Cuidados de enfermagem ao paciente em pós-operatório de prostatectomia: revisão integrativa

Este estudo trata-se de revisão integrativa da literatura com objetivo de sintetizar o conhecimento produzido em artigos sobre os cuidados de enfermagem aos pacientes em pós-operatório de prostatectomia. Para seleção dos artigos foram consultadas cinco bases de dados – SCOPUS, CINAHL, PUBMED, LILACS e Cochrane – sendo incluídos dezenove artigos. Os resultados mostram estudos que se enquadram nos níveis II, IV, V, VI e VII de evidência, a maioria realizada nos Estados Unidos durante os anos de 1999 a 2011. Os cuidados de enfermagem identificados foram agrupados em seis categorias: acompanhamento psicológico, orientações pós-operatórias, tratamento da disfunção erétil, tratamento da incontinência urinária, tratamento da dor e tratamento da hiponatremia. Conclui-se que os estudos com maior nível de evidência identificado recomendam cuidados de enfermagem centrados no acompanhamento psicológico, nas orientações do período pós-operatório e no tratamento da disfunção erétil. Destaca-se ainda que tais recomendações concentram-se, sobretudo, nas ações de apoio emocional e educativo

Avaliação das condições higiênico-sanitárias da produção de refeições à base de carne da alimentação escolar no município de Natal-RN

The National School Nutrition Program is the oldest program in the country directed at food and nutrition safety. Its aims are to offer nutritional food as a supplement to students of public and philanthropic schools. Studying school nutrition transcends the investigation as a purely social program, given that it reaches the fields of public health, nutrition and food, using a wide variety of approaches. Thus, it is characterized by a multidisciplinary study, where the disciplines work side by side in distinct aspects of a single problem. Aim: This study aims to assess hygiene practices during the preparation of meat-based meals in public schools in the city of Natal, Brazil. Methods: A list was applied at 27 schools to identify the procedures of good food preparation practices. In addition, cooking and meal distribution temperature were measured and a microbiological analysis of the final preparation and of the water used in preparing it was performed. For microbiological analyses of the food, we analyzed coliforms at 45°C, coliforms at 35°C and Enterococcus, and for the water, we analyzed thermotolerant coliforms and total coliforms, using the methods recommended by APHA, 1995. Results: Most of the schools did not meet the required standards in all the variables related to good food preparation practices, except for the time spent preparing the meat, in which 89% were within the norm. Cooking temperature of the meals was within the standard; however, the temperature at distribution and the time spent dispensing the meals were inadequate. Of the 27 schools, 22 (81.5%) showed the presence of coliforms at 35° C in at least one meal sample and 18 (66.7%) had values above the recommended limit for coliforms at 45°C. The presence of E. coli was identified in 6.1% of the samples analyzed. The presence of Enterococcus was not found at any of the schools. With respect to the water, the North district of the city was the only one that did not meet the standards for the two indicators evaluated. The contamination found was not associated with the hygiene or food storage problems observed. Conclusions: The results show that the hygiene-sanitary conditions of meat-based public school meals were unsatisfactory, demonstrating the need for improvements in the production process to preserve the health of the student population. Multidisciplinarity: Researchers from the areas of food microbiology, nutrition, public health and statistics took part in this study, a decisive factor for characterizing the research as multidisciplinary

Um modelo analítico da qualidade da dieta de adolescentes estudantes da rede publica de ensino de Natal, Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Estudo da influência de pré-tratamentos de dois resíduos lignocelulósicos (bagaço do pedúnculo de caju e casca de coco) utilizados como substrato na indução à síntese de enzimas celulolíticas

Nowadays generation ethanol second, that t is obtained from fermentation of sugars of hydrolyses of cellulose, is gaining attention worldwide as a viable alternative to petroleum mainly for being a renewable resource. The increase of first generation ethanol production i.e. that obtained from sugar-cane molasses could lead to a reduction of lands sustainable for crops and food production. However, second generation ethanol needs technologic pathway for reduce the bottlenecks as production of enzymes to hydrolysis the cellulose to glucose i.e. the cellulases as well as the development of efficient biomass pretreatment and of low-cost. In this work Trichoderma reesei ATCC 2768 was cultivated under submerged fermentation to produce cellulases using as substrates waste of lignocellulosic material such as cashew apple bagasse as well as coconut bagasse with and without pretreatment. For pretreatment the bagasses were treated with 1 M NaOH and by explosion at high pressure. Enzyme production was carried out in shaker (temperature of 27ºC, 150 rpm and initial medium pH of 4.8). Results showed that T.reesei ATCC 2768 showed the higher cellulase production when the cashew apple bagasse was treated with 1M NaOH (2.160 UI/mL of CMCase and 0.215 UI/mL of FPase), in which the conversion of cellulose, in terms of total reducing sugars, was of 98.38%, when compared to pretreatment by explosion at high pressure (0.853 UI/mL of CMCase and 0.172 UI/mL of Fpase) showing a conversion of 47.39% of total reducing sugars. Cellulase production is lower for the medium containing coconut bagasse treated with 1M NaOH (0.480 UI/mL of CMcase and 0.073 UI/mL of FPase), giving a conversion of 49.5% in terms of total reducing sugars. Cashew apple bagasse without pretreatment showed cellulase activities lower (0.535 UI/mL of CMCase and 0,152 UI/mL of FPase) then pretreated bagasse while the coconut bagasse without pretreatment did not show any enzymatic activity. Maximum cell concentration was obtained using cashew nut bagasse as well as coconut shell bagasse treated with 1M NaOH, with 2.92 g/L and 1.97 g/L, respectively. These were higher than for the experiments in which the substrates were treated by explosion at high pressure, 1.93 g/L and 1.17 g/L. Cashew apple is a potential inducer for cellulolytic enzymes synthysis showing better results than coconut bagasse. Pretreatment improves the process for the cellulolytic enzyme production

Estudo da desidratação osmótica da cenoura (Daucus carota) em fatias

In the area of food dehydration, drying of vegetables has a very representative position, it has the objective to preserve the surplus of crops and began with sun drying. Among the vegetable is the carrot, which had its origin in Southeast Asia and in Brazil is a vegetable cultivated enough. The principal objective of this works is to find alternative ways for the conservation of carrot slices by osmotic dehydration with additional drying in heart. Were initially defined the best conditions of pre-osmotic dehydration (temperature, immersion time, type of osmotic solution) based on the results of humidity loss, solid gain, weight reduction and efficiency ratio of predehydrated carrots slices. The osmotic solutions used were composed by NaCl (10%) and sucrose (50 ° Brix) named DO1 and sucrose (50 ° Brix) called DO2. Was made experiment of pre-osmotic dehydration of carrot slices in two temperature levels, with complementary drying in heart with air circulation at 70 º C. Sensory analysis was performed and the study of slices dehydration osmotically and the slices without osmotic treatment. The best results were obtained with the solution DO1 60°C with immersion time of 60 min. The drying of carrot slices presented period of constant rate and decreasing rate. The osmotic pre-treatment reduced the initial humidity of carrot slices, reducing the time to the product to reach the same humidity content. Fick's model, considering the shrinkage, and the Page s model, adapt satisfactorily to experimental datas, allowing the determination of effective diffusion coefficients, consistent with the references. The results of sensory analysis of dry product, showed greater acceptance of sliced carrots with osmotic treatment

Produção de enzimas por fungos em fermentação semi-sólida utilizando bagaço de coco e pedúnculo de caju como substratos

The production of enzymes by microorganisms using organic residues is important and it can be associated with several applications such as food and chemical industries and so on. The objective of this work is the production of CMCase, Xylanase, Avicelase and FPase enzymes by solid state fermentation (SSF) using as substrates: bagasse of coconut and dried cashew stem. The microorganisms employed are Penicillium chrysogenum and an isolated fungus from the coconut bark (Aspergillus fumigatus). Through the factorial design methodology and response surface analysis it was possible to study the influence of the humidity and pH. For Penicillium chrysogenum and the isolated fungus, the coconut bagasse was used as culture medium. In another fermentation, it was used the mixture of coconut bagasse and cashew stem. Fermentations were conducted using only the coconut bagasse as substrate in cultures with Penicillium chrysogenum fungus and the isolated one. A mixture with 50% of coconut and 50% of cashew stem was employed only for Penicillium chrysogenum fungus, the cultivation conditions were: 120 hours at 30 °C in BOD, changing humidity and pH values. In order to check the influence of the variables: humidity and pH, a 2 2 factorial experimental design was developed, and then two factors with two levels for each factor and three repetitions at the central point. The levels of the independent variables used in ascending order (-1, 0, +1), to humidity, 66%, 70.5% and 75% and pH 3, 5 and 7, respectively. The software STATISTICA TM (version 7.0, StatSoft, Inc.) was used to calculate the main effects of the variables and their interactions. The response surface methodology was used to optimize the conditions of the SSF. A chemical and a physic-chemical characterization of the coconut bagasse have determined the composition of cellulose (%) = 39.09; Hemicellulose (%) = 23.80, Total Lignin (%) = 36.22 and Pectin (%) = 1.64. To the characterization of cashew stem, the values were cellulose (g) = 15.91 Hemicellulose (%) = 16.77, Total Lignin (%) = 30.04 and Pectin (%) = 15.24. The results indicate the potential of the materials as substrate for semisolid fermentation enzyme production. The two microorganisms used are presented as good producers of cellulases. The results showed the potential of the fungus in the production of CMCase enzyme, with a maximum of 0.282 UI/mL and the Avicelase enzyme the maximum value ranged from 0.018 to 0.020 UI/ mL, using only coconut bagasse as substrate. The Penicillium chrysogenum fungus has showed the best results for CMCase = 0.294 UI/mL, FPase = 0.058 UI/mL, Avicelase = 0.010 UI/mL and Xylanase = 0.644 UI/ mL enzyme, using coconut bagasse and cashew stem as substrates. The Penicllium chrysogenum fungus showed enzymatic activities using only the coconut as substrate for CMCase = 0.233 UI/mL, FPase = 0.031 to 0.032 UI/ mL, Avicelase = 0.018 to 0.020 UI/mL and Xylanase = 0.735 UI/ mL. Thus, it can be concluded that the used organisms and substrates have offered potential for enzyme production processes in a semi-solid cultivation

Suco desidratado de caju (Anacardium occidentale L.) por atomização: caracterização físico-química, bioativa e estudo da vida de prateleira do produto

Despite the relatively organized cashew (Anacardium occidentale L.) productive chain and the number of cashew derivatives found in the market, it is estimated that over 90% of the cashew peduncle is wasted. A possible strategy for a better commercial exploitation of this agroindustrial commodity would be the production of spray dried cashew pulp. Thus, this paper approaches the yellow cashew pulp spray drying process and the final product evaluation. Based on that, the shelf life of the spray dried cashew pulp packed in different packaging was evaluated. Drying was conducted in two drying temperatures (140 °C to 150 °C) and two concentrations of Arabic gum (AG, 15% and 25%), which summed four experimental groups. The drying performance was evaluated as well as the physicochemical characteristics (moisture, water activity, total soluble solids, pH, density, solubility, particle diameter, hygroscopicity, degree of caking, color, scanning electronic microscopy and X-ray diffraction), composition (protein, ash, fat and sugars) and bioactive and functional value (total phenolic compounds, carotenoids, ascorbic acid and antioxidant activity) of the final products. Results showed spray drying efficiency higher than 65% for all experiments, mainly for the C4 group (150 °C and 25% AG) which reached efficiency of 93.4%. It was also observed high solubility (94.7% to 97.9%) and the groups with lower hygroscopicity (5.8% and 6.5%) were those with the highest proportion of drying coadjuvant. The particle diameters ranged between 14.7 μm and 30.2 μm and increased with the proportion of AG. When comparing the product before and after spray drying, the drying impact was evident. However, despite the observed losses, dried yellow cashew showed high phenolic concentration (from 235.9 to 380.4 mg GAE eq / 100 g DM), carotenoids between 0.22 and 0.49 mg/100 g DM and remarkable ascorbic acid levels (852.4 to 1346.2 mg/100 g DM), in addition to antioxidant activity ranging from 12.9 to 16.4 μmol TE/ g DM. The shelf life study revealed decreased phenolic content over time associated to a slight water activity increase. Overall, our results unveil the technological and bioactive potential of dried yellow cashew as a functional ingredient to be used in food formulations or as a ready-to-use product. The technological approach presented here can serve as an efficient strategy for a rational use of the cashew apple, avoiding its current underutilization

Estudo da produção de pectinase por fermentação em estado sólido utilizando pedúnculo de caju como substrato

Pectinolytic enzymes, or simply pectinases, are complex enzymes that degrade pectic polymers. They have many uses, such as fruit juice extraction and purification, textile fiber treatment and vegetal oil extraction. The aim of this work was to study the kinetics of pectinases production by solid-state fermentation, using dry cashew apple residue as substrate and the microorganism Aspergillus niger CCT 0916. The influence of the initial medium moisture and medium supplementation with a source of nitrogen and phosphorus was evaluated using the factorial experimental planning and response surface methodology. Ammonia sulphate and potassium phosphate were used as nitrogen and phosphorus source, respectively. The variables time of contact (T) and ratio volume solvent/fermented medium (RZ), in systems with and without agitation, were evaluated in order to study the best extraction condition of the produced enzyme. Washed and unwashed cashew apple residues were tested as the growth medium. The unwashed residue was obtained by drying the residue after the extraction of the juice, while the washed residue was obtained by water washing 5 times using the proportion of 1 kg pulp/2 liters of water. Samples were taken every 12 hours for moisture content, pH, protein, reducing sugars, polygalacturonase activity (PG) and viscosity reduction. The physical-chemical composition of the residues had different sugar and pectin levels. For the unwashed residue, the peak activity was reached with 40% of initial moisture content, 1% of nitrogen supplementation without phosphorus addition after 30 hours of process. These conditions led to 16 U/g of PG activity and 82% of viscosity reduction. The calculated models reached similar values to the experimental ones in the same process conditions: 15.55 U/g of PG and 79.57% of viscosity eduction. Similarly, the greatest enzyme production for washed residue was reached with 40% initial moisture content, 1% nitrogen supplementation without phosphorus addition after 22 hours of cultivation. In this condition it was obtained polygalacturonase activity of 9.84 U/g and viscosity reduction of 81.36%. These values are close to experimental values that were of 10.1 U/g and 81%, respectively. The conditions that led to the best PG activity results was the agitated one and the best extraction condition was obtained with 100 minutes of solvent/medium contact and RZ of 5 (mL/g)

Desenvolvimento de sorvete probiótico a base de leite de cabra: estudo da formulação, características físico químicas, sensoriais e viabilidade das bactérias probióticas

This work targetet the caprine ice cream production added with probiotic bacteria Bifidobacterium animalis subsp. lactis. It is divided into two parts. In the first one, four caprine ice cream formulations were evaluated, in which it was used hydrogenated fat (F1 and F3) or fat substitute (F2 and F4) in two different flavors (F1 and F2, passion fruit, F3 and F4, guava). Statistical differences (p<0.05) were detected for their physical-chemical properties, mainly for total solids and fat, but no differences were observed for melting test results. When it went to sensory acceptance, all four ice cream formulations reached high acceptance indexes, mostly formulation F4, which was selected for further studies. In the second part, F4 formulation was prepared with the addition of probiotic bacteria Bifidobacterium animalis subsp. lactis. The growth kinetics was studied and it was observed that the cellular concentration peak was reached after four fermentation hours (10.14 log UFC/g). This time was selected for pre-fermentation procedure and posterior addition at ice cream syrup. In this part of the study, two experimental groups were evaluated: group G1, in which the probiotic addition occurred before the maturation step and group G2, which included a pre-fermentation step and probiotic addition after ice cream maturation. The physical-chemical properties of these two ice cream groups were similar, except for pH, which was higher for group G2 (p<0.05). G1 samples had superior melting rate (3.566 mL/min) and both groups presented microbiological and sanitary results in accordance to current Brazilian legislation. Also, G1 and G2 were considered sensory accepted due to their acceptance indexes higher than 70%. G1 and G2 sensory profiles were similar (p>0.05), and both ice cream samples exhibited high creaminess (6.76 to 6.91) and mouth melting sensation (6.53 to 6.67) scores, while low sandiness scores (0.85 to 0.86) were observed, positive characteristics for this kind of food product. During the first 24 hours after ice cream production, the population of B. animalis subsp. lactis decreased, reaching 7.15 e 6.92 log CFU/g for G1 and G2, respectively. Probiotic bacteria counts fluctuated in ice cream samples during the first 108 days at frozen storage, especially for G2 group. Decreased probiotic viability was observed for G1 samples during the first 35 days of frozen storage, mild variation between 35 and 63 days and stabilized counts were observed after this time. After 21 days at frozen storage, ice cream samples of G1 and G2 groups reached 1.2 x 109 and 1.3 x 109 CFU/portion, respectively. After 108 days under these storage conditions, the survival rate of B. animalis subsp. lactis was 94.26% and 81.10% for G1 and G2 samples, respectively. After simulation of gastroenteric conditions, G2 group reached 9.72 x 105 CFU/portion. Considering the current requirements of Brazilian legislation, which stipulates that functional foods must have minimum probiotic count between 108 and 109 CFU/portion and detectable probiotic bacteria after being submitted to gastroenteric conditions, it is concluded that the ice cream with the addition of Bifidobacterium animalis subsp. lactis made as shown in this work, can be considered as a dairy functional food

A falta de ética e de espírito público na política brasileira

Unfortunately, the Brazilian politics has been characterized by lack of ethics. In a few exceptions, our representatives often behave in the exercise of power as if they were there to care for their own interests and not public affairs. Despite the dissatisfaction that the situation seems to trigger to society, the electorate does not get to transform their anger into effective gesture in order to withdraw from the public setting people who can not fulfill their mandate at the polls. Instead, the re-election of bad politicians has become commonplace fact. In this study, we proposed to discuss the matter in light of traditional philosophical theories, by selecting exponents of ethical thought from the Ancient Period to the Modern. We put special emphasis on behalf of amorality in Florentine thinker's ideas, to Machiavelli s political doctrine.

Existência e liberdade: a trans-descendência extática da vida no livro A religião e o nada de Nishitani Keiji

The dialog between the East philosophy and the Western thinking allow us to think the problems inherent to our time from several point of views. Nishitani Keiji, from the Kyoto School, sees the contemporaneity, or the time of the technic, for Heidegger, as derivation and as an immediate consequence of perspective introduced in the modern era form the Cartesian s cogito which creates a barrier that separates man and world. Scientific thinking that dominates our era was created from the thinking that ennobles human reason to the detriment of the others things in the world, determining that the knowledge just can be produced by the man himself and his set of rational powers. However, alerts us Nishitani, this point of view derived from modern thought which imposes subjectivity egocentric type besides not apprehend things in their truth, neither achieves the true self of man. In an attempt to overcome the abuses produced in modernity and that reverberates in our way of be until today, our philosopher will propose the point of view of the nothingness (śūnyatā) as a way to trans-descendance, that is, to overcome the traditional thinking overvalues the reason for the encounter with the original face of man, which by no longer impose its cognitive power can know all things in their true, in the tathatā

Desempenho e efeitos agudos da espirometria de incentivo volume-orientada sobre os volumes pulmonares em pacientes após AVC e sujeitos saudáveis

O Acidente Vascular Cerebral (AVC) é uma síndrome clínica caracterizada por uma perturbação focal da função cerebral. Geralmente ocasiona quadro de disfunção motora acompanhada de prejuízo da função respiratória. Tendo em vista tal quadro e suas possíveis repercussões, a fisioterapia respiratória tem sido amplamente requisitada com o intuito reverter ou minimizar as complicações. Dentre os recursos utilizados para este fim, os espirômetros de incentivo são utilizados com o objetivo de restaurar os volumes pulmonares, modificando o padrão respiratório e de ventilação pulmonar, prevenindo a incidência das complicações pulmonares. O objetivo do presente estudo foi comparar o desempenho na realização da espirometria de incentivo volume-orientada (EI) e seus efeitos agudos sobre os volumes pulmonares em pacientes após AVC e sujeitos saudáveis. Foram selecionados 40 voluntários, de ambos os gêneros, divididos em grupo experimental (GE), composto por 20 pacientes após AVC e grupo controle (GC) composto por 20 sujeitos saudáveis, pareados quanto à idade, gênero e Índice de Massa Corpórea (IMC). A coleta dos dados foi realizada em duas etapas: (1) Avaliação cognitiva e neurofuncional (Mini Exame do Estado Mental, National Institute Stroke Scale, Medida de Independência Funcional, teste de desempenho da aprendizagem) (2) Avaliação Respiratória (espirometria, manovacuometria e cinemática tóraco-abdominal, através da Pletismografia Opto-eletrônica). A análise estatística foi realizada através do software Graphpad Prism 4.0, em que foram utilizados os testes t Student e ANOVA two-way para comparação intergrupos e adotado nível de significância de 5%. Os resultados mostraram que os pacientes apresentam desempenho inferior na aprendizagem da espirometria de incentivo, com uma média de erros maior 2,95 ± 1,39, quando comparados aos sujeitos saudáveis, 1,15 ± 0,98. Em relação à prática observacional utilizada não foi encontrada diferença entre a aprendizagem através do vídeo ou do terapeuta. Em relação aos efeitos agudos da espirometria de incentivo volume-orientada, os pacientes após AVC apresentaram valores de volume corrente 24,7%, 18% e 14,7% inferiores quando comparados aos sujeitos saudáveis nos momentos pré-EI, EI e pós-EI, porém a espirometria de incentivo induziu incrementos de volume similares em ambos os grupos estudados, com 75, 3% para os pacientes e 73,3% para os sujeitos saudáveis. A espirometria de incentivo promove ganhos significativos no volume corrente da parede torácica, tanto em pacientes acometidos por AVC como em sujeitos saudáveis, no entanto o desempenho da aprendizagem é inferior para os pacientes, para ambas as práticas com vídeo ou terapeuta

Cuidados de enfermagem ao paciente em pós-operatório de prostatectomia: revisão integrativa

Este estudo trata-se de revisão integrativa da literatura com objetivo de sintetizar o conhecimento produzido em artigos sobre os cuidados de enfermagem aos pacientes em pós-operatório de prostatectomia. Para seleção dos artigos foram consultadas cinco bases de dados – SCOPUS, CINAHL, PUBMED, LILACS e Cochrane – sendo incluídos dezenove artigos. Os resultados mostram estudos que se enquadram nos níveis II, IV, V, VI e VII de evidência, a maioria realizada nos Estados Unidos durante os anos de 1999 a 2011. Os cuidados de enfermagem identificados foram agrupados em seis categorias: acompanhamento psicológico, orientações pós-operatórias, tratamento da disfunção erétil, tratamento da incontinência urinária, tratamento da dor e tratamento da hiponatremia. Conclui-se que os estudos com maior nível de evidência identificado recomendam cuidados de enfermagem centrados no acompanhamento psicológico, nas orientações do período pós-operatório e no tratamento da disfunção erétil. Destaca-se ainda que tais recomendações concentram-se, sobretudo, nas ações de apoio emocional e educativo