Avaliação clínica de duas ke0 no mesmo modelo farmacocinético de propofol: estudo da perda e recuperação da consciência

JUSTIFICATIVA E OBJETIVOS: A constante de equilíbrio entre o plasma e o sítio efetor (ke0) é utilizada pelos modelos farmacocinéticos para prever a concentração do fármaco em seu local de ação (Ce). Seria interessante que a Ce de propofol fosse semelhante na perda e na recuperação da consciência. O objetivo deste estudo foi avaliar o desempenho clínico de duas diferentes ke0 (rápida = 1,21 min-1 e lenta = 0,26 min-1) com relação à Ce durante a perda e a recuperação da consciência, usando o modelo farmacocinético de Marsh. MÉTODO: Participaram deste estudo 20 voluntários adultos sadios do sexo masculino. em todos os voluntários, administrou-se propofol em regime de infusão alvo-controlada, modelo farmacocinético de Marsh ke0 rápida e, em outra oportunidade, usou-se o mesmo modelo farmacocinético com a ke0 lenta. Inicialmente, o propofol foi infundido em concentração-alvo plasmática de 3,0µg.mL-1. A perda de consciência e a recuperação de consciência basearam-se na resposta ao estímulo verbal. A Ce foi anotada no momento da perda e da recuperação da consciência. RESULTADOS: Na perda e na recuperação da consciência a Ce pela ke0 rápida foi diferente (3,64 ± 0,78 e 1,47 ± 0,29µg.mL-1, respectivamente, p < 0,0001), enquanto com a ke0 lenta a Ce foi semelhante (2,20 ± 0,70 e 2,13 ± 0,43µg.mL-1, respectivamente, p = 0,5425). CONCLUSÕES: do ponto de vista clínico, a ke0 lenta (0,26 min-1) incorporada ao modelo farmacocinético de Marsh apresentou melhor desempenho que a ke0 rápida (1,21 min-1), uma vez que a concentração de propofol prevista em seu local de ação na perda e recuperação da consciência foi semelhante.

Petrologia aplicada da formação Corumbataí (região de Rio Claro - SP) e produtos cerâmicos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Importance of physical therapy in the family health strategy: integrative review

Objective: to analyze the importance of physical therapy in the Family Health Strategy (FHS). Methodology: integrative literature review, guided by the research question << What is the importance of physical therapy in the FHS? >>. The survey was conducted in the Virtual Health Library and in the website Google Scholar in November and December 2012. The inclusion criteria were: fully available scientific study, published between 2007 and 2012, with free access, and having at least one of the DeCS selected in the title. Results: we found out that the importance of physical therapist’s action at the FHS has been recognized both by professionals included in the teams and users of health care units, showing that, by means of the physical therapist’s preventive and clinical action, the costs and demands in the tertiary care can be reduced. Conclusion: the population and the professionals recognize the physical therapist’s positive impact on the FHS.

O trabalho docente na rede pública do estado de São Paulo: apontamentos iniciais para a discussão da jornada de trabalho

The changes in the world of work that, in turn, directly affect the teaching work, have expanded the processes of precariousness and intensification, contributing for deteriorating conditions which teachers use to labor. Considering that the time designated for teaching activities is an important part of work conditions, we look for, in this article, to analyze the work shift of teachers in São Paulo state educational public system. Regarding that teachers are a very heterogeneous group, we have chosen to discuss the workday those professionals who dedicate themselves in the last years of elementary and high school. Through a literature review and a research about the legislation related to the topic, in Brazil and São Paulo state, we have highlighted that the teachers’ work shifts should include not only the time for classroom activities, but also for other extra activities. Moreover, we emphasize that the state of São Paulo government has promoted, since 2012, a reformulation of the teachers’ work shift that has not properly include the appropriate length of time for extra educational activities, contrasting the parameters founded in the national legislation. Besides the legal non-compliance, that fact has accentuated the process of intensification of teaching work, contributing for the embrittlement of the collective activities.

Tree species community spatial structure in a terra firme Amazon forest, Brazil

All trees with diameter at breast height dbh >= 10.0 cm were stem-mapped in a "terra firme" tropical rainforest in the Brazilian Amazon, at the EMBRAPA Experimental Site, Manaus, Brazil. Specifically, the relationships of tree species with soil properties were determined by using canonical correspondence analyses based on nine soil variables and 68 tree species. From the canonical correspondence analyses, the species were grouped into two groups: one where species occur mainly in sandy sites, presenting low organic matter content; and another one where species occur mainly in dry and clayey sites. Hence, we used Ripley's K function to analyze the distribution of species in 32 plots ranging from 2,500 m(2) to 20,000 m(2) to determine whether each group presents some spatial aggregation as a soil variations result. Significant spatial aggregation for the two groups was found only at over 10,000 m(2) sampling units, particularly for those species found in clayey soils and drier environments, where the sampling units investigated seemed to meet the species requirements. Soil variables, mediated by topographic positions had influenced species spatial aggregation, mainly in an intermediate to large distances varied range (>= 20 m). Based on our findings, we conclude that environmental heterogeneity and 10,000 m(2) minimum sample unit sizes should be considered in forest dynamic studies in order to understand the spatial processes structuring the "terra firme" tropical rainforest in Brazilian Amazon.

Particularities in the technique of calvaria graft

Calvaria grafts provide good bone quantity for the reconstruction of the atrophic maxilla, and have lower morbidity and resorption rates when compared to iliac crest. The aim of this paper is to present the technique for obtaining a graft of the skull. Initially, the depth of the osteotomy is determined by a manually conducted bur, which establishes the limits of the structures of the skull (outer table, diploe and inner table), making the removal of bone blocks easier and safer. Thus, osteotomies of the blocks are made with greater security, avoiding the complications inherent to surgical technique. The case that will be presented it is from a male patient of 65 years who refused to submit to the iliac crest graft, opting for the calvaria, despite being bald, that is a contraindication for this treatment modality. A delicate suture associated with placement of titanium mesh to maintain the conformation of the patient's skull in the region of the bone defect, created after removal of the graft, provided a good cosmetic result at the donor site. The use of titanium mesh for re-anatomization of bone defects created in the grafts is well indicated for bald patients.

Social Watch: espaço alternativo para a comunicação da sociedade civil global

The text aims to show how Social Watch alternative site contributes to the construction of world citizenship to publish proposals for non-governmental organizations (NGOs), identified with groups excluded from traditional means of mass communication. The structure of the site is analyzed and studied in depth one of its publications, the Bulletin of August 2014, using some resources from the methodology of the framing and content analysis. The analysis shows that, in fact, the site is presented as place where civil society can express themselves and collect public power projects and proposals to increase the global citizenship.