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

Diagnóstco geoambiental e avaliação de uso e ocupação do campo de dunas da zona especial de interesse turístco II (ZET-II) Natal/RN

The accelerated pressure of use and occupation of Rio Grande do Norte coastline in the last two decades presented the tourism as its main vector, having as a consequence a strong, articulated and growing real estate speculation of this area. In the Natal County there is a Zona Especial de Interesse Turistico II (Special Zone of Tourism Interest II) (ZET-II), consisted of urban beaches with approximately 8.5 km that is an important seashore of the city. The purpose of this research was identification, characterization and assessment of the process of use and occupation of dunes fields emphasizing the role of ZET-II, whereas the specific goals was the analysis of weather, geology and geomorphology, characterization of use and occupation of soil, and elaboration of an environmental diagnosis with identification and description of its mains consequences. The result of this work was the delineation of geologic-geomorphological map of the area with identification of principals units, determining its use and occupation, the measurement of the area already occupied by equipments, besides the description of the environmental impacts on dune fields: devastation, coastline erosion, ocean pollution by sewer and pluvial waters, contamination of groundwater, distribution inadequate of solid residues, landscape degradation, and occupation of seashore through the privatization of public areas. Concluding that the degrading changes occurred in this areas are resulting from the nature of use and urban seashore regulations, which have been diminishing the natural aspect, altering the landscape definitely, compromising the quality of hydro resources and altering its use, privatizing the areas between tides, complicating the population access and obstructing the scenery visualization of dunes and ocean. There is an urgent necessity of improvement of public politics in order to improve the strategies and organization of use and occupation of space urban-coastline

Acelaração do universo e criação gravitacional de matéria escura fria: novos modelos e testes observacionais

Recent astronomical observations (involving supernovae type Ia, cosmic background radiation anisotropy and galaxy clusters probes) have provided strong evidence that the observed universe is described by an accelerating, flat model whose space-time properties can be represented by the FriedmannRobertsonWalker (FRW) metric. However, the nature of the substance or mechanism behind the current cosmic acceleration remains unknown and its determination constitutes a challenging problem for modern cosmology. In the general relativistic description, an accelerat ing regime is usually obtained by assuming the existence of an exotic energy component endowed with negative pressure, called dark energy, which is usually represented by a cosmological constant ¤ associated to the vacuum energy density. All observational data available so far are in good agreement with the concordance cosmic ¤CDM model. Nevertheless, such models are plagued with several problems thereby inspiring many authors to propose alternative candidates in the relativistic context. In this thesis, a new kind of accelerating flat model with no dark energy and fully dominated by cold dark matter (CDM) is proposed. The number of CDM particles is not conserved and the present accelerating stage is a consequence of the negative pressure describing the irreversible process of gravitational particle creation. In order to have a transition from a decelerating to an accelerating regime at low redshifts, the matter creation rate proposed here depends on 2 parameters (y and ߯): the first one identifies a constant term of the order of H0 and the second one describes a time variation proportional to he Hubble parameter H(t). In this scenario, H0 does not need to be small in order to solve the age problem and the transition happens even if there is no matter creation during the radiation and part of the matter dominated phase (when the ß term is negligible). Like in flat ACDM scenarios, the dimming of distant type Ia supernovae can be fitted with just one free parameter, and the coincidence problem plaguing the models driven by the cosmological constant. ACDM is absent. The limits endowed with with the existence of the quasar APM 08279+5255, located at z = 3:91 and with an estimated ages between 2 and 3 Gyr are also investigated. In the simplest case (ß = 0), the model is compatible with the existence of the quasar for y > 0:56 whether the age of the quasar is 2.0 Gyr. For 3 Gyr the limit derived is y > 0:72. New limits for the formation redshift of the quasar are also established

Competição entre caminhantes aleatórios

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Aplicabilidade da voltametria de pulso diferencial na quantificação de ácido fólico e ácido oxálico: um método comparativo

The development of more selective and sensitive analytical methods is of great importance in different areas of knowledge, covering, for example, food, biotechnological, environmental and pharmaceutical sectors. The study aimed to employ the technique electroanalytical differential pulse voltammetry (DPV) as an innovative and promising alternative for identification and quantification of organic compounds. The organic compounds were investigated in this study oxalic acid (OA) and folic acid (FA). The electrochemical oxidation of oxalic acid has been extensively studied as a model reaction in the boundary between the organic and inorganic electrochemistry. Since the AF, an essential vitamin for cell multiplication in all tissues, which is essential for DNA synthesis. The AF has been investigated using analytical techniques, liquid chromatography and molecular absorption spectrophotometry. The results obtained during the experimental procedure indicated that the process of electrochemical oxidation of oxalic acid is strongly dependent on the nature of the anode material and the oxidation mechanism, which affects their detection. Efficient removal was observed in Ti/PbO2 anodes, graphite, BDD and Pt 90, 85, 80 and 78% respectively. It was also shown that the DPV employing glassy carbon electrode offers a fast, simple, reliable and economical way to determine the AO during the process of electrochemical oxidation. Furthermore, electroanalytical methods are more expensive than commonly used chromatographic analysis and other instrumental methods involving toxic reagents and higher cost. Compared with the classical method of titration and DPV could be a good fit, confidence intervals and detection limits confirming the applicability of electroanalytical technique for monitoring the degradation of oxalic acid. For the study of AF was investigated the electrocatalytic activity of the carbon paste electrode for identification and quantification in pharmaceutical formulations by applying the DPV. The results obtained during the experimental procedure showed an irreversible oxidation peak at 9.1 V characteristic of FA. The carbon paste sensor showed low detection limit of 5.683×10−8 mol L-1 reducing matrix effects. The spectrophotometric analysis showed lower concentrations of HF compared with those obtained by HPLC and DPV. The levels of AF were obtained according to the methodology proposed by the Brazilian Pharmacopoeia. The electroanalytical method (DPV) proposed is cheaper than GC analysis commonly used by the pharmaceutical industry. The results demonstrated the potential of these electroanalytical techniques for future applications in environmental, chemical and biological sensors

O cuidador familiar do idoso com alzheimer: percepções e sentimentos

The Brazilian Constitution maintains that care for elderly people is a responsibility shared by the state, the family and the society. The politics for the elderly corroborate this understanding and treats home as a privileged place for elderly care taking. This determines the participation of the familiar as a caregiver, but highlights the lack of strategic assistance for the needs of the relative caregiver who feels helplessly and unattended in their responsibility for elderly homecare. In recent years , despite the recently pursuit for health and life quality, there is an increasing incidence of elderly patients with dementia diseases that lead to disability, the most common among then is the Alzheimer´s disease. This disease affects seriously and irreversibly cognition, memory and independence of the elderly, making it dependent on others to perform basic activities of daily life, for all his life. The present study aims to evaluate the perceptions and feelings of family caregivers of elders with Alzheimer on the role of caregiver. This is a qualitative study conducted with family caregivers of seniors with Alzheimer´s, caregivers linked to the group of the Specialized Care Center of the Elderly´s Health, located in Natal / RN. Through semi-structured interview research sought to investigate the perceptions of family caregivers on the role of caregiver, the feelings and the changes in the caregiver´s life since they assumed this role. The data were organized into categories and units of semantic analysis and analyzed using thematic content analysis by Bardin. The reports originated three categories: the perception of the role of caregiver, feelings related to the caregving and consequences of the caregiver role. Perceptions of caregivers of elderly from the requirement of dedication to the care generates losses in personal and professional life for the familiar who assumes this responsibility. The lack of family and social support, aggravates the burden of care for the dependent elderly. Public health politics for the elderly recognize the importance and needs of family caregivers, but not enough to provide support and meet the needs and assist them in supporting their limitations. The research results show the urgent need to take measures to assist the caregivers of seniors with Alzheimer, recognizing them as an action of promotion quality of life and health of the elderly and protection the health of the caregiver

Evolução espaço-temporal da ocupação urbana sobre áreas naturais no município de Natal-RN

In this work the landscape morphodynamics was used to check the strength and importance of the changes carried out by man on the environment over time, in Natal-RN municipality. The occupation of partially preserved natural areas was analyzed, but environmentally fragile, such as riparian forests, vegetation on the banks of waterways, which play regulatory role of the water flow, and the dunes, which guarantee the rapid recharge of aquifers. The impacts of urban sprawl in Natal Southern and West zones Were identified and characterized, through a detailed mapping in the period between 1969 and 2013 the main Permanent Preservation Areas - PPA (banks of rivers and lagoons, and dunes remaining) and their temporal changes. For this were used aerial photographs and satellite imagery, altimetry data, and pre-existing information, which allowed the creation of a spatial database, and evolution of maps of impervious areas, evolution of the use and occupation and Digital Terrain Model (DTM) from contour lines with contour interval of 1 meter. Based on this study presents a diagnosis of the environmental situation and the state of conservation of natural areas, over the last 44 years, compared to human pressures. In general, it was found that the urban settlement has advanced about 60% of studied natural areas. This advance was growing by the year 2006, when there was a slowdown in the process, except for the Environmental Protection Zone (EPZ) 03, where the river Pitimbú and your PPA, which experienced a more significant loss area. The urban occupation affected the natural drainage and contributed to the contamination of groundwater Natal, due to increased sealed area, the release of liquid and solid waste, as well as the removal of riparian vegetation. Changed irreversibly the natural landscape, and reduced the quality and quantity of water resources necessary for the population. Thus, it is necessary to stimulate the adoption of use and protection of PPA planning measures, to the preservation of the San Valley Region inserted into the EPZ 01, and integrate more remaining dunes, in good condition, this EPZ, due to the importance of those remaining on the environment and the maintenance of quality of life. It is suggested, also, protection of catchment areas, such as PPA ponds and Pitimbú River. Finally, it is expected that this study can assist the managers in making decisions in urban and environmental planning of the municipality

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