Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

Objetivo: relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações _________________________________________________ABSTRACT Purpose: we report a small series of pregnant women who underwent gastric bypass surgery for severe obesity, with a review of the literature on this topic. Methods: five consecutive cases of pregnancy after gastroplasty between 2001 and 2004 were evaluated, and clinical, laboratory and therapeutic features were considered. Patients were 30 to 34 years old and all had been submitted to gastroplasty by the Capella technique. The outcomes for both the pregnant woman and the fetus were evaluated. A search of the English language literature was done through MEDLINE and Web of Science databases with the following terms: gastroplasty, gastric bypass surgery, bariatric surgery, and pregnancy. Results: all 5 pregnancies were singleton. No major obstetric complications were observed and there were no premature or lowbirth weight infants. Conclusion: our data suggest that pregnancy following gastroplasty is safe for mother and fetus. However, since information about this topic is limited, further investigations are required to establish appropriate recommendations concerning the follow-up of these pregnancies

Lactação materna: a contribuição do pai

BRITO, Rosineide Santana de; ENDERS, Bertha Cruz; SOARES, Verônica Guedes. Lactação materna: a contribuição do pai. Revista Baiana de Enfermagem, Salvador, v.19/20,n.1-3, p.105-112, jan./dez. 2004,jan./dez. 2005.

Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações

Cuidados de enfermagem ao paciente em pós-operatório de prostatectomia: revisão integrativa

Este estudo trata-se de revisão integrativa da literatura com objetivo de sintetizar o conhecimento produzido em artigos sobre os cuidados de enfermagem aos pacientes em pós-operatório de prostatectomia. Para seleção dos artigos foram consultadas cinco bases de dados – SCOPUS, CINAHL, PUBMED, LILACS e Cochrane – sendo incluídos dezenove artigos. Os resultados mostram estudos que se enquadram nos níveis II, IV, V, VI e VII de evidência, a maioria realizada nos Estados Unidos durante os anos de 1999 a 2011. Os cuidados de enfermagem identificados foram agrupados em seis categorias: acompanhamento psicológico, orientações pós-operatórias, tratamento da disfunção erétil, tratamento da incontinência urinária, tratamento da dor e tratamento da hiponatremia. Conclui-se que os estudos com maior nível de evidência identificado recomendam cuidados de enfermagem centrados no acompanhamento psicológico, nas orientações do período pós-operatório e no tratamento da disfunção erétil. Destaca-se ainda que tais recomendações concentram-se, sobretudo, nas ações de apoio emocional e educativo

Saúde bucal no programa de saude da família: o caso do distrito sanitário norte em Natal - RN

The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health

O uso do móbile marketing como estratégia de fidelização de clientes :um estudo e empresas do setor de comércio e serviços em natal-RN

This study aims to understand the effects of the mobile marketing use as a relationships tool for companies that operate locally, because of the lack of information about this new marketing tool, as well as the scarcity of studies in this area. This is an exploratory and qualitatively study, based on primary sources, raised through books, articles in the marketing area and the telecommunications industry organs as well as secondary sources. With the purpose to look into the issue, a semi-structured interview is made with the companies managers of the sectors of trade and services in Natal-RN. The advances in technology allow an important discussion focused on the marketing in the new communication technologies scenario. It appears that the mobile marketing adoption and use by local companies is already a reality and companies are awake to changes and technological innovations accessible, especially the mobile telephony as well as convergence with other media. There is, however, that the use of technologies offered by mobile marketing is still limited to the sending of text messages (SMS), despite the numerous possibilities of it use. Moreover, the results obtained with mobile marketing use show that companies can identify them, but there is no effective monitoring in quantity and financial terms. Only affect sales growth and support for progress in loyalty with customers. It shows up that the mentality of not measuring the results still in the plan of changes and technological innovations. The data allow saying that the mobile marketing is a reality, however has not yet signed as a tool for carrying out campaigns and marketing tool for loyalty of customers, despite presenting a wide range of possibilities to streamline and make more effective the marketing businesses process

Gestão da informação: um estudo de caso em um instituto de pesquisa tecnológica

Each two years the amount of available information in the world double. This is the Information Age, where the success depends on what one knows, not on what one has. A new economy appears with the capacity to generate, to store, to process and to apply effectively the knowledge, based on information, determining the companies productivity and competitiveness.The objective of this work is to understand the information management model of a technological research institute - CTGÁS (Gas Technology Center). The research has been done focused on the 5 main processes and the 15 support processes of the organization value chain , aiming to understand the information management in the organization based on Davenport´s Information Management model (1998). Therefore, it was necessary to identify how the necessary information for the organizational processes accomplishment are determined, obtained, distributed and used by the organization. The research can be classified as descriptive, regarding to its aims, and as a case study, related to the research ways. Interviews with the managers of the organization value chain processes have been carried through, with the objective to identify how they perceive the Information Management process that circulates in the organizational processes. Complementarily, a documentary research has been carried through, associated to the direct observation and procedures and actions follow up, involving the Information Management. The data treatment and analysis have been done from the authors theoretical support and from the managers interviews analysis, documents and processes observed by the researcher in the organization. It was noticed that the organization has raised its level of information needs that are not difficult to be determined and are satisfactorily obtained and distributed, although the majority of them are not structuralized, automatized or even classified regarding to its confidence. These peaces of information have good quality and are important, however they reflect a medium dependence on external and informal information, besides being used only in its great majority for people to know what and how to do something

Processo de planejamento estratégico em universidade pública: o caso da Universidade Federal do Pará

The goal of this research is to check if the strategic planning developed between 2001 and 2009 into the State University of Para (Universidade Federal do Pará - UFPA) was consolidated into its Academic Centers as a management practice. To this end, we identified the planning formalization degree of the Academic Centers, the conceived tools for the planning, the conception and the methodological process used in the tools elaboration, as also its implementation. The research used a qualitative approach: it is descriptive and it uses the case study technique. The data were gathered from primary and secondary sources, through bibliography, documents, and field researches through semi-structure interviews. The analysis and data interpretation were done by each investigated Academic Center from the analytics categories guided by the specifics goals. We used theoretic fundamental based principles and the university as a study empiric reference based on its structure analysis, organizational processes and institutional strategic plan. We inspected how the strategic planning process was developed throughout the fixed period and how the investigated Academic Centers are from the collected documents and interviews. The theoretical foundation was built from three axis: the Brazilian undergraduate and posgraduate education system; the university itself including its singularity and complexity as an organization; and the planning as a strategic management process. The main results show us that the UFPA has updated regulatory milestones, presenting organizational structure, laws, instructions, manuals and deployed management model that give the strategic planning development conditions beyond its administration, i. e., into its Academic Centers. The centers also present those established milestones and develop the basic planning processes of the institution. Those processes are conceived based on the institutional strategic planning and the managers mainly use the procedural orientation defined by the university management, from where the conceptual foundation is originated and propagated. According to the literature and to the research done in this work, we can conclude that the Academic Centers from the UFPA developed the strategic planning practice. This planning is organized and founded and guided the plans and decisions which avoided the disordered management and, according to the managers, allowed the advances and performance improvement. We can conclude that the UFPA built an important foundation with respect to the management professionalization. On the other hand, we can not conclude that the management practice is consolidated since there are weaknesses into the structuring of the technical teams and there is not any management tool for the implementation of the elaborated plans

Círculos ao invés de linhas: em busca de valores e princípios estruturantes da gestão social. Projeto juventude, participação e autonomia (Instituto Universidade Popular - UNIPOP)

The organizations are characterized as dynamic spaces, they are being revisited and redefined, because they constitute structural human spaces and new vain outlines won expression. As it begins, of the non consensus in its conception, it is explicit the complexity degree that is identified in the plurality and diversity, brought by the people that compose them, characterizing it as accomplishment space, of happiness and also of conflict, of relationships of power and organizational limits and from birth and burial of faiths, values, norms, symbols, knowledge and rituals, therefore, deeply human. In that way, to know the administration of the organization is preponderant condition for the format of the human relationships to be delineated in its living. Like this the work makes an option in knowing the social administration, this work tries to know and analyze the values and beginnings of the social administration; revealling characteristics and specificities of the organizational performance of UNIPOP that contribute to the formation of the conception of Social Administration, it tends as source of the information the managers of the institution; to identify the formative values of UNIPOP that contribute to the youths' partner-political action in the community, tends for reference the current students of the organization and last to evaluate values structurates and supporting that interconnection between the organizational Administration, formation youth's program, participation and autonomy and attendance, starting from the existences gained by the exits, of that program. This way, the research will be qualitative, looking for understanding starting from their documents, the existence of those values

Sociabilidades e hedonismos: etnografia entre jovens usuários de substâncias psicoativas sintéticas Fortaleza Ceará

This dissertation shows a comparison between practices related to the body, to identities and to the health of young drug takers of synthetic and manipulated psychoactive substances living in Fortaleza. Through ethnographic accompaniment of parties and two social nets of young people I was able to verify the differences and similarities that make these addicted singular and plural in their notion of ethos and world vision. Notions of being hippie/alternative and being punk are present between these nets. Because their use and circulation are developed in environments usually distinct, it is possible to trace singular aspects between the nets and its actions. In parallel, on the attempt to build a triangulated data, I had information related to youth and drugs in local media and in governmental institutions bound to health mental and city security policies. With this junction of data I present a perspective to questions evolving formal and informal important controls to the conduction of their lives and identities. I present this as a sequel to well developed studies in Brasil about youth in interface to drug use, although still not very explored in the state of Ceará.

A assistência técnica nos habitats do MST e o papel do arquiteto e urbanista

This dissertation is about Architect and town planner inserts in the technical support of the Rural establishment and of the possibilities of changes in their habitat. It also looks for its participation through the production of those spaces with or without its performance through two references cases, in Rio Grande do Norte , one called settlement Eldorado de Carajás and another one called Maria da Paz. At first the process represents the model that was adopted systematically by Incra until the middle of the year 2000 with the sub-contracting of their construction work through small companies. These standardized projects which are executed without registration in the system CONFEA/CREA without demand of professional authorship and of technical responsibility of the work. But the process taken place at Maria da Paz s area was configured as one of the first initiatives that stopped with those practices. Consolidated through a partnership among UFRN MST and INCRA/RN, the Architect s technical support and town planner brought new technician-scientific organization and execution of the soil parcels and its habitat. The participation of UFRN was done through a group of studies in land reform and Habitat (GERAH) being this author and coordinator of the methodological proposal, based on the regressive-progressive method and in the inclusion of the conflict as responsible of the ruptures and transductions both done by Henry Léfèbvre and in the research action approached by Carlos Brandão. Therefore it included the process of social learning and collective production of new knowledge and attitudes in relation to the environment in the process called as attended self management in spite of the transformations happened with this new agent s participation. The people re-located to the new areas that got involved in the process and finished their constructions reelaborating the daily practice of the collective effort passed to the self management without technical support. Years later the implantation of those two experiences our research verified that there is a positive image concerning the Architect and town planner, related, most of all to the conception of the activities, orientation and execution of constructions projects and of acceptance of those professionals to the processes of implementation of the Habitats of the Rural establishments. This dissertation analyses this form of performance, from and beyond these images trying to find the professional, specificities or methodological in such a way to demonstrate the importance of its insertion in the formulation and attendance of the more of 100.000 habitats of Rural establishments of the land reform of the country that correspond to most of the housing social interest in the country side

Plano setorial: a construção de estratégias para implementação do plano diretor de Natal

The Sectoral Plan was inserted as an urban instrument in Master Plan of Natal (LC82/07), since then it has been deepened. It is guided to the equitable distribution of the benefits of urbanization, aimed the efetivation of the Right to the City and the Environmental function of property in the context of urban planning. Thereby, the Sectoral Plan was inserted into the perspective of promoting a favorable field for applying articulated of instruments defined in the Master Plan, and them with urban interventions, through the deepening of macrozoning - coming out of dimension of the city and going to a small fraction of the urban by reducing scaling - facilitating democratic management in accordance with the City Statute. However, the absence of regulation and the conceptual and operational fragility of the instrument, approached it of other existent experiences and instruments, limiting its application and evaluation. Considering the innovative nature of the instrument and the intense social participation, we inquire about conceptual and operational elements which could give greater effectiveness to Sector Plan in construction? Guided by that question, this dissertation aim to understand the nature and operational procedures of Sectoral Plan, seeking to do indications about the conceptual and operational aspects of implementing a Sector Plan. The neighborhood of Ponta Negra was selected as empirical universe because it was the first sector defined in the Master Plan. This research adopts reference authors who´s make reflection and insights about the matrix of Urban Reform, whose principles constitute the basis of the trajectory of revision of urban planning in Brazil since the 1980s, highlighting Raquel Rolnik, Nelson Saule Júnior and Orlando Alves dos Santos Júnior. For the local monitoring, we use the authors Alexsandro Ferreira Cardoso Silva, Rosa Maria Pinheiro Oliveira e Marise Costa da Souza Duarte, in order to understand the growth dynamics of Natal, lawfully and urbanistically

Parâmetros urbanísticos na regulação do uso e ocupação do solo: estudo da densidade e do coeficiente de aproveitamento nos planos diretores de Natal de 1994 e 2007

A Constituição Federal de 1988 e o Estatuto da Cidade estabelecem o Plano Diretor como instrumento básico da política de ordenamento territorial, tendo como princípio fundamental o cumprimento da função social da propriedade e do direito à cidade. Na perspectiva de adequação às diretrizes e objetivos da política urbana estabelecidos em 1988, o município de Natal elaborou os Planos Diretores de 1994 e 2007, definindo instrumentos e parâmetros de regulação do uso e ocupação do solo possíveis de assegurar o cumprimento da função social da propriedade urbana e de gerar subsídios ao planejamento e à gestão da cidade. Apesar de Natal ter sido um dos municípios brasileiros pioneiros na adoção desses princ pios, antecipando e incorporando os instrumentos que em 2001 viriam a ser definidos no Estatuto da Cidade, identifica-se que alguns desses instrumentos e parâmetros direcionados à regulação do uso e ocupação do solo não tiveram sua aplicação plena, a exemplo do mecanismo de acompanhamento e controle dado pelo Estoque de Área Edificável e da Densidade, que foi substituída pelo Coeficiente de Aproveitamento no Plano Diretor de 2007. Questionando esse procedimento, busca-se na presente pesquisa investigar de que maneira essa substituição do parâmetro densidade pelo coeficiente de aproveitamento influenciou na capacidade da gestão pública de regular os processos de uso e ocupação do solo, de forma a adequar a sua intensificação ao suporte da infraestrutura instalada. Foram tomadas como referência teórico-conceitual as contribuições sobre a prática de planejamento urbano no Brasil, nos marcos do ideário da reforma urbana, com destaque para as reflexõe s de Flávio Villaça, Orlando Alves Santos Junior e Daniel Todtmann Montandon, Luiz César de Q. Ribeiro, Raquel Rolnik, Ermínia Maricato, Laura Machado de Bueno e Renato Cymbalista, José Roberto Bassul e Carlos F. Lago Burnett, e, com relação aos parâmetros de controle urbanístico, o estudo identifica as diferentes abordagens sobre a densidade urbana e o coeficiente de aproveitamento com base nas reflexões de Claudio Acioly Jr., Forbes Davidson, Juan Luis Mascaró, Ricardo Ojima, Marcelo de Souza, José Rámon Navarro Vera e Armando Ortuño Padilla, Nestor Goulart Reis, Marta Dora Grostein e Susana Ricardo Alves. Como conclusão, discute-se a hipótese formulada, inicialmente, de que a mudança de parâmetros verificada colocou limites para o município realizar uma gestão adequada do solo urbano e, portanto, de fazer cumprir a função social da propriedade, considerando a necessidade de adequação entre a intensificação do uso e ocupação do solo e a infraestrutura instalada

Indicações para o projeto arquitetônico de edifícios multifamiliares: uma análise pósocupação em Natal/RN

Confirming the Brazilian tendency in the field, the multifamily vertical condominium habitats in Natal are defined as buildings with three or more floors which have been an increasingly used solution. In the mentioned project, the connection between the projectarchitects and the user/ buyers are spread out, by which the first people conceive the realestate property as a creation for the market and not the individual client in specific. Such situation along with technical and financial limitations of the project lead to the adoption of standard solutions to be utilized by clients with different profiles. Besides that, there are various legal and urban parameters by the City Director Plan showing elements of great influence in the final solution adopted by the mentioned edifices. Moving to this subject in general, this project is focused on the case study of the Ed. Ville de Montpellier, having as a base of Post Occupancy Evaluation (POE), considered an efficient tool to analyze and keep up with the progress of the construction of the building, including technical approvals, the application of surveys with the local residents and the creation of informal interviews. The data shows that with time some items that initially motivated the acquisition of the realestate property (with a social common area) move to being less valued, and that the residents quickly alter the pre constructed space, thus seeking to alter the property in a more personal and conforming manner. The possibility of a new emphasis for projects on the mentioned space should also be in discussion, the created project calls for the attention of projected conceptual aspects and interdependence within project and construction which permits the indication of some recommendations for the projection of multifamily residential buildings within the studied realm

O teatro do oprimido e sua contribuição na formação da criança com transtorno do déficit de atenção com hiperatividade

This research investigates and reports the contributions of the Theatre of the Oppressed and its techniques as a therapeutic resource in the education of children with Attention Deficit Disorder with Hyperactivity. In the first chapter organize one studying theoretical seeking to conceptualize and understand the Learning, Attention Deficit Hyperactivity Disorder, seeking to better understand the behavior and the behavior of children with ADHD. Researching on the symptoms, causes and effects of this syndrome. Trace a relationship between familyschool- specialists in an attempt to prove the importance of family support in the teachinglearning process and treatment of these children. In the second chapter start conceptualizing theater, the relationship between work-Theatre-Education Therapy, explain the difference between the theatrical stage and the therapeutic stage. Account the importance of theater games in the classroom and its contribution to social and educational training of the child. Justify the choice of the Theatre of the Oppressed recognizing him as the primary method for this research, because it is a set of exercises, games and techniques that help the child regain equilibrium relations, developing autonomy, encourages creativity and spontaneity, freeing them from their oppression. Besides being an efficient transformation behavior, improving behavior, allowing the inclusion of children in society. It is verified the effectiveness of the method and techniques in their work with children Municipal School Professor. Antonio Severiano in Natal / RN, allowing these children develop body awareness, working senses, thought, memory, inhibition, teaching to expose your point of view, understand and deal with their emotions, respecting its limits and develop their motor and cognitive skills