Consenso brasileiro para a abordagem clínica e tratamento do hipotireoidismo subclínico em adultos: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

INTRODUÇÃO: O hipotireoidismo subclínico (HSC), definido por concentrações elevadas do TSH em face de níveis normais dos hormônios tireoidianos, tem elevada prevalência no Brasil, particularmente entre mulheres e idosos. Embora um número crescente de estudos venha associando o HSC com maior risco de doença arterial coronariana e de mortalidade, não há ensaio clínico randomizado sobre o benefício do tratamento com levotiroxina na redução dos riscos e o tratamento permanece controverso. OBJETIVO: Este consenso, patrocinado pelo Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia e desenvolvido por especialistas brasileiros com vasta experiência clínica em tireoide, apresenta recomendações baseadas em evidências para uma abordagem clínica do paciente com HSC no Brasil. MATERIAIS E MÉTODOS: Após estruturação das questões clínicas, a busca das evidências disponíveis na literatura foi realizada inicialmente na base de dados do MedLine-PubMed e posteriormente nas bases Embase e SciELO - Lilacs. A força da evidência, avaliada pelo sistema de classificação de Oxford, foi estabelecida a partir do desenho de estudo utilizado, considerando-se a melhor evidência disponível para cada questão e a experiência brasileira. RESULTADOS: Os temas abordados foram definição e diagnóstico, história natural, significado clínico, tratamento e gestação, que resultaram em 29 recomendações para a abordagem clínica do paciente adulto com HSC. CONCLUSÃO: O tratamento com levotiroxina foi recomendado para todos os pacientes com HSC persistente com níveis séricos do TSH > 10 mU/L e para alguns subgrupos especiais de pacientes.

Consenso brasileiro para o diagnóstico e tratamento do hipertireoidismo: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

INTRODUÇÃO: O hipertireoidismo é caracterizado pelo aumento da síntese e liberação dos hormônios tireoidianos pela glândula tireoide. A tireotoxicose refere-se à síndrome clínica decorrente do excesso de hormônios tireoidianos circulantes, secundário ao hipertireoidismo ou não. Este artigo descreve diretrizes baseadas em evidências clínicas para o manejo da tireotoxicose. OBJETIVO: O presente consenso, elaborado por especialistas brasileiros e patrocinado pelo Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia, visa abordar o manejo, diagnóstico e tratamento dos pacientes com tireotoxicose, de acordo com as evidências mais recentes da literatura e adequadas para a realidade clínica do país. MATERIAIS E MÉTODOS: Após estruturação das questões clínicas, foi realizada busca das evidências disponíveis na literatura, inicialmente na base de dados do MedLine-PubMed e posteriormente nas bases Embase e SciELO - Lilacs. A força das evidências, avaliada pelo sistema de classificação de Oxford, foi estabelecida a partir do desenho de estudo utilizado, considerando-se a melhor evidência disponível para cada questão. RESULTADOS: Foram definidas 13 questões sobre a abordagem clínica inicial visando ao diagnóstico e ao tratamento que resultaram em 53 recomendações, incluindo investigação etiológica, tratamento com drogas antitireoidianas, iodo radioativo e cirurgia. Foram abordados ainda o hipertireoidismo em crianças, adolescentes ou pacientes grávidas e o manejo do hipertireoidismo em pacientes com oftalmopatia de Graves e com outras causas diversas de tireotoxicose. CONCLUSÕES: O diagnóstico clínico do hipertireoidismo, geralmente, não oferece dificuldade e a confirmação diagnóstica deverá ser feita com as dosagens das concentrações séricas de TSH e hormônios tireoidianos. O tratamento pode ser realizado com drogas antitireoidianas, administração de radioiodoterapia ou cirurgia de acordo com a etiologia da tireotoxicose, as características clínicas, disponibilidade local de métodos e preferências do médico-assistente e paciente.

Transient stability indices from a hybrid approach

This paper deals with hybrid method for transient stability analysis combining time domain simulation and a direct method. Nowadays, the step-by-step simulation is the best available tool for allowing the uses of detailed models and for providing reliable results. The main limitation of this approach involves the large time of computational simulations and the absence of stability margin. On the other hand, direct methods, that demand less CPU time, did not show ample reliability and applicability yet. The best way seems to be using hybrid solutions, in which a direct method is incorporated in a time domain simulation tool. This work has studied a direct method using the transient potential and kinetic energy of the critical machine only. In this paper the critical machine is identified by a fast and efficient method, and the proposal is new for using to get stability margins from hybrid approaches. Results from systems, like 16-machine, show stability indices to dynamic security assessment. © 2001 IEEE.

Uso de aeradores e substratos no cultivo semi-intensivo do camarão-da-amazônia Macrobrachium amazonicum: análise técnica, econômica e emissão de gases do efeito estufa

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Desenvolvimento de marcadores SNPs (Single Nucleotide Polymorphisms) para estudos populacionais do mosquito Aedes aegypti no Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dimensionamento da equipe de enfermagem de um hospital psiquiátrico de referência

Pós-graduação em Enfermagem (mestrado profissional) - FMB

O professor que ensina matemática formado em ambientes virtuais de aprendizagem à distância

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Evidências à intervenção de enfermagem controle de infecção da classificação das intervenções de enfermagem: orientação e ensino sobre a lavagem das mãos

Pós-graduação em Enfermagem - FMB

Estudo e análise de sistemas de refrigeração industrial integrados a plantas de processo químico

This work approaches the analysis of industrial refrigeration systems applied to a chemical processing industry that, in this case, consists of refrigeration machines, cooling tower system, cold water system and brine system. In this study it is highlighted the function and characteristics of different systems, including the main components, the most important features, their functionality and best practices. The motivation for this work is the fact that refrigeration systems are essential in many industrial processes, presenting a high energy consumption that is related to a significant parcel of production costs. It has aimed to understand the case studied in order to evaluate the energy efficiency of systems and to compare with Carnot efficiency and best available technologies. The assessment aims to identify irregularities, find opportunities and propose solutions that increases the performance of equipment and the overall system efficiency. Therefore, the studies intend to reduce the operation costs and generate gains for the company

The amount of solar energy made available for the production of a sabia (Mimosa caesalpinaefolia Benth.) seed has a determinating effect on its becoming dormant

The amount of solar energy made available for the production of a sabid seed varied as a function of the time of the year, the face of the plant in which, the position in the plant on which and the position in the pod in which it was produced.Variation in solar energy availability as a consequence of the time of the year was a direct consequence of latitude. At 21degrees5'22 S the highest amounts of Global Solar Radiation (GSR) reaching the site where the experiment was conducted took place during the months from November through February. During these months there were no marked differences between any two of the amounts of GSR reaching faces North (N), South (S), West (W) East (E). From February through November (period during which the sabid plants of this study flowered and the resulting seeds matured and were harvested) the total GSR's were the lowest and marked differences were found between faces N and S, with face N receiving much more GSR than face S. During that period, faces W and E received practically the same amount of GSR and it was much less than that received by face N and much more than the one received by face S.The amount of biological energy made available for the development of a seed seemed also to vary according to a dry matter partitioning strategy by the plant -the central third of the plant seemed to be the one receiving the highest amounts of energy, followed either by the upper or the lower third of the plant- it was not very clear which third of the plant immediately followed the central one. The partitioning of biological energy at the pod level also seemed to follow a strategy by which the central seeds would be the ones to receive more, followed by the proximal seeds and these by the distal ones.This availability of energy seemed to have a direct effect on seed size, weight and on the percentage of seeds which showed a degree of dormancy deep enough to prevent their germinating under the conditions of a standard germination test.The implications of these results for the improvement of methods for the overcoming of dormancy of sabia seeds are discussed.

Dehydration of dedo de moça pepper: kinetics and phytochemical concentration

A pimenta vermelha é rica em vitamina C e outros fitoquímicos e pode ser consumida como produto desidratado. A avaliação das melhores condições de secagem pode garantir melhor qualidade do produto. Assim, o objetivo deste trabalho foi estudar o efeito da temperatura do ar de secagem (55, 65, 75 ºC) sobre a cinética de secagem, conteúdos de vitamina C e fenólicos totais e cor do produto desidratado, comparando-os à pimenta in natura. A desidratação foi feita por convecção forçada em estufa. A cinética de secagem foi determinada por pesagens periódicas até peso constante. A umidade da pimenta in natura foi de aproximadamente 86%. As curvas de secagem foram ajustadas por três modelos diferentes, avaliados na literatura. O modelo de Page apresentou o melhor ajuste para este processo. A análise de variância mostrou que a temperatura de secagem influenciou significativamente (p < 0,05) os parâmetros de qualidade (conteúdo de vitamina C, conteúdo de fenólicos totais, cor) da pimenta desidratada quando comparados aos da pimenta in natura. Após a secagem, a retenção de vitamina C aumentou com a redução da temperatura de secagem. de maneira geral, a qualidade do produto foi favorecida na secagem com menor temperatura, devido à redução nas perdas de compostos bioativos.

Analysis of relative humidity sensors at the WMO Radiosonde intercomparison experiment in Brazil

The quality of the vertical distribution measurements of humidity in the atmosphere is very important in meteorology due to the crucial role that water vapor plays in the earth's energy budget. The radiosonde is the humidity measurement device that provides the best vertical resolution. Also, radiosondes are the operational devices that are used to measure the vertical profile of atmospheric water vapor. The World Meteorological Organization (WMO) has carried out several intercomparison experiments at different climatic zones in order to identify the differences between the available commercial sensors. This article presents the results of an experiment that was carried out in Brazil in 2001 in which major commercial radiosonde manufacturers [e.g., Graw Radiosondes GmbH & Co., KG (Germany); MODEM (France); InterMet Systems (United States); Sippican, Inc. (United States); and Vaisala (Finland)] were involved. One of the main goals of this experiment was to evaluate the performance of the different humidity sensors in a tropical region. This evaluation was performed for different atmospheric layers and distinct periods of the day. It also considers the computation of the integrated water vapor (IWV). The results showed that the humidity measurements achieved by the different sensors were quite similar in the low troposphere (the bias median value regarding the RS80 was around 1.8%) and were quite dispersed in the superior layers (the median rms regarding the RS80 was around 14.9%).

Strand Analysis, a free online program for the computational identification of the best RNA interference (RNAi) targets based on Gibbs free energy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The use of extruded feed in fish food

In our country, the intensive culture of fish has been making progress due to the availability of extruded rations, which are characterized by the way they have been formulated to assist the nutritional demands of the tropical species and for facilitating a better practice of alimentary handling. This process checks the extruded product density and the desirable physical/chemical aspects to a diet that should be handled in the water, the critical factor of this activity. It is important to emphasize that this product stays to the surface of the water, facilitates the consumption control and the observation of the general aspects of the school of fish, as well as guaranteeing that no deterioration of the physical/chemical characteristics of the water occurs. The floating characteristic of the extruded ration is preferable for farmers because most of the tropical species feed at the surface of the water. In some cases, in the function of the alimentary habit, the thermal conditions of the water and the handling system produce granules with different densities. This is due to the humidity and the applied cooking heat, which modifies the time of hydration, and consequently the ability to float. To establish the physical presentation idea for a ration for tropical fishes, it is necessary that the pellets come in sizes, textures, humidities and densities in order to allow for the different phases of the lives of the fishes. This ration should be the result of characteristics of the species, such as the anatomophysiologics particularities, alimentary habits, digestive capacity and alimentary behavior. Only in this way is it possible to offer to those fishes a ration whose nutritious value and physical presentation facilitate the best biological and economic answers.Those aspects need to be reviewed because the tropical species that are cultivated in our country present selective behavior in relation to the size of the pellet. Generally, this has access to the digestive system without waste; the digestibility, therefore, is dependent upon the size of the particles and the physical aspects of the pellets. They should still consider that those granules could be less abrasive and softer. The extruded rations available in the national market present a qualitative reference to its proteic level, whose consequence allows us to infer that those are overestimated for the final phase of those fishes. Thus, the final cost of production is made unfeasible. In this point of view of the development of the national fish culture, and the growing adoption of the intensive system of production, it can link that such progress is a function of the availability of the rations in the extruded form. Although this technique of processing of rations has revolutionized the market in such a way that has been seen as preferable for farmers, some feel that there is a lack of products best suited for the initial phases of fingerlings production.