Distribuição regional da ventilação pulmonar em indivíduos com insuficiência cardíaca crônica após serem submetidos a um programa de treinamento da musculatura inspiratória e sua correlação com dados funcionais

Introduction: Chagas Disease is a serious public health problem, with 5 million infected individuals in Brazil. Of these, approximately 30% develop chronic Chagas cardiomyopathy (CCC), where the main symptoms are fatigue and dyspnea. Objective: To correlate maximal exercise capacity with pulmonary function, inspiratory muscle strength and quality of life in patients with CCC. Methodology: Twelve individuals suffering from CCC were evaluated (7 men), with a mean age of 54.91± 8.60 years and the following inclusion criteria: functional class II and III according to the New York Heart Association (NYHA); left ventricle ejection fraction below 45%; clinical stability (> 3 months); symptom duration > 1 year, body mass index (BMI) < 35Kg/m2 and non-smokers or ex-smokers with a history of smoking <10 packs/day. All subjects were submitted to spirometry, manometer testing, maximal cardiopulmonary exercise testing (CPX) and a quality of life questionnaire (Minnesota). Results: A negative correlation was observed between VO2máx and MLHFQ scores (r=-0.626; p=0.03) and a positive association with MIP (r=0.713; p=0.009). Positive correlations were also recorded between MIP and spirometric variables [FEV1(r=0.825;p=0.001 ), FVC(r=0.66;p=0.01 and FEF25-75%(r=0.639;p=0.02)]. Conclusion: The present study demonstrated that in patients with CCC: VO2MAX is directly related to inspiratory muscle strength and quality of life, while deteriorating lung function is directly associated with respiratory muscle weakness

Influência da intensidade de aeração na formação do floco de lodo ativado e na eficiência de remoção de matéria orgânica

In wastewater treatment, activated sludge systems have been a technology widely applied as secondary treatment. During this step, which has a strong biological aspect, it is necessary to introduce oxygen supply for the maintenance of metabolic activity of the bacteria through the aerators. Aeration devices are responsible for most of the energy consumption in this stage. In this background, the influence of three aeration intensities (atmospheric air flow 3.5, 7.0 and 10.5 L.min-1) and the concentration of dissolved oxygen (DO) on the dimension of activated sludge flocs as well as on the efficiency of organic matter removal were assessed using a traditional activated sludge system which was fed with synthetic domestic wastewater. Samples were taken weekly from the three units that make up the system feed, aeration and storage tank in order to verify the Chemical Oxygen Demand (COD). It was established the process efficiency through a comparison between the initial and final COD. Besides the parameters already mentioned, this monitoring work on activated sludge batch system was also observed by Mixed Liquor Suspend Solids (MLSS), Volatile Suspend Solids (VSS), pH and temperature measures. The results have showed a maximum removal efficiency around 75% in the first aeration sequence and approximately 85% for the second and third one. For the first aeration, the DO concentration remained higher than 3.0 mg.L-1 and a diameter range from 10 to 60 μm was observed. In the second e third sequence, the DO concentration remained higher than 4.0 mg.L-1 with a diameter range of 10 until 200 μm. Although the sequence 1 and 2 have presented similar performances for organic matter removal, the sequence 2 promoted a regular floc size distribution and with lower values of Sludge Volumetric Index (SVI) meaning a better flocculating ability. In addition, the results reaffirmed what the literature has reported: higher DO concentrations produce flocs with greater dimensions

Dinâmica de Sedimentação de Lodo em Lagoas de Estabilização

Stabilization ponds are an effective sewage treatment alternative for the climatic conditions prevailing in Brazil. In the present work, a primary facultative pond was studied, in the city of Natal, Rio Grande do Norte, Northeast Brazil. The aim of this study was to evaluate the sedimentation dynamics in the facultative pond. The pond was divided in three section or zones along its length starting from the inlet end namely A1, A2 and A3. The research was accomplished in three phases. In the first the mapping of the sludge layer was done, sludge core samples were also collected for analysis for total, fixed and volatile solids and the depth of the sludge layer was determined using a portable echo sounder. In the second solids sedimentation rates were measured using traps placed in the inlet and outlet zones and in the third phase resuspension sludge was evaluate using a tracer. The amount accumulated sludge since the start operation was 13.583 m3. The sedimentation constant averages changed between 0.93 to 2.94 and 3.90 to 5.80 for the depths of 0.5 and 1.0 m respectively. The relationship between volatile and fixed solids (SV/SF) increased along the pond. The removal efficiencies were 52.12%, 36.09%, and 37.50% for BOD, COD and SS, respectively. The sludge accumulation model proposed had a good adjustment with 0.17 m3/hab.year rate. The results presented here demonstrated that the wind had a direct influence on the sedimentation of solids in this pond affecting the efficiency and sludge accumulation

Uso urbano não potável de água de lagoas do sistema de drenagem de Natal

The detention and infiltration ponds of urban drainage system has function to protect the population from undesirable effects of floods. In general these ponds are not completly used and it potential is wasted. As it are disseminated at different places at cities it can reduce costs with water transport and permit water preservation of best quality. Some it utilities includes use in green areas irrigation, industrial among than cooling towers and boiler, soil compaction, cleaning urban road, pisciculture and fire fighting system. The quality these water is influenced by anauthorized sewage in the drainage system. This study was performed in six detention and infiltration ponds at drainage system of Natal, which aim was to verify the non-portable use these ponds on urban environment. As indirect aim would to incentive the water utilization these ponds as a water source to another uses in urban environment. These ponds represents the characteristics of detention and infiltration of Natal city and consequently of Brazil. As the water quality, the ponds presents following characteristics: three has apparently good quality, other showed intermediate condition and two had water polluted. Were performed twenty sample in each ponds and the following parameters assessed: pH, temperature, dissolved oxygen, turbidity, electrical conductivity, coliform thermotolerant, ammonia, organic nitrogen, TKN, nitrate, total phosphorus and alkalinity, bicarbonate, chloride, total hardness, calcium and magnesium hardness, total solids, TSS, TDS, COD and SAR°. To utilization on pisciculture we recommend use in ponds which presents the best quality. Only one pond presented higher pollutants and it not being appropriated for use in cooling tower. The content of solids suspension restricted the water use in all ponds in boilers. As water use in soil compaction, cleaning urban road and fire fighting system the water from these ponds are not appropriated. However, the recommended limits from literature are to domestic sewage, due to this, the parameters are restrictive to diminish the sanitary risk that could be offered with it utilization. The infiltration velocity of water these assessed ponds restrict a moderato use, however the effects are potentiated only in soil less sandy, which not occur in Natal. It is recommend the unrestricted irrigation utilization in ponds with best quality of water, and a restricted irrigation to ponds with worst quality of water. As load of pollutants, it is recommended a complementary treatment in those ponds whit higher load to diminish sanitary risks. In only one pond was found one helminth eggs and due to the convention formula of results, it was found for all ponds less than 1 helminth/liter eggs.

Remoção de nitrogênio em biofiltros aerado e anóxico, com alto índice de vazios e sem remoção de lodo

The improper disposal of nitrogen in receiving water courses causes problems such as toxicity to living beings through the consumption of oxygen to meet the nitrogen demand, eutrophication and nitrate contamination of aquifers. For this reason it is often necessary to be carried out complementary treatment of wastewater to eliminate or reduce the concentration of this compound in the wastewater. The objective of this study is to evaluate the biological removal of nitrogen compounds using submerged aerated and anoxic filters as post-treatment of an anaerobic system, with low cost and innovative technology, which in previous studies has shown high removal efficiency of organic matter and great potential biological nitrogen compounds removal. The simple design with perforated hoses for air distribution and filling with plastic parts proved to be very efficient in relation to organic matter removal and nitrification. The system presented, in the best stage, efficiency in converting ammonia to nitrate by 71%, and produced a final effluent concentration below 10 mg / L of NH3-N. In addition, carbon concentration was removed by 77%, producing final effluent with 24 mg/L COD. However, denitrification in anoxic filter was not effective even with the addition of an external carbon source. There was a reduction of up to 56% of nitrogen caused by the process of simultaneous nitrification and denitrification (SND). The high voids space presented by this type of support material coupled with direct aeration of the sludge, allows the respiration of biomass retained between the endogenous phase, increased cell retention time and sludge retention capacity, producing a final effluent with turbidity less than 5 UT and total suspended solids around 5.0 mg/L

Remoção de Microalgas de efluentes de lagoas de estabilização utilizando biofiltro

This research evaluated the microalgae removal produced in a stabilization pond system using biofilters as post-treatment, besides characterizing the effluents of stabilization ponds and filters in relation to concentrations of algal biomass (chlorophyll a and suspended solids), organic matter (BOD and COD), total phosphorus, orthophosphate, pH and dissolved oxygen, and tried to correlate physicochemical parameters with chlorophyll "a". It was held at the Ponta Negra ETE which is constituted by three stabilization ponds, with a primary facultative pond and two of maturation. For the algae removal were used two submerged bio-filters: the filter FPF (Facultative Pond Filter), fed with facultative pond effluent; and the filter MPF (Maturation Pond Filter), fed with second maturation pond effluent. The filling material of both filters was predominantly gravel no. 2, although it contains portions of gravel no. 1 and no. 3. The filters operating conditions were bad, they were nearly 10 years without maintenance, without cleaning or removal of sludge since the time of its construction, and part of the filling material may be obstruct. Despite poor operating conditions were obtained satisfactory results, in level of posttreatment. Removal efficiencies in relation to BOD and COD were 7 and 25% in FPF and 9 and 19% and in MPF, respectively. In relation to TSS efficiencies in MPF and FPF were 37 and 20%, respectively. As for the chlorophyll "a" removal, the FPF efficiency was 44% and the MPF was 40%. There was 50% of consumption of dissolved oxygen, on average, within the filters. Two profiles were performed in the filters, and it was possible to conclude that variations throughout the day were not statistically significant, and that, regardless of the time of collection, they would have the same representation comparing to the time of data collection (7 am) and the daily average, although individual variations throughout the day have been shown to be significant. Another important observation is that the correlations between Chlorophyll a and TSS were bigger and more significant in the effluent of the filters than in the effluent of the ponds

Eficiência de uma ETE em escala real composta por reator UASB seguido de lodo ativado

In the state of Rio Grande do Norte (RN), Brazil, there are about 80 sewage treatment systems being the predominant technology waste stabilization ponds. The Baldo s WWTP , due to its location and low availability of area, was designed as a hybrid conventional system (UASB reactor followed by activated sludge with biodiscs) at a tertiary level, being the most advanced WWTP in the State and also with the larger treatment capacity (1620 m3/h) .The paper presents the results of its performance based on samples collections from May to December 2012. Composite samples of the effluent of the grit chamber, UASB reactors, anoxic chambers, aeration tanks and treated effluent were collected weekly, every 4 hours for 24 hours. The results showed that the WWTP effluent presented adequate ranges of temperatures, pH and DO, however removal efficiencies of BOD and TSS were below the predicted by design. The UASB reactors also showed removals of BOD and TSS less than expected, due to the accumulation of sludge in the reactors, which eventually, was washed out in the effluent. The nitrification process was not satisfactory mainly due to problems in the oxygen distribution in the aeration tanks. The removal of ammonia and TKN were high, probably by the assimilation process

Treinamento muscular inspiratório para asma: revisão sistemática com metanálise

In asthmatic, the lung hyperinflation leaves the inspiratory muscle at a suboptimal position in length-tension relationship, reducing the capacity of to generate tension. The increase in transversal section area of the inspiratory muscles could reverse or delay the deterioration of inspiratory muscle function. Objective: To evaluate the evidence for the efficacy of inspiratory muscle training (IMT) with an external resistive device in patients with asthma. Methods: A systematic review with meta-analysis was carried out. The sources researched were the Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov and reference lists of articles. All databases were searched from their inception up to November 2012 and there was no restriction on the language of publication. Randomised controlled trials that involved the use of an external inspiratory muscle training device versus a control (sham or no inspiratory training device) were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated risk of bias in studies and extracted data. Results: A total of five studies involving 113 asthmatic patients were included. Three clinical trials were produced by the same group. The included studies showed a significant increase in maximal inspiratory pressure (MD 13.34 cmH2O, 95% CI 4.70 to 21.98), although the confidence intervals were wide. There was no statistically significant difference between the IMT group and the control group for maximal expiratory pressure, peak expiratory flow rate, forced expiratory volume in one second, forced vital capacity, sensation of dyspnea and use of beta2-agonist. There were no studies describing exacerbation events that required a course of oral and inhaled corticosteroids or emergency department visits, inspiratory muscle endurance, hospital admissions and days of work or school. Conclusions: There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma, once the evidence was limited by the small number of studies included, number of participants in them together with the risk of bias. More well conducted randomized controlled trials are needed, such trials should investigate respiratory muscle strength, exacerbation rate, lung function, symptoms, hospital admissions, use of medications and days off work or school. IMT should also be assessed in the context of more severe asthma

Efeitos do treinamento muscular inspiratório domiciliar sobre a atividade eletromiográfica dos músculos respiratórios em asmáticos: estudo piloto

Asthma treatment aims to achieve and maintain the control of the disease for prolonged periods. Inspiratory muscle training (IMT) may be an alternative in the care of patients with asthma, and it is used as a complementary therapy to the pharmacological treatment. Thus, the aim of this study was to investigate the effects of a domiciliary program of IMT on the electromyographic activity of the respiratory muscles in adults with asthma. This is a clinical trial in which ten adults with asthma and ten healthy adults were randomized into two groups (control and training). The electrical activity of inspiratory muscles (sternocleidomastoid (ECM) and diaphragm) was obtained by a surface electromyography. Furthermore, we assessed lung function (spirometry), maximal inspiratory pressure - MIP - (manometer). The functional capacity was evaluated by six minute walk test. Participants were assessed before and after the IMT protocol of 6 weeks with POWERbreathe® device. The training and the control groups underwent IMT with 50% and 15 % of MIP, respectively. The sample data were analyzed using SPSS 20.0, attributing significance of 5 %. Were used t test, ANOVA one way and Pearson correlation. It was observed an increase in MIP, after IMT, in both training groups and in healthy sham group (P < 0.05), which was accompanied by a significant increase in ECM activity during MIP in healthy training group (1488 %) and in asthma training group (ATG) (1186.4%). The ATG also showed a significant increase in diaphragm activity in basal respiration (48.5%). Functional capacity increased significantly in the asthma sham group (26.5 m) and in the asthma training group (45.2 m). These findings suggest that IMT promoted clinical improvements in all groups, especially the ATG, which makes it an important complementary treatment for patients with asthma

Eficácia do aconselhamento no tratamento das disfunções temporomandibulares

The aim of this controlled trial was to evaluate the effectiveness of counseling in pain, function and well-fare outcomes on the management of patients with temporomandibular disorder (TMD). Therefore, 51 consecutive patients were allocated to one of the research groups. In Group I, was instituted counseling therapy for Group II was conducted treatment as usual with occlusal splint. Patients were followed for returns at 7, 15, 30 and 60 days after baseline. At baseline, all patients were examined and assessed RDC/TMD form, which was administered by a single trained and calibrated examiner, in addition, the patients were referred for specific treatment according to the group to which belonged. The clinical and functional impairment was assessed at each visit through the Temporomandibular Index (TMI). In each session, the patients were also surveyed about pain intensity using a Visual Analogue Scale (VAS). To analyze the impact of pain on quality of life, OHIP-14 questionnaire was used. The results showed 26 patients in Group I with a mean age of 35.15 ± 10.79 years. 25 patients were allocated to Group II. The mean age was 27.36 ± 10.34 years. The counseling was effective in reducing the intensity of pain (VAS), with significant improvement observed at 7 day follow-up (p <0.001). The functional impairment (TMI) showed significant results at 15 days follow-up (p = 0.002). Counseling was also responsible for significant improvement in the impact of TMD on quality of life (OHIP-14) at all times of the analysis (p <0.001). When comparing research groups, no significant difference was observed for any of the analyzed indices (p> 0.05) nor in the short term (7 days) neither in long term (60 days). It was concluded therefore that, for the studied sample, counseling consisted in an effective treatment option for the control of signs and symptoms of TMD, with results in the short and long term similar to the usual treatment group.

Saúde do trabalhador: entre os dispositivos legais e as práticas efetivas

The health worker is seized in this research beyond the mere applicability of legal devices concerning the legislation of Labor, in order to be established correlations with activities alluding to the public power in the ambit of State of Rio Grande do Norte (RN). This dissertation is an cutting of analysis circumscribed in the research, "Accidents at work: law, citizenship and justice," of the Grupo de Estudos Seguridade Social e Trabalho (GESTO) of Universidade Federal do Rio Grande do Norte (UFRN). The overall goal turned to apprehend and relate contradictory elements inherent compliance of Occupational Health and Safety (OHS) in the supermarket which showed the highest occurrence of legal violations recognized by the Labor Justice of RN in the period between 2006 and 2008 . The specific objectives turned to identify, from the condemnatory sentences, violations inherent in the protective direction of the OH & S legislation; analyze the relationship of health damages to workers at the supposed recognition of rights claimed in condemnatory sentences and correlate violations inherent in the legislation OSH impacts on the health of workers, from data contained in expert reports. The justification for perform the research backed up, among other factors, in the fact that class of activity has been presented as the most recurrent in condemnatory sentences, since it chose to focus the analysis on documentary evidence from the supermarket which showed greater expression in relation to violations of the OSH legislation. From a qualitative perspective, the methodological approach was based on content analysis of thirteen condemnatory sentences, handed down by the potiguar labor justice, and three expert reports from a large supermarket in the city of Natal/RN. Aftermaths are evidenced relating to the cyclical processes of reorganization of capital, demanding requirements for labor organizations whose strategies for survival include identifying mechanisms to extract as much of the work force. Structural determination and ideological context that puts into question the historical achievements of workers, for example the legal devices aimed at preventing workplace accidents, expressed in this research as relativized, showing limitations of reach, as was inferred the indemnities, by material and moral damages, arising from Work-Related Musculoskeletal Diseases (MSDs'S), recognized by the laborite judiciary

Monitoramento ambiental da costa do Rio Grande do Norte com base em sensoriamento remoto e geodésia de precisão

This paper presents models of parameters of Sea Surface Layer (SSL), such as chlorophyll-a, sea surface temperature (SST), Primary Productivity (PP) and Total Suspended Matter (TSM) for the region adjacent to the continental shelf of Rio Grande do Norte (RN), Brazil. Concentrations of these parameters measured in situ were compared in time quasi-synchronous with images AQUA-MODIS between the years 2003 to 2011. Determination coefficients between samples in situ and bands reflectance sensor AQUA-MODIS were representative. From that, concentrations of SSL parameters were acquired for the continental shelf of the RN (eastern and northern) analyzing the geographic distribution of variation of these parameters between the years 2009-2012. Geographical and seasonal variations mainly influenced by global climate phenomena such as El Niño and La Niña, were found through the analysis of AQUA-MODIS images by Principal Components Analysis (PCA). Images show qualitatively the variance and availability of TSM in the regions, as well as their relationship with coastal erosion hotspots, monitored along the coast of the RN. In one of the areas identified as being of limited availability of TSM, we developed a methodology for assessment and evaluation of Digital Elevation Models (DEM) of beach surfaces (emerged and submerged sections) from the integration of topographic and bathymetric data measured in situ and accurately georeferenced compatible to studies of geomorphology and coastal dynamics of short duration. The methodology consisted of surveys with GNSS positioning operated in cinematic relative mode involved in topographic and bathymetric executed in relation to the stations of the geodetic network of the study area, which provided geodetic link to the Brazilian Geodetic System (GBS), univocal , fixed, and relatively stable over time. In this study Ponta Negra Beach, Natal / RN, was identified as a region with low variance and availability of MPS in the region off, as characterized by intense human occupation and intense coastal erosion in recent decades, which presents potential of the proposed methodology for accuracy and productivity, and the progress achieved in relation to the classical methods of surveying beach profiles

Geoprocessamento de dados meteo-oceonográficos (cor do oceano e temperatura da superfície do mar) aplicado ao monitoramento ambiental na costa setentrional do Rio Grande do Norte

Orbital remote sensing has been used as a beneficial tool in improving the knowledge on oceanographic and hydrodynamic aspects in northern portion of the continental shelf of Rio Grande do Norte, offshore Potiguar Basin. Aspects such as geography, temporal and spatial resolution combined with a consistent methodology and provide a substantial economic advantage compared to traditional methods of in situ data collecting. Images of the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor onboard NASA's AQUA satellite were obtained to support systematic data collections related to the campaign of environmental monitoring and characterization of Potiguar Basin, held in May 2004. Images of Total Suspension Matter (TSM) and values of radiance standard were generated for the calculation of concentrations of total suspension matter (TSM), chlorophyll-a and sea surface temperature (SST). These data sets were used for statistical comparisons between measures in situ and satellite estimates looking validate algorithms or develop a comprehensive regional approach empirically. AQUA-MODIS images allowed the simultaneous comparison of two-dimensional water quality (total suspension matter), phytoplankton biomass (chlorophyll-a) variability and physical (temperature). For images of total suspension matter, the generated models showed a good correlation with the field data, allowing quantitative and qualitative analysis. The images of chlorophyll-a showed a consistent correlation with the in situ values of concentration. The algorithms adjusted for these images obtained a correlation coefficient fairly well with the data field in order that the sensor can be having an effect throughout the water column and not just the surface. This has led to a fit between the data of chlorophyll-the integration of the average sampling interval of the entire water column up to the level of the first optical depth, with the data generated from the images. This method resulted in higher values of chlorophyll concentration to greater depths, due to the fact that we are integrating more values of chlorophyll in the water column. Thus we can represent the biomass available in the water column. Images SST and SST measures in situ showed a mean difference DT (SST insitu - SST sat) around -0.14 ° C, considered low, making the results very good. The integration of total suspension matter, chlorophyll-a, the temperature of the sea surface (SST) and auxiliary data enabled the recognition of some of the main ways to fund the continental shelf. The main features highlighted were submerged canyons of rivers Apodi and Açu, some of the lines and beachrocks reefs, structural highs and the continental shelf break which occurs at depths around -60 m. The results confirmed the high potential for use of the AQUA-MODIS images to environmental monitoring of sea areas due to ease of detection of the field two-dimensional material in suspension on the sea surface, temperature and the concentration of chlorophyll-a