Efeitos da perda de peso induzida pela cirurgia bariátrica sobre a função respiratória

Background: Obesity leads to alteration of lung volumes and capacities due to accumulation of fat in the chest wall and abdomen. Few studies have shown that weight loss induced by surgery improves lung function. Our objective was to evaluate the anthropometric development, pulmonary function, respiratory muscle, strength and endurance after weight loss induced by bariatric surgery. Methods: We evaluated in pre and post operative period variables of weight, BMI, NC, WHR and spirometric and respiratory pressure. Results: 39 subjects were evaluated, with age mean 35.9 ± 10.9 years, predominantly by women (76.3%). The weight mean decreased from 124.8 ± 17.5 kg to 88.8 ± 14.28 kg in post operative. The mean BMI ranged from 47,9 ± 5,6 Kg/m² to 34,3 ± 4,75 Kg/m². There was a significant increase in FVC from 3,63 ± 0,94 to 4,01±1,03, FEV1 from 3,03 ± 0,72 to 3,39 ± 0,85, FEF 25-75% from 3,41 ± 0,72 to 3,82 ± 0,94, PEF from 6,56 ± 1,47 to 7,81 ± 1,69, ERV from 0,35 ± 0,39 to 0,66 ± 0,38, MVV ranged from 103,43 ± 22,21 to 137,27 ± 29,84, all of them to p<0,01. The MIP and MEP showed no significant difference in pre and post operative. It was noted that for every centimeter reduced in neck circumference, an increase of 0.06 in FVC and 5.98 in MVV is observed. This is also observed in weight and BMI. Conclusion: We conclude that weight loss induced by bariatric surgery in obese provides a significant improvement in lung function and reduction of fat around the neck is more important in the generation of lung volume than the reduction of BMI

A Perda Auditiva Induzida pelo Ruído (PAIR) na formação odontológica: conhecimentos e níveis de exposição

The rationalization of work in the Dentistry has been taking the professional to work for ways and systems based in the ergonomics, turning their work efficient and less tiring. Since their academic formation, the dentists surgeons are concerned with the high productivity in clinic and with the final result of the work, neglecting the way as it is executed, which reduce their work capacity and exhibits them to occupational diseases that could be minimized and/or forewarned. This research had as the main objective to investigate the knowledge of the Dentistry academics of Rio Grande do Norte Federal University concerning the Noise-induced Hearing Loss (NIHL), relating them at the noise levels that they are exposed, as well as to the preventive measures taken during the clinical activities. Was observed that 95% of the individuals know that the dentist surgeon is a professional in risk for NIHL. Among the causes of NIHL, the one that obtained the largest frequency citation was the high-speed handpieces, reminded by 92,4% of the academics. Among the students which enumerated protective measures for NIHL, 92% mentioned the use of the ear plugs, although 97% of the researched have told do not use any kind of preventive measure related to the noise. Was also observed that 96% of the academics notice the noise during the clinical attendance, what inconvenience 28,1% of them. Related the noise levels, the high-speed handpieces of the academics presented a medium value of 80,5 dB varying from 72,3 to 88,3 dB. The average of the ambient noise observed at the Integrated Clinic was about 74,8 dB. In spite of the noise levels in this research were observed below the established limits of tolerance by the legislation, they can provoke damages to the Dentistry professionals' health, or that suggests the need of an intervention and use of immediate preventive measures able to generate a healthy atmosphere of work and less risky

Experiências maternas de perda de um filho com câncer infantil: uma compreensão fenomenológico-existencial

Death due to childhood cancer reflects an early outcome of life, which can cause a strong repercussion in the mother s existence - figure to whom the greatest part of responsibilities during the child s illness is commonly allocated. The aim of this study is to understand the experience of mothers who have lost a kid as a consequence of childhood cancer, approaching the personal senses of this fact. Following a qualitative research design, with an exploratory and comprehensive approach, the study used the narrative method, which was obtained from a semi-structured interview, as the data generation procedure. The research counted on the participation of three adult mothers who had lost their kids because of childhood cancer, after - at least - a six-month period of oncologic treatment. The proposal of analysis follows the parameters of the phenomenological method and the data are based on Martin Heidegger s existential analytic. The results were structured into three thematic axes: previous History, child illness and its repercussions; The network of support and care; Loss and after loss: facing and signifying. It was possible to comprehend that the emergence of cancer in childhood promotes, since the diagnosis, a disruption of everyday meanings, accentuating the fragile condition of human life. In this specific circumstance of childhood illness, all the participants restricted their possibilities of being-in-the-world, dedicating exclusively to the practice of maternity. Concerning their relationship with their children in treatment, the narratives unveiled, in a convergent manner, the existence of care in a substitutive mode. In the network of support - primarily constituted by family, the health team and the support institutions - the relations were marked by proximity and detachment movements. With the child s death, mothers began to live a way of being-with the absent child , ensuring the continuity of the relationship with the dead infant. From the results exposed above, we can understand the motherly mourn as a singular experience in constant resignification, in which the subjective time overlaps the cronological time. The increment of anguish, resulting from the mother s confrontation to the question of finitude, mobilizes a process of change in their way of being-in-the-world, promoting an openness to new possibilities in their lives. Singular attention to the mother, during the process of illness and child loss, turns out to be fundamental

Hidrofobização, caracterização e aplicação da vermiculita para remoção de óleo insolúvel em água

Among the various layered silicates, vermiculite has been used as one of the adsorbent material by presenting the ion exchange capacity which facilitates the removal of organic compounds which are potential pollutants in relation to the water surface. The importance of the modification of clay minerals by hydrophobization with carnauba wax establishes the increase in oil removal capacity in aqueous medium, it contributes to a better environment for life in ecosystems. The vermiculite when expanded decreases its hydrophobicity requiring the use of a hydrophobizing leaving - the organoclay. In this work were used in the process of modifying the particle sizes of vermiculite -18+16, -16 +20 and -20 +35 #. Samples of vermiculite hydrophobized with carnauba wax and clay mineral without hydrophobizing were characterized with physicochemical analyzes and analytical. Techniques were used: thermal analysis (thermogravimetry and derivative thermogravimetry), infrared spectroscopy, scanning electron microscopy, fluorescence rays - x adsorption tests. The TG / DTG was used to evaluate the thermal behavior of expanded vermiculite and carnauba wax and samples hidrofobizadas with percentages of 5, 10 and 15 % by weight of hydrophobizing. The results of FTIR confirmed increase of the characteristic signs of carnauba wax in samples hidrofobizadas as the greatest amount of hydrophobizing the clay mineral used in hydrophobization. Thermogravimetry and FTIR show based on the results that coating the surface of the vermiculite occur homogeneously. The data obtained by the technique of x-ray fluorescence with loss on ignition confirmed the results of thermogravimetric analysis in relation to the percentage of wax incorporated. The fluorescence indicates through information provided by the analysis shows that the material covered - is homogeneous. The mev inspection was used to texture and morphology of the clay mineral with and without carnauba wax. The scanning electron microscopy confirms the deposition of wax evenly over the surface of the mineral as indicated by the other techniques. To verify the adsorption capacity of the clay without hydrophobizing hydrophobized and used a fixed volume of water to 1 ½ liters in each experiment with 3 g to 50 g of oil sample. The results show that better extraction of oil for the material processed corresponds to 260 % relative to the weight of the sample coated and greater than 80 % of the oil drop in the system

Influência da densidade de carga e da massa molar da poliacrilamida na reologia de sistemas microemulsionados

The knowledge of the rheological behavior of microemulsionated systems (SME) is of fundamental importance due to the diversity of industrial applications of these systems. This dissertation presents the rheological behavior of the microemulsionated system formed by RNX 95/alcohol isopropyl/p-toulen sodium sulfonate/kerosene/distilled water with the addition of polyacrylamide polymer. It was chosen three polymers of the polyacrylamide type, which differ in molar weight and charge density. It was studied the addition of these polymers in relatively small concentration 0,1% in mass and maximum concentration of 2,0%. It was made analysis of flow to determine the appearing viscosities of the SME and rheological parameters applying Bingham, Ostwald de Waale and Herschell-Buckley models. The behavior into saline environment of this system was studied for a solution of KCl 2,0%, replacing the distilled water. It was determined the behavior of microemulsions in relation with the temperature through curves of flow in temperatures of 25 to 60ºC in variations of 5ºC. After the analysis of the results the microemulsion without the addition of polymer presented a slight increase in its viscosity, but it does not mischaracterize it as a Newtonian fluid. However the additive systems when analyzed with low concentration of polymer adjusted well to the applied models, with a very close behavior of microemulsion. The higher concentration of the polymer gave the systems a behavior of plastic fluid. The results of the temperature variation point to an increase of viscosity in the systems that can be related to structural changes in the micelles formed in the own microemulsion without the addition of polymer

Interações entre a carboximetilcelulose, carbonato de cálcio e bentonita: repercussões sobre as propriedades dos fluidos de perfuração aquosos

The role of carboxymethylcellulose (CMC) in association to calcium carbonate particles (CaCO3) in most water-based drilling fluids is to reduce the fluid loss to the surrounding formation. Another essential function is to provide rheological properties capable of maintaining in suspension the cuttings during drilling operation. Therefore, it is absolutely essential to correlate the polymer chemical structure (degree of substitution, molecular weight and distribution of substituent) with the physical-chemical properties of CaCO3, in order to obtain the better result at lower cost. Another important aspect refers to the clay hydration inhibitive properties of carboxymethylcellulose (CMC) in drilling fluids systems. The clay swelling promotes an undesirable damage that reduces the formation permeability and causes serious problems during the drilling operation. In this context, this thesis consists of two main parts. The first part refers to understanding of interactions CMC-CaCO3, as well as the corresponding effects on the fluid properties. The second part is related to understanding of mechanisms by which CMC adsorption occurs onto the clay surface, where, certainly, polymer chemical structure, ionic strength, molecular weight and its solvency in the medium are responsible to affect intrinsically the clay layers stabilization. Three samples of carboximetilcellulose with different molecular weight and degree of substitution (CMC A (9 x 104 gmol DS 0.7), CMC B (2.5 x 105 gmol DS 0.7) e CMC C (2.5 x 105 gmol DS 1.2)) and three samples of calcite with different average particle diameter and particle size distribution were used. The increase of CMC degree of substitution contributed to increase of polymer charge density and therefore, reduced its stability in brine, promoting the aggregation with the increase of filtrate volume. On the other hand, the increase of molecular weight promoted an increase of rheological properties with reduction of filtrate volume. Both effects are directly associated to hydrodynamic volume of polymer molecule in the medium. The granulometry of CaCO3 particles influenced not only the rheological properties, due to adsorption of polymers, but also the filtration properties. It was observed that the lower filtrate volume was obtained by using a CaCO3 sample of a low average size particle with wide dispersion in size. With regards to inhibition of clay swelling, the CMC performance was compared to other products often used (sodium chloride (NaCl), potassium chloride (KCl) and quaternary amine-based commercial inhibitor). The low molecular weight CMC (9 x 104 g/mol) showed slightly lower swelling degree compared to the high molecular weight (2.5 x 105 g/mol) along to 180 minutes. In parallel, it can be visualized by Scanning Electron Microscopy (SEM) that the high molecular weight CMC (2.5 x 105 g/mol e DS 0.7) promoted a reduction in pores formation and size of clay compared to low molecular weight CMC (9.0 x 104 g/mol e DS 0.7), after 1000 minutes in aqueous medium. This behavior was attributed to dynamic of interactions between clay and the hydrodynamic volume of CMC along the time, which is result of strong contribution of electrostatic interactions and hydrogen bounds between carboxylate groups and hydroxyls located along the polymer backbone and ionic and polar groups of clay surface. CMC adsorbs on clay surface promoting the skin formation , which is responsible to minimize the migration of water to porous medium. With the increase of degree of substitution, it was observed an increase of pores onto clay, suggesting that the higher charge density on polymer is responsible to decrease its flexibility and adsorption onto clay surface. The joint evaluation of these results indicate that high molecular weight is responsible to better results on control of rheological, filtration and clay swelling properties, however, the contrary effect is observed with the increase of degree of substitution. On its turn, the calcite presents better results of rheological and filtration properties with the decrease of average viii particle diameter and increase of particle size distribution. According to all properties evaluated, it has been obvious the interaction of CMC with the minerals (CaCO3 and clay) in the aqueous medium

Desempenho auditivo ao longo do tempo e satisfação dos usuários de implante coclear com perda auditiva pós-lingual

Most cochlear implant (CI) users, who suffer from post lingual hearing loss, are able to perceive sounds and comprehend speech after the implant. The prediction of maximal benefit over time, with the use of CI, can be useful for counseling patients about their expectations in using the new device. The measurement of satisfaction should be of primary interest in medical intervention, as the results may be used for intervention feedback. The purpose of this study is to analyze auditory performance of CI over time, as well as to evaluate users‟ satisfaction. Therefore two types of study designs were employed: a) retrospective cohort study with the analysis of medical records from 59 subjects about auditory performance before and after surgery. Results were submitted to the Kaplan -Meier estimator of cumulative probability and compared to prognostic factors of auditory performance using the logrank test. b) A sectional study design was conducted to evaluate the satisfaction of 51 subjects. The instrument consists of two specific questionnaires: Satisfaction with Amplification in Daily Life SADL and International Outcome Inventory Cochlear Implant IOI- CI. Results show statistical significant differences (p<0,001) in auditory performance before and after CI. The majority obtained satisfactory results of CI use during the first six months. Logrank tests does not indicate significant correlation between the analyzed covariates and the time in which adequate speech perception occurs. SADL e IOI-CI questionnaires indicate that most of the CI users are satisfied with their devices. The SADL detected a 27, 5% insatisfaction amongst CI users in relation to services and costs involved with the CI. The results of the IOI show 4% of insatisfaction with the use of CI and the social environment. In conclusion CI is capable to rehabilitate social auditory function in a short period of time and CI users demonstrate satisfaction with auditory, social and psychological gain offered through CI device

Bolton freeware: aplicativo de avaliação de discrepância de massa dentária desenvolvido pelo programa de pós-graduação em odontologia/UFRN

The calculation of tooth mass discrepancy, essential for good planning and a proper orthodontic finishing, when performed manually, besides being laborious, requires considerable time consumption. The aim of this study was to develop and test Bolton Freeware, a software for analysis of the tooth mass discrepancy of Bolton, aiming to minimize the consumption of time in a less onerous way. The digital analysis of the software was done by means of two-dimensional scanning of plaster study models and compared to manual evaluation (gold standard), using 75 pairs of stone plaster study models divided into two groups according to the magnitude of the Curve of Spee (group I from 0 to 2 mm, group II greater than 2 to 3mm). All the models had permanent dentition and were in perfect condition. The manual evaluation was performed with a digital caliper and a calculator, and the time required to perform the analysis for both methods was recorded and compared. In addition, the software was evaluated by orthodontists regarding its use, by means of questionnaires developed specifically for this purpose. Calibration was performed prior to manual analysis, and excellent levels of inter-rater agreement were achieved, with ICC > 0.75 and r > 0.9 for total and anterior proportion. It was observed in the evaluation of error of the digital method that some teeth showed a significant systematic error, being the highest measured at 0.08 mm. The analysis of total tooth mass discrepancy performed by Bolton Freeware, for those cases in which the curve of Spee is mild and moderate, differ from manual analysis, on average, 0.09 mm and 0.07 mm respectively, for each tooth evaluated, with r> 0, 8 for total and anterior proportion. According to the specificity and sensitivity test, Bolton Freeware has an improved ability to detect true negatives, i.e. the presence of discrepancy. The Bolton analysis digitally performed was faster, with an average difference of time consumed to perform the analysis of Bolton between the two methods of approximately 6 minutes. Most experts interviewed (93%) approved the usability of the software

Influência do tamoxifeno associado ao diabete melito na densidade mineral óssea

Considering that osteopenia and osteoporosis are diabetes mellitus complications, and that tamoxifen (TAM) is an anti-estrogenic drug used in breast cancer treatment, this drug may have a beneficial action preventing accentuaded bone loss associated to diabetes. Female Wistar rats (n=60) weighting 180-250g were divided in four groups: Group C, control animals (n=5); Group T, animals treated with TAM (n=5); Group D, diabetic animals (n=5); and Group DT, diabetic animals treated with TAM (n=5). Oestrus cycle was evaluated before the beggining of experimental period to select the animals with regular cycle. This evaluation continued throughout the study period and for all studied groups. Diabetes was induced by a intra perithoneal injection of streptozotocin (STZ) in a concentration of 45 mg/Kg of body weight. Those animals with serum glicose levels 250 mg/dL were considered diabetics. Animals were sacrificed in the periods of 30, 60 and 90 days after diabetes onset. Left femur histomorphometric measurements and serum biochemical analysis (glycemia, alkaline phosphatase, tartaric-resistant acid phosphatase, calcium, phosphorous, magnesium, total proteins, albumin, globulins, urea and creatinine) were done. Histomorphometric results showed a progressive bone loss in Group D animals when compared to those from Group C all over the experimental period, becoming accentuaded in the 90 days period. In relation to Groups T and DT, values approcimated to those obtained for control group were found during the whole period of study. Those data may indicate a bone mass recovery or a diminished bone loss due to diabetes when animals were treated with TAM. During the whole experimental period animals of groups D and DT maintained glycemic levels above 250 mg/dL whereas animals of groups C and T maintained those levels below 150mg/dL. Alkaline phosphatase activity was increased in all study periods for groups D and DT when compared to group C animals over the 90 days period. Tartarate-resistant acid phosphatase activity was showed unaltered in all periods of study and for all groups. Calcium and magnesium results were also unaltered, maintaining reference levels for all groups in all experimental periods. Phosphorous levels were increased in groups D and DT when compared to groups C and T in the 30 days period. However no difference was found in the periods of 60 and 90 days for this test. No difference was found for total proteins levels for groups C, T, D and DT over the study period. Albumin levels were reduced in DT group in the 60 days period and in D and DT groups in the 90 days period. Urea levels were significantly increased in the 30, 60 and 90 days study periods in groups D and DT when compared to groups C and T. Creatinine results showed a significantly increase in the 90 days period for groups D and DT when compared to groups C and T, and maintaining unaltered in the 30 and 60 days periods. These results suggest that the treatment with TAM may reduce bone loss caused by diabetes mellitus