Avaliação da eficácia analgésica no pós-operatório de revascularização do miocárdio: ensaio clínico randomizado controlado

A analgesia pós-operatória eficaz é especialmente importante após cirurgias torácicas, pois, além de aliviar a dor, facilita a retomada de atividades normais, incluindo a deambulação, a respiração e a tosse. Dessa forma, os objetivos deste estudo são: avaliar a eficácia analgésica da associação entre anestesia geral e raquianestesia com morfina e ropivacaína mais esquema multimodal em relação à anestesia geral e esquema multimodal em cirurgia de revascularização do miocárdio; analisar a eficácia analgésica da injeção subcutânea de lidocaína e analgesia multimodal na remoção de tubos torácicos em cirurgia de revascularização do miocárdio. A metodologia consiste em ensaio clínico randomizado, controlado, envolvendo 58 pacientes, de ambos os sexos, com idade média de 59,8  8,9 anos, estado físico ASA II e III. Os participantes foram alocados em dois grupos, sendo o GI composto por indivíduos submetidos à anestesia geral combinada à raquianestesia com morfina 400μg e 6 ml (30mg) a 8 ml (40mg) de ropivacaína a 0,5% e analgesia multimodal; já o GII foi composto por indivíduos submetidos à anestesia geral associada à analgesia multimodal. Foi avaliada a dor, ao despertar, nas primeiras 24 horas, e ao realizar exercício respiratório, ao retirar drenos de torácicos e o tempo para extubação. A análise estatística foi realizada pelos testes do Qui-quadrado e Teste t de Student e o teste de Fisher. O resultado obtido foi o seguinte: o GI apresentou menor intensidade de dor ao despertar (p= 0,001), nas primeiras 24 horas (p= 0,001) e durante a realização dos exercícios respiratórios (p= 0,004). Houve maior necessidade de analgesia complementar no grupo GII, com maior consumo de morfina (p= 0,05), e os efeitos colaterais leves, como náuseas (p= 0,001), vômito (p= 0,002), prurido (p= 0,030), predominaram no GI. Não houve diferença estatisticamente significante entre os grupos (P= 0,47), em relação à intensidade de dor na remoção dos drenos. Após as observações feitas, o estudo sugere que a anestesia geral combinada à raquianestesia com morfina associada à ropivacaína oferece melhor efeito analgésico no pós-operatório de cirurgia cardíaca. Adicionalmente, o estudo sugere que o efeito analgésico da injeção subcutânea de lidocaína 1% associado à analgesia multimodal não é eficaz

Segurança e eficácia da tibolona na transição menopausal: um ensaio clínico randomizado, duplo-cego e controlado com placebo

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Ensaio clínico duplo-cego controlado e randômico, comparando a eficácia da Clofazimina com a Cloroquina, no tratamento das lesões cutâneas do Lúpus Eritematoso Sistêmico

PURPOSE: To evaluate the capacity of clofazimine (CFZ) to control cutaneous activity of systemic lupus erythematosus (SLE), compared with chloroquine diphosphate (CDP). METHODS: A prospective, randomized, controlled, double blind clinical trial was carried out in thirty-three patients with SLE and cutaneous lesions (malar rash and/or discoid lupus and/or subacute cutaneous lupus), after approval by the respective Ethics Committee. Sixteen patients received clofazimine - 100mg/day (CFZ group) and 17 received chloroquine diphosphate - 250mg/day (CDP group), during six months. Both groups applied broad-spectrum sunscreens twice a day. The dose of prednisone was kept stable during the study. Cutaneous lesions were evaluated by 2 blinded observers and photographed at baseline and at months 1, 2, 4 and 6. RESULTS: Thirty-three patients began and 27 completed the 6 months of treatment. The groups were homogeneous and comparable in terms of demographic and clinical characteristics. Five CFZ-patients and one CDP-patients dropped out due to severe flare of disease requiring other treatment. At the end of the study, 12 CFZ-patients (75%) and 14 CDP-patients (82,4%) presented complete or near-complete remission of skin lesions; intention-to-treat analysis showed no significant difference in the response rates between groups. Side effects in both groups were frequent, but patients didn t have to discontinue the drugs. CONCLUSIONS: Clofazimine and chloroquine were effective in controlling cutaneous lesions in SLE patients

The Beatles: ensaio sobre a ética do amor

The thesis intends to discuss the ethics by the way of love. So, it uses as a mention the musical work and the set of attitudes of the group that changed the way of thinking across the 20th Century mass-comm, entering a new way of thinking about the World: The Beatles. Analyzing the lyrics and the writing of the songs was searched the comprehension of he intrinsic love message at the Ethics it expresses. At the musical art of The Beatles political messages had been announced in a time that the World sought a Ethic way beyond the several declared war and the Cold War. Taking the Edgar Morin works as a base, O método 6, Ética (2005), it sought to understand the idea who permeates the human relations: the good, the possible, the necessary. Another works used as a cognitive base were Meus demônios (2003), Cultura de massas no Século XX: neurose (2005), Cultura de massas no Século XX (2006), The Beatles Anthology (2000) and Many years from now (2000). Holding the Ethics idea showed by Morin were established imaginary lines that perpass the behavior of the group known in the entire World understood till nowadays as tolerance, comprehension, peace, love and endurance messengers. The Beatles operate during the sixties a musical reborn, which allowed to the people the discussion and the reflexion about the World and the human being new behavior,endurance but acting with tolerance. Permeating the basic study, we find the Beatles way, the group origin, the fast walk till success, the spiritual choice, who guide their behavior and the end of the band. The music used as a masscomp instrument passes by the condition of a simple way of communicating. It deeply action feeds feelings, allows transcendence and is showed as target of human being transformation. The Ethics in music passes by the ideological barriers and becomes to comprehension with a clear synthony for the man, cause the polyphony and the new musical order establish the messages worldwide

Cola para quem tem fome: um ensaio sobre as potencialidades e limitações da sociologia da fome

This work aims to present a systematic study of sociology developed by Josué de Castro. It is a theoretical work that aims to evidence the potentialities and limitations of the hunger analysis theoretical models of contemporary sociology. It was used concepts of Social Institution (Berguer and Bourdieu), Habitus-precário and Ralé (Jessé Sousa) as weapons to comprehend better the hunger phenomenon on the sociology field, to consequently generate dialogs between Castros writings and the contemporary sociology. It demonstrates how hunger reproduces more by pre reflexive behavior patterns in a way that the moral rules become invisible and allow the phenomenon to continue in an invisible way

Max Stirner, o único e o que lhe é próprio: uma interpretação e(m) algun(s) ensaio(s)

This work has a study object the main thinking work of Johan Kaspar Schmidt well known as Max Stirner (1806-1856) - originally titled (in German), Der Einzige und sein Eigentun, and translated into Portuguese by the Portuguese publisher Antígona in 2004, under the title The Unique and its Ownership. This book was known in 1844 although its publication dated 1845 seen that the censor of that time rejected the publication request in that year - saying that ( ) in concrete passages of that work, not only God, Christ, the church and the religion are usually object of proposal blasphemy, but also because all social order, the state and the government are defined as something that should not exist simultaneously as one justifies the lie, perjury, the murder and suicide and denies the ownership right. After this first attack and rejection by its bearing the unique come to be others target, due practically to all the philosophical political thinkers its time including thinkers like Ludwig Feuerbach and Karl Marx & Friedrich Engels in spite of, on the other hand, having inspired formulations and reformulations of many of those thinkers that were against then in their times, as well as those thinkers that came after then such as Nietzsche himself. Even though this work was be victim of powerful attempts of erasing it of history, it has shown a great repercussion power and that is the main reason that led us to ask the following questions what is its big originality? , how could his author arrive at a so impactant perspective? What is its most legitimate political place? We endeavored in elaborate answers to those questions trough the exegesis of its text, taking in account both the scholarship environment where the author produced his intellectual life set - and the detailed reading of texts linked to discussion in focus, where this reading is always based upon the meaning and senses traced by the texts and its contexts as a precaution against the limits and the traps of the readings which shed light markedly on strict letter of the phrases constructs. Ours conclusions point at to the idea that a work like this , that subverts the characteristic ways of thought of the modernity, completely, continues being a utter odds, without rank in the history of thought and the moderns political practices, finding parallel possibility only, in a very special way, with a certain autharchic perspective of Ancient Greece

Estabilização de um Solo com Cimento e Cinza de Lodo Para Uso em Pavimentos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estudo de concretos de diferentes resistências à compressão submetidos a altas temperaturas sem e com incorporação de fibras de politereftalato de etileno (PET)

The reinforced concrete structures are largely used in buildings worldwide. Upon the occurrence of fire in buildings, there is a consensus among researchers that the concrete has a high resistance to fire, due mainly to its low thermal conductivity. However, this does not mean that this material is not affected by exposure to high temperatures. Reduction of the compressive strength, modulus of elasticity, discoloration and cracking, are some of the effects caused by thermal exposure. In the case of concretes with higher resistance occurs even desplacamentos explosives, exposing the reinforcement to fire and contributing to reducing the support capacity of the structural element. Considering the above, this study aims to examine how the compressive strength and porosity of concrete are affected when subjected to high temperatures. Were evaluated concrete of different resistances, and even was the verified if addition fibers of polyethylene terephthalate (PET) in concrete can be used as an alternative to preventing spalling. The results indicated that explosive spalling affect not only high strength concrete whose values of this study ranged from 70 to 88 MPa, as well as conventional concrete of medium strength (52 MPa) and the temperature range to which the concrete begins to suffer significant changes in their resistance is between 400 º C and 600 º C, showing to 600 º C a porosity up to 188% greater than the room temperature

Algoritmo SOM com estrutura hierárquica e dinâmica aplicado a compressão de imagens

ln this work the implementation of the SOM (Self Organizing Maps) algorithm or Kohonen neural network is presented in the form of hierarchical structures, applied to the compression of images. The main objective of this approach is to develop an Hierarchical SOM algorithm with static structure and another one with dynamic structure to generate codebooks (books of codes) in the process of the image Vector Quantization (VQ), reducing the time of processing and obtaining a good rate of compression of images with a minimum degradation of the quality in relation to the original image. Both self-organizing neural networks developed here, were denominated HSOM, for static case, and DHSOM, for the dynamic case. ln the first form, the hierarchical structure is previously defined and in the later this structure grows in an automatic way in agreement with heuristic rules that explore the data of the training group without use of external parameters. For the network, the heuristic mIes determine the dynamics of growth, the pruning of ramifications criteria, the flexibility and the size of children maps. The LBO (Linde-Buzo-Oray) algorithm or K-means, one ofthe more used algorithms to develop codebook for Vector Quantization, was used together with the algorithm of Kohonen in its basic form, that is, not hierarchical, as a reference to compare the performance of the algorithms here proposed. A performance analysis between the two hierarchical structures is also accomplished in this work. The efficiency of the proposed processing is verified by the reduction in the complexity computational compared to the traditional algorithms, as well as, through the quantitative analysis of the images reconstructed in function of the parameters: (PSNR) peak signal-to-noise ratio and (MSE) medium squared error

Compressão auto-adaptativa de imagens coloridas

Image compress consists in represent by small amount of data, without loss a visual quality. Data compression is important when large images are used, for example satellite image. Full color digital images typically use 24 bits to specify the color of each pixel of the Images with 8 bits for each of the primary components, red, green and blue (RGB). Compress an image with three or more bands (multispectral) is fundamental to reduce the transmission time, process time and record time. Because many applications need images, that compression image data is important: medical image, satellite image, sensor etc. In this work a new compression color images method is proposed. This method is based in measure of information of each band. This technique is called by Self-Adaptive Compression (S.A.C.) and each band of image is compressed with a different threshold, for preserve information with better result. SAC do a large compression in large redundancy bands, that is, lower information and soft compression to bands with bigger amount of information. Two image transforms are used in this technique: Discrete Cosine Transform (DCT) and Principal Component Analysis (PCA). Primary step is convert data to new bands without relationship, with PCA. Later Apply DCT in each band. Data Loss is doing when a threshold discarding any coefficients. This threshold is calculated with two elements: PCA result and a parameter user. Parameters user define a compression tax. The system produce three different thresholds, one to each band of image, that is proportional of amount information. For image reconstruction is realized DCT and PCA inverse. SAC was compared with JPEG (Joint Photographic Experts Group) standard and YIQ compression and better results are obtain, in MSE (Mean Square Root). Tests shown that SAC has better quality in hard compressions. With two advantages: (a) like is adaptive is sensible to image type, that is, presents good results to divers images kinds (synthetic, landscapes, people etc., and, (b) it need only one parameters user, that is, just letter human intervention is required

Compressão Seletiva de Imagens Coloridas com Detecção Automática de Regiões de Interesse

There has been an increasing tendency on the use of selective image compression, since several applications make use of digital images and the loss of information in certain regions is not allowed in some cases. However, there are applications in which these images are captured and stored automatically making it impossible to the user to select the regions of interest to be compressed in a lossless manner. A possible solution for this matter would be the automatic selection of these regions, a very difficult problem to solve in general cases. Nevertheless, it is possible to use intelligent techniques to detect these regions in specific cases. This work proposes a selective color image compression method in which regions of interest, previously chosen, are compressed in a lossless manner. This method uses the wavelet transform to decorrelate the pixels of the image, competitive neural network to make a vectorial quantization, mathematical morphology, and Huffman adaptive coding. There are two options for automatic detection in addition to the manual one: a method of texture segmentation, in which the highest frequency texture is selected to be the region of interest, and a new face detection method where the region of the face will be lossless compressed. The results show that both can be successfully used with the compression method, giving the map of the region of interest as an input

Capacidade de absorção de energia de tubos de compósitos submetidos à compressão

Structures capable of absorbing large amounts of energy are of great interest, particularly for the automotive and aviation industries, to reduce tbe impact on passengers in the case of a collision. The energy absorption properties of composite materials structures can be tailored, thus making these structures an appealing option a substitute of more traditional structures in applications where energy absorption is crucial. ln this research, the influence of some parameters, which affect the energy absorption capacity of composite material tubes, was investigated. The tubes were fabricated by hand lay-up, using orthophthalic polyester resin and a plain weave E-glass fabric Test specimens were prepared and tested under compression load. The ínfluence of the following parameters on the specific energy absorption capacity of the tubes was studied: fiber configuration (0/90º or ± 45°), tube cross-section (circular or square), and processing conditions (with or without vacuum). The results indicated that circular cross-section tubes with fibers oriented at 0/90º presented the highest level of specific energy absorbed. Further, specimens from tubes fabricated under vacuum displayed higher energy absorption capacity, when compared with specimens from tubes fabricated without vacuum. Thus, it can be concluded that the fabrication process with vacuum produce composite structures with better energy absorption capacity

Desenvolvimento de um compósito de espuma rígida de poliuretana de mamona e fibras de sisal para isolação térmica

The search for sustainable technologies that can contribute to reduce energy consumption is a great challenge in the field of insulation materials. In this context, composites manufactured from vegetal sources are an alternative technology. The principal objectives of this work are the development and characterization of a composite composed by the rigid polyurethane foam derived from castor oil (commercially available as RESPAN D40) and sisal fibers. The manufacture of the composite was done with expansion controlled inside a closed mold. The sisal fibers where used in the form of needlepunched nonwoven with a mean density of 1150 g/m2 and 1350 g/m2. The composite characterization was performed through the following tests: thermal conductivity, thermal behavior, thermo gravimetric analysis (TG/DTG), mechanical strength in compression and flexural, apparent density, water absorption in percentile, and the samples morphology was analyzed in a MEV. The density and humidity percentage of the sisal fiber were also determined. The thermal conductivity of the composites was higher than the pure polyurethane foam, the addition of nonwoven sisal fibers will become in a higher level of compact foam, reducing empty spaces (cells) of polyurethane, inducing an increase in k value. The apparent density of the composites was higher than pure polyurethane foam. In the results of water absorption tests, was seen a higher absorption percent of the composites, what is related to the presence of sisal fibers which are hygroscopic. From TG/DTG results, with the addition of sisal fibers reduced the strength to thermal degradation of the composites, a higher loss of mass was observed in the temperature band between 200 and 340 °C, related to urethane bonds decomposition and cellulose degradation and its derivatives. About mechanical behavior in compression and flexural, composites presented a better mechanical behavior than the rigid polyurethane foam. An increase in the amount of sisal fibers induces a higher rigidity of the composites. At the thermal behavior tests, the composites were more mechanically and thermally resistant than some materials commonly used for thermal insulation, they present the same or better results. The density of nonwoven sisal fiber had influence over the insulation grade; this means that, an increaser in sisal fiber density helped to retain the heat

Análise teórico-experimental do coeficiente de perfomance (COP) de um sistema de refrigeração por jato-compressão

The use of waste heat of energy conversion equipment to produce a cooling effect, consists currently in a very interesting way of efficiency improvement of energy systems. The present research has as intention the theoretical and experimental study of a new intermittent refrigeration system ejector cycle characteristics, with use of waste heat. Initially, was doing a bibliographical survey about the vapor ejector refrigeration system technology. In the following stage was doing a simulation of the corresponding thermodynamic cycle, with preliminarily intention to evaluate the performance of the system for different refrigerants fluids. On the basis of the results of the simulation were selected the refrigerant fluid and developed an experimental group of benches of the refrigeration system considered, where pressure and temperature sensory had been inserted in strategical points of the refrigeration archetype and connected to a computerized data acquisition system for measure the refrigerant fluid properties in the thermodynamic cycle. The test results obtained show good agreement with the literature

Estudo da flamabilidade e resistência à chama de compósito de poliéster insaturado e fibra da folha do abacaxizeiro (PALF)

In the present research work, composites were prepared using pine apple leaf fibres (PALF) as reinforcement with unsaturated polyester resin as matrix, incorporating with fire retardant at different compositions. The PALF was obtained from the decortication of pine apple leaves obtained from Ramada 4 from Ielmo Marinho in the State of Rio Grande do Norte. The unsaturated polyester resin and the catalyzer were bought from the local establishment. The fire retardant, aluminium tri-hydroxide - Al(OH)3 was donated by Alcoa Alumínio S.A and was used in the proportions of 20%, 40% and 60% w/w. Initially the fibres were treated with 2% NaOH for 1 hour, to remove any impurities present on the fibre surface, such as wax, fat, pectin and pectate, in order to have a better adsorption of the fibres with the matrix as well as the flame retardant. The fibre mat was prepared in a mat preparator by immersion, developed in the Textile Engineering Laboratory, at the UFRN. The composites (300x300x3 mm) were prepared by compression molding and the samples (150x25x3 mm) for analysis of the properties were cut randomly using a laser cutter. Some of the cut samples were used to measure the smoke emission and fire resistance using UL94 standard. Mechanical tension-extension and flexural properties were carried in CTGás RN and the Laboratório de Metais e Ensaios Mecânicos Engenharia de Materiais UFRN , as well as SEM studies were carried out at Núcleo de Estudos em Petróleo e Gás Natural - UFRN . From the observed results, it was noted that, there was no marked influence of the fire retardant on the mechanical properties. Also in the water absorption test, the quantity of water absorbed was less in the sample with higher concentration of fire retardant. It was also observed that the increase in the proportion of the fire retardant increased the time of burning, may be due to the compactness of the composite due to the presence of fire retardant as a filling material even though it was meant to reduce the rate of inflammability of the composite