Desmame em recém-nascidos de muito baixo peso ao nascer no primeiro retorno ambulatorial após a alta hospitalar

Investigate intrahospital and neonatal determinants associated to the weaning of very low birth weight (VLBW) infants. Methods: 119 VLBW (<1500g) infants 81 were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Results: Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB) and 66 (75%) were weaned (partial breastfeeding or formula feeding). Univariate analysis found an association between weaning and lower birth weight, longer stays in the NICU and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. Conclusion: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants

Tratamento de fístulas enterocutâneas através de sistema a vácuo com alta pressão e dieta oral normal

Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/mortality, and increase in hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. Normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after five days, 16(22%) after 10 days and 4(5%) after 15 days. Treatment failed in 6(8%) patients, who subsequently underwent surgery. Only one patient with low-output did not close her fistula. The cost of the treatment was US$ 41.75/day and it was considered cost effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns

Desenvolvimento e validação de método analítico para determinação de teor de ácido gálico e catequina no fitoterápico sanativo® por cromatografia líquida de alta eficiência

The herbal medicine Sanativo® is produced by the Pernambucano Laboratory since 1888 with indications of healing and hemostasis. It is composed of a fluid extract about Piptadenia colubrina, Schinus terebinthifolius, Cereus peruvianus and Physalis angulata. Among the plants in their composition, S. terebinthifolius and P. colubrina have in common phenolic compounds which are assigned most of its pharmacological effects. The tannins, gallic acid and catechin were selected as markers for quality control. The aim of this study was the development and validation of analytical method by HPLC/UV/DAD for the separation and simultaneous quantification of gallic acid (GAC) and catechin (CTQ) in Sanativo®. The chromatographic system was to stationary phase, C-18 RP column, 4,6 x 150 mm (5 mm) under a temperature of 35 ° C, detection at 270 and 210 nm. The mobile phase consisted of 0.05% trifluoroacetic acid and methanol in the proportions 88:12 (v/v), a flow rate of 1 ml/min. The analytical method presented a retention factor of 0.30 and 1.36, tail factor of 1.8 and 1.63 for gallic acid and catechin, respectively, resolution of 18.2, and theoretical plates above 2000. The method validation parameters met the requirements of Resolution n º 899 of May 29, 2003, ANVISA. The correlation coefficient of linear regression analysis for GAC and CTQ from the standard solution was 0.9958 and 0.9973 and when performed from the Sanativo® 0.9973 and 0.9936, the matrix does not interfere in the range 70 to 110 %. The limits of detection and quantification for GAC and CQT were 3.25 and 0.863, and 9.57 and 2.55 mg/mL, respectively. The markers, GAC and CQT, showed repetibility (coefficient of variation of 0.94 % and 2.36 %) and satisfactory recovery (100.02 ± 1.11 % and 101.32 ± 1.36 %). The method has been characterized selective and robust quantification of GAC and CTQ in the Sanativo® and was considered validated

Nanopartíulas de magnetita com oxacilina obtida por moagem de alta energia para aplicações biomédicas

The drug targeting has been the subject of extensive studies in order to develop site-specific treatments that minimize side effects and become more effective anticancer therapy. Despite considerable interest in this class, drugs like antibiotics also have limitations, and have been neglected. Using new pharmaceutical technologies, the use of magnetic vectors appear as promising candidate for drug delivery systems in several studies. Small magnetic particles bound to the drug of interest can be modulated according to the orientation of a magnet outside the body, locating and holding in a specific site. In this work, we propose the use of High Energy Milling (HEM) for synthesis of a magnetic vector with characteristics suitable for biomedical applications by intravenous administration, and for the formation of an oxacillin-carrier complex to obtain a system for treating infections caused by Staphylococcus aureus. The results of the variation of milling time showed that the size and structural properties of the formed material change with increasing milling time, and in 60 hours we found the sample closest to the ideal conditions of the material. The vector-drug system was studied in terms of structural stability and antimicrobial activity after the milling process, which revealed the integrity of the oxacillin molecule and its bactericidal action on cultures of Staphylococcus aureus ATCC

Visões da cidade : da cidade histórica aos bairros da Cidade Alta e Ribeira em Natal-RN

The present work is an initiative of undertaking a perspective that values the aspects of the city in its diversity. The one that t intends is to discuss the urbanity starting from the aspect of the image, of the history, and about main point, to value the point of the individual's view that lives the urban space in its more several configurations: the house, the street, the neighborhood, and the city in wider scale. The described historical research defines the city as space of the human accomplishments. When analyzing the moments of the most recent history of the urban life the modernity/post-modernity notions they are explored in the sense of illuminating the wealth, continuity and it breaks of patterns of behavior, and on the other hand, to describe a I overfly in the several times of the city. The prominences of aspects of the archaeology and of the descriptive resource they are related, for its time, the most punctual perspective of the practical research, the instance of the neighborhood, specifically High City and Riverside, configuring an immersion in the daily more punctual of the city, valuing forms of being, aiming the perspective of the personal computer as point-of-view. The images of the city assume the paper of representing the documental about the current features of the urbanity. It is without a doubt that at the present time the photographic image already possesses a paper of prominence it is as research instrument, be as main source for a work on files of photos. The photographic images in the present work possess a prominence place, focusing specific places of the city in the time. Finally, the individual's voice valued under the perspective on as the person's knowledge that inhabits and live the urbanity he/she understands the knowledge of the life in the city and, more than in any other place, a middle where the loss of action models is pointed very easily tends in view the dynamic movement of the practices and renewal of new indications; in the same space in that becomes urgent to build marks starting from which the individual can shimmer the future. And in that space the individual's voice is valued as rich source of information on living the scenery of conflicts of the present time

Aqui, todo mundo é da mesma família : parentesco e relações étnicas entre os ciganos na cidade alta, Limoeiro do Norte CE

This study aims to understand how facing a context of Constant interaction whit the local population, the gypsies family Alves dos Santos, neighborhood residentes in uptown, Limoeiro do Norte Ce, maintain a sense of ethnic belonging. To that end, I analyze both the social relations between Gypsies and non-gypsies community, as it is from the contact that the social boundaries are delineated, as the discourses and social representations that are used to qualify them from stigma. So, I found that grounded in the notion of family, gypsies are seen as a group, searching the history / past nomadic origing and blood common elements that underlie its condition, and the language a cultural trait that makes it possible to establish objective distinctions among gypsies and other community residentes, becoming thus a diacritical mark.

Entre a potência e o ato: atitudes políticas e percepções de mobilização em Natal e Porto Alegre

The recent democratic process in Brazil made it as element for its consolidation the idea of participation. It requires a state model that included on its agenda democratic society participation in decision-making process, and a society that has as a principle based participatory civic consciousness. Therefore, this study aims to analyze the level of political participation in two Brazilian state capitals , Natal and Porto Alegre. Data were obtained through quantitative data from the application of 384 questionnaires in both capitals. We chose some variables that will form the basis for our study; Duties of a good citizen, a good citizen rights, Confidence, Index of socialization, exposure to media, degree of interest in politics; Mobilization; Associations. Already qualitative research sought to address the political, cultural and institutional of the two municipalities

Análise dos remanescentes de mata atlântica do Estado do Rio Grande do Norte : uma perspectiva em alta resolução

The habitat loss and fragmentation are considered the main threats to the biodiversity. These threats operate at the landscape level, which drives the need to manage entire landscapes, not just its components. Although systematic monitoring of the Atlantic Forest biome has been ongoing since the late eighties, current data on forest fragmentation for the sub-region of Pernambuco are practically nonexistent. This study aimed to map out, with high spatial resolution, the remnants of Atlantic forest in Rio Grande do Norte, and conduct a landscape level analysis. The results show that the landscape is highly fragmented, where about 13.6% to 17% of biome remains. Most of the fragments is less than 10 ha, while a few fragments have area larger than 100 ha. Although the high degree of fragmentation, the average distance between fragments found was small (128 m), this estimate is lower than has been observed for the biome (1440m). There is evidence that abrupt changes in the quantification of landscape structure can occur when one observes the fragmentation at high spatial resolution. The results presented here can be used in management actions, in order to make the scenario more conducive to maintaining biodiversity.

Efeitos da laserterapia de baixa potência sobre a fadiga do músculo quadríceps de indivíduos jovens

The objective of this study was to evaluate the effect of low laser power on the performance of anaerobic endurance of the quadriceps muscle in young subjects. Low-level laser therapy (LLLT) appears to decrease some indices of muscle fatigue. Most of these effects may be due to the influence of the laser on the muscles predominantly aerobic. Animal studies and clinical trials have already shown that the laser can improve the efficiency of mitochondrial metabolism for the resynthesis of adenosine triphosphate and thus slow down - or minimize, the deleterious effects of muscle fatigue. This research was characterized as an experimental study of the controlled clinical trial, randomized, blinded, attended by 93 volunteers, military, with ages between 18 and 19 years. The subjects were randomly allocated into three groups: Control (G1), Placebo (G2) and Laser (G3). All volunteers underwent an anthropometric assessment and a protocol Fatigue. This protocol was applied to an initial assessment (AV-1) for the collection of baseline data, and a final evaluation (AV-2). As the study variables, we used the blood lactate concentrations and indices of muscle power, as average power and peak velocity. The fatigue protocol consisted of a test of speed with twenty repetitions, performed on an exercise machine leg press 45º . In conclusion, it was found that, in this study, LLLT caused a significant increase in the Average of the Averages Powers, phase eccentric exercise in leg press 45º performed by young individuals

Efeitos agudos da aplicação do laser de baixa potência sobre o desempenho neuromuscular do sóleo em sujeitos saudáveis

A laserterapia de baixa potência (LBP) tem demonstrado recentemente ser capaz de aumentar a resistência à fadiga, bem como potencializar o desempenho neuromuscular através de seus efeitos metabólicos e fotoquímicos. Estudos anteriores mostraram que o LBP reduziu o estresse oxidativo do exercício, promovendo um retardo da fadiga muscular e minimizando seus efeitos deletérios. O objetivo desse estudo foi avaliar se a aplicação do LBP antes de um protocolo de fadiga teria efeito sobre o desempenho neuromuscular nas variáveis eletromiográficas e dinamométricas do músculo sóleo em sujeitos saudáveis. Esta pesquisa caracterizou-se como um estudo experimental do tipo ensaio clínico controlado, randomizado e cego, no qual participaram 60 voluntários de ambos os sexos, com faixa etária entre 18 e 28 anos e fisicamente ativos, segundo o questionário internacional para a prática de atividade física (IPAQ). Os sujeitos foram alocados randomicamente em três grupos: Controle (G1), Placebo (G2) e Laser (G3) e todos os voluntários foram submetidos a uma avaliação inicial (AV-1), um Protocolo de Fadiga e uma avaliação final (AV-2), compostas por contrações isocinéticas para flexão plantar a uma velocidade de 90°/s. Os resultados encontrados nesse estudo mostraram que não houve diferença estatística entre os três grupos da pesquisa nas variáveis eletromiográficas de RMS e Frequência Mediana, contudo, em relação à dinamometria, o grupo que recebeu a aplicação do Laser obteve um índice de fadiga significativamente menor (p=0,04) quando comparado aos grupos Controle e Placebo. Além disso, a aplicação do laser pré-exercício também resultou em um aumento nas variáveis de desempenho potência e trabalho. Com isso, pode-se concluir que o LBP foi capaz de melhorar o desempenho do sóleo em sujeitos saudáveis, justificado pelo aumento da resistência à fadiga

Sensibilidade interoceptiva e respostas psicofisiológicas ao exercício submaximo

The complex human behavior related to exercise involves cognitive, physical and emotional processing. The recent theories about exercise s intensity regulation have highlighted the role played by psychophysics aspects in controlling exercise s intensity. In this regard, recent evidences have shown that there is variability in human capacity in perceiving interoceptives clues. Thus, subjects more sensitive show higher physiological arousal to physical and/or emotional stress, and sensations with higher intensity. In fact, studies have evidenced that interoceptive feedback modifies behavior in exercise with free load. However, exercise recommendations are based in a constant load standard. Therefore, we aimed to analyze the influence of interoceptive sensibility on psychophysics responses during dynamic exercise performed with constant load. Twenty-four adult males were allocated into two groups accordingly with their interoceptive sensibility: high sensibility (n=11) and low sensibility (13). They underwent to an incremental test (IT) and then randomly to two sections of moderate and severe exercise intensity for 20 minutes. Heart rate (HR), rating of perceived exertion (RPE), affective feelings (AF), alert state (AS), and percentage of associative thoughts were collect during exercise. A two-way ANOVA with repeated measures was used to assess differences between psychophysics responses. There were differences between group in RPE, AF, and AS in moderate intensity. There was no difference in any measure in severe intensity. We conclude that subjects with high interoceptive sensibility feel dynamic moderate exercise more intense than the subjecs with low interoceptive sensibility

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Controle Adaptativo Robusto para Filtros Ativos de Potência Paralelo

Conventional control strategies used in shunt active power filters (SAPF) employs real-time instantaneous harmonic detection schemes which is usually implements with digital filters. This increase the number of current sensors on the filter structure which results in high costs. Furthermore, these detection schemes introduce time delays which can deteriorate the harmonic compensation performance. Differently from the conventional control schemes, this paper proposes a non-standard control strategy which indirectly regulates the phase currents of the power mains. The reference currents of system are generated by the dc-link voltage controller and is based on the active power balance of SAPF system. The reference currents are aligned to the phase angle of the power mains voltage vector which is obtained by using a dq phase locked loop (PLL) system. The current control strategy is implemented by an adaptive pole placement control strategy integrated to a variable structure control scheme (VS-APPC). In the VS-APPC, the internal model principle (IMP) of reference currents is used for achieving the zero steady state tracking error of the power system currents. This forces the phase current of the system mains to be sinusoidal with low harmonics content. Moreover, the current controllers are implemented on the stationary reference frame to avoid transformations to the mains voltage vector reference coordinates. This proposed current control strategy enhance the performance of SAPF with fast transient response and robustness to parametric uncertainties. Experimental results are showing for determining the effectiveness of SAPF proposed control system

Implementação de um algoritmo para a análise de curtos-circuitos de alta impedância baseado no fluxo de carga soma de potências

This work has as main objective to show all the particularities regarding the Three-phase Power Summation Method, used for load flow calculation, in what it says respect to the influence of the magnetic coupling among the phases, as well as to the losses presented in all the existent transformers in the feeder to be analyzed. Besides, its application is detailed in the study of the short-circuits, that happen in the presence of high impedance values, which possess a problem, that is its difficult detection and consequent elimination on the part of common devices of protection. That happens due to the characteristic presented by the current of short¬ circuit, in being generally of the same order of greatness that the load currents. Results of simulations accomplished in several situations will be shown, objectifying a complete analysis of the behavior of the proposed method in several types of short-circuits. Confront of the results obtained by the method with results of another works will be presented to verify its effectiveness

Técnica de controle adaptativo robusto aplicada a filtros ativos de potência e paralelo

The Methods for compensation of harmonic currents and voltages have been widely used since these methods allow to reduce to acceptable levels the harmonic distortion in the voltages or currents in a power system, and also compensate reactive. The reduction of harmonics and reactive contributes to the reduction of losses in transmission lines and electrical machinery, increasing the power factor, reduce the occurrence of overvoltage and overcurrent. The active power filter is the most efficient method for compensation of harmonic currents and voltages. The active power filter is necessary to use current and voltage controllers loop. Conventionally, the current and voltage control loop of active filter has been done by proportional controllers integrative. This work, investigated the use of a robust adaptive control technique on the shunt active power filter current and voltage control loop to increase robustness and improve the performance of active filter to compensate for harmonics. The proposed control scheme is based on a combination of techniques for adaptive control pole placement and variable structure. The advantages of the proposed method over conventional ones are: lower total harmonic distortion, more flexibility, adaptability and robustness to the system. Moreover, the proposed control scheme improves the performance and improves the transient of active filter. The validation of the proposed technique was verified initially by a simulation program implemented in C++ language and then experimental results were obtained using a prototype three-phase active filter of 1 kVA