899 resultados para LOWER 3RD MOLAR
Função visual e desempenho na leitura em crianças do 1º ciclo do ensino básico do concelho de Lisboa
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RESUMO - Esta tese pretende ser um contributo para o estudo das anomalias da função visual e da sua influência no desempenho da leitura. Apresentava como objetivos: (1) Identificar a prevalência de anomalias da função visual, (2) Caracterizar o desempenho da leitura em crianças com e sem anomalias da função visual, (3) Identificar de que modo as anomalias da função visual influenciam o desempenho da leitura e (4) Identificar o impacto das variáveis que determinam o desempenho da leitura. Foi recolhida uma amostra de conveniência com 672 crianças do 1º ciclo do ensino básico de 11 Escolas do Concelho de Lisboa com idades compreendidas entre os 6 e os 11 anos (7,69±1,19), 670 encarregados de educação e 34 Professores. Para recolha de dados, foram utilizados três instrumentos: 2 questionários de perguntas fechadas, avaliação da função visual e prova de avaliação da leitura com 34 palavras. Após observadas, as crianças foram classificadas em dois grupos: função visual normal (FVN=562) e função visual alterada (FVA=110). Identificou-se uma prevalência de 16,4% de crianças com FVA. No teste de leitura, estas crianças apresentaram um menor número de palavras lidas corretamente (FVA=31,00; FVN=33,00; p<0,001) e menor precisão (FVA=91,18%; FVN=97,06%; p<0,001). Esta tendência também foi observada na comparação entre os 4 anos de escolaridade. As crianças com função visual alterada mostraram uma tendência para a omissão de letras e a confusão de grafema. Quanto à fluência (FVA=24,71; FVN=27,39; p=0,007) esta foi inferior nas crianças com FVA para todos os anos de escolaridade, exceto o 3º ano. As crianças com hipermetropia (p=0,003) e astigmatismo (p=0,019) não corrigido leram menos palavras corretamente (30,00; 31,00) e com menor precisão (88,24%; 91,18%) que as crianças sem erro refrativo significativo (32,00; 94,12%). A performance escolar classificada pelos professores foi inferior nas crianças com FVA e mais de ¼ necessitavam de medidas de apoio especial na escola. Não se verificaram diferenças significativas na performance da leitura das crianças com FVA por grupos de habilitações dos encarregados de educação. Verificou-se que o risco de ter um desempenho na leitura alterado é superior [OR=4,29; I.C.95%(2,49;7,38)] nas crianças que apresentam FVA. Relativamente ao 1º ano de escolaridade, o 2º, 3º e 4º anos apresentam um menor risco de ter um desempenho na leitura alterado. As variáveis método de ensino, habilitações dos encarregados de educação, tipo de escola (pública/privada), idade do Professor e número de anos de experiência do Professor, não foram fatores estatisticamente significativos para explicar a alteração do desempenho na leitura, quando o efeito da função visual se encontra contemplado no modelo. Um mau desempenho na leitura foi considerado nas crianças que apresentaram uma precisão inferior a 90%. Este indicador pode ser utilizado para identificar crianças em risco, que necessitam de uma observação Ortóptica/Oftalmológica para confirmação ou exclusão da existência de alterações da função visual. Este trabalho constitui um contributo para a identificação de crianças em desvantagem educacional devido a anomalias da função visual tratáveis, propondo um modelo que pretende orientar os professores na identificação de crianças que apresentem um baixo desempenho na leitura.
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INTRODUCTION: Use of a Bacillus sphaericus based mosquito larvicide was evaluated as an intervention for malaria vector control at a mining site in Amapá, Brazil. Impacts on larval and adult densities of the primary vector Anopheles darlingi were measured over the course of a 52 week study period.METHODS: In Calçoene, State of Amapá, gold mining activity occurs in 19 mining sites in gold-miners of Lourenço. Large pools are formed in mining sites and naturally colonized by Anopheles darlingi. During one year, the impact of applications of VectoLex(r) CG to these larval sources was evaluated. Applications of 20kg/ha were made as needed, based on 10 immature (3rd, 4th instars and pupae) surveillance of health and established thresholds. RESULTS: One hundred percent initial control was observed 48h after each treatment. The pools received from 2-10 (5.3±1.6) treatments during the year. The average re-treatment interval in productive pools was 9.4±4.3 weeks. During weeks 3-52 of the study, mean density of late stage larvae was 78% and pupae were 93% lower in the treated pools than in untreated pools (p< 0.0001, n=51) while reduction of adult mosquitoes was 53% in comparison to the untreated area during the last five months of the study, which were the rainy season (p<0.001).CONCLUSIONS:VectoLex(r) CG reduced immature Anopheles darlingi infestation levels during the entire study period, and reduced adult mosquito populations during the rainy season.
Successful treatment of lower urinary tract infections with oral fosfomycin: a report of three cases
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Infections due to multidrug-resistant organisms continue to increase, and therapeutic options remain scarce. Given this challenge, it has become necessary to use older antimicrobials for treatment of these pathogens. We report three patients with lower urinary tract infections caused by Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae who were successfully treated with a seven-day course of oral fosfomycin monotherapy.
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RESUMO: Nos países desenvolvidos a lombalgia é a condição músculo-‐esquelética mais prevalente. Quando evolui para um quadro crónico é responsável por um encargo económico bastante considerável, não só em relação aos indivíduos, mas também para a sociedade. A lombalgia crónica é por isso uma das principais causas de perda de produtividade e de perda de independência económica, nomeadamente através do absenteísmo (ausência do trabalho), do presenteísmo (perda de produtividade no trabalho, devido à capacidade diminuída provocada pela lombalgia) e da incapacidade para trabalhar (invalidez permanente, total ou parcial). Até à data, em Portugal, a prevalência e carga social da lombalgia crónica eram desconhecidas. Até agora não existiam estudos populacionais de grande dimensão sobre este tema. O objetivo principal desta tese foi determinar a prevalência de lombalgia crónica, e também avaliar a carga social que esta tem na população adulta Portuguesa. O trabalho de investigação foi desenvolvido no âmbito do Estudo Epidemiológico de Doenças Reumáticas em Portugal (EpiReumaPt). Este foi o primeiro estudo de larga escala e de base populacional, que determinou a prevalência de doenças reumáticas e músculo-‐ esqueléticas na população adulta portuguesa. Foi realizado numa amostra aleatória e representativa, de 10.661 indivíduos do Continente, da Região Autónoma dos Açores e da Região Autónoma da Madeira, entre Setembro de 2011 e Dezembro de 2013. Esta tese foi dividida em duas secções. A primeira secção incluiu o detalhe das questões relativas ao desenvolvimento e gestão do EpiReumaPt, constituindo-‐se como um guia prático sobre como realizar um estudo de base populacional de larga escala, em Portugal. A metodologia detalhada do EpiReumaPt foi também descrita nesta secção e incluiu os objectivos, o desenho do estudo, as características de recrutamento e a preparação de dados para análise. Nesta secção foram ainda descritos os principais resultados do EpiReumaPt. Estes evidenciaram que a lombalgia foi a condição músculo-‐esquelética com maior prevalência na população adulta portuguesa.A segunda secção desta tese estimou a prevalência da lombalgia crónica ativa na população adulta Portuguesa, e avaliou a carga social esta condição. A lombalgia ativa foi definida com base na dor auto-‐relatada no dia da entrevista e que persistia há pelo menos 90 dias (independentemente da causa). A lombalgia foi definida como dor na área definida entre a margem inferior das décimas segundas costelas até às pregas glúteas inferiores, com ou sem dor nos membros inferiores. A carga social foi medida tendo em conta os seguintes parâmetros: qualidade de vida, função, consumo de recursos de saúde, consumo de analgésicos e outros fármacos usados no alívio da dor, sintomas de ansiedade e sintomas de depressão. Os resultados mostraram que o consumo de recursos em saúde e a carga social da lombalgia crónica na população adulta Português é significativa. Também a incapacidade causada pela lombalgia crónica,nos indivíduos com idade ativa, é responsável por elevadas taxas de absenteísmo e má qualidade de vida, aos quais acresce o consequente ónus socioeconómico. Esta tese também concluiu que o consumo de analgésicos e outros medicamentos para alívio da dor, na população adulta portuguesa com lombalgia crónica ativa, é relativamente baixa. A maioria destes indivíduos não tomava nenhum medicamento analgésico, independentemente da intensidade da dor. Mesmo os indivíduos que reportaram dor intensa, apenas 4.0% estavam no primeiro degrau da escada analgésica da Organização Mundial de Saúde; 2.3% usavam opióides fracos e 0.03% usavam opióides fortes para controlar a dor (segundo e terceiro degrau da escada analgésica da Organização Mundial da Saúde). O trabalho de investigação também confirmou que a prevalência de sintomas de ansiedade e depressão entre os indivíduos adultos portugueses com lombalgia crónica ativa é elevada. Nestes indivíduos, registou-‐se um consumo mais elevado de analgésicos e outros medicamentos para alívio da dor, quando comparados com os indivíduos com lombalgia crónica activa sem esses sintomas psicológicos. Os grupos terapêuticos mais utilizados foram os ansiolíticos, sedativos e hipnóticos, os antidepressivos e os anti-‐inflamatórios não esteróides. A intensidade média da dor reportada foi também maior entre os indivíduos com lombalgia ativa e sintomas de ansiedade e/ou depressão. Também nestes, foi reportada pior função e pior estado de saúde. Em relação ao consumo de recursos de saúde foram encontradas diferenças significativas entre as duas populações: os indivíduos com lombalgia ativa e sintomas psicológicos concomitantes registaram maior número de consultas de psiquiatria de outras especialidades médicas, assim como precisaram de mais apoio domiciliário nos 12 meses prévios à entrevista do EpiReumaPt. Foram também identificados os fatores associados a sintomas isolados de ansiedade, a sintomas isolados de depressão e a sintomas de ansiedade e depressão. Resumindo,esta tese permitiu concluir que a lombalgia crónica é um problema de saúde comum na população adulta portuguesa, contribuindo para um elevado grau de incapacidade e que consequentemente afeta o desempenho laboral e o bem-‐estar dos indivíduos. A lombalgia crónica é também responsável por um consumo considerável de recursos de saúde. Acresce ainda que os sintomas de ansiedade e depressão são comuns, entre os indivíduos com lombalgia crónica, contribuindo com uma carga social adicional.---------------------------------- ABSTRACT:Low Back Pain(LBP) is the most prevalent of musculoskeletal condition in developed countries.When it becomes chronic, LBP causesan enormous economic burden on individuals and society -‐ it is one of the leading causes of loss of productivity and economic independence through absenteeism (time off work), presenteeism (lost productivity because of diminished capacity while at work) and work disability (permanent, partial or complete disablement for work purposes). In Portugal the prevalence and burden of LBP and chronic LBP (CLBP) were poorly defined. Until now no large population-‐based studies have focused on this. The main aim of this thesis was to determine the prevalence of LBP and CLBP, and also to assess the burden of CLBP in the adult rtuguese population. The research work was developed under the scope of EpiReumaPt (the Portuguese Epidemiologic Study of Rheumatic Diseases). EpiReumaPt was the first national large population-‐based and prevalence study of rheumatic and musculoskeletal diseases (RMD). It was performed among a randomized and representative sample of 10,661 adult Portuguese subjects recruited in Mainland, Azores and Madeira Islands, from September 2011 to December 2013. The first section of this thesis included detailed issues regarding the development and management of EpiReumaPt, and provided a practical guide on how to set-‐up a large population-‐based study in Portugal. The detailed methodology of EpiReumaPt, including its objectives,study design,recruitment features,and data preparation for analyses were also described. The main results from EpiReumaPt study were provided in this section and showed that LBP was the musculoskeletal condition with highest prevalence among Portuguese population. The second section of this thesis estimated the prevalence of active CLBP among adult Portuguese population, and assessed the social burden of this condition. Active CLBP was defined based on self-‐reported pain on the day of the interview, and for most of the time for at least 90 days (independently from cause). LBP was defined as pain in the back area from the lower margin of the twelfth ribs to he lower gluteal folds, with or without pain referred to the lower limbs. Social burden was measured taking into account the following outcomes: quality of life, function, healthcare resources consumption, analgesic and other pain relief drugs intake, anxiety and depression symptoms. Results showed that the healthcare consumption and social burden of CLBP among adult Portuguese population were enormous, and the disability caused by CLBP among subjects in a working age provides high rates of absenteeism (work loss) and poor quality of life, with a consequent socioeconomic burden. This thesis also concluded that analgesic and other pain relief drugs untake among adult Portuguese population with active CLBP was very low. Most of the subjects with active CLBP did not take any analgesic drug regardless pain severity. Even when subjects self-‐reported severe pain, only 24.0% were in the 1st step of the analgesic ladder,2.3% used weak analgesic opioids and 0.03% used strong opioids (2nd and 3rd step of WHO analgesic ladder, respectively) to control pain . The research work also confirmed that the prevalence of anxiety and depression symptoms among adult Portuguese subjects with active CLBP was high. Regarding pharmacological therapy, the intake of analgesic and other pain relief drugs was higher among subjects with anxiety and/or depression symptoms, when compared with subjects without these psychological symptoms. Anxiolytics, sedatives and hypnotics, antidepressants and NSAIDs intake had higher usage rates among these subjects. The pain severity mean was also higher among this subjects and function and health status was worse. Regarding healthcare resources consumption,significant differences between the two populations were found. Subjects with ctive CLBP and concomitant psychological symptoms had a higher number of psychiatrist and other physician visits. They also needed more home care in the previous 12 months. Factors associated with isolated symptoms of anxiety, depression,and concomitant anxiety and depression symptoms were also identified. Summarizing, we concluded that CLBP is a common health problem among adult Portuguese population contributing to disability and affecting labor performance, and the well being of subjects. it is also responsible for considerable healthcare resource consumption. Anxiety and depression symptoms are common among subjects with CLBP and provided an additional burden among them.
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This present study aimed to investigate the fatigue life of unused (new) endodontic instruments made of NiTi with control memory by Coltene™ and subjected to the multi curvature of a mandibular first molar root canal. Additionally, the instrument‟s structural behaviour was analysed through non-linear finite element analysis (FEA). The fatigue life of twelve Hyflex™ CM files was assessed while were forced to adopt a stance with multiple radius of curvature, similar to the ones usually found in a mandibular first molar root canal; nine of them were subjected to Pecking motion, a relative movement of axial type. To achieve this, it was designed an experimental setup with the aim of timing the instruments until fracture while worked inside a stainless steel mandibular first molar model with relative axial motion to simulate the pecking motion. Additionally, the model‟s root canal multi-curvature was confirmed by radiography. The non-linear finite element analysis was conducted using the computer aided design software package SolidWorks™ Simulation, in order to define the imposed displacement required by the FEA, it was necessary to model an endodontic instrument with simplified geometry using SolidWorks™ and subsequently analyse the geometry of the root canal CAD model. The experimental results shown that the instruments subjected to pecking motion displayed higher fatigue life values and higher lengths of fractured tips than those with only rotational relative movement. The finite element non-linear analyses shown, for identical conditions, maximum values for the first principal stress lower than the yield strength of the material and those were located in similar positions to the instrument‟s fracture location determined by the experimental testing results.
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The work conelete of a survey of the mvaewe plants which appeared during the first six months of seedling stage in foreet plantations of second and third rotation, in the Jari area, Brazil. The resulting list showed two types of invasives: (1) true weeds - those cosmopolitan species that are typical of disturbed habitats; and (2) pioneer species - those which were probably remnants from the original natural vegetation of the studied area.
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The species composition of the seasonal várzea forest growing on a bank of the Ilha de Marchantaria / lower Solimões-Amazonas River, Brazil was studied in an area of slightly less than one hectare. Two biomass plots were harvested. Forty-seven arboreal species representing 46 genera in 25 families were recorded. Tree density was 1086 per hectare. Total basal area was 45 m2 ha1. Mean species density was 6.5 ± 1.98 per 100 m2. The most abundant species were Crataeva benthamii(Capparidaceae), Laetia corymbutosa(Flacourtiaceae) and Vitex cymosa(Verbenaceae). The highest basal area per species was 10.2 m2 for Pseudobombax munguba(Bombacaceae). The common species are known to be typical floristic elements of the seasonal varzea forest. Above ground dry biomass was equal to 97 and 255 t ha', respectively. Its chemical composition is characterized by comparatively high bioelement contents equal to 2.4 percent on the average. Calcium was the most important bioelement. Structure of the forest and age darings of trees allow the successional classification of the stands.
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Várzea and terra-firme forests in the lower course of the Amazon were compared in terms of forest structure, wood volume increments and forest biomass. The wood volume of várzea forests was smaller than that of terra-firme forests, particularly when severe human intervention such as the cultivation of açaí palm occurred. The difference was even greater in the forest weight comparison because of the lower wood density of várzea trees. These trees are not directly influenced by water stress during the dry season, while late wood with a high density is formed in the terra-firme trees. The annual forest disappearance area due to firewood for tile factories was estimated to be about 276 ha on the island investigated, which had an area of 36,200 ha. Assuming that the forests are rotatively cultivated every 25 to 30 years, the total deforestation area is 6,870-6,948 ha in 25 years and 8,244~8,337 ha in 30 years. This result means that the balance between forest biomass and utilization is not in crisis, however, this balance might be lost as long as substitutive energy such as electricity is not supplied.
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The recycling of pavements is nowadays a very important question to the road paving industry. With the objective of incorporating higher percentages of reclaimed asphalt (RA) materials in recycled asphalt mixtures, new techniques have been developed in the last years. The use of foamed bitumen is normally associated with the production of cold asphalt mixtures, which usually show lower quality standards. However, the objective of the work presented in this paper is to assess the use of foamed bitumen as the binder of warm asphalt mixtures incorporating 30% RA, which have quality standards similar to those of conventional mixtures. Thus, five mixtures have been produced with 30% RA, one of them with a conventional bitumen (control mix) and the others with foamed bitumen at different production temperatures. The mixtures were tested for compactability and water sensitivity and the results show a possible reduction of 25 ºC in the production temperatures, while the water sensitivity test results were kept close to 90 %.
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Several archaeological black earth (ABE) sites occur in the Amazon region. They contain fragments of ceramic artifacts, which are very important for the archaeological purpose. In order to improve the archaeological study in the region we carried out a detailed mineralogical and chemical study of the fragments of ceramic artifacts found in the two ABE sites of Cachoeira-Porteira, in the Lower Amazon Region. Their ceramics comprise the following tempers: cauixi, cariapé, sand, sand +feldspars, crushed ceramic and so on and are composed of quartz, clay equivalent material (mainly burned kaolinite), feldspars, hematite, goethite, maghemite, phosphates, anatase, and minerals of Mn and Ba. Cauixi and cariapé, siliceous organic compounds, were found too. The mineralogical composition and the morphology of their grains indicate a saprolite (clayey material rich on quartz) derived from fine-grained felsic igneous rocks or sedimentary rocks as source material for ceramic artifacts, where silica-rich components such cauixi, cariapé and/or sand (feldspar and rock fragments) were intentionally added to them. The high content of (Al,Fe)-phosphates, amorphous to low crystalline, must be product of the contact between the clayey matrix of pottery wall and the hot aqueous solution formed during the daily cooking of animal foods (main source of phosphor). The phosphate crystallization took place during the discharge of the potteries put together with waste of organic material from animal and vegetal origin, and leaving to the formation of the ABE-soil profile.
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Mansonella ozzardi is transmitted by two dipterian families, Ceratopogonidae (midges) and Simuliidae (black flies). In Brazil, black flies are vectors for this filariasis until now. In this paper, we determined the seasonality, parity capacity and parasitic infection rate of Cerqueirellum argentiscutum. The work was carried out in the Porto Japão community, Lower Solimões River, Amazonas, Brazil. Results show that the black flies were more abundant during the rainy season (from December to May). The number of parous flies was higher in every sampling during the course of year. Monthly Biting Rate (MBR1 123742.00, MBR2 86701.50) was high, although Parasitic Infection Rate (PIR1 0.06, PIR2 0.08) and Annual Transmission Potential (ATP 7.25) were low in numbers.
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This paper carried out a chemical investigation of archaeological ceramic artifacts found in archaeological sites with Black Earth (ABE) in the Lower Amazon Region at Cachoeira-Porteira, State of Pará, Brazil. The ceramic artifacts, mostly of daily use, belong to Konduri culture (from 900 to 400 years BP). They are constituted of SiO2, Al2O3, Fe2O3, Na2O and P2O5; SiO2 and Al2O3 together add up to 80 % and indicate influence of acid rocks, transformed into clay minerals basically kaolinite. The relative high contents of P2O5 (2.37 % in average) come out as (Al,Fe)-phosphate, an uncommon fact in primitive red ceramics, but found in some roman and egyptian archaeological sites. The contents of the trace elements are similar or below the Earth's crust average. This chemical composition (except P2O5) detaches saprolite material derived acid igneous rocks or sedimentary ones as the main raw material of the ceramics. The contents of K, Na and Ca represent the feldspars and rock fragments possibly introduced into saprolitic groundmass, indicated by mineralogical studies. The presence of cauixi and cariapé as well as quartz sand was confirmed by optical microscope, SEM analyses and by the high silica contents of ceramic fragments. Phosphorus was possibly incorporated into groundmass during cooking of foods, and ABE soil profile formation developed on yellow Latosols. The raw materials and its tempers (cauixi, or cariapé, feldspar, crushed rocks, old ceramic artifacts and quartz fragments) are found close to the sites and therefore and certainly came from them.
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O objetivo foi analisar a relação entre desempenho motor (DM) e variáveis antropométricas de crianças e adolescentes de escolas públicas de Florianópolis. Metodologia: 300 alunos do 3º ao 5º ano e da 4ª a 6ª série do Ensino Fundamental, entre os 8 e 16 anos. Os resultados vão ao encontro à literatura, que indicam correlações negativas entre DM e variáveis antropométricas em crianças e adolescentes.
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Despite a natural history interest in the early 1900s, relatively little ecological research has been carried out in the Rio Purús basin of central Amazonia, Brazil. Here we describe a new study area in the region of Lago Uauaçú with an emphasis on the climate, forest structure and composition, and soil characteristics between adjacent unflooded (terra firme) and seasonally inundated forests; situated within both the white-water (várzea) and black-water (igapó) drainage systems that dominate the landscape. The climate was found to be typical of that of the central Amazon. Várzea forest soils had high concentrations of nutrients, while terra firme and igapó soils were comparatively nutrient-poor. Terra firme forests were the most floristically diverse forest type, whereas várzea was intermediate, and igapó the most species-poor. The Lecythidaceae was the most important family in terra firme while the Euphorbiaceae was the most important in both várzea and igapó. There were significant differences between forest types in terms of number of saplings, canopy cover and understorey density. In contrasting our results with other published information, we conclude that the Lago Uauaçú region consists of a typical central Amazonian forest macro-mosaic, but is a unique area with high conservation value due to the intimate juxtaposition of terra firme, várzea and igapó forests.
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Freshwater stingrays, or potamotrygonids, are restricted to Neotropical river drainages. These elasmobranchs are well adapted to freshwater environments and the number of described species gradually increases as further research is carried out. Some of the first studies on their systematics and natural history were carried out in the 1960s and 1970s in southern South America. However, there is no new published data on potamotrygonids from Uruguayan waters since then (except for local journal reports from sportive fishermen and specimens deposited in Uruguayan collections). The present study aims to record the recent occurrence of two species of potamotrygonids caught by sport fishermen, with comments on other published historical records for the same area. As many other elasmobranchs, these species have an important, but not always well understood, role in the Uruguayan rivers ecosystems.