Morfina nasal: Avaliacao da analgesia e dos efeitos colaterais no tratamento da dor pos-operatoria em criancas

Background and Objectives - Postoperative pain is one of the major discomforts but often under treated, especially in the pediatric patient. The aim of this study was to evaluate nasal morphine postoperative analgesia as an alternative drug administration route and show its applicability, effectiveness, tolerability and side effects. Methods - Participated in this study 20 patients aged 3 to 13 years, physical status ASA I and II sequentially submitted the different small and medium-size surgeries. Analgesia was obtained with nasal morphine hydrochloride in aqueous solution in variable concentrations of 2%, 1%, 0.5%, 0.25% and 0.125%. The dose for each instillation has been 0.1 mg.kg -1 at three-hour intervals for 36 postoperative hours. Quality of analgesia in pre-verbal age patients was evaluated by a pain intensity scale based on facial expression and crying, sleep, motor activity, sociability and food ingestion was used. Standardized evaluations were performed at 3-hour intervals. A four-grade scale was used to evaluate tolerability, where: 1) Good; 2) Regular; 3) Bad; 4) Very bad. Result - Postoperative analgesia results have proven to be good and safe, especially from the third evaluation on (6 hours). Drug tolerability has been good, although side effects were observed, especially nausea and vomiting. Conclusions - Patients and relatives accepted the method very well. The nasal route was considered an adequate way for opioid administration although more studies are needed to accept it as a routine for postoperative morphine analgesia.

Pediatras e os distúrbios respiratórios do sono na criança

OBJECTIVES. assessment of opinions and practices of pediatricians concerning sleep-disordered breathing (SDB) in children. Methods. randomly 516 pediatricians were selected in the state of São Paulo, Brazil. A survey mailed to them included questions regarding: their professional profile, knowledge about SDB in childhood, opinions and practices for diagnosis and treatment of these diseases. RESULTS. 112 anonymous completed surveys were returned (21.7%). The teaching of SDB during medical school and pediatric residency training was considered unsatisfactory respectively by 65.2% and 34.8% of the pediatricians. Forty-nine respondents (43.8%) rated their knowledge about SDB in children as regular, 39 (34.8%) as good and 17 (15.2%) as unsatisfactory. The most important sleep-related questions were: mouth breathing, breathing pauses, sleep amount, excessive daytime sleepiness and nocturnal wheezing. Clinical aspects regarded as the most significant for suspecting obstructive sleep apnea syndrome (OSAS) were: breathing pauses, adenoid hypertrophy, mouth breathing, craniofacial anomaly and snoring. The most frequent practices for evaluation of OSAS in children were: cavum radiography with referral to an otorhinolarnygologist (25%) and nocturnal pulse oximetry (14.2%). Only 11.6% of pediatricians recommended overnight polysomnography and 4.5%, nap polysomnography. The most effective practices for SDB were considered to be: adenoidectomy and adenotonsillectomy, parents counseling, weight loss and sleep hygiene. CONCLUSIONS. there is a gap between research on SDB in childhood and pediatric practice. © 2006 Associação Médica Brasileira.

La salud bucal en la percepción del adolescente

Objective An individual does not always experience the best health and vitality indexes during her/his adolescence. This study evaluated young people's awareness of their oral health and the factors involved in dental maintenance and promotion Material and Method Adolescents (n=493) from the Mirim Foundation in the town of Araçatuba in the state of São Paulo, Brazil, were asked to fill in a semi-structured questionnaire. Results 68.4 % of the youngsters interviewed regarded oral health as referring to hygiene and 16.2 % to physical appearance; 53.6 % of the group perceived their oral health to be good and 24 % optimum. 90.1 % indicated oral hygiene when asked how oral health could be ensured; however, only 4.8 % mentioned brushing their tongues. Physical appearance (62.9 %) was one of the main reasons stated as being important for teeth. A statistically significant relationship was observed between perception of regular dental and mouth health and having visited the dentist at least six months beforehand (x2=30.75; p<0.05). Conclusion Even though the youngsters had a general idea regarding their oral health, its maintenance and promotion, better information should be made available regarding such topics and be approached through health education so that these adolescents can have good oral health for the rest of their lives, as well as becoming knowledge multiplying agents for those who do not have access to the same information.

Estudo comparativo entre o tratamento radioterápico com elétrons e betaterapia, após cirurgia de queloides

Introduction: The surgery of keloids as an individual therapy with high rates of recurrence needs adjuvant therapies as complement. Recent keloids are rich in fibroblasts, which are highly radiosensitive and what explains the good results of percutaneous radiotherapy after surgery. Objective: To compare the beta-therapy results with electron-beam technique in newly operated keloids. Material and Methods: a prospective, comparative and randomized study was outlined including patients in the immediate postoperative period of surgical excision of keloids. Divided in G1 and G2 groups respectively, they received treatment with Sr90 (beta-therapy)plates or with electrons from the linear accelerator. The monitoring lasted 10 years. The results were performed using the information from patients, photograph parameters, observation and measurement of injuries, according to the criteria: Unchanged, Regular, Good and Excellent. Results: There were 26 patients, 13 in each group. In G1, 54% presented regular and unchanged improvement criteria and 46% had good or excellent criteria. In G2, the results were respectively 23% and 77%. Conclusion: The irradiation with electron-beam is better than beta-teraphy for the treatment of keloids surgery, due to the distribution in the tissue. No radio-induced tumors were observed.

Methodology for DSC calibration in high heating rates

Despite the large use of differential scanning calorimetry (DSC) technique in advanced polymer materials characterization, the new methodology called DSC in high heating rates was developed. The heating rate during conventional DSC experiments varying from 10 to 20°C.min-1, sample mass from 10 to 15mg and standard aluminum sample pan weighting, approximately, 27mg. In order to contribute to a better comprehension of DSC behavior in different heating rates, this work correlates as high heating rate influences to the thermal events in DSC experiments. Samples of metallic standard (In, Pb, Sn and Zn) with masses varying from 0.570mg to 20.9mg were analyzed in multiples sample heating rate from 4 to 324°C. min-1. In order to make properly all those experiments, a precise and careful temperature and enthalpy calibrations were performed and deeply discussed. Thus, this work shows a DSC methodology able to generate good and reliable results on experiments under any researcher choice heating rates to characterize the advanced materials used, for example, for aerospace industry. Also it helps the DSC users to find in their available instruments, already installed, a better and more accurate DSC test results, improving in just one shot the analysis sensitivity and resolution. Polypropylene melting and enthalpy thermal events are also studied using both the conventional DSC method and high heating rate method.

An analysis of the Hygiea asteroid family orbital region

(10) Hygiea is the fourth largest asteroid of the main belt, by volume and mass, and it is the largest member of its family, that is made mostly by low-albedo, C-type asteroids, typical of the outer main belt. Like many other large families, it is associated with a 'halo' of objects, that extends far beyond the boundary of the core family, as detected by traditional hierarchical clustering methods (HCM) in proper element domains. Numerical simulations of the orbital evolution of family members may help in estimating the family and halo family age, and the original ejection velocity field. But, in order to minimize the errors associated with including too many interlopers, it is important to have good estimates of family membership that include available data on local asteroid taxonomy, geometrical albedo and local dynamics. For this purpose, we obtained synthetic proper elements and frequencies of asteroids in the Hygiea orbital region, with their errors. We revised the current knowledge on asteroid taxonomy, including Sloan Digital Sky Survey-Moving Object Catalog 4th release (SDSS-MOC 4) data, and geometric albedo data from Wide-field Infrared Survey Explorer (WISE) and Near-Earth Object WISE (NEOWISE). We identified asteroid family members using HCM in the domain of proper elements (a, e, sin (i)) and in the domains of proper frequencies most appropriate to study diffusion in the local web of secular resonances, and eliminated possible interlopers based on taxonomic and geometrical albedo considerations. To identify the family halo, we devised a new hierarchical clustering method in an extended domain that includes proper elements, principal components PC1, PC2 obtained based on SDSS photometric data and, for the first time, WISE and NEOWISE geometric albedo. Data on asteroid size distribution, light curves and rotations were also revised for the Hygiea family. The Hygiea family is the largest group in its region, with two smaller families in proper element domain and 18 families in various frequencies domains identified in this work for the first time. Frequency groups tend to extend vertically in the (a, sin (i)) plane and cross not only the Hygiea family but also the near C-type families of Themis and Veritas, causing a mixture of objects all of relatively low albedo in the Hygiea family area. A few high-albedo asteroids, most likely associated with the Eos family, are also present in the region. Finally, the new multidomains hierarchical clustering method allowed us to obtain a good and robust estimate of the membership of the Hygiea family halo, quite separated from other asteroids families halo in the region, and with a very limited (about 3 per cent) presence of likely interlopers. © 2013 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society.

Motorista de ônibus urbano: insatisfação e desconforto com a poltrona

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cinema, linguagem e sociedade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A nação é católica: educação e cidadania nas primeiras décadas republicanas (1890 a 1930)

Pós-graduação em História - FCHS

Desempenho de sistema de diagnóstico óptico para detecção de lesões de cárie

Pós-graduação em Ciências Odontológicas - FOAR

O processo de planejamento do turismo de natureza: reflexões sobre a construção da política municipal de desenvolvimento sustentável do turismo de Brotas

Pós-graduação em Geografia - IGCE

Uniformidade de distribuição de água em irrigação localizada com sistema de aeração, decantação e filtragem

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Entre o kháos e o kósmos, a demiourgía da excelência: a seleção de pessoal como regulação, normalização e mediação no contexto das novas políticas de gestão de recursos humanos

Pós-graduação em Psicologia - FCLAS

Tecendo vias pelas quais o amor se fala: cartografias dos discursos amorosos na atualidade

Pós-graduação em Psicologia - FCLAS

Avaliação da qualidade da água em piscicultura com sistema de cultivo em tanques-rede no município de Santa Fé do Sul - SP

Pós-graduação em Engenharia Civil - FEIS