Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

Objetivo: relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações _________________________________________________ABSTRACT Purpose: we report a small series of pregnant women who underwent gastric bypass surgery for severe obesity, with a review of the literature on this topic. Methods: five consecutive cases of pregnancy after gastroplasty between 2001 and 2004 were evaluated, and clinical, laboratory and therapeutic features were considered. Patients were 30 to 34 years old and all had been submitted to gastroplasty by the Capella technique. The outcomes for both the pregnant woman and the fetus were evaluated. A search of the English language literature was done through MEDLINE and Web of Science databases with the following terms: gastroplasty, gastric bypass surgery, bariatric surgery, and pregnancy. Results: all 5 pregnancies were singleton. No major obstetric complications were observed and there were no premature or lowbirth weight infants. Conclusion: our data suggest that pregnancy following gastroplasty is safe for mother and fetus. However, since information about this topic is limited, further investigations are required to establish appropriate recommendations concerning the follow-up of these pregnancies

Infiltração de sal de alumínio em fibras de sisal para obtenção de fibras de alumina

ANDRADE JR., T. E. et al. Infiltração de sal de alumínio em fibras de sisal para obtenção de fibras de alumina. Cerâmica, v.51, n.317, p.37-41.ISSN 0366-6913. Disponível em:. Acesso em: 06 out. 2010.

Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações

Diagnóstico, estadiamento e tratamento cirúrgico do adenocarcinoma de pâncreas

O adenocarcinoma pancreático é um dos tumores sólidos de pior prognóstico, sendo o tratamento cirúrgico o único potencialmente curativo. Na grande maioria dos pacientes o tumor é diagnosticado em fase avançada, comumente na presença de doença metastática. A introdução de modernos métodos diagnósticos associados ao aperfeiçoamento dos já existentes tem gerado controvérsia quanto à melhor maneira de se estabelecer o diagnóstico e estadiamento do tumor. Da mesma forma, o papel da cirurgia na paliação e aspectos técnicos da ressecção de lesões localizadas estão longe de alcançarem consenso na prática. Método - Revisão da literatura sobre os aspectos controversos relacionados ao tema e um algoritmo para a abordagem dos pacientes com suspeita de tumor de pâncreas são apresentados. Foram utilizados os descritores: “adenocarcinoma” e “pâncreas” para pesquisa no PubMed (www.pubmed.com) e na Bireme (www.bireme.br) e a seguir selecionadas as publicações pertinentes a cada tópico escolhido com atenção especial para metanálises, estudos clínicos controlados, revisões sitemáticas e ainda publicações de grandes centros especializados em doenças pancreáticas. Conclusões - Na suspeita de adenocarcinoma de pâncreas é possível realizar estadiamento muito próximo do real sem a necessidade da exploração cirúrgica sistemática em virtude da disponibilidade na prática de exames modernos e eficientes. Isso permite que paliação menos invasiva seja praticada na maioria dos pacientes com lesões avançadas e incuráveis. Nos em que a cura é possível, a operação deve ser realizada objetivando-se, essencialmente, a remoção da lesão com margens livres e com aceitáveis índices de morbi-mortalidade

Cooperação e competição entre políticas no Brasil: os cursos da governabilidade no presidencialismo da catalização

Public policies have been studied in the various fields of humanities and social sciences, from different theoretical and technical aspects. However, there is still a lack of studies that incorporate the dimension that encompasses the political action and its interference in such actions, also recognizing the importance of the institutional setting of the Brazilian presidential model in implementing these policies. This fragmented and multiparty system has led to power heterogeneous sets of political parties. Thus, the ministerial offices, more than assisting the President´s government project, manage particularized agendas, which are party biased and have the influence of interest groups in hegemonic themes addressed by government agencies. When these agendas operate in sectoral and specialized policies, the friction level is apparently low. However, when this occurs in intersectoral actions, such as in regional development, there is evidence of strong signs of competition among government agencies, which in theory, should operate in an integrated manner. Although this is not a specific feature of Luiz Inacio Lula da Silva´s government- the period to be studied- there was similar behavior in Fernando Henrique Cardoso´s presidency, one realizes that the expansion of coalition on behalf of governance is increasingly interfering in the outcome of intersectoral public policies, due to these multiple arguments in action. In order to understand these processes, this study focused on the Sustainable and Integrated Development Programme for Differentiated Meso-Regions (PROMESO), part of the National Policy for Regional Development (NPRD). The program provides interface with various government agencies and their public policies in a clear intersectoral design. The research sought to identify and analyze the relationships between government agencies and their programs with interest groups, whether political parties or other segments of civil society, highlighting the logic of favoritism, which poses in second place the integration of actions in the intersectoral policies. Therefore, besides the theoretical debate that incorporates several categories of political science, public administration, public policy, geography and economics, the study focused on secondary sources, using different government agencies databases in order to raise information. It was observed that the interference of partisan politics has been disastrous for some public policies. Thus, the research confirms that cooperative character is fragile within government agencies, often limited to official documents, and that there is indeed, a striking feature of competition, especially when it comes to transversalized policies

A implementação de ações de integração na segurança pública: o caso das polícias civil e militar do Rio Grande do Norte

The research aimed to understand the challenges for the implementation of the proposed integration between the Civil Police and the Military Police in Rio Grande do Norte to the proposals of the SUSP. This study aimed to explore the gap with regard to the deepening of the possible causes that may hinder the implementation of integrated working between the police in public security, through a specific analysis on the state of Rio Grande do Norte. Was based on a theoretical framework that includes policies: general concepts, the steps of a public policy, the implementation stage , public security : conceptual definitions, policies on security in Brazil, the structure of public security in Brazil and systems police, Military Police x Civil Police: Roles and conflicts , integrating public security: the challenges to be overcome, the Unified public Safety (SUSP) and the main difficulties in the integration of the police. Being classified as to the purposes as an exploratory research on how to approach ranks as qualitative. The research unit was the Center for Integrated Operations Public Safety (CIOSP) through three subjects who were the chief CIOSP, the representative of the military police acting with the CIOSP, and representative civil police also active with the CIOSP. These subjects were chosen because of the understanding that individuals occupying senior positions would have more ability to respond to questions that guide the research problem. Data were collected through a set of interviews, qualitative data analysis was performed based content analysis, based on the definition of categories of analysis, gated time cross. With the results, it was revealed that the main problems of integration between the state police are treatment protocols, lack of political will and lack of infrastructure. The relationship between the Military Police and Civil Police in Rio Grande do Norte has differing cultural aspect, but can be considered as good value, professionalism and integrated operations. The implementation of CIOSP-RN followed the characteristics of the top-down model, the main difficulties in implementing the proposals of the SUSP, lack of own resources, the lack of standardization in public safety and the lack of professional training of public safety. It was concluded that with respect to the challenges to the implementation of the proposed integration between the Civil Police and the Military Police in Rio Grande do Norte to the proposals of the SUSP, the actions follow the characteristics of the top-down model, with no autonomy of administrators public to say in decisions, which restricts the view of the public safety of the state

Terrenos de marinha: terras públicas com função social? um estudo da orla marítima de natal

This work has as its theme the social function of terrenos de marinha. Theresearch universe is the terrenos de marinha of Natal coastline, focusing on thefulfillment of its social function. Prescribed by law since the colonial period with thepurpose of protecting the coast and free movement of people and goods, theywere swathes of land not available to private use by individuals. With the transitionfrom the allotments system to the purchase and sale, regard to land access,crystallized with the creation of the Land Law in the nineteenth century, the land isheld as merchandise and terrenos de marinha, following this logic, also acquireexchange value and become capable of enjoyment by private individuals, with thecondition of tax payments to the state. This is seen until the twentieth century,when in 1988, primarily because of the Federal Constitution promulgation, begins anew cycle when is possible to use on terrenos de marinha the principle of thesocial function of property. From this perspective this study aims to identify thesocial function of terrenos de marinha in Natal, focusing on the public destinationand the use value of the city coastline. To this end, it was made a data collection inthe on-line information system of the Federal Heritage Department of Rio Grandedo Norte (SPU / RN) and in the terrenos de marinha areas, in order to find out ifthey had public or private use, or if they were empty lots, as well as if thepopulation access to the shore exist. Interviews with managers of the SPU weremade. The empirical study showed that the social function of terrenos de marinhain the city of Natal still didn´t happen, considering the constant existence of vacantlots in their areas, the lack of access in significant portions of the coastline and thereduced areas directed to common use along the coastline, minimizing its potentialof enjoyment by the population. It concludes by pointing to the existence of a newtransition phase on the terrenos de marinha, in witch, gradually, come up lawprovisions in the legal system and public policies to expand the purely taxcollection function attributed to this land for two centuries. In this direction, thesocial function of terrenos de marinha is embodied in concomitant adjustment ofthe tax collection function and the rescue of coastline use value, national heritageand a place for sociability and social relations development

Influência de fatores ambientais na Leishmaniose visceral no Rio Grande do Norte

The Visceral Leishmaniose (LV) disease is endemic in some places in Brazil. It is caused by the protozoa Leishmania chagasi, being transmitted for vector, the phlebotomies, Lutzomyia longipalpis. In virtue of the expansion of the illness in Rio Grande do Norte, it is necessary to evaluate the determinative ambient factors in the proliferation of the vector for better control of the illness. The variable rainfall and the social variables had been analyzed using space regression with two models and the ambient variable of ZANE and the variables analyzed in 205 houses in the cities of Natal, Extremoz, Nísia Floresta, São Gonçalo do Amarante, São Jose do Mipibu, Parnamirim and Macaíba the Person and ML Chi-square were used . The analyses had shown that high rainfall, plain relief, the forest, the humid tropical climate the activities of production culture of sugar cane and fruit culture and the presence of bovines increase the risk of the LV. The work showed that it has space aggregation and that ambient factors influence in the LV in the State

Análise da contribuição de fatores genéticos e ambientais na manutenção da hanseniase nos estados do Rio Grande do Norte e Pará

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Desenvolvimento de formulações para produção de grés porcelanato a partir de matérias-primas da região da bacia do Parnaíba

Brazil is a great ceramic raw materials productor because of the its big number of clay deposits, in various areas of the ceramic industry. Although, the majority of the natural reservations are unknown or not studied yet, so there is no scientific technical dates that can guide their usage and industrial application, as well as the racional and optimazed way of usage by the industrial sector. The state of Maranhão has a gigant mineral wealth as esmectite, bentonite, kaolin, clays, feldspates, marine salt, iron and others, but produce only products with small agregated value compared to the porcelanato, one of the most expensives ceramic cover tiles, the reason for that is the low water absorption (lower than 0,5%), beside present amazing tecnicals features, like mechanical resistence. The main objective of the work is to do the characterization of four clays, with the finallity of find an application by the results and develop formulations to produce porcelanato using these raw materials from Timon-MA. For this were made the raw materials characterization using X ray fluorecence; X ray diffraction; Differencial thermal analysis; Dilatometric analysis and Tecnological properties, planing three formulations that were sinterized at six different temperatures: 1150, 1170, 1190, 1210, 1230 and 1250ºC for 7 minutes. After the sinteratization, the samples were submitted to tension resistance analysis. Were attained two formulations with the requested properties to produce porcelanato

Influência do lodo de ETE na massa para fabricação de cerâmica vermelha

The WTP produce many kinds of residue on your treatment stages, but the sludge is the more problematic from the final disposition point view. The actual rate of residue production deriving from technological evolution and the crescent population needs prevents the subtle equilibrium generation between consumption and recycling/reuse, creating problems of pollution resulting from inappropriate management of residues. Thus, is necessary achieve a new equilibrium between the grow from raw materials and energy and the residue generation. This equilibrium should be achieved by technical and economic feasibility of environmental supported models through recycling and reuse. The red ceramic industry stand out in residue absorption question as raw material due their clay mass heterogeneity, constituted by clay minerals and non-clay minerals with wide mineralogical variation, allowing residue inclusion which act like plastic or non-plastic materials, contributing to retain heavy metals contained in residues in the vitreous mass formed during the burning of the ceramic bodies. This work propose the study of the influence of incorporation of 25 wt.% sludge from wastewater treatment plant, according preliminary results, in the mass to produce ceramic bodies. The raw materials was characterized through chemical composition analyses by XRF, mineralogical analyses by XRD, thermal analyses by TG and DTA, Atterberg limits and thermodilatometry. Subsequently was composed the mass with 75 wt.% of clay and 25 wt.% of dried wastewater sludge from UFRN WWTP. Samples with 6,0 x 2,0 x 0,5 cm was produced with unidirectional compacting under pressure of 20MPa and burned in temperatures between 950 and 1,200ºC. After fired, the ceramic bodies have been submitted to physical and mechanical analyses through the measure of firing shrinkage, water absorption, density, apparent porosity and flexural strength; crystallographic analyses through XRD and microstructure analyses by SEM. The technological properties obtained was satisfactory to production of roof tiles with 25 wt.% at 1,200 ºC, but the production of others products at lower temperatures was not feasible

Avaliação de concretos reforçados por confinamento com manta de fibra de vidro estrutural e pré-impreganada

Due to the occurrence of diseases in the use of structural reinforcements in composites, with presentation of concrete blanket detachment, has been identified the need to evaluate the performance of concrete reinforced with glass fiber. This study aims to evaluate these concretes by means of testing methodologies, using concrete with low resistance with structural reinforcement for confinement by preimpregnated glass fiber and traditional fiberglass blanket. The first stage of work was the development of methodologies for analysis, opting for four types, such as the acoustic survey, strength to compressive, the pull-off and ultrasound. Next, tests were carried out using the four selected methodologies in 30 of proof-of-specimens by 5x10 cm, 15 were reinforced with the traditional fiberglass blanket with 5specimens exposed to test a marine environment of marine coastline of Natal-RN and 15 were reinforced with a pre-impregnated glass fiber blanket, as well as 5specimens exposed to a test environment of the marine coastline of Natal-RN. After conducting the acoustic survey, it has been verified a lack of delaminating and air bubbles in the samples, confirming the absence of gross shortcomings in the implementation of the ribs both the traditional fiberglass blanket and in the preimpregnated fiber glass blanket. After carrying out methods of pull-off and compressive strengthening test it was observed that the reinforced proof-bodies with pre-impregnated glass blanket showed maximum stresses higher than the traditional fiberglass blanket; consequently a greater grip with the formation of a smaller area of . fracture, unlike traditional glass mat, which showed lower maximum stresses, with a greater area of fracture. It was also found that the traditional fiberglass blanket presented detachment of blanket-concrete interface, unlike the pre-impregnated fiberglass blanket, which showed a better grip on the blanket-concrete interface. In the trial of ultrasound there was no presence of cracks in the blanket-concrete interface, yielding to both blankets good compactness of the concrete. At the end of this work, they were developed and proposed two methods of testing for evaluation of reinforced concrete structures with composites, for standardization, the acoustic survey and pull-off

Desenvolvimento e caracterização de compósitos poli(tereftalato de etileno) reciclado (PET reciclado) com flocos de vidro.

The growing concern with the solid residues management, observed in the last decade, due to its huge amount and impact, has motivated the search for recycling processes, where these residues can be reprocessed to generate new products, enlarging the cycle of materials and energy which are present. Among the polymeric residues, there is poly (ethylene terephthalate) (PET). PET is used in food packaging, preferably in the bottling of carbonated beverages. The reintegration of post-consumer PET in half can be considered a productive action mitigation of environmental impacts caused by these wastes and it is done through the preparation of several different products at the origin, i.e. food packaging, with recycling rates increasing to each year. This work focused on the development and characterization mechanical, thermal, thermo-mechanical, dynamic mechanical thermal and morphology of the pure recycled PET and recycled PET composites with glass flakes in the weight fraction of 5%, 10% and 20% processed in a single screw extruder, using the following analytical techniques: thermogravimetry (TG), differential scanning calorimetry (DSC), tensile, Izod impact, Rockwell hardness, Vicat softening temperature, melt flow rate, burn rate, dynamic mechanical thermal analysis (DMTA) and scanning electron microscopy (SEM). The results of thermal analysis and mechanical properties leading to a positive evaluation, because in the thermograms the addition of glass flakes showed increasing behavior in the initial temperatures of thermal decomposition and melting crystalline, Furthermore was observed growing behavior in the mechanical performance of polymer composites, whose morphological structure was observed by SEM, verifying a good distribution of glass flakes, showing difference orientation in the center and in the surface layer of test body of composites with 10 and 20% of glass flakes. The results of DMTA Tg values of the composites obtained from the peak of tan ä showed little reductions due to poor interfacial adhesion between PET and recycled glass flakes.

Influência do método de síntese e caracterização de pós compósitos de NiO- Ce1-xEuxO2-δ para anodos catalíticos de células a combustível

Fuel cells are electrochemical devices that convert chemical energy into electricity. Due to the development of new materials, fuel cells are emerging as generating clean energy generator. Among the types of fuel cells, categorized according to the electrode type, the solid oxide fuel cells (SOFC) stand out due to be the only device entirely made of solid particles. Beyond that, their operation temperature is relatively high (between 500 and 1000 °C), allowing them to operate with high efficiency. Another aspect that promotes the use of SOFC over other cells is their ability to operate with different fuels. The CeO2 based materials doped with rare earth (TR+3) may be used as alternatives to traditional NiO-YSZ anodes as they have higher ionic conductivity and smaller ohmic losses compared to YSZ, and can operate at lower temperatures (500-800°C). In the composition of the anode, the concentration of NiO, acting as a catalyst in YSZ provides high electrical conductivity and high electrochemical activity of reactions, providing internal reform in the cell. In this work compounds of NiO - Ce1-xEuxO2-δ (x = 0.1, 0.2 and 0.3) were synthesized from polymeric precursor, Pechini, method of combustion and also by microwave-assisted hydrothermal method. The materials were characterized by the techniques of TG, TPR, XRD and FEG-SEM. The refinement of data obtained by X-ray diffraction showed that all powders of NiO - Cex-1EuxO2-δ crystallized in a cubic phase with fluorite structure, and also the presence of Ni. Through the characterizations can be proved that all routes of preparation used were effective for producing ceramics with characteristics suitable for application as SOFC anodes, but the microwave-assisted hydrothermal method showed a significant reduction in the average grain size and improved control of the compositions of the phases

Efeito da tecnologia de microondas nas propriedades tecnológicas dos componentes de cerâmica estrutural

O processamento térmico de materiais cerâmicos via energia de microondas, no estágio atual, vem ganhando cada dia mais importância, tendo em vista suas inúmeras aplicações, como por exemplo: aplicação de microondas na área de processamento mineral (aquecimento de minérios antes da moagem, secagem, redução carbotérmica de óxidos minerais, lixiviação, fusão, pré-tratamento de minérios e concentrados de ouro refratário, regeneração de carvão, etc. de acordo com Kigman & Rowson, 1998). Em virtude de uma série de vantagens em potencial, frente aos métodos convencionais de aquecimento, como redução no tempo de processamento; economia de energia; diminuição do diâmetro médio das partículas e melhoramento nas propriedades tecnológicas em geral, esta tecnologia vem se destacando. Neste contexto, o objetivo geral deste trabalho, é desenvolver uma pesquisa visando identificar e caracterizar novas opções de matérias-primas cerâmicas como argilas, feldspatos e caulins que sejam eficazes para definir a formulação de uma ou mais massas para produção de componentes de cerâmica estrutural com propriedades físicas, mecânicas e estéticas adequadas após passarem por sinterização convencional e por energia de microondas destacando as vantagens desta última. Além dos requisitos técnicos e de processo, as formulações apresentadas deverão atender às expectativas de preço e de logística de fornecimento. No estudo foram conformados corpos-de-prova por extrusão e prensagem, sinterizados em fornos microondas e convencional, sob ciclos de queima mais rápidos que os atualmente praticados. As matérias-primas foram caracterizadas e analisadas, utilizando as técnicas de fluorescência por raios X (FRX), difração por raios X (DRX), análise térmica diferencial (DTA), análise térmica gravimétrica (DTG), análise granulométrica (AG), microscopia eletrônica de varredura (MEV), absorção d agua (AA), massa especifica aparente (MEA), porosidade aparente (PA), retração linear (RL) e tensão de ruptura e flexão (TRF). Os resultados obtidos indicaram que as propriedades tecnológicas de Absorção de água (AA) e Tensão de Ruptura e flexão (TRF), proposto no trabalho foram adquiridos com sucesso e estão bem além do limite exigido pelas especificações das normas da ABNT NBR 15.270/05 e 15.310/09