptivo y longitudinal, incluyó 102 pacientes con diagnóstico de trastorno hipertensivo del embarazo tipo eclampsia durante 2006-2007. Se utilizó una hoja de registro que contenía las variables del presente estudio. Ambiente: Unidad de Medicina Materno Fetal, Maternidad "Concepción Palacios", Caracas. Resultados: En este período se atendió un total de 28 617 partos, de los cuales 102 (0,35 %) presentaron eclampsia. Los principales síntomas fueron cefalea (57,84 %) e hipertensión (85,29 %), la convulsión se presentó anteparto en el 63,72 %, la principal complicación fue síndrome HELLP en 38,23 %. Un 80,48.% de los neonatos nacieron vivos y la mortalidad perinatal fue de 18,75 %. Conclusión: La eclampsia es una causa importante de morbi-mortalidad materna y perinatal. Objective: To evaluate the impact of eclampsia on maternal and fetal morbidity and mortality. Methods: Retrospective, descriptive and longitudinal study, that included 102 patients with diagnostic hypertensive distress of pregnancy eclampsia’s type during 2006-2007. A record sheet containing the variables of the study was used. Setting: Unidad de Medicina Materno Fetal, Maternidad "Concepcion Palacios", Caracas. Results: During the study period 28 617 deliveries were attended, from which 102 (0.35 %) presented eclampsia. The main symtoms were headache (57.84 %) and hypertension (85.29 %), seizure appreas before delivery in 63.72 %, the main complication was HELLP syndrome in 38.23 %. The 80-48 % of the neonates were born alive and perinatal mortality was 18.75 %. Conclusion: Eclampsia is an important cause of maternal and perinatal morbi-mortaliy.
MANAGEMENT OF ECLAMPSIA
Mahmood Aleem
The Professional Medical Journal , 1997,
Abstract: OBJECTIVE:1. To evaluate various factors responsible for the disease.2. Effectiveness of mother and childhealth activities and outcome of the management. DESIGN: prospective study. PERIOD: (January 1989-Dec1995 SETTING: Department of obstetrics and Gynaecology Allied Hospital Faisalabad. PATIENTS ANDMETHODS: Out of 16952 total births, 249 patients has eclampsia and were managed according to the setprotocol. RESTUTS: The incidence of eclampsia was 1.4% and maternal mortality was 13.6% Eclampticpatients from rural earea were 66.5% and that of urban area was 33.7%, 54% patients were primigravida and46% were multigravidas. The percentage of ante, Intra and postpartum eclampsia were 56, 57 and 12respectively. 45% patients had abdominal delivery, 30% had forceps delivery, 11% delivered at home, 8%had vaginal delivery in hospital and 6% expired undelivered. CONCLUSION: Community educationprogramme created awareness about the importance pf antenatal check up which led to early detection andtreatment of pre-eclampsia thereby preventing development of eclampsia. Special programme of trainingthe traditional birth attendants (TBA) to recognized pre-eclampsia in early stage and to refer the patient tothe hospital, and availability of reliable transport to bring the patient from periphery or patient’s home tothe hospital where prompt treatment be started by the experienced staff would certainly decrease theincidence of eclampsia and its adverse outcome.
Neurological aspects of eclampsia  [PDF]
Jovanovi? Dejana,Besla?-Bumba?irevi? Ljiljana G.,Ercegovac Marko,Sto?i?-Opin?al Tatjana L.
Srpski Arhiv za Celokupno Lekarstvo , 2003, DOI: 10.2298/sarh0302060j
Abstract: The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless eclampsia isn’t just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used - fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.
Predictores de la preeclampsia/eclampsia en un grupo de gestantes de alto riesgo Pre-eclampsia/eclampsia predictors in high risk pregnants  [cached]
Juan Antonio Suárez González,Mario Gutiérrez Machado,María Rosa Cabrera Delgado,Alexis Corrales Gutiérrez
Revista Cubana de Obstetricia y Ginecolog?-a , 2011,
Abstract: INTRODUCCIóN: Los trastornos hipertensivos durante el embarazo son muy frecuentes y ocurren en más del 10 % de todas las gestaciones a término. OBJETIVO: Determinar los factores de riesgos en este grupo de pacientes que permitan establecer estrategias de trabajo diferenciadas en pro del bienestar materno fetal. MéTODOS: Se realizó un estudio descriptivo, de corte transversal, en 30 gestantes con riesgo de preeclampsia/eclampsia que acuden a la consulta municipal de atención al riesgo de preeclampsia/eclampsia en la ciudad de Santa Clara, Villa Clara, en el periodo comprendido entre septiembre de 2009 a enero de 2010. RESULTADOS: La mayoría de las pacientes fueron nulíparas (70 %), con malnutrición por exceso (80 %) y en edades extremas (56,6 %) con predominio de la avanzada edad materna (33,3 %), se encontró un gran porcentaje de gestantes con riesgo de síndrome metabólico. Se proponen estrategias de atención con enfoque de riesgo a estas gestantes en la atención prenatal. CONCLUSIONES: La nuliparidad, las cifras de glicemia elevadas en la captación del embarazo y la malnutrición por exceso fueron algunos de los factores de predicción más frecuentemente encontrados para la preeclampsia/eclampsia en el grupo estudiado. INTRODUCTION: The hypertensive disorders during pregnancy are very frequent and occur in more then the 10% of all term pregnancies. OBJECTIVE: To determine the risk factors in this group of patients to allow establishing differential working strategies for the social maternal wellbeing. METHODS: A cross-sectional and descriptive study was conducted in 30 pregnant women with risk of pre-eclampsia/eclampsia in the Santa Clara city, Villa Clara province from September, 2009 to January, 2010. RESULTS: Most of patients were nulliparous (70 %), with excessive malnutrition (80 %) and in extreme ages (56.6 %) with predominance of maternal old age (33.3 %), as well as a high percentage of pregnants with metabolic syndrome risk. Authors propose care strategies approaching the risk of these patients during the prenatal care. CONCLUSIONS: Nulliparity, figures of a high level glycemia during the pregnancy screening and the excessive malnutrition were some the more frequent prediction factors for the pre-eclampsia/eclampsia in the study group.
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