Arquitetura, litofácies e evolução tectonoestratigráfica da bacia do rio do peixe, nordeste do Brasil

The Rio do Peixe Basin is located in the border of Paraíba and Ceará states, immediately to the north of the Patos shear zone, encompassing an area of 1,315 km2. This is one of the main basins of eocretaceous age in Northeast Brazil, associated to the rifting event that shaped the present continental margin. The basin can be divided into four sub-basins, corresponding to Pombal, Sousa, Brejo das Freiras and Icozinho half-grabens. This dissertation was based on the analysis and interpretation of remote sensing products, field stratigraphic and structural data, and seismic sections and gravity data. Field work detailed the lithofacies characterization of the three formations previously recognised in the basin, Antenor Navarro, Sousa and Rio Piranhas. Unlike the classical vertical stacking, field relations and seismostratigraphic analysis highlighted the interdigitation and lateral equivalency between these units. On bio/chrono-stratigraphic and tectonic grounds, they correlate with the Rift Tectonosequence of neocomian age. The Antenor Navarro Formation rests overlies the crystalline basement in non conformity. It comprises lithofacies originated by a braided fluvial system system, dominated by immature, coarse and conglomeratic sandstones, and polymict conglomerates at the base. Its exposures occur in the different halfgrabens, along its flexural margins. Paleocurrent data indicate source areas in the basement to the north/NW, or input along strike ramps. The Sousa Formation is composed by fine-grained sandstones, siltites and reddish, locally grey-greenish to reddish laminated shales presenting wavy marks, mudcracks and, sometimes, carbonate beds. This formation shows major influence of a fluvial, floodplain system, with seismostratigraphic evidence of lacustrine facies at subsurface. Its distribution occupies the central part of the Sousa and Brejo das Freiras half-grabens, which constitute the main depocenters of the basin. Paleocurrent analysis shows that sediment transport was also from north/NW to south/SE

Caracterização Morfodinâmica e Sedimentologia da Plataforma Continental Rasa na APA Estadual dos Recifes de Corais - RN

This study had to aimed to characterize the sediments of shallow continental shelf and realize the mapping of features visible for satellite images by using remote sensing techniques, digital image processing and analysis of bathymetry between Maxaranguape and Touros - RN. The study s area is located in the continental shallow shelf of Rio Grande do Norte, Brazil, and is part of the Environmental Protection Area (APA) of Coral Reefs. A total of 1186 sediment samples were collected using a dredge type van veen and positioning of the vessel was made out with the aid of a Garmin 520s. The samples were treated In the laboratory to analyze particle size of the sediment, concentration of calcium carbonate and biogenic composition. The digital images from the Landsat-5 TM were used to mapping of features. This stage was used the band 1 (0,45-1,52 μm) where the image were georeferenced, and then adjusting the histogram, giving a better view of feature bottom and contacts between different types of bottom. The results obtained from analysis of the sediment showed that the sediments of the continental shelf east of RN have a dominance of carbonate facies and a sand-gravelly bottom because the region is dominated by biogenic sediments, that are made mainly of calcareous algae. The bedform types identified and morphological features found were validated by bathymetric data and sediment samples examined. From the results obtained a division for the shelf under study is suggested, these regions being subdivided, in well characterized: (1) Turbid Zone, (2) Coral Patch Reefs Zone, (3) Mixed Sediments Carbonates Zone, ( 4) Algae Fouling Zone, (5) Alignment Rocky Zone, (6) Sand Waves Field (7) Deposit siliciclastic sands

Expressão em superfície do sistema de falhas Poço Verde-caraúbas, Bacia Potiguar

The structural knowledge of the western portion of the Potiguar Basin is still in its infancy, especially these related to NW-trending fault systems. This paper analyzes the Poço Verde-Caraúbas Fault System, which was initially recognized in subsurface. The activities involved in this study correspond to remote-sensing analysis and, in particular, to the geometric and kinematic analysis of post-rift sequences of the basin. In addition, the study aimed to determine the stress fields operating in the area. The studies were carried out in an area of 1,000 km², located in the western portion of Potiguar Basin along the Poço Verde-Caraúbas Fault System, Rio Grande do Norte State. The remote sensing imagery indicates a predominance of NW-SE-trending lineaments, consistent with the fault system under study, followed by the NE-SW, N-S and E-W directions. The tectonic structures mapped were analyzed only in outcrops of the Jandaíra Formantion. They are joints (filled or not) in all directions, but with predominance of the NW-trending joints. Faults are usually N-S-trending normal faults and NW-SE and NE-SW-trending strike-slip faults. Geodynamic analysis identified two tectonic stress fields: the first field, "Field 1" is represented by an N-S-trending horizontal compression and E-W-trending horizontal extension. This field affected the Potiguar Basin at least until the Miocene. The second field, "Field 2", is represented by an E-W-trending horizontal compression and N-S-trending horizontal extension. This is the present-day stress field and has affected the Potiguar basin since the Pliocene

Caracterização geomorfológica e modelagem de dados espaciais na plataforma continental rasa do RN nos limites da folha Touros

This work focuses the geomorphological characterization and spatial data modeling in the shallow continental shelf within the Folha Touros limits (SB-25-CV-II), based on bathymetric data analysis and remote sensing products interpretation. The Rio Grande do Norte state is located in northeastern Brazil and the work area is located at the transition region between the eastern and northern portions of their coast. The bathymetric surveys were conduced between march and may 2009, using a 10 meters long vessel and 0.70 meters draught, equipped with global positioning system and echo sounder (dual beam, 200KHz , 14°). The fieldwork resulted in 44 bathymetric profiles espaced 1.5 km and 30 km average length. The bathymetric data amount were 111,200 points and were navigated 1395.7 km within na area about 1,850 km2. The bathymetric data were corrected for the tide level, vessel draught and were subsequently entered into a geographic information system for further processing. Analysis of remote sensing products was carried out using Landsat 7/ETM + band 1, from november 1999. The image was used for visualization and mapping submerged features. The results showed the presence of geomorphological features within the study area. Were observed, from the analysis of local bathymetry and satellite image, seven types of geomorphological features. The channels, with two longitudinals channels (e. g. San Roque and Cioba channels) and other perpendicular to the coast (e. g. Touros, Pititinga and Barretas). Coastal reef formations (Maracajaú, Rio do Fogo and Cioba). Longitudinal waves, described in the literature as longitudinal dunes. The occurrence of a transverse dune field. Another feature observed was the oceanic reefs, an rock alignment parallel to the coast. Were identified four riscas , from north to south: risca do Liso, Gameleira, Zumbi, Pititinga (the latter being described for the first time). Finally, an oceanic terrace was observed in the deepest area of study. Image interpretation corroborated with the in situ results, enabling visualization and description for all features in the region. The results were analysed in an integrating method (using the diferent methodologies applied in this work) and it was essential to describe all features in the area. This method allowed us to evaluate which methods generated better results to describe certain features. From these results was possible to prove the existence of submerged features in the eastern shallow continental shelf of Rio Grande do Norte. In this way, the conclusions was (1) this study contributed to the provision of new information about the area in question, particularly with regard to data collection in situ depths, (2) the method of data collection and interpretation proves to be effective because, through this, it was possible to visualize and interpret the features present in the study area and (3) the interpretation and discussion of results in an integrated method, using different methodologies, can provide better results

Monitoramento costeiro das praias de São Bento do Norte e Caiçara do Norte RN: implicações para o pólo petrolífero de Guamaré

This dissertation the results of a research developed in the area of São Bento do Norte and Caiçara do Norte, northern coast of the State of Rio Grande do Norte, during the period of June of 2000 to August of 2001, in the ambit of the projects MAMBMARÉ (CNPq/CTPETRO) and PROBRAL (CAPES/DAAD).The objective principal of this research was the characterization of the sedimentary dynamics of this coast, with base in data of coastal process (winds, currents, waves and tides), with topographical risings (beach profiles and dunes), satellite images and sedimentary analyses. The more specific objectives were accomplished the coastal monitoring of this coast, to verify the maintenance of an erosive tendency or progradacional after the groynes construction for contention of the erosion in the beach of Caiçara do Norte, as well as to verify the influence of the features of bottom of the platform interns adjacent on the pole petroliferous of Guamaré. The executed monitoramento allowed to identify that the movement of the sediments, along the year, in that area, is cyclical, reaching the largest oscillations during the months of winter (deposition) and they will summer (erosion). The sedimentologic studies indicated a general tendency for sands quartzosas, with gravel presence, moderately to good selected, with asymmetry predominantly negative. In agreement with the parameter of Dean (1957), used in the identification of the state morfodinâmico of the beaches, monitored beaches, are basically reflectivas with tendency to middlemen, what frames that space of the coast norteriograndense, as a space strongly vulnerable to erosive processes. The studies developed in the platform, it interns of this area, allowed to visualize for the first time, in large scale, the distribution of the features of the submarine bottom to the batométrico coat of 25 meters. Being pointed out the presence of a high one topographical submerged, with about 5 meters of height, 1 km of width and more than 24 meters of extension, located in the platform it interns in front of São Bento do Norte; coincident with the trend of the system of flaws of Carnaubais. This feature relay an important paper on the control of the sedimentary processes and oceanographic, as well as in the coastal evolution of this area of the RN state, and they affect the area of the pole petroliferous of Guamaré directly. These results contribute to a better knowledge of the processes in the area, and consequently as subsidies implantation of measures of coastal and environmental protection for the cities of São Bento do Norte and Caiçara do Norte, as well as to understand how the geological-sedimentary processes and oceanographic, in this area, are influencing the characteristics geoambientais of the pole petroliferous of Guamaré

Dinâmica da paisagem no litoral oriental do Rio Grande do Norte: geocartografia e padrões espaciais dos campos de dunas móveis

This study shows the results of a research developed in the coastal regions of the Maxaranguape and Touros municipalities, more specific in the mobile dune fields of the Rio Grande do Norte's eastern coast. Although the coastal zones, represent a small percentage of the earth's surface it concentrates a great part of the world's population. The Rio Grande do Norte's state coastal landscape mosaic composed by the dune fields suggest a dynamic scene of changes in the spatial and temporal arranges, with significant changes in the geometry of the sedimentary cover. Following this perspective this research has the objective to map the emerged coastal zone of the Rio Grande do Norte's eastern coast under the perspective of the time-space evolution of the mobile dune fields using geoprocessing techniques, which includes remote sensing, digital images processing and geographic information system (GIS). The results imply the issue of thematic maps: Geologic map; multitemporal evolution map of the mobile dune fields; quantification of the mobile dune fields differences map; temporal evolution of the mobile dune fields surrounds map. The El Niño episodes have directly affected the atmospheric circulation, what have enhanced the sedimentary input in the sand dune, what can justify the relative area growth between the years of 1993 and 2001. The dynamic of the landscape transition were higher than the stability of the spatial pattern of the dune and it's surrounds, as a result the Rio Grande do Norte eastern coast dune fields, specially the mobile dunes from Touros, Zumbi and Maracajau have shown a decrease on the sedimentary cover without vegetation area from 1970 to 2007. Therefore, the data acquired and the techniques used, can be, eventually applied to the mobile dune fields monitoring in order to preserve the dune ecosystems in the Rio Grande do Norte coast

Sistemas orbitais e aéreos aplicados à análise multi-escala da tectônica rúptil atuante na borda sudeste da Bacia do Parnaíba

The tectonics activity on the southern border of Parnaíba Basin resulted in a wide range of brittle structures that affect siliciclastic sedimentary rocks. This tectonic activity and related faults, joints, and folds are poorly known. The main aims of this study were (1) to identify lineaments using several remotesensing systems, (2) to check how the interpretation based on these systems at several scales influence the identification of lineaments, and (3) to contribute to the knowledge of brittle tectonics in the southern border of the Parnaíba Basin. The integration of orbital and aerial systems allowed a multi-scale identification, classification, and quantification of lineaments. Maps of lineaments were elaborated in the following scales: 1:200,000 (SRTM Shuttle Radar Topographic Mission), 1:50,000 (Landsat 7 ETM+ satellite), 1:10,000 (aerial photographs) and 1:5,000 (Quickbird satellite). The classification of the features with structural significance allowed the determination of four structural sets: NW, NS, NE, and EW. They were usually identified in all remote-sensing systems. The NE-trending set was not easily identified in aerial photographs but was better visualized on images of medium-resolution systems (SRTM and Landsat 7 ETM+). The same behavior characterizes the NW-trending. The NS-and EW-trending sets were better identified on images from high-resolution systems (aerial photographs and Quickbird). The structural meaning of the lineaments was established after field work. The NEtrending set is associated with normal and strike-slip faults, including deformation bands. These are the oldest structures identified in the region and are related to the reactivation of Precambrian basement structures from the Transbrazilian Lineament. The NW-trending set represents strike-slip and subordinated normal faults. The high dispersion of this set suggests a more recent origin than the previous structures. The NW-trending set may be related to the Picos-Santa Inês Lineament. The NS-and EW-trending sets correspond to large joints (100 m 5 km long). The truncation relationships between these joint sets indicate that the EW-is older than the NS-trending set. The methodology developed by the present work is an excellent tool for the understanding of the regional and local tectonic structures in the Parnaíba basin. It helps the choice of the best remote-sensing system to identify brittle features in a poorly known sedimentary basin

Detecção de áreas degradadas na sub-bacia hidrográfica do rio taperoá/pb, utilizando parâmetros físicos dos sensores modis/terra e tm/landsat

This study includes the results of the analysis of areas susceptible to degradation by remote sensing in semi-arid region, which is a matter of concern and affects the whole population and the catalyst of this process occurs by the deforestation of the savanna and improper practices by the use of soil. The objective of this research is to use biophysical parameters of the MODIS / Terra and images TM/Landsat-5 to determine areas susceptible to degradation in semi-arid Paraiba. The study area is located in the central interior of Paraíba, in the sub-basin of the River Taperoá, with average annual rainfall below 400 mm and average annual temperature of 28 ° C. To draw up the map of vegetation were used TM/Landsat-5 images, specifically, the composition 5R4G3B colored, commonly used for mapping land use. This map was produced by unsupervised classification by maximum likelihood. The legend corresponds to the following targets: savanna vegetation sparse and dense, riparian vegetation and exposed soil. The biophysical parameters used in the MODIS were emissivity, albedo and vegetation index for NDVI (NDVI). The GIS computer programs used were Modis Reprojections Tools and System Information Processing Georeferenced (SPRING), which was set up and worked the bank of information from sensors MODIS and TM and ArcGIS software for making maps more customizable. Initially, we evaluated the behavior of the vegetation emissivity by adapting equation Bastiaanssen on NDVI for spatialize emissivity and observe changes during the year 2006. The albedo was used to view your percentage of increase in the periods December 2003 and 2004. The image sensor of Landsat TM were used for the month of December 2005, according to the availability of images and in periods of low emissivity. For these applications were made in language programs for GIS Algebraic Space (LEGAL), which is a routine programming SPRING, which allows you to perform various types of algebras of spatial data and maps. For the detection of areas susceptible to environmental degradation took into account the behavior of the emissivity of the savanna that showed seasonal coinciding with the rainy season, reaching a maximum emissivity in the months April to July and in the remaining months of a low emissivity . With the images of the albedo of December 2003 and 2004, it was verified the percentage increase, which allowed the generation of two distinct classes: areas with increased variation percentage of 1 to 11.6% and the percentage change in areas with less than 1 % albedo. It was then possible to generate the map of susceptibility to environmental degradation, with the intersection of the class of exposed soil with varying percentage of the albedo, resulting in classes susceptibility to environmental degradation

Universalização do acesso à saúde e regulação dos planos privados de assistência à saúde: a atuação regulatória da ANS como instrumento de harmonia contratual e viabilização do papel suplementar da iniciativa privada na efetivação do direito social à saúde

While essential to human nature, health and life have been protected since ancient times by various areas of knowledge, particularly by the Law, given its dynamics within the regulation of social interactions. In Brazil, health has been granted major importance by the Federal Constitution of 1988, which, disrupting the dictatorial authoritarianism, inaugurating a Social State and focusing on the values of freedom and human dignity, raises health to the condition of a social right, marked predominantly by an obligational bias directed, primarily, to the State, through the enforcement of public policies. Although, given the limitation of the State action to the reserve for contingencies, it turns clear that an universalizing access to public health is impossible, seen that the high cost of medical provisions hinders the State to meet all the health needs of the rightholders. As a result of the inefficiency of the State, the effort of the Constituent Assembly of 1988 in creating a hybrid health system becomes nuclear, which, marked by the possibility of exploration of healthcare by the private initiative, assigns to the private enterprise a key role in supplementing the public health system, especially through the offer of health insurance plans. At this point, however, it becomes clear that health provisions rendered by the private agents are not unlimited, which involves discussions about services and procedures that should be excluded from the contractual coverage, for purposes of sectoral balance, situation which draws the indispensability of deliberations between Fundamental Rights on one hand, related to the protection of health and life, and contractual principles on the other hand, connected to the primacy of private autonomy. At this point, the importance of the regulation undertaken by the ANS, Brazilian National Health Agency, appears primordial, which, by means of its seized broad functions, considerable autonomy and technical discretion, has conditions to implement an effective control towards the harmonization of the regulatory triangle, the stability and development of the supplementary health system and, consequently, towards the universalization of the right to health, within constitutional contours. According to this, the present essay, resorting to a broad legislative, doctrinal and jurisprudential study, concludes that economic regulation over the private healthcare sector, when legitimately undertaken, provides progress and stability to the intervening segment and, besides, turns healthcare universalization feasible, in a way that it can not be replaced efficiently by any other State function.

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Desenvolvimento e avaliação do emprego de dispositivo ajustável ao corpo para treinamento de habilidade de acesso venoso periférico no membro superior

OBJECTIVE: To dev elop and evaluate the use of a body adjustable device for training of peripheral venous catheterization for healthcare undergraduate students . METHODS: This study involved two phases: I) development of the innovative simulator and II) a controlled trial co mparing the performance of the body adjustable device in relation to the commercial simulator for the training of venipuncture skills. A total of 79 first - year medical students participated in the intervention phase, which consisted of pretest assessment, lecture on peripheral venous access, randomization into two groups according to the simulator used for training (Commercial Simulator and Experimental Simulator), real venipuncture procedure, post - test assessment and evaluation of satisfaction. RESULTS: Gr oups were homogeneous in age, sex, pre - test and post - test scores, attitudinal assessment and performance in performing the real venipuncture. Students from the Experimental Simulator group performed better on the filling of simulated records. At the end of the study, cognitive gain significantly increased in both groups. The degree of realism perceived by students was equivalent for two groups. A total of 85.7% of students rated the Experimental Simulator as good or excellent. CONCLUSIONS: Experimental simu lator proved to be a low cost alternative for the training of venipuncture skills in upper limb. The cognitive procedural and attitudinal performances of students who used the experimental simulator were similar to those observed in the group trained with commercial simulator.

Análise da influência do efeito esteira de aerogeradores no microclima na superfície do solo: o caso do parque eólico piloto de Macau/RN

This study aimed to evaluate the microclimate changes surrounding the wind farm Macau Pilot / RN, present in the municipality of the same name. To achieve this goal made use of remote sensing techniques using Landsat - 5 TM and 7 ETM +, from which made it possible evaluation of temperature changes on the surface, this around the park in periods prior to its implementation, to the today. For evaluation of the temperature data that has been generated by applying a template was performed its correlation with field data collection and evaluated the degree of correlation, in order to confirm the validity of the data acquired by satellite. Also held was a characterization of the climate of the region based on the data of this climatological station in Macau. Once collected this data made possible the evaluation of climate change policy in the study region. After validation of the temperature models, an analysis of the generated temperature histograms was performed visually could not identify any significant change. However when analyzing the temperature data at a higher level of detail, a data pattern of behavior was detected for both periods evaluated, yet could not see a distinction between the periods of pre-operation of the park, and post-operation . From this result was levantas hypotheses to explain the behavior of the data, the first of which is the presence of moisture in the soil, and the second to the soil composition. In order to validate the hypotheses were applied PDI techniques, involving a combination of different RGB bands of Landsat 5 and the implementation of Reason bands procedure that might show the elements present on the soil surface.

Referência e contra referência em saúde bucal: regulação do acesso aos centros de especialidades odontológicas

Objective Based on the system of reference and counter-reference and comprehensiveness in oral health care, we aimed to examine ways of refering users to Specialized Dental Care Centers (SDCC) and the interface between them and Primary Care. Methods This is a cross-sectional study carried out with users and dentists of SDCC in a metropolitan region of Northeast of Brazil. Analyses were descriptive, and the association test was done with chi-square. Results Six forms of entry to specialized service were identified: free demand (13.8 %) and reference by the Primary Care dentist (63.2 %) were most frequent. Users referred by the basic health unit dentist had more interest in making a counter-reference than the others (p<0.001, PR=4.65, 95 % CI: 2.74 to 7.91), while individuals without this referral had 1.49 times more difficulty obtaining care (95 % CI: 1.02 to 2.17). Referral procedures are a decisive factor for counter-references. However, the high demand for primary care services and the short supply these services can offer in the face of needs make SDCC performance difficult. Conclusion The analysis of oral health practices from the perspective of network modeling points to the service's need to establish protocols for regulation in a bid to improve access to and the quality of care provided.

Referência e contra referência em saúde bucal: regulação do acesso aos centros de especialidades odontológicas

Objective Based on the system of reference and counter-reference and comprehensiveness in oral health care, we aimed to examine ways of refering users to Specialized Dental Care Centers (SDCC) and the interface between them and Primary Care. Methods This is a cross-sectional study carried out with users and dentists of SDCC in a metropolitan region of Northeast of Brazil. Analyses were descriptive, and the association test was done with chi-square. Results Six forms of entry to specialized service were identified: free demand (13.8 %) and reference by the Primary Care dentist (63.2 %) were most frequent. Users referred by the basic health unit dentist had more interest in making a counter-reference than the others (p<0.001, PR=4.65, 95 % CI: 2.74 to 7.91), while individuals without this referral had 1.49 times more difficulty obtaining care (95 % CI: 1.02 to 2.17). Referral procedures are a decisive factor for counter-references. However, the high demand for primary care services and the short supply these services can offer in the face of needs make SDCC performance difficult. Conclusion The analysis of oral health practices from the perspective of network modeling points to the service's need to establish protocols for regulation in a bid to improve access to and the quality of care provided.

Fuzzy angel: uma arquitetura distribuída de telemedicina para monitoramento de pacientes com esclerose lateral amiotrófica

The Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease characterized by progressive muscle weakness that leads the patient to death, usually due to respiratory complications. Thus, as the disease progresses the patient will require noninvasive ventilation (NIV) and constant monitoring. This paper presents a distributed architecture for homecare monitoring of nocturnal NIV in patients with ALS. The implementation of this architecture used single board computers and mobile devices placed in patient’s homes, to display alert messages for caregivers and a web server for remote monitoring by the healthcare staff. The architecture used a software based on fuzzy logic and computer vision to capture data from a mechanical ventilator screen and generate alert messages with instructions for caregivers. The monitoring was performed on 29 patients for 7 con-tinuous hours daily during 5 days generating a total of 126000 samples for each variable monitored at a sampling rate of one sample per second. The system was evaluated regarding the rate of hits for character recognition and its correction through an algorithm for the detection and correction of errors. Furthermore, a healthcare team evaluated regarding the time intervals at which the alert messages were generated and the correctness of such messages. Thus, the system showed an average hit rate of 98.72%, and in the worst case 98.39%. As for the message to be generated, the system also agreed 100% to the overall assessment, and there was disagreement in only 2 cases with one of the physician evaluators.