Desfechos clínicos e mortalidade de sujeitos submetidos à cirurgia bariátrica no Rio Grande do Norte

Introduction: Actually the obesity is a public health problem throughout the world. Bariatric surgery has been an efficient method of weight reduction body in severe obesity, reducing its associated effects and presenting low levels of immediate and late postoperative complications. In Brazil, bariatric surgery asa recent therapeutic that has been growing recently. Being Brazil a country with continental dimensions and with a huge diversity socioeconomic and cultural, it is essential to understand the reality of patients undergoing bariatric surgery in less economically privileged regions of Brazil. Objectives: To evaluate the epidemiological, clinical outcomes and mortality of patients undergoing videolaparoscopic bariatric surgery through the public health system in the Brazilian state of Rio Grande do Norte- Brazil. Methods: Observational descriptive study of a prospective, carried out from February 2009 to February 2011, the Clinic Obesity and Bariatric Surgery at Universitary Hospital Onofre Lopes - Federal University of Rio Grande do Norte (HUOL-UFRN). Anthropometric measures, comorbidity and deaths register were made in the postoperative period. Results: Seventy patients (54 women) with low income aged 22 to 63 years completed the study. We recorded the death of three patients during the study period. The results show significant decrease anthropometric parameters, especially in relation to body weight, waist circumference and hipin both sexes. Only Waist / Hip ratio showed no difference after intervention in male patients It had a resolution of comorbidities. No significant differences in reports of daily sleepiness and the snoring male patients. Conclusion: Our findings attest laparoscopic bariatric surgery as an effective method reducing weight and comorbidities in morbidly obese patients

Disfunção sexual feminina e níveis dos hormônios esteroidais em mulheres obesas atendidas no ambulatório de cirurgia bariátrica do hospital universitário Onofre Lopes em Natal/RN

A disfunção sexual corresponde a alterações em uma ou mais fases da resposta sexual humana e apresenta maior prevalência na população feminina. Ademais, a participação de alguns fatores como obesidade e níveis dos hormônios esteroidais na disfunção sexual feminina (DSF) permanece incerta. O presente estudo deteve-se na análise da ocorrência de DSF numa população de mulheres portadoras de obesidade, cadastradas no Ambulatório de Cirurgia Bariátrica do Hospital Universitário Onofre Lopes, da Universidade Federal do Rio Grande do Norte, no município de Natal, RN. O estudo foi realizado em uma amostra composta por trinta e uma mulheres, com idade entre 20 e 50 anos, com índice de massa corpórea (IMC) > 30 Kg/m2. A todas as pacientes foi aplicado um questionário composto por uma seção com dados socio-econômicos, e outra abordando a saúde sexual feminina, sendo esta última correspondente ao Female Sexual Function Index (FSFI), para diagnóstico de DSF. A partir dessa caracterização, as pacientes foram reunidas nos grupos CD (pacientes com disfunção, n= 9) e SD (sem disfunção, n= 22). Para a análise do efeito da obesidade na DSF, as pacientes foram reunidas nos grupos 1 (6 pacientes com IMC grau I e II: entre 30 e 40 Kg/m2) e 2 (25 com IMC grau III: acima de 40). Para o estudo da participação dos hormônios esteroidais foram determinadas as concentrações séricas de cortisol, estradiol e dehidroepiandrosterona (DHEA) pelo método de quimiluminescência. A análise estatística dos dados foi realizada usando os testes ANOVA, MANOVA (Pillai), além de análise de Cluster. Para identificar as diferenças entre os domínios do FSFI, foi usado o teste T de Student. A significância considerada para todos os testes foi para p< 0,01. Das pacientes estudadas, 25,8% apresentaram DSF de acordo com o escore total do FSFI. A análise estatística posterior evidenciou que as diferenças ocorreram para os domínios desejo, excitação e orgasmo. Não foi encontrada relação da presença de DSF com os diferentes graus de obesidade ou com os níveis hormonais dos esteróides cortisol, estradiol ou DHEA. Contudo, foi encontrado aumento significativo nos níveis séricos de estradiol para o grupo 1, que corresponde ao de menor índice de IMC. Estes resultados mostram que a prevalência de DSF não diferiu entre os graus I,II e III de obesidade das pacientes deste estudo mas, quando presente, a disfunção ocorre nos domínios desejo, excitação e orgasmo. A maior concentração de estradiol encontrada nas pacientes de menor índice de IMC sugere uma possível relação entre as duas variáveis que precisa ser investigada em estudos futuros.

Evidências de validade do Millon Behavioral Medicine Diagnostic (MBMD) na avaliação psicológica de candidatos à cirurgia bariátrica

the Millon Behavioral Medicine Diagnostic is an instrument, developed from a consensus among health professionals, to identify psychological factors that may compromise the conducting of medical treatment in order to allow a better adhesion. As it has been one of the most used tools to assess bariatric surgery, the objective of this research is to verify the evidence validity of Millon Behavioral Medicine Diagnostic (MBMD) for psychological assessment of candidates for bariatric surgery. Method: males and females volunteers, aged 18 to 70, grouped in 150 patients admitted for surgical procedures or suffering from chronic diseases (control group) and 426 patients candidates for bariatric surgery, contacted in person or by the internet. For the study in the face group were also administered Millon Index of Personality Styles (MIPS), the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the General Health Questionnaire of Goldberg, just in bariatric surgery patients. Results: there are indicators of semantic adaptation of the instrument, with 27 factors in five areas of the instrument, all with satisfactory levels of validity. The reliabitity indicators were satisfactory in 18 of the 32 scales that comprise the MBMD, while relations with the other three instruments showed significant variations compared to the original indicators. The MBMD was sensitive to differences between groups about gender, age, education, marital status, body mass index, comorbidities and chronic disease patients and with or without obesity. The use of this instrument in the assessment of candidates for bariatric surgery presents indicators of validity in view the limitations as to the realiability of certain scales

Cenário da produção acadêmica em história da matemática no ensino de matemática: uma análise reflexiva das teses e dissertações (1990-2010)

This research aims to make a reflective analysis about the academic production originated in the stricto sensu post graduation programs in the country, produced in the period of 1990 to 2010, in the field of History of Mathematics, especifically on works about the History of Mathematics in Mathematics education and that present pedagogical proposals that make use of the History of Mathematics in order to teach Mathematics. Defending the thesis that the researches on mathematics education with goals turned to the use of didactic proposals related to the history of mathematic that take in consideration the coherency between epistemological aspects inherent to mathematics history and anthological elements materialized on the conceptions of mathematics and mathematics history and of apprenticeship (implicitly or explicitly exposed) may originate significant contribution to the field of history of mathematics on education. Among these, nine were Master’s Degree dissertations and five PHD’s theses. The reflective analysis was accomplished from two matrixes; one from theoretical nature and the other, ontologic nature, elaborated from the pretexts of Sanches Gamboa, about the epistemological analysis from academic production in the field of Mathematics Education and the following theoretical perspectives in the field of History of Mathematics Education, that are: linear evolutionary theory, structural construtivist operative, evolutionary discontinuous, historical and socialcultural investigation and the use of activities estimulating the usage of verbal and nonverbal expressions. These perspectives were based on the works of Miguel and Miorim, Mendes and Radford. As results, we have detected some established dissonances between the categories related to theoretical and ontologic levels and the pedagogical proposal presented in these researches. On the other hand, we have discovered works that are able to establish consonances between the theoretical and ontological elements and the presented pedagogical proposal. These works carry significative contributions to the field of History of Mathematics applied to Mathematics pedagogical practice, inclusively presenting significative theoretical elements to the production of knowledge recognized as scientific in the Mathematics field

Características psicológicas do paciente obeso grave e suas implicações pós-operatórias na cirurgia bariátrica

Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach – Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compulsão Alimentar Periódica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group – and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.

Prevalência e fatores associados à diminuição da função pulmonar em obesos em pré-operatório de cirurgia bariátrica

Introduction: Obesity shows changes in pulmonary function and respiratory mechanics, however, little is known regarding the prevalence of worsening respiratory function when considering the increase in central or peripheral adiposity or general obesity. Objectives: To analyze the association between anthropometric adiposity and decreased lung function in obese. Materials and Methods: Patients eligible for this study obese individuals (IMC≥30kg/m2) in pre-bariatric surgery and referred for Treatment Clinic of Obesity and Related Diseases, located at the University Hospital Onofre Lopes (HUOL), from October 2005 and July 2014. The evaluation included clinical information and measurement of anthropometric measures (body mass index (BMI), body fat index (BFI) and waist circumference (WC) and neck (NC)) and spirometric. The prevalence and analysis by Poisson regression was performed considering the following outcome variables: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and Maximum Voluntary Ventilation (MVV) and as predictor variables were considered: BMI, IAC, WC and NC and as control variables: age, gender, smoking history and comorbidities (diabetes mellitus, dyslipidemia and hypertension). Statistical analysis was performed using Statistical Package for Social Sciences software (SPSS - version 20.0). Results: We analyzed 384 individuals, 75% women, mean BMI: 46.6 (± 8.7) kg/m2, IAC: 49.26 (± 9.48)%, WC: 130.84 (± 16.23) cm and NC: 42.3 (± 4.6) cm. The higher prevalence of FVC and FEV1 <80% was observed in individuals with NC above 42 cm, followed those with a BMI above 45 kg/m2. Multivariate analysis using Poisson regression showed as risk factors associated with FVC <80%, the variables: NC above 42 cm (odds ratio (OR) 2.41) and BMI over 45Kg/m2 (OR 1.71 ). As for FEV1 <80% predicted, all predictor variables were associated, with the largest odds presented by the NC (3.40). MVVV was not associated with any studied varaible. Conclusion: Individuals with NC above 42 cm had higher prevalence of reduced lung function and the NC was the measure with the highest association with reduced lung function in obese.

Resumo de dissertações e teses: a estrutura composicional à luz da Análise Textual dos Discursos

This doctoral dissertationproposes the description, interpretation and analysis of the compositional structure of thesis and dissertation abstracts, with regard to the linguistic mechanisms that evidence text zones of different typological sequences, such as those of the text plan. Along these lines, the research problem was developed from the notion of compositional structure (sequences and text plans), as one of the levels or plans of text analysis, according to the theoretical framework proposed by Jean-Michel Adam (2011a). The main objective of this study was to recognize how the compositional structure, of thesis and dissertation abstracts, is achieved, with respect to text units and the global organization of this text category. The hypothesis posed in this research posits that specific informational text composition categories of abstracts are necessary to process the representation of the original text and the way in which it makes its meaning. Subsequently, this study is based on the theoretical and methodological framework of Text Linguistics (TL) and, above all, Textual Discourse Analysis (TDA), as we endeavor to understand the organizational structure of abstracts from both a linguistic and textual perspective. This structure involves the text plan of abstracts, with respect to their communicative purpose, i.e, the sharing of scientific information in its standard textual form. Thus, the development of this study, from a theoretical and methodological perspective, is based on the theoretical and descriptive premises from TDA (ADAM, 2011a, 2012; PASSEGGI et al., 2010), and also from TL (BEAUGRANDE; DRESSLER, (2012 [1981]); COSERIU; LAMAS (2010); MARCUSCHI, 2009 [1983]; FÁVERO; KOCH, 1994;KOCH, 2006; BENTES, 2004; BENTES; LEITE, 2010), within the field of text studies. The methodology of this study relies on empirical, documental research, which is qualitative, and adopts a descriptive and interpretive approach. From the empirical perspective, our objective is to understand the problems pertaining to the textual composition of abstracts, aiming to elucidate them in light of the theoretical and methodological framework previously mentioned. The corpus of the analysis is comprised of seven abstracts designated for systematic data collection. These texts, written between 2004 and 2011,were selected from Master’s theses and Doctoral dissertations in their electronic version, from the graduate program at the Federal University of Rio Grande do Norte. A thorough review of the literature reveals a clear fluctuation in the terminology of the concept, ‘abstract’. The results of the analysis revealed that the abstracts, which comprise the corpus of analysis in this study, in general, present typological heterogeneity, while the text plan remains fixed. Finally, the new knowledge gained in this research contributes both to the understanding of the compositional structure of abstracts as well as their production.

Avaliação da imagem corporal de mulheres submetidas à cirurgia oncológica mamária

Breast cancer is the second type of cancer that affects more women of reproductive age in Brazil. Surgical treatments include: conserving surgery or mastectomy. Aimed to evaluate body image of women undergoing breast cancer surgery, based on the scale Body Image After Breast Cancer Questionnaire. It is a descriptive, exploratory, transversal, with a quantitative approach. Data were collected in Norte-riograndense League Against Cancer, between the months from March to May 2015, after consideration of the Research Ethics Committee of that institution CAEE 35155714.1.0000.5293. The study population consisted of women undergoing breast onco-surgery. To calculate the sample considered the finite population, totaling 120 subjects, collected four guys the most. Data were analyzed by the software Statistical Package for Social Sciences version 20.0. The domain scores of the scale were evaluated using descriptive and inferential statistics. The surgical group mastectomy without reconstruction showed greater impairment of body image in the field "vulnerability", "Care for the body" and "transparency" in relation to other surgical types, and suggests susceptibility to cancer, body appearance and worry that disturb other. The Kruskal-Wallis test showed greater dissatisfaction with body image in the fields "body Stigma" and "transparency" to the radical neoplastic surgery over other surgical types. Dissatisfaction with body image and physical appearance was detected in this study in all six image fields present in scale, with emphasis on the "body Stigma" and "Transparency". This means that the body image disorder is formulated based on the perception of others about themselves and not by perception "self", which justifies the concern with appearance, with body and hide the consequences stemmed cancer. It is expected that the data obtained from the evaluation of body image presented in this study contribute to enable the assistance to oncocirurgiada woman breast integral, essential for the practice of Nursing.

Avaliação da imagem corporal de mulheres submetidas à cirurgia oncológica mamária

Breast cancer is the second type of cancer that affects more women of reproductive age in Brazil. Surgical treatments include: conserving surgery or mastectomy. Aimed to evaluate body image of women undergoing breast cancer surgery, based on the scale Body Image After Breast Cancer Questionnaire. It is a descriptive, exploratory, transversal, with a quantitative approach. Data were collected in Norte-riograndense League Against Cancer, between the months from March to May 2015, after consideration of the Research Ethics Committee of that institution CAEE 35155714.1.0000.5293. The study population consisted of women undergoing breast onco-surgery. To calculate the sample considered the finite population, totaling 120 subjects, collected four guys the most. Data were analyzed by the software Statistical Package for Social Sciences version 20.0. The domain scores of the scale were evaluated using descriptive and inferential statistics. The surgical group mastectomy without reconstruction showed greater impairment of body image in the field "vulnerability", "Care for the body" and "transparency" in relation to other surgical types, and suggests susceptibility to cancer, body appearance and worry that disturb other. The Kruskal-Wallis test showed greater dissatisfaction with body image in the fields "body Stigma" and "transparency" to the radical neoplastic surgery over other surgical types. Dissatisfaction with body image and physical appearance was detected in this study in all six image fields present in scale, with emphasis on the "body Stigma" and "Transparency". This means that the body image disorder is formulated based on the perception of others about themselves and not by perception "self", which justifies the concern with appearance, with body and hide the consequences stemmed cancer. It is expected that the data obtained from the evaluation of body image presented in this study contribute to enable the assistance to oncocirurgiada woman breast integral, essential for the practice of Nursing.

Avaliação clínica e da qualidade de vida utilizando dois protocolos para recuperação miofuncional em pacientes que se submeteram à cirurgia ortognática: resultados preliminares

The objective of this randomized, blind and prospective clinical trial was to compare the pain, the edema, the mandibular movements, the masticatory efficiency and life quality, in the first 60 days after surgery using 2 different clinical protocols for myofunctional recovery, in patients who underwent orthognathic surgery. A sample of 19 patients was used and divided into 2 groups. The control group (CG) consisted of 10 patients who had postoperative rehabilitation guided by a standard protocol, conducted by the Service of Surgery and Traumatology Oral and Maxillofacial. In other hand, the experimental group (EC) totaled 9 patients who received the speech therapy rehabilitation protocol specialized, by professionals in the area. The variables pain, edema and mandibular movements were analyzed during 48h, 96h, 7 days, 14 days, 30 and 60 days post-surgery. The masticatory efficiency and the quality of life were classified with 60 days after surgery . The data were submitted an analysis of variance, Student's t-test and Fisher's independence, at the level of 5% probability. It was identified that patients of GE have benefited in the first 14 days(p<0,001), as they have had reported less pain than those in the CG. Significant statistics differences between groups for pain parameters (after 14 days) (p=0,065), edema(p=0,063), mandibular movements(p=0,068), masticatory efficiency(p=0,630) and the impact on quality of life (p=0,813) were not observed on this study. The speech therapy protocol for myofunctional recovery (EG), although it has not obtained statistical results superiors than the CG in the general context, presents itself as a viable alternative to conventional therapy assumed by many maxillofacial surgeons, allowing the surgeon to optimize time with patients in the period postoperatively.

Avaliação do banco de dissertações e teses da associação brasileira de antropologia: uma análise cienciométrica

VITULLO, Nadia Aurora Vanti. Avaliação do banco de dissertações e teses da Associação Brasileira de Antropologia: uma análise cienciométrica. 2001. 143 f. Dissertaçao (Mestrado) - Curso de Mestrado em Biblioteconomia e Ciência da Informação, Pontifícia Universidade Católica de Campinas, Campinas, 2001.

Biblioteca digital de teses e dissertaçoes: uma referência fundamental

OLIVEIRA, Raimundo Muniz de. Biblioteca digital de teses e dissertaçoes: uma referencia fundamental. In: CINFORM ENCONTRO NACIONAL DE ENSINO E PESQUISA DA INFORMAÇAO,HUMANISMO E DESENVOLVIMENTO CIENTIFICO E TECNOLOGICO,7.,2007,Salvador. Anais...Salvador:UFBA, 2007.Disponivel em:www.cinform.ufba.br>. Acesso em: 27 set. 2007. Acesso em: 27 set. 2010.

Bibblioteca Digital de Teses e Dissertações: uma estratégia de preservação digital

CUNHA, Jacqueline de Araújo. Biblioteca Digital de Teses e Dissertações: uma estratégia de preservação da memória científica. 2009. 141f. Dissertação (Mestrado)- Programa de Pós-Graduação em Ciência da Informação. Universidade Federal da Paraíba, João Pessoa, 2009.

Biblioteca Digital de Teses e Dissertações: grau de utilização pelos mestrandos do curso de Ciência da Informação das Universidades Públicas Brasileiras

A pesquisa aborda o uso das Tecnologias de Informação e Comunicação, que vem revolucionando as atividades e ocasionando muitas mudanças relacionadas ao acesso e uso de informações. O objetivo foi analisar o grau de utilização do conhecimento científico produzido pelos Programas de Pós-Graduação das Universidades Públicas Brasileiras, através da BDTD, pelos mestrandos dos referidos programas. Nos procedimentos metodológicos realizados, procurou-se inicialmente analisar o amplo espectro da população do corpus da pesquisa. Em razão da impossibilidade de trabalhar com os Programas de Pós-Graduação como um todo, optou-se por fazer um recorte, elegendo os cursos de Pós-Graduação em Ciência da Informação, vez que estes representam o principal segmento social de interesse da pesquisa. Foi utilizado o método de estudo de usuários, onde se optou por adotar o grupo, “estudos orientados aos usuários”, que identifica as necessidades e comportamento de acesso e uso da informação. Para coletar os dados, elaborou-se um questionário semi-estruturado com 25 questões, que versavam sobre o uso, dificuldades de acesso e recuperação da informação, bem como a satisfação na utilização dessa fonte informacional. Dentre os vários resultados obtidos, podemos destacar o fato de que a maioria dos mestrandos (71,8%) só teve contato com a BDTD somente no momento em que se encontrava cursando o mestrado e, somente 24,3%, tiveram contato durante a graduação. Estes resultados representam um problema, que pode afetar o bom desempenho do projeto BDTD, o qual consiste em disseminar e divulgar a produção científica dos Programas de Pós-Graduação das Universidades Públicas Brasileiras para a sua comunidade. Foi observado também, que os mestrandos oriundos do curso de Biblioteconomia tende a ter contato com a BDTD bem mais cedo do que mestrandos de outros cursos de graduação. A fim de minimizar o problema detectado, propõe-se uma divulgação mais eficaz na graduação através de dois procedimentos: Primeiro, o docente deve fazer uma divulgação mais eficaz da BDTD junto aos discentes de todos os cursos de graduação; segundo: deverá ser feita a divulgação na mídia eletrônica, através da inserção de ícones da BDTD, nos portais dos Departamentos dos Cursos de Graduação das Universidades Públicas Brasileiras. Acredita-se que com estes procedimentos seja possível aperfeiçoar o uso dessa fonte de informação científica.

Bibliotecas digitais de teses e dissertações brasileiras: paradigma do acesso livre à informação científica

A evolução da comunicação científica ao longo do tempo e o impacto causado pela A evolução da comunicação científica ao longo do tempo e o impacto causado pela A evolução da comunicação científica ao longo do tempo e o impacto causado pela se analisar as contribuições da Biblioteca Digital de Teses e Dissertações (BDTD)para a comunicação científica atual, destacando possibilidades emergentes e desafios a serem superados. Apresenta uma breve evolução da comunicação científica ao longo do tempo; discute os impactos causados pela Internet na comunicação, disponibilização e acessibilidade de informações técnico-científicas; e caracteriza BDTD destacando os desafios a serem superados. Dentre eles estão, a questão dos direitos autorais que ocasionam a baixa adesão dos autores ao projeto piloto do IBICT para disponibilizar teses e dissertações no meio eletrônico. Para este desafio, são apontadas sugestões.