122 resultados para Complicações Pós-operatórias


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Bone marrow transplantation (BMT) is currently the best therapeutic option for patients with hematologic diseases, solid tumors or autoimmune disorders. It is characterized by intravenous infusion of hematopoietic stem cells in order to restore marrow function. However, this procedure requires concomitant immunosuppression treatment, which favors the development of certain complications, often manifested in the oral cavity. This study aimed to evaluate the incidence of oral changes in patients undergoing BMT and to correlate these results with clinical aspects related to the patients and the transplants performed. This is a prevalence study, with cross-sectional design, carried out in a BMT service at the Institute of Onco-Hematology of Natal (ION) and Natal Hospital Center. Data collection was based on questionnaires, clinical examination of the oral cavity and consultation in the medical records. The sample consisted of 51 patients undergoing BMT. After the analysis, was found a general status with good health conditions and presence of oral changes in about half of patients who composed the sample. The manifestations observed were, in decreasing order of frequency: mucositis; gingival alteration and thrombocytopenic purpura; mucosal pigmentation; lichenoid reaction and candidiasis. The oral changes were observed more frequently in cases of allogeneic TMO, in different periods post-transplant, without significant differences related to the source of cells. It was found statistically significant association between the presence of graft-versus-host disease (GVHD) and oral changes (p < 0,001). Therefore, it is concluded that there is a relatively high incidence of changes in oral cavity of patients receiving bone marrow transplantation, a fact which confirms the need to consider this site for examination, diagnosis, treatment and prognosis of possible complications of BMT

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The childhood cancer is characterized by a predominance of hematogenic and lymphatic system neoplasm, although a fTequency of the central nervous system tumors and sarcomas are widely common. Particularities of many childhood cancers and the adverses effect of the antineoplastic agents can change radically the oral environrnent and predisposes to the risk of oral complications. This study assessment clinically the oral health of 40 children on treatment for different types of malignant neoplasm with age range of O to 1S years old (Group I) and compared to 38 nonnal children in the same age range (Group lI). The results shown that nonnal patients had a gingival bleeding index (GBI) and caries experience minar than patients of Group lI, the visivel plaque index (VPI) was lightly higher in patients of Group 1. There was not difference statistically significant in the variables. Sixteen patients of Group I developed together 61 oral complications with predominance of mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy, that complication were most commons in patients with systemic neoplasm. Its was concluded that patients submitted to antineoplastic therapy with poor oral health had a higher risk to develop oral complications

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The present study evaluated the influence of non-surgical periodontal treatment on the levels of C- reactive protein (hsCRP) in patients with chronic renal failure (CRF) in pretransplant. We conducted a controlled and randomized trial to evaluate the periodontal condition and plasma concentrations of hsCRP, albumin and transferrin in 56 dialysis patients divided into two groups: experimental and control. The study was conducted at the dental clinic of Family and Community Health s Unit (USFC), located in Onofre Lopes University Hospital (HUOL), Federal University of Rio Grande do Norte (UFRN), from December 2010 to November 2011. Severe periodontitis was the type of periodontal disease more common, affecting 78.6% of patients. Periodontal conditions, evaluated through the means of probing depth, clinical attachment level, bleeding index and plaque index, proved to be uniform for both groups at the initial examination. There were no differences in levels of inflammatory markers between the two groups. The analysis of the concentrations of hsCRP allowed classifying study participants as at high risk of developing cardiovascular disease. After completion of periodontal treatment in the experimental group, there was a statistically significant reduction of the mean of all periodontal parameters assessed; however this improvement of periodontal health was not accompanied by changes in the levels of hsCRP, albumin and transferrin in the evaluation time. Given this, the periodontal treatment did not promote the reduction of systemic inflammatory burden and risk of cardiovascular complications in patients with CRF

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Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome characterized by widespread musculoskeletal pain with palpable tender points, muscle stiffness, fatigue, and sleep disturbances. Patients with FM have hormonal changes that are directly correlated with symptoms of the syndrome. The neuroendocrine regulation may be impaired, with abnormalities in the hypothalamus-pituitary-adrenal (HPA) axis with various hormones showing changes in their levels. In women in fertile period, various gonadal hormones are associated with symptoms of the syndrome, but studies focusing only a population of women in post-menopausal period who do not use hormone replacement are rare. We developed an analytical cross sectional study to assess the plasma levels of cortisol and dehidroepiandrosterona sulfate (DHEA-S) with quimioluminescence method in a group of 17 women with FM and 19 healthy women in post-menopause who do not use hormone replacement and observe the correlation with the symptoms of pain through algometry, depression and physical functional capacity measured from the Beck Depression Index (BDI) and the Fibromyalgia Impact Questionnaire (FIQ). Three blood samples were collected in the morning (between 8:00 9:30) with an interval of 24 hours for the measurements of hormonal levels and biochemical profile. There were no immunological or lipid changes in patients with FM. Comparing the two groups, there is no difference in levels of cortisol and a tangential effect for DHEA-S (p=0,094) with the lowest levels in the FM. DHEA-S also correlated with pain threshold (r=0,7) and tolerance (r=0,65) in group FM. We found the presence of depressive state and low physical functional capacity in FM. It was also evident that women in post-menopausal period, DHEA-S should influence the symptoms of increased sensitivity to pain, but not the presence of depressive status and low physical functional

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Parental care s costs increase with the time spent due to incapacity of parents give assistance to increasing offspring food s requirement. This parental care deficits is crucial to offspring s emancipation that involve abilities development to they survive independently. In this work we observe 16 Red-footed boobies chick (Sula sula) on different stages of development, at area of Parque Nacional Marinho of Fernando de Noronha s archipelago, from August to October of 2005. Our data show the parents presence decrease during chick development and an activity frequency modification, in move and fly, which suggest the emancipation s chick development. We observe also the action of Kleptoparasits and the influence with offspring parental care. Our data show consistency with the literature. However, we consider that studies carried through during the peak of the reproductive station can support the hypothesis of that the conflicts, together with the initial period of development of the flight, can be representative in terms of mortality of chicks for the studied species

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Worldwide, the diabetes mellitus is considered a serious problem of public health; it also involves high costs for its treatment and its complications. Even though the onset of diabetes mellitus type 1 is on 5% to 10% of the diabetic population, it is the most aggressive type of anifestation; furthermore, it is the commonest chronic disease in childhood and adolescence. Such data show the importance of understanding the development of this disease from the moment the individual perceives it, according to their experience, observing the complexity of the phenomenon thoroughly. This study aimed to comprehend the experience of the adolescent with onset of diabetes mellitus type 1 in order to learn how these young individuals perceive and reason their place in the world when they experience this illness. The methodological strategy was based on qualitative research of phenomenological inspiration. We applied the main ideas of heideggerian ontology and some concepts of existential phenomenological psychology to guide our reflexive path. The participants were 10 young individuals (06 female and 04 male), ages between 15 and 18, under treatment in the city of Recife, Pernambuco. The methodological resource was the narrative, which allowed us access to the adolescents experience. The comprehension of the reports was based on the heideggerian hermeneutics, whose priority is the interpretation of the meaning expressed by the participants speech. The results showed that factors such as social, family, economic and cultural context greatly influence the perception and the way the individuals deal with, perceive and reason their experience. We noticed that the diabetes type 1 may often represent a limitation, but it does not make it impossible to be part of the world with others. The data show a significant affective ambivalence regarding the content more directly related to the disease. This demonstrates the unique way which each one gives meaning and reasons their condition of existence. This research points out the need to understand the complexity of this phenomenon in a more complete manner, considering the adolescent in their timely and historical context. We believe we can encourage thinking that may become actions which are more fit to the reality researched regarding all the parties involved with the subject, such as health professionals, adolescents, family, support programs and public health policies

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

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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

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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

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O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

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The present research study the work professional of the Social worker in the National Institute of Social Security of Rio Grande do Norte s State, especially about the working terms, the demands and working process of Social worker in consequence of the limits established with disorganization of his institutional space derived of the Counter-Reforms of the State and of Social Security. In decade of 1990 there was in Brazil adhesion to the neoliberal politics what configured a new organization of work and a new performance of the State. Inside this context, it was accomplished the Counter-Reforms with emphasis in the privatizations, reform of the Social Security and of the device of the Brazilian State, among other actions. Particularly, in Social Service reforms brought profound consequences for the Social workers of INSS, among it: reduction of professionals and in his institutional space. This study situates the Social Worker of Social Security in front of the contemporary modifications in the world of work as well as in front of the consequences come upon of the Counter-Reforms implemented and executed by the neoliberal governments in the country of way the of frame and to enter to the globalized world and the new order of the capital. From the qualitative research based in the critical and dialectic theoreticianmethodological perspective that study the phenomena from your relations, mediations and contradictions, was possible unveil the limits and the possibilities of the professional work of the Social worker in INSS placed the Counter-Reforms of Social Security. Synthetically, the results of this investigation indicate that, there is an worsening in the inconsistency of the work with relation to social worker's functional situation and his working terms in the institution

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A dissertação versa sobre a Política de Assistência Estudantil e o processo de luta pela democratização do acesso à universidade, no contexto de expansão do ensino superior em tempos de crise estrutural do capital. Apresenta como unidade de análise as particularidades da pós-graduação em Serviço Social da UFRN e tem como objetivo principal apreender e analisar as condições de permanência disponibilizadas pela UFRN aos discentes de pós-graduação no contexto de expansão do Ensino Superior. O percurso teórico-metodológico de análise adotado na pesquisa se fundamentou numa perspectiva crítica do objeto de estudo a partir de uma concepção de totalidade, que pressupõe apreender as determinações socioeconômicas e políticas que incidem sobre a política de ensino superior e as condições de vida dos discentes do Programa de Pós-Graduação em Serviço Social (PPGSS). As análises fundamentaram-se em pesquisa bibliográfica como base teórico-metodológica da investigação, articulada com as reflexões que resultaram dos dados empíricos da pesquisa de campo na perspectiva de apreensão do objeto, em sua densidade histórica e num quadro de múltiplas determinações. Do ponto de vista metodológico foram entrevistados 26 discentes e realizada análise documental referentes a leis e documentos da política educacional em nível federal e dos organismos internacionais. A luta por ampliação do acesso à universidade está na agenda dos movimentos sociais no âmbito da educação, no entanto na conjuntura dos governos de Luis Inácio Lula da Silva (2003 a 2010) e Dilma Rousseff (2011 a 2012) a tendência tem sido seguir as orientações dos organismos internacionais e promover expansão de vagas sem assegurar estratégias de permanência compatíveis com as exigências de excelência acadêmica postas, por exemplo, na pós-graduação. Discentes entrevistados acessam o ensino superior e os cursos de pós-graduação e vivenciam dificuldades diárias para atender com qualidade às exigências acadêmicas em face de suas condições materiais de vida e de trabalho e dos limites da política de assistência estudantil que tem um perfil de programas e ações localizadas

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The study consists in an analysis of researches with tourism issues, in Master s and Doctoral level, investigating their epistemological trends, regarding the type of study that is being produced and the methods used. It is characterized as exploratory, documental and bibliographical, having undertaken a cross-sectional study which covers the period from 2007 to 2011. It analyzes the context of academically production in tourism, the nature of these researches, the methodological aspects adopted in these theses and dissertations, the philosophical inclinations and the coherence and contribution of the same. This research uses, the Digital Library of Theses and Dissertations (BDTD) and the secretariats of the Academic Centers of the Federal University of Rio Grande do Norte (UFRN) as means to collect data. It employs the technique of sampling by judgment and undertakes the research in various Academic Centers in UFRN, using the method of content analysis. It shows that, from the 643 studies analyzed, 43 of them have themes related to tourism, which characterized this study sample. This study realizes that PPGA is the largest producer of researches on tourism issues, ahead of PPGTur, which ranks the third position, in this aspect. Also realizes that all surveys analyzed are crosssectional and the theme further investigated, with 21% of the sample, is related to the marketing aspects of tourism, with the theme Directors of Hotels and Restaurants (DHR) . This research demonstrates that all sample surveys make use of interviews, and these are, mostly, structured. Also realizes that most of these studies, with 21% of the sample, employ the method of content analysis. The references in Portuguese are surveyed about five times more than the ones in other languages. It estimates that more than half of the sample is characterized as positivist, associated with aspects of functionalism. A minority of 21% of these researches seeks to identify and recommend solutions to the tourism issues, or even represent part of them. This research concludes that the studies in tourism are mostly unifocal, being driven by issues related to the touristic trade. PPGTur produces a number still unrepresentative of studies. The theses and dissertations of the sample are limited and/or unable to analyze the changes of the phenomenon caused by the time. The studies from the sample present criteria and make use of other methods and techniques to associate with the interviews and content analysis to obtain more solid and reliable data and results. They use a low number of references in languages other than Portuguese. Most of these studies, characterized as positivist-functionalist, investigate the functioning, planning, coordination and expectations in organizations, leaving aside other issues, also relevant for tourism. The number of studies aimed at identifying solutions to the problems of tourism, or that even represents part of them, is not expressive

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This study analyzed the perception of ethics on the part of students of Post-graduation in Tourism, to develop their academic research. It is characterized as exploratory-descriptive, being considered quantitative with some elements analyzed qualitatively. Data were collected through an electronic questionnaire, originated in google docs and sent via e-mail to 54 students in three graduate programs in Tourism: The Tourism Master of the Federal University of Rio Grande do Norte (UFRN), the Master in Tourism and Hospitality of the University of Vale do Itajai (UNIVALI) and Master of Tourism at the University of Caxias do Sul (UCS), resulting in 22 responses. The study presents a profile of the dissertation research of post-graduate students, their perception about research ethics, as well as the difficulties encountered in the research process. Notes that research of dissertation are geared mostly for the historical and cultural aspects of tourism and the choice of topics for the essays came in first place, due to the influence of the guiding lines of research and, secondly, due to social relevance. The methods used in post-graduate research are descriptive, the literature and exploratory. It also notes that most students graduate in tourism (81%) attaches great importance to ethics in carrying out their dissertation research, students claim that ethics brings credibility and seriousness to research. Furthermore, it was realized that they have no knowledge about the practice of misconduct by researchers in the field of Tourism. Demonstrate that the major ethical challenge encountered by students is in relationship with the research subject, what happens during data collection. It also notes that none of the respondents sent any project to be evaluated by an Ethics Committee (CEP), moreover, most do not know the resolution 196/96, which has the main guidelines on research ethics at national level. Concludes that the students post-graduate in tourism have little knowledge about the standards and guidelines on research ethics. They demonstrate ignore the benefits of research ethics in regarding the protection and preservation of the participant, as well as the benefits it generates for society

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This paper is set in a scenario in which higher education institutions suffer from external pressure to increase efficiency. The legislation after the Law of Directives and Bases for Education (LDBE), from 1996, is characterized by the fragmentation in its implementation, raising a concern with flexibility and innovation in several normative devices as well as aspects that must be incorporated to its organizational structure. The policies examined in this thesis are: Distance Education (DE); Law of Innovation and the Program of Support to Restructuring and Expansion of Federal Universities (PSREFU). This thesis aims to observe to what extent the characteristics of innovation and flexibility, which mark the new post- LDBE educational legislation, influence the organizational redesign of the Federal University of Ceará (UFC). For being about implementation policies, using contingency approach in order to collect the internal dynamics permeating the redesign of higher education institutions, the thesis focuses on the impacts caused by flexibility and innovation. This is a qualitative research, with case study methods, archive research and semi-structured interviews with members of the university administration. The results don t allow us to confirm the adoption of a more flexible and innovative configuration in the university but it is possible to identify the presence of those elements in the implementation changes, characterizing the hybrid structure. The changes mainly expose the extension of the management of projects to the administrative and academic components related to the institution. In terms of projection, the study found changes in the elements which characterize the current setting and the tendency of the university for adopting a diverse organizational structure. However, if the decentralization of management persists, the academic units may adopt their own structural solutions, but with no evidence of changes in the professional organization in most units. In this perspective, this thesis states that there are difficulties when incorporating innovation and flexibility to their organizational structure, which lead to improvised solutions, superposing skills through the redundancy of structures created with the same purpose or copying exogenous solutions