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Search Results: 1 - 10 of 4135 matches for " Guilherme;Ederlon "
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Consenso brasileiro de monitoriza??o e suporte hemodinamico - Parte V: suporte hemodinamico
Lobo, Suzana Margareth Ajeje;Rezende, Ederlon;Mendes, Ciro Leite;Rea-Neto, álvaro;David, Cid Marcos;Dias, Fernando Suparregui;Schettino, Guilherme;
Revista Brasileira de Terapia Intensiva , 2006, DOI: 10.1590/S0103-507X2006000200010
Abstract: background and objectives: shock occurs when the circulatory system cannot maintain adequate cellular perfusion. if this condition is not reverted irreversible cellular injury establishes. shock treatment has as its initial priority the fast and vigorous correction of mean arterial pressure and cardiac output to maintain life and avoid or lessen organic dysfunctions. fluid challenge and vasoactive drugs are necessary to warrant an adequate tissue perfusion and maintenance of function of different organs and systems, always guided by cardiovascular monitorization. the recommendations built in this consensus are aimed to guide hemodynamic support needed to maintain adequate tisular perfusion. methods: modified delphi methodology was used to create and quantify the consensus between the participants. amib indicated a coordinator who invited more six experts in the area of monitoring and hemodynamic support to constitute the consensus advisory board. twenty five physician and two nurses selected from different regions of the country completed the expert panel, which reviewed the pertinent bibliography listed at the medline in the period from 1996 to 2004. results: recommendations were made answering 17 questions about hemodynamic support with focus on fluid challenge, red blood cell transfusions, vasoactive drugs and perioperative hemodynamic optimization. conclusions: hemodynamic monitoring by itself does not reduce the mortality of critically ill patients, however, we believe that the correct interpretation of the data obtained by the hemodynamic monitoring and the use of hemodynamic support protocols based on well defined tissue perfusion goals can improve the outcome of these patients.
Consenso brasileiro de monitoriza??o e suporte hemodinamico - Parte IV: monitoriza??o da perfus?o tecidual
Réa-Neto, álvaro;Rezende, Ederlon;Mendes, Ciro Leite;David, Cid Marcos;Dias, Fernando Suparregui;Schettino, Guilherme;Lobo, Suzana Margareth Ajeje;
Revista Brasileira de Terapia Intensiva , 2006, DOI: 10.1590/S0103-507X2006000200009
Abstract: background and objectives: the main cardiovascular function is to maintain the adequate perfusion e oxygen delivery to the cells. physiologically, this is controlled by the cellular metabolic rate. the critically ill patients are in high danger of tissue hipoperfusion and this is directly related to cellular injury and organ dysfunction. therefore, the tissue perfusion monitoring makes part and is indissociated of hemodynamic evaluation of the critically ill patient and is indicated to all this patients. the objective was to define recommendations about clinical utility of different tolls to bedside perfusion monitoring. methods: modified delphi methodology was used to create and quantify the consensus between the participants. amib indicated a coordinator who invited more six experts in the area of monitoring and hemodynamic support to constitute the consensus advisory board. twenty five physician and two nurses selected from different regions of the country completed the expert panel, which reviewed the pertinent bibliography listed at the medline in the period from 1996 to 2004. results: recommendations were done about the utility of clinical monitoring of tissue perfusion, temperature gradient and transcutaneous oxygen monitoring, serum lactate, base excess, svo2 and scvo2, gastric and sublingual capnometry, co2 venous-arterial gradient and orthogonal polarization spectral (ops). conclusions: the homodynamic compensation of a critically ill patient isn?t complete unless the tissue perfusion is corrected. many different methods of monitoring is available and are useful in clinical practice, however, none has accuracy and effectiveness characteristics to be used independently of clinical context.
Consenso brasileiro de monitoriza??o e suporte hemodinamico - parte III: métodos alternativos de monitoriza??o do débito cardíaco e da volemia
Schettino, Guilherme;Ederlon, Rezende;Mendes, Ciro Leite;Réa-Neto, álvaro;David, Cid Marcos;Lobo, Suzana Margareth Ajeje;Barros, Alberto;Silva, Eliézer;Friedman, Gilberto;Amaral, José Luiz Gomes do;Park, Marcelo;Monachini, Maristela;Oliveira, Mirella Cristine de;Assun??o, Murillo Santucci César;Akamine, Nelson;Mello, Patrícia Veiga C;Pereira, Renata Andréa Pietro;Costa Filho, Rubens;Araújo, Sebasti?o;Pinto, Sérgio Félix;Ferreira, Sérgio;Mitushima, Simone Mattoso;Agareno, Sydney;Brilhante, Yuzeth Nóbrega de Assis;
Revista Brasileira de Terapia Intensiva , 2006, DOI: 10.1590/S0103-507X2006000100013
Abstract: background and objectives: cardiac output and preload as absolute data do not offer helpful information about the hemodynamic of critically ill patients. however, monitoring the response of these variables to volume challenge or inotropic drugs is a very useful tool in the critical care setting, particularly for patients with signs of tissue hypoperfusion. although pac remains the " gold standard" to measure cardiac output and preload, new and alternative technologies were developed to evaluate these hemodynamic variables. methods: modified delphi methodology was used to create and quantify the consensus between the participants. amib indicated a coordinator who invited more six experts in the area of monitoring and hemodynamic support to constitute the consensus advisory board. twenty three physician and two nurses selected from different regions of the country completed the expert panel, which reviewed the pertinent bibliography listed at the medline in the period from 1996 to 2004. results: recommendations regarding the use of arterial pulse pressure variation during mechanical ventilation, continuous arterial pulse contour and lithium dilution cardiac output measurements, esophageal doppler waveform, thoracic electrical bioimpedance, echocardiography and partial co2 rebreathing for monitoring cardiac output and preload were created. conclusions: the new and less invasive techniques for the measurement of cardiac output, preload or fluid responsiveness are accurate and may be an alternative to pac in critically ill patients.
Parte II: monitoriza??o hemodinamica básica e cateter de artéria pulmonar
Dias, Fernando Suparregui;Rezende, Ederlon;Mendes, Ciro Leite;Réa-Neto, álvaro;David, Cid Marcos;Schettino, Guilherme;Lobo, Suzana Margareth Ajeje;Barros, Alberto;Silva, Eliézer;Friedman, Gilberto;Amaral, José Luiz Gomes do;Park, Marcelo;Monachini, Maristela;Oliveira, Mirella Cristine de;Assun??o, Murillo Santucci César;Akamine, Nelson;Mello, Patrícia Veiga C;Pereira, Renata Andréa Pietro;Costa Filho, Rubens;Araújo, Sebasti?o;Félix Pinto, Sérgio;Ferreira, Sérgio;Mitushima, Simone Mattoso;Agareno, Sydney;Brilhante, Yuzeth Nóbrega de Assis;
Revista Brasileira de Terapia Intensiva , 2006, DOI: 10.1590/S0103-507X2006000100012
Abstract: background and objectives: monitoring of vital functions is one of the most important tools in the management of critically ill patients. nowadays is possible to detect and analyze a great deal of physiologic data using a lot of invasive and non-invasive methods. the intensivist must be able to select and carry out the most appropriate monitoring technique according to the patient requirements and taking into account the benefit/risk ratio. despite the fast development of non invasive monitoring techniques, invasive hemodynamic monitoring using pulmonary artery catheter still is one of the basic procedures in critical care. the aim was to define recommendations about clinical utility of basic hemodynamic monitoring methods and the use of pulmonary artery catheter. methods: modified delphi methodology was used to create and quantify the consensus between the participants. amib indicated a coordinator who invited more six experts in the area of monitoring and hemodynamic support to constitute the consensus advisory board. twenty-five physicians and nurses selected from different regions of the country completed the expert panel, which reviewed the pertinent bibliography listed at the medline in the period from 1996 to 2004. results: recommendations were made based on 55 questions about the use of central venous pressure, invasive arterial pressure, pulmonary artery catheter and its indications in different settings. conclusions: evaluation of central venous pressure and invasive arterial pressure, besides variables obtained by the pac allow the understanding of cardiovascular physiology that is of great value to the care of critically ill patients. however, the correct use of these tools is fundamental to achieve the benefits due to its use.
Avalia??o da variabilidade de interven??es baseadas no cateter de artéria pulmonar: experiência brasileira
Mendes, Ciro Leite;Rezende, Ederlon;Dias, Fernando Suparregui;Réa-Neto, álvaro;
Revista Brasileira de Terapia Intensiva , 2006, DOI: 10.1590/S0103-507X2006000200006
Abstract: background and objectives: use of pulmonary artery catheter (pac) is still a debatable issue, mainly due to questions raised about its security and efficacy. this study reproduced in a sample of brazilian physicians, another one conducted amidst american doctors, in which was pointed out the heterogeneity of clinical decisions guided by data obtained from pac. methods: during the brazilian congress of intensive care medicine (curitiba 2004), doctors were asked to answer a survey form with three vignettes. each of them contained pac data and one half of the surveys contained echocardiographic information. every doctor was asked to select one of six interventions for each vignette. a homogeneous answer was considered when it was selected by at least 80% of the respondents. results: two hundred and thirty seven doctors answered the questionnaires. they selected completely different therapeutic interventions in all three vignettes and none of the interventions achieved more than 80% agreement. variability persisted with the choices guided by echocardiography. conclusions: as in the original study, we observed total heterogeneity of therapeutic interventions guided by cap and echocardiography. these results could be caused by lack of knowledge about basic pathophysiologic concepts and maybe we had to improve its teaching at the medical school benches.
Concomitant Use of Glycoprotein IIb/IIIa Inhibitor and Streptokinase after Unsuccessful Rescue Angioplasty
Sousa José Marconi Almeida de,Severino Leonardo,Rezende Ederlon de Carvalho,Alencar Jairon Nascimento
Arquivos Brasileiros de Cardiologia , 2002,
Abstract: A 38-year-old man with acute myocardial infarction in the lower wall affecting the right ventricle underwent thrombolytic treatment with streptokinase. Approximately 2 hours after the thrombolytic treatment started, he presented with signs of coronary reocclusion. He underwent emergency cineangiocoronariography that revealed that his right coronary artery was completely occluded by a clot. He unsuccessfully underwent angioplasty and stent implantation. After the concomitant use of glycoprotein IIb/IIIa inhibitor, coronary TIMI III flow was achieved without additional dilations, and he was discharged from the hospital 5 days later with no further complications.
Mixed Model, AMMI and Eberhart-Russel Comparison via Simulation on Genotype × Environment Interaction Study in Sugarcane  [PDF]
Guilherme Moraes Ferraudo, Dilermando Perecin
Applied Mathematics (AM) , 2014, DOI: 10.4236/am.2014.514205
Abstract: Brazil is the world leader in sugarcane production and the largest sugar exporter. Developing new varieties is one of the main factors that contribute to yield increase. In order to select the best genotypes, during the final selection stage, varieties are tested in different environments (locations and years), and breeders need to estimate the phenotypic performance for main traits such as tons of cane yield per hectare (TCH) considering the genotype × environment interaction (GEI) effect. Geneticists and biometricians have used different methods and there is no clear consensus of the best method. In this study, we present a comparison of three methods, viz. Eberhart-Russel (ER), additive main effects and multiplicative interaction (AMMI) and mixed model (REML/BLUP), in a simulation study performed in the R computing environment to verify the effectiveness of each method in detecting GEI, and assess the particularities of each method from a statistical standpoint. In total, 63 cases representing different conditions were simulated, generating more than 34 million data points for analysis by each of the three methods. The results show that each method detects GEI differently in a different way, and each has some limitations. All three methods detected GEI effectively, but the mixed model showed higher sensitivity. When applying the GEI analysis, firstly it is important to verify the assumptions inherent in each method and these limitations should be taken into account when choosing the method to be used.
Plástica e anonimato: modernidade e tradi??o em Lucio Costa e Mário de Andrade
Wisnik, Guilherme;
Novos Estudos - CEBRAP , 2007, DOI: 10.1590/S0101-33002007000300009
Abstract: there is an analogy between the uniform and patterned antiinvidualism of modern architecture and the anonymous and collective character of popular art. this perception, stated by mário de andrade in 1928, can be seen as a guideline for the equation "modernity-patrimony" conceived by lucio costa by the end of the 30's. however, the latter acknowledgement of the "legitimacy of the plastic intention", by costa, will gradually set apart their conception regarding the role of art in society, and, as a consequence, the meaning they attribute to the process of brazilian cultural formation.
Espa?o e técnica como estruturas do cotidiano: capítulos Braudelianos da história do pensamento geográfico
Ribeiro, Guilherme;
Investigaciones geográficas , 2011,
Abstract: from the first two volumes of the trilogy civilisation matérielle, économie et capitalisme (1979) -les structures du quotidian and les jeux d'échange- written by french historian fernand braudel (1902-1985), the purpose of this article is to discuss how he articulated the geography and history. linking geographical space and historical time and seeing the space as structure and technique as a means, you can take stock of the introductory meetings and disagreements between the geographical thought and historiography in the twentieth century.
Fernand Braudel e a geo-história das civiliza??es
Ribeiro, Guilherme;
História, Ciências, Saúde-Manguinhos , 2011, DOI: 10.1590/S0104-59702011000100005
Abstract: the article discusses the valuable role of geography in the study of civilizations entitled grammaire des civilisations (a history of civilizations), by french historian fernand braudel. it also focuses on the epistemological role of the concept of geo-history in braudel's thought. the article's underlying assumption is that geography has been crucial to comprehending history over large spans of time.
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