Efeitos do tratamento com Hidrogel na cicatrização de úlceras venosas de membros inferiores: revisão sistemática

Chronic venous disease (CVD) is evident among the chronic diseases and affects the elderly population and primarily is responsible for leg ulcers in this population. The use of dressings in the care of a venous ulcer is a fundamental part of the treatment for healing, however, evidence to assist in choosing the best dressing is scarce. The main objective of this study was to evaluate the effectiveness of treatment with hydrogel in the healing of venous ulcers using search methods, synthesis of information and statistical research through a systematic review and meta-analysis. Randomized controlled trials were selected in the following databases: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Beyond these databases three websites were consulted to identify ongoing studies: ClinicalTrials.gov, OMS ICTRP e ISRCTN. The primary outcomes were analyzed: complete wound healing, incidence of wound infection and the secondary were: changes in ulcer size, time to ulcer healing, recurrence of ulcer, quality of life of participants, pain and costs of treatment. Four studies are currently included in the review with a total of 250 participants. The use of hydrogel appears to be superior to conventional dressing, gauze soaked in saline, for the healing of venous leg ulcers; 16/30 patients showed complete healing of ulcers (RR 5,33, 95%CI [1,73,16,42]). The alginate gel was shown to be more effective when compared to the hydrogel dressing in reduction of the wound area; 61,2% (± 26,2%) with alginate e 19,4% (± 24,3%) with hydrogel at the end of four weeks of treatment. Manuka honey has shown to be similar to the hydrogel dressings in percentage of area reduction. This review demonstrated that there is no evidence available about the effectiveness of the hydrogel compared to other types of dressings on the healing of venous leg ulcers of the lower limbs, thus demonstrating the need of future studies to assist health professionals in choosing the correct dressing.

O Circuito espacial de produção do biodiesel: configuração no território brasileiro e uso do território Norte-Rio-Grandense

This research aims to understand the use of the territory from the Rio Grande do Norte to the circuit spatial of production from the Biodiesel understanding it as part of the national context. The introduction of biodiesel into the Brazilian energy matrix begins to take shape in the year 2005 with the implementation of the National Program for Production and Use of Biodiesel (NPPB). This is anchored on three pillars: social inclusion (through family agriculture), environmental sustainability and economic viability. The NPPB consists of a set of standards, which turned into shares and distributed by almost all the national territory. Our reflection assumes that the places accommodating different forms of productive activities and, thus, the performance of the circuit space of biodiesel production depends on several factors, including the configuration of the territory they receive this new nexus economic. Understanding that the places by their technical content determine the realization of productive activities, it was found that the inclusion of this circuit space production in Rio Grande do Norte, reveals the reality expressed in the national territory, where some places are endowed with a privileged technical content and other extremely poor infrastructure. As our research could confirm the circuit space of biodiesel production that is expressed in the way plants are distributed within the country (mostly in South-Central), in more significant participation of small farmers in the South in the supply of raw material for the production of biodiesel and the main raw material used for the production of agrofuels (soybeans, whose production sector is highly consolidated and technified). Already the project materialization of NPPB regarding the settlements and communities of the Rio Grande do Norte State, we observed that the "event" or advent of realization encountered a technical means lacking in infrastructure that need to be molded to the needs of production, or is to cultivate castor beans or sunflower would be needed inputs and implements that farmers don´t have. Given the above, the research concludes that, as proposed previously, the use of the territory of Rio Grande do Norte to this circuit has summarized the performance of experiments, either with regard to the participation of family farmers as suppliers of raw materials, including the development of related research in the stage of production fuel oil by Petrobras. This finding came from research done from the concept of "spatial circuits of production," which allowed the verification of the circuit that steps outlined in Potiguar territory. Regarding the inclusion of family farmers in the productive circuit in RN, research reveals that, in the manner as has been done, it is doomed to failure. Furthermore, we dare say that this persistence in trying to put these family farmers, the way is being made, and the resulting successive failures, indicating that social inclusion advocated by NPPB not take place, and that this production circuit relies on the same logic circuit concentrated and exclusive space for ethanol production