Em luciane da novo impulso. Sementes do futuro. Arranjos coletivos de producao. Redes domesticas. Linha epistemologica. Economia solidaria. Economia social. Valorizar a autonomia do sugeito. O novo homem. Departamento de Museologia Cury Cucicanqui e C. Conceitos-chave de Museologia. Armand Colin. ISBN: Neves, PT de 26 maio . Certamente que sim. Para a cidade de Lisboa? E se sim aonde. Na Baixa Pombalina, a Oriente …. Para os turistas ou para os lisboetas. Para a comunidade local ou para a comunidade visitante.
Tal acontece porque os seus protagonistas assim o promovem. Uma cultura que parece ser incapaz de se pensar como um todo. Olhamos para o que os portugueses consideram digno de se conservar. O que se escolhe para preservar. Regista-se portanto. Como se vive a festa. Como se faz a festa. Forma que procuram discursos alternativos de pensar o mundo. Pensamos que sim. A celle du patrimoine? Mais de quel patrimoine? Tem como concorrente, na TV o caso Alcochete, e nesta lista o tal regulamento europeu sobre dados que ocupa paginas de leitura nesta lista.
E com que motivo. Darem uns acoites para jogarem melhor, como se fazia da antigamente???. Quanto aos dados. Por toda a gente a fazer o mesmo. No final pago 5 euros e tenho que assinar um papel onde autorizo a que conste os dados que acabo de dor. Paguei e fui fazer coisas mais proveitosas. Isto tudo para escrever, que o tal museu da Portugalidade estamos perante um problema semelhante. Muda, reconfigura-se. De criar a nossa identidade europeia.
A biblioteca de Alexandria e o Museu. Que sabia fazer contas da tabuada. No somos feitos de tempo e vivemos no tempo. Mas, podemos acrescentar qualquer coisa. As listagens sempre me fascinaram. Os meus pais falavam comigo em Italiano. Eu nunca falava em dialeto.
Apesar disso, vivia num ambiente onde se falava dialeto e eu compreendia bem esse dialeto. Agora, falo bem o dialeto. Quando morrer recordar-me-ei de tudo. Concepts of popular, alternative and community communication revisited, and the re-elaborations in the sector. Study about the theoretical aspects of popular, alternative and community communication, emphasizing the re-elaborations processed nowadays.
The objective is to recover its concepts in the context of social movements and communities, observing their congruence and distinctions. Joana Puntel , p. Muitos autores6  latino-americanos dedicaram-se a estudos nessa linha de pesquisa. Para Festa , p. Ele , p. Throughout this article we will discuss the incidence, scoring systems, pathophysiology, prevention, risk factors, diagnosis and treatment of this condition. A review of the evidence and utility of ketamine.
This includes discussion of its role as an anaesthetic and analgesic drug for use in the pre-hospital environment, emergency department, operating theatre and critical care unit. Intraoperative cell salvage in obstetrics is a safe adjunct or alternative treatment to allogenic blood transfusions during a postpartum hemorrhage.
This tutorial will describe how the cell salvage circuit works and review the indications, contraindications, advantages, disadvantages and risks of intraoperative cell salvage in obstetrics. Hyperthermic intraperitoneal chemotherapy HIPEC is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery as an effective multimodality treatment option for selected patients with peritoneal surface malignancies. This tutorial discusses the anaesthetic considerations and physiological impacts of the procedure. This case report describes a number of risk factors that are associated with potential deformation or fracture of spinal needles during subarachnoid anaesthesia, followed by some practical tips on how to avoid this complication and how to deal with it if it occurs.
This tutorial aims to provide the reader with a framework for approaching the complex physiologic changes and challenges of liver transplant anesthesiology. After reading this article the reader should be able to understand the common perioperative issues surrounding the patient with liver failure and recognize that outcomes are dependent on a multidisciplinary approach to management.
This tutorial covers ultrasound-guided paravertebral nerve block. It discusses the basic anatomy, indications and complications associated with this peripheral regional anaesthesia. The article goes into detail the preparation required to carry out this block and discusses 3 common ultrasound-guided approaches that can be utilized. This article highlights factors that make patients at high risk of perioperative myocardial ischaemia.
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- Swamp Gas;
It also discusses evidence for anaesthetic technique for this high-risk group and the management of intra-operative myocardial ischaemia. This tutorial is based on learning from incidents reported to the National Health Service England and Wales National Reporting and Learning System, and covers infusion safety, preoperative assessment and bone cement implantation syndrome. This tutorial describes the conduct of Deep Hypothermic Circulatory Arrest and its relevance to the anaesthetist, using the latest available evidence.
The concept of therapeutic hypothermia, options for intraoperative monitoring and the different neuroprotective strategies are discussed. The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding.
Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality.
The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. View this article. The aim of these guidelines is to provide a comprehensive range of evidence-based recommendations for interventions to be applied during the pre-, intra- and postoperative periods for the prevention of SSI, while also considering aspects related to resource availability and values and preferences.
Liberation from mechanical ventilation and the artificial airway support in the intensive care unit is difficult and challenging. Success hinges on the perfect blend of art and science. An algorithmic evidence based approach along with a very strong clinical acumen is possibly the best recipe for success. This tutorial attempts to summarise the currently accepted guidelines in this area. Possible reasons for the inadequate postoperative pain management include limited financial resources, lack of time and personnel, but also reluctance to address this issue, organizational aspects of the health care facility, and lack of simple and clear guidelines for the treatment of postoperative pain.
Providing such easy-to-follow recommendations is one of the objectives of this book. The availability of postoperative analgesia to anyone who needs it requires a high-quality postoperative pain management, as well as accepting and understanding the fact that good analgesia is not only necessary, but also a fundamental right of every patient suffering from pain and a basic duty of any health care facility that treats these patients.
Surgery for metastatic spinal disease is an expanding discipline with an ever increasing patient demand. This tutorial aims to cover anaesthetic considerations related to metastatic spinal disease surgery including airway management, prone positioning, massive haemorrhage, chemotherapy considerations and complex analgesia. O artigo abrange porque as epidurais falham e como essas falhas podem ser corrigidas. In this tutorial, the classical anatomy of the brachial plexus will be described.
Anatomical variations of the brachial plexus will be subsequently explored and the associated clinical implications for the anaesthetist discussed. This tutorial provides a review of the common causes of acute airway obstruction in children. It also discusses how children may be assessed and managed in this emergency situation. This tutorial will explore six common challenges that arise at induction of anaesthesia when looking after a paediatric patient.
Anxiety, behavioural problems, the need for restraint, difficult IV access, the full stomach and co-morbidities add complexity and can make the art of maintaining a calm and smooth induction difficult. Every year around , women die due to complications in pregnancy and childbirth. Can you imagine facing difficulties during birth in an environment where access to safe anaesthesia and surgery is limited? Happy Birth Days is an insight into everyday childbirth in Tanzania, and into the Safer Anaesthesia From Education SAFE obstetric anaesthesia course which brings Tanzanian anaesthesia providers together for training on how to address the major causes of maternal mortality and give the safest possible care.
Happy Birth Days defines access to safe anaesthesia and surgery, not as a luxury, but as a basic human right - with the potential to save the lives of hundreds of thousands of mothers and babies around the world. View this video. The second article of this labour epidural series features 4 cases requiring identification of the most appropriate neuraxial technique.
It covers why epidurals fail and how these failures may be rectified. Learn more: www. The film explores the nature of pain management at hospitals in Argentina, the Essential Pain Management EPM course and the impact it will have on patients. The film explores the nature of pain management at hospitals in Argentina, the Essential Pain Management EPM course and the impact it will have on patients [in Spanish].
World Federation Of Societies of Anaesthesiologists - Virtual Library Results
Alu, a trainee anaesthetist in Papua New Guinea, talks about his interest in pursuing a career treating pain as an anesthetist and about the Essential Pain Management EPM course. Sin embargo, la tasa de mortalidad sigue siendo alta en entornos de bajos recursos. The two articles in this series will provide an overview of epidurals for labour analgesia. The first article covers the indications and contraindications for labour epidurals, anatomy and the range of neuraxial approaches available.
However, mortality rates remain high in low resource settings. Due to increased patient life expectancy and number of total hip replacements being performed annually, the burden of revision hip surgery is increasing. Surgery is complex and creates unique challenges for the anaesthetist. This tutorial summarizes the surgical techniques, potential peri-operative complications and anaesthetic care of these patients. Open this file File size: 1MB. Humidification of inspired gases is vital for the safe practice of anesthesia.
This article focuses on the basic science of humidification, its measurement and its relevance in anaesthesia clinical practice. Coronary angiography is increasingly performed pre-operatively to investigate for the presence of coronary artery disease. As peri-operative physicians, we need a basic understanding of coronary angiography and terminology used. This tutorial aims to give an overview of coronary anatomy and provide a working knowledge of coronary angiography. This tutorial is a comprehensive review of up to date evidence regarding management of both the elective patient with known or suspected sleep apnoea and the emergency patient.
Together with a practical approach to risk stratification and management, this tutorial provides a holistic approach to perioperative management of these patients. This article highlights a selection of recent publications from various anaesthesia journals. This article defines standards and makes recommendations to help guide maternity and critical care providers in establishing and managing a maternal critical care service.
Appropriate management of hyponatraemia is often challenging because of both numerous pathophysiological mechanisms and multiple underlying pathological conditions. After revising the normal control of sodium balance this article will review the causes, classification, diagnosis and management of hyponatraemia. An algorithm for investigations and treatment is provided at the end of this article. The aim of this article is to provide the reader with an overview of the current guidelines and evidence for the management of sepsis in children.
Originally published as Anaesthesia Tutorial of the Week , 28 January Knowledge of the pharmacological differences between opioids can be applied to select the appropriate drug for the relevant clinical setting and minimise the impact of side-effects. Over the last 20 years more information regarding the pharmacodynamics and pharmacokinetics in terms of opioid receptor dimers and oligomers, second messenger system effects and genotyping has come to light.
Originally published as Anaesthesia Tutorial of the Week , 3 December A wrist block is the technique of blocking terminal branches of some or all of the six nerves that supply the wrist, hand and fingers. The combination of nerves that need to be blocked depends upon the exact location of surgery. This block can be used to provide regional anaesthesia for a patient undergoing surgery awake or as an analgesic technique to be used in combination with general anaesthesia or brachial plexus block BPB using short-acting local anaesthetic the wrist block will provide prolonged pain relief once the BPB has worn off.
Originally published as Anaesthesia Tutorial of the Week , 19 November Typhoid intestinal perforation is a surgical emergency. The child presents acutely ill with fluid and electrolyte derangement and a full stomach.
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This tutorial covers the assessment, pre-anaesthetic optimization, intraoperative management and post-operative care of a child with typhoid intestinal perforation. Typhoid enteric fever is a bacterial infection of the gastrointestinal tract common in the low resource setting and can be fatal if not treated promptly. This tutorial provides a comprehensive summary of the disease including epidemiology, pathophysiology, signs and symptoms, complications, diagnosis, medical management, and prevention.
Rapid sequence induction RSI is a core skill for anaesthesia providers.
This tutorial describes indications, method, drug choice, controversies, and variations in the performance of RSI. The 70th World Health Assembly WHA , held in Geneva in May , was an opportune occasion to discuss the role of anaesthesia and surgery within the global health agenda with stakeholders and decision-makers from around the world. Multiple Sclerosis is an autoimmune disease of the central nervous system that effects 1 million people worldwide, of which two-thirds are women and many are in their child-bearing years. The effects of pregnancy on disease progression, pregnancy outcome as well as anesthetic considerations is discussed in this tutorial.
Minimally invasive interventions in the cardiac catheterisation laboratory are now routine in the management of children with congenital heart disease. The majority of the procedure requires the child to be anaesthetised. This tutorial discusses the general principles, specific situations, associated complications and highlights the importance of vigilance and effective communication in management of these cases.
Open this file File size: 4. La primera parte de la serie se centra en el reconocimiento y el manejo inicial del colapso neonatal. An update on learning from recent anaesthesia-related patient safety incidents reported in the UK. This tutorial covers three areas featured in these reports: safe neuraxial blockade, drug errors and never events. There can be few more challenging scenarios for non-paediatric intensive care teams than the initial management and stabilisation of a sick neonate. This article is Part 2 of the tutorial series and it expands on the specific management of each of the four most common conditions responsible for causing neonatal collapse.
The 2 articles in this series will provide practical advice for doctors and nurses from adult critical care, anaesthesia, paediatric and emergency medicine backgrounds. The first part of the series focuses on recognition and initial management of neonatal collapse. Ensuring favourable professional well-being requires awareness, recognition and dedication for cultivating a healthy mindset. This tutorial discusses occupational related stress in anaesthesia, associated risk factors, coping capacities, individual and organisational initiatives to safeguard professional well-being.
Though uncommon event since the discontinuation of older more flammable anaesthetic agents, they are nonetheless associated with potentially devastating patient morbidity and mortality. An awareness of its risk factors is important for anesthesia providers in order to minimize its occurrence and to provide prompt and effective treatment should it arise. Prolonged fasting in children, especially infants can result in dehydration, hypoglycaemia, hypovolaemia, hypotension, and other metabolic complications. A lot of debate in the recent years has risen about the usefulness of prolonged periods of fasting.
Ideally children should not be starved for longer than absolutely necessary. This article explores the new guidelines surrounding this issue. Open this file File size: 0MB. Many assume that healthcare providers see the effects of substance use disorders SUD on individuals as well as society.
It is believed that such exposure serves to discourage the use of such drugs. Healthcare providers are in no way protected from such diseases. In fact healthcare providers have about the same incidence as the general population but unlike those outside of medicine, have the lives of members of society in their hands.
This tutorial describes the clinical features and classification of BCIS, along with its incidence and proposed pathophysiological mechanisms. It also covers the prevention, recognition and management of BCIS, which is important for every anaesthesia provider. This tutorial discusses the feasibility of neuraxial anesthesia in a parturient with scoliosis or previous spinal surgery with emphasis on the challenges, practical tips as well as alternative approaches to labor analgesia.
Ultrasound is a favourite tool of the anaesthetist, but is seldom used in neuraxial anaesthesia. This tutorial aims to enlighten the reader; show the evidence behind neuraxial ultrasound, and guide them through the process of performing ultrasound guided neuraxial blocks, so they may consider integrating it into their own practice. Open this file File size: 2. As experience of the technique and valve technology rapidly progress anaesthesiologists are increasingly required to help facilitate safe care in hybrid operating theatres.
This tutorial aims to provide a summary on the perioperative management of patients for this procedure. Intrathecal opioids provide effective analgesia for a variety of surgical procedures. This tutorial provides an overview of the clinical indications, complications and recommendations on their safe and effective use. PECS blocks are regional fascial blocks that block the pectoral and intercostal nerves and provides analgesia for breast surgery and other procedures involving the thoracic wall.
This tutorial covers the anatomy, technique and tips for performing PECS blocks. Management of pregnant women with haemoglobinopathies and thrombophilia disorders can be challenging. This tutorial provides an overview of clinical presentation and key elements of anaesthetic management of these patients. El Golpe de Calor es una causa de morbimortalidad significativa a nivel mundial.
This tutorial covers three areas featured in these reports: complications of vascular access, local anaesthetic systemic toxicity, and anaphylaxis. Accurate risk prediction allows identification of high risk patients and improves decision making including allocation of critical care resources. This article below describes both surgery and patient specific risk stratification tools and their applicability and limitations.
The applications of remifentanil for anaesthesia and intensive care medicine are rapidly expanding. In this tutorial we discuss these applications and the properties of remifentanil that make it so versatile. Considerations for the safe use of remifentanil are also covered as well as the Minto model for target controlled infusions. Heat stroke is a cause of significant morbidity and mortality worldwide.
Rapid cooling and resuscitative treatments are the mainstays of treatment. This tutorial discusses the diagnosis, risk factors and the different cooling methods that are used in the management of heat stroke. Air embolism is associated with significant morbidity and mortality. In this tutorial, we discuss the role of an anaesthetist in the prevention, monitoring and management of air embolism during the perioperative period. Solo haga clic en el link para leer el tutorial completo. Es el primer agente de su clase.
It contains case reports associated with severe harm to patients. In this tutorial, we highlight learning points from incident reports of gastric aspiration, patient access and corneal abrasions. This video discusses the latest threat to medical access to ketamine around the world and the negative impact this could have in low and middle income hospital settings. This video explores the importance of anaesthesia training and how the WFSA are delivering training programmes to young anaesthesiologists.
This video explores the importance of building stronger health systems in countries around the world. This video explores the current state of anaesthesia in a global context. This article outlines the management of the obstructed airway, including diagnosis, different airway management options and key lessons learnt from the 4th UK National audit project of major airway complications NAP 4. The procedure involves placement of electrodes into appropriate brain locations for clinical testing and connection to an implanted stimulator.
This tutorial will review current anaesthetic techniques and recommendations for insertion and management of deep brain stimulators. The tutorial discusses some of the newer developments in this area and the important post-operative management considerations. Can you tell which breathing circuit this diagram shows? In this tutorial, we describe the important features of the Mapleson and Circle breathing circuits relevant to the practicing anaesthetist. We explain the fresh gas flow requirements to prevent rebreathing, the positioning of the individual components of the circuit as well as the changes that occur during spontaneous and controlled ventilation.
Just click on the link to read the full tutorial! Se han realizado cambios importantes en la forma como se reporta la mortalidad materna en el Reino Unido. It combines an award-winning tutorial book with powerful, easy-to-use software. Each concept taught by Gas Man is fully documented and further explained in the tutorial. The Gas Man computer model graphically simulates the pharmacokinetics of anesthesia administration. This article provides a summary of the unique reversal agent, Sugammadex.
- El caso Leganés (Spanish Edition).
- Wish You Were Here.
- Laser Europe | SpringerLink.
- Proceedings of the 4th IPLeiria’s International Health Congress?
- Léducation non formelle (Education comparée) (French Edition).
As the use of this drug is increasing, we explain its mechanism of action, pharmacokinetics, compare it to alternative reversal agents and discuss some of the additional implications of its use in clinical practice. Successful airway management is central to the practice of anaesthesia. In resource-rich environments, there are numerous tools of increasing complexity and cost available to deal with difficult airway management. Basic airway management is usually accomplished using laryngoscopes, endotracheal tubes and laryngeal mask airways; more difficult cases may utilise video laryngoscopes or other specialised devices.
Fibreoptic bronchoscopes are reserved for particularly difficult intubations, awake intubations, or other special situations. This brief report describes the use of communication technology to allow distance learning between trainers in the UK and trainees in low- and middle-income countries. The advantages and disadvantages of this technique are discussed. The article explores three cases of different cerebral challenge and how each patient should be managed.
Acute kidney injury AKI is a common problem in the perioperative period and an independent contributor to morbidity and mortality. Newer diagnostic criteria based on changes in serum creatinine and decreased urine output have improved earlier detection of AKI but are neither fully sensitive nor specific.
Tubular injury results from a complex interaction between baseline predisposition, haemodynamic disturbances, nephrotoxic insults and inflammatory responses. Striking a careful balance between fluid under- and over-resuscitation, maintaining adequate systemic arterial pressure and avoidance of nephrotoxins are the cornerstones to preventing or halting the progression of kidney disease. Cardiopulmonary bypass and IV contrast are additional factors contributing to AKI in cardiac and endovascular surgery respectively.
This article explores the factors involved in planning an effective day surgery service, as well as some of the potential barriers to implementation of such a service.
- The Phantom Of Bogue Holauba 1911.
- Psychics Speak, The Individual Interviews: To-Ree-Nee Wolf (Psychics Speak: The Individual Interviews Book 8).
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This article describes the pharmacology underlying our commonly used antiemetics. The physiology of nausea and vomiting is outlined with practical advice on use of antiemetic drugs to prevent and treat postoperative nausea and vomiting. The emergency laparotomy is a common procedure with high rates of morbidity and mortality. Recent national audits have shown wide variation in practice and outcomes.
Outcomes are improved by implementation of clinical care pathways, emphasising early decision-making by experienced surgeons, early antibiotic administration, early operation involving a senior surgeon and anaesthetist, and appropriate postoperative care in a critical care facility. Peripartum cardiomyopathy is a rare condition that affects women in late pregnancy and in the postpartum period.
It is characterised by heart failure that presents in the absence of any other identifiable cause. It is associated with significant morbidity and mortality. Early recognition and aggressive management of the condition is crucial to improving outcome. The use of novel oral anticoagulants NOACs is also increasing and so it is crucial to understand both the pharmacokinetics of these drugs and their use in the perioperative period.
This article aims to give a concise update of perioperative anticoagulation and to guide readers on the perioperative management of patients on NOACs. Timely surgery for Neck of femur fracture NOFs presents a challenge for health care systems as it involves large numbers of elderly patients with significant comorbidities. To manage this complexity, a protocol-driven and multidisciplinary approach is ideal. They are unique because they are specifically directed towards helping anaesthetists manage patients with hip fracture.
Although the threat of imported cases to the UK and other international countries is low, there remains the distinct possibility that further cases may occur. Health Disparities. Health Inequality. Health Equity.
Health Promotion. Health Outcomes. Social Environment. Social Medicine. Preventive Medicine. Childhood Obesity. Maria-Raquel G. Daniela Rodrigues. University of Coimbra. Email: rodrigues gmail. Margarida Pereira.