Integração dos processos de flotação e foto-fenton para redução de óleos e graxas de água produzida em campos de petróleo

During production of oil and gas, there is also the production of an aqueous effluent called produced water. This byproduct has in its composition salts, organic compounds, gases and heavy metals. This research aimed to evaluate the integration of processes Induced Air Flotation (IAF) and photo-Fenton for reducing the Total Oils and Greases (TOG) present in produced water. Experiments were performed with synthetic wastewater prepared from the dispersion of crude oil in saline solution. The system was stirred for 25 min at 33,000 rpm and then allowed to stand for 50 min to allow free oil separation. The initial oil concentration in synthetic wastewater was 300 ppm and 35 ppm for the flotation and the photo-Fenton steps, respectively. These values of initial oil concentration were established based on average values of primary processing units in Potiguar Basin. The processes were studied individually and then the integration was performed considering the best experimental conditions found in each individual step. The separation by flotation showed high removal rate of oil with first-order kinetic behavior. The flotation kinetics was dependent on both the concentration and the hydrophilic-lipophilic balance (HLB) of the surfactant. The best result was obtained for the concentration of 4.06.10-3 mM (k = 0.7719 min-1) of surfactant EO 2, which represents 86% of reduction in TOG after 4 min. For series of surfactants evaluated, the separation efficiency was found to be improved by the use of surfactants with low HLB. Regarding the TOG reduction step by photo-Fenton, the largest oil removal reached was 84% after 45 min of reaction, using 0.44 mM and 10 mM of ferrous ions and hydrogen peroxide, respectively. The best experimental conditions encountered in the integrated process was 10 min of flotation followed by 45 min of photo-Fenton with overall TOG reduction of 99%, which represents 5 ppm of TOG in the treated effluent. The integration of processes flotation and photo-Fenton proved to be highly effective in reducing TOG of produced water in oilfields

The presence of fungi on contact electrical stimulation electrodes and ultrasound transducers in physiotherapy clinics

Objectives To evaluate the presence of fungi on contact electrodes and ultrasound transducers from physiotherapy clinics.Design Quantitative study conducted at the Laboratory of Microbiology and Immunology, Faculty of Health Sciences and Technology of Piaui - NOVAFAPI, Teresina, Brazil.Setting Sample collection was performed in 10 clinics ( 20 ultrasound transducers and 20 contact electrodes).Main outcome measures Swabs were soaked with saline solution, inoculated in culture and incubated for filamentous fungi and yeast growth.Results Fourteen taxons were identified: Acremomium hyalinulum (Sacc.), Aspergillus terreus, Candida albicans, Cladosporium cladosporioides, Cladosporium elatum, Cladosporium oxysporum, Cladosporium sphaerospermum, Cladosphialophora bantiana, Curvularia clavata, Curvularia senegalensis, Fusarium oxysporum, Penicillium decumbens, Scopulariopsis candida and Sporothrix schenckii. Aspergillus terreus, Cladosporium oxysporum, Sporothrix shenckii and Candida albicans were found most often on contact electrodes, and Penicillium decumbens and Cladosporium cladosporioides were found most often on ultrasound transducers.Conclusion Fungi were found on all of the contact electrodes and ultrasound transducers. Physiotherapy professionals need to improve the disinfection procedures for this equipment. (C) 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Dexamethasone-induced insulin resistance is associated with increased connexin 36 mRNA and protein expression in pancreatic rat islets

Augmented glucose-stimulated insulin secretion (GSIS) is an adaptive mechanism exhibited by pancreatic islets from insulin-resistant animal models. Gap junction proteins have been proposed to contribute to islet function. As such, we investigated the expression of connexin 36 (Cx36), connexin 43 (Cx43), and the glucose transporter Glut2 at mRNA and protein levels in pancreatic islets of dexamethasone (DEX)-induced insulin-resistant rats. Study rats received daily injections of DEX (1 mg/kg body mass, i.p.) for 5 days, whereas control rats (CTL) received saline solution. DEX rats exhibited peripheral insulin resistance, as indicated by the significant postabsorptive insulin levels and by the constant rate for glucose disappearance (K-ITT). GSIS was significantly higher in DEX islets (1.8-fold in 16.7 mmol/L glucose vs. CTL, p < 0.05). A significant increase of 2.25-fold in islet area was observed in DEX vs. CTL islets (p < 0.05). Cx36 mRNA expression was significantly augmented, Cx43 diminished, and Glut2 mRNA was unaltered in islets of DEX vs. CTL (p < 0.05). Cx36 protein expression was 1.6-fold higher than that of CTL islets (p < 0.05). Glut2 protein expression was unaltered and Cx43 was not detected at the protein level. We conclude that DEX-induced insulin resistance is accompanied by increased GSIS and this may be associated with increase of Cx36 protein expression.

Emprego da levomepromazina no bloqueio da arritmia induzida pela adrenalina em cães anestesiados pelo Sevoflurano

Este experimento objetivou estudar o possível efeito antiarritmogênico da levomepromazina em cães anestesiados pelo sevoflurano e submetidos a doses crescentes de adrenalina. Para tal, foram empregados 21 animais adultos, machos e fêmeas, sem raça definida e considerados sadios. Os cães foram separados em dois grupos, sendo um de 11 (G1) e outro de 10 (G2) animais. O G1 recebeu, por via intravenosa, solução salina a 0,9%, na dose de 0,2ml/kg (placebo), seguida 15 minutos após, pela aplicação de tiopental, pela mesma via, na dose suficiente para abolir o reflexo laringotraqueal. Procedeu-se à intubação orotraqueal e iniciou-se a administração de sevoflurano a 2,5V%, em circuito anestésico semi-fechado. Decorridos 20 minutos da indução anestésica, iniciou-se a administração contínua, por via intravenosa, com emprego de bomba de infusão, de solução de adrenalina a 2%, em doses crescentes de 1, 2, 3, 4 e 5m g/kg/min (M1 a M5, respectivamente), com incremento da dose a intervalos de 10 minutos. Para o G2, empregou-se a mesma metodologia substituindo-se o placebo por levomepromazina, na dose de 1mg/kg. Foi tomado o traçado eletrocardiográfico, na derivação D2, a partir da indução da anestesia. Para efeito estatístico, foi considerado o número total de batimentos cardíacos de origem não sinusal, coincidentes com cada dose de adrenalina. Os dados numéricos foram submetidos à Análise de Perfil, quando foi possível constatar que as médias do G1 foram crescentes de M1 a M3, diminuindo a partir deste último, até M5. No G2, foi encontrada arritmia ventricular sustentada apenas em M5. Os achados permitiram concluir que a levomepromazina minimiza a arritmia ventricular sustentada, induzida pela adrenalina em cães anestesiados pelo sevoflurano.

Expressão de zif-268 durante a aquisição, evocação e extinção de uma memória aversiva

In the behavioral paradigm of discriminative avoidance task, both short and long-term memories have been extensively investigated with behavioral and pharmacological approaches. The aim of the present study was to evaluate, using the abovementioned model, the hippocampal expression of zif-268 - a calcium-dependent immediate early gene involved with synaptic plasticity process - throughout several steps of memory formation, such as acquisition, evocation and extiction. The behavioral apparatus consisted of a modified elevaated plus-maze, with their enclosed arms disposed in "L". A pre-exposure to the maze was made with the animal using all arms enclosed, for 30 minutes, followed by training and test, during 10 minutes each. The between sections interval was 24h. During training, aversive stimuli (bright light and loud noise) were actived whenever the animals entered one of the enclosed armas (aversive arm). Memory acquisiton, retention and extinction were evaluated by the percentage of the total time spent exploring the aversive arm. The parameters evaluated (time spent in the arms and total distance traveled) were estimated with an animal tracking software (Anymaze, Stoelting, USA). Learning during training was estimated by the decrease of the time spent exploring the aversive arm. One hour after the beginning of each section, animals were anaesthetized with sodium-thiopental (i.p.) and perfused with 0.9% heparinized saline solution followed by 4% paraformaldehyde. Brains were cryoprotected with 20% sucrose, separeted in three blocks and frozen. The middle block, containing the hippocampus, was sectioned at 20 micro meters in the coronal plane and the resutant sections were submitted to zif-268 immunohistochemistry. Our results show an increased expression of zif-268 in the dentate gyrus (DG) during the evocation and extinction stages. There is a distinct participation of the DG during the memory evocation, but not during its acquisition. Inaddition, all hippocampal regions (CA1, CA3 and DG) presented an increased zif-268 expression during the process of extinction.

Alterações na evocação de uma memória aversiva ao liongo do ciclo estral de ratas: influências da transmissão gabaérgica na amígdala

GABAergic neurotransmission has been implicated in many aspects of learning and memory, as well as mood and anxiety disorders. The amygdala has been one of the major focuses in this area, given its essential role in modulating emotionally relevant memories. However, studies with male subjects are still predominant in the field. Here we investigated the consequences for an aversive memory of enhancing or decreasing GABAergic transmission in the basolateral nucleus of the amygdala (BLA). Wistar female rats were trained in the plus-maze discriminative avoidance task, in which they had to learn to avoid one of the enclosed arms where an aversive stimulus consisting of a bright light and a loud noise was given (day 1). Fifteen minutes before the test session (day 2) animals received 0,2 μL infusions of either saline solution, the GABAergic agonist muscimol (0,05 mg/ml), or the GABAergic antagonist bicuculine (0,025 mg/ml) bilaterally intra-BLA. On the test day, females in proestrous or estrous presented adequate retrieval and did not extinguish the task, while females in metestrous or diestrous presented impaired retrieval. In the first group, muscimol infusion impaired retrieval and bicuculline had no effect, suggesting naturally low levels of GABAergic transmission in the BLA of proestrous and estrous females. In the second group, muscimol infusion had no effect and bicuculline reversed retrieval impairment, suggesting naturally high levels of GABAergic transmission in the BLA of metestrous and diestous females. Additionally, proestrous and estrous females presented higher anxiety levels compared to metestrous and diestrous females, which could explain better performance of this group. On the other hand, BLA GABAergic system did not interfere with the innate fear response because drug infusions had no effect in anxiety. Thus, retrieval alterations caused by the GABAergic drugs were probably related specifically to memory processes

Avaliação do potencial anticorrosivo de tiossemicarbazonas solubilizadas em sistemas microemulsionados

In this work thiosemicarbazones [4-N-cinnamoyl-thiosemicarbazone (CTSC), 4-N-(2'-methoxycinnamoyl)-thiosemicarbazone (MCTSC), and 4-N-(4'-hydroxy-3'-methoxybenzoyl)-thiosemicarbazone (HMBTSC)] were solubilized in an microemulsion system (ME_OCS) which is rich in aqueous phase (O/W system). The system ME_OCS was obtained with saponified coconut oil (OCS) as (surfactant), butanol (cosurfactant), and kerosene as oil phase (Fo), using 40% of C/T (cosurfactant/surfactant), 5% of Fo and 55% of aqueous phase. The microemulsions systems CTSC_ME_OCS, MCTSC_ME_OCS and HMBTSC_ME_OCS effectiveness on a AISI 1020 carbon steel corrosion inhibition process were evaluated in a saline solution (NaCl 0.5%), using a galavostatic method. The tested thiosemicarbazones (TSC) showed highest inhibitors effects (85.7% for CTSC_ME_OCS, 84.0% for MCTSC_ME_OCS, and 83.3% HMBTSC_ME_OCS) at lower concentrations [0.19% of CTSC, 0.07% (MCTSC), and 0.26% (HMBTSC)]. Comparatively, the surfactant OCS (solubilized in H2O) as well as the system ME_OCS showed lower efficacy [71% for OCS (at 0.20 - 0.25% of concentration) and 74% for ME_OCS (at 0.5% of concentration)]. Since the microemulsion systems ME_OCS showed satisfactory interfacial adsorption, the greatest inhibitory effect of those TSC_ME_OCS systems could be correlated to both chemical composition of each tested TSC (which is rich in heteroatoms and aromatic ring) and also the presence of the surfactant OCS

efeito da aplicação de uma solução salina no crescimento e na composição química da atriplex nummularia

This study aimed to analyze the effect of a saline solution on growth and chemical composition of Atriplex nummularia, shrubby plant, absorbing salts used in the diet of animals and the management of water and saline soils. These plant seedlings were planted and grown in a reserved area at the Federal University of Rio Grande do Norte. The plantation was divided into two blocks, in which one of them was irrigated with saline solution with a concentration of 2840 mgL-1 of NaCl and the second group was irrigated with drinking water. After six months, the plants were collected, harvested and divided into three parts: leaf, thin and thick stem. Monthly, dimension measurements were carried out for cataloging the growth of Atriplex. Ion Chromatography (IC) and Optical Emission Spectroscopy Inductively Coupled Plasma (ICP-OES) were used to analyze the chemical composition of the partition plant parts. The results of these analyses revealed that an absorption process of anions and cations by Atriplex nummularia plant during its growth was achieved, in particular by a higher concentration of sodium and chloride ions. Scanning electron microscopy images showed and confirmed the presence of small crystals on the leaf surface. Electrical conductivity and pH measurements of the aerial parts of the plant were carried out and these results showed that the leaf is the plant part where there is a largest concentration of ions. In addition, measurements of specific surface were obtained from irrigated plants with saline solution, achieving higher surface area, in all cases. Plant dimensions obtained monthly showed that the plants irrigated with water grew 5% more than those plants irrigated with saline solution. Based on results obtained, Atriplex plant showed a higher potential to survive and adapt to environments (aquatic or geological) with high levels of salinity and this property can be used as a tool for removing salts/metals from industrial contaminated soils and effluents.

Tratamento de borra de petróleo com sistemas microemulsionados

During the storage of oil, sludge is formed in the bottoms of tanks, due to decantation, since the sludge is composed of a large quantity of oil (heavy petroleum fractions), water and solids. The oil sludge is a complex viscous mixture which is considered as a hazardous waste. It is then necessary to develop methods and technologies that optimize the cleaning process, oil extraction and applications in industry. Therefore, this study aimed to determine the composition of the oil sludge, to obtain and characterize microemulsion systems (MES), and to study their applications in the treatment of sludge. In this context, the Soxhlet extraction of crude oil sludge and aged sludge was carried out, and allowing to quantify the oil (43.9 % and 84.7 % - 13 ºAPI), water (38.7 % and 9.15 %) and solid (17.3 % and 6.15 %) contents, respectively. The residues were characterized using the techniques of X-ray fluorescence (XRF), Xray diffraction (XRD) and transmission Infrared (FT-IR). The XRF technique determined the presence of iron and sulfur in higher proportions, confirming by XRD the presence of the following minerals: Pyrite (FeS2), Pyrrhotite (FeS) and Magnetite (Fe3O4). The FT-IR showed the presence of heavy oil fractions. In parallel, twelve MES were prepared, combining the following constituents: two nonionic surfactants (Unitol L90 and Renex 110 - S), three cosurfactants (butanol, sec-butanol and isoamyl alcohol - C), three aqueous phase (tap water - ADT, acidic solution 6 % HCl, and saline solution - 3.5 % NaCl - AP) and an oil phase (kerosene - OP). From the obtained systems, a common point was chosen belonging to the microemulsion region (25 % [C+S] 5 % OP and AP 70 %), which was characterized at room temperature (25°C) by viscosity (Haake Rheometer Mars), particle diameter (Zeta Plus) and thermal stability. Mixtures with this composition were applied to oil sludge solubilization under agitation at a ratio of 1:4, by varying time and temperature. The efficiencies of solubilization were obtained excluding the solids, which ranged between 73.5 % and 95 %. Thus, two particular systems were selected for use in storage tanks, with efficiencies of oil sludge solubilization over 90 %, which proved the effectiveness of the MES. The factorial design delimited within the domain showed how the MES constituents affect the solubilization of aged oil sludge, as predictive models. The MES A was chosen as the best system, which solubilized a high amount of aged crude oil sludge (~ 151.7 g / L per MES)

Adequação da metodologia do teste de envelhecimento acelerado em sementes de rúcula

The use of high vigor seed constitutes basic and fundamental. Given the increasing development os the seeds industry and the improvement of vigor tests used to differentiate subtle variations in the quality of seeds of vegetable crops, is needed. The objective was to study variations in conducting the accelerated aging test, to verify their sensitivity for identifying different vigor levels of arugula seed. Were used the cultivars Cultivada and Gigante, using five lots of seeds for each. The seeds were subjected to the determination of water content, germination, first germination, emergence of seedlings and variations in the accelerated aging test, without salt solution ( traditional procedure) and with salt solution in 48, 72 and 96 hours; at 38 degrees C, 41 degrees C and 45 degrees C. The accelerated aging test in traditional procedure is not efficient to evaluation the vigor of arugula seeds. The accelerated aging test with saline solution using the combination 41 degrees C for 72 hours, was sensitive to evaluated of the physiological potential of arugula seeds.

Intrapleural analgesia after endoscopic thoracic sympathectomy

OBJETIVO: Comparar a analgesia tradicionalmente utilizada para simpatectomia videotoracoscópica à injeção intrapleural de ropivacaína em duas doses diferentes. MÉTODOS: Vinte e quatro pacientes foram distribuídos em três grupos semelhantes, e todos eles receberam dipirona endovenosa. O grupo A recebeu tramadol endovenoso e injeção intrapleural de solução salina. O grupo B recebeu injeção intrapleural de ropivacaína a 0,33%, e Grupo C ropivacaína a 0,5%. Os aspectos analisados foram: capacidade inspiratória, freqüência respiratória e dor. A dor foi avaliada no período pós-operatório por meio da escala visual analógica e durante o período de uma semana. RESULTADOS: Nos grupos A e B, a redução da capacidade inspiratória foi observada no período pós-operatório. Nas primeiras 12 horas de pós-operatório, apenas 12,5% dos pacientes nos grupos B e C apresentaram dor intensa em comparação a 25% no Grupo A. Na semana seguinte, apenas um paciente do grupo A apresentou dor leve, enquanto o restante relatou dor intensa. No Grupo B, metade dos pacientes apresentou dor intensa, e no Grupo C, apenas um apresentou intensa dor. CONCLUSÃO: A analgesia intrapleural com ropivacaína resultou em menos dor no pós-operatório tardio com os melhores resultados analgésicos nas doses mais altas, proporcionando um melhor padrão ventilatório.

The effects of intrathecal administration of betamethasone over the dogs' spinal cord and meninges

OBJETIVO: Determinar possíveis alterações clínicas e histológicas determinadas pela administração da betametasona no espaço subaracnóideo de cães. MÉTODOS: Vinte e um cães foram incluídos no estudo de forma aleatória e encoberta. Depois de anestesiados, os cães foram submetidos a punção subaracóidea com injeção de 1 ml da solução sorteada. Os animais receberam solução salina 0,9% em G1, betametasona na dose de 1,75 mg em G2 e betametasona na dose de 3,5 mg em G3. Todos os animais foram mantidos em observação clínica por 21 dias, sendo posteriormente sacrificados. Porções da medula espinhal e sacral foram removidas para análise histológica por microscopia óptica. RESULTADOS: Não foram detectadas alterações clínicas em quaisquer dos animais incluídos no estudo. da mesma forma, nenhum animal do G1 apresentou alterações histológicas. Infiltração inflamatória foi observada em dois cães, um do G2 e outro e G3. No cão do G2 onde a infiltração inflamatória foi observada ocorreu, conjuntamente, hemorragia e necrose. em dois cães, um de G2 e outro de G3, observou-se discreta fibrose e espessamento da aracnóide, sendo focal em um e difusa no outro. CONCLUSÃO: A administração subaracnóidea de betametasona determinou alterações histológicas em medula e meninges de alguns dos cães envolvidos no estudo.

The Effects of Subarachnoid Administration of Preservative-Free S(+)-Ketamine on Spinal Cord and Meninges in Dogs

BACKGROUND: The N-methyl-D-aspartate receptor antagonist ketamine and its active enantiomer, S(+)-ketamine, have been injected in the epidural and subarachnoid spaces to treat acute postoperative pain and relieve neuropathic pain syndrome. In this study we evaluated the effects of a single dose of preservative-free S(+)-ketamine, in doses usually used in clinical practice, in the spinal cord and meninges of dogs.METHODS: Under anesthesia (IV etomidate (2 mg/kg) and fentanyl (0.005 mg/kg), 16 dogs (6 to 15 kg) were randomized to receive a lumbar intrathecal injection (L5/6) of saline solution of 0.9% (control group) or S(+)-ketamine 1 mg/kg(-1) (ketamine group). All doses were administered in a volume of 1 mL over a 10-second interval. Accordingly, injection solution ranged from 0.6% to 1.5%. After 21 days of clinical observation, the animals were killed; spinal cord, cauda equine root, and meninges were removed for histological examination with light microscopy. Tissues were examined for demyelination (Masson trichrome), neuronal death (hematoxylin and eosin) and astrocyte activation (glial fibrillary acidic protein).RESULTS: No clinical or histological alterations of spinal tissue or meninges were found in animals from either control or ketamine groups.CONCLUSION: A single intrathecal injection of preservative-free S(+)-ketamine, at 1 mg/kg-1 dosage, over a concentration range of 6 to 15 mg/mL injected in the subarachnoid space in a single puncture, did not produce histological alterations in this experimental model. (Anesth Analg 2012;114:450-55)

Eficácia do propofol e da associação de propofol e dexametasona no controle de náusea e vômito no pós-operatório de laparoscopia ginecológica

JUSTIFICATIVA E OBJETIVOS: A laparoscopia ginecológica é procedimento que determina alta incidência de náusea e vômito no pós-operatório. Este estudo teve por finalidade comparar a eficácia do propofol isoladamente ou em associação com a dexametasona na prevenção de náusea e vômito em pacientes submetidas à laparoscopia ginecológica. MÉTODO: Participaram do estudo 40 pacientes, estado físico ASA I e II, com idades entre 18 e 46 anos, sem queixas gástricas prévias, submetidas à laparoscopia para diagnóstico ou cirurgia. As pacientes foram divididas em 2 grupos: o grupo 1 recebeu (solução fisiológica 2 ml) e o grupo 2 dexametasona (8 mg), por via venosa antes da indução da anestesia. Todas as pacientes receberam midazolam (7,5 mg) por via oral como medicação pré-anestésica, sufentanil (0,5 µg.kg-1), propofol em infusão contínua para indução e manutenção da anestesia (BIS - 60) e N2O/O2 em fração inspirada de O2 a 40% e atracúrio (0,5 mg.kg-1) como bloqueador neuromuscular. A analgesia pós-operatória foi realizada com cetoprofeno (100 mg) e buscopam composto ®.As pacientes fora avaliadas na sala de recuperação pós-anestésica (SRPA) e na enfermaria 1, 2, 3 e 12 horas após a alta da SRPA. RESULTADOS: Ambos os grupos foram idênticos quanto aos dados antropométricos e à duração da cirurgia e da anestesia. No grupo 1 (n = 20) uma paciente apresentou náusea na SRPA e na enfermaria e três pacientes vomitaram na enfermaria. No grupo 2 (n = 20) nenhuma paciente apresentou náusea ou vômito durante o período de observação clínica, resultados estatisticamente não significativos. CONCLUSÕES: O propofol isoladamente ou associado à dexametasona foi eficaz na prevenção de náusea e vômito no pós-operatório de pacientes submetidas à laparoscopia ginecológica

The effect of salinization in maintenance of intermittent catheter

O uso de cateter intermitente representa um procedimento muito utilizado em ambiente hospitalar. Este estudo, de natureza experimental, teve como propósito a análise comparativa entre o cateter intermitente, preenchido com solução de heparina 100 U/ml e o preenchido com soro fisiológico 0,9%. Foi realizado um estudo comparativo, avaliando a formação de coágulos e se estes estivessem presentes seriam quantificados. Para tanto, foram utilizados quatro grupos de 7 coelhos, da linhagem Norfolk, sendo realizado acesso venoso em veia auricular conectado ao dispositivo de infusão múltipla. em dois destes grupos, foi usada solução salina; em um grupo, caso fosse encontrada resistência, esta seria forçada; no outro, esta resistência não seria forçada. Nos dois outros grupos, foi usada solução de heparina; em um grupo, caso fosse encontrada resistência, esta seria forçada; no outro esta resistência não seria forçada. O cateter intermitente foi mantido por 72 horas e, a cada 12 horas foi infundida água destilada, simulando a administração de medicamento. Durante o experimento foram observadas as seguintes variáveis: presença da formação de coágulos, comprimento do coágulo, peso fresco do coágulo, peso seco do coágulo, contagem plaquetária e desconforto. Na análise estatística feita pelo método não paramétrico Kruskal-Wallis, com nível de significância de sigma = 5%, não foi encontrada diferença significativa entre os grupos e momentos. Pôde-se constatar a presença de formação de coágulo em todos os grupos independentemente da solução de preenchimento. Concluímos, principalmente, que há necessidade de elaboração de novas normas e rotinas na utilização de cateter intermitente.