24 resultados para new knowledge for advancing practice in pain management
em Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP)
Resumo:
Background: The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance). Results: 60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score <= 5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%. Conclusion: the planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.
Resumo:
International theory and practice have promoted state-assisted upgrading of `informal` urban areas worldwide since the late 1970s, with various forms of monitoring and assessment of impact. Two independent studies of how residents perceive and evaluate such interventions have recently been undertaken for neighbouring parts of the upgraded area of Novos Alagados on the Itapagipe peninsula in the northwestern part of Salvador, Brazil`s third largest city. These studies start from different premises and have been implemented in very different ways, but both have the objective of permitting the `voice` of the residents to be heard concerning the upgrading process. Comparing them helps highlight the essential `fuzzy` nature of values concerning urban interventions of this nature and leaves us with thought-provoking questions concerning the role of local society in relation to the state in urban development, and the potential this has for on-going forms of urban management in cities which are emerging globally. Crown Copyright (C) 2009 Published by Elsevier Ltd. All rights reserved.
Resumo:
A great deal of attention in the supply chain management literature is devoted to study material and demand information flows and their coordination. But in many situations, supply chains may convey information from different nature, they may be an important channel companies have to deliver knowledge, or specifically, technical information to the market. This paper studies the technical flow and highlights its particular requirements. Drawing upon a qualitative field research, it studies pharmaceutical companies, since those companies face a very specific challenge: consumers do not have discretion over their choices, ethical drugs must be prescribed by physicians to be bought and used by final consumers. Technical information flow is rich, and must be redundant and early delivered at multiple points. Thus, apart from the regular material channel where products and order information flow, those companies build a specialized information channel, developed to communicate to those who need it to create demand. Conclusions can be extended to supply chains where products and services are complex and decision makers must be clearly informed about technology-related information. (C) 2009 Elsevier B.V. All rights reserved.
Resumo:
In this study, 53 patients received piroxicam, administered orally or sublingually, after undergoing removal of symmetrically positioned lower third molars, during two separate appointments. This study used a randomized, blind, cross-over protocol. Objective and subjective parameters were recorded for comparison of postoperative results for 7 days after surgery. Patients treated with oral or sublingual piroxicam reported low postoperative pain scores. The patients who received piroxicam orally took a similar average amount of analgesic rescue medication compared with patients who received piroxicam sublingually (p > 0.05). Patients exhibited similar values for mouth opening measured just before surgery and immediately following suture removal 7 days later (p > 0.05), and showed no significant differences between routes of piroxicam administration for swelling control during the second or seventh postoperative days (p > 0.05). In summary, pain, trismus and swelling after lower third molar extraction, independent of surgical difficulty, could be controlled by piroxicam 20 mg administered orally or sublingually and no significant differences were observed between the route of delivery used in this study.
Resumo:
Nucleotide sequences of the internal transcribed spacer 2 (ITS2) rDNA and partial sequences of the cytochrome coxidase subunit I (COI) mtDNA and white gene nDNA were obtained from specimens of Anopheles nuneztovari A collected in Macapá (state of Amapá), Óbidos, Prainha and Almeirim (state of Pará), Itacoatiara and Parintins (state of Amazonas), Brazil, and compared with previously published sequences of A. nuneztovari s.l. Results of the Bayesian phylogenetic analyses performed using either COI or combined ITS2, COI and white gene sequences suggest that An. nuneztovari B/C is distinct from specimens obtained in the Amazonas/Solimões River basin. Anopheles goeldii, currently in synonymy with An. nuneztovari, was described from individuals collected in Belterra (= Fordlândia) in the Tapajós River, state of Pará, Southern Amazonas River. Morphological comparisons of the characteristics of the male genitalia indicated that An. nuneztovari A and An. goeldii are similar but distinct from An. nuneztovariB/C by the apex of the aedeagus. In considering the results of the phylogenetic analyses and morphological comparisons, An. goeldii is resurrected from synonymy with An. nuneztovari. Additionally, Anopheles dunhamiis reported for the first time in Parintins. This species can be distinguished from An. goeldiiby characters of the male genitalia and molecular data
Resumo:
As a part of our galaxy-cluster redshift survey, we present a set of 79 new velocities in the 4 clusters Abell 376, Abell 970, Abell 1356, and Abell 2244, obtained at Haute-Provence observatory. This set now completes our previous analyses, especially for the first two clusters. Data on individual galaxies are presented, and we discuss some cluster properties. For A376, we obtained an improved mean redshift (z) over bar = 0.04750 with a velocity dispersion of sigma(V) = 860 km s(-1). For A970, we have (z) over bar = 0.05875 with sigma(V) = 881 km s(-1). We show that the A1356 cluster is not a member of the ""Leo-Virgo"" supercluster at a mean redshift (z) over bar = 0.112 and should be considered just as a foreground group of galaxies at (z) over bar = 0.0689, as well as A1435 at (z) over bar = 0.062. We obtain (z) over bar = 0.09962 for A2244 with sigma(V) = 965 km s(-1). The relative proximity of clusters A2244 and A2245 ((z) over bar = 0.08738, sigma(V) = 992 km s(-1)) suggests that these could be members of a supercluster that would include A2249; however, from X-ray data there is no indication of interaction between A2244 and A2245.
Resumo:
Context. VISTA Variables in the Via Lactea (VVV) is one of the six ESO Public Surveys operating on the new 4-m Visible and Infrared Survey Telescope for Astronomy (VISTA). VVV is scanning the Milky Way bulge and an adjacent section of the disk, where star formation activity is high. One of the principal goals of the VVV Survey is to find new star clusters of different ages. Aims. In order to trace the early epochs of star cluster formation we concentrated our search in the directions to those of known star formation regions, masers, radio, and infrared sources. Methods. The disk area covered by VVV was visually inspected using the pipeline processed and calibrated K(S)-band tile images for stellar over-densities. Subsequently, we examined the composite JHK(S) and ZJK(S) color images of each candidate. PSF photometry of 15 x 15 arcmin fields centered on the candidates was then performed on the Cambridge Astronomy Survey Unit reduced images. After statistical field-star decontamination, color-magnitude and color-color diagrams were constructed and analyzed. Results. We report the discovery of 96 new infrared open clusters and stellar groups. Most of the new cluster candidates are faint and compact (with small angular sizes), highly reddened, and younger than 5 Myr. For relatively well populated cluster candidates we derived their fundamental parameters such as reddening, distance, and age by fitting the solar-metallicity Padova isochrones to the color-magnitude diagrams.
Resumo:
Strategies aimed at improving spinal cord regeneration after trauma are still challenging neurologists and neuroscientists throughout the world. Many cell-based therapies have been tested, with limited success in terms of functional outcome. In this study, we investigated the effects of human dental pulp cells (HDPCs) in a mouse model of compressive spinal cord injury (SCI). These cells present some advantages, such as the ease of the extraction process, and expression of trophic factors and embryonic markers from both ecto-mesenchymal and mesenchymal components. Young adult female C57/BL6 mice were subjected to laminectomy at T9 and compression of the spinal cord with a vascular clip for 1 min. The cells were transplanted 7 days or 28 days after the lesion, in order to compare the recovery when treatment is applied in a subacute or chronic phase. We performed quantitative analyses of white-matter preservation, trophic-factor expression and quantification, and ultrastructural and functional analysis. Our results for the HDPC-transplanted animals showed better white-matter preservation than the DMEM groups, higher levels of trophic-factor expression in the tissue, better tissue organization, and the presence of many axons being myelinated by either Schwann cells or oligodendrocytes, in addition to the presence of some healthy-appearing intact neurons with synapse contacts on their cell bodies. We also demonstrated that HDPCs were able to express some glial markers such as GFAP and S-100. The functional analysis also showed locomotor improvement in these animals. Based on these findings, we propose that HDPCs may be feasible candidates for therapeutic intervention after SCI and central nervous system disorders in humans.
Resumo:
This investigation aimed at assessing the extent to which memory from practice in a specific condition of target displacement modulates temporal errors and movement timing of interceptive movements. We compared two groups practicing with certainty of future target velocity either in unchanged target velocity or in target velocity decrease. Following practice, both experimental groups were probed in the situations of unchanged target velocity and target velocity decrease either under the context of certainty or uncertainty about target velocity. Results from practice showed similar improvement of temporal accuracy between groups, revealing that target velocity decrease did not disturb temporal movement organization when fully predictable. Analysis of temporal errors in the probing trials indicated that both groups had higher timing accuracy in velocity decrease in comparison with unchanged velocity. Effect of practice was detected by increased temporal accuracy of the velocity decrease group in situations of decreased velocity; a trend consistent with the expected effect of practice was observed for temporal errors in the unchanged velocity group and in movement initiation at a descriptive level. An additional point of theoretical interest was the fast adaptation in both groups to a target velocity pattern different from that practiced. These points are discussed under the perspective of integration of vision and motor control by means of an internal forward model of external motion.
Resumo:
The effect of lateralized practice on manual preference was investigated in right-handed children. Probing tasks required reaching and grasping a pencil at distinct eccentricities in the right and left hemifields (simple), and its transportation and insertion into a small hole (complex). During practice, the children experienced manipulative tasks different from that used for probing, using the left hand only. Results showed that before practice the children used almost exclusively the right hand in the right hemifield and at the midline position. Following lateralized practice frequency of use of the left hand increased in most lateral positions. A more evident effect of lateralized practice on shift of manual preference was detected in the complex task. Implications for lateralization of behavior in a developmental timescale are discussed on the basis of the proposition of amplification and diffusion of manual preference from lateralized practice. (C) 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 723-730, 2010.
Resumo:
The aim of this work is the production and preliminary characterization of adsorbent new materials useful for sensor development. A new plasma chamber was simulated and designed in order to obtain multiple layers and/or composites in a single step. Plasma deposited organic fluorocompound and hexamethyldisilazane (HMDS) thin films were produced and tested as adsorbent layers. Chemical characterization used ellipsometry, Raman. infrared and X-ray photoelectron spectroscopy. Hydrophobic and oleophobic character were determined by contact angle measurements. Adsorption characteristics were evaluated using quartz crystal microbalance. Not only HMDS but also the fluorocompound can polymerize but intermixing and a double layer are only obtained in very narrow conditions. The films are adsorbent and mildly hydrophobic. Films deposited on a microchromatographic column can be used on sample pretreatment to remove and/or preconcentrate volatile organic Compounds. Therefore, with this approach it is possible to obtain films with different monomers on double layer or composites, with organic/inorganic materials or particles and use them on sample pretreatment for chemical analysis. (C) 2008 Elsevier B.V. All rights reserved.
Resumo:
MARTINS, A. R. (Institute of Biology, State University of Campinas - UNICAMP, 13083-970, Campinas, SP, Brazil), N. PUT, (Division of Biology and Education, University of Vechta, 49377 Vechta, Germany), A. N. SOARES, A.B BOMB, and B. APPEZZATO DA GLORIA (Biological Science Department, Escola Superior de Agricultura `Luiz de Queiroz`, University of Sao Paulo, 13418-900, Piracicaba, SP, Brazil). J. Torrey Bot. Soc. 137: 220-235. 2010.-New approaches to underground systems in Brazilian Smilax species (Smilacaceae). Scientific studies show that the watery extract of the thickened underground stem and its adventitious roots of the genus Smilax can act as a therapeutic agent in immunoinflammatory disorders, such as rheumatic arthritis. Brazilians have used this genus of plants in folk medicine, however it is very hard to identify these species, since the morphology of the underground systems is very similar in this group. For better identification of those systems, we studied six species of Smilax L. (S. brasiliensis, S. campestris, S. cissoides, S. goyazana, S. oblongifolia and S. rufescens), collected in different regions of Brazil with different physiognomies and soil characteristics. The main purpose is to describe the morpho-anatomy of the underground systems and to analyze if their structure depends on environmental conditions. The underground stem (rhizophore) is of brown color and it is knotty, massive, slender (S. rufescens) or tuberous (S. brasiliensis, S. campestris, S. cissoides, S. goyazana and S. oblongifolia). The tuberization is a result of primary thickened meristem (PTM) activity. The color and thickness of the adventitious roots change during development because the epidermis and outer cortex are disposed of, so the inner cortex becomes the new covering tissue with lignified and dark color cells. There are differences in starch grain shapes in mature roots. The chemical attributes of the soil are very similar in all studied environments and, even when soil characteristics varied, all the species` underground system was distributed close to the soil surface (10 to 15 cm deep). The species exhibited clonal growth hence their underground system functions as storage structures and the axillary buds can sprout into new stems. Only Smilax rufescens, collected in sandy soil of Restinga, has vegetative dispersal due to the runners.
Resumo:
Crop rotation can play a valuable role in managing plant parasitic nematodes, depending on the availability of profitable non-host or poor host crops. Alternatively, non-host cover crops or green manures can be used in succession to summer cash Crops for this Purpose. The aim of the current study was to evaluate, under greenhouse conditions, the host status of commercial hybrids and cultivars of grain and silage sorghum (Sorghum bicolor) for Meloidogyne javanica, and to assess the effect of sorghum on nematode population in comparison with pearl millet (poor host for M. javanica), showy crotalaria and sunn hemp (both non-hosts). Based on two experiments, it was stated that, as a rule, grain sorghum is a poor host for M. javanica, but silage sorghum is a good host. Silage sorghum `BRS 601` was an exception. In other experiments, grain sorghum, pearl millet (Pennisetum glaucum `BN 2`), showy crotalaria (Crotolaria spectabilis `Comum`) and sunn hemp (C. juncea `IAC-KR-1`) reduced M. javanica population level, while silage sorghum increased the nematode density.
Resumo:
Leaves from four different Ginkgo biloba L. trees (1 and 2 - females; 3 and 4 - males), grown at the same conditions, were collected during a period of 5 months (from June to October, 2007). Water and 12% ethanol extracts were analyzed for total phenolics content, antioxidant activity, phenolic profile, and the potential in vitro inhibitory effects on alpha-amylase, alpha-glucosidase, and Angiotensin I-Converting Enzyme (ACE) enzymes related to the management of diabetes and hypertension. The results indicated a significant difference among the trees in all functional benefits evaluated in the leaf extracts and also found important seasonal variation related to the same functional parameters. In general, the aqueous extracts had higher total phenolic content than the ethanolic extracts. Also, no correlation was found between total phenolics and antioxidant activity. In relation to the ACE inhibition, only ethanolic extracts had inhibitory activity. (C) 2009 Elsevier Ltd. All rights reserved.