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

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

Síndrome de Cogan: achados oculares em um caso da forma atípica

A síndrome de Cogan é entidade multissistêmica rara caracterizada por ceratite intersticial associada à disfunção áudio-vestibular e possível surdez irreversível classificada em duas formas clínicas: típica e atípica. Há discordância na literatura quanto à presença de acometimento corneano na forma atípica. Uma paciente de 32 anos queixando-se de hiperemia e dor ocular, fotofobia e baixa da acuidade visual no olho direito, associada à perda súbita de audição à esquerda, vômitos, diarréia, oligúria, dor na orofaringe e febre. História prévia de semelhante acometimento do olho esquerdo e audição direita. Havia intensa hiperemia conjuntival, esclerite nodular, episclerite e infiltrados circulares no estroma corneano. A paciente recebeu pulsoterapia com metilprednisolona e ciclofosfamida. Evoluiu com grande melhora ocular, porém com resposta auditiva pobre. O caso reportado pode constituir forma típica da síndrome de Cogan (de acordo com autores que defendem o nãoacometimento corneano na forma atípica) com alguns achados característicos da forma atípica ou um caso da forma atípica da síndrome de Cogan (para aqueles que defendem o acometimento corneano na forma atípica). O diagnóstico diferencial também é discutido

Análise das manifestações auditivas em individuos com hipertensão arterial sistêmica

Objective: To determine the prevalence of auditory manifestations in individuals with hypertension and analyze the association between hearing loss, systemic hypertension and quality of life in hypertensive patients. Method: This was a prospective, observational, case-control study, carried out from June 2010 to December 2013 at the University Hospital Onofre Lopes, in Natal, Brazil, which involved 120 patients of both sexes were analyzed with a diagnosis of hypertension and 120 patients without a diagnosis of hypertension. The audiological function was assessed by tonal and vocal audiometry. The quality of life was defines by the MINICHAL BRASIL questionnaire. Results: The prevalence of hearing loss was high in both groups (82.5 % and 75.8 %, in hypertension group and control, respectively, p=0.003). The sensorineural was the most common type of hearing loss (48.5 %) in hypertension group while conductive hearing loss was predominant (61.5 %) in the control group. There were no difference in the intensity of hearing loss between the groups (p=0,21). The main hearing complaint was hearing loss (51 %), followed by ear pain (14 %). There was worse quality of life in hypertensive individuals with hearing loss (p= 0.0001). Conclusion: Hypertensive individuals showed higher prevalence of auditory events, including hearing loss, sensorineural hearing loss is predominant . Hearing loss is associated with worse quality of life of hypertensive individuals even when these pressure values are within normal limits

Prevalência e fatores associados à alteração vocal em idosos institucionalizados com capacidade cognitiva preservada

Voice disorders (VD) in the elderly can interfere negatively in communication, emotional well-being and quality of life, conditions that correspond to greater exposure to illness and social isolation bringing consequent economic impact for the health system. It is assumed that institutionalized confinement, weakness and morbidity associated to nursing home (NH) contribute to transform VD an especially prevalent condition in institutionalized elderly, including those without cognitive impairment. Thus, the aim of this study was to determine the prevalence and associated factors of VD in NH elderly residents without cognitive impairment. There is no epidemiological diagnostic instruments of VD for elderly populations, so the first step of this study was dedicated to prepare and analyze the psychometric properties of a short, inexpensive and easy to use questionnaire named Screening for Voice Disorders in Older Adults (Rastreamento de Alterações Vocais em Idosos—RAVI). The methodological procedures of this step followed the guidelines of the Standards for Educational and Psychological Testing and contemplated validity evidence based on test content, based on response processes, based on internal structure and based on relations with other variables, as well as reliability analysis and clinical consistency. The result of the validation process showed that the RAVI final score generate valid and reliable interpretations for the epidemiological diagnosis of VD in the elderly, which endorsed the use of the questionnaire in the second stage of the study, performed in ten NH located in the city of Natal, Rio Grande do Norte. At this stage, data from socioeconomic and demographic variables, lifestyle, general health conditions and characterization of the institution were collected. It was performed a bivariate analysis and it was calculated the prevalence ratio as a magnitude association measure, with a confidence interval of 95%. The variables with p-value less than 0.20 were included in the multiple logistic regression model that followed the Forward selection method. The odds ratio found in the multivariate model was converted into prevalence ratio and the level of significance was 5%. The sample consisted of 117 subjects with predominance of females and average of 79.68 (± 7.92) years old. The prevalence of VD was 39.3% (95% CI: 30.4-48.1%). The multivariate model showed statistically significant association between VD and depressive symptoms, smoking for a year or more and selfreported hearing loss. In conclusion, VD is a prevalent health condition in NH elderly residents without cognitive impairment and is associated with factors involving psychosocial, lifestyle and communicative disability that require attention of managers and professionals involved with NH environment. Strategies to encourage communication and social integration, actions to combat smoking and minimizing the effects of hearing loss could stimulate the physical well-being, emotional and mental health of institutionalized elderly population, contributing to the vocal and communicative maintenance, a more effective social inclusion and better overall health condition.

Síndrome de Cogan: achados oculares em um caso da forma atípica

A síndrome de Cogan é entidade multissistêmica rara caracterizada por ceratite intersticial associada à disfunção áudio-vestibular e possível surdez irreversível classificada em duas formas clínicas: típica e atípica. Há discordância na literatura quanto à presença de acometimento corneano na forma atípica. Uma paciente de 32 anos queixando-se de hiperemia e dor ocular, fotofobia e baixa da acuidade visual no olho direito, associada à perda súbita de audição à esquerda, vômitos, diarréia, oligúria, dor na orofaringe e febre. História prévia de semelhante acometimento do olho esquerdo e audição direita. Havia intensa hiperemia conjuntival, esclerite nodular, episclerite e infiltrados circulares no estroma corneano. A paciente recebeu pulsoterapia com metilprednisolona e ciclofosfamida. Evoluiu com grande melhora ocular, porém com resposta auditiva pobre. O caso reportado pode constituir forma típica da síndrome de Cogan (de acordo com autores que defendem o nãoacometimento corneano na forma atípica) com alguns achados característicos da forma atípica ou um caso da forma atípica da síndrome de Cogan (para aqueles que defendem o acometimento corneano na forma atípica). O diagnóstico diferencial também é discutido

Influencia do meloxicam sobre a perda ossea alveolar em periodontite experimental: avaliaçao histometrica em ratos

GURGEL, Bruno Cesar de vasconcelos.Influencia do meloxicam sobre a perda ossea alveolar em periodontite experimental: avaliaçao histometrica em ratos. 2003.97f. Dissertaçao (Mestrado) - Universidade Estadual de Campinas. Faculdade de Odontologia de Piracicaba. Piracicaba, 2003. Disponivel em: . Acesso em: 04 out. 2010.

Desenvolvimento de um sistema misto de pasta à base de geopolímero e cimento portland para correção de perda de circulação

The materials engineering includes processes and products involving several areas of engineering, allowing them to prepare materials that fulfill the needs of various new products. In this case, this work aims to study a system composed of cement paste and geopolymers, which can contribute to solving an engineering problem that directly involves the exploitation of oil wells subject to loss of circulation. To correct it, has been already proposed the use of granular materials, fibers, reducing the drilling fluid or cement paste density and even surface and downhole mixed systems. In this work, we proposed the development of a slurry mixed system, the first was a cement-based slurry and the second a geopolymer-based slurry. The cement-based slurry was formulated with low density and extenders, 12.0 ppg (1.438 g/cm ³), showing great thixotropic characteristics. It was added nano silica at concentrations of 0.5, 1.0 and 1.5 gps (66.88, 133.76 and 200.64 L/m3) and CaCl2 at concentrations of 0.5, 1, 0 and 1.5%. The second system is a geopolymer-based paste formulated from molar ratios of 3.5 (nSiO2/nAl2O3), 0.27 (nK2O/nSiO2), 1.07 (nK2O/nAl2O3) and 13.99 (nH2O/nK2O). Finally, we performed a mixture of these two systems, for their application for correction of circulation lost. To characterize the raw materials, XRD, XRF, FTIR analysis and titration were performed. The both systems were characterized in tests based on API RP10B. Compressive strength tests were conducted after curing for 24 hours, 7 and 28 days at 58 °C on the cement-based system and the geopolymer-based system. From the mixtures have been performed mixability tests and micro structural characterizations (XRD, SEM and TG). The results showed that the nano silica, when combined with CaCl2 modified the rheological properties of the cement slurry and from the concentration of 1.5 gpc (200.64 L / m³) it was possible to obtain stable systems. The system mixture caused a change in the microstructure of the material by favoring the rate of geopolymer formation to hinder the C3S phase hydration, thus, the production of CSH phases and Portlandite were harmed. Through the mixability tests it can be concluded that the system, due to reduced setting time of the mixture, can be applied to plug lost circulation zones when mixed downhole

Modelagem e previsão da perda de injetividade em poços canhoneados

Waterflooding is a technique largely applied in the oil industry. The injected water displaces oil to the producer wells and avoid reservoir pressure decline. However, suspended particles in the injected water may cause plugging of pore throats causing formation damage (permeability reduction) and injectivity decline during waterflooding. When injectivity decline occurs it is necessary to increase the injection pressure in order to maintain water flow injection. Therefore, a reliable prediction of injectivity decline is essential in waterflooding projects. In this dissertation, a simulator based on the traditional porous medium filtration model (including deep bed filtration and external filter cake formation) was developed and applied to predict injectivity decline in perforated wells (this prediction was made from history data). Experimental modeling and injectivity decline in open-hole wells is also discussed. The injectivity of modeling showed good agreement with field data, which can be used to support plan stimulation injection wells

Estudo da perda de carga e calor no poço injetor no processo De drenagem gravitacional assistida por vapor (SAGD)

The oil companies in the area in general are looking for new technologies that can increase the recovery factor of oil contained in reservoirs. These investments are mainly aimed at reducing the costs of projects which are high. Steam injection is one of these special methods of recovery in which steam is injected into the reservoir in order to reduce the viscosity of the oil and make it more mobile. The process assisted gravity drainage steam (SAGD) using steam injection in its mechanism, as well as two parallel horizontal wells. In this process steam is injected through the horizontal injection well, then a vapor chamber is formed by heating the oil in the reservoir and, by the action of gravitational forces, this oil is drained down to where the production well. This study aims to analyze the influence of pressure drop and heat along the injection well in the SAGD process. Numerical simulations were performed using the thermal simulator STARS of CMG (Computer Modeling Group). The parameters studied were the thermal conductivity of the formation, the flow of steam injection, the inner diameter of the column, the steam quality and temperature. A factorial design was used to verify the influence of the parameters studied in the recovery factor. We also analyzed different injection flow rates for the model with pressure drop and no pressure drop, as well as different maximum flow rates of oil production. Finally, we performed an economic analysis of the two models in order to check the profitability of the projects studied. The results showed that the pressure drop in injection well have a significant influence on the SAGD process.

Análise da modelagem experimental da perda de injetividade

Injectivity decline, which can be caused by particle retention, generally occurs during water injection or reinjection in oil fields. Several mechanisms, including straining, are responsible for particle retention and pore blocking causing formation damage and injectivity decline. Predicting formation damage and injectivity decline is essential in waterflooding projects. The Classic Model (CM), which incorporates filtration coefficients and formation damage functions, has been widely used to predict injectivity decline. However, various authors have reported significant discrepancies between Classical Model and experimental results, motivating the development of deep bed filtration models considering multiple particle retention mechanisms (Santos & Barros, 2010; SBM). In this dissertation, inverse problem solution was studied and a software for experimental data treatment was developed. Finally, experimental data were fitted using both the CM and SBM. The results showed that, depending on the formation damage function, the predictions for injectivity decline using CM and SBM models can be significantly different

Efeito da perda de carga e calor no poço injetor no processo de drenagem gravitacional assistido com vapor e solvente

Nowadays, most of the hydrocarbon reserves in the world are in the form of heavy oil, ultra - heavy or bitumen. For the extraction and production of this resource is required to implement new technologies. One of the promising processes for the recovery of this oil is the Expanding Solvent Steam Assisted Gravity Drainage (ES-SAGD) which uses two parallel horizontal wells, where the injection well is situated vertically above the production well. The completion of the process occurs upon injection of a hydrocarbon additive at low concentration in conjunction with steam. The steam adds heat to reduce the viscosity of the oil and solvent aids in reducing the interfacial tension between oil/ solvent. The main force acting in this process is the gravitational and the heat transfer takes place by conduction, convection and latent heat of steam. In this study was used the discretized wellbore model, where the well is discretized in the same way that the reservoir and each section of the well treated as a block of grid, with interblock connection with the reservoir. This study aims to analyze the influence of the pressure drop and heat along the injection well in the ES-SAGD process. The model used for the study is a homogeneous reservoir, semi synthetic with characteristics of the Brazilian Northeast and numerical simulations were performed using the STARS thermal simulator from CMG (Computer Modelling Group). The operational parameters analyzed were: percentage of solvent injected, the flow of steam injection, vertical distance between the wells and steam quality. All of them were significant in oil recovery factor positively influencing this. The results showed that, for all cases analyzed, the model considers the pressure drop has cumulative production of oil below its respective model that disregards such loss. This difference is more pronounced the lower the value of the flow of steam injection

Avaliação da incontinência urinária de esforço em mulheres na pós-menopausa com e sem queixa de perda urinária através da aplicação do pad-test de 1 hora

Stress urinary incontinence (SUI) is defined as "involuntary loss of urine" due to several processes that alter the ability of the bladder to hold urine properly, regarded as a social and hygienic problem that adversely affects quality of life. In postmenopausal women, IU is associated with atrophy and weakness of the pelvic floor muscles. The objective this study was investigate, using the onehour pad test, stress urinary leakage (SUI), evaluate and compare their results in postmenopausal and premenopausal women. The survey was characterized as a cross-sectional study. The study consisted of 60 postmenopausal women were divided into GIU - consisting of 34 volunteers complaining of involuntary loss of urine during stress - and GSIU - consisting of 26 volunteers without complaints of loss of urine during stress, and 15 women, during the premenopausal (GPM), and ovulatory with normal menstrual cycle. All volunteers were evaluated clinically, subjected to one-hour pad test, after the biochemical evaluation of blood and sex hormones. Statistical analysis was performed by descriptive analysis, ANOVA, Turkey´s post-test and Pearson correlation. The results showed that 100% of postmenopausal patients had involuntary loss of urine during one hour pad test (GIU: 4.0 g; GSIU: 4.5 g). GPM remained continent after an hour pad test (GPM: 0.4 g). In addition, Pearson showed a strong correlation between urine loss with time since menopause (r = 0.8, p <0.01) and body mass index - BMI (r = 0.7; p = 0.01). These data suggest that the one-hour pad test is a useful test to assess and quantify urinary leakage, including those volunteers who had no previous complaint of SUI

Análise de parâmetros da função reprodutiva masculina após perda ponderal induzida pela cirurgia bariátrica

Introdução: A obesidade e suas formas extremas como a forma mórbida, vem assumindo preocupação nos sistemas de saúde pública e é atualmente considerado um dos mais importantes agravos de saúde no mundo desenvolvido. Acarreta repercussões em várias partes do corpo, com potencial para interferir negativamente também na função reprodutiva, recentemente sendo mais estudado na população masculina. Objetivo: avaliar parâmetros hormonais e seminais da função reprodutiva em um grupo de homens obesos mórbidos, antes e após 6 meses da perda de peso induzida pela cirurgia bariátrica. Métodos: Inicialmente, de uma amostra de 36 pacientes com idade entre 18 e 40 anos e índice de massa corporal (IMC) ≥40 Kg/m2, apenas 1 caso foi excluído por ser portador de hiperprolactinoma e outros 24 pacientes não completaram todo o protocolo de avaliação laboratorial solicitada. Um total de apenas 11 pacientes completou o protocolo. Todos foram previamente avaliados por uma equipe multidisciplinar. O grupo selecionado foi submetido a avaliação seminal e dosagens hormonais de testosterona total(TT), FSH e LH. Os parâmetros foram reavaliados após 6 meses de realização da cirurgia pela técnica de Y-em-Roux, para análise dos efeitos da perda de peso sobre os parâmetros da função reprodutiva. Resultados: No grupo selecionado ao estudo, os exames pré-operatórios mostraram um grupo heterogêneo de resultados. Após seis meses do tratamento cirúrgico, a perda ponderal foi significativa no grupo analisado, com redução do IMC de mediana 46 Kg/m2para mediana de 36 Kg/m2(p=0,03). Em relação ao perfil hormonal, houve elevação significativa do nível sérico de TT com mediana de 187ng/ml no período pré-operatório para 457 ng/ml (p=0,02) no período pós-operatório. Entre os períodos pré e pós-operatório, não foram observadas alterações significantes do FSH (2,70 mIU/ml para 3,31 mIU/ml, p=0,79), LH (4,82 mIU/ml para 3,00mIU/ml, p=0,39), concentração espermática (38milhões/ml para 31milhões/ml, p=0,88) e motilidade A+B (50% para 50%, p=0,89).Conclusão: A redução ponderal decorrente da cirurgia em obesos mórbidos parece levar a uma elevação dos níveis de testosterona total, sem alterações nas demais provas de avaliação reprodutiva. Estudos adicionais com casuística maior e múltiplos parâmetros são necessários para esclarecimento definitivo do impacto da obesidade e da perda de peso induzida pela cirurgia sobre a função reprodutiva masculina

A perda de grupos funcionais em comunidades virtuais: efeito das interações entre espécies e grupos funcionais

High levels of local, regional, and global extinctions has progressively simplified communities in terms of both species and ecosystem functioning. Theoretical models demonstrated that the degree of functional redundancy determines the rates of functional group loss in response to species extinctions. Here, we improve the theoretical predictions by incorporating in the model interactions between species and between functional groups. In this study, we tested the effect of different scenarios of interspecific interactions and effects between functional groups on the resistance to loss of community functional groups. Virtual communities have been built with different distribution patterns of species in functional groups, both with high and low evenness. A matrix A was created to represent the net effect of interspecific interactions among all species, representing nesting patterns, modularity, sensitive species, and dominant species. Moreover, a second matrix B was created to represent the interactions between functional groups, also exhibiting different patterns. The extinction probability of each species was calculated based on community species richness and by the intensity of the interspecific interactions that act upon it and group to which it belongs. In the model, successive extinctions decrease the community species richness, the degree of functional redundancy and, consequently, the number of functional groups that remain in the system. For each scenario of functional redundancy, A, and B, we ran 1000 simulations to generate an average functional extinction curve. Different model assumptions were able to generate remarkable variation on functional extinction curves. More extreme variations occurred when the matrix A and B caused a higher heterogeneity in the species extinction probability. Scenarios with sensitive species, positive or negative, showed a greater variation than the scenarios with dominant species. Nested interactions showed greater variation than scenarios where the interactions were in modules. Communities with maximal functional evenness can only be destabilized by the interactions between species and functional groups. In contrast, communities with low functional evenness can have its resistance either increased or decreased by the interactions. The concentration of positive interactions in low redundancy groups or negative interactions in high redundancy groups was able to decrease the functional extinction rates. In contrast, the concentration of negative interactions in low redundancy groups or positive interactions in high redundancy groups was able to increase the functional extinction rates. This model shows results that are relevant for species priorization in ecosystem conservation and restoration