24 resultados para Transplante de Tecidos
em Universidade Federal do Rio Grande do Norte(UFRN)
Resumo:
The transplantation of organs and tissues presents itself as an important therapeutic option, both from a medical standpoint, the social or economic. Thus, the identification of variables that can interfere in the effectiveness of organs and tissues donation for transplantation needs to be investigated adequately, because it stands before increasing index of chronic and degenerative diseases in the population, what makes the waiting list for transplantation grow disproportionately and patients come to death without the opportunity of realization the treatment due to a lack of donors. In this context, has defined as objective of this study evaluate the factors associated with the effectiveness of organs and tissues donation for transplantation. It is a evaluative research, quantitative, prospective, with longitudinal design, developed at Central of Catchment, Notification and organ donation for transplant, Organ Procurement Organization and in six accredited hospitals to collect and transplantation of organs and tissues, in Natal/RN, between august 2010 and february 2011, after the approval of the Research Ethics Committee, under No. 414/10 and CAAE 007.0.294.000-10. The probabilistic sample without replacement was composed of 65 potential donors. It was used as an instrument of data collection a structured script non-participant observation of checklist type. Data were analyzed using descriptive statistics and presented in tables, charts, graphs and figures. For this, was used Microsoft Excel 2007 and statistical program SPSS version 20.0. To check the level of significance was chosen by applying the chi-square test (χ2) and Mann Whitney and caselas for less than five, it is considered the Fisher exact test. It was adopted as the significance level p-value <0.05. Among the surveyed it was observed that most of the individuals were male (50,8%), in the age group 45 years (53,8%), mean age of 42,3 years, minimum 5 and maximum 73 years (± 17,32 years). Single / widowers / divorced (56,9%), with up to completed elementary school (60,0%) in the exercise of professional activity (86,2%), catholic (83,1%) and residents in metropolitan region of Natal (52,3%). Was obtained donation effectiveness of 27,7%. There was no statistical significance between structure and effectiveness of the donation, but were observed inadequacies in physical resources (36,9%), materials (30,8%), organizational structure (29,2%) and human resources (18,5%). In the process, the maintenance phase (p= 0.004), diagnosis of brain death (p= 0.032), family interview (p≤ 0.001) and documentation (p= 0.001) presented statistical significance with effectiveness. Thus, it is accepts the alternative hypothesis of the study, in which is evidenced that the adequacy of the factors related to structure and process is associated to effectiveness of organs and tissues donation for transplantation. In this way, the effectiveness of organ and tissue donation ends in an essential way the rapidity and accuracy with which the donation process is conducted, requiring appropriate structure, with appropriate physical and material resources and skilled human resources to optimize the reduction of time and the suffering of those waiting for an organ or tissue transplant queued in Brazil
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
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This work reports the influence of the poly (ethylene terephthalate) textile surface modification by plasmas of O2 and mixtures (N2 + O2), on their physical and chemical properties. The treatment was carried out in a vacuum chamber. Some parameters remained constant during all treatment, such as: Voltage 470 V; Pressure 1,250 Mbar; Current: 0, 10 A and gas flow: 10 cm3/min. Other parameters, such as working gas composition and treatment time, were modified as the following: to the O2 plasma modified samples only the treatment time was changed (10, 20, 30, 40, 50 and 60 minutes). To the plasma with O2 and N2 only the chemical concentrations were changed. Through Capillary tests (vertical) an increase in textile wettability was observed as well as its influence on aging time and its consequence on wettability. The surface functional groups created after plasma treatments were investigated using X-ray Photoelectron Spectroscopy (XPS). The surface topography was examined by scanning electron microscope (SEM)
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As most current studies, reinforced plastics have been, in recent years, a viable alternative in building structural elements of medium and large, since the lightness accompanied by high performance possible. The design of hybrid polymer composites (combination of different types of reinforcements) may enable structural applications thereof, facing the most severe service conditions. Within this class of composite materials, reinforced the underlying tissues hybrid high performance are taking space when your application requires high load bearing and high rigidity. The objective of this research work is to study the challenges in designing these fabrics bring these materials as to its mechanical characterization and fracture mechanisms involved. Some parameters associated with the process and / or form of hybridization stand out as influential factors in the final performance of the material such as the presence of anisotropy, so the fabric weave, the process of making the same, normative geometry of the specimens, among others. This sense, four laminates were developed based hybrid reinforcement fabrics involving AS4 carbon fiber, kevlar and glass 49-E as the matrix epoxy vinyl ester resin (DERAKANE 411-350). All laminates were formed each with four layers of reinforcements. Depending on the hybrid fabric, all the influencing factors mentioned above have been studied for laminates. All laminates were manufactured industrially used being the lamination process manual (hand-lay-up). All mechanical characterization and study of the mechanism of fracture (fracture mechanics) was developed for laminates subjected to uniaxial tensile test, bending in three and uniaxial compression. The analysis of fracture mechanisms were held involving the macroscopic, optical microscopy and scanning electron microscopy
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In this study, it has been investigated the influence of silver film deposition onto 100% polyester woven and non-woven, on the survival of Escherichia coli and Staphylococcus aureus in contact with these surfaces. The treatment was performedin a chamber containing the working gas at low pressure (~ 10-2 mbar). Some process parameters such as as voltage: 470 V; pressure: 10-2 mbar; current : 0.40 A and gas flow: 6 and 10 cm3/min were kept constant. For the treatments with purêargon plasma using a flow of 6 and 10 cm3/min, different treatment times were evaluated, such as, 10 , 20, 30, 40, 50 and 60 minutes. Contact angle (sessile drop), measurements were used to determine the surface tension of the treated fabrics and its influence on the bacteria grow as weel as the possibilities of a biofilm formation. The formation of a silver film, as well as the amount of this element was verified byEDX technique. The topography was observed through scanning electron microscopy (SEM) to determine the size of silver grains formed on the surfaces of the fabric and assess homogeneity of treatment. The X-ray diffraction (XRD) was used to analyze the structure of silver film deposition. The woven fabric treatments enabled the formation of silver particulate films with particle size larger than the non-woven fabrics. With respect to bacterial growth, all fabrics were shown to be bactericidal for Staphylococcus aureus (S. aureus), while for the Escherichia coli (E. coli), the best results were found for the non-woven fabric (TNT) treated with a flow of 10 cm3/min to both bacteria
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Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant
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This study was developed with the aim of analyzing the effectiveness of renal transplantation on quality of life of kidney recipients in the Rio Grande do Norte State. This is a descriptive study with longitudinal design, panel type with quantitative approach to data analysis. The Quality of Life (QoL) of chronic disease kidney patients before and after kidney transplantation was assessed by the WHOQOL-bref, The population consisted of patients in pre and post-renal transplantation, the sample had 63 patients older than 18 years. The study was conducted after approval by the Research Ethics Committee of the Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, No. CAAE 0008.0.294.000-10. Data collection was performed at a referral center for renal transplantation in Rio Grande do Norte, from May 2010 to May 2013. Data were analyzed using descriptive statistics and presented in tables and graphs. For statistical analyzes, Microsoft Excel XP and SPSS 15.0 software were used. The tests used were simple variance (ANOVA), t-test, Mann-Whitney and Wilcoxon test to compare means, and Spearman correlations. P values <0.05 were considered significant. The demographic data showed a predominance of people between 18 and 45 years (68.2%) with a mean age of 39.9 years (SD 12.2), male (63.5%), married (58.7%), with children (51.0%). Regarding the education level was observed that 49.2% of participants had completed primary school, and most did not engage in any work activity (90.4%) during the study period. Hemodialysis was the predominant renal replacement therapy (96.8%) and the average waiting time for execution of transplantation was 1.9 years (SD 1.9). Comparison of QoL before and after transplantation showed significant differences in all areas analyzed, demonstrating that kidney transplantation had a positive impact on QoL in chronic renal patients undergoing kidney transplantation. Sociodemographic factors did not influence the quality of life in this group of patients, indicating that transplantation was the main factor to explain the improvement in quality of life. Thus, the alternative hypothesis of the study was accept, that there is a significant difference in quality of life before and after kidney transplant. It is expected that the results of this study may contribute to the development of strategies to encourage organ donation and kidney transplantation process
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Exploratory descriptive study, prospective with quantitative approach, performed in the nefrology outpatient service from the Onofre Lopes University Hospital (HUOL), Natal/RN, aiming to identify aspects that concern Quality of Life (QOL) on transplanted and hemodialysis patients, as measured by WHOQOL-bref and describe the aspects that differentiate QL between the two groups as measured by the same instrument. The population was of 62 renal patients in hemodialysis and 58 transplantd, with data collected from february to march 2006. The instrument used was WHOQOL-bref, translated to and validated for Portuguese by the multicentric group of the World Health Organization (WHO) in Brazil. The results show predominance of the masculine gender both in the post-transplant group (55,17%), as well as in the hemodialysis group (51,61%); the age strip of 28 to 43 prevailed, among which were 53,45% transplanted and 48,99% hemodialysis patients; 79,93% of the hemodialysis patients and 62,07% of the transplanted were provenient from ouside the capital of the state; from the hemodialysis population, 59,68% were married, while among the transplanted 48,28% were single; 58,06% of the hemodialisys patients had 1 to 3 children, while the majority of the transplanted, 44,83%, had no children; regarding scholarity level on both groups, there was a predominance of incomplete fundamental school, representing 62,9% of the hemodialysis patients and 46,6% of the transplanted; regarding work status, 98,39% of those in hemodialysis informed not to be working, and the same applied to the transplanted, with 75,86%; regarding treatment time, most patients of both populations were in the 1- to 4-year interval, of which were 62,9% of the hemodialisys patients and 53,45% of the transplanted. The analysis of WHOQOL-bref reliability through Crobach s Alpha coefficient had a value of 0,8816, demonstrating good internal consistency for the instrument. Regarding description of QOL tests, the average scores of the post-transplant were (Q-1) 18,14 e (Q-2) 18,69, and 12,3 (Q-1) and 11,29 (Q-2) for the group in hemodialisys. Regarding the aspects that differentiate QOL on the two groups observed through average scores from the Domains: Physical, 15,91 for the post-transplant group and 12,71 for the hemodialisys group; Psychological, 16,75 for the post-transplant group and 14,84 for the hemodialisys group; Social Relations, 17,79 on the post-transplant group and 16,58 on the hemodialisys group; Environment, 14,16 on the post-transplant group and 12,38 on the hemodialisys group. On every evaluated item, the post-transplant group achieved higher scores when compared to the hemodialisys group. The diference in QOL for both populations was significant on all items evaluated with a p<0,005
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Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing
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There are a number of damaging mechanisms that various materials can suffer in service. However, when working with polymer composite materials, this is something that requires analysis, especially when exposed to adverse environmental conditions. Thus, the objective of the present thesis is the study of the direct influence of environmental aging and the form of hybridization of the reinforcement woven on the structural stability, surfacedegradation and fracture process of polymer composites laminates. For this, the development of two polymer composite laminates was necessary, where one of them was reinforced with a bi-directional woven with hybrid strandsofkevlar-49/glass-Efibers, and the other also with a bi-directionalwoven, however with weft and warpformed of alternating strandsof Kevlar-49 fibers and glass-E fiber The reinforcementwoven are industrially manufactured. Both laminates use a polyester resin as a matrixand are made up of four layers each. All laminates were industrially prepared by the hand lay-up method of manufacturing. To do this, test specimens were manufactured of the respective laminates and submitted to environmental aging accelerated through the aging chamber. They were exposed to alternating cycles of UV radiation and moisture (heated steam) for a standard defined period. At the end of the exposure period the specimens were subjected to mechanical tests of uniaxial tensile and bending in three points and to the characterizationsof the fracture and surface deterioration. In addition, they were submitted to a structural degradation assessment by the measurement of mass variation technique (MMVT) and the measurement of thickness variation technique (MTVT), this last technique being developed in this thesis. At the end of the analysis it was observed that the form of hybridization of the reinforcement woven and the aging process directly influence with losses or gain in mechanical properties, with losses in the structural degradation and in the formation and propagation of damage mechanism of the developedcomposite laminates
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The utilization of synthetic fibers for plastic reinforcement is more and more frequent and this growing interest requires that their mechanic behavior under the most variable conditions of structural applications be known. The use of such materials in the open and exposed to the elements is one of them. In this case, it becomes extremely necessary to study their mechanical properties (strength, stiffness) and the mechanism of fracture by which the environment aging them out. In order to do that, the material must be submitted to hot steam and ultraviolet radiation exposure cycles, according to periods of time determined by the norms. This study proposal deals with the investigation of accelerated environmental aging in two laminated polymeric composites reinforced by hybrid woven made up of synthetic fibers. The configurations of the laminated composites are defined as: one laminate reinforced with hybrid woven of glass fibers/E and Kevlar fibers/49 (LHVK) and the other laminate is reinforced with hybrid tissue of glass fibers/E and of carbon fibers AS4 (LHVC). The woven are plane and bidirectional. Both laminates are impregnated with a thermofix resin called Derakane 470-300 Epoxy Vinyl-Ester and they form a total of four layers. The laminates were industrially manufactured and were made through the process of hand-lay-up. Comparative analyses were carried out between their mechanical properties by submitting specimen to uniaxial loading tractions and three-point flexion. The specimen were tested both from their original state, that is, without being environmentally aging out, and after environmental aging. This last state was reached by using the environmental aging chamber
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Materials known as technical textiles can be defined as structures designed and developed to meet specific functional requirements of various industry sectors, which is the case in automotive and aerospace industries, and other specific applications. Therefore, the purpose of this work presents the development and manufacture of polymer composite with isophthalic polyester resin. The reinforcement of the composite structure is a technical textile fabric made from high performance fibers, aramid (Kevlar 49) and glass fiber E. The fabrics are manufactured by the same method, with the aim of improving the tensile strength of the resulting polymer composite material. The fabrics, we developed some low grammage technical textile structures in laboratory scale and differentiated-composition type aramid (100%), hybrid 1 aramid fiber / glass (65/35%) and hybrid 2 aramid fiber / glass (85/15% ) for use as a reinforcing element in composite materials with unsaturated isophthalic polyester matrix. The polymer composites produced were tested in uniaxial tensile fracture surface and it´s evaluated by SEM. The purpose of this work characterize the performance of polymer composites prepared, identifying changes and based on resistance to strain corresponding to the mechanical behavior. The objectives are to verify the capability of using this reinforcement structure, along with the use of high performance fibers and resin in terms of workability and mechanical strength; verify the adherence of the fiber to the matrix and the fracture surface by electron microscopy scanning and determination of tensile strength by tensile test. The results indicate that, in a comparative study to the response of uniaxial tensile test for tensile strength of the composites and the efficiency of the low percentage of reinforcement element, being a technical textile fabric structure that features characteristic of lightness and low weight added in polymer composites
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Os polímeros biodegradáveis, como o poliácido láctico (PLA) apesar de consolidado nos campos farmacêuticos, médico e biomédico como biomateriais úteis para aplicações variadas, porém, depende da necessidade de funcionalizar a sua superfície estudando suas propriedades tais como hidrofilidade e hidrofobicidade favorecendo a interação do polímero com os materiais de aplicação farmacêutica, médica e biomédica. Este trabalho tem como objetivo produzir um material com características diferentes em cada um de seus lados, sendo um lado hidrofílico e o outro hidrofóbico. O substrato têxtil utilizado neste estudo foi um tecido de malha de composição 100% PLA que é biodegradável e biocompatível, o que possibilita sua aplicação na área biomédica. Para modificação superficial foi utilizado o tratamento a plasma de baixa pressão. A técnica de modificação de superfície por plasma foi escolhida por ser uma tecnologia limpa, anticorrosiva e não tóxica ao contrario de muitos processos químicos convencionais utilizados na indústria têxtil, além disso, não afeta as propriedades de massa do substrato. Neste estudo, um lado da superfície do substrato foi tratado com plasma oxigênio, argônio e nitrogênio, para o trabalho de melhoria da hidrofilidade da superfície e metano para a hidrofobicidade da amostra. A espectroscopia de emissão ótica (OEE) foi utilizada para fazer o diagnóstico das espécies do plasma durante o tratamento. Após o tratamento a plasma as amostras foram caracterizadas por medidas de ângulo de contato, microscopia eletrônica de varredura (MEV), Espectroscopia de fotoelétrons de raios-X (XPS), Infravermelho com Transformada de Fourier (FTIR) de reflexão total atenuada (ATR), medidas da área de espalhamento do líquido e arraste vertical. Onde foi caracterizado o aumento e diminuição da molhabilidade das amostras tratadas por plasma bem como as variáveis que contribuíram para tal efeito. O tratamento das amostras de PLA com O2 + CH4 apresenta comportamento hidrofílico no lado tratado com O2, apresentando aumento de rugosidade e grupos funcionais e no lado tratado com CH4, apresentando a formação de um filme polimérico formado sobre a superfície da amostra. O tratamento com N2 + CH4 apresenta comportamento hidrofóbico, porém com variações no fluxo do CH4 tem-se um controle da molhabilidade na superfície das amostras, podendo ir de hidrofóbico a hidrofílico, neste tratamento as amostras apresentaram pequenas diferenças de molhabilidade entre os lados tratados com plasma de N2 e com plasma de CH4
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Bone marrow transplantation (BMT) is currently the best therapeutic option for patients with hematologic diseases, solid tumors or autoimmune disorders. It is characterized by intravenous infusion of hematopoietic stem cells in order to restore marrow function. However, this procedure requires concomitant immunosuppression treatment, which favors the development of certain complications, often manifested in the oral cavity. This study aimed to evaluate the incidence of oral changes in patients undergoing BMT and to correlate these results with clinical aspects related to the patients and the transplants performed. This is a prevalence study, with cross-sectional design, carried out in a BMT service at the Institute of Onco-Hematology of Natal (ION) and Natal Hospital Center. Data collection was based on questionnaires, clinical examination of the oral cavity and consultation in the medical records. The sample consisted of 51 patients undergoing BMT. After the analysis, was found a general status with good health conditions and presence of oral changes in about half of patients who composed the sample. The manifestations observed were, in decreasing order of frequency: mucositis; gingival alteration and thrombocytopenic purpura; mucosal pigmentation; lichenoid reaction and candidiasis. The oral changes were observed more frequently in cases of allogeneic TMO, in different periods post-transplant, without significant differences related to the source of cells. It was found statistically significant association between the presence of graft-versus-host disease (GVHD) and oral changes (p < 0,001). Therefore, it is concluded that there is a relatively high incidence of changes in oral cavity of patients receiving bone marrow transplantation, a fact which confirms the need to consider this site for examination, diagnosis, treatment and prognosis of possible complications of BMT
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Although photodynamic therapy have been used as a useful tool over the past 30 years in oncology, few clinical trials have been conducted in dentistry. Photodynamic therapy (PDT) uses non - toxic photosensitizers and selective which are administered in target cells followed by local application of visible light, producing reactive oxygen species capable of causing cell death by apoptosis or necrosis, injured the local vasculature, and exert important effects on the im mune system. New generations of photosensitizing agents, such as nanoparticulate phthalocyanines, has shown excellent results in antitumor and antibacterial activity . In this context, the present work constitutes the first clinical protocol of local appli cation of nanoemulsion chloro - aluminum phthalocyanine (AlClFc) followed by irradiation in human gingiva, and analyzed descriptively and comparatively , by means of immunohistochemistry , the expression of RANK , RANKL , OPG and VEGF in a split - mouth model . Eight healthy volunteers with clinical indication for extraction were included in the study . Seven days before the extraction, was injected in the gingiva of participants, 5 μ M of nanoemulsion AlClFc followed by irra diation with diode laser (660nm , 7 J/cm2 ), the contralateral side was used as control. Tissue specimens were removed seven days after the TFD is performed. Tissues sample were divided into two groups (test and con trol groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy. Vascular alterations were seen in gingival samples that received PDT. Areas of edema and vascular con gestion, and intense vascularization were viewed . Additionally, dystrophic calcification in subepithelial region were observed in the test group. The results showed a similar pattern of immunostaining scores of RANK, RANKL and VEGF between the test and co ntrol groups, with no statistically significant difference (p = 0.317, p = 0.777, p = 0 .814, respectively). RANK and RANKL exhibited weak or absent immunostaining in most specimens analyzed. There was n o immunostaining for OPG. VEGF showed moderate to stro ng immunostaining in specimens from the test group. In addition, the clinical study showed that therapy was well tolerated by all patients. Adverse effects were short - time and completely reversible. Taken together, the results presented in this study showe d that PDT mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that a strong immunostaining for VEGF after therapy .