Trabalho de Conclusão de Curso - TCC

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Navegando Trabalho de Conclusão de Curso - TCC por Assunto "Acurácia dos dados"

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    Avaliação da acurácia diagnóstica entre glicemia capilar e glicemia venosa no diagnóstico de hiperglicemia hospitalar
    (Centro Universitário do Estado do Pará, 2021) Abreu, Júlio César Setubal Modesto de; Medeiros, Rogério Corrêa; Moraes Junior, Rudival Faial de; http://lattes.cnpq.br/5666162407518627
    Hospital hyperglycemia is a very common clinical condition, including in patients requiring hospitalization, with stress hyperglycemia as one of the factors. This condition has negative repercussions for the patient, such as increased mortality rate and risk of cardiovascular events. The study was developed in the Fundação Santa Casa de Misericórdia do Pará - FSCMPA, in the medical clinic wards of the hospital, São Roque and São Paulo, and the glycemic values were collected in two ways, one by venipuncture and the other by capillary blood sampling. The venous puncture used a colorimetric method, with internal quality controls Level 1 and 2; the capillary glucose determination used electrochemical reactive strips (glucose dehydrogenase) by glucometer, using Level 1 and 2 control solutions. For the analysis of numeric variables, the Shapiro Wilk Normality test was used, so in case of normality the One Criterion ANOVA test will be calculated and in case of non-normality the Krulkal Wallis test. Categorical variables were evaluated using the Chi-square Adherence Tests for univariate tables and G and Chi-square Independence Tests for bivariate tables. BioEstat® 5.3 software was used for descriptive and analytical analyses, using the significance level α=0,05 or 5%. It was observed that 93.3% of patients had glycemic concentration higher than 140 mg/dL when performed via capillary blood glucose, while 90% had concentration higher than 140 mg/dL when performed venous blood glucose measurement. The capillary blood glucose was generally higher (140 to 450 mg/dL) compared to the venous blood glucose (118 to 394 mg/dL). However, the median variation between methods (9.8%) is within the confidence interval for the median variation, demonstrating that the values are within those recommended by the FDA, the ADA, and the ISO. As the result, capillary blood glucose can be safely used, as it is as accurate as venous blood glucose for the diagnosis of hospital-acquired hyperglycemia.
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    Avaliação do teste de impulso cefálico clínico (HIT-c) realizado por examinadores com diferentes níveis de experiência
    (Centro Universitário do Estado do Pará, 2020) Tuma, Sarah Maués; Cal, Renato Valerio Rodrigues; http://lattes.cnpq.br/9362044691690331
    Introduction: The Clinical Head Impulse Test (c-HIT) identifies the vestibular function and uses that information to help diferentiating pathologies of central origin from those of peripheral origin in the emergency room. However, this test is underused due to the difficulty of interpretation. Objective: Express the current level of experience of the examiners in carrying out the c-HIT and using the findings to make the exam (examinor’s dependente) more acurate. Methodology: This is an accurate, prospective, double-blind study for examiners and patients, for which a data collection form was prepared, containing the evaluation for c-HIT for the three levels of examiners and the comparation with the results of the Video Head Impulse Test (v-HIT). Patients who failed to perform the test or did not accept to participate the research were excluded. Results: Fifty-seven patients met the inclusion and exclusion criteria. Thirtyeight participants (66.8%) were female and nineteen male (33.3%). The primary diagnosis was of Menière’s diseas with fourteen patients. There was significant agreement between the diferent levels of examiners, with a weak agreement (kappa between 0 and 0.2) between residentes level 1 and 2. And a slight agreement (kappa between 0.2 and 0.4) between level 3 and levels 1 and 2. There was a decrease in sensitivity (level 1 and 2: 86,7% and level 3: 60%), na increase in specificity (level 1: 57.1%, level 2: 78.6% and level 3 : 81%) and increased accuracy (level 1: 64.9%, level 2: 80.7 %% and level 3: 75.4%). Conclusion: It was concluded that the level of experience directly influences the interpretation of the HIT-c result. Accuracy was low for the level 1 examiner, increased for level 2 examiner and remained high for the level 3 examiner. In addition, the sensitivity was inversely proportional to the examiner’s level of experience and the specificity was directly proporcional.
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    Perfil epidemiológico dos pacientes com síndrome vertiginosa atendidos no ambulatório de otorrinolaringologia do Centro de Especialidades Médicas do Cesupa (CEMEC) de 2015 a 2017
    (Centro Universitário do Estado do Pará, 2019) Santos, Erik Matheus de Oliveira; Rocha, Iago Henriques Leite; Nunes, Leonardo Mendes Acatauassú; Penha, Nelson Elias Abrahão da; http://lattes.cnpq.br/5207645183090927; http://lattes.cnpq.br/3512764081076675
    Introduction: Vertigo is a disabling symptom, with direct repercussions on the patient´s life, and has a significant prevalence. especially with the advancing age. Objective: To determine the epidemiological profile of patients with vertigo attended at the Otorhinolaryngology outpatient clinic of the CESUPA Medical Specialties Center (CEMEC). Method: This is a cross-sectional and descriptive study, based on the review of medical records of patients with vertigo attended at the Otorhinolaryngology outpatient clinic of the Center of Medical Specialties of CESUPA (CEMEC), between 2015 and 2017. The data analyzed included: age, gender, race, marital status, type of vertigo, previous treatment, presence of other clinical manifestations and etiological diagnosis of vertigo syndrome. Results: Females were the most prevalent with 91.4% of the individuals, and the age range between 61 and 70 years represented the highest prevalence with 41.4% of the total. As for comorbidities, 52.9% of the individuals did not present comorbidities and 47.1% had comorbidities, 46.1% had systemic arterial hypertension and 40.4% had dyslipidemia. When assessing the clinical manifestations, the most prevalent were imbalance, tinnitus and headache. No cases of paresis, diplopia and dysarthria were observed. Regarding the type of vertigo, 94% presented vertigo of peripheral origin and 6% of central origin. Of the individuals with central vertigo, 50% had vestibular migraine, 25% cerebrovascular accident or brainstem and 25% undetermined. In relation to the diagnosis of peripheral vertigo, 45.4% of the individuals presented benign paroxysmal positional vertigo (BPPV), 6.1% of the individuals presented Ménière's disease, 6.1% bacterial labyrinthitis and 42.4% undetermined. Regarding drug treatment for vertigo, 51.4% of patients used drugs as therapy once at time, 7% used dimenhydrate, 4.2% of the subjects used betahistine, 41.8% flunarizine and 7% other treatments. There was no significant difference between the factors evaluated about the treatment (p value> 0.05). Conclusion: Vertigo is a more common pathology in females and associated with advancing age, which requires careful clinical investigation. It may have an important impact on the quality of life and need pharmacological therapy. The most prevalent causes are those with peripheral etiology and benign paroxysmal positional vertigo (BPPV), which is the most common.