Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária

Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP), as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia), através da mensuração de parâmetros ultra-sonográficos. Método: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS), velocidade de pico diastólico (VPD), índice de pulsatibilidade (IP) e índice de resistência (IR) nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. Resultados: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%), seja isoladamente (25%) ou associada a T4 (62,50%) ou a T2 (8,33%). Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (p<0,05). A VPD da artéria carótida interna diminuiu em ambos os lados (p<0,05). A VPS e a VPD da artéria vertebral direita também aumentaram (p<0,05). Achados assimétricos foram observados, de modo que artérias do lado direito foram as mais freqüentemente afetadas. Conclusões: Alterações hemodinâmicas foram observadas nas artérias vertebral e carótida após simpaticotomia para tratamento de HP. VPS foi o parâmetro mais freqüentemente alterado, principalmente nas artérias do lado direito, representando alterações assimétricas significantes nas artérias carótida e vertebral. Entretanto, são necessárias pesquisas subseqüentes para verificar se essas alterações são definitivas ou temporárias, uma vez que as inferências clínicas somente terão validação se as alterações forem permanentes

"Reforma urbana já"; "arroz, feijão, saúde e habitação" :A luta por moradia na grande João Pessoa

Our object of study in this work concerns to the movement of fight for the housing in the Great João Pessoa, Paraíba, Brazil, and looks for to investigate the conditions and context of the occupations of building, public or private, for devoid populations that do not have where to live. Front to the absence of politics effective directed to the habitation or the cities, in a picture of unemployment and impoverishment of the population, the result of the habitation point of view, is the absolute lack of popular housings, the degradation of the cities and the growth of the number of homeless and also of its occupations. The urban occupations today represent a reply of these devoid populations that from an involvement with parties or Not Governmental Organizations, and social movements leave for the class action known by the occupation of abandoning public or private buildings. These occupations, even so initially if assume as pressure instrument or of visibility for attainment of housings, for the delay in obtaining the attention of the public agencies and a solution for the problem, becomes definitive or is drawn out per many years. E this if gives although the deficiencies, of the accumulation or families neither in an adequate, always precarious space nor in sanitary installations, that the necessary privacy does not allow. The study it consisted of an empirical research, through the participant comment and open and half-open interviews, and counted on the audiovisual register of two occupations, one in the downtown of João Pessoa City (old building of the INSS, in the Ponto dos Cem Réis) and other (Community of the Cajueiro), next to the Beach "Praia do Jacaré", in the city of Cabedelo.The choice of the Visual Anthropology as research instrument is on to a concern in better translating other ways of life, therefore the accomplishment of the video in allows them to know with more precision the reality where the citizens of the research live. We also use as methodological resource in the research the deepened interview, in intention to better understand the description of the way of life of the studied families and the movements of fight for the housing, particularly the MDM - Movement of Right for the Housing, and the MNLM- Nacional Movement of Fight for the Housing

Do controle de constitucionalidade dos atos jurisdicionais transitados em julgado

The following study aims to verify in which hypothesis res judicata, when it comes of an unconstitutional decision, shall not prevail over Constitution. It displayed the characteristics of formal and material constitutional systems. It debated the concepts of existence, validity and efficacy of juridical rules and acts. It dissertated about the idea of Constitution s superiority and about the birth of the judicial review of constitutionality. It focused some contemporary models of this judicial review and its historical evolution in Brazil, showing its effects towards the current Constitution. It sustained that the decision given by Supremo Tribunal Federal during abstract control of rules must bind even legislative bodies, preventing them to produce the same rules previously declared unconstitutional. It held up that all parts of the decision of Supremo Tribunal Federal oblige, even the juridical arguments employed, in both diffused and concentrated reviews. It showed that, despite these models of review live together in Brazil, our constitutional system preferred the concentrated one, considering one only court over the other constitutional organs. It discussed about res judicata with the purpose of clarifying its juridical nature, its objective and subjective limits and its regulation in collective demands. It explained that the material res judicata is an effect of a decision which cannot be reviewed, which makes the law s will free of discussion, binding the contendants and avoiding that other courts, judging future demands about the same object, may decide differently. It showed how the regulation of res judicata in collective demands, in respect oh their subjective limits, is useful to demonstrate that it is not the material law who must adapt itself to res judicata as traditionally thought, but res judicata, as a warranty of juridical certainty and security, who must be shaped from the debated rule. It presented to view the main doctrinal conceptions about res judicata s review in the hypothesis of unconstitutional judgement. It concluded that the decisions forged by unconstitutional rules or interpretations reputed not compatible to the Constitution by Supremo Tribunal Federal, in spite of it can make res judicata, may be reviewed beyond the term to file a recissory claim, since while the debated law is still valid, no matter if its decision was before or after the res judicata. At the end, it asserted that, when it is not legally authorized, the judicial review of res judicata is not admissible, after the term to file a recissory claim, under the argument that there was no direct violation to the constitutional principle or rule

Epítese gengival removível: alternativa estética e de rápida resolução para repor tecidos periodontais anteriores

The gingiva, part of the masticatory mucosa tissue that covers the alveolar process and surrounds the cervical portion of teeth, has a definitive shape and texture associated with the eruption of teeth. Therefore, it must be included in rehabilitative planning, as the absence of papillae induces problems with esthetics, phonetics and food-impaction. The purpose of the present study was to approach the indications, limitations and techniques for making a removable artificial gingiva made of acrylic resin, by reporting on a clinical case. The patient, a 29-year-old woman, with the sequelae of periodontal disease, presented loss of interdental papilla causing “black holes”. She was dissatisfied with the esthetic appearance of her teeth, and also complained of long teeth and air escaping when she spoke. As treatment, prosthetic reconstruction was proposed, by means of a removable artificial gingiva (gingival epithesis) to simulate the presence of interdental papillae, providing better esthetics and phonetics. Gingival epithesis is an easily made, inserted and hygienically cleaned appliance that provides a simple and safe alternative solution for cases in which surgical techniques are limited.

Epítese gengival removível: alternativa estética e de rápida resolução para repor tecidos periodontais anteriores

The gingiva, part of the masticatory mucosa tissue that covers the alveolar process and surrounds the cervical portion of teeth, has a definitive shape and texture associated with the eruption of teeth. Therefore, it must be included in rehabilitative planning, as the absence of papillae induces problems with esthetics, phonetics and food-impaction. The purpose of the present study was to approach the indications, limitations and techniques for making a removable artificial gingiva made of acrylic resin, by reporting on a clinical case. The patient, a 29-year-old woman, with the sequelae of periodontal disease, presented loss of interdental papilla causing “black holes”. She was dissatisfied with the esthetic appearance of her teeth, and also complained of long teeth and air escaping when she spoke. As treatment, prosthetic reconstruction was proposed, by means of a removable artificial gingiva (gingival epithesis) to simulate the presence of interdental papillae, providing better esthetics and phonetics. Gingival epithesis is an easily made, inserted and hygienically cleaned appliance that provides a simple and safe alternative solution for cases in which surgical techniques are limited.

Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária

Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP), as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia), através da mensuração de parâmetros ultra-sonográficos. Método: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS), velocidade de pico diastólico (VPD), índice de pulsatibilidade (IP) e índice de resistência (IR) nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. Resultados: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%), seja isoladamente (25%) ou associada a T4 (62,50%) ou a T2 (8,33%). Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (p<0,05). A VPD da artéria carótida interna diminuiu em ambos os lados (p<0,05). A VPS e a VPD da artéria vertebral direita também aumentaram (p<0,05). Achados assimétricos foram observados, de modo que artérias do lado direito foram as mais freqüentemente afetadas. Conclusões: Alterações hemodinâmicas foram observadas nas artérias vertebral e carótida após simpaticotomia para tratamento de HP. VPS foi o parâmetro mais freqüentemente alterado, principalmente nas artérias do lado direito, representando alterações assimétricas significantes nas artérias carótida e vertebral. Entretanto, são necessárias pesquisas subseqüentes para verificar se essas alterações são definitivas ou temporárias, uma vez que as inferências clínicas somente terão validação se as alterações forem permanentes