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Biomedical subjects

M C de Almeida

Publications and source records attributed to M C de Almeida.

At least 19 recordsLinked to original sources
PubMed2004

Leishmanial infection: analysis of its first steps. A review.

The first steps in leishmaniasis are critical in determining the evolution of the disease. Major advances have recently been done in understanding this crucial moment. Fundamental research in parasite-vector interaction, parasite biology, insect saliva, and vertebrate host response have shed new light and uncovered a most fascinating and complex moment in leishmaniasis. We review here some of these aspects and we try to connect them in a logical framework.

Animals↗
PubMed2000

Use of tandem stents for treatment of helicoidal dissection of the right coronary artery.

Coronary dissection occurs frequently and in several degrees during coronary angioplasty, which is one of the mechanisms for increasing the lumen diameter of a vessel. However the length of the dissection may affect the procedure, becoming the most frequent cause of total occlusion after coronary angioplasty. We report here a case of extensive dissection that occurred during the coronary angioplasty of a focused lesion, which we treated with two long stents.

Aortic Dissection↗
PubMed2000

[Knowledge obtained in the master's program of public health nursing at the Nursing School of Ribeirao Preto - USP and its relationship with health practices].

The purpose of this study was to analyze the research objects of the theses produced in the Master Program on Public Health offered by the Department of Maternal-Infant Nursing and Public Health--University of São Paulo at Ribeirão Preto College of Nursing and their relationship with the problems originated from health care practice. These practices were classified within six major areas: Health Care Organization, Health Promotion, Health-Disease Process, Nutrition-Feeding, Professional Practice and Immunology. The contribution of works focussing on the crisis of health paradigms, gender relations and Social Movements in Health were emphasized. Authors concluded that the themes are closely related to the students' professional context, enabling them to present suggestions regarding interventions in health practices.

Brazil↗
PubMed2000

[The process of nursing work in collective health and interdisciplinary studies].

This study aims at discussing and stimulating reflections on the need of an interdisciplinary dialogue when the object of work is the health-illness-care process. The authors discuss the definition of Nursing by considering its essence, care, its history and practice. Following, considerations about inter- and trans-disciplinary studies on collective health are presented and the authors conclude with a proposal of basing care on the theory of communicative action developed by Jürgen Habermas.

Interdisciplinary Communication↗
PubMed1999

Nursing and the health system in Brazil.

The purpose of this article is to describe nursing in the Brazilian health system and to analyze the characteristics of nursing personnel in Brazil. This description includes types of health institutions, services rendered, and the distribution of nursing personnel by professional categories in 1956, 1982, and 1995. Discussion of the challenges facing Brazilian nurses is presented using data from the Brazilian Institute of Geography and Statistics (IBGE), Federal Nursing Board (COFEn), Regional Nursing Board (COREn), and the Brazilian Nursing Association (ABEn). An increase in the number of outpatient units and in diagnostic and therapeutic examinations has led to an increased the demand for nurses. Public health nurses participate in planning, management, sanitary education, health promotion, and supervision of nursing care provided by nursing technicians, assistants, and other helpers.

Brazil↗
PubMed1999

[The work of nursing in the production of health care in a clinical model].

The subject of this research study is the technological and social organization of health work in hospital, considering the position of nursing practice within production of care. The aim is to analyze the work process at a University Hospital to apprehend the configuration of practices, knowledges, social relations and technologies that are operated by agents in intervention on the body of an ill person. Using a dialectical approach, empirical data were collected by direct observation of the work process in a medical in-patient unit and by semi-structured interviews with professionals. It was found that the production of care is developed based on collective work, that is structured by the division in parts and fragmentation of the actions of the different agents, in order to produce a diagnosis and therapy. The agents articulate their actions around the medical act which takes up a central position in the production of care. The importance of broadening the clinical model to contemplate the social and subjective dimension of the health/disease process is pointed out in a therapeutical project shared by different health care team professionals. It is proposed to change the work process associated with the construction of new management models in health care institutions.

Attitude of Health Personnel↗
PubMed1999

[Use of participating observation and semi-structured interviews in nursing research].

An experience report of the researchers in the development of a qualitative research is presented. The limits and the possibilities found in the realization of the field work are described, while adopting participant observation and semi-structured interview as techniques for data collection. The importance of the involvement level of the researcher with the subjects and some aspects that may interfere in the results to be achieved are emphasized.

Data Collection↗
PubMed1997

[The interaction between rocuronium and smoking. The effect of smoking on neuromuscular transmission after rocuronium].

UNLABELLED: Recent studies have shown different results concerning the effects of smoking on neuromuscular blocking agents. Some reports indicate that smokers need higher doses of vecuronium, but are more sensitive to atracurium. The aim of this study was to evaluate the effects of smoking on onset and recovery time after a single 0.6 mg/kg intubating dose of rocuronium an analog of vecuronium. METHODS: Following institutional approval and informed consent, 20 smokers (> 10 cigarettes/day) and 20 nonsmokers were included in the study. Following oxazepam premedication and induction with fentanyl and thiopental, single-twitch stimulation of the ulnar nerve was performed every 10 s. Following stabilisation of control responses, patients received rocuronium 0.6 mg/kg for intubation. Anaesthesia was maintained with enflurane < or = 0.8 vol.% (end-tidal) and 65% nitrous oxide in oxygen. Onset time and recovery to 25% and 75% of the twitch control values were recorded. RESULTS: Onset and recovery times were not different between smokers and nonsmokers. CONCLUSIONS: The results of the present study suggest that chronic nicotine exposure does not change onset time or duration of rocuronium neuromuscular blockade. A previous study found a greater need for vecuronium in smokers and discussed stimulation of the neuromuscular junction and enhanced biotransformation due to the enzyme-inducing properties of nicotine. The differences in our results could be partly due to a longer period of refraining from smoking in our patients, leading to very low nicotine blood concentrations without the proposed receptor-stimulating effect. Another cause for different behaviour of the two analogs could be different elimination pathways. Recent investigations suggest that rocuronium may not be eliminated principally by the liver. Therefore, enhanced nicotine-induced biotransformation, as suggested for vecuronium, would not occur with rocuronium.

Adult↗
PubMed1996

[The effects of cimetidine on the pharmacodynamics of rocuronium].

UNLABELLED: Cimetidine is a commonly used H2-receptor antagonist that has been recommended for the prevention of acid aspiration syndrome and has been shown to potentiate vecuronium-induced neuromuscular block. The present study was designed to investigate the influence of a single IV dose of cimetidine on the neuromuscular effects of rocuronium, an analogue of vecuronium with a short onset time. METHODS: Twenty adults aged 18-65 years were included in the study with their informed consent and approval of the Ethics Committee. Following oxazepam premedication, 10 patients were randomly allocated to receive cimetidine 400 mg IV 30 min before anaesthesia. After fentanyl and thiopentone induction, single-twitch stimulation of the ulnar nerve was performed every 10 s. Following stabilisation of control responses, patients received rocuronium 0.6 mg/kg for intubation. Anaesthesia was maintained with enflurane < or = 0.8 vol.% (end-tidal) and 65% nitrous oxide. Onset time and recovery times to 25% and 75% of the twitch control values were recorded. RESULTS: Onset and recovery times did not differ between groups. CONCLUSIONS: The results of the present study demonstrate that cimetidine does not increase the duration of rocuronium neuromuscular blockade. Inhibition of the cytochrome P450 system or a direct effect at the neuromuscular junction have been suggested as the mechanisms of drug interaction associated with cimetidine. Impairment of hepatic microsomal drug metabolism results in a prolonged duration of action of vecuronium, which appears to be eliminated primarily via the liver. Data on the elimination pathway of rocuronium in humans are not available. The fact that cimetidine does not alter the recovery from rocuronium-induced neuromuscular block confirms a previous suggestion that rocuronium may not be eliminated principally by the liver. A direct effect of cimetidine on the neuromuscular junction could not be confirmed by this study. Therefore, cimetidine can be given as premedication without a risk of prolonged rocuronium block.

Adolescent↗
PubMed1996

[The effects of age on onset and recovery from atracurium, rocuronium and vecuronium blockade].

UNLABELLED: Elderly patients may show an age-related decline in physiologic functions, which may be responsible for the prolonged duration of some neuromuscular blocking agents. Previous studies have yielded conflicting results as to the effects of these drugs in the elderly. METHODS: After obtaining informed consent and approval of the Ethics Committee, we compared onset and recovery times of single IV doses of atracurium, rocuronium, and vecuronium given to 108 patients divided into three groups according to age (18-50, 51-64, > or = 65 years). Following oxazepam premedication and fentanyl and thiopentone induction, patients were randomly allocated to receive atracurium, rocuronium or vecuronium (0.5, 0.6, or 0.1 mg/kg, respectively) in < or = 0.8 vol.% enflurane (end-tidal)-nitrous oxide anaesthesia. Muscular relaxation was assessed by electromyographic (EMG) recording of the adductor pollicis muscle after supramaximal single-twitch stimulation of the ulnar nerve every 10 s. Onset time and recovery to 25%, 75% and 90% of twitch control values (DUR25, 75, 90) were recorded. Creatinine clearance predicted from serum creatinine (Ccr) was correlated with recovery from neuromuscular block. RESULTS: Onset time was not different among groups or relaxants. The results showed a prolonged duration of action for atracurium (DUR75, DUR90), rocuronium (DUR25, DUR75), and vecuronium (DUR25) in the elderly. A number of patients did not reach DUR75 or DUR90. There was a significant relationship between age and failure to return to control values during recovery from neuromuscular block, especially after atracurium and rocuronium. Ccr showed a negative correlation with age for all relaxants, but a negative significant correlation between Ccr and recovery was found only for rocuronium. CONCLUSIONS: This study suggests that onset time for atracurium, rocuronium and vecuronium is not age-dependent. Recovery was prolonged in the elderly for all three relaxants. This effect appears to be secondary to changes in body composition and function accompanying the aging process. Neither atracurium nor vecuronium depends significantly on the kidney for elimination, but the negative correlation between Ccr and rocuronium suggests an appreciable role for the kidney in the elimination of this relaxant. The long recovery times observed in this study could also be related to enflurane anaesthesia. We suggest that failure of EMG responses to return to baseline values during recovery from neuromuscular block may be related to age, especially for atracurium and rocuronium.

Adolescent↗
PubMed1994

[Decreased demand for nursing courses--a profile of the profession among young people].

This study, which is based in a descriptive exploratory charter objectified to identify the perception that young people have concerning to the factors which possibly have been influencing the process of how to choose a professional career for nursing, been possibly to identify an outline for nursing. Outline, is not so attractive for the young people to select this profession.

Career Choice↗
PubMed1993

[The origin of modern pediatric nursing].

The object of study of this investigations in the knowledge in pediatrics nursing from the institutionalization of the modern nursing beginning from the XIX Century. The knowledge in this study is considered as an instrument from which man apprehends his working object. From an historical perspective nursing is seen as a social articulated practice, as part of a collective process of works, whose purposes are: the control of the disease in the society, based on collective level and the recuperation of the individual working strength. Through the bibliography, we try to identify the characteristics of children's nursing assistance in England, during the XIX Century and the simultaneous movements of the medicinal practice: the social medicine, the clinic medical practice and puericulture. Followed the characteristics of the children's assistance in the United States in the beginning of the century and the theoretical reference in which it is located.

History, 19th Century↗
PubMed1993

[Postgraduate nursing education in Brazil--the current situation].

This article describes the actual situation of post-graduate programs in nursing in Brazil based on data for the biennium 90/91, from the Coordination of Post-Graduate Programs (CAPES) regarding: the faculty, curricular structure, organization of research, scientific production by the faculty, scientific production by the students, mean time for receipt of degree, and student flux. A global evaluation of post-graduate programs in nursing throughout their 20 years of existence is presented.

Brazil↗
PubMed1989

[Anatomo-clinical diagnosis correlation. Retrospective assessment of the clinical diagnosis in necropsies].

The post mortem findings in 200 autopsies were compared with the clinical diagnoses. Twenty diseases were analysed with respect to clinico-pathological correlation. In relation to the respective totals the diseases most frequently missed clinically were (false negative) pyelonephritis (100%), pulmonary embolus (87.50%) and bronchopneumonia (58.16%). In relation to the respective totals the clinical diagnoses less frequently confirmed (false positive) were tuberculosis (69.56%), paracoccidioidomycosis (57.14%), sepsis (53.13%) and Chagas' disease (44.44%). There was clinicopathological agreement in 97 autopsies (48.50%). In 19 cases (9.50%) if the diagnostic error had been detected during life this probably would have changes the prognosis. The findings are discussed in the light of previous studies. The importance of routine post-mortem examination and clinico-pathological correlation is stressed.

Autopsy↗