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HOSPITAL DESPONTOU NA PRODUÇÃO DE CONTEÚDOS CIENTÍFICOS EM 2008 PDF Imprimir

Idealizado para ser um hospital escola, o Hospital Risoleta Tolentino Neves se firma como campo para produção de conhecimento acadêmico-científico ligado as unidades da UFMG. Através da reestruturação do NEP – Núcleo de Ensino e Pesquisa — as produções científicas ganharam suporte e, desde então, são apresentadas em congressos e seminários nacionais e internacionais.

 

Leia e acesse os links sobre os conteúdos científicos, pôsteres, trabalhos e relatos de apresentações orais realizados pelos docentes e alunos do HRTN usando como base para as pesquisas a própria instituição.

 

* contribuição Gabriel Caldeira

acesse os links:

-  XI Encontro de Extensão do UFMG ( A humanização do atendimento ao paciente em estágio avançado da doença: em casa ou no hospital );
-  II Seminário de Humanização do HC-UFMG (Evento paralelo ao I Congresso Brasileiro de Saúde) 

 

* contrubuição Drº João B. Rezende Neto

PUBLICACOES FEITAS NO HOSPITAL E PORTANTO LEVAM O NOME DO HOSPITAL. 

1.                  Rezende-Neto JB, Marques AC, Guedes LJ, Teixeira LC. Damage Control Principles

Applied to Penetrating Neck and Mandibular Injury. J Trauma 2008; 64: 1142-1143.

2.                  Rezende-Neto JB, Petroainu A, Santana SK. Subtotal Splenectomy and Central Splenorenal Shunt for Treatment of Bleeding from Roux En Y Jejunal Loop Varices Secondary to Portal Hypertension. Dig Dis Sci 2008; 53:539-543. 

ARTIGOS ACEITOS PARA PUBLICACAO:

1.  Nonoperative management of right thoracoabdominal penetrating injuries: chest

tube effluent testing for bile.  (REVISTA) Injury.

AUTORES: Rezende-Neto JB et al. (ESTE TRABALHO FOI REALIZADO ANTES DA MINHA ENTRADA NO HOSPITAL MAS COLOQUEI O NOME DO HOSPITAL COMO SENDO UMA DAS INSTITUICOES QUE TRABALHO)

2. Penetrating Injury to the Chest Caused by a Plastic Bullet. (REVISTA) Journal of Trauma.

AUTORES: Joao B. Rezende-Neto, MD, MSc, PhD,   Fabriccio D. Fernandes-Silva, MD,  Leonardo B. Otoni-Porto, MD,  Luiz C. Teixeira, MD.

3. Acute appendicitis by Enterobius vermicularis: Case report and review of the literature.(REVISTA) Rev Med Minas Gerais.

AUTORES: Joao B. Rezende-Neto, Leonardo B. Otoni-Porto,  Paula Martins , Leandro Pereira.

TRABALHOS ENVIADOS PARA CONGRESSOS E ACEITOS PARA APRESENTACAO EM 2009:

1) TRABALHO ENVIADO E ACEITO PARA APRESENTACAO ORAL NO CONGRESSO DA EASTERN ASSOCIATION FOR THE SURGERY OF TRAUMA  EM ORLANDO - FLORIDA JANEIRO 13 a 17 DE 2009.

AUTORES: REZENDE-NETO JB, ANDRADE MV, MARTINS P, LISBOA T, CUNHA-MELO JR.

TITULO: Coagualtion profile and permissive hypotension: The role of DDAVP

Objective: This study was set forth to determine the effects of permissive hypotension, with or without desmopressin (DDAVP), on clotting function in an animal model of uncontrolled hemorrhagic shock.

Methods: Forty two male New Zealand rabbits, weighing between 2000 and 2800g (mean 2600 ± 137,5g), were anesthetized with ketamin (60mg/kg) and xylazin (8mg/kg). A tracheotomy was performed and polyethylene catheters filled with lactated Ringers (LR) were used to cannulate the right carotid artery and right jugular vein. Blood was withdrawn from the arterial catheter for: Complete blood count (CBC), platelet count, activated thromboplastin time (APTT), arterial blood gases (ABG), and thromboelastography (TEG) immediately after cannulation. A laparotomy was performed to create a standardized aortic injury using a 16G needle. The abdomen was closed immediately afterwards. Intra-arterial pressure was continuously monitored. LR infusion began 15 minutes after the injury. DDAVP (0,3μg/kg) was given either 1h before injury or at 15 minutes after injury. A heating pad was used at all times. Animals were randomly assigned to one of 7 groups ( 6 in each): Sham (no aortic injury); Normal Blood Pressure (NBP) resuscitation; Permissive Hypotension (PH) resuscitation to 60% of initial mean arterial pressure; (NBP DDAVP) given 1h before injury; (PH DDAVP) given 1h before injury; (NBP DDAVP 15’ ) given 15’ after injury; (PH DDAVP 15’ ) given 15’ after injury. Eighty five minutes after the injury, blood samples were obtained for previously described tests. The abdomen was opened and total blood loss was calculated as the difference between blood-soaked sponges minus the weight of pre-weighed dry sponges. Statistical significance was set at a value of p < 0.05.

Results: Significantly less intraabdominal blood was noted in both PH and DDAVP PH groups. No significant difference was noted between baseline and final results of platelet count, ABG, and APTT. However, TEG results demonstrated a significantly better coagulation status in animals belonging to groups treated with PH and DDAVP.  Conclusion: In a model of uncontrolled hemorrhagic shock, permissive hypotension treated rabbits suffered less intraabdominal blood loss and had better coagulation profile by TEG. This effect was enhanced by DDAVP.

2) DOIS TRABALHOS  ENVIADOS E ACEITOS PARA APRESENTAÇÃO ORAL NO CONGRESSO DA "TRAUMA ASSOCIATION OF CANADA". O CONGRESSO SERÁ REALIZADO NA NOVA ZELANDIA EM MARÇO DE 2009.

2.1) AN ALTERNATIVE VACUUM-ASSISTED DRESSING FOR THE OPEN ABDOMEN.

J.B. Rezende-Neto1,2,3,4,5, S.B. Rizoli3,5, P. Martins2, F. Lisboa2, R.G. Oliveira2, J.R. Cunha-Melo2
1; 2Federal University of Minas Gerais - Risoleta Tolentino Neves University Hospital Trauma Centre, Belo Horizonte, BRAZIL; 3Sunnybrook Health Sciences Centre, Toronto, CANADA; 4CAPES, Belo Horizonte, BRAZIL; 5University of Toronto, Toronto, CANADA

Aim

The quest for a wound dressing capable of hastening definitive abdominal closure gave rise to many innovative techniques. Vacuum-assisted dressing systems are now frequently used. We describe an alternative vacuum-assisted method.

Methods

A total of 12 patients underwent the alternative wound dressing procedure. The technique consists of placing a fenestrated plastic sheet over the abdominal viscera, followed by two laparotomy pads. A latex tubing fenestrated at the distal end is placed over the pair of laparotomy pads. Two more laparotomy pads are placed over the tubing and everything is covered with a clear plastic adhesive surgical drape. The tubing is connected to a wall based vacuum system (-50 to -100 mmHg). The dressing is changed every 24h or at physician’s discretion.

Results

The mean to obtain abdominal wound closure by either the approximation of the fascia or the skin was 11 days in 65% of the patients. There were no complications related to the method.

Conclusions

The method described herein is cost effective and provides safe temporary abdominal coverage, with definitive closure rate similar to other techniques.

2.2) WE TREAT THE BLEEDING WE SEE – THE USE OF FRESH FROZEN PLASMA IN TRAUMA

J.B. Rezende, R. Pinto, J. Hoffman, H. Tien, L. Tremblay, V. Speers, S.B. Rizoli.

Federal University of Minas Gerais Brazil - Risoleta Tolentino Neves University Hospital Trauma Center. Sunnybrook Hospital Health Sciences Centre - University of Toronto.

Aim

Fresh frozen plasma (FFP) is indicated to treat coagulopathy (to correct clotting factor deficits) while surgery is to control mechanical sources of bleeding. Distinguishing coagulopathic from mechanical bleeding is often unachievable. We examined FFP use in trauma resuscitation by measuring clotting factor levels in trauma patients.

Methods

A total of 319 patients (267 blunt, 42 penetrating) underwent multiple measurements of clotting factors, PTT, INR, platelets, fibrinogen, hemoglobin, all analyzed against FFP transfusion.

Results

A total of 56 blunt (21%) and 9 penetrating (21.4%) had critical clotting factor deficits (<30%), thus coagulopathic. PTT, INR, platelets, fibrinogen were equally abnormal in both groups. In contrast, analyzing the mechanism, almost 2x more penetrating patients received FFP than blunt (19.1% vs. 11.2%). Red blood cell transfusion and crystalloids infusion were similar in both groups. Adjusting for, ISS, INR, aPTT, and Platelets, penetrating trauma patients were 8x more likely to received FFP (OR=8.4; 95%CI (2.71-26.25) p = 0.0002). Amongst 31 patients, who had low clotting factors at baseline, only 36% corrected within the first 24h after receiving FFP.

Conclusions

Objective measurements of clotting factor deficit demonstrate that only 1 in 4 coagulopathic patients receive FFP, and only 4 in 10 has the critical deficit corrected. Our results also suggest that FFP is being used to treat mechanical bleeding. We speculate that the more visible bleeding to the surgeon, from penetrating injuries (compared to blunt) accounts for FFP over transfusion.

 

* contribuição Profº Antônio Arthur

acesse o link:

 - Relatório de Pesquisa - FACE / UFMG

Departamento de Ciências Contábeis – CIC  http://www.face.ufmg.br/

Faculdade de Ciências Econômicas - FACE

Universidade Federal de Minas Gerais - UFMG

Avenida Antônio Carlos, 6627 - Sala 2031

Pampulha CEP: 31270-901 Belo Horizonte-MG

(31) 3409-7061

 

* contribuição Drº Bruno Sanches

Material para consulta e orientação dentro da emergência do Hospital Risoleta Tolentino Neves.

acesse o link:

 - Pôster sobre reanimação

 

* contribuição NEP - Núcleo de Ensino e Pesquisa HRTN

Posteres acadêmicos apresnetados em seminários e congressos.

acesse os links:

CORRELAÇÃO ENTRE ÍNDICE DE MASSA  CORPORAL, DISTRIBUIÇÃO DE GORDURA E COMPOSIÇÃO CORPORAL EM FUNCIONÁRIOS DE UM HOSPITAL DA REGIÃO METROPOLITANA DE BELO HORIZONTE – MG ;

CONSUMO DE FRUTAS E HORTALIÇAS POR ADULTOS EM IDADE LABORAL DE UM HOSPITAL DE BELO HORIZONTE/MG ;

SONO, ATIVIDADE FÍSICA E A PREVALÊNCIA DE EXCESSO DE PESO EM FUNCIONÁRIOS DE UM HOSPITAL DA REGIÃO METROPOLITANA DE BELO HORIZONTE ;

FATORES DE RISCO NUTRICIONAIS PARA O DESENVOLVIMENTO DE ÚLCERAS DE PRESSÃO

 
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