Avaliação da argila atapulgita para potencial uso como excipiente farmacêutico em formas sólidas

Clays are natural materials that have great potential for use as excipients for solid dosage forms. Palygorskite is a type of clay that has hydrophilic properties as well as a large surface area, which could contribute to the dissolution of drugs. Thus, the present study aims to evaluate the use of palygorskite clay, from Piaui (Northeast region of Brazil), as a pharmaceutical excipient for solid dosage forms, using rifampicin and isoniazid as the model drugs. The former is a poorly soluble drug often associated with isoniazid for tuberculosis treatment. Palygorskite was characterized by X-ray diffraction (XRD), X-ray fluorescence (XRF), particle size, transmission electron microscopy (TEM), scanning electron microscopy (SEM) and specific surface area (BET). The rheological and technological properties of palygorskite were determined and compared to those of talc, magnesium stearate and Aersosil 200. Mixtures between drugs and palygorskite were analyzed by differential scanning calorimetry (DSC), thermogravimetric analysis (TG) combined with thermal analysis (DTA) and Fourier Transform Infrared Spectroscopy (FT-IR), where the results were compared with those of the individual compounds. In addition, dissolution studies of solid dispersions and capsules containing the drugs, mixed with either palygorskite or a mixture of talc and magnesium stearate, were performed. The results showed that palygorskite has small particles with a high surface area. Its rheological characteristics were better than those of others commonly used glidants and lubricants. There was no interaction between palygorskite and the drugs (rifampicin and isoniazid). Among the dispersions studied, the mixture with palygorskite (5%) showed the highest drug dissolution when compared to other excipients. The dissolution of the rifampicin capsules containing palygosrkite was faster in higher concentrations. However, these differences were statistically different only in the first minutes of the dissolution experiment. The dissolution profile of isoniazid was also statistically different on the initial part of the experiment. The formulations prepared with isoniazid and palygorskite showed higher drug dissolution, but it was in descending order of concentration. According to these results, the palygorskite clay used in this study has great potential for application as an excipient for solid dosage forms

Características genotípicas e fenotípicas de Candida Albicans isoladas da cavidade bucal de pacientes transplantados renais com ênfase na ação do extrato bruto de Eugenia uniflora em fatores de virulência

Candida albicans is a diploid yeast that in some circumstances may cause oral or oropharyngeal infections. The investigation of natural products is mandatory for the discovery of new targets for antifungal drugs development. This study aimed to determine the genotypes of 48 clinical isolates of C. albicans obtained from the oral cavity of kidney transplant patients from two distinct geographic regions of Brazil. In addition, we investigated three virulence factors in vitro: phospholipase activity, morphogenesis and the ability to evade from polymorphonuclear neutrophils. The expression of these virulence factors in vitro was also investigated in the presence of the crude extract of Eugenia uniflora. The genotype A was the most prevalent (30 isolates; 62.5%), followed by genotype C (15 isolates; 31.5%) and genotype B (3 isolates; 6.25%). When microsatellite technique with primer M13 was applied, 80% of the isolates from the South were placed within the same cluster. All Genotype C strains were grouped together within two different clusters. Genotype C was considered more resistant to PMNs attack than genotypes A and B. Strains isolated from the South of Brazil showed higher ability to combat PMNs phagocytosis. We found a high rate of genotype C strains isolated from the oral cavity of this group of patients. The crude extract of E. uniflora inhibited proper hypha formation and phagocytosis by PMNs, but had no significant effect on phospholipase activity. This study characterized oral C. albicans strains isolated from kidney transplant recipients and will contribute for the better understanding of the pathogenesis and alternative therapeutics for oral candidiasis

Direitos da personalidade: uma análise acerca da concretização da tutela constitucional

It dares to ensure that the Constitution of the Republic strengthened the rights of personality. No longer considering the denial of protection to intangible rights, against the imperative command coming from the art. 5 ° of our highest law, relevant to items V and X. Overlooking these emerge with precision, those rights of personality. Innocuous have been isolated attempts of the opposition to this constitutional protection. Deny it, or rather to restrict it, as it has done insignificant part of the doctrine and isolated judgmental pronouncements, no longer prove appropriate. Today, more than before, there is pointed out that if the human being has personal rights acquired from the design, adding to this other identity elements that allow the projection of a particular social personality. Such rights, it is worth mentioning, there are bases on the principle of human dignity that is considered general provision for the protection of personality. Based on the demonstration of this fact, after climbing into the general theory of personal rights and demonstrate the legal protection that has been present in his favor, it is hoped will, general objective, to show the effectiveness of this constitutional protection. At that point, will be reserved for special to the procedural tools that it has made a decisive contribution to the realization and effectiveness of the rights of the personality, a reality that must be imposed for the benefit of the dignity of the human person, presented here as basic foundation of the Democratic State of Law. The brazilian legal system provides the normative basis needed to provide an adequate protection to personality, from the general clause of the protection of the personality. For the achievement of its effectiveness, however, is an important update methodological and cultural of the Right as well as an effective deployment of public policies and private ensuring a better quality of life for citizens

Convergência ou divergência no desenvolvimento? um estudo multidimensional para o sudeste e o nordeste do Brasil, 1990-2010

The analysis of some aspects of development in Brazil in the past three decades reveals an improvement on a range of indicators isolated in the south east the richest region and north east the poorest region. From a database of twenty variables, the main purpose the study was to verify if there are indications of convergence or divergence in five dimensions of development between the two regions from 1990 to 2010. Aiming to identify the states more similar and different, and to verify changes in the composition of low development groups and high development in the adressed period, was used the analysis of groupings (Cluster Analysis). Additionally, to test equality of distance between states all the time, was used the non-parametric Test of Wilcoxon. This makes it possible to verify IF the distance between the states of two regions has been increasing or has been falling, showing signs of divergence or convergence. The results of Cluster s analysis suggest that there are indications of convergence inside the cluster of north east, but the distance between two regions has not changed. The results of test of Wilcoxon suggests that there have been no changes statistically significant in the distance between the states, in the two regions the standards of development became more homogenous, but the two regions will be far apart

Serviço social na educação: saberes e competências necessárias no fazer profissional

The Theory analyzes what should know and what competes, formally, to the Professional of Social Service to act in the School Education. He/she investigates, starting from studies on the theme, and close to Council Federal and Regional of Social Service, and of the Brazilian Association of Studies and Researches in Social Service, that you know and competences are necessary for the social worker performance in that specific area. Through a research of nature empiric, bibliographical and documental, the analysis focus outlines the glance and the understanding of the professionals' category that represent the defense organs, fiscalization and formation of the profession. The importance of the scientific study is justified for the social worker necessary contribution acting in the School Education, whose political and pedagogic context presents multiple demands, you know and relationships, and when it is lived a social and education picture at the present time with order words in formation, as inclusion, empowerment, competence, that they demand other specialists in the school scenery to work with the varied expressions of the social subject. Since the years 1930 the social worker acts in the area of the Education, with an originating from knowledge the human and social areas that you/he/she makes possible him/it to contribute, undisciplinement, close to the pedagogic team of the School Education. The clarity of the you know and of the necessary competences to intervene in that field of specific work makes possible the legitimation of the identity, of the social worker professionalization and the formalization of his/her practice. The Theory ends that the profissionality and the social worker professionalism is built and it is recognized in the area of the Education starting from the knowledge of the you know and pertinent competences to intervene in that context, beginning that knowledge on the part of the category of the Social Service and of the formation organs and representation of the profession so that the school community - administration and pedagogic coordination, teachers and students - he understands and recognize the social worker necessary intervention in that field. The formalization of those you know and competences are built starting from actions and thought mobilizations and operation in the group of the category, and not for isolated actions and individualized. It is revealed, in the opinion of the ones that represent Regional Council of Social Service, a wide vision of the social worker in that space exercising, among other, functions that don't compete to the professional's profile or restricted to actions and techniques historically exercised in their work fields. A new profile of the professional of the Social Service that it acts in the School Education is possible when his/her action is visualized centered not just in the work with the family, but, doing of the school a proposition space and execution of programs, projects, studies and social researches. He intends, an action politics and of popularization on them know and the social worker competences in the School Education

Serviço de atendimento móvel de urgência (SAMU) e a assistência às urgências psiquiátricas

The objective of this work which is characterized as an applied research, with a qualitative exploratory approach and has case study character has been the analysis of the conceptions and dealings of health professionals of SAMU in Natal RN about the attendance of psychiatric urgencies. The information was collected between the months of March and April of 2010, by means of semi-structured interviews, performed with 24 health professionals integrating of SAMU-Natal as well as the usage of direct observation technique, performed in the institution's medical regulation room. Both the number of professionals involved in the interviews and the bringing about of the observations, were determined by saturation methods in qualitative research's information collecting. The interviews and observations were transcribed and submitted to contents analysis technique , more specifically, to thematic analysis, which made possible to reach the deepest levels, that go beyond what has simply been manifest in the speech of the interviewed, getting to the relations among the categories and social structures of the issue of the research. Keeping this in mind, three analysis categories have been built, namely: conceptions and concepts of psychiatric urgencies shared by health professionals in SAMU-Natal; attendances to psychiatric urgencies in SAMU-Natal; and the Brazilian Psychiatric Reformation under the view of the SAMU-Natal's health professionals. Reflection about the analyzed information revealed discussions pertaining to the stigma and prejudice on mental illness, and also, pointed out to some hindrances which impair the attendance to individuals in mental suffering in SAMU-Natal. The interviewed health professionals' conceptions on the individual in psychical crisis involve concepts of unpredictability, aggressiveness and risk, stigmatizing elements and historically associated to the social hazard ideology and need for mentally sicks' segregation. The predominance of these conceptions, seen in health professionals speech, had identifiable reflexes on assistance to psychiatric demands performed by SAMU-Natal, namely: indiscriminate request for military police's presence during psychic crisis intervention, neglect about occasions that involve mental health patients, as well as repetitive assisting practice directed on physical contention, and transportation to psychiatric hospital. Associated to it, the professionals have shown distorted and reductionist understanding about Brazilian Psychiatric Reformation, and, in the majority, haven't lent credibility to present model of attention to mental health, based on psycho-social treatment, pointing their speech to a need for psychiatric patient's internment. In this sense, we notice that the hospital-centered and excluding model conceived by classical psychiatry still remains alive in these health professionals' mentality as a reference to psychiatric urgency's assistance. Therefore, the research revealed a sequence of elements, that make us think about the challenges that health sector and society must face to realize Brazilian Psychiatric Reformation's principles and guidelines

Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Trajetória de profissionais da saúde de um hospital colônia para hanseníase

Leprosy as a public health problem , there is still quite some time , even with treatment for decades . Your health-disease process is marked by a historical backdrop of stigma , prejudice, social exclusion and authoritarian decisionducts , in order to extinguish the disease milieu under the regime of compulsory confinement of the patient. In this perspective , the Brazilian public health twentieth century adopted policies of compulsory isolation , which meant that those who receive a diagnosis of leprosy were isolated from society and their families in hospitals colonies . Objective is, to the study, rescue the trajectory of health professionals in the Colony Hospital St. Francis of Assisi , in Natal / RN ; Identify the policy was perceived as compulsory institutionalization imposed for leprosy patients by health professionals ; describe the behaviors Professional Hospital adopted in Cologne ; Retrieve information about the existence and functioning of the Hospital and Create a documentary of historical fragments of leprosy from the point of view of professionals from a former colony. Exploratory - descriptive method with a qualitative approach , using the methodological framework thematic oral history was used . Obtained approval by the IRB of the Federal University of Rio Grande do Norte, under Protocol No 461 403 and CAAE 19476913.9.0000.5537 . Be interviewed during the period of November and December 2013 , five health professionals who worked in the hospital colony , using audio recorder and images to capture and record the statements. The interviews were transcribed , textualized, transcriadas and sent to reviewers to step conference of the reports. Subsequently , analysis of the stories was made from the proposed content analysis of Bardin . The results and discussion are presented in the form of article: Opinion of nursing professionals who worked in a hospital for leprosy colony , which aimed to : identify the opinion of nurses who worked in hospital colony on the lives of patients . In this article, three main themes were highlighted and discussed from the reports of colaboradoes : I - The socialization process of internal II - 16 Prejudice , stigma and discrimination III - Social exclusion versus inclusion . We conclude that , in the context of the colony hospital, the performance of health professionals contributed significantly to that stigma , prejudice and social exclusion would be minimized and that the experience of asylum seekers in the colony were not seen more traumatic

Modelos para análise e dimensionamento de painéis de alvenaria estrutural

The main objective of this thesis was the study of bracing panels of structural masonry, by applying the Finite Element Method and Strut and Tie Method. It was analyzed the following aspects: the effect of orthotropy on the behavior of the panels; distribution of horizontal forces between panels for buildings; comparison between Equivalent Frame and Finite Elements models; panels design with the Strut and Tie Method. The results showed that one should not disregard the orthotropy, otherwise this can lead to models stiffer than the real. Regarding the distribution of horizontal forces, showed that the disregard of lintels and shear deformation leads to significant differences in the simplified model. The results showed also that the models in Finite Element and Equivalent Frame exhibit similar behavior in respect to stiffness of panels and stress distribution over the sessions requested. It was discussing criteria for designing Strut and Tie Method models in one floor panels. Then, the theoretical strength these panels was compared with the rupture strength of panels tested in the literature. The theoretical maximum strength were always less than the rupture strength of the panels obtained in tests, due to the fact that the proposed model cannot represent the behavior of the masonry after the start of the panel cracking due to plasticization of the reinforcement

Projeto, construção e análise de desempenho de um forno solar alternativo tipo caixa a baixo custo

An alternative box-type solar oven constructed from the scrap iron of a gas conventional cook is presented, which functions principles are the effect greenhouse and the concentration. The oven of the conventional cook is the baking enclosure where the absorber (pot) of the solar oven is located, being re-covered for a glass blade for the generation of the greenhouse effect isolated lateral and having deep its and for a composite the plaster base and EPS. Segments of plain mirrors had been placed in the laterals of the oven for the concentration of the radiation and a reflecting parabola was introduced in the baking enclosure for the exploitation of the incident reflected radiation in the interior of the oven. The oven is mobile to allow one better aiming of exactly in relation to the apparent movement of the sun. The thermal economic and of materials viabilities of the stove in study will be demonstrate The average internal temperature of the absorber was around 150°C and the internal temperature around 120°C. Will demonstrate that its low cost and good thermal performance represents basic characteristics for the viability of large use of such archetype, mainly for cooking the decreases and averages temperatures. One will reveal that the archetype in study is competitive with the box-type solar cooker conceived in the whole world

Avaliação, identificação e atividade enzimática de bactérias psicotróficas presentes no leite cru refrigerado

Extended storage of refrigerated milk can lead to reduced quality of raw and processed milk, which is a consequence of the growth and metabolic activities of psychrotrophic bacteria, able to grow under 7oC or lower temperatures. Although most of these microorganisms are destroyed by heat treatment, some have the potential to produce termoresistant proteolytic and lipolytic enzymes that can survive even UHT processing and reduce the processed products quality. Recently, the IN 51 determineds that milk should be refrigerated and stored at the farm what increased the importance of this group of microorganisms. In this work, psychrotrophic bacteria were isolated from 20 communitarian bulk tanks and 23 individual bulk tanks from dairy farms located at Zona da Mata region of Minas Gerais State and from southeastern Rio de Janeiro. Selected milk dilutions were plated on standard agar and after incubation for 10 days at 7oC, five colonies were isolated, firstly using nutrient agar and after using McConkey agar for 24 hours at 21oC. The isolates were identified by morphology, Gram stain method, catalase production, fermentative/oxidative metabolism and by API 20E, API 20NE, API Staph, API Coryne or API 50 CH (BioMerieux). In order to ensure reproductibility, API was repeated for 50% of the isolates. Species identification was considered when APILAB indexes reached 75% or higher. 309 strains were isolated, 250 Gram negative and 59 Gram positive. 250 Gram negative isolates were identified as: Acinetobacter spp. (39), Aeromonas spp. (07), A. Hydrophila (16), A. sobria (1), A. caviae (1), Alcaligenes feacalis (1), Burkholderia cepacia (12), Chryseomonas luteola (3), Enterobacter sp. (1), Ewingella americana(6), Hafnia alvei (7), Klebsiella sp. (1), Klebsiella oxytoca (10), Yersinia spp. (2), Methylobacterium mesophilicum (1), Moraxella spp. (4), Pantoea spp. (16), Pasteurella sp. (1), Pseudomonas spp. (10), P. fluorescens (94), P. putida (3), Serratia spp. (3), Sphigomonas paucomobilis (1). Five isolates kept unidentified. Pseudomonas was the predominant bacteria found (43%) and P. fluorescens the predominant species (37.6%), in accordance with previous reports. Qualitative analysis of proteolytic and lipolytic activity was based on halo formation using caseinate agar and tributirina agar during 72 hours at 21oC and during 10 days at 4°C, 10oC and 7°C. Among 250 Gram negative bacteria found, 104 were identified as Pseudomonas spp. and 60,57% of this group showed proteolytic and lipolytic acitivities over all four studied temperatures. 20% of Acinetobacter, Aeromonas, Alcaligenes, Burkholderia, Chryseomonas, Methylobacterium, Moraxella presented only lipolytic activity. Some isolates presented enzymatic activity in one or more studied temperatures. Among Gram positive bacteria, 30.51% were proteolytic and lipolytic at 10oC, 8.47% were proteolytic at 7oC, 10oC, and 21oC, 8.47% were proteolytic at all studied temperatures (4oC, 7oC, 10oC and 21oC) and 3.38% were proteolytic only at 21oC. At 4oC, only one isolate showed proteolytic activity and six isolates were lipolytic. In relation to Gram negative microorganisms, 4% were proteolytic and lipolytic at 7oC, 10oC and 21oC, 10% were proteolytic at 10oC and 4.4% were lipolytic at 4oC, 7oC, 10oC and 21oC, while 6.4% of all isolates were proteolytic and lipolytic at 10oC and 21oC as well as lipolytic at 4oC and 7oC. These findings are in accordance with previous researches that pointed out Pseudomonas as the predominant psycrotrophic flora in stored refrigerated raw milk

Efeitos de interface em bicamadas magnéticas

We study magnetic interface roughness in F/AF bilayers. Two kinds of roughness were considered. The first one consists of isolated defects that divide the substrate in two regions, each one with an AF sub-lattice. The interface exchange coupling is considered uniform and presents a sudden change in the defects line, favoring Neel wall nucleation. Our results show the interface field dependence of the threshold thickness for the reorientation of the magnetization in the ferromagnetic film. Angular profiles show the relaxation of the magnetization, from Neel wall, at the interface, to reoriented state, at the surface. External magnetic field, perpendicular to the easy axis of the substrate, favors the reoriented state. Depending, of the external magnetic field intensity, parallel to the easy axis of the AF, the magnetization profile at surface can be parallel or perpendicular to the field direction. The second one treats of distributed deffects, periodically. The shape hysteresis curves, exchange bias and coercivity were characterized by interface field intensity and roughness pattern. Our results show that dipolar effects decrease the exchange bias and coercivity

Efeitos da interação dipolar na nucleação de vórtices em nano-cilindros magnéticos

The effect of confinement on the magnetic structure of vortices of dipolar coupled ferromagnetic nanoelements is an issue of current interest, not only for academic reasons, but also for the potential impact in a number of promising applications. Most applications, such as nano-oscillators for wireless data transmission, benefit from the possibility of tailoring the vortex core magnetic pattern. We report a theoretical study of vortex nucleation in pairs of coaxial iron and Permalloy cylinders, with diameters ranging from 21nm to 150nm, and 12nm and 21nm thicknesses, separated by a non-magnetic layer. 12nm thick iron and Permalloy isolated (single) cylinders do not hold a vortex, and 21nm isolated cylinders hold a vortex. Our results indicate that one may tailor the magnetic structure of the vortices, and the relative chirality, by selecting the thickness of the non-magnetic spacer and the values of the cylinders diameters and thicknesses. Also, the dipolar interaction may induce vortex formation in pairs of 12nm thick nanocylinders and inhibit the formation of vortices in pairs of 21nm thick nanocylinders. These new phases are formed according to the value of the distance between the cylinderes. Furthermore, we show that the preparation route may control relative chirality and polarity of the vortex pair. For instance: by saturating a pair of Fe 81nm diameter, 21nm thickness cylinders, along the crystalline anisotropy direction, a pair of 36nm core diameter vortices, with same chirality and polarity is prepared. By saturating along the perpendicular direction, one prepares a 30nm diameter core vortex pair, with opposite chirality and opposite polarity. We also present a theoretical discussion of the impact of vortices on the thermal hysteresis of a pair of interface biased elliptical iron nanoelements, separated by an ultrathin nonmagnetic insulating layer. We have found that iron nanoelements exchange coupled to a noncompensated NiO substrate, display thermal hysteresis at room temperature, well below the iron Curie temperature. The thermal hysteresis consists in different sequences of magnetic states in the heating and cooling branches of a thermal loop, and originates in the thermal reduction of the interface field, and on the rearrangements of the magnetic structure at high temperatures, 5 produce by the strong dipolar coupling. The width of the thermal hysteresis varies from 500 K to 100 K for lateral dimensions of 125 nm x 65 nm and 145 nm x 65 nm. We focus on the thermal effects on two particular states: the antiparallel state, which has, at low temperatures, the interface biased nanoelement with the magnetization aligned with the interface field and the second nanoelement aligned opposite to the interface field; and in the parallel state, which has both nanoelements with the magnetization aligned with the interface field at low temperatures. We show that the dipolar interaction leads to enhanced thermal stability of the antiparallel state, and reduces the thermal stability of the parallel state. These states are the key phases in the application of pairs of ferromagnetic nanoelements, separated by a thin insulating layer, for tunneling magnetic memory cells. We have found that for a pair of 125nm x 65nm nanoelements, separated by 1.1nm, and low temperature interface field strength of 5.88kOe, the low temperature state (T = 100K) consists of a pair of nearly parallel buckle-states. This low temperature phase is kept with minor changes up to T= 249 K when the magnetization is reduced to 50% of the low temperature value due to nucleation of a vortex centered around the middle of the free surface nanoelement. By further increasing the temperature, there is another small change in the magnetization due to vortex motion. Apart from minor changes in the vortex position, the high temperature vortex state remains stable, in the cooling branch, down to low temperatures. We note that wide loop thermal hysteresis may pose limits on the design of tunneling magnetic memory cells

Avaliação da função pulmonar em obesos mórbidos com sonolência diurna excessiva

Background: Obesity impairment to the pulmonary function related to the magnitude of adiposity and is associated with excessive daytime sleepiness (EDS) and snoring, among others symptoms of respiratory disorders related to sleep. It is possible that obese individuals with excessive daytime sleepiness may make changes in lung function on spirometry monitored during the day as a consequence of fragmented sleep or episodes of nocturnal hypoventilation that cause respiratory and changes that can persist throughout the day. The combination of these findings alone sleepiness observed by subjective scales with pulmonary function in obese patients is unknown. Objective: To assess the influence of EDS and snoring on pulmonary function in morbidly obese and distinguish between different anthropometric markers, the snoring and sleepiness which the best predictors of spirometric function and respiratory muscle strength and endurance of these patients. Methods: We evaluated 40 morbidly obese markers on the anthropometric, spirometric respiratory variables, maximal inspiratory and expiratory pressures (MIP and MEP) and maximal voluntary ventilation (MVV) and the measured excessive daytime sleepiness (the Epworth sleepiness scale) and snoring (snoring scale of Stanford). The data were treated when the differences between the groups of obese patients with and without sleepiness, whereas the anthropometric variables, respiratory and snoring. Pearson's correlation was performed, and multiple regression analysis assessed the predictors of pulmonary function. For this we used the software SPSS 15.0 for windows and p <0.05. Results: 39 obese patients were included (28 women), age 36.92+11.97y, body mass index (BMI) 49.3+5.1kg/m², waist-hip ratio (WHR) 0.96+0.07 and neck circumference (NC) 44.1+4.2 cm. Spirometric values and respiratory pressures were up 80% of predicted values, except for endurance (MVV <80%). Obese with EDS have lower tidal volume. Positive correlation was observed between BMI and EDS, EDS and NC and between snoring and BMI, and negative correlation between EDS and tidal volume (TV), and between snoring and snoring FVC and FEV1. In linear regression the best predictor of pulmonary function was snoring, followed by NC. NC has more obese with higher strength (MEP, p = 0.031) and endurance (MVV p = 0.018) respiratory muscle. Conclusion: Obese with EDS tend to have lower TV. In addition, snoring and NC can better predict pulmonary function in obese when compared with other anthropometric markers or EDS. Obese patients with higher NC tend to have greater capacity for overall strength of respiratory muscles, but may have low muscle endurance

Efeitos do alongamento e do aquecimento no desempenho isocinético e na atividade eletromiográfica do músculo bíceps femoral ensaio clínico randomizado

To evaluate the effects of warm-up and stretching, singly or combined, on isokinetic performance and electromyographic activity of the biceps femoris. Materials and methods: Sixty-four volunteers of both sexes, with mean age of 23,1 ± 3,5 years and mean body mass index of 23,5 ± 2,5 Kg/m2 were randomly assigned into 4 groups: control, warm-up (stationary bicycle for 10 minutes), stretching (4 sets of 30 seconds of hamstring muscles static stretching) and warm-up + stretching. All the volunteers were submitted to evaluation pre and post-intervention of the muscle latency time and biceps femoris RMS and the passive torque, peak torque and power of the hamstring muscles. Results: The warm-up + stretching group had reduction of muscle latency time. There was a reduction of RMS during passive torque evaluation in stretching group. The RMS during isometric evaluation was reduced in all experimental groups. The RMS during eccentric evaluation showed reduction in control and warm-up + stretching groups. The passive torque and the eccentric peak torque had no significant differences pre to post-intervention in any group. There was reduction in isometric peak torque in all groups. Conclusion: The warm-up and stretching, when applied in combination can reduce the muscle latency time; stretching protocol promoted neural changes; the protocols used did not alter the muscle viscoelastic properties