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

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

Avaliação da eficiência da remoção de matéria orgânica e microbiológica de três sistemas de lagoas de estabilização em série na Grande Natal-RN: Beira Rio, Jardim Lola I e Jardim Lola II

Waste stabilization ponds are the main technology in use for domestic sewage treatment in Rio Grande do Norte State (RN), northeast Brazil. The are around 80 systems, constructed mainly by municipal city halls, being series comprised by a primary facultative pond followed by two maturation ponds the most used configuration. Due to problems related with the production and destination of sludge and generation of bad odors, the designers have avoided the use of anaerobic lagoons. The majority of systems are rarely monitored to verify their efficiencies and to get new project parameters for future designing. This work has as purpose to make a diagnosis of efficiency of three series of waste stabilization pond series (WSPS) of Jardim Lola 1, Jardim Lola 2 and Beira Rio, located in the North Zone of the city of the Natal/RN, treating domestic raw sewage, on the removal of organic matter and thermotolerant coliform, comparing the operational conditions of the systems this inside of the bands foreseen in the project, through parameters BOD5, QOD, thermotolerant coliforms, dissolved oxygen, pH, temperature, ammoniac nitrogen, total and suspended solids. The work was carried through in the WSPS, all constituted by a primary facultative pond followed by two maturation ponds. Socioeconomic characteristics of population are predominantly low and all the plants are very near of the contributing basins. The series were monitored from of May the November of 2002, totalizing 20 collections of grab samples of raw sewage and ponds effluents between 8:00 and 9:50 h. The main aspect to be detached by the results was the great concentration of organic matter (BOD and COD) and microorganisms the raw sewage which were around two times more concentrated than those values foreseen one in project. Considering all series the highest removals of organic matter were observed in system Beira Rio (84 and 78% of BOD and COD, respectively), which presented high hydraulic detention time (TDH = 89 days). On the other hand, Jardim Lola 1 and Jardim Lola 2 presented a much lower values of HDT (36 days and 18 days respectively) and their removals of BOD and COD were the same (76% and 60%, respectively). The Beira Rio WSPS, was the most efficient verified in relation to solids and ammonia, proving the great influence of the operational variables such as HDT and applied surface organic loadings on the performance of pond series. Although the treatment plants have reached efficiencies of thermotolerant coliforms around 99,999%, the concentrations in the final effluent can be considered very high for launching in aquatic bodies, particularly those produced by Jardim Lola 1 and Jardim Lola 2 series

O ensino de óptica no nível fundamental: uma proposta de ensino aprendizagem contextualizada para a oitava série

This dissertation presents the investigation and possible interference in the current teaching of physics, specially of optics, in the eighth grade/ ninth year / fourth cycle of junior high school. The context of the current science teaching is also presented. Besides, the following aspects are discussed: the preparation of the eighth grade teachers, their professional needs, the pedagogical practices and the theoreticmethodological difficulties faced by them. Another important issue in Science Teaching, which is also discussed in this dissertation, is the need for an efficient scientific literacy so that the citizen may express value judgment about Science and Technology issues. The data about the context were gathered from questionaires answered by the teachers. In value of this information, lesson plans were elaborated and implemented. The goal was to point out alternatives for the development of a teaching-learning evaluation which would be both pleasant for the teachers in relation to the implemented methodology, end meaningful for the students by adding elements such as: interdisciplinary approach, contextualization and preparation by competences. Furthermore it was carried out a deeper analysis of the Brazilian curriculum references (LDB, DCN, PCN, RCB) and content aspects (concepts, procedures e attitudes) to be executed by that branch of human knowledge, aiming at a really Contextualized Science Teaching, qualified and pleasant for the eighth grade level. It is also presented in this paper the profile or the Professional which teach this level at state public schools in Russas, state of Ceará, Vale do Jaguaribe Region. The efficacy of the lesson plans were also analysed by using evaluation procedures with the eighth grade students of the following schools: CAIC Senador Carlos Jereissati and EEF Manuel Matoso Filho, from which the concepts acquired during the implementation of the classes became evident in the students

Estudo clínico e níveis de ansiedade em uma série de casos de líquen plano oral

Oral Lichen Planus (OLP) is a relatively common, cronic inflammatory disease. Its etiopathogenesis is no completely understood and several factors have proposed in attempt to explain the appearance, variety of clinical manifestations and periods of exacerbation and remission of the symptons of the lesions. The objective of the present study was to assess the presence of local factors, systemic diseases and levels of anxiety in patients with OLP, investigating their association with the clinical characteristics of the lesions. The sample consisted of 37 patients with histopathologically confirmed OLP that were submitted to a clinical exam to evaluate the presence of smoking habits, consumption of alcoholic beverages, diabetes mellitus, hypertension and hepatitis C virus (HCV) infection. The existence of skin lesions, as well as the time course, clinical form, symptomatology, number and location of the oral lesions were also registered. The trait anxiety was measured by Spielberger s Stai-Trait Anxiety Inventory (STAI), and to associate the variables we used the chi-square or Fisher s exact test. It was observed that females were the most affected (75%) and the mean age of the patients was 53,3 years. Most cases were non-smoker (97,3%) and none was drinker. Diabetes mellitus and hypertension were present in 10,8% e 16,2% of the sample, respectively and only one patient was HCV-seropositive (2,7%). Moderate levels of anxiety were seen in most cases (78,4%) and 21,6% had elevated levels. The oral lesions persisted in 95% of the cases for a period of 6 months to 13 years. The erosive form was the most prevalent (57,1%) and symptons were reported by 45,7% of the patients. Multiple lesions were frequent (60%), affecting mainly the buccal mucosa, followed by gums e tongue. There was no significant association of the presence of diabetes mellitus, hypertension and levels of anxiety with the clinical form or symptomatology of the oral lesions (p>0,005), despite a trend in patients with hypertension to have erosive lesions. It was concluded that, in the sample studied, moderate levels of anxiety were commonly observed, and the HCV infection apparently is not related to the onset of the OLP. In this study, the presence of diabetes mellitus, hypertension and levels of anxiety seem not to be associated with the clinical characteristics of the lesions of OLP

Orientação geográfica: uma proposta metodológica para o ensino da geografia na 5ª série

Cartographical representations (maps, charters and plans) are taken as didactic resources in Geography classes in the 5th grade of the municipal public schools in São José de Ribamar through a methodological approach taking into consideration the use of those resources is still worries an important part of the teachers of the Maranhão State public schools who teach in this level. Papers related to the theme, most of the time, are non accessible to the teachers of the maranhense public schools, mainly because the education instilutions, which use those resources, do it in a very incipient way. So this research proposes from the drawings of magnetccoursein the school courtyards, together with maps, charts, plans among others representation used in the classroom environment, motivate the students to a deeper interests in participating in Geography learning process in the 5th grade. Interviews, analyses of socialcultural questionnaires of the families involved in the process; observations of classes, trainings, geocartographical orientations, application of pre and posttests, discussions about the usage of cartographic representations, proposed and effectivated tasks in the classroom, as well as around the school, were the basis of the researched population. As a result of this process, it was produced a was complement didatical material showing, among others, the space in which students, for sure, will contribute in an effective way to a better teaching practice in the chain of maranhense public schools, having in mind that these geographic subjects may be taught in the level we focused our study