Tratamento de fístulas enterocutâneas através de sistema a vácuo com alta pressão e dieta oral normal

Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/mortality, and increase in hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. Normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after five days, 16(22%) after 10 days and 4(5%) after 15 days. Treatment failed in 6(8%) patients, who subsequently underwent surgery. Only one patient with low-output did not close her fistula. The cost of the treatment was US$ 41.75/day and it was considered cost effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns

Proposição de um modelo para análise de fluxo de carga, curto-circuito e simulação de relés de produção

The objective of the present work is develop a model to simulate electrical energy networks in transient and stead states, using the software ATP (Alternative Transient Program), able to be a way to join two distinct themes, present in classical methodology planning networks: short circuit analysis and load flow theory. Beyond that, using a tool for relay simulation, this paper intend to use the new developed model to investigate the influence of transient phenomenon in operation of protection relays, and calibrate the enterprise's protections relays. For testing the model, some relays, actually, installed at COSERN were used

Otimização da injeção cíclica de vapor em reservatório de óleo pesado

Thermal methods made heavy oil production possible in fields where primary recovery failed. Throughout the years steam injection became one of the most important alternatives to increase heavy oil recovery. There are many types of steam injection, and one of them is the cyclic steam injection, which has been used with success in several countries, including Brazil. The process involves three phases: firstly, steam is injected, inside of the producing well; secondly, the well is closed (soak period); and finally, the well is put back into production. These steps constitute one cycle. The cycle is repeated several times until economical production limit is reached. Usually, independent of reservoir type, as the number of cycles increases the cyclic injection turns less efficient. This work aims to analyze rock and reservoir property influence in the cyclic steam injection. The objective was to study the ideal number of cycles and, consequently, process optimization. Simulations were realized using the STARS simulator from the CMG group based in a proposed reservoir model. It was observed that the reservoir thickness was the most important parameter in the process performance, whilst soaking time influence was not significant

Qualidade de vida, eficiência mastigatória e presença de disfunção temporomandibular em usuários de prótese parcial removível com arco dental curto inferior

Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. In addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of different lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory efficiency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OHIP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quality of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinical analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability. The statistical tests used were chi-squared and analysis of variance as well as Tukey s post test, when applicable, all with a 95% confidence level. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn t, but this result wasn t statistically significant. The mean of the results of masticatory efficiency, WHOQOL and OHIP didn t show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that studied patients with low posterior support using lower PRP didn t have better masticatory efficiency, general quality of life, less impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn t use the prosthesis

A memória de curto prazo e a síndrome de down: a relação entre contextos de desenvolvimento

Down syndrome (DS) is one of the most frequent causes of intellectual disability, affecting one in every 600 to 1000 live births. Studies have demonstrated that people with DS have a lower capacity for short-term memory (STM) and working memory (WM), which affects their capability to learn new words and to follow spoken instructions, specially when they involve multiple information or consecutive orders/orientations. It seems that the basis of the learning process, as it happens with language and mathematics comprehension and reasoning, relies in the STM and WM systems. Individuals with DS are increasingly included in mainstream education, and yet, very few researches have been conducted to investigate the influence of memory development and the type of enrollment (regular school and special school). This study investigated the relationship between the type of school enrollment with the performance on STM tests and also, the relationship of this performance with early stimulation (ES). The tests used in the first research were the digit span, free recall, word recognition and subtests of the Wechsler Intelligence Scale for Children Third Edition (WISC-III). Individuals enrolled in the regular schools group had higher scores on the digit span test and the subtests of the WISC-III. In the free recall and recognition tests, no differences were found. This study indicates that the type of enrollment might influence the memory development of individuals with DS and clearly points the need for future investigations. In the second research, the tests used were the digit span, free word recall and subtests of the WISC-III. The test results showed better performance by adults that received ES before six months of age. The studies showed improvement in STM both in people who attended or were attending regular school, as well as those who benefited from ES before six months of age. However, some issues still need to be better understood. What is the relation between this stimulation with the individual s education? Since ES may reflect a greater family involvement with the individual, what is the role of emotional components derived from this involvement in the cognitive improvement? These and other questions are part of the continuity of this study

Uma colônia de formigas para o caminho mais curto multiobjetivo

Multi-objective combinatorial optimization problems have peculiar characteristics that require optimization methods to adapt for this context. Since many of these problems are NP-Hard, the use of metaheuristics has grown over the last years. Particularly, many different approaches using Ant Colony Optimization (ACO) have been proposed. In this work, an ACO is proposed for the Multi-objective Shortest Path Problem, and is compared to two other optimizers found in the literature. A set of 18 instances from two distinct types of graphs are used, as well as a specific multiobjective performance assessment methodology. Initial experiments showed that the proposed algorithm is able to generate better approximation sets than the other optimizers for all instances. In the second part of this work, an experimental analysis is conducted, using several different multiobjective ACO proposals recently published and the same instances used in the first part. Results show each type of instance benefits a particular type of instance benefits a particular algorithmic approach. A new metaphor for the development of multiobjective ACOs is, then, proposed. Usually, ants share the same characteristics and only few works address multi-species approaches. This works proposes an approach where multi-species ants compete for food resources. Each specie has its own search strategy and different species do not access pheromone information of each other. As in nature, the successful ant populations are allowed to grow, whereas unsuccessful ones shrink. The approach introduced here shows to be able to inherit the behavior of strategies that are successful for different types of problems. Results of computational experiments are reported and show that the proposed approach is able to produce significantly better approximation sets than other methods

Avaliação dos efeitos da retirada do etanol em curto e longo prazo sobre respostas comportamentais relacionadas à ansiedade e sobre células imunorreativas para a serotonina no núcleo dorsal da Rafe em ratas

Ethanol withdrawn individuals present a wealth of signs and symptoms, some of them related with anxiety. To better understand brain areas involved in anxiety caused by ethanol abstinence, preclinical studies have been employing models of ethanol consumption followed by withdrawal in rodents submitted to behavioral tests of anxiety, such as the elevated plus-maze. The aim of this study was to investigate if short- or long-term ethanol withdrawal could alter both anxiety-related behaviors in the elevated plus-maze (EPM) and open field tests and the number of serotonin immunorreactive cels in the dorsal raphe nucleus, a midbrain area associated with anxiety. Female Wistar rats (90 days old) were submitted to increasing concentrations of ethanol (2% for 3 days, 4% for 3 days and 6% for 15 days) as the only source of liquid diet and the control group received water ad libitum. Both groups received food ad libitum. In the behavioral experiments, on 21st day of consumption, ethanol was substituted by water (withdrawal) and 72 h or 21 days after withdrawal animals were submitted to the EPM, where it was evaluated the percentage of time and entries in the open arms and the entries in the enclosed arms during 5 minutes. Twenty and four hours after testing in the EPM, animals were submitted to the open field test for 15 minutes, where the distance traveled by the animals was observed along this period. During the first 5 minutes, the distance traveled, entries and time spent in the center of the test were analyzed. In the immunohistochemistry study, animals were submitted to 21 days of consumption of ethanol followed or not by 72 hours and 21 days of withdrawal previously perfusion, brain tissue preparation and quantification of serotonin dyed cells in the dorsal and caudal portions in the dorsal raphe nucleus. Behavioral data showed that both short- and long-term ethanol withdrawals reduced the open arms exploration in the EPM. In the open field test there were no locomotor activity changes during the total 15 minutes; however, longterm ethanol withdrawal reduced the exploration in the center of the open field during the first 5 minutes. In the immunohistochemistry step, there were no differences, when short- and long-term withdrawn groups were compared with control group; nevertheless, the chronic consumption of ethanol decreased the number of serotonergic immunorreactive cells in the dorsal part of dorsal raphe nucleus. Taken together, results here obtained suggest that both short- and long-term ethanol withdrawals promoted an anxiogenic-like effect that was not related with changes in the serotonin immunorreactivity in the dorsal and caudal parts of the dorsal raphe nucleus.

Da casa grande ao condomínio fechado: o que mudou nas formas e modos de morar da família intergeracional no Nordeste e Sudeste do Brasil?

The focus of this study is to draw attention to the intergenerational family’s lifestyles and their various ways of cohabitation, in special to those families which are made by individuals of different generations, these families being constituted of, two or more individuals, or, two or more smaller families, which live under the same roof and have the elderly person as referential in their cohabitation. In those types of families, as for their ways of organization, it is interesting to note that the researches and productions done by inner architects and inner designers do not include this type of family arrangement because their studies do not cover this kind of structuralization nor was this type of organization put together with any of the ways of cohabitation. Therefore there is a theoretical concept void which is propositional, interventional and does not relate to the empirical reality. In observation to these remarks, the research starts a theoretic challenge of deconstruct or reconstruct our modern only habitational template, which is used today in all families configurations which out any regards to where this template will be used, unfitting to the intergenerational families who have elders. This study is then meant to give an differential analysis of the various domestic space’s templates in regards to the new families formats, their basic and special necessities, the home identities of those families which indicates the differential gap in housing and lifestyle from the higher social classes in comparison to the lower social classes. The interdisciplinary method was chosen in order to describe arrangements found in the lifestyles and the ways of cohabitation of the intergenerational families, this method is used for its knowledge base that better articulates the procedure method and the inductive reflexive approach made possible after an qualitative research. In order to accomplish that, an geographical space which tow real possibilities was selected, that is, the space where the people of great social and anthropological proximity are concentrated and the people which are the researcher kinships and friends, in between those are the habitants of Capim Macio’s, Candelária’s, Tirol’s and Petrópolis’s, neighborhoods, located in the south west zone of her home city Natal. It has been noticed that, meanwhile these intergenerational spaces do not claim their said spaces, because of their habits, necessities and relations in between generations and gender, their arrangements of said space are extremely creative. That means that alterations in the concepts of planning, construction and utilization of built spaces are imperative.

Da casa grande ao condomínio fechado: o que mudou nas formas e modos de morar da família intergeracional no Nordeste e Sudeste do Brasil?

The focus of this study is to draw attention to the intergenerational family’s lifestyles and their various ways of cohabitation, in special to those families which are made by individuals of different generations, these families being constituted of, two or more individuals, or, two or more smaller families, which live under the same roof and have the elderly person as referential in their cohabitation. In those types of families, as for their ways of organization, it is interesting to note that the researches and productions done by inner architects and inner designers do not include this type of family arrangement because their studies do not cover this kind of structuralization nor was this type of organization put together with any of the ways of cohabitation. Therefore there is a theoretical concept void which is propositional, interventional and does not relate to the empirical reality. In observation to these remarks, the research starts a theoretic challenge of deconstruct or reconstruct our modern only habitational template, which is used today in all families configurations which out any regards to where this template will be used, unfitting to the intergenerational families who have elders. This study is then meant to give an differential analysis of the various domestic space’s templates in regards to the new families formats, their basic and special necessities, the home identities of those families which indicates the differential gap in housing and lifestyle from the higher social classes in comparison to the lower social classes. The interdisciplinary method was chosen in order to describe arrangements found in the lifestyles and the ways of cohabitation of the intergenerational families, this method is used for its knowledge base that better articulates the procedure method and the inductive reflexive approach made possible after an qualitative research. In order to accomplish that, an geographical space which tow real possibilities was selected, that is, the space where the people of great social and anthropological proximity are concentrated and the people which are the researcher kinships and friends, in between those are the habitants of Capim Macio’s, Candelária’s, Tirol’s and Petrópolis’s, neighborhoods, located in the south west zone of her home city Natal. It has been noticed that, meanwhile these intergenerational spaces do not claim their said spaces, because of their habits, necessities and relations in between generations and gender, their arrangements of said space are extremely creative. That means that alterations in the concepts of planning, construction and utilization of built spaces are imperative.