Estimulação transcraniana por corrente contínua e a flutuação de força em idosas durante exercício isométrico

The fluctuacion force has been increasingly used in studies with elderly as a good predictor of performance and functionality of the motor. However, most analyzes the fluctuation of force in one session. Thus, identifying the minimum amount of sessions needed for familiarization with the fluctuation strength in isometric exercise become relevant. Furthermore, to investigate the effects of applying transcranial direct current stimulation (tDCS) associated with regular exercise on rates fluctuation task force is extremely important. In the first experiment, volunteers were subjected to a protocol marked by a familiarization session to establish the parameters of VCM and eight sessions with intensity of 30% MVC in office. It was observed that two familiarization sessions are required so there is a fluctuation stabilizing force. In experiment II, subjects performed an isometric contraction before and after applying tDCS (cathode, anode and sham) applied to M1. ETCC anodic effectively contributed to reducing the fluctuation of force during isometric exercise in the elderly, while the cathodic caused the increased levels of strength fluctuation. It was concluded that there is a need to implement a familiarization protocol with at least two sessions to avoid possible misunderstandings of measurements in tests of fluctuacion force. Besides that tDCS interfered with the behavior of the oscillations of force, with cathodic promoting increased fluctuation strength and anodic contributed to greater stability, demonstrating the potential of this technique neuromodulation associated with exercise as rehabilitation tools

Submucous myomas: A new presurgical classification to evaluate the viability of hysteroscopic surgical treatment - Preliminary report

STUDY OBJECTIVE: To develop a new preoperative classification of submucous myomas for evaluating the viability and the degree of difficulty of hysteroscopic myomectomy.DESIGN: Retrospective study (Canadian Task Force classification II-3)SETTING: University teaching hospitals.PATIENTS: Fifty-five patients who underwent hysteroscopic resection of submucous myomas.INTERVENTION: the possibility of total resection of the myoma, the operating time, the fluid deficit, and the frequency of any complications were considered. The myomas were classified according to the Classification of the European Society for Gynaecological Endoscopy (ESGE) and by our group's new classification (NC), which considers not only the degree of penetration of the myoma into the myometrium, but also adds in such parameters as the distance of the base of the myoma from the uterine wall, the size of the nodule (cm), and the topography of the uterine cavity. The Fisher's exact test, the Student's t test, and the analysis of variance test were used in the statistical analysis. A p value less than .05 in the two-tailed test was considered significant.MEASUREMENTS AND MAIN RESULTS: In 57 myomas, hysteroscopic surgery was considered complete. There was no significant difference among the three ESGE levels (0, 1, and 2). Using the NC, the difference between the numbers of complete surgeries was significant (p < .001) for the two levels (groups I and H). The difference between the operating times was significant for the two classifications. With respect to the fluid deficit, only the NC showed significant differences between the levels (p = .02).CONCLUSIONS: We believe that the NC gives more clues as to the difficulties of a hysteroscopic myomectomy than the standard ESGE classification. It should be stressed that the number of hysteroscopic myomectomies used in this analysis was low, and it would be interesting to evaluate the performance of the classification in a larger number of patients. (c) 2005 AAGL. All rights reserved.

Validation of hysteroscopic view in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding

STUDY OBJECTIVE: To validate hysteroscopic view with histology in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding (AUB)DESIGN: Retrospective study.(Canadian Task Force classification II-3).SETTING: University teaching hospitals in Rio de Janeiro and São Paulo, and private office in Rio de Janeiro.PATIENTS: Four thousand and fifty-four patients with AUB in whom hysteroscopic views were complete and the histologic result was conclusive.INTERVENTION: Four thousand and fifty-four office hysteroscopies with complete views and conclusive histologic results. The material for histologic examination was obtained through biopsy of the lesion in an outpatient unit or through the resection of the entire lesion in patients who underwent surgery. Histology was considered the gold standard and compared with the hysteroscopic view.MEASUREMENTS AND MAIN RESULTS: In the histology of the 4054 examinations, 613 (15.2%) were endometrial hyperplasia, and 105 (2.6%) were endometrial cancer. The most frequent hysteroscopic finding was endometrial polyps (31.2%). In endometrial hyperplasia, the sensitivity of the hysteroscopic view was 56.3% (95% CI 52.21-60.2%), specificity was 89.1% (95% CI 88.0%-90.1%), positive predictive value (PPV) was 48.0% (95% CI 44.3%-51.7%), negative predictive value (NPV) was 92.0% (95% Cl 90.1%-92.9%), and accuracy was 72.7% (95% CI 70.7%-74.7%). Accuracy was defined as the proportion of correct results among the hysteroscopic examinations. In endometrial cancer, the sensitivity of the hysteroscopic view was 80.0% (95% Cl 71.1%-87.2%), specificity was 99.5% (95% CI 99.2%-99.7%), PPV was 81.5% (95% Cl 72.7%-88.5%), NPV was 99.5% (95% CI 99.2%-99.7%), and accuracy was 89.8% (95% CI, 85.9%-93.6%). In the 814 patients (20.0%) in whom the hysteroscopic view was normal, there were no false negatives for endometrial cancer; however, there were 37 (4.5%) false negatives for endometrial hyperplasia. In the histologic cases of endometrial cancer, 101 (96.2%) hysteroscopic views were compatible with cancer or hyperplasia (80.0% and 16.2%, respectively). Ninety-seven out of 103 hysteroscopic views with cancer findings (94.2%) had histologic diagnosis of cancer or hyperplasia (81.5% and 12.6%, respectively).CONCLUSION: It seems that even in face of good validity of hysteroscopic view for endometrial hyperplasia and cancer, histologic study is mandatory in the presence of any lesion as the hysteroscopic view cannot completely replace the histologic study in patients with AUB. (C) 2006 AAGL. All rights reserved.

Prevention of Money Laundering and of the Financing of Terrorism to Ensure the Integrity of Financial Markets in Latin America and the Caribbean

This paper reviews the current status of the international fight against money laundering and the financing of terrorism, highlighting the importance of its prevention for economic and financial stability in Latin America and the Caribbean. It synthesizes the recent history of international legislation and agreements with respect to the issues, and presents the framework of public and private sector actors engaged in combating these threats. It reviews Latin American and Caribbean countries’ compliance with the Financial Action Task Force (FATF) (40 + 9) Recommendations, and analyzes the region’s performance with respect to their third round Mutual Evaluation Reports.

A política de regularização fundiária e reforma agrária: o PAE nas ilhas do Pará

O objetivo desse trabalho é realizar um estudo sobre a Política de Regularização Fundiária e Reforma Agrária na Região Amazônica, a partir do II Plano Nacional de Reforma Agrária (II PNRA), que inseriu as populações tradicionais ribeirinhas no conjunto de seu público. Tendo como foco de análise os projetos de assentamentos em ilhas dos municípios da Microrregião do Baixo Tocantins/PA, realizados por uma força tarefa entre o INCRA e a SPU. Contudo, a proposta de democratização do uso e posse da terra, que possibilita a seguridade fundiária às populações ribeirinhas, não foi priorizada e estrategicamente planejada pelas instituições públicas. Mediante as análises do processo decisório e dos planos de ação das instituições, das percepções e coleta de dados do associativismo das populações assentadas e dos resultados das eleições do período de 2000 a 2010, chegou-se à conclusão de que os projetos de assentamentos foram realizados de forma intensa e desordenada, para responder positivamente a índices de reforma agrária do governo Lula e para causar impacto nos resultados eleitorais essenciais à manutenção da governabilidade do sistema político.

Usefulness of Clinical, Ultrasonographic, Hysteroscopic, and Immunohistochemical Parameters in Differentiating Endometrial Polyps From Endometrial Cancer

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Produção científica docente em tratamento temático da informação nos cursos de Biblioteconomia do Mercosul: uma análise preliminar

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

Practising Arithmetic Using Educational Video Games with an Interpersonal Computer

Studies show the positive effects that video games can have on student performance and attitude towards learning. In the past few years, strategies have been generated to optimize the use of technological resources with the aim of facilitating widespread adoption of technology in the classroom. Given its low acquisition and maintenance costs, the interpersonal computer allows individual interaction and simultaneous learning with large groups of students. The purpose of this work was to compare arithmetical knowledge acquired by third-grade students through the use of game-based activities and non-game-based activities using an interpersonal computer, with knowledge acquired through the use of traditional paper-and-pencil activities, and to analyze their impact in various socio-cultural contexts. To do this, a quasi-experimental study was conducted with 271 students in three different countries (Brazil, Chile, and Costa Rica), in both rural and urban schools. A set of educational games for practising arithmetic was developed and tested in six schools within these three countries. Results show that there were no significant differences (ANCOVA) in the learning acquired from game-based vs. non-game-based activities. However, both showed a significant difference when compared with the traditional method. Additionally, both groups using the interpersonal computer showed higher levels of student interest than the traditional method group, and these technological methods were seen to be especially effective in increasing learning among weaker students.

Estudo comparativo entre ressecção e eletrocoagulação endometrial em paciebtes com sangramento uterino anormal

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Recomendações para prevenção clínica: aspectos relevantes em idosos

The American Academy of Family Physicians (AAFP) released a summary of the “Recommendations for Clinical Preventive Services”. It is a publication based on “Recommendations for Clinical Preventive Services” published by the United States Preventive Services Task Force (USPSTF). These recommendations are provided only as an aid to physicians in making clinical decisions about the care of their patients. They reflect the clinic references existing at the time of publication. But its only should be used with the clear understanding that continued research may result in new knowledge and consequently there is a need for updates. Some recommendations of the USPSTF are important in clinical practice with the elderly.

Adaptação transcultural do formulário POLST: Physician Orders for Life-Sustaining Treatment

Pós-graduação em Saúde Coletiva - FMB

Diltiazem como alternativa ao betabloqueador na angiotomografia de artérias coronárias

FUNDAMENTO: A redução da frequência cardíaca (FC) na angiografia por tomografia das artérias coronarianas (ATCCor) é fundamental para a qualidade de imagem. A eficácia dos bloqueadores de cálcio como alternativas para pacientes com contraindicações aos betabloqueadores não foi definida. OBJETIVOS: Comparar a eficácia na redução da FC e variabilidade RR do metoprolol e diltiazem na ATCCor. MÉTODOS: Estudo prospectivo, randomizado, aberto, incluiu pacientes com indicação clínica de ATCCor, em ritmo sinusal, com FC>70bpm e sem uso de agentes que interferissem com a FC. Cinquenta pacientes foram randomizados para grupos: metoprolol IV 5-15 mg ou até FC≤60 bpm(M), e diltiazem IV 0,25-0,60mg/kg ou até FC≤60 bpm (D). Pressão arterial (PA) e FC foram aferidas na condição basal, 1min, 3min e 5min após agentes, na aquisição e após ATCCor. RESULTADOS: A redução da FC em valores absolutos foi maior no grupo M que no grupo D (1, 3, 5min, aquisição e pós-exame). A redução percentual da FC foi significativamente maior no grupo M apenas no 1 min e 3 min após início dos agentes. Não houve diferença no 5 min, durante a aquisição e após exame. A variabilidade RR percentual do grupo D foi estatisticamente menor do que a do grupo M durante a aquisição (variabilidade RR/ FC média da aquisição). Um único caso de BAV, 2:1 Mobitz I, revertido espontaneamente ocorreu (grupo D). CONCLUSÃO: Concluímos que o diltiazem é uma alternativa eficaz e segura aos betabloqueadores na redução da FC na realização de angiografia por tomografia computadorizada das artérias coronarianas. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0)

An Overview of the Use of Metadata in Agriculture

Metadata is data that fully describes the data and the areas they represent, allowing the user to decide on their use as best as possible. Allow reporting on the existence of a set of data linked to specific needs. The use of metadata has the purpose of documenting and organizing a structured organizational data in order to minimize duplication of efforts to locate them and to facilitate maintenance. It also provides the administration of large amounts of data, discovery, retrieval and editing features. The global use of metadata is regulated by a technical group or task force composed of several segments such as industries, universities and research firms. Agriculture in particular is a good example for the development of typical applications using metadata is the integration of systems and equipment, allowing the implementation of techniques used in precision agriculture, the integration of different computer systems via webservices or other type of solution requires the integration of structured data. The purpose of this paper is to present an overview of the standards of metadata areas consolidated as agricultural.

International Consensus Guidelines for Nutrition Therapy in Pancreatitis

Guidelines for nutrition support in pancreatitis have been inconsistently adapted to clinical practice. The International Consensus Guideline Committee (ICGC) established a pancreatitis task force to review published guidelines for pancreatitis in nutrition support. A PubMed search using the terms pancreatitis, acute pancreatitis, chronic pancreatitis, nutrition support, parenteral nutrition, enteral nutrition, and guidelines was conducted for the period from January 1999 to May 2011. Eleven guidelines were identified for review. The ICGC used the following process to develop unified guideline statements: summarize the strength of evidence (grading) of the guidelines; establish level of evidence for ICGC statements as high, intermediate, and low; assign published guideline levels of evidence; and define an ICGC grading system. International Pancreatitis Guideline Grades were established as follows: platinum-high level of evidence and consistent agreement among the guidelines; gold-acceptable level of evidence and no conflicting statements in guidelines; and silver-single existing guideline statement with no conflict in other guidelines. Eighteen ICGC statements were derived from the 11 published pancreatitis guidelines. Uniform agreement from widely disparate groups (United States, Europe, Japan, and China) resulted in 4 platinum-level guideline statements for nutrition in pancreatitis: nutrition support therapy (NST) is generally not needed for mild to moderate disease, NST is needed for severe disease, enteral nutrition (EN) is preferred over parenteral nutrition (PN), and use PN when EN is contraindicated or not feasible. This methodology provides a template for future ICGC nutrition guideline development. (JPEN J Parenter Enteral Nutr. 2012;36:284-291)

Patients With Endometriosis of the Rectosigmoid Have a Higher Percentage of Natural Killer Cells in Peripheral Blood

Study Objective: To estimate the concentration of natural killer (NK) cells in the peripheral blood in patients with and without endometriosis. Design: Case-control study (Canadian Task Force classification II-2). Setting: Tertiary referral hospital. Patients: One hundred fifty-five patients who had undergone videolaparoscopy were divided into 2 groups: those with endometriosis (n = 100) and those without endometriosis (n = 55). Interventions: The percentage of NK cells relative to peripheral lymphocytes was quantified at flow cytometry in 155 patients who had undergone laparoscopy. In addition to verifying the presence of endometriosis, stage of disease and the sites affected were also evaluated. Measurements and Main Results: The mean (SD) percentage of NK cells was higher (15.3% [9.8%]) in patients with endometriosis than in the group without the disease (10.6% [5.8%]) (p < .001). The percentage of NK cells was highest (19.8 [10.3%]) in patients with advanced stages of endometriosis and in those in whom the rectosigmoid colon was affected. In a statistical model of probability, the association of this marker (NK cells >= 11%) with the presence of symptoms such as pain and intestinal bleeding during menstruation and the absence of previous pregnancy yielded a 78% likelihood of the rectosigmoid colon being affected. Conclusion: Compared with patients without endometriosis, those with endometriosis demonstrate a higher concentration of peripheral NK cells. The percentage of NK cells is greater, primarily in patients with advanced stages of endometriosis involving the rectosigmoid colon. Therefore, it may serve as a diagnostic marker for this type of severe endometriosis, in particular if considered in conjunction with the symptoms. Journal of Minimally Invasive Gynecology (2012) 19, 317-324 (C) 2012 AAGL. All rights reserved.