RESUMO
This study evaluated the effectiveness of thermocycler temperature control, considering the influence of other determinant factors for the optimization of PCR. The reduction in the number of repeated PCR tests, applied in the diagnosis and prognosis of chronic myeloid leukemia at the National Cancer Institute in Brazil, was used as a measure of effectiveness. This indicator was evaluated using samples obtained before and after the temperature control in the wells of the thermocyclers. There was a reduction of 18.9% in the number of repeated exams in the second sample. A structured interview with laboratory staff indicated that there was no change in the other determinant factors.
Assuntos
Reação em Cadeia da Polimerase/métodos , Brasil , Primers do DNA/química , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , TemperaturaRESUMO
CONTEXT: Spinal morphine is a common form of postoperative analgesia after caesarean section, but it is associated with postoperative nausea and vomiting. OBJECTIVE: To evaluate the hypothesis that dexamethasone reduces nausea and vomiting in patients undergoing caesarean section under spinal anaesthesia with morphine. DESIGN: Interventional, randomised, double-blinded, placebo-controlled study to evaluate a preoperative single dose of dexamethasone. SETTING: Patients from a tertiary hospital in the city of Sao Paulo, Sao Paulo, Brazil observed from 1 January through 30 June 2008. PATIENTS OR OTHER PARTICIPANTS: Seventy full-term pregnant patients (American Society of Anesthesiologists 1 or 2) were studied. Patients were randomly allocated into two groups determined by a computerised table. Exclusion criteria were contraindication to regional anaesthesia, allergy to dexamethasone, opioids or local anaesthetics, hypertension or diabetes originated during pregnancy and use of any antiemetic drug received before surgery. Spinal anaesthesia consisted of hyperbaric bupivacaine and morphine. INTERVENTION: Patients received either dexamethasone 10 mg in 100 ml of isotonic saline, intravenously or 100 ml of isotonic saline (placebo) prior to surgery. MAIN OUTCOME: Incidence of postoperative nausea and vomiting in the first 24 h were rated and recorded. Pain scores at rest and on movement were evaluated using a visual analogue scale. RESULTS: During the first 24 hours, nausea occurred in 12/35 (34.4%) patients receiving dexamethasone and in 32/35 (91.4%) receiving placebo (P<0.001). During the same time period, vomiting occurred in 12/35 (34.4%) patients receiving dexamethasone and in 29/35 (82.9%) receiving placebo (P<0.001). Pain at rest and pain on movement was lower in patients who received dexamethasone at some time points during the study period. CONCLUSION: Dexamethasone reduced the cumulative incidence of nausea and vomiting after caesarean section under spinal anaesthesia with morphine and lowered pain scores on the first postoperative day.
Assuntos
Antieméticos/administração & dosagem , Cesárea/métodos , Dexametasona/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Náusea e Vômito Pós-Operatórios/prevenção & controle , Vômito/prevenção & controle , Adulto , Raquianestesia/métodos , Brasil , Método Duplo-Cego , Feminino , Humanos , Morfina/administração & dosagem , Complicações Pós-Operatórias , Gravidez , Fatores de Tempo , Adulto JovemRESUMO
Utilizando-se os bancos de dados de Autorização de Internação (BDAIH) e o Sistema de Informação Ambulatorial (BDSIA), recentemente disponibilizados pelo Ministério da Saúde (MS), este trabalho caracteriza o uso de uma tecnologia diagnóstica de alto custo (Tomógrafo Computadorizado), para Municípios do Rio de Janeiro, no período janeiro a outubro de 1995; relativamente à natureza dos hospitais e freqüência dos procedimentos médicos envolvidos. Os resultados apontam para uma deficiência na alocação da tecnologia, tanto em termos de sua distribuição geográfica quanto em relação aos hospitais que a oferecem.
With the help ofthe BDAIH (Hospital Admission Authorization Data Base)and BDSIA (Ambulatory Health System Data Base), recently made available by the Health Ministery, this work characterizes the use of a high cost diagnostic technology (Computerized Tomography), in Rio de Janeiro State, Brazil, January - October/95. The results show a skewed use ofthe technology, both in geographical and hospital provision terms.