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Search Results: 1 - 10 of 183157 matches for " Munhóz Derli da Concei??o "
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Influência da freqüência de estímulos na instala??o do bloqueio neuromuscular produzido pelo rocur?nio e pancur?nio: avalia??o pelo método acelerográfico
Munhóz, Derli da Concei??o;Braga, Angélica de Fátima de Assun??o;Potério, Glória Maria Braga;
Revista Brasileira de Anestesiologia , 2004, DOI: 10.1590/S0034-70942004000100002
Abstract: background and objectives: factors associated to patients and neuromuscular blockers (nmb), as well as others inherent to neuromuscular function monitoring, may affect neuromuscular block onset. this study aimed at the influence of two different stimulation frequencies on rocuronium and pancuronium-induced neuromuscular block. methods: participated in this study 120 patients, physical status asa i and ii, submitted to elective procedures under general anesthesia, who were randomly allocated in two groups, according to the stimulation frequency employed to monitor neuromuscular block: group i - 0.1 hz (n = 60) and group ii - 1 hz (n = 60). two subgroups were formed within each group (n = 30), according to the neuromuscular blocker: subgroup p (pancuronium) and subgroup r (rocuronium). patients were premedicated with muscular midazolam (0.1 mg.kg-1), 30 minutes before surgery. anesthesia was induced with propofol (2.5 mg.kg-1) preceded by alfentanil (50 μg.kg-1) and followed by pancuronium or rocuronium. patients were ventilated under mask with 100% oxygen until 75% or more decrease in adductor pollicis muscle response, when laryngoscopy and tracheal intubation were performed. neuromuscular function was monitored by acceleration transducer. the following parameters were evaluated: pancuronium and rocuronium onset time; time for complete block and tracheal intubation conditions. results: mean times (seconds) for pancuronium-induced neuromuscular block onset and for complete neuromuscular block were: group i (159.33 ± 35,22 and 222 ± 46.56) and group ii (77.83 ± 9.52 and 105.96 ± 15.58); rocuronium-induced values were: group i (83 ± 17.25 and 125.33 ± 20.12) and group ii (48.96 ± 10.16 and 59.83 ± 10.36) with statistical difference between groups. tracheal intubation conditions were satisfactory in 117 patients (97.5%) and unsatisfactory in 3 (2.5%). conclusions: rocuronium and pancuronium-induced neuromuscular block onset and time required for complete adductor pollici
Influência da freqüência de estímulos na instala o do bloqueio neuromuscular produzido pelo rocur nio e pancur nio: avalia o pelo método acelerográfico
Munhóz Derli da Concei??o,Braga Angélica de Fátima de Assun??o,Potério Glória Maria Braga
Revista Brasileira de Anestesiologia , 2004,
Abstract: JUSTIFICATIVA E OBJETIVOS: Fatores relacionados ao paciente e ao bloqueador neuromuscular (BNM), assim como outros inerentes à monitoriza o da fun o neuromuscular podem influenciar na instala o do bloqueio neuromuscular. O objetivo deste estudo foi avaliar a influência de duas diferentes freqüências de estímulos sobre o tempo de instala o do bloqueio produzido pelo pancur nio e pelo rocur nio. MéTODO: Foram incluídos no estudo 120 pacientes, estado físico ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos, de acordo com a freqüência de estímulo empregada, para a monitoriza o do bloqueio neuromuscular: Grupo I - 0,1 Hz (n = 60) e Grupo II - 1 Hz (n = 60). Em cada grupo formaram-se dois subgrupos (n = 30) de acordo com o bloqueador neuromuscular empregado: Subgrupo P (pancur nio) e Subgrupo R (rocur nio). A medica o pré-anestésica consistiu de midazolam (0,1 mg.kg-1) por via muscular, 30 minutos antes da cirurgia. A indu o anestésica foi obtida com propofol (2,5 mg.kg-1) precedido de alfentanil (50 μg.kg-1) e seguido de pancur nio ou rocur nio. Os pacientes foram ventilados sob máscara com oxigênio a 100% até a obten o de redu o de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intuba o traqueal. A fun o neuromuscular foi monitorizada com aceleromiografia. Foram avaliados: tempo de início de a o do pancur nio e do rocur nio; tempo para instala o do bloqueio total e condi es de intuba o traqueal. RESULTADOS: Os tempos médios (segundos) para o início de a o e instala o de bloqueio neuromuscular total produzido pelo pancur nio foram: Grupo I (159,33 ± 35,22 e 222 ± 46,56) e Grupo II (77,83 ± 9,52 e 105,96 ± 15,58); para o rocur nio: Grupo I (83 ± 17,25 e 125,33 ± 20,12) e Grupo II (48,96 ± 10,16 e 59,83 ± 10,36) com diferen a significativa entre os grupos. As condi es de intuba o traqueal foram satisfatórias em 117 pacientes (97,5%) e insatisfatórias em 3 (2,5%). CONCLUS ES: O início de a o e o tempo para obten o do bloqueio neuromuscular total no músculo adutor do polegar, produzidos pelo rocur nio e pelo pancur nio, s o mais curtos quando há emprego de maiores freqüências de estímulos.
Um estudo da aprendizagem e desenvolvimento de crian as em situa o de interna o hospitalar =A study of learning and development of hospitalized children
Munhóz, Maria Alcione,Ortiz, Leodi Concei??o Meireles
Educa??o , 2006,
Abstract: O presente artigo faz uma incurs o em dois universos temáticos: Saúde e Educa o, refletindo sobre os efeitos da interna o hospitalar nos processos de aprendizagem e desenvolvimento de crian as em tratamento no Hospital Universitário de Santa Maria - HUSM. Este estudo vem ancorado em aportes teóricos do método Clínico Piaget e o Nível da Lecto-escrita de Emília Ferreiro. A partir do enfoque pedagógico e lúdico, foi observado um significativo avan o nos estágios das opera es mentais das crian as e uma supera o no quadro das dificuldades de aprendizagem.
Are Smaller Cities More Sustainable? Environmental Externalities in Urban Areas. Evidences from Cities in São Paulo, Brazil  [PDF]
Priscila B. Santiago, Jorge M. Nogueira, Pedro H. Z. da Concei??o
Current Urban Studies (CUS) , 2014, DOI: 10.4236/cus.2014.24031
Abstract: The objective of this essay is to explore the relationship between economics of agglomeration, city sizes and negative environmental externalities. Therefore, we contribute to illuminating the controversy on optimal city size, which has been much more concentrated on the reality of developed nations. We emphasize environmental dimensions related to this debate focusing on developing country urban agglomerations. In order to do so we test the hypothesis that smaller cities present better environmental quality indicators than bigger urban centers. Our tentative of rejecting this hypothesis was based upon data on more than 600 cities in the state of Sao Paulo, Brazil, including its capital city of Sao Paulo, one of the largest cities in the world with more than 12 million inhabitants. We used cluster technique for a multivariable analysis with several environmental indicators—for water quality and for solid waste disposal and management—and an aggregated quality of life indicator very similar to the Human Development Indicator (HDI). Our results reject the hypothesis that smaller cities in a developing country reality are more environmentally sustainable than bigger cities.
Development of a method of robust rain gauge network optimization based on intensity-duration-frequency results
A. Chebbi,Z. K. Bargaoui,M. da Concei??o Cunha
Hydrology and Earth System Sciences Discussions , 2012, DOI: 10.5194/hessd-9-14205-2012
Abstract: Based on rainfall intensity-duration-frequency (IDF) curves, a robust optimization approach is proposed to identify the best locations to install new rain gauges. The advantage of robust optimization is that the resulting design solutions yield networks which behave acceptably under hydrological variability. Robust optimisation can overcome the problem of selecting representative rainfall events when building the optimization process. This paper reports an original approach based on Montana IDF model parameters. The latter are assumed to be geostatistical variables and their spatial interdependence is taken into account through the adoption of cross-variograms in the kriging process. The problem of optimally locating a fixed number of new monitoring stations based on an existing rain gauge network is addressed. The objective function is based on the mean spatial kriging variance and rainfall variogram structure using a variance-reduction method. Hydrological variability was taken into account by considering and implementing several return periods to define the robust objective function. Variance minimization is performed using a simulated annealing algorithm. In addition, knowledge of the time horizon is needed for the computation of the robust objective function. A short and a long term horizon were studied, and optimal networks are identified for each. The method developed is applied to north Tunisia (area = 21 000 km2). Data inputs for the variogram analysis were IDF curves provided by the hydrological bureau and available for 14 tipping bucket type rain gauges. The recording period was from 1962 to 2001, depending on the station. The study concerns an imaginary network augmentation based on the network configuration in 1973, which is a very significant year in Tunisia because there was an exceptional regional flood event in March 1973. This network consisted of 13 stations and did not meet World Meteorological Organization (WMO) recommendations for the minimum spatial density. So, it is proposed to virtually augment it by 25, 50, 100 and 160% which is the rate that would meet WMO requirements. Results suggest that for a given augmentation robust networks remain stable overall for the two time horizons.
Influence of stimulus frequency on blockade induced by pancuronium and rocuronium: study on rats phrenic nerve-diaphragm preparation
Braga, Angélica de Fátima de Assun??o;Munoz, Derli Concei??o;Braga, Franklin Sarmento da Silva;Araujo, Daniele Ribeiro de;Potério, Glória Maria Braga;Mantovani, Mario;
Acta Cirurgica Brasileira , 2007, DOI: 10.1590/S0102-86502007000600006
Abstract: purpose: to evaluate the influence of two stimulation frequencies on the installation of neuromuscular blockade produced by pancuronium and rocuronium on the rat diaphragm. methods: diaphragms were submitted to an indirect frequency stimulation of 0.1 and 1hz (groups i and ii, respectively). subgroups were formed (n=5) according to the neuromuscular blocker employed (pancuronium-2μg/ml and rocuronium-4μg/ml). the twitch height depression was evaluated at 5, 15 and 30 minutes after adding the neuromuscular blocker. results: the decrease in twitch height was greater (p<0.01) with a frequency of 1hz at all time periods studied both in preparations that are blocked with pancuronium and in those that are blocked with rocuronium. conclusion: the frequency of stimulation interferes significantly with the installation of neuromuscular blockade produced by pancuronium and rocuronium, since the reduction in amplitude of the rat diaphragm response was greater for 1hz frequencies, at all periods studied.
Ferns and lycophytes from municipality of Caxias, state of Maranh o, Brazil
Rozijane Santos Fernandes,Gon?alo Mendes da Concei??o,Jeferson Miranda Costa,Eliete Lima de Paula-Zárate
Boletim do Museu Paraense Emílio Goeldi : Ciências Naturais , 2010,
Abstract: This study presents an inventory of the ferns and lycophytes from the Caxias municipality (Maranh o State, Brazil), which is the second work with these plant groups in the state. Whereas plants are very poorly sampled in Maranh o, we understand to be important to study the floristic composition of these groups for the knowledge of plant diversity as a whole. The municipality has 531,350 ha of area and is located in the eastern side of the state, where the vegetation coveris characterized by the contact between cerrado and forest. The material was collected between November 2005 and August 2007. The 21 registered species belong to 14 genera and 11 families, among which the richest was Pteridaceae (five species), followed by Thelypteridaceae (four species). Six species were cited as new registers to Maranh o [Selaginella erythropus (Mart.) Spring, S. flagellata Spring, Acrostichum danaeifolium Langsd. & Fisch., Adiantum serratodentatum Humb. & Bonpl. ex Willd., Lindsaea divaricata Klotzsch and Salvinia auriculata Aubl.]. The majority of the species was terrestrial, occurred inside the forests and presented American distribution.
Compara??o entre os efeitos hemodinamicos da intoxica??o aguda com bupivacaína racêmica e a mistura com excesso enatiomérico de 50% (S75-R25): estudo experimental em c?es
Udelsmann, Artur;Munhoz, Derli Concei??o;Silva, William Adalberto;Moraes, Ana Cristina de;Marcondes, Giancarlo;
Revista Brasileira de Anestesiologia , 2006, DOI: 10.1590/S0034-70942006000400007
Abstract: background and objectives: racemic bupivacaine has been widely used in locoregional anesthesia due to the quality and duration of its anesthetic action. however, its cardiovascular toxicity has worried anesthesiologists for a long time, and new options have been sought. one of them is the use of its levorotatory isomer that, due to a lesser affinity for the sodium channel receptors in the cardiac cell, would be less toxic. the presentation containing 75% of the levorotatory isomer and 25% of the dextrorotatory isomer, named 50% enantiomeric excess mixture (s75-r25), is available in our country. the objective of this study was to compare the hemodynamic effects of the acute intoxication with racemic bupivacaine and with the s75-r25 mixture in animals. methods: forty-four dogs were anesthetized with pentobarbital, intubated and placed on mechanical ventilation. hemodynamic monitorization was accomplished with a swan-ganz catheter and intra-arterial blood pressure measurements. after a period of rest, they were randomly and blindly divided in two groups, according to the intoxication with either agent at a dose of 5 mg.kg-1. hemodynamic data were collected during 30 minutes and analyzed statically to allow for the comparison of both agents. results: the mixture s75-r25 had more hemodynamic repercussions causing, especially, a significant reduction of the mean arterial pressure, cardiac index, and the left ventricle work index. conclusions: these results contradict those found in human beings regarding the pure levorotatory isomer, but confirm recent animal studies. one must be very careful when extrapolating animal data to human beings. further studies involving larger samples and more homogeneous groups are necessary.
Influência do propofol e do etomidato no bloqueio neuromuscular produzido pelo rocur?nio: avalia??o pela aceleromiografia
Munhoz, Derli Concei??o;Braga, Angélica de Fátima de Assun??o;Potério, Glória Maria Braga;
Revista Brasileira de Anestesiologia , 2002, DOI: 10.1590/S0034-70942002000600003
Abstract: background and objectives: some hypnotics may interact with neuromuscular blockers and potentiate their effects. this study aimed at evaluating the influence of propofol and etomidate on rocuronium-induced neuromuscular block. methods: participated in this study 60 patients, physical status asa i and ii, scheduled for elective surgeries under general anesthesia, who were randomly distributed in two groups according to the hypnotic drug: group i (propofol) and group ii (etomidate). all patients were premedicated with intramuscular midazolam (0.1 mg.kg-1), 30 minutes before surgery. anesthesia was induced with propofol (2.5 mg.kg-1) or etomidate (0.3 mg.kg-1) preceded by alfentanil (50 μg.kg-1) and followed by rocuronium (0.6 mg.kg-1). patients were ventilated under mask with 100% oxygen until achieving a decrease of 75% or more in the adductor pollicis muscle response amplitude. neuromuscular function was monitored by accelerometry. the following parameters were evaluated: rocuronium onset (t1 £ 25%); time for complete neuromuscular block; neuromuscular block degree at tracheal intubation; tracheal intubation conditions and hemodynamic effects. results: complete rocuronium-induced neuromuscular block onset times (in seconds) were: group i (48.20 ± 10.85 s and 58.87 ± 10.73 s) and group ii (51.20 ± 13.80 s and 64.27 ± 18.55 s). neuromuscular block degree at tracheal intubation was: group i (77.50%) and group ii (76.96%). tracheal intubation conditions were satisfactory in 100% of group i patients and in 83.33% of group ii patients. there has been a significant decrease in mean blood pressure, followed by an increase after hypnotic injection, in both groups. conclusions: propofol and etomidate had a similar behavior regarding time for rocuronium-induced neuromuscular block and tracheal intubation conditions.
Influência do propofol e do etomidato no bloqueio neuromuscular produzido pelo rocur nio: avalia o pela aceleromiografia
Munhoz Derli Concei??o,Braga Angélica de Fátima de Assun??o,Potério Glória Maria Braga
Revista Brasileira de Anestesiologia , 2002,
Abstract: JUSTIFICATIVA E OBJETIVOS: Alguns hipnóticos podem interagir com os bloqueadores neuromusculares (BNM) potencializando seus efeitos. O objetivo deste estudo foi avaliar a influência do propofol e do etomidato sobre o bloqueio neuromuscular produzido pelo rocur nio. MéTODO: Foram incluídos no estudo 60 pacientes, estado físico ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos de acordo com o hipnótico empregado: Grupo I (propofol) e Grupo II (etomidato). Todos os pacientes receberam midazolam (0,1 mg.kg-1) por via muscular como medica o pré-anestésica, 30 minutos antes da cirurgia. A indu o anestésica foi obtida com propofol (2,5 mg.kg-1) ou etomidato (0,3 mg.kg-1) precedido de alfentanil (50 μg.kg-1) e seguido de rocur nio (0,6 mg.kg-1). Os pacientes foram ventilados sob máscara com oxigênio a 100% até a obten o de redu o de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intuba o traqueal. A fun o neuromuscular foi monitorizada com aceleromiografia. Foram avaliados: tempo de início de a o do rocur nio (T1 <= 25%); tempo para instala o do bloqueio neuromuscular total; grau de bloqueio neuromuscular no momento da intuba o traqueal; condi es de intuba o traqueal e repercuss es hemodinamicas. RESULTADOS: Os tempos de início de a o e instala o de bloqueio neuromuscular total (segundos) produzido pelo rocur nio foram: Grupo I (48,20 ± 10,85 s e 58,87 ± 10,73 s) e Grupo II (51,20 ± 13,80 s e 64,27 ± 18,55 s). O grau de bloqueio neuromuscular no momento da intuba o traqueal foi: Grupo I (77,50%) e Grupo II (76,96%). As condi es de intuba o traqueal foram satisfatórias em 100% dos pacientes do Grupo I e em 83,33% no Grupo II. Nos dois grupos, após a inje o do hipnótico, observou-se diminui o significativa da press o arterial média seguida de eleva o. CONCLUS ES: O propofol e o etomidato comportaram-se de maneira semelhante em rela o à instala o do bloqueio neuromuscular e às condi es de intuba o traqueal produzidos pelo rocur nio.
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