Hospital Universitario Do Oeste Do Parana

Santa Bárbara d'Oeste, Brazil

Hospital Universitario Do Oeste Do Parana

Santa Bárbara d'Oeste, Brazil
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Loth E.A.,West Parana State University | da Silva J.R.,West Parana State University | Gandra R.F.,Hospital Universitario do Oeste do Parana
Revista da Sociedade Brasileira de Medicina Tropical | Year: 2011

Introduction: The study investigated the incidence of disease and death events among patients with paracoccidioidomycosis who were residents in the Itaipu Lake region from 2008 to 2009. Methods: A review of patient records was conducted at the Department of Tuberculosis of the Epidemiology Center of the city of Foz do Iguaçu, Paraná. Results: The results identified 102 new cases of paracoccidioidomycosis in the period described, 72 men and 30 women, and 15 deaths were recorded during the study. Conclusions: It can be concluded that the Itaipu Lake region is an endemic region.

da Costa J.B.,Hospital Universitario do Oeste do Parana | Marcon S.S.,State University of Maringá | Rossi R.M.,UEM PR
Jornal Brasileiro de Psiquiatria | Year: 2012

objective: Identify the incidence of post-traumatic stress disorder (PTSD), in patients submitted to MV and analyze its relation with clinical and demographical variables, and with the presence of memories regarding intensive care unit (ICU). Method: It is a longitudinal prospective study, carried out in one year at an ICU of a university hospital. Evaluation occurred three months after ICU discharge during patients follow up at the ambulatory. Subjects were evaluated using the ICU memories (ICU-AMI) and the Impact of Event Scale-Revised (IES-R) instruments. results: From the total of subjects, 68.8% were male from 18 to 79 years of age, 43.5 years old average ± 17.1. From the evaluated patients, 14.5% presented symptoms of PTSD when a cut-of score > 20 was used. For a diagnostic accuracy a ≥ 33 cut-of score was also used, and in this case, only seven patients (5.1%) showed signs of PTSD. Conclusion: A few patients met the criteria for the PTSD diagnosis indicating that the great majority of patients admitted at ICU show only symptomatology related to PTSD.

PubMed | West Parana State University, Hospital Universitario do Oeste do Parana and State University of Maringá
Type: Journal Article | Journal: Revista Brasileira de terapia intensiva | Year: 2014

To investigate the relationship between sedation and the memories reported by patients subjected to mechanical ventilation following discharge from the intensive care unit.This prospective, observational, cohort study was conducted with individuals subjected to mechanical ventilation who remained in the intensive care unit for more than 24 hours. Clinical statistics and sedation records were extracted from the participants clinical records; the data relative to the participants memories were collected using a specific validated instrument. Assessment was performed three months after discharge from the intensive care unit.A total of 128 individuals were assessed, most of whom (84.4%) reported recollections from their stay in the intensive care unit as predominantly a combination of real and illusory events. The participants subjected to sedation (67.2%) at deep levels (Richmond Agitation-Sedation Scale [RASS] -4 and -5) for more than two days and those with psychomotor agitation (33.6%) exhibited greater susceptibility to occurrence of illusory memories (p>0.001).The probability of the occurrence of illusory memories was greater among the participants who were subjected to deep sedation. Sedation seems to be an additional factor that contributed to the occurrence of illusory memories in severely ill individuals subjected to mechanical ventilation.

Araujo A.C.F.,West Parana State University | Araujo A.C.F.,Hospital Universitario do Oeste do Parana | Bonfleur M.L.,West Parana State University | Balbo S.L.,West Parana State University | And 2 more authors.
Obesity Surgery | Year: 2012

Background: The aim of this studywas to investigate the effect of the duodenal-jejunal bypass (DJB) on glucose homeostasis and islet insulin secretion in Western diet (WD) obese rats. Methods: Male Wistar rats received a standard rodent chow diet (CTL group) or WD ad libitum. After 32 weeks of diet, WD rats were submitted to duodenal - jejunal bypass (WD DJB) or sham (WD S-DJB) operation. Intraperitoneal (ip) glucose tolerance test was performed 1 week after surgery. Body weight, fat pad depots, glycemia, insulinemia, HOMAIR, and glucose-induced insulin secretion were evaluated 1 month after surgery. Results: Body weight and fat pads of the WD group were higher than those of the CTL group. Sham and DJB surgeries did not alter these parameters. WD and WD S-DJB rats were glucose intolerant, insulin resistant, and hyperinsulinemic. WD DJB rats showed similar glucose tolerance, insulin sensitivity, and plasma insulin levels to those of CTL rats. WD rats presented higher fat and glycogen contents in the liver. DJB surgery normalized fat and glycogen stores in the liver of the WD DJB group. Insulin release at 11.1-mM glucose, in isolated islets from WD and WD S-DJB rats, was higher than from islets of CTL rats. In contrast, DJB surgery improves the beta-cell secretory capacity with increased glucose-induced secretion at 5.6-, 11.1-, and 22.2-mM glucose in WD DJB islets, compared with CTL islets. Conclusions: DJB surgery improves glucose homeostasis and enhances beta-cell glucose responsiveness in rats submitted to the WD diet without any modification in adiposity. © Springer Science+Business Media, LLC 2012.

Talini C.,Universitario Do Oeste Do Parana | Oliveira L.O.,West Parana State University | Araujo A.C.F.,West Parana State University | Netto F.A.C.S.,West Parana State University | Westphalen A.P.,Hospital Universitario Do Oeste Do Parana
International Journal of Surgery Case Reports | Year: 2015

Introduction Rene De Garengeot, a French surgeon, was the first to describe the presence of the appendix inside a femoral hernia sac in 1731. It is a rare entity that has fewer than 100 cases reported in literature. Presentation of case An 86 years-old male patient, comes to Emergency Department complaining of painful bulging in the right inguinal region, associated with local inflammatory signs. He was initially diagnosed as incarcerated femoral hernia and underwent emergency open surgery. Inguinotomy was performed and after hernia sac dissection it was possible to observe the presence of the appendix incarcerated in its interior, without clinical signs of appendicitis. Surgeons performed appendectomy and inguinal repair of the femoral hernia with placement of a polypropylene mesh. Discussion De Garengeot hernia is a rare entity that requires early treatment in order to avoid possible complications. When facing a patient with incarcerated hernia emergency surgery must be indicated even if it is not possible to determine the contents of the hernia. Conclusion This paper presents a case report of a De Garengeot hernia patient who presented a good evolution after surgery. © 2015 The Authors. Published by Elsevier Ltd.

PubMed | West Parana State University and Hospital Universitario do Oeste do Parana
Type: Journal Article | Journal: Revista do Colegio Brasileiro de Cirurgioes | Year: 2016

to describe and evaluate the acceptance of a low-cost chest tube insertion porcine model in a medical education project in the southwest of Paran, Brazil.we developed a low-cost and low technology porcine model for teaching chest tube insertion and used it in a teaching project. Medical trainees - students and residents - received theoretical instructions about the procedure and performed thoracic drainage in this porcine model. After performing the procedure, the participants filled a feedback questionnaire about the proposed experimental model. This study presents the model and analyzes the questionnaire responses.seventy-nine medical trainees used and evaluated the model. The anatomical correlation between the porcine model and human anatomy was considered high and averaged 8.11.0 among trainees. All study participants approved the low-cost porcine model for chest tube insertion.the presented low-cost porcine model for chest tube insertion training was feasible and had good acceptability among trainees. This model has potential use as a teaching tool in medical education.

PubMed | West Parana State University and Hospital Universitario do Oeste do Parana
Type: Journal Article | Journal: Revista Brasileira de terapia intensiva | Year: 2014

This study sought to assess the influence of prone positioning on the stress of newborn premature infants through the measurement of the salivary cortisol concentration and the evaluation of physiological and behavioral responses before and after changes in body positioning.Saliva samples were collected from newborn infants at two different times: the first (corresponding to the baseline) after a period of 40 minutes during which the infants were not subjected to any manipulation and were placed in the lateral or supine position, and the second 30 minutes after placement in the prone position. Variables including heart rate, respiratory rate, peripheral oxygen saturation, and the Brazelton sleep score were recorded before, during, and at the end of the period in the prone position.The sample comprised 16 newborn premature infants (56.3% male) with a gestational age between 26 and 36 weeks, postnatal age between 1 and 33 days, birth weight of 935 to 3,050g, and weight at the time of intervention of 870 to 2,890g. During the intervention, six participants breathed room air, while the remainder received oxygen therapy. The median salivary cortisol concentration was lower in the prone position compared to baseline (0.13 versus 0.20; p=0.003), as was the median Brazelton sleep score (p=0.02). The average respiratory rate was lower after the intervention (54.887.15 versus 607.59; p=0.0004). The remainder of the investigated variables did not exhibit significant variation.Prone positioning significantly reduced the salivary cortisol level, respiratory rate, and Brazelton sleep score, suggesting a correlation between prone positioning and reduction of stress in preterm infants.

A multicenter, cross-sectional study took place from December 2009 to June 2010 and aimed to assess the quality of Nursing Prescription (NP) in two public teaching hospitals. The sample consisted of 1,307 NP and data were processed using the G-test and chi-square. The determination of the quality of NP was based on the classification indices reported in literature. Among the results, 1,083 (82.8%) correct and appropriate NP, 154 (11.8%) inadequate NP and 52 (3.9%) incomplete NP were found. In 18 (1.37%) patient charts, the NP was nonexistent. There was statistic signficance (alpha < 0.05) for incomplete and absent NP between the two hospitals (0.00), as well as inappropriate NP between age groups (0.03). It was concluded that, in the hospitals under study, the NP needs to be improved both in terms of quantity and quality.

Marchiori R.,Hospital Universitario do Oeste do Parana
Einstein (São Paulo, Brazil) | Year: 2012

To analyze the histopathological lung findings of four fatal cases of the 2009 H1N1 influenza pandemic and their correlation with clinical and epidemiological characteristics. Descriptive data from medical records of four patients who died in the Intensive Care Unit of a university hospital in 2009. Nasopharyngeal aspirate specimens were collected from the patients and were analyzed by real-time polymerase chain reaction. Lung biopsy was performed post mortem; a score of intensity for pathological changes was applied. Three patients had positive real-time polymerase chain reaction (although all of them had a clinical diagnose of influenza H1N1). The main histopathological changes were: exudative diffuse alveolar damage with atelectasis; varying degrees of alveolar hemorrhage and edema, necrosis and sloughing of the respiratory epithelium in several bronchioli; and thrombus formation. One of the patients (the pregnant one) presented histopathological findings of cytomegalic inclusion. The pulmonary histopathological findings in patients with fatal 2009 H1N1 influenza pandemic disclosed intense alveolar damage and hemorrhage and severe bronchiolitis. A co-infection with cytomegalovirus was described in the pregnant patient.

This study aimed to evaluate the quality of nursing care of an Adult Intensive Care Unit. Data from fifty in-hospital patients, who stayed in ICU for more than three days, were collected through observation, physical examination and patients' medical-information records analysis, using an Operational Auditing Plan. Care considered of quality were those that obtained positive answer percentage ≥ 70%, as those related to Physical Safety (71%) and Equipment Use (72%). Physical Activity (28%) and Oxygenation/Ventilation (29%) reached the lowest scores. We concluded that is urgent to implement continuing education actions in the service studied, since most care items and sub-items did not present the quality needed.

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