Efeitos da reabilitação vestibular em idosos com vertigem posicional paroxística benigna (VPPB): ensaio clínico controlado e randomizado

Introdução: a Vertigem Posicional Paroxística Benigna (VPPB) é uma das principais causas de tontura em idosos. O tratamento mais empregado para essa afecção é a Manobra de Reposicionamento Canalítico (MRC). Apesar de útil na resolução clínica da sintomatologia vertiginosa e do nistagmo, os pacientes podem continuar demonstrando prejuízo na estabilidade postural após serem submetidos à MRC. Outra opção não farmacológica disponível são os exercícios de Reabilitação Vestibular (RV) que podem ser direcionados à melhora do equilíbrio postural dos idosos, porém há escassez de estudos que avaliem a efetividade da RV no equilíbrio postural de idosos com VPPB. Objetivo: analisar a efetividade da Terapia de Reabilitação Vestibular associada às Manobras de Reposicionamento Canalítico em comparação às Manobras de Reposicionamento Canalítico no tratamento de idosos com Vertigem Posicional Paroxística Benigna (VPPB) crônica. Métodos: participaram do presente ensaio clínico controlado, randomizado e cego 14 idosos de ambos os sexos e idade igual ou superior a 65 anos e com diagnóstico de VPPB crônica. Os idosos foram randomizados em dois grupos, sendo sete (mediana: 69 anos, 65-78) para o grupo experimental e sete (mediana: 73 anos, 65-76) para o grupo controle. Ambos os grupos foram submetidos a Manobras de Reposicionamento Canalítico (MRC) para VPPB e somente o grupo experimental à Terapia de Reabilitação Vestibular (TRV) associada às MRC. Os efeitos da TRV foram mensurados em relação à conversão do teste de Dix-Hallpike de positivo para negativo, recorrência da VPPB, número de manobras para obter a negativação do teste de Dix-Hallpike, sintomatologia da tontura, qualidade de vida e ao equilíbrio estático e dinâmico. Os idosos foram submetidos a uma avaliação inicial (T0), em uma semana (T1), cinco (T5), nove (T9) e treze semanas (T13). Em todas as avaliações o teste de Dix-Hallpike foi realizado com o auxílio do sistema de Videonistagmoscopia (SVNC) da Contronic - Brasil, e em caso positivo, nova MRC foi empregada. As diferenças entre os grupos foram analisadas pelos testes de Mann Whitney e exato de Fisher e para elucidar as diferenças intra-grupo os testes não paramétricos de Friedman e Wilcoxon foram usados. Resultados: nenhuma diferença significativa foi encontrada na conversão do teste de Dix-Hallpike de positivo para negativo, na recorrência da VPPB e no número de manobras para a negativação do teste de Dix-Hallpike, entre os grupos ao longo do ensaio. Também não foram encontradas diferenças entre os grupos na sintomatologia da tontura, qualidade de vida e equilíbrio estático. Contudo, diferenças significativas foram observadas nos aspectos do equilíbrio dinâmico entre os grupos (p< 0,05). Na análise intra-grupo ambos os grupos obtiveram melhora em todas as medidas de desfecho, porém o grupo controle não obteve melhora no equilíbrio dinâmico. Conclusões: a TRV adicional não influenciou na conversão do teste de Dix-Hallpike de positivo para negativo, na recorrência da VPPB, no número de manobras para a negativação do teste de Dix-Hallpike, na redução da sintomatologia da tontura e na qualidade de vida dos idosos com VPPB crônica. Porém, os participantes que receberam a TRV adicional demonstraram melhores resultados no equilíbrio dinâmico do que aqueles que foram submetidos somente às MRC. Os resultados desse estudo deverão repercutir nas estratégias de reabilitação baseadas em evidências nos pacientes idosos com disfunções otoneurológicas.

Análise não-linear de treliças pelo método dos elementos finitos posicional

This work presents the positional nonlinear geometric formulation for trusses using different strain measures. The positional formulation presents an alternative approach for nonlinear problems. This formulation considers nodal positions as variables of the nonlinear system instead of displacements (widely found in literature). The work also describes the arc-length method used for tracing equilibrium paths with snap-through and snap-back. Numerical applications for trusses already established in the literature and comparisons with other studies are provided to prove the accuracy of the proposed formulation

Sistema de numeração posicional e a lógica da divisão de inteiros

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Uma avaliação comparativa de estratégias de arranjos físicos para estaleiros de construção de embarcações metálicas de pequeno porte

The present study aims to analyse, in different levels of demand, what is the best layout strategy to adopt for the small metallic shipbuilding. To achieve this purpose, three simulation models are developed for analyze these production strategies under the positional, cellular and linear layouts. By the use of a simulation tool for compare the scenarios, Chwif and Medina (2010) and Law (2009)´s methodologies were adapted that includes three phases: conception, implementation and analysis. In conception real systems were represented by process mapping according to time, material resources and human resources variables required for each step of the production process. All of this information has been transformed in the cost variable. Data were collected from three different production systems, two located in Natal RN with cellular and positional layouts and one located in Belém-PA with linear layout. In the implementation phase, the conceptual models were converted in computacional models through the tool Rockwell Software Arena ® 13.5 and then validated. In the analysis stage the production of 960 ships in a year vessels were simulated for each layout noting that, for a production of until 80 units positional layout is the most recommended, between 81 and 288 units the cellular layout and more than 289 units the linear layout

Odometria visual baseada em técnicas de structure from motion

Visual Odometry is the process that estimates camera position and orientation based solely on images and in features (projections of visual landmarks present in the scene) extraced from them. With the increasing advance of Computer Vision algorithms and computer processing power, the subarea known as Structure from Motion (SFM) started to supply mathematical tools composing localization systems for robotics and Augmented Reality applications, in contrast with its initial purpose of being used in inherently offline solutions aiming 3D reconstruction and image based modelling. In that way, this work proposes a pipeline to obtain relative position featuring a previously calibrated camera as positional sensor and based entirely on models and algorithms from SFM. Techniques usually applied in camera localization systems such as Kalman filters and particle filters are not used, making unnecessary additional information like probabilistic models for camera state transition. Experiments assessing both 3D reconstruction quality and camera position estimated by the system were performed, in which image sequences captured in reallistic scenarios were processed and compared to localization data gathered from a mobile robotic platform

Propriedades dos sistemas de numeração: uma sequência didática em uma abordagem histórica

This paper aims to describe the construction and validation of a notebook of activities whose content is a didactic sequence that makes use of the study of ancient numbering systems as compared to the object of our decimal positional numbering system Arabic. This is on the assumption that the comparison with a system different from our own might provide a better understanding of our own numbering system, but also help in the process of arithmetic operations of addition, subtraction and multiplication, since it will force us to think in ways that are not routinely object of our attention. The systems covered in the study were the Egyptian hieroglyphic system of numbering, the numbering system Greek alphabet and Roman numbering system, always compared to our numbering system. The following teachung is presented structured in the form of our activities, so-called exercise set and common tasks around a former same numbering system. In its final stage of preparation, the sequence with the participation of 26 primary school teachers of basic education

Mapeamento das projeções retinianas para o sistema óptico acessório, colículo superior e complexo pré-tectal do sagui (callithrix jacchus)

The accessory optical system, the pretectal complex, and superior colliculus are important control centers in a variety of eye movement, being extremely necessary for image formation, consequently to visual perception. The accessory optical system is constituted by the nuclei: dorsal terminal nucleus, lateral terminal nucleus, medial terminal nucleus and interstitial nucleus of the posterior superior fasciculus. From a functional point of view they contribute to the image stabilization, participating in the visuomotor activity where all system cells respond to slow eye movements and visual stimuli, which is important for the proper functioning of other visual systems. The pretectal complex comprises a group of nuclei situated in mesodiencephalic transition, they are: anterior pretectal nucleus, posterior pretectal nucleus, medial pretectal nucleus, olivary pretectal nucleus and the nucleus of the optic tract, all retinal projection recipients and functionally are related to the route of the pupillary light reflex and the optokinetic nystagmus. The superior colliculus is an important subcortical visual station formed by layers and has an important functional role in the control of eye movements and head in response to multisensory stimuli. Our aim was to make a mapping of retinal projections that focus on accessory optical system, the nuclei of pretectal complex and the superior colliculus, searching mainly for pretectal complex, better delineation of these structures through the anterograde tracing with the B subunit of cholera toxin (CTb) followed by immunohistochemistry and characterized (measured diameter) synaptic buttons present on the fibers / terminals of the nucleus complex pré-tectal. In our results accessory optical system, including a region which appears to be medial terminal nucleus and superior colliculus, were strongly marked by fibers / terminals immunoreactive CTb as well as pretectal complex in the nucleus: optic tract, olivary pretectal nucleus, anterior pretectal nucleus and posterior pretectal nucleus. According to the characterization of the buttons it was possible to make a better definition of these nucleus.

Contribuição ao estudo de treliças não lineares considerando efeitos térmicos

This work presents the numerical analysis of nonlinear trusses summited to thermomechanical actions with Finite Element Method (FEM). The proposed formulation is so-called positional FEM and it is based on the minimum potential energy theorem written according to nodal positions, instead of displacements. The study herein presented considers the effects of geometric and material nonlinearities. Related to dynamic problems, a comparison between different time integration algorithms is performed. The formulation is extended to impact problems between trusses and rigid wall, where the nodal positions are constrained considering nullpenetration condition. In addition, it is presented a thermodynamically consistent formulation, based on the first and second law of thermodynamics and the Helmholtz free-energy for analyzing dynamic problems of truss structures with thermoelastic and thermoplastic behavior. The numerical results of the proposed formulation are compared with examples found in the literature.