Ritmo de piscar em portadores de pterígio antes e após a exérese

OBJETIVO: Avaliar o ritmo de piscar de portadores de pterígio antes e depois da exérese. MÉTODOS: Foram avaliados os movimentos palpebrais de 41 pacientes antes e 60 dias depois da remoção cirúrgica da lesão. Os movimentos palpebrais foram capturados durante 1 minuto, usando filmadora Sony Digital 8 DCR - TRV110, sob iluminação artificial, com o indivíduo em posição primária do olhar, tendo como ponto de fixação a própria filmadora. As imagens obtidas foram processadas por computador, quantificando-se o total de movimentos de piscar, o número de piscar completo e incompleto, e as respectivas durações. Os dados foram submetidos à análise estatística. RESULTADOS: Antes da cirurgia 36,36% dos pacientes queixavam-se de sensação de corpo estranho e após a cirurgia, 61,02% estavam assintomáticos. A avaliação do ritmo de piscar revelou que a freqüência do piscar incompleto aumentou no pós-operatório. A duração do piscar não se alterou antes e após a cirurgia. CONCLUSÃO: A exérese do pterígio leva à diminuição dos sintomas irritativos. Após a remoção da lesão, houve discreto aumento da freqüência de piscar incompleto. Há a possibilidade da presença do pterígio não estar relacionada com alterações do filme lacrimal, considerando que a alteração do ritmo de piscar foi discreta. No entanto, outros estudos deverão ser realizados para afirmar ou contestar esta hipótese.

A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation

Introduction Oral mucositis (OM) is a significant early complication of hematopoietic cell transplantation (HCT). This phase III randomized double-blind placebo-controlled study was designed to compare the ability of 2 different low level GaAlAs diode lasers (650 nm and 780 nm) to prevent oral mucositis in HCT patients conditioned with chemotherapy or chemoradiotherapy.Materials and methods Seventy patients were enrolled and randomized into 1 of 3 treatment groups: 650 nm laser, 780 nm laser or placebo. All active laser treatment patients received daily direct laser treatment to the lower labial mucosa, right and left buccal mucosa, lateral and ventral surfaces of the tongue, and floor of mouth with energy densities of 2 J/cm(2). Study treatment began on the first day of conditioning and continued through day +2 post HCT. Mucositis and oral pain was measured on days 0, 4, 7, 11, 14, 18, and 21 post HCT.Results the 650 nm wavelength reduced the severity of oral mucositis and pain scores. Low level laser therapy was well-tolerated and no adverse events were noted.Discussion While these results are encouraging, further study is needed to truly establish the efficacy of this mucositis prevention strategy. Future research needs to determine the effects of modification of laser parameters (e.g., wavelength, fluence, repetition rate of energy delivery, etc.) on the effectiveness of LLE laser to prevent OM.

Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations

Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30-50 % of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological, mechanical, or nutritional in nature. During intense exercise, and especially when hypohydrated, mesenteric blood flow is reduced; this is believed to be one of the main contributors to the development of gastrointestinal symptoms. Reduced splanchnic perfusion could result in compromised gut permeability in athletes. However, although evidence exists that this might occur, this has not yet been definitively linked to the prevalence of gastrointestinal symptoms. Nutritional training and appropriate nutrition choices can reduce the risk of gastrointestinal discomfort during exercise by ensuring rapid gastric emptying and the absorption of water and nutrients, and by maintaining adequate perfusion of the splanchnic vasculature. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates, and potentially the use of nutrients that stimulate the production of nitric oxide in the intestine and thereby improve splanchnic perfusion. However, at this stage, evidence for beneficial effects of such interventions is lacking, and more research needs to be conducted to obtain a better understanding of the etiology of the problems and to improve the recommendations to athletes.

Non-conventional cement-based composites reinforced with vegetable fibers: a review of strategies to improve durability

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

Ergonomic research applied in the design of pre-school furniture: The Mobipresc 3.6

This research describes the application of a scientific and technological model of Ergonomics in the design of pre-school furniture. The constant presence of the desk in early education and its influence in the relationship between the user and his educational environment determined the necessity of this project. The pre-school desk was considered as a work station, where the joint aspects of education and child anthropometry substantiate the problem. The review of the Historical application of Ergonomics in the Design of children's products consolidated the importance of this report. The development of ergonomic research, characterised by investigations of the Brazilian child's Anthropometry Data and Biomechanical Features, resulted in dimensional parameters of the user and physical characteristics of the present furniture. These elements, together with a comprehension of activities and needs in the pre-school, were connected with aspects of bibliographical revision to result in a series of recomendations for design. Through the methods of Ergonomic Design, a new proposal for the pre-school desk was developed, denominated Mobipresc 3.6.

Committees for ethics in research involving human subjects

In Brazil since October 1996 there have been guidelines for research involving human subjects. Now human subjects know when their treatment is part of research. Deceit is no longer tolerated. But is not enough to say we offer an explanation to the potential subject and we offer a choice before he or she is confronted with an informed consent form. As in all professional activity, scientific investigation needs social controls. In Brazil, the ultimate responsibility of an investigation lies on the investigator, but in every institution where research is carried out there is a Committee for Ethics in Research. All Committees are subordinated to the National Commission of Ethics in Research, which is submitted to the Brazilian Institute of Health. During 2005 around 17,000 protocols involving 700,000 human subjects were revised by 475 Committees distributed all over the country. Approximately 7,000 people are now working in these Committees.

An Educational international partnership responding to local needs: Process evaluation of the Brazil FAIMER Regional Institute

The Brazilian public health system requires competent professionals sensitive to the needs of the population. The Foundation for Advancement of International Medical Education and Research (FAIMER) provides a two-year faculty development programme for health professions educators, aiming to build leadership in education to improve health. A partnership with governmental initiatives and FAIMER was established for meeting these needs. This paper describes the initial process evaluation results of the Brazilian FAIMER Institute Fellowship (FAIMER BR). Methods: Data were analysed for the classes 2007-2010 regarding: application processes; innovation project themes; retrospective post-pre self-ratings of knowledge acquisition; and professional development portfolios. Results: Seventeen of 26 Brazilian states were represented among 98 Fellows, predominantly from public medical schools (75.5%) and schools awarded Ministry of Health grants to align education with public health services (89.8%). One-third (n = 32) of Fellows' innovation projects were related to these grants. Significant increases occurred in all topic subscales on self-report of knowledge acquisition (eff ect sizes, 1.21-2.77). In the follow up questionnaire, 63% of Fellows reported that their projects were incorporated into the curriculum or institutional policies. The majority reported that the programme deepened their knowledge (98%), provided new ideas about medical education (90%) and provided skills for conflict management (63%). One-half of the Fellows reported sustained benefits from the programme listserv and other communications, including breadth of expertise, establishment of research collaboration and receiving emotional support. Conclusion: Contributors to initial programme success included alignment of curriculum with governmental initiatives, curriculum design merging educational technology, leadership and management skills and central role of an innovation educational project responding to local needs.

Current status, uncertainty and future needs in soil organic carbon monitoring

Increasing human demands on soil-derived ecosystem services requires reliable data on global soil resources for sustainable development. The soil organic carbon (SOC) pool is a key indicator of soil quality as it affects essential biological, chemical and physical soil functions such as nutrient cycling, pesticide and water retention, and soil structure maintenance. However, information on the SOC pool, and its temporal and spatial dynamics is unbalanced. Even in well-studied regions with a pronounced interest in environmental issues information on soil carbon (C) is inconsistent. Several activities for the compilation of global soil C data are under way. However, different approaches for soil sampling and chemical analyses make even regional comparisons highly uncertain. Often, the procedures used so far have not allowed the reliable estimation of the total SOC pool, partly because the available knowledge is focused on not clearly defined upper soil horizons and the contribution of subsoil to SOC stocks has been less considered. Even more difficult is quantifying SOC pool changes over time. SOC consists of variable amounts of labile and recalcitrant molecules of plant, and microbial and animal origin that are often operationally defined. A comprehensively active soil expert community needs to agree on protocols of soil surveying and lab procedures towards reliable SOC pool estimates. Already established long-term ecological research sites, where SOC changes are quantified and the underlying mechanisms are investigated, are potentially the backbones for regional, national, and international SOC monitoring programs. © 2013 Elsevier B.V.

School inclusion: analyzing the establishment and organization of a special needs education service in a brazilian municipality

The present research integrates a network of studies called National Monitoring Center for Special Education (NMCSE) which studies the Multi-purpose Feature Rooms (MFRs) in regular schools. We aim to investigate whether the service offered by such rooms, maintained by the Department of Education of the Municipality of Araraquara, in São Paulo State, Brazil, is being successful at supporting the education of children and youth with special needs, pervasive developmental disorders and high skilled/gifted individuals. We have also investigated the limits and possibilities of such rooms concerning the set of services offered to their participants. In order to conduct the present research, we have performed: an interview with the Special Education Program manager from the abovementioned Department of Education; and the analysis of a Training Program that MFRs teachers must take. The training program consists of ten morning and afternoon shift meetings. The analyzed data leads us to conclude that the policy of implementation of MFRs, even in this relatively restricted universe is seen from different perspectives. Some interpretations are still permeated by the clinical model, considering individual action. The challenges observed in the classrooms show that the cooperation among teachers still occur randomly and, among other difficulties raised by them, is the selection of the right placement methods to identify eligible students who will benefit from the Specialized Educational Service (SES). In addition, teaching evaluation was considered fragile, as well as the training and the general requirements demanded in order to achieve the expected results.