bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capacidade dos Profissionais de Saúde de Medicina e Enfermagem dos Cuidados de Saúde Primários em Identificar Doentes de Cuidados Paliativos
Authors: Innis Mariana van , Capelas Manuel Luís , Caldas Alexandre Castro 
Published: May 2018

INTRODUÇÃO: Os cuidados paliativos são cuidados de saúde especializados, dirigidos a indivíduos com doenças crónicas. De acordo com dados de estudos recentes, apenas uma parte da população portuguesa tem acesso a eles, sendo o número de indivíduos referenciados para equipas especializadas inferior ao esperado. Os cuidados de saúde primários podem desenvolver um papel importante na identificação e referenciação dos doentes, pois são o primeiro contacto da população com o Serviço Nacional de Saúde.
OBJETIVO: Avaliar a capacidade dos médicos e enfermeiros dos cuidados de saúde primários em identificar doentes de cuidados paliativos e determinar os fatores pessoais facilitadores.
MATERIAL E MÉTODOS: É um estudo analítico e transversal, efetuado através da aplicação de um questionário junto a 49 profissionais de saúde de medicina e enfermagem de dois Agrupamentos dos Centros de Saúde de Lisboa, entre junho e setembro de 2014. A análise estatística foi realizada através do programa SPSS® 20.
RESULTADOS: Somente 14,3% da amostra identificou corretamente os casos clínicos referenciáveis para cuidados paliativos. Dos vários fatores pessoais analisados, observámos uma relação estatisticamente significativa (p < 0,05) entre o contacto com a área dos cuidados paliativos na vida pessoal e a formação diferenciada e a identificação de doentes de cuidados paliativos por parte dos médicos e enfermeiros dos cuidados de saúde primários.
CONCLUSÕES: Os resultados obtidos sugerem a necessidade de reforçar a formação em cuidados paliativos junto dos profissionais de saúde e facilitar a comunicação entre os diferentes elementos envolvidos no processo de identificação e referenciação dos doentes.
Lesões Ósseas de Novo: Quando a Origem Não é a Mais Evidente
Authors: Batista Marta Vaz , Braga Sofia 
Published: May 2018

É apresentado o caso de uma doente de 50 anos com diagnóstico concomitante de esclerose sistémica e neoplasia da mama em estádio precoce. Em exames complementares são detetadas lesões ósseas no esqueleto axial. Surge adúvida diagnóstica de qual a doença primária que está na base destas alterações. Conclui-se tratar-se de envolvimento ósseo da esclerose sistémica que, apesar de raro na localização onde surgiu, se encontra descrito na literatura.
Recebido: 12/07/2017 - Aceite: 05/09/2017
Corações “Fora do Prazo”: Dois Casos de Amiloidose AL
Authors: Silva Francisco Ferreira da , Fernandes João Paulo , Oliveira Luís Moura de , Cacela Duarte 
Published: May 2018

A amiloidose cardíaca é considerada uma doença rara e classicamente descrita como de mau prognóstico, com sobrevivência média de seis meses, desde a instalação da sintomatologia de insuficiência cardíaca. Quando há suspeita de amiloidose cardíaca está indicado o estudo etiológico, para caracterização do tipo de proteína implicada, bem como a avaliação do atingimento de outros órgãos. Neste artigo, os autores relatam dois casos, diagnosticados e tratados no Hospital CUF Descobertas (HCD) - em colaboração com o Instituto Português de Oncologia de Lisboa (IPOL) e o National Amyloidosis Centre (NAC), Londres- de insuficiência cardíaca por amiloidose AL associada a gamapatia monoclonal.Atualmente os doentes mantêm seguimento no HCD e apresentam-se clinicamente bem.
Recebido: 02/05/2017 - Aceite: 18/08/2017
Ressecção de um Gliossarcoma com Cirurgia Acordada para Mapeamento da Linguagem
Authors: Viegas Catarina Pessanha , Leote João , Silvestre Ana , Pérez-Hick António , Albuquerque Luísa , Sá Manuel Cunha e 
Published: May 2018

A ressecção cirúrgica tem um papel fulcral no tratamento dos gliomas de alto grau, no qual se incluem os gliossarcomas. A cirurgia deve ser realizada conhecendo a neuroanatomia funcional e a proximidade do tumor com as áreas eloquentes, para diminuir a morbilidade cirúrgica. Reportamos o caso de uma doente de 66 anos com alterações da linguagem devido à presença de uma lesão intra-axial fronto-opercular e insular esquerda.Foi realizada a ressecção cirúrgica desta lesão com mapeamento cerebral da linguagem e da função motora, com a doente acordada. A remoção foi total, sem indução de défices neurológicos definitivos de novo.A cirurgia com o doente acordado com eletroestimulação cortico-subcortical constitui uma abordagem segura na ressecção máxima de gliomas de alto grau, preservando a função e otimizando a qualidade de vida.
Recebido: 03/05/2017 - Aceite: 01/08/2017
Carcinoma de Células Acinares da Parótida: Caso Clínico
Authors: Araújo João Pedro , Jardim Ana , Subtil João , Sousa Pedro Machado de , Montalvão Pedro , Saraiva José 
Published: May 2018

Apresentamos um caso clínico de tumor da parótida – carcinoma de células acinares – envolvendo o lobo superficial e profundo da parótida, tratado cirurgicamente por parotidectomia total e radioterapia adjuvante local e cervical. Escolhemos este caso pelo facto de o tumor envolver o lobo superficial e profundo da parótida, sem envolver o nervo facial, o que constituiu um desafio cirúrgico maior, que foi a remoção do tumor e da glândula preservando o nervo e todos os seus ramos.No Hospital CUF Descobertas, o tratamento dos doentes com cancro da cabeça e pescoço é assegurado pela colaboração multidisciplinar entre as especialidades de Otorrinolaringologia, Hemato-Oncologia e Radioterapia. Os tumores das glândulas salivares são um exemplo, como demonstrado no caso clínico apresentado.
Recebido: 02/05/2017 - Aceite: 29/08/2017
Ação de hidrocoloides na estabilidade física de suco tropical de cagaita pronto para consumo
Authors: Silva Siqueira Ana Paula , Campos Marizete , Barbosa Thaís , Souza Eli Regina , Vera Rosangela 
Published: May 2018

A cagaita é uma fruta nativa do cerrado e altamente perecível, portanto uma das formas de manter seu consumo é processando-a. O processamento de frutos para elaboração de polpas, sucos e néctares tem crescido nos últimos anos, o consumo tem aumentado devido à praticidade e também a variabilidade de sabores encontrados no mercado. Um dos maiores problemas na produção de sucos é assegurar a estabilidade da dispersão para isso, comercialmente tem-se utilizado os hidrocoloides. Diante disso, objetivou-se com este estudo elaborar um suco tropical de cagaita com 35% de polpa já adoçado e pronto para consumo, pasteurizado a 85°C adicionado de hidrocoloides. O estudo foi realizado em esquema fatorial (3 x 1 x 4) sendo 3 hidrocoloides (goma guar, goma gelana e pectina), uma temperatura de tratamento (85 ºC) e quatro tempos de pasteurização (0, 2, 5 e 10 minutos). As avaliações físico-químicas do suco foram pH, sólidos solúveis, acidez e ratio, realizou-se também uama avaliação enzimática qualitativa e o teste de estabilidade física em 0, 24 e 48 horas após a pasteurização. Notou-se que o balanço de acidez e doçura é alto para as formulações com hidrocoloide (ratio 17) e que a acidez é característica do fruto. A decantação de 24 para 48 horas não é alterada e os melhores tratamentos envolvem uso de goma gelana com pasteurização por 2 a 5 minutos.
STUDI PENGETAHUAN IBU NIFAS TENTANG TANDA BAHAYA SELAMA MASA NIFAS (Di Desa Pomahan Janggan Kecamatan Turi Kabupaten Lamongan 2015)
Authors: Sumiyati Sumiyati , Latifah Hetti 
Published: May 2018

Masa nifas berlangsung selama kira-kira 6-8 minggu, masa nifas masih beresiko mengalami perdarahan atau infeksi yang dapat menyebabkan kematian ibu. Pengetahuan ibu nifas tentang tanda bahaya selama masa nifas sangat minim sehingga paling sedikit 4 kali kunjungan pada masa nifas untuk menilai status ibu dan bayinya untuk melaksanakan screening yang komprehensif, mendeteksi masalah, mengobati atau merujuk bila terjadi komplikasi pada ibu dan bayi.Desain yang digunakan dalam penelitian ini adalah deskriptif dengan menggunakan metode consecutive sampling. Sampling diambil dari jumlah populasi yaitu 15 ibu nifas dengan menggunakan alat ukur kuesioner.Hasil penelitian didapatkan sebagian besar responden berpengetahuan kurang yaitu reponden dan sebagian kecil berpengetahuan baik yaitu responden tentang tanda bahaya selama masa nifas.Baik kurangnya pengetahuan ibu nifas di pengaruhi oleh beberapa faktor yaitu pendidikan, umur, pekerjaan, pengalaman, lingkungan, informasi, sosial ekonomi dan sosial budaya. Dari penelitian diatas diharapkan ibu nifas lebih peka dalam mendeteksi tanda bahaya selama masa nifas. Selain itu bagi petugas kesehatan agar mengoptimalkan perannya sebagai konselor sehingga mencegah komplikasi selama masa nifas.Keywords: Pengetahuan, ibu nifas, tanda bahaya
GAMBARAN PENGETAHUAN DAN SIKAP REMAJA PUTRI TERHADAP ABORSI
Authors: Nasihah Mimatun 
Published: May 2018

Kasus aborsi adalah fenomena sosial yang tak kunjung ada solusi pemecahan masalahnya. Faktor penyebab terjadinya aborsi adalah ekonomi, karir/Sekolah, penundaan usia perkawinan, pengetahuan, sikap, incest, menarche, pemerkosaan.Desain penelitian ini adalah deskriptif dengan pendekatan survey, populasinya adalah semua remaja putri di MAN Lamongan kelas XI IPS. Pengambilan sampel dengan metode total sampling dengan jumlah sampel 40 responden. Data dikumpulkan dari responden dengan menggunakan kuesioner. Tujuan dari penelitian ini adalah untuk mengetahui gambaran pengetahuan dan sikap remaja putri terhadap aborsi di Madrasah Aliyah Negeri Lamongan.Dari pengumpulan data pengetahuan responden diperoleh 17 responden (42.5%) berpengetahuan kurang, 13 responden (32.5%) berpengetahuan cukup dan 10 responden (25%) berpengetahuan baik.Dari pengumpulan data sikap responden diperoleh 23 responden (57.5%) bersikap negatif, 17 responden (42.5%) bersikap positif.Diharapkan institusi yang terkait dengan masalah kesehatan reproduksi khususnya remaja putri dapat berkerjasama dengan media elektronik khususnya televise dalam menyiarkan pembelajaran tentang aborsi dan bahayanya.Keywords: Pengetahuan, Sikap, Remaja Putri, Aborsi
Bilateral fracture-dislocation of the calcaneus
Authors: Abdul Ghani Mahmoud Beerens , Barroco Rui Dos Santos , Miranda Bruno Rodrigues de , Oliveira Letícia Zaccaria Prates de 
Published: May 2018

The calcaneus is the most commonly fractured tarsal bone. However, locked fracture-dislocation of the calcaneus is a rare condition because of the bone and ligament stability between the calcaneus, talus, and cuboid. We report the unique features of a case of bilateral fracture-dislocation of the calcaneus, including open fractures, bilateral fibular dislocation, and bilateral interposition of the flexor hallucis longus tendon at the fracture site. A literature review identified only 19 cases of locked fracture-dislocation, but none of these cases involved the combination of injuries observed in this case. Fracture of the calcaneus may be associated with a variety of injuries requiring proper diagnosis and treatment.
Level of evidence V; Therapeutic Studies; Expert Opinion.
Rancang Bangun Aplikasi Dengan Linear Congruent Method (LCM) Sebagai Pengacakan Soal
Authors: Arizqia Muhammad Ganda , Widodo Anang Aris 
Published: May 2018

Pendidikan merupakan hal penting yang harus dimiliki oleh setiap orang. Kualitas pendidikan dapat diketahui dengan melalui pelaksanaan ujian untuk mengetahui pencapaian kemampuan dan keberhasilan dalam memahami bidang studi yang ditempuhnya. Seiring perkembangan teknologi informasi dan komunikasi sistem ujian sudah tidak lagi menggunakan media konvensional melainkan sudah secara komputerisasi. pelaksanaan ujian secara konvensional rentan terhadap kebocoran soal yang akan diajukan sebelum ujian dan kecurangan yang dilakukan seperti mencontek jawaban teman.
Adanya kelemahan itulah perlu dilakukan perancangan pengacakan soal. Pengacakan soal tersebut dirancang dan diimplementasikan dengan menggunakan metode Linear Congruent Method (LCM). Pengacakan soal ini diharapkan mampu mengatasi kelemahan dari cara yang ada sehingga setiap pihak dapat membuat soal nya sendiri secara efektif dan efisien.
Game Edukasi Berbasis Kinect untuk Anak Berkebutuhan Khusus (Autis) dengan Metode Finite State Machine
Authors: Anugraha Dhimas Mulia , Agustina Ina , Fauziah Fauziah 
Published: May 2018

Game merupakan perkembangan dalam teknologi saat ini. Game edukasi merupakan permainan yang dirancang untuk dijadikan sebuah media pembelajaran melalui materi yang berisikan teks,video,audio,gambar dan animasi. Game ini ditujukan untuk anak berkebutuhan khusus. Anak berkebutuhan khusus merupakan anak yang mempunyai karakter khusus dibandingkan dengan anak pada umumnya. Salah satu dari anak berkebutuhan khusus adalah anak autis. Autis merupakan gangguan saraf seseorang. Dalam penyelesaian proses game menggunakan metode finite state machine. Metode finite state machine berfungsi untuk menentukan alur pengguna dalam menjawab suatu pertanyaan yang tampil dalam game. Tujuan dalam penelitian ini adalah mengimplementasikan game edukasi berbasis kinect untuk anak berkebutuhan khusus autis mengenal benda di dalam rumah serta mengimplementasikan metode finite state machine untuk membantu pengguna mengetahui alur game saat dimainkan. Dari hasil penelitian dapat disimpulkan rata-rata jarak ideal kinect dan pengguna dalam memainkan game adalah 2,2 meter. Waktu respon pengguna dalam memilih tombol button dalam game adalah 1,4 detik. Rata-rata FPS terbaik dan terburuk adalah 113,2 fps dan 82,5 fps.
Kata kunci – Autis, Finite State Machine,Game, Kinect
Pengaruh Duty Cycle dan Frekuensi Terhadap Kecepatan Putar Motor DC
Authors: Murtianta Budihardja 
Published: May 2018

Tulisan ini dibuat untuk mengetahui pengaruh perubahan frekuensi dan duty cycle terhadap kecepatan putar motor DC saat terbebani dan saat tidak dibebani yang diterapkan dengan menggunakan sistem PWM ( Pulse Width Modulation ). DC Chopper direalisasikan guna menerapkan sistem PWM. DC Chooper mengubah secara langsung dari dc ke dc dan biasanya hal ini disebut konverter dc ke dc. Alat ini disimulasikan dengan motor DC tape 9V dan IGBT sebagai saklar chopper. Perancangan terdiri dari modul regulator 5V, modul microcontroller AT89S52, modul keypad, modul receiver IR sebagai pendeteksi kecepatan, modul transmiter IR, modul LCD, dan modul DC Chopper + driver. Setiap operasi dilakukan dari sebuah keypad dan besarnya kecepatan motor yang terdeteksi dapat ditampilkan pada LCD. Dari hasil pengujian didapatkan bahwa pemakaian DC Chopper untuk aplikasi motor, IGBT yang dipakai bekerja lebih baik saat mendapat masukan frekuensi lebih besar dari 1KHz. Dari hasil percobaan duty cycle 10% frekuensi pensaklaran chopper dc adalah >2Khz tanpa beban dan >1Khz dengan beban1 dan beban 2. Pada duty cycle 25% dan 50% adalah >3Khz tanpa beban, >2Khz pada beban 1 dan >1Khz pada beban 2. Pada duty cycle 75% adalah >2Khz tanpa beban, dan duty cycle 90% adalah >800Hz tanpa beban. Semakin tinggi nilai frekuensi maka semakin baik titik kerja dari DC Chopper.
Spreading depolarization in acute brain injury inhibited by ketamine: a prospective, randomized, multiple crossover trial
Authors: Carlson Andrew P. , Abbas Mohammad , Alunday Robert L. , Qeadan Fares , Shuttleworth C. William 
Published: May 2018

OBJECTIVERetrospective clinical data and case studies support a therapeutic effect of ketamine in suppression of spreading depolarization (SD) following brain injury. Preclinical data strongly support efficacy in terms of frequency of SD as well as recovery from electrocorticography (ECoG) depression. The authors present the results of the first prospective controlled clinical trial testing the role of ketamine used for clinical sedation on occurrence of SD.METHODSTen patients with severe traumatic brain injury (TBI) or aneurysmal subarachnoid hemorrhage (SAH) were recruited for this pilot trial. A standard ECoG strip was placed at the time of craniotomy, and the patients were then placed on an alternating every-6-hour schedule of ketamine or other sedation agent. The order of treatment was randomized. The ketamine dose was adjusted to clinical effect or maintained at a subanesthetic basal dose (0.1 mg/kg/hr) if no sedation was required. SD was scored using standard criteria, blinded to ketamine dosing. Occurrence of SD was compared with the hourly dose of ketamine to determine the effect of ketamine on SD occurrence.RESULTSSuccessful ECoG recordings were obtained in all 10 patients: 8 with SAH and 2 with TBI. There were a total of 1642 hours of observations with adequate ECoG: 833 hours off ketamine and 809 hours on ketamine. Analysis revealed a strong dose-dependent effect such that hours off ketamine or on doses of less than 1.15 mg/kg/hr were associated with an increased risk of SD compared with hours on doses of 1.15 mg/kg/hr or more (OR 13.838, 95% CI 1.99–1000). This odds ratio decreased with lower doses of 1.0 mg/kg/hr (OR 4.924, 95% CI 1.337–43.516), 0.85 mg/kg/hr (OR 3.323, 95% CI 1.139–16.074), and 0.70 mg/kg/hr (OR 2.725, 95% CI 1.068–9.898) to a threshold of no effect at 0.55 mg/kg/hr (OR 1.043, 95% CI 0.565–2.135). When all ketamine data were pooled (i.e., on ketamine at any dose vs off ketamine), a nonsignificant overall trend toward less SD during hours on ketamine (χ2 = 3.86, p = 0.42) was observed.CONCLUSIONSKetamine effectively inhibits SD over a wide range of doses commonly used for sedation, even in nonintubated patients. These data also provide the first prospective evidence that the occurrence of SD can be influenced by clinical intervention and does not simply represent an unavoidable epiphenomenon after injury. These data provide the basis for future studies assessing clinical improvement with SD-directed therapy.Clinical trial registration no.: NCT02501941 (clinicaltrials.gov)
Spot sign as a predictor of rebleeding after endoscopic surgery for intracerebral hemorrhage
Authors: Miki Koichi , Yagi Kenji , Nonaka Masani , Iwaasa Mitsutoshi , Abe Hiroshi , Morishita Takashi , Arima Hisatomi , Inoue Tooru 
Published: May 2018

OBJECTIVEIn patients with spontaneous intracerebral hemorrhage (sICH), postoperative recurrent hemorrhage (PRH) is one of the most severe complications after endoscopic evacuation of hematoma (EEH). However, no predictors of this complication have been identified. In the present study, the authors retrospectively investigated whether PRH can be preoperatively predicted by the presence of the spot sign on CT scans.METHODSIn total, 143 patients with sICH were treated by EEH between June 2009 and March 2017, and 127 patients who underwent preoperative CT angiography were included in this study. Significant correlations of PRH with the patients’ baseline, clinical, and radiographic characteristics, including the spot sign, were evaluated using multivariable logistic regression models.RESULTSThe incidence of and risk factors for PRH were assessed in 127 patients with available data. PRH occurred in 9 (7.1%) patients. Five (21.7%) cases of PRH were observed among 23 patients with the spot sign, whereas only 4 (3.8%) cases of PRH occurred among 104 patients without the spot sign. The spot sign was the only independent predictor of PRH (OR 5.81, 95% CI 1.26–26.88; p = 0.02). The following factors were not independently associated with PRH: age, hypertension, poor consciousness, antihemostatic factors (thrombocytopenia, coagulopathy, and use of antithrombotic drugs), the location and size of the sICH, other radiographic findings (black hole sign and blend sign), surgical duration and procedures, and early surgery.CONCLUSIONSThe spot sign is likely to be a strong predictor of PRH after EEH among patients with sICH. Complete and careful control of bleeding in the operative field should be ensured when surgically treating such patients. New surgical strategies and procedures might be needed to improve these patients’ outcomes.
Predictors of postoperative motor function in rolandic meningiomas
Authors: Ottenhausen Malte , Rumalla Kavelin , Younus Iyan , Minkowitz Shlomo , Tsiouris Apostolos John , Schwartz Theodore H. 
Published: May 2018

OBJECTIVEResection of supratentorial meningiomas is generally considered a low-risk procedure, but tumors involving the rolandic cortex present a unique challenge. The rate of motor function deterioration associated with resecting such tumors is not well described in the literature. Thus, the authors sought to report the rates and predictors of postoperative motor deficit following the resection of rolandic meningiomas to assist with patient counseling and surgical decision-making.METHODSAn institution’s pathology database was screened for meningiomas removed between 2000 and 2017, and patients with neuroradiological evidence of rolandic involvement were identified. Parameters screened as potential predictors included patient age, sex, preoperative motor severity, tumor location, tumor origin (falx vs convexity), histological grade, FLAIR signal (T2-weighted MRI), venous involvement (T1-weighted MRI with contrast), intratumoral hemorrhage, embolization, and degree of resection (Simpson grade). Variables of interest included preoperative weakness and postoperative motor decline (novel or worsened permanent deficit). The SPSS univariate and bivariate analysis functions were used, and statistical significance was determined with alpha < 0.05.RESULTSIn 89 patients who had undergone resection of convexity (80.9%) or parasagittal (19.1%) rolandic meningiomas, a postoperative motor decline occurred in 24.7%. Of 53 patients (59.6%) with preoperative motor deficits, 60.3% improved, 13.2% were unchanged, and 26.4% worsened following surgery. Among the 36 patients without preoperative deficits, 22.2% developed new weakness. Predictors of preoperative motor deficit included tumor size (41.6 vs 33.2 cm3, p = 0.040) and presence of FLAIR signal (69.8% vs 50.0%, p = 0.046). Predictors of postoperative motor decline were preoperative motor deficit (47.2% vs 22.2%, p = 0.017), minor (compared with severe) preoperative weakness (25.6% vs 21.4%, p < 0.001), and preoperative embolization (54.5% vs 20.5%, p = 0.014). Factors that trended toward significance included parafalcine tumor origin (41.2% vs 20.8% convexity, p = 0.08), significant venous involvement (44.4% vs 23.5% none, p = 0.09), and Simpson grade II+ (34.2% vs 17.6% grade I, p = 0.07).CONCLUSIONSResection of rolandic area meningiomas carries a high rate of postoperative morbidity and deserves special preoperative planning. Large tumor size, peritumoral edema, preoperative embolization, parafalcine origin, and venous involvement may further increase the risk. Alternative surgical strategies, such as aggressive internal debulking, may prevent motor decline in a subset of high-risk patients.