The purposes of the study were to identify the prevalence of defining characteristics (DC) of decreased cardiac output (DCO) in patients with cardiac insufficiency under evaluation for heart transplantation, and to ascertain the likelihood of defining characteristics being
Prevalencia del diagnóstico de enfermería de disminución del gasto cardíaco y valor predictivo de las características definidoras en pacientes en fase de evaluación para trasplante cardíacoEl estudio tiene como objetivos identificar la prevalencia de las características definitorias de la disminución del gasto cardíaco (DGC) en pacientes con insuficiencia cardíaca (IC) en evaluación para el trasplante de corazón y ver la probabilidad de las características definitorias sean factores predictivos de la existencia de una disminución del gasto cardíaco. Los datos se obtuvieron mediante el análisis documental retrospectivo de historias clínicas de cateterismo cordiaco derecho en 38 pacientes con insuficiencia cardíaca en la evaluación para el trasplante de corazón entre 2004 y 2009. Los resultados mostraron que el 71% de los pacientes habían reducido el gasto cardíaco (medido por el índice cardíaco). La mayoría de las características definitorias de la NANDA-International para el DGC fueron más frecuentes en individuos con índice cardíaco reducido. Los aspectos más destacados son la razón de probabilidad (odds ratio / OR) RVS mayor OR=4,533, el tercer sonido OR=3,429 y la disminución de la fracción de eyección OR=2,850. Al obtener el valor predictivo de las características definitorias de estudio indica la importancia de las características para el diagnóstico de la disminución del gasto cardíaco.
A taxa de mortalidade infantil é considerada indicador síntese da qualidade de vida e do nível de desenvolvimento de uma população. Este artigo analisa a evolução dessas taxas no Município do Rio de Janeiro, no período de 1979 a 2004, e as causas em 2004. Trata de estudo descritivo a partir do total de óbitos infantis e nascimentos ocorridos, utilizando-se os sistemas de informação produzidos pelo Ministério da Saúde. Para avaliação, segundo causa básica de morte, usou-se a Classificação Internacional de Doenças. As taxas de mortalidade infantil por mil nascidos vivos decresceram de 37,4 em 1979 para 15,1 em 2004, sendo o componente pós-neonatal o principal responsável por este declínio. Em 2004, as principais causas de óbito neonatais foram as afecções perinatais e as malformações congênitas; entre os óbitos pós-neonatais destacaram-se as doenças infecciosas e parasitárias, as causas mal definidas e as doenças respiratórias. Embora tenha sido observada queda da taxa de mortalidade infantil, esta não teve uma redução maior, devido ao pequeno declínio do componente neonatal precoce. Observou-se que a assistência à saúde da criança, no município do Rio de Janeiro, ainda deixa a desejar no que se refere à integralidade da assistência desde o período pré-natal.
Objective:to verify the association between the prognostic scores and the quality of
life of candidates for heart transplantation. Method:a descriptive cross-sectional study with a convenience sample of 32
outpatients applying to heart transplantation. The prognosis was rated by
the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model
(SHFM); and the quality of life by the Minnesota Living With Heart Failure
Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire
(KCCQ). The Pearson correlation test was applied. Results:the correlations found between general quality of life scores and prognostic
scores were (HFSS/MLHFQ r = 0.21), (SHFM/MLHFQ r = 0.09), (HFSS/KCCQ r =
-0.02), (SHFM/KCCQ r = -0.20). Conclusion:the weak correlation between the prognostic and quality of life scores
suggests a lack of association between the measures, i.e., worse prognosis
does not mean worse quality of life and the same statement is true in the
opposite direction.
The study aimed to analyze the defining characteristics of the Dysfunctional Ventilatory Weaning Response as an indicator of the accuracy of ventilatory weaning. Observational study of 38 events of ventilatory weaning in adult patients admitted to intensive care. For the defining characteristics, it was calculated: sensitivity, specificity, positive and negative predictive values, accuracy or efficiency, likelihood ratio positive and negative, and diagnostic odds ratio. It was also considered the median number of defining characteristics in the event of success and failure. It was considered accurate: agitation, deterioration in arterial blood gases from baseline parameters, moderate use of accessory muscles of respiration, increased respiratory rate from baseline parameters and respiratory rate increases significantly with respect to baseline parameters. There was statistical difference in the median number of defining characteristics observed. It was concluded that the defining characteristic and the number of them would influence the success of the weaning decision.
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