Hiperidrose compensatória após simpatectomia toracoscópica: características, incidência e influência na satisfação do paciente

Hyperhidrosis is an idiopathic condition characterized by excessive sweating. Symptoms generally begin in childhood or early adolescence, and rarely improve with age. The excessive localized sweating generally occurs either spontaneously, or in association with stressful or emotionally charged situations. This prospective study aimed to investigate predictive factors for compensatory hyperhidrosis after thoracoscopic sympathicotomy. From 2000 to 2002, 80 patients (53 female and 27 male) underwent hyperhidrosis surgery. The patients, ranging from 12 to 56 years old, were studied and followed-up for 42.51 ±5.98 months. A satisfaction grading using a visual analogue scale -VAS (0 = not at all satisfied, and 10 = fully satisfied) was used. The surgical procedure was performed bilaterally on the second ganglion (T2) for facial hyperhidrosis, on the third and fourth ganglia (T3 and T4) for axillary hyperhidrosis, and on the third ganglion (T3) for palmar hyperhidrosis. The results showed that, 68 patients (85%) presented with compensatory sweating (CS), which was classified as mild (33.8%), moderate (33.8%) and severe (32.4%). Considering the final surgical results, 70 patients (87.5%) were satisfied with the outcome of the operation, while 10 patients (12.5%) were dissatisfied. Degrees of satisfaction varied according to sex, age, BMI and extent of denervation. Moreover, the compensatory hyperhidrosis was more severe in abdomen and back than in legs. In conclusion, although CS is a frequent adverse effect of sympathicotomy, the degree of patient satisfaction was high. Some factors were related to the occurrence and severity of CS and the most adequate patients to be submitted to this operation are young adult women whose BMI is less than 24.9

Do mestre aos discípulos: o legado educacional de Nestor dos Santos Lima (1910-1930)

Cette étude analyse La pratique pédagogique de l éducateur norte-rio-grandense Nestor dos Santos Lima, de 1910 a 1930, période ou se concentre son plus grand nombre de publications sur lês questions scolaires. Nous désirons comprendre de quelle forme cet intelectuel a contribué au développement du systeème d enseignement primaire à travers sés écrits sur lês principes et méthodes de l enseignement de la lecture et à l écriture, appliqués dans lês Groupes Scolaires de l État. Nestor Lima a joué um grand role dans la sociaété, à la tetê de fonctoins comme celle de La présidence de l Institut Historique e Geographique du Rio Grande do Norte (IHGRN), directeur de lÉcole Normale de Natal et du Dápartament d Education de État. Il a pulié de diverses oeuvres de caractere scolaire, comme lês Régiments Internes pour lês Groupes Scolaires, Écoles Isolées, Écoles Rudimentaires et Conseil d Education. Dans cette étude, nous mettons em évidence lês leçons de métodologique pour l enseignement de la lecture ET de évidence lês leçons de metodologie pour l enseignement de la lecture et de l ecriture, adresses aus eleves de lÉcole Normale de Natal, publiées dans la colonne Pádagogie du journal A República. Dans ces matièrs, nous observons que lês aspects qui composaient la pratique développe par Nestor Lima impliquaient lês questions Morales et civiques, la preocupation de la formation enseignante à l École Normale de Natal et le Célibat Pédagogique Féminin. Nous observons que la preocupations dês pratiques de lecture et lécriture sont presentes dans l oeuvre de cet éducateur comme legs important aux générations qui se succédent. Il est évident qu Il a cherché das sés productions une meilleure qualification dês enseignants pour que le niveau de l enseignement primaire puísse ainsi évoluer

Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

Autoestima e qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária

Venous ulcers (VU) is a chronic injury of the lower extremities and because of its high incidence and recurrence implies long and complex treatments, damaging the quality of life (QOL) and self-esteem (SE) of the people. This study aimed to analyze the association between self-esteem with the quality of life of people with venous ulcers treated in primary care. Cross sectional analytical study with a quantitative approach conducted with 44 people met with VU at 13 primary care units 2 and Mixed units in Natal/RN. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. Held data collection from February to April 2014 and used three instruments: a structured form covering sociodemographic, health care and clinical variables, the Rosenberg Self-Esteem Scale and the SF-36. The collected data were entered into a database and processed on computerized software for descriptive and inferential analyzes. The results showed a predominance of people with UV females (65,9%), with more than 60 years (59,1%), married or in a stable relationship (52,3%), low education (86,4%) without occupation (68,2%) and less than one minimum wage income (81,8%). Regarding assistance characteristics was observed that most patients performed the dressing with appropriate material (72,7%), professional or trained caregiver (61,4%) did not use compression therapy (81,8%), treating the injury for more than 6 months (77,3%), lack of guidelines for the use of compression therapy, elevation of legs, and regular exercise (77,3%) and consulting the angiologist last year (52,3% ). Regarding clinical features of the lesion was found that most of the recurrent lesions are (77,3%), over one year of current lesion (52,3%) medium to large lesions (54,8%), without signs of infection (61,3%) and pain (79,5%). The mean SE of respondents was 9,3 (± 5,1). The relations between the SE and the sociodemographic variables, health care and clinics showed that individuals without a partner (a) (p = 0,01), who did not wear compression therapy (p = 0,04), with more 6 months of treatment (p = 0,01) and larger lesions (p = 0,01) had a lower SE. The mean domain and the dimensions of the SF-36 were lower emphasizing the functional capacity 36.5 (± 27,6) and the physical aspects of 15.3 (± 30,6). There were significant correlations between AE people with VU and the domains and dimensions of the SF-36: physical functioning (r = -0,432), general health (r = -0,415), vitality (r = -0,573), aspects social (r = -0,517), mental health (r = -0,612) and mental health dimensions (r = -0,612) and physical health (r = -0,473). Based on these results it is concluded by rejecting the null hypothesis and accept the alternative proposed in the study in which it was found that there is a negative correlation between the SE and the QOL of people with venous ulcers

Efeitos imediatos da eletroestimulação nervosa transcutânea e crioterapia na espasticidade e na atividade eletromiográfica de sujeitos hemiparéticos

Cerebrovascular accident (CVA) is a term used to characterize an ischemic or hemorrhagic vascular injury, which has got as main clinic manifestations, the motor and reflex function disturbance. In the first stage there is flaccidity and loss of voluntary movements that afterwards is substituted by mass patterns and spasticity. The spasticity brings with itself functional deficits and can generate negative impacts in various motor patterns. The aim of this research was to investigate the hyperreflexia and identify the immediate effects of transcutaneous nervous stimulation (TENS) and cryotherapy in the spasticity and electromyographic activity of hemiparetic subjects. The study is characterized as an almost experimental type, in which were selected, to compose the sample, 16 patients of both sex with CVA sequel. These individuals were evaluated by collecting the amplitude peak to peak and H reflex latency, Motor response (M response) in solear muscle and the electromyography (EMG) of the injured and healthy legs anterior tibial muscles. In the injured limb the evaluations occurred in different days for cryotherapy, TENS and control, in two moments, before and after the interventions. The healthy limb was evaluated one single time to serve as baseline, for comparison with the injured limb. It was used an statistic analysis, the t paired student test to identify the H reflex differences, latency and EMG of the injured and healthy limbs and to compare the results before and after the recourses application. The ANOVA for related samples was used to identify the differences among the recourses used. It was attributed for the statistic tests a significance level of 5%. The amplitude peak to peak of normalized maximum H reflex through the maximum motor response (Hmax/Mmax), showed itself significantly increased in the injured limb (p=0.0245). The H reflex latency was presented reduced in the injured limb (p=0, 0375). The electromyographic activity was showed decreased in the injured limb (p< 0.0001). After the TENS there was a Hmáx/Mmáx ratio decrease (0.60±0.16 versus 0.49.±0.18; P = 0.0006). Nonetheless, Just after the cryotherapy application there was an increase of Hmáx/Mmáx ratio (0.58 ± 0,15 to 0.77 ± 0.13, P=0,0007) and increase of signal latency (30.41 ± 1.87 versus 33.24 ± 2.19; P=0.0001). The electromyographic activity wasn t altered significantly by any resource. It was met statistic significant differences when the Hmáx/Mmáx P<0.0001) ratio and H reflex latency (P<0.0001) were compared between the post TENS, cryotherapy and control. One can conclude that the TENS can be used to spasticity immediate reduction, and that the cryotherapy can increase the hyperreflexia state in spastic patients. Nonetheless, the spasticity decrease or increase didn t provoke lectromyographic activity change in the muscle that is opponent to the spastic one

Efeito do treinamento resistido na pressão arterial e capacidade funcional de idosas hipertensas

The results of studies about the ideal resistance training intensity for reduction of resting blood pressure levels, as well as this type of training to increase the functional capacity of hypertensive older women are still unclear, since the few investigations usually analyze young individuals normotensive, and the literature lacks precise information in elderly hypertensive subjects. Objectives: To determine the effect of two resistance training intensities on resting blood pressure and the effect of resistance training on functional capacity in elderly women with systemic arterial hypertension, analyzing these variables before and after eight weeks of intervention. Methods: Patients underwent eight weeks of resistance training, with a frequency of three times per week on alternate days, in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. Results: It was found that patients who underwent training with moderate resistance, showed a reduction on resting values of diastolic blood pressure (DBP) p<0.03 and of mean arterial pressure (MAP) p<0.03. Patients who underwent mild resistance training showed reduction in resting values of MAP (p<0.03) and a tendency to decrease in DBP (p<0.06). With regard to functional capacity, the results showed significant increase in the strength of arms and legs, agility and aerobic endurance (p<0.001) and maintaining flexibility (p>0.05). Conclusion: The data indicated that both mild and moderate resistance training, even when started in old age, promoted cardiovascular benefits and also improve the functional capacity of hypertensive older women.

Características da carcaça e qualidade da carne de ovinos terminados em pastagens cultivadas

The objective of this study was to evaluate the quality of housing and the physical and chemical characteristics of meat from sheep raised on pasture Brachiaria brizantha and Panicum maximum. The experiment was conducted in the physical area of the Study Group on Forage (GEFOR), located in the Academic Unit Specialized in Agricultural Sciences - Federal University of Rio Grande do Norte - UFRN in Macaíba, RN, Brazil. We used 32 lambs SPRD, obtained from herds in the state, with liveweight (LW) of 24.5 kg were assigned randomly to four treatments consisting of tropical grasses, two cultivars of Brachiaria brizantha, Marandu and Piatã, and two of Panicum maximum, Aruana and Massai. The experimental area was 2.88 ha, divided into 4 paddocks of 0.72 ha, where each picket consisted of a farm and was divided into six plots of 0.12 ha, where the animals remained under rotational grazing. The period of adaptation to the pickets was seven days. At the beginning of the experiment the animals were weighed, identified with plastic earrings and necklaces colored according to the treatment, and treated against. The lambs were loose in the paddock at 8 am and collected at 16 hours, which returned to collective pens. During the time of grazing animals had free access to mineral supplement with monensin Ovinofós ® and water. Before entering the paddocks of pasture were sampled to characterize the chemical composition. Every seven days occurred at weighing, with fasting, to monitor the weight development. Cultivars Marandu, Aruana, Piatã and Massai were grazed for 133, 129, 143 and 142 days, respectively, until the lambs reach slaughter weight. Arriving at 32 kg lambs were evaluated subjectively for body condition score by, passed through fasting period, diet and water for 16 hours were slaughtered. Measurements were made in the inner and outer casings in addition to subjective evaluations regarding muscling, finish and quantity of pelvic-renal fat, then each was divided longitudinally into two half-carcases and cuts were made in the commercial left half, and after heavy calculated their income. Between the 12th and 13th thoracic vertebrae, was performed a cut to expose the cross section of the Longissimus dorsi, which was drawn on the rib eye area (REA) in transparent film. Fat thickness and extent of AOL GR were determined using a caliper. A tissue composition was determined by dissection of the legs. Analyzes were performed physical (color, cooking loss and shear force) and chemical composition of meat (moisture, ash, protein and lipids) in Longissimus dorsi muscle. Grazing tropical grass Brachiaria brizantha cvs. Marandu and Piatã and Panicum maximum cvs. Aruana and Massai can be used for lambs SRPD in the rainy season, because not alter the physico-chemical and chemical composition of meat

Agricultura familiar: uma perspectiva da qualidade de vida do produtor rural orgânico da Paraíba

Knowledge of quality of life is a very complex and rich in cultural and subjective dimensions, understood in a broad sense and multivariate theme. Considering the rural areas from agriculture, it is observed that the production standard defines significant changes in the environmental context and the quality of life of rural workers. To explain the relationship between quality of life and Family Organic Agriculture, we sought to analyze the quality of life of the organic family farmer, after change in agricultural management. The research, based on a procedure exploratory study supported the articulation theoretically constructed, showed their relevance and allowed to delimit with greater security, the central question of work. The WHOQOL - 100 treated the instrument of research on quality of life that directed the field study with organic farmers from the town of Lagoa Seca / PB. Farmers and family members are from rural regions Almeida, Alvinho, Lagoa de Barro, Lagoa Gravatá, Oiti and Pau Ferro. The average time is 39 years farming and organic family farm is 16 years. In the analysis work was found that the process of production of vegetables and fruits is divided into 08 steps and with respect to workloads observations showed the presence of: physical loads, mechanical stresses, psychological burden and ergonomic factors. Most farmers reported symptoms were fatigue and cramps in the legs . Regarding the quality of life was noticed that the Psychological Domain contributed positively to the quality of life with mean and standard deviation (17.83 ± 12.78) and Domain Environment negatively contributing to the quality of life of this group (9.00 ± 6.82). We conclude that the practice of Family Organic Agriculture should be seen as an effective strategy in promoting quality of life and social values in between, since it presents environmental sustainability with regard to life and socio-cultural diversity of populations

Orientação de falhas presentes em testemunhos de sondagens do campo de Xaréu/bacia do Ceará

A research project is being developed by PPGG/UFRN and PETROBRAS in the Xaréu Oil Field located in Ceará Basin, Northeastern Brazil. The objective of the research is to characterize a fractured carbonate reservoir, the Trairi Limestone, in order to drill a borehole with two horizontal legs taking advantage of the natural fracture system to enhance the oil recovery. The present master thesis is part of this research and its contribution is to estimate fault orientation from unoriented cores, using the method proposed by Hesthammer & Henden (2000). In order to orient a fault cutting a bed observed in the core, the bed should be previously oriented. As additional constraint to orient the bed, we use regional bedding orientation obtained from structure maps of Trairi Limestone. Because the number of cores drilled from the Trairi Limestone was too small, we analyzed all cores from the field. As geologic constraint, we admit that all faults were formed as result of the South America and Africa separation, in the context of a regional dextral strike-slip fault formation. In this context, secondary faults are manly T and R faults according Riedel s classification. We analyzed 236.5 m of cores. The dip of bedding varies from 0o to 8o, being the most frequent value equal to 2o. We interpret this result as evidence that the deformation process was manly ruptil. 77 faults were identified in the cores. These faults strike manly to NW and NE with dips, in general, inside the interval 700 - 900. We suggest that the horizontal legs of the borehole should be oriented to NW and NE in order to improve the probability of intercepting open fractures and faults