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Search Results: 1 - 10 of 38539 matches for " Evelyn Soares;Santos "
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Validation of MagedanzSCORE as a predictor of mediastinitis after coronary artery bypass graft surgery
, Michel Pompeu Barros de Oliveira;Figueira, Evelyn Soares;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110013
Abstract: objective: the aim of this study is to evaluate the applicability of a new score for predicting mediastinitis - magedanzscore - in patients undergoing coronary artery bypass graft (cabg) surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study involving 500 patients operated between may/2007 and april/2010. the registers contained all the information used to calculate the magedanzscore. the outcome of interest was mediastinitis. we calculated sensitivity, specificity, positive predictive value, negative predictive value, concordance and accuracy. the accuracy of the model was evaluated by roc (receiver operating characteristic) curve. results: the incidence of mediastinitis was 5.6%, with a lethality rate of 32.1%. in univariate analysis, the five variables of the magedanzscore were predictors of postoperative mediastinitis: chronic obstructive pulmonary disease (or 6.42; 95.0% ci 2.76-14.96; p<0.001), obesity (or 3.06; 95.0% ci 1.32-7.09; p=0.009), surgical reintervention (or 82.40; 95.0% ci 30.40-223.30; p<0.001), multiple transfusion (or 3.33; 95.0% ci 1.52-7.29; p=0.003) and stable angina class iv or unstable (or 2.59; 95.0% ci 1.19-7.64; p=0.016) according to canadian cardiovascular society. the score had a sensitivity of 96.4%, specificity of 90.0%, positive predictive value of 36.5%, negative predictive value of 99.8% and 90.4% concordance. the accuracy measured by the area under the roc curve was 96.2% (95.0% ci 94.5%-97.9%). conclusions: the magedanzscore proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative mediastinitis in patients undergoing cabg surgery at our institution
Predictors of transfusion of packed red blood cells in coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110044
Abstract: objectives: finding predictors of blood transfusion may facilitate the most efficient approach for the use of blood bank services in coronary artery bypass grafting procedures. the aim of this retrospective study is to identify preoperative and intraoperative patient characteristics predicting the need for blood transfusion during or after cabg in our local cardiac surgical service. methods: 435 patients undergoing isolated first-time cabg were reviewed for their preoperative and intraoperative variables and analyzed postoperative data. patients were 255 males and 180 females, with mean age 62.01 ± 10.13 years. regression logistic analysis was used for identifying the strongest perioperative predictors of blood transfusion. results: blood transfusion was used in 263 patients (60.5%). the mean number of transfused blood products units per patient was 2.27 ± 3.07 (0-23) units. the total number of transfused units of blood products was 983. univariate analysis identified age >65 years, weight <70 kg, body mass index <25 kg/m2, hemoglobin <13mg/dl, hematocrit < 40% and ejection fraction <50%, use of cardiopulmonary bypass (cpb), not using an internal thoracic artery as a bypass, and multiple bypasses as significant predictors. the strongest predictors using multivariate analysis were hematocrit < 40% (or 2.58; ci 1.62-4.15; p<0.001), cpb use (or 2.00; ci 1.27-3.17; p=0.003) and multiple bypasses (or 2.31; ci 1.31-4.08; p=0.036). conclusions: the identification of these risk factors leads to better identification of patients with a grater probability of using blood, allocation blood bank resources and cost-effectiveness use of blood products.
Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Ferraz, Paulo Ernando;Lima, Ricardo Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.1590/S0102-76382011000200007
Abstract: background: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. diabetes is a feared risk factor for mediastinitis and viewed with caution by cardiovascular surgeons. objective: to identify risk factors for mediastinitis in diabetics undergoing cabg surgery with use of unilateral ita in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study of 157 diabetics operated between may 2007 and april 2010. nine preoperative variables, five intraoperative variables and seven postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated. univariate and multivariate logistic regression analyses were applied. results: the incidence of mediastinitis was 7% (n=11), with a lethality rate of 36.1% (n=4). variables associated with increased risk of mediastinitis were: use of pedicled ita (or 8.25, 95% ci 2.03 to 66.10, p=0.016), postoperative renal complications (or 5.10, 95% ci 1.03 to 25.62, p=0.049) and re-operation (or 7.45, 95% ci 1.24 to 42.17, p=0.023). in multivariate analysis using backward logistic regression, only one variable remained as independent risk factor: use of pedicled ita (or 7.64, 95% ci 1.95 to 61.6, p=0.048), in comparison to skeletonized ita. conclusions: we suggest that diabetics should be considered for strategies to minimize risk of infection. in diabetics that undergo unilateral ita, the problem seems to be related to how ita is harvested. diabetics should always be considered for use of skeletonized ita.
Risk factors for mediastinitis after coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.1590/S0102-76382011000100008
Abstract: objective: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. the aim of this study is to identify risk factors for mediastinitis in patients undergoing coronary artery bypass grafting (cabg), without the use of bilateral internal thoracic artery (ita), at the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: a retrospective study of 500 consecutive patients operated on between may 2007 and april 2010. ten preoperative variables, seven intraoperative variables and seven postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated. univariate and multivariate logistic regression analyses were performed. results: the incidence of mediastinitis was 5.6% (n=28), with a lethality rate of 32.1% (n=9). in multivariate analysis using logistic regression, five variables remained as independent risk factors: obesity (or 2.60, 95% ci 1.11 to 6.68), diabetes (or 2.71, 95% ci 1.18 to 6.65), smoking (or 2.10, 95% ci 1.12 to 4.67), use of pedicled internal thoracic artery (or 5.17, 95% ci 1.45 to 18.42) and on-pump cabg (or 2.26, 95% ci 1.14 to 5.85). conclusion: this study identified the following independent risk factors for mediastinitis after cabg: obesity, diabetes, smoking, use of pedicled ita and on-pump cabg.
EuroSCORE e mortalidade em cirurgia de revasculariza??o miocárdica no Pronto Socorro Cardiológico de Pernambuco
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Silva, Frederico Pires Vasconcelos;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000400010
Abstract: objective: the aim of this study is to evaluate the applicability of euroscore in patients undergoing coronary artery bypass graft (cabg) surgery at the division of cardiovascular surgery of pernambuco cardiologic emergency medical services - procape. methods: a retrospective study involving 500 patients operated between may 2007 and april 2010. the registers contained all the information used to calculate the euroscore. the outcome of interest was death. univariate analysis and multivariate analysis by backward logistic regression were applied to assess the association between each variable in the euroscore and deaths. the following parameters were calculated: sensitivity, specificity, positive predictive value, and negative predictive value. the power of concordance between the predicted mortality by the euroscore and the observed mortality was measured using the kappa coefficient. the accuracy of the model was evaluated by the roc (receiver operating characteristic) curve. results: the incidence of death was 13%. in multivariate analysis, nine variables remained independent predictors of death: chronic obstructive pulmonary disease, creatinine >2,3mg/dl, active endocarditis, preoperative critical state, unstable angina, ejection fraction 30% to 50%, acute myocardial infarction < 90 days, emergency surgery and additional surgery. the score had a sensitivity of 88.4%, specificity of 79.3%, positive predictive value of 40.7%, negative predictive value of 97.7% and 80.6% concordance. the accuracy measured by the area under the roc curve was 0.892 (95% ci 0.862-0.922). conclusions: the euroscore proved to be a simple and objective index, revealing a satisfactory discriminator of postoperative evolution in patients undergoing cabg surgery at our institution.
Mortalidade perioperatória em diabéticos submetidos à cirurgia de revasculariza??o miocárdica
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Lima, Ricardo de Carvalho;
Revista do Colégio Brasileiro de Cirurgi?es , 2012, DOI: 10.1590/S0100-69912012000100006
Abstract: objective: to investigate the risk factors for in-hospital death in diabetic patients undergoing isolated coronary artery bypass grafting (cabg). methods: we conducted a retrospective study with 305 consecutive diabetic patients undergoing cabg in the division of cardiovascular surgery of our institution from april 2004 to april 2010. univariate analysis for categorical variables was performed with the chi-square or fisher's exact test, as appropriate. potential risk factors with p <0.05 in the univariate analysis were included in the multivariate analysis, which was performed by backward logistic regression. values of p <0.05 were considered statistically significant. results: the study population had a mean age of 61.44 years (± 9.81) and 65.6% (n=200) were male. the in-hospital mortality rate was 11.8% (n=36). the following independent risk factors for death were identified: on-pump cabg (or 6.15, 95% ci 1.57 to 24.03, p=0.009) and low cardiac output in the postoperative period (or 34.17, 95% ci 10.46 to 111.62, p <0.001). the use of internal thoracic artery (ita) was an independent protective factor for death (or 0.27, 95% ci 0.08 to 0.093, p=0.038). conclusion: this study identified the following independent risk factors for death after cabg: on-pump cabg and low cardiac output syndrome. the use of ita was an independent protective factor.
THE USE OF THE AEROBIC SUBMERGED BIOFILTER IN THE TREATMENT OF WINE EFFLUENT: SYSTEM IN BATCH = USO DE BIOFILTRO AERADO SUBMERSO COM MATERIAL SUPORTE ALTERNATIVO PARA O TRATAMENTO DE EFLUENTE VINíCOLA: SISTEMA EM BATELADA
Petrick Anderson Soares,Evelyn Zucco,Sandra Denise Camargo Mendes
Holos Environment , 2010,
Abstract: This study was evaluated the potential use of Submerged Aerated Biofilter (ASB) in the winery effluent treatment. The use of the support of corks stoppers angle for to test the reuse of this material, in order to minimize the deployment cost of a sewage treatment plant effluent. The unit installed in a laboratory scale, showed average removal of chemical oxygen demand (COD), suspended solids and turbidity of 78,5%, 60,1% and 82,8% respectively. The reactor was operated with hydraulic retention time of 48 hours and feeding occurred with the organic load of 1,73 kg.COD.m3d-1. It was noted that the use of ASB presents an advantageous alternative, as well as the use of cork stoppers as support material in wineries effluent treatment. = Neste trabalho foi avaliado o uso potencial do Biofiltro Aerado Submerso (BAS) no tratamento de efluente vinícola. A utiliza o do meio suporte de rolhas de corti a visou testar o reuso deste material, com o objetivo de minimizar o custo de implanta o de uma esta o de tratamento de efluentes. A unidade instalada, em escala laboratorial, apresentou médias de remo o de demanda química de oxigênio (DQO), sólidos suspensos e turbidez de 78,5%, 60,1% e 82,8%, respectivamente. O reator operou com tempo de deten o hidráulica de 48 horas e a alimenta o ocorreu com carga organica de 1,73 kg.DQO.m3d-1. Foi constatado que o emprego do BAS como apresenta-se uma alternativa vantajosa, bem como o uso das rolhas de corti as como material suporte no tratamento de efluentes vinícolas.
Os valores de uma luta: A economia moral do movimento pela terra dos pequenos lavradores do Sert?o Carioca nos difíceis anos de 1945-1964
Soares dos Santos,Leonardo;
Mundo agrario , 2006,
Abstract: this article attempts to discuss on concept of moral economy, presenting the case of "pequenos lavradores" (quatters) in rio de janeiro' landscape between 1945-1964. in the first place, the focus falls on the discussion of anthropologists as klaas and ellen woortman about that concept. in the second, i make a verification one of how moral economy one has been expressed by "pequenos lavradores" in you fight for the land. my hypothesis is that moral economy one not is only a set of values, but it play too an important rule in the establishment of a political speech one and of your social identity. the sources explored are newspapers, peasant meeting documents and letters envoy to the president getúlio vargas.
Profissionais de saúde frente ao aborto legal no Brasil: desafios, conflitos e significados
Soares, Gilberta Santos;
Cadernos de Saúde Pública , 2003, DOI: 10.1590/S0102-311X2003000800021
Abstract: this article discusses the roles of social workers, psychologists, nurses, and physicians concerning abortion and their participation in assisting legal abortion in brazil for women victims of sexual violence. the working hypothesis was that many health professionals might oppose such programs on the grounds that they involve interruption of pregnancy. this qualitative study interviewed 12 health professionals and two program managers in the state of paraíba and the federal district (brasilia). the health professionals' representations of abortion ranged from a moralist and religious concept to the promotion of women's rights and autonomy. the health professionals faced obvious challenges in dealing with the abortion issue. their experience in treating women had fostered changes in values and a reinterpretation of the meaning of their own practice.
Evidência sobre o mix público-privado em países com cobertura duplicada: agravamento das iniquidades e da segmenta??o em sistemas nacionais de saúde
Santos,Isabela Soares;
Ciência & Saúde Coletiva , 2011, DOI: 10.1590/S1413-81232011000600013
Abstract: this paper seeks to identify the potential negative effects of private health insurance on the universality of national health systems. it systematizes the operational concepts of the public-private mix model and presents the results from international research into duplicated and supplementary coverage that shows that universality is negatively affected by inequities derived from duplicated coverage though not from supplementary coverage. it demystifies the supplementary nature of private health insurance as the villain in the brazilian healthcare system and recommends that public policies should be fully oriented to improving the public health system instead of private health insurance.
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