Eficácia da fisioterapia respiratória em pacientes pediátricos hospitalizados com pneumonia adquirida na comunidade : um ensaio clínico randomizado

Objetivo: Avaliar a eficácia da fisioterapia respiratória como tratamento adjuvante em pacientes pediátricos com pneumonia adquirida na comunidade. Delineamento: Ensaio clínico randomizado Local do estudo: Hospital da Criança Santo Antônio – Complexo Hospitalar Santa Casa, Porto Alegre, Brasil. Participantes e métodos: Foram arroladas crianças com idade entre 1 e 12 anos, com diagnóstico clínico e radiológico confirmado de pneumonia, hospitalizadas no período de setembro de 2001 a setembro de 2002. Os pacientes que preencheram os critérios de inclusão foram randomizados para receber fisioterapia respiratória três vezes ao dia (grupo intervenção) ou para receber, uma vez ao dia, orientações para respirar profundamente, expectorar a secreção e manter preferencialmente o decúbito lateral (grupo controle). As variáveis analisadas na linha de base, no primeiro e no segundo períodos de seguimento e no dia da alta hospitalar foram: escore de gravidade (composto pela freqüência respiratória anormal para a idade, tiragem supra-esternal, intercostal, e subcostal, febre, saturação de oxigênio da hemoglobina e raio-x de tórax), duração da hospitalização, freqüência respiratória, temperatura e saturação do oxigênio. Resultados: Setenta e dois pacientes foram randomizados para os grupos intervenção ou controle. Destes, sete foram retirados devido a complicações como atelectasia ou drenagem pleural. Dentre os 65 pacientes estudados no primeiro seguimento (terceiro dia), a febre foi mais prevalente no grupo intervenção (34,4%) do que no grupo controle (12,5%), bem como o escore de gravidade 9,63 ± 1,62 e 8,71 ± 0,86 pontos, respectivamente. No segundo seguimento, entre o quarto e sexto dia, a diferença entre os grupos teve tendência à significância apenas para febre, 31,6% no grupo intervenção e 6,7% no grupo controle (P= 0,07). A duração média da hospitalização foi de 7,41 ± 6,58 dias para o grupo intervenção e 4,52 ± 2,21 dias para o controle. Conclusão: Neste ensaio clínico, a fisioterapia prolongou a hospitalização e a duração da febre nos pacientes pediátricos com pneumonia adquirida na comunidade. Nestes pacientes, a fisioterapia é prejudicial e não deveria ser prescrita até que evidências de benefício estejam disponíveis.

Resistência ao cisalhamento de solos não saturados : análise experimental e teórica

Um equipamento triaxial convencional originalmente utilizado para ensaios em amostras de solos saturados saturada foi modificado para que fosse possível a realização de ensaios triaxiais em solos não saturados. As principais modificações foram a instalação de uma pedra cerâmica de alto valor de entrada de ar (300 kPa) na nova base da câmara triaxial e uma nova linha de aplicação de pressão para aplicação de pressão de ar na amostra. A técnica de translação de eixos é utilizada para evitar cavitação no sistema de aplicação de pressão. O solo estudado nesta pesquisa consiste de um colúvio de arenito localizado nas encostas da Formação Serra Geral, entre os municípios de Timbé do Sul (SC) e São José dos Ausentes (RS). Ensaios triaxiais convencionais foram realizados nas condições drenado e não drenado em amostras indeformadas para tensões de confinamento iniciais variando de 50 até 500 kPa; ensaios triaxiais convencionais foram realizados na condição drenada em amostras remoldadas para as tensões de confinamento iniciais de 50, 100 e 200kPa. Ensaios triaxiais com sucção controlada foram realizados na condição drenado em amostras indeformadas para as tensões normais líquidas de 50, 100, 150 e 200 kPa em níveis de sucção variando de 25 até 150 kPa. A partir dos resultados dos ensaios triaxiais determinou-se os parâmetros de resistência ao cisalhamento: c’ – intercepto coesivo efetivo; f´ - ângulo de atrito interno efetivo; fb – ângulo de atrito interno que quantifica a contribuição da sucção na resistência ao cisalhamento. O comportamento encontrado foi de uma envoltória de resistência ao cisalhamento não saturada bilinear com acréscimo na resistência ao cisalhamento para baixos níveis de sucção até aproximadamente 75 kPa, e após um decréscimo na resistência ao cisalhamento. A tensão normal líquida não influencia no valor de fb e a sucção não provoca alteração no valor de f´. O valor de fb apresenta valores superiores ao valor de f´, quando se utiliza o critério de ruptura clássico de resistência ao cisalhamento. Alguns critérios de determinação dos valores máximos de ruptura foram aplicados para um melhor entendimento do comportamento resistente deste material.

Estrutura e dinâmica do fitoplânctone bacterioplâncton em cultivos de camarão no Rio Grande do Norte-Brasil: impacto sobre o ambiente natural

This work aimed to study the structure and dynamic of Phytoplankton and Bacterioplankton in a complete cycle of shrimp cultivation (Litopenaeus vannamei) and determine the environmental factors responsible for the structural changes of these communities. The study was realized in a saltwater shrimp farm (Macaíba, RN), between September/2005 and February/2006, and in a freshwater shrimp farm (Ceará Mirim, RN), between May/2007 and September 2007. The samplings were collected weekly in saltwater farm and every fifteen days in freshwater farm. Total phosphorus, chlorophyll a and environmental parameters (pH, dissolved oxygen, salinity, temperature, depth and water transparency) were measured. Qualitative and quantitative analysis of the phytoplankton and bacterioplankton were carried out. The Shannon-Wiener ecologic indexes of diversity and the Pielou equitability indexes were calculated to the phytoplankton. Bacterial density was determined by epifluorescence microscopy. The data were statistically analyzed by Pearson correlation and t-Test. Chlorophycea were predominat in salt water and in the captation/drainage point (24 to 99%). Diatoms had higher wealth. The species Choricystis minor had the highest occurrence (100%) and dominance (90-100%), thus showing its adaptation to the high temperatures, salinity and low water transparency conditions. Filamentous Cyanobacteria like Oscillatoria sp., Pseudoanabaena sp. and Phormidium sp. had constant levels. The negative correlation between chlorophycea and water transparency, and the positive correlation between chlorophyll a and salinity, showed that the phytoplankton was well adapted to the low transparency and to the high salinity. The bacterioplankton was negatively correlated with the total phosphorus and salinity. In freshwater, Cyanobacteria were predominant (>80%), presenting some producers of toxins species like Microcystis sp., Aphanizomenon sp., Cylindrospermopsis raciborskii e Anabaena circinalis. Cyanobacterial density and total phosphorus and chlorophyll a concentrations exceeded the maximum value allowed by legislation. The means of total phosphorus varied from 264 to 627 Wg.L-1 and the means of chlorophyll a oscillated between 22 and 182 Wg.L-1. The phytoplankton species were selected by low availability of the light, high pH, temperature and high availability of total phosphorus. The bacterioplankton showed high densities (5,13 x 107 to 8,50 x107 Bac.mL-1). The studied environments (ponds and rivers) presented a high level of trophic state based on the high concentrations of chlorophyll a and total phosphorus and cyanobacteria dominance. The composition of species in the ponds and rivers was similar, as well as high concentrations of total phosphorus and chlorophyll a, highlighting the pollution caused by the discharges of the farms in natural environment

Estudo paramétrico da recuperação de óleo no processo de drenagem gravitacional com injeção de CO2

The gas injection has become the most important IOR process in the United States. Furthermore, the year 2006 marks the first time the gas injection IOR production has surpassed that of steam injection. In Brazil, the installation of a petrochemical complex in the Northeast of Brazil (Bahia State) offers opportunities for the injection of gases in the fields located in the Recôncavo Basin. Field-scale gas injection applications have almost always been associated with design and operational difficulties. The mobility ratio, which controls the volumetric sweep, between the injected gas and displaced oil bank in gas processes, is typically unfavorable due to the relatively low viscosity of the injected gas. Furthermore, the difference between their densities results in severe gravity segregation of fluids in the reservoirs, consequently leading to poor control in the volumetric sweep. Nowadays, from the above applications of gas injection, the WAG process is most popular. However, in attempting to solve the mobility problems, the WAG process gives rise to other problems associated with increased water saturation in the reservoir including diminished gas injectivity and increased competition to the flow of oil. The low field performance of WAG floods with oil recoveries in the range of 5-10% is a clear indication of these problems. In order to find na effective alternative to WAG, the Gas Assisted Gravity Drainage (GAGD) was developed. This process is designed to take advantage of gravity force to allow vertical segregation between the injected CO2 and reservoir crude oil due to their density difference. This process consists of placing horizontal producers near the bottom of the pay zone and injecting gás through existing vertical wells in field. Homogeneous models were used in this work which can be extrapolated to commercial application for fields located in the Northeast of Brazil. The simulations were performed in a CMG simulator, the STARS 2007.11, where some parameters and their interactions were analyzed. The results have shown that the CO2 injection in GAGD process increased significantly the rate and the final recovery of oil

Detecção de interface em tanques de petróleo usando transmissores de nível e controladores Fuzzy

This work presents a proposal to detect interface in atmospheric oil tanks by installing a differential pressure level transmitter to infer the oil-water interface. The main goal of this project is to maximize the quantity of free water that is delivered to the drainage line by controlling the interface. A Fuzzy Controller has been implemented by using the interface transmitter as the Process Variable. Two ladder routine was generated to perform the control. One routine was developed to calculate the error and error variation. The other was generate to develop the fuzzy controller itself. By using rules, the fuzzy controller uses these variables to set the output. The output is the position variation of the drainage valve. Although the ladder routine was implemented into an Allen Bradley PLC, Control Logix family it can be implemented into any brand of PLCs

Análise paramétrica da simulação composicional do processo de Drenagem Gravitacional Assistida por Gás (GAGD)

In Brazil and around the world, oil companies are looking for, and expected development of new technologies and processes that can increase the oil recovery factor in mature reservoirs, in a simple and inexpensive way. So, the latest research has developed a new process called Gas Assisted Gravity Drainage (GAGD) which was classified as a gas injection IOR. The process, which is undergoing pilot testing in the field, is being extensively studied through physical scale models and core-floods laboratory, due to high oil recoveries in relation to other gas injection IOR. This process consists of injecting gas at the top of a reservoir through horizontal or vertical injector wells and displacing the oil, taking advantage of natural gravity segregation of fluids, to a horizontal producer well placed at the bottom of the reservoir. To study this process it was modeled a homogeneous reservoir and a model of multi-component fluid with characteristics similar to light oil Brazilian fields through a compositional simulator, to optimize the operational parameters. The model of the process was simulated in GEM (CMG, 2009.10). The operational parameters studied were the gas injection rate, the type of gas injection, the location of the injector and production well. We also studied the presence of water drive in the process. The results showed that the maximum vertical spacing between the two wells, caused the maximum recovery of oil in GAGD. Also, it was found that the largest flow injection, it obtained the largest recovery factors. This parameter controls the speed of the front of the gas injected and determined if the gravitational force dominates or not the process in the recovery of oil. Natural gas had better performance than CO2 and that the presence of aquifer in the reservoir was less influential in the process. In economic analysis found that by injecting natural gas is obtained more economically beneficial than CO2

Análise da trajetória de poços horizontais em reservatório de óleo pesado

The application of thermal methods, to increase the recovery of heavy oil in mature fields through drainage with multilateral and horizontal wells, has been thoroughly studied, theorically, experimentally, testing new tools and methods. The continuous injection of steam, through a steam injector well and a horizontal producer well in order to improve horizontal sweep of the fluid reservoir, it is an efficient method. Starting from an heterogeneous model, geologically characterized, modeling geostatistics, set history and identification of the best path of permeability, with seismic 3D, has been dubbed a studying model. It was studied horizontal wells in various directions in relation to the steam and the channel of higher permeability, in eight different depths. Into in the same area were studied, the sensitivity of the trajectories of horizontal wells, according to the depth of navigation. With the purpose of obtaining the highest output of oil to a particular flow, quality, temperature and time for the injection of steam. The wells studied showed a significant improvement in the cumulative oil recovery in one of the paths by promoting an alternative to application in mature fields or under development fields with heavy oil

Estudo da perda de carga e calor no poço injetor no processo De drenagem gravitacional assistida por vapor (SAGD)

The oil companies in the area in general are looking for new technologies that can increase the recovery factor of oil contained in reservoirs. These investments are mainly aimed at reducing the costs of projects which are high. Steam injection is one of these special methods of recovery in which steam is injected into the reservoir in order to reduce the viscosity of the oil and make it more mobile. The process assisted gravity drainage steam (SAGD) using steam injection in its mechanism, as well as two parallel horizontal wells. In this process steam is injected through the horizontal injection well, then a vapor chamber is formed by heating the oil in the reservoir and, by the action of gravitational forces, this oil is drained down to where the production well. This study aims to analyze the influence of pressure drop and heat along the injection well in the SAGD process. Numerical simulations were performed using the thermal simulator STARS of CMG (Computer Modeling Group). The parameters studied were the thermal conductivity of the formation, the flow of steam injection, the inner diameter of the column, the steam quality and temperature. A factorial design was used to verify the influence of the parameters studied in the recovery factor. We also analyzed different injection flow rates for the model with pressure drop and no pressure drop, as well as different maximum flow rates of oil production. Finally, we performed an economic analysis of the two models in order to check the profitability of the projects studied. The results showed that the pressure drop in injection well have a significant influence on the SAGD process.

Estudo do processo de drenagem gravitacional do óleo assistido com injeção de vapor e solvente

Como os recursos de hidrocarbonetos convencionais estão se esgotando, a crescente demanda mundial por energia impulsiona a indústria do petróleo para desenvolver mais reservatórios não convencionais. Os recursos mundiais de betume e óleo pesado são estimados em 5,6 trilhões de barris, dos quais 80% estão localizados na Venezuela, Canadá e EUA. Um dos métodos para explorar estes hidrocarbonetos é o processo de drenagem gravitacional assistido com injeção de vapor e solvente (ES-SAGD Expanding Solvent Steam Assisted Gravity Drainage). Neste processo são utilizados dois poços horizontais paralelos e situados verticalmente um acima do outro, um produtor na base do reservatório e um injetor de vapor e solvente no topo do reservatório. Este processo é composto por um método térmico (injeção de vapor) e um método miscível (injeção de solvente) com a finalidade de causar a redução das tensões interfaciais e da viscosidade do óleo ou betume. O objetivo deste estudo é analisar a sensibilidade de alguns parâmetros operacionais, tais como: tipo de solvente injetado, qualidade do vapor, distância vertical entre os poços, porcentagem de solvente injetado e vazão de injeção de vapor sobre o fator de recuperação para 5, 10 e 15 anos. Os estudos foram realizados através de simulações concretizadas no módulo STARS (Steam Thermal, and Advanced Processes Reservoir Simulator) do programa da CMG (Computer Modelling Group), versão 2010.10, onde as interações entre os parâmetros operacionais, estudados em um modelo homogêneo com características de reservatórios semelhantes aos encontrados no Nordeste Brasileiro, foram observadas. Os resultados obtidos neste estudo mostraram que os melhores fatores de recuperação ocorreram para níveis máximos do percentual de solvente injetado e da distância vertical entre os poços. Observou-se também que o processo será rentável dependendo do tipo e do valor do solvente injetado

Efeito da perda de carga e calor no poço injetor no processo de drenagem gravitacional assistido com vapor e solvente

Nowadays, most of the hydrocarbon reserves in the world are in the form of heavy oil, ultra - heavy or bitumen. For the extraction and production of this resource is required to implement new technologies. One of the promising processes for the recovery of this oil is the Expanding Solvent Steam Assisted Gravity Drainage (ES-SAGD) which uses two parallel horizontal wells, where the injection well is situated vertically above the production well. The completion of the process occurs upon injection of a hydrocarbon additive at low concentration in conjunction with steam. The steam adds heat to reduce the viscosity of the oil and solvent aids in reducing the interfacial tension between oil/ solvent. The main force acting in this process is the gravitational and the heat transfer takes place by conduction, convection and latent heat of steam. In this study was used the discretized wellbore model, where the well is discretized in the same way that the reservoir and each section of the well treated as a block of grid, with interblock connection with the reservoir. This study aims to analyze the influence of the pressure drop and heat along the injection well in the ES-SAGD process. The model used for the study is a homogeneous reservoir, semi synthetic with characteristics of the Brazilian Northeast and numerical simulations were performed using the STARS thermal simulator from CMG (Computer Modelling Group). The operational parameters analyzed were: percentage of solvent injected, the flow of steam injection, vertical distance between the wells and steam quality. All of them were significant in oil recovery factor positively influencing this. The results showed that, for all cases analyzed, the model considers the pressure drop has cumulative production of oil below its respective model that disregards such loss. This difference is more pronounced the lower the value of the flow of steam injection

Transfer function-noise modeling and spatial interpolation to evaluate the risk of extreme (shallow) water-table levels in the Brazilian Cerrados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prácticas culturales para el manejo de la Sigatoka negra en bananos y plátanos

Black sigatoka (Mycosphaerella fijiensis) control consists in the continuous use of fungicide sprays and cultural practices. Cultural control reduces inoculum sources of the pathogen and favorable environmental conditions for its development, as well as it increases the vigor of the plants. In order to manage the disease it is necessary to know its behavior through the time, its relationship with the weather and the crop management. The most important cultural practice to reduce the inoculum source is the removal of the whole affected leaves or only the diseased portions of the leaves. The removed tissue is placed over the ground and the use of urea is feasible to accelerate its decomposition. An alternative practice is the "mini-composting" that consists in forming small heaps with the dead leaves and harvested plants for its quick degradation, which allows to reduce the pathogen inoculum and to incorporate nutrients and organic matters into the soil. The early pruning of the tips of the Young leaves before they show symptoms of the disease and the quick elimination of harvested plants reduce the inoculum. Also, the agronomic management of the crop helps to reduce the favorable conditions and to increase the vigor of the plants: this management considers plantation density, drainage systems, irrigation methods, control of weeds, chemical-biological fertilization, and nematode control.

Efetividade da terapia fisica descongestiva na cicatrização de úlceras venosas

A venous ulcer is the most serious clinical manifestation of chronic venous failure, and the most frequent in lower limbs, accounting for 70% of all ulcers. Patients may suffer from this infirmity for several years without healing of the lesion if treatment is inadequate. The aim of this investigation was to verify the effectiveness of decongestive physical therapy in the healing of venous ulcers. This is a quasi-experimental, interventionist study, with paired, non-probabilistic sampling, composed of 50 patients divided into two groups: control and intervention, each composed of 25 patients. Both groups were identically treated for six months with daily dressings and the latter also underwent complex physical therapy consisting of a combination of the following techniques: manual lymphatic drainage, compression bandaging, lower limb elevation, myolymphokinetic exercises and skin care. The study was approved (Protocol no. 59/2007) by the Ethics Committee of the State University of Southeast Bahia. The Mann-Whitney and Chi-square tests were applied for data analysis. After statistical analysis the patients who underwent therapy showed a statistically significant difference with respect to wound contraction starting in the second month of treatment. Compared to the control, the intervention group showed a greater reduction in both pain and edema starting in the third and fourth month of therapy, respectively. To reinforce these findings, the mean percentage of tissue present at the base of the ulcer (granulation/fibrin ratio) was calculated. The intervention group showed greater granulation at the base of the ulcer compared to the control, significant from the second month of treatment on. It was observed in this study that lymphotherapy, when compared between the intervention and control groups, accelerated the healing process, and reduced pain and edema in the affected limbs. It is expected, therefore, that these results widen scientific knowledge and we suggest that this therapy be used 78 not only to reduce lymphedema, but also as a treatment option for venous ulcers, given its easy application and low cost. The data, therefore, demonstrated the importance of basic care on the part of a multiprofessional and transdisciplinary health team involved in the healing process of these infirmities, thereby contributing to better quality of life in these individuals

Compartimentação fisiográfica para análise ambiental do potencial erosivo a partir das propriedades da rede de drenagem

O presente trabalho teve como objetivo compartimentar a sub-bacia do Baixo Rio Piracicaba - SP, em unidades homogêneas quanto à potencialidade à erosão visando a subsidiar o gerenciamento ambiental. A importância desta pesquisa concentra-se no intenso desenvolvimento dos processos erosivos na área em foco e na sua importância socioeconômica em níveis estadual e nacional. O procedimento adotado para atingir o objetivo foi a análise da rede de drenagem e dos lineamentos obtidos pelas imagens TM/Landsat-5. O resultado obtido foi a divisão da área em quatro compartimentos quanto à potencialidade à erosão: muito alta, alta, média e baixa. Concluiu-se que a área estudada é heterogênea, com regiões sujeitas a diferentes intensidades de processos erosivos e que a sistemática adotada se mostrou eficiente para caracterizar as compartimentações fisiográficas da potencialidade erosiva, e essas compartimentações podem e devem ser utilizadas como ponto de partida para estudos ambientais e de utilização do território, em consonância com o desenvolvimento sustentável.

New species of Harttia (Loricariidae, Loricariinae) from the Rio Sao Francisco Basin

A new species of the mailed catfish genus Harttia is described from the Sao Francisco River drainage, States of Minas Gerais and Bahia, Brazil. The new species is distinguished from congeners by the combination of an abdominal region covered by small bony plates; plates 3-4 times in eye diameter; interorbital width 3.1-4.0 in head length and greater than eye diameter; body width at anal fin origin 6.3-8.3 in standard length; margins of the head and pectoral fin spine of mature males with elongate and conspicuous odontodes; anal fin of males longer than of females. A key to Harttia species and a comparison with other species are provided.