Conflicting structural and geochronological data from the Ibituruna quartz-syenite (SE Brazil): Effect of protracted ""hot"" orogeny and slow cooling rate?

The Ibituruna quartz-syenite was emplaced as a sill in the Ribeira-Aracuai Neoproterozoic belt (Southeastern Brazil) during the last stages of the Gondwana supercontinent amalgamation. We have measured the Anisotropy of Magnetic Susceptibility (AMS) in samples from the Ibituruna sill to unravel its magnetic fabric that is regarded as a proxy for its magmatic fabric. A large magnetic anisotropy, dominantly due to magnetite, and a consistent magnetic fabric have been determined over the entire Ibituruna massif. The magmatic foliation and lineation are strikingly parallel to the solid-state mylonitic foliation and lineation measured in the country-rock. Altogether, these observations suggest that the Ibituruna sill was emplaced during the high temperature (similar to 750 degrees C) regional deformation and was deformed before full solidification coherently with its country-rock. Unexpectedly, geochronological data suggest a rather different conclusion. LA-ICP-MS and SHRIMP ages of zircons from the Ibituruna quartz-syenite are in the range 530-535 Ma and LA-ICP-MS ages of zircons and monazites from synkinematic leucocratic veins in the country-rocks suggest a crystallization at similar to 570-580 Ma, i.e., an HT deformation >35My older than the emplacement of the Ibituruna quartz-syenite. Conclusions from the structural and the geochronological studies are therefore conflicting. A possible explanation arises from (40)Ar-(39)Ar thermochronology. We have dated amphiboles from the quartz-syenite, and amphiboles and biotites from the country-rock. Together with the ages of monazites and zircons in the country-rock, (40)Ar-(39)Ar mineral ages suggest a very low cooling rate: <3 degrees C/My between 570 and similar to 500 Ma and similar to 5 degrees C/My between 500 and 460 Ma. Assuming a protracted regional deformation consistent over tens of My, under such stable thermal conditions the fabric and microstructure of deformed rocks may remain almost unchanged even if they underwent and recorded strain pulses separated by long periods of time. This may be a characteristic of slow cooling ""hot orogens"" that rocks deformed at significantly different periods during the orogeny, but under roughly unchanged temperature conditions, may display almost indiscernible microstructure and fabric. (C) 2009 Elsevier B.V. All rights reserved.

Boron isotope composition of tourmalinite and vein tourmalines associated with gold mineralization, Serra do Itaberaba Group, central Ribeira Belt, SE Brazil

Important concentrations of tourmaline occur as gold-bearing stratiform tourmalinites and in mineralized quartz-tourmaline veins at the Tapera Grande and Quartzito gold prospects in the Mesoproterozoic Serra do Itaberaba Group, central Ribeira Belt (Sao Paulo State, SE Brazil). The main rock types in both prospects constitute the volcanic-sedimentary Morro da Pedra Preta Formation, which formed in a submarine back-arc setting. At Tapera Grande, the volcanic-sedimentary sequence is composed of metabasic and metavolcaniclastic rocks, graphitic and sulfur-rich metapelites, banded iron formation, metandesite, metarhyolite, calcsilicates, tourmalinites and metahydrothermalites derived from mafic and felsic rocks. The Mesoproterozoic rocks at Quartzito prospect are lithologically similar but they have been affected by Neoproterozoic faulting and shearing and by the emplacement of granitic rocks, resulting in the formation of tourmaline-rich quartz-carbonate veins with gold and base metal mineralization. We conducted a chemical and B-isotope study of tourmalines in order to better understand the origin of the stratiform tourmalinites in the Morro da Pedra Preta Formation and their relationship with gold mineralization. The overall range of delta(11)B values obtained for the tourmalinite and vein tourmalines is between - 15%. and -5 parts per thousand, with the tourmalinites failing at the low end of this range (-15 to -8 parts per thousand). Such values are typical for continental crust and inconsistent with a primary marine boron signature as expected from the submarine-exhalative model for the gold prospects. We conclude from this that tourmaline formed or recrystallized from crustal fluids related to the amphibolite-grade metamorphism which affected the Serra do Itaberaba Group and that gold deposition occurred syn- to post-peak metamorphism by phase immiscibility, as attested by fluid inclusions in Tapera Grande tourmalinite tourmaline and quartz. The vein-hosted tourmalines at Quartzito have isotopically variable boron signatures, with heavier delta(11)B values of -5 parts per thousand to -8 parts per thousand for acicular green tourmalines and lighter values (-15 parts per thousand to -7 parts per thousand for light blue, Ti-firee tourmaline from quartz-carbonate veins). We attribute the heavier boron to fluids derived from the volcano-sedimentary rocks of marine affinity whereas the lighter boron was contributed by crustal fluids related to the granitoids or metasediments in the continental crust. (c) 2009 Elsevier B.V. All rights reserved.

Mineralogical and microthermometric studies and structural aspects of imperial topaz mineralization in Antonio Pereira, Ouro Preto District (Minas Gerais) - Brazil

The occurrences of imperial topaz in the Antonio Pereira mine, Ouro Preto, Minas Gerais, are associated with the metamorphic carbonate rocks of the Minas Supergroup. The crystals have densities varying from 3.46 to 3.58. The parameters of the unitary cells obtained were: 4.658 to 4.663 angstrom (ao), 8.823 to 8.832 angstrom (b(o)), 8.382 to 8.389 angstrom (c(o)), and 344.65 to 345.46 angstrom 3 (V). The refraction indices presented the following variations: 1.622 to 1.630 (nX), 1.624 to 1.632 (nY), 1.633 to 1.640 (nZ), and 0.008 to 0.011 (B). These properties are coherent with the low fluorine contents obtained (16,48%/17,05wt%). Infrared spectroscopy and microthermometry showed that the fluid inclusions, which represent the mineralizing fluids, are formed by H(2)O (with Ca(2+), Mg(2+) and Na(+)), and CO(2) +/- CH(4). The minimal trapping T-P conditions of 290/320 degrees C and 2,349/2,497bar were obtained for the primary fluid inclusions. The pseudo-secondary fluid inclusions were trapped at conditions of lower temperatures and variable pressures, during the deformation process under local alternating states of stress. The microthermometric studies, the structural analysis and the fluorine contents suggest that the mineralized veins were formed from hydrothermal fluids originated during the Brasiliano tectono-metamorphic event.

Isotopic evidence for the late Brasiliano (500-550 Ma) ore-forming mineralization of the Araes gold deposit, Brazil

The Araes gold deposit, located in eastern Mato Grosso State, central Brazil, is hosted in Neoproterozoic volcanosedimentary rocks of the Paraguay belt, which formed during collision of the Amazonian craton and the Rio Apa block. Ar-40/Ar-39 geochronology and Pb and S isotopic analyses constrain the timing and sources of mineralization. Three biotite flakes from two samples of metavolcanic host rock yield Ar-40/Ar-39 plateau ages between 5941 and 531 Ma, interpreted as cooling ages following regional metamorphism. Clay minerals from a hydrothermal alteration zone yield an Ar-40/Ar-39 integrated age of 503 +/- 3 Ma. Galena grains from ore-bearing veins yield values of Pb-206/(204)pb from 17.952 to 18.383, Pb-207/Pb-204 from 15.156 to 15.811, and Pb-208/Pb-204 from 38.072 to 39.681. Pyrite grains from ore-bearing veins yield values of Pb-206/Pb-204 from 18.037 to 18.202, Pb-207/Pb-204 from 15.744 to 15.901., and Pb-208/(204)pb from 38.338 to 38.800. Pb isotope variations may be explained in terms of mixing a less radiogenic lead component (mu similar to 8.4) from mafic and ultramafic basement host-rocks (Nova Xavantina metavolcanosedimentary rocks) and a more radiogenic lead component (mu similar to 9.2) probably derived from supracrustal rocks (Cuiaba sedimentary groups). Sulfur isotope compositions are homogeneous, with delta S-34 values ranging from -1.1 parts per thousand to 0.9 parts per thousand (galena) and -0.7 parts per thousand to 0.9 parts per thousand (pyrite), suggesting a mantle-derived reservoir for the mineralizing solutions. Based on the Ar, Pb, and S isotope data, we suggest that the precious metals were remobilized from metavolcanic host rocks by hydrothermal solutions during Brasilide-Panafrican regional metamorphism. The Arabs gold deposit probably formed during a late stage of the orogeny, coeval with other mineralization events in the Paraguay Belt.

Morphology and composition of gold in a lateritic profile, Fazenda Pison ""Garimpo"", Amazon, Brazil

This study describes the morphological evolution of gold grains in a lateritic weathering profile in an equatorial rainforest climate. Primary sources of gold are quartz veins associated with shallow granophyric intrusion. Gold grains were found in fresh ore, saprolite, transition zones, ferruginous duricrust, red latosol, and yellow latosol. Irregularly shaped grains predominate, with smaller proportions of dendritic and prismatic forms. Gold grains are weathered in the uppermost 10 m of the regolith. Mean gold grain size is maximum in the duricrust (> 125 mu m) and decreases progressively upward into the yellow latosol (<90 mu m). Voids and corrosion pits appear on grain surfaces, and progressive rounding is observed from the bottom of the profile to the top. Gold grains can be classified as either homogeneous or zoned with respect to their chemical composition. Homogeneous grains contain 2-15% Ag (mean 8.3%). Zoned grains have more variable Ag contents; grain cores have means of approximately 10% or 23% Ag, with Ag-poor zones of approximately 3.7% Ag along internal discontinuities and/or outer rims. Formation of Ag-poor rims is due to preferential depletion of silver. Processes responsible for duricrust formation may preserve some grains as large aggregates, but subsequent transformation into latosol further modifies them. (c) 2007 Elsevier Ltd. All rights reserved.

Efetividade da terapia fisica descongestiva na cicatrização de úlceras venosas

A venous ulcer is the most serious clinical manifestation of chronic venous failure, and the most frequent in lower limbs, accounting for 70% of all ulcers. Patients may suffer from this infirmity for several years without healing of the lesion if treatment is inadequate. The aim of this investigation was to verify the effectiveness of decongestive physical therapy in the healing of venous ulcers. This is a quasi-experimental, interventionist study, with paired, non-probabilistic sampling, composed of 50 patients divided into two groups: control and intervention, each composed of 25 patients. Both groups were identically treated for six months with daily dressings and the latter also underwent complex physical therapy consisting of a combination of the following techniques: manual lymphatic drainage, compression bandaging, lower limb elevation, myolymphokinetic exercises and skin care. The study was approved (Protocol no. 59/2007) by the Ethics Committee of the State University of Southeast Bahia. The Mann-Whitney and Chi-square tests were applied for data analysis. After statistical analysis the patients who underwent therapy showed a statistically significant difference with respect to wound contraction starting in the second month of treatment. Compared to the control, the intervention group showed a greater reduction in both pain and edema starting in the third and fourth month of therapy, respectively. To reinforce these findings, the mean percentage of tissue present at the base of the ulcer (granulation/fibrin ratio) was calculated. The intervention group showed greater granulation at the base of the ulcer compared to the control, significant from the second month of treatment on. It was observed in this study that lymphotherapy, when compared between the intervention and control groups, accelerated the healing process, and reduced pain and edema in the affected limbs. It is expected, therefore, that these results widen scientific knowledge and we suggest that this therapy be used 78 not only to reduce lymphedema, but also as a treatment option for venous ulcers, given its easy application and low cost. The data, therefore, demonstrated the importance of basic care on the part of a multiprofessional and transdisciplinary health team involved in the healing process of these infirmities, thereby contributing to better quality of life in these individuals

Consequências da deriva de clomazone e sulfentrazone em clones de E. grandis x E. urophylla

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Detecção ultrassonográfica do ovário fetal em loba-guará (Chrysocyon brachyurus): relato de caso

Identificaram-se, por ultrassonografia, os ovários fetais e o sexo dos fetos em uma loba-guará. Ao exame ultrassonográfico, foi possível identificar estruturas fetais e realizar medidas (relação entre diâmetro cranial e abdominal dos fetos) que indicavam idade fetal de 59 dias. Observaram-se: estruturas torácicas e abdominais formadas, diafragma, membros, estruturas do crânio definidas, coluna vertebral, medula, costelas, batimentos cardíacos normais, movimentação fetal, câmaras e valvas cardíacas, grandes vasos, rins, peristaltismo intestinal e ovários fetais. O exame ultrassonográfico foi eficaz nessa espécie, pois foi possível observar estruturas fetais para a avaliação da viabilidade fetal e, também, identificou-se a imagem ovariana em um dos fetos, mostrando-se importante para estudos de sexagem fetal.

Estudo do sistema portal hepático no pato doméstico (Cairina moshata)

Estudou-se o comportamento do sistema portal hepático em 30 patos domésticos, adultos, machos e fêmeas. O sistema apresenta-se constituído por duas veias portais hepáticas: direita e esquerda. A veia portal hepática esquerda é formada por veias gástricas esquerdas (em número de 1 a 2), veias da margem ventral do ventrículo, veia pilórica e veia proventricular caudal. A veia portal hepática direita é formada pela veia mesentérica caudal, veia mesentérica cranial, veia proventrículo-esplênica e veia gastropancreaticoduodenal. A veia mesentérica caudal recebe tributárias do mesorreto, cloaca e junção ileocecocólica. A veia mesentérica cranial recebe tributárias jejunais (em número de 12 a 21) e se anastomosa com a veia mesentérica caudal, formando a veia mesentérica comum. A veia pancreaticoduodenal recebe duas veias gástricas direitas, constituindo assim a veia gastropancreaticoduodenal. A veia proventrículo-esplênica é formada pelas veias proventriculares dorsal e direita e pelas veias esplênicas.

Análise morfológica da placenta da paca (Agouti paca, Linnaeus, 1766: Estudo ao microscópio de luz e à microscopia eletrônica de transmissão

Foram estudados os aspectos morfológicos de nove placentas de paca (Agouti paca, L., 1766) mediante análises em microscopia de luz e eletrônica de transmissão dos fragmentos teciduais correspondentes à porção de maior conexão placentária em diferentes fêmeas gestantes, nos estágios intermediário e final da prenhez. Realizamos este estudo, pois, aliada à necessidade da procura de novas espécies que atuem como modelos experimentais adequados, havia a disponibilidade deste roedor em nosso meio; por outro lado, o melhor conhecimento dos aspectos reprodutivos destes animais oferece subsídios ao estabelecimento de criatórios racionais desta espécie, uma vez que a preservação deste vertebrado é necessária, além do grande interesse comercial em torno de sua carne. Os resultados mostraram que este roedor possui uma placenta do tipo vitelina e outra do tipo corioalantoidiana, sendo este órgão do tipo hemocorial, labiríntico, que se apresenta histologicamente composto por lóbulos divididos em três regiões distintas: o centro do lóbulo, o labirinto e o interlóbulo. Na região do centro do lóbulo, verificou-se a presença de artérias e veias; e em sua região periférica estavam presentes dois sistemas tubulares arranjados de forma paralela, onde as lacunas sangüíneas e os capilares estavam em íntimo contato, formando a região do labirinto. O interlóbulo era composto de artérias e veias. O trofoblasto era o principal componente da placenta, que, independentemente da região onde se encontrava, mostrava-se de natureza sincicial. Ultra-estruturalmente a barreira placentária da paca foi classificada como hemomonocorial.

Descrição anátomo-topográfica do coração da paca (Agouti paca)

Background: The domestic animals heart is a conical hollow viscera, surrounded by pericardium, laterally compressed, accompanying the thorax shape. Atriums constituted the heart basis and their auricles partially bound the initial portion of the aorta and pulmonary trunk. In mammals, heart is kept suspended in the thoracic cavity and the pericardic sac is fixed dorsally by great veins and arteries roots, and ventrally fixed to the sternum, although its fixation to the diaphragm varies among species. This paper aimed to describe morphological aspects of the heart of the paca, the second biggest Brazilian rodent.Materials, Methods & Results: There were used 12 hearts of adult pacas for this study, obtained from the UNESP, Jaboticabal, SP, which died due fights or anesthesia during bandages or radiograph exams. The thoracic aorta was filled with colored latex and the animal was set in a 10% formaldehyde solution for at least 72 hours. The thoracic cavity was dissected and hearts individualized and measured with a paquimeter, lateromedially, craniocaudally and dorsoventrally. The paca heart is placed between the first and fifth intercostal space (ICS), in a craniocaudal oblique position; its basis is craniodorsally positioned, on the middle third between the first and second ICS and its apex is located near the sternodiaphragmatic joint, on the fifth ICS, tilted to the left antimere. The heart is surrounded by pericardium, which from ventrocaudally is originated the sternopericardic ligament, that continues as phrenopericardic ligament. At the heart basis, the rising of the pulmonary trunk was observed and the conus arteriosus formed a typical projection. The aorta also rised from the heart basis and its arch, which was caudally curved, crossed dorsally the pulmonary trunk; the right cranial and caudal cava veins drained to the right atrium. There is a left cranial cava vein, which surrounded the left atrium and joined the right caudal cava vein on the right atrium. The azygos vein joins the right cranial cava vein and four pulmonary veins drained to the left atrium. At palpation, a hard structure on the rising of the aorta was observed, similarly to a cartilaginous tissue, which would be part of the cardiac skeleton. The left and right coronary arteries were observed in all hearts.Discussion: The paca heart is anatomica and topographically similar to those of domestic mammals, differing from them for being placed one intercostal space more cranial and due to the presence of two cranial cava veins, the left and the right ones, besides the presence of the caudal cava vein. This vascular description is similar to that of small rodents, as rats and mice. In paca heart, the sinus venous, the terminal crest, the oval fossa, the atrioventricular valvae, the papillary muscles and tendinous cords, besides smooth atriums and auricles covered by pectinate muscles, were observed. The sternopericardic ligament, which is dorsally elongated as phrenopericardic ligament, is similar to the one present in humans, pigs, castors, and different from the one observed in carnivorous, that presents the phrenopericardic ligament and from the one of horses and ruminants, which present the sternopericardic ligament.

Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity