Influence of the Processing Conditions on the Characteristics of the Clad Layers Produced with Laminar Plasma Technology

Laminar plasma technology was used to produce ceramic hardened layers of Al2O3-40% mass Ni composite powders on stainless steel substrates. In order to investigate the influences of processing conditions on the morphologies of the surface modified layers, two different powder-feeding methods were tested, one with carrier gas called the powder injection method, and the other without carrier gas called powder transfers method. The microscopic investigations demonstrate that the cross-section of the clad layers consists of two distinct microstructural regions, in which the Al2O3 phases exhibit different growth mechanisms. When the powder transfers method is adopted, the number density and volume fraction of the Al2O3 particles increase considerably and their distributions exhibit zonal periodical characteristics. When the powder-feeding rate increases, the microstructure of the Al2O3 phases changes from a small globular to a long needle shape. Finite element simulations show that the transient thermo-physical features of the pool substances, such as solidification rate and cooling rate, influence strongly the mechanisms of the nucleation and the directional growth of the Al2O3 phases in the thermal processing.

Growth of bulk single crystals beta-FeSi2 by chemical vapour deposition

Bulk single crystals b-FeSi2, as a new photoelectric and thermoelectric material, has been successfully grown using chemical vapor transport technique by using iodine as transport agent in a sealed ampoule. The effects of crystal growth condition on quality and morphologies of the single crystals were studied. Both needle-like and grain-like single crystals were gained. By changing substrate temperature, tetrahedral high quality a-FeSi2 single crystals were also obtained.

Study on Microstructure and Nanomechanics Properties of Antibacterial Bone China

Fracture appearance, surface and nanomechanics properties of antibacterial ceramics contairing rare earth phosphate composite antibacterial materials were characterized and measured by SEM, AFM and Nanoindenter, respectively. Results show that grain of fracture surface of antibacterial ceramics grows uniform refinement topography of bubble break-up appears at the surface, which is flat and has liquid character, by adding the phosphate composite containing rare earth, nevertheless needle-like crystal and granular outgrowth form at fracture surface and surface of common ceramics, respectively. Young's modulus of antibacterial ceramic film is 74. 397 GPa and hardness is 8. 134 GPa, which increses by 4.4﹪ and 1.6﹪ comparing with common ceramics, respectively. Loading curves of two kind of ceramics have obvious nonlinear character under 700 nm and linear character between 700 ～ 1000 nm, and unloading curve have obvious linear character.

Microstructure Study Of Laser Welding Cast Nickel-Based Superalloy K418

Experiments of laser welding cast nickel-based superalloy K418 were conducted. Microstructure of the welded seam was characterized by optical microscopy (OM), scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy dispersive spectrometer (EDS). Mechanical properties of the welded seam were evaluated by microhardness. The corresponding mechanisms were discussed in detail. Results show that the laser welded seam have non-equilibrium solidified microstructures consisting of Cr-Ni-Fe-C austenite solid solution dendrites as the dominant and some fine and dispersed Ni-3(Al,Ti) gamma' phase as well as little amount of MC needle carbides and particles enriched in Nb, Ti and Mo distributed in the interdendritic regions, cracks originated from the liquation of the low melting points eutectics in the HAZ grain boundary are observed, the average microhardness of the welded seam and HAZ is higher than that of the base metal due to alloy elements' redistribution of the strengthening phase gamma'. (C) 2008 Elsevier B.V. All rights reserved.

Dissimilar autogenous full penetration welding of superalloy K418 and 42CrMo steel by a high power CWNd : YAG laser

Experiments of autogenous laser full penetration welding between dissimilar cast Ni-based superalloy K418 and alloy steel 42CrMo flat plates with 3.5 mm thickness were conducted using a 3 kW continuous wave (CW) Nd:YAG laser. The influences of laser welding velocity, flow rate of side-blow shielding gas, defocusing distance were investigated. Microstructure of the welded seam was characterized by optical microscopy (OM), scanning electron microscopy (SEM) and X-ray diffraction (XRD) and energy dispersive spectrometer (EDS). Mechanical properties of the welded seam were evaluated by microhardness and tensile strength testing. Results show that high quality full penetration laser-welded joint can be obtained by optimizing the welding velocity, flow rate of shielding gas and defocusing distance. The laser-welded seam have non-equilibrium solidified microstructures consisting of gamma-FeCr0.29Ni0.16C0.06 austenite solid solution dendrites as the dominant and very small amount of super-fine dispersed Ni3Al gamma' phase and Laves particles as well as MC needle-like carbides distributed in the interdendritic regions. Although the microhardness of the laser-welded seam was lower than that of the base metal, the strength of the joint was equal to that of the base metal and the fracture mechanism showed fine ductility. (c) 2007 Elsevier B.V. All rights reserved.

Collision tumour involving a rectal gastrointestinal stromal tumour with invasion of the prostate and a prostatic adenocarcinoma

Background: Gastrointestinal stromal tumours (GISTs) are the most common primary mesenchymal neoplasia in the gastrointestinal tract, although they represent only a small fraction of total gastrointestinal malignancies in adults (<2%). GISTs can be located at any level of the gastrointestinal tract; the stomach is the most common location (60-70%), in contrast to the rectum, which is most rare (4%). When a GIST invades into the adjacent prostate tissue, it can simulate prostate cancer. In this study, we report on a case comprising the unexpected collision between a rectal GIST tumour and a prostatic adenocarcinoma. Findings: We describe the complexity of the clinical, endoscopic and radiological diagnosis, of the differential diagnosis based on tumour biopsy, and of the role of neoadjuvant therapy using imatinib prior to surgical treatment. Conclusions: Although isolated cases of coexisting GISTs and prostatic adenocarcinomas have reviously been described, this is the first reported case in the medical literature of a collision tumour involving a rectal GIST and prostatic adenocarcinoma components.

Respuesta a la sequía de Pinus radiata D. Don y su implicación en los procesos de tolerancia

160 p. (Bibliogr. 141-160)

Celiac disease in the Mediterranean area

Background: The World Gastroenterology Organization recommends developing national guidelines for the diagnosis of Celiac Disease (CD): hence a profile of the diagnosis of CD in each country is required. We aim to describe a cross-sectional picture of the clinical features and diagnostic facilities in 16 countries of the Mediterranean basin. Since a new ESPGHAN diagnostic protocol was recently published, our secondary aim is to estimate how many cases in the same area could be identified without a small intestinal biopsy. Methods: By a stratified cross-sectional retrospective study design, we examined clinical, histological and laboratory data from 749 consecutive unselected CD children diagnosed by national referral centers. Results: The vast majority of cases were diagnosed before the age of 10 (median: 5 years), affected by diarrhea, weight loss and food refusal, as expected. Only 59 cases (7.8%) did not suffer of major complaints. Tissue transglutaminase (tTG) assay was available, but one-third of centers reported financial constraints in the regular purchase of the assay kits. 252 cases (33.6%) showed tTG values over 10 times the local normal limit. Endomysial antibodies and HLA typing were routinely available in only half of the centers. CD was mainly diagnosed from small intestinal biopsy, available in all centers. Based on these data, only 154/749 cases (20.5%) would have qualified for a diagnosis of CD without a small intestinal biopsy, according to the new ESPGHAN protocol. Conclusions: This cross-sectional study of CD in the Mediterranean referral centers offers a puzzling picture of the capacities to deal with the emerging epidemic of CD in the area, giving a substantive support to the World Gastroenterology Organization guidelines.

Experimental chemical physics of droplets and clusters

Time-of-flight measurements of energetic He atoms, field ionization of cryogenic liquid helium clusters, and time-of-flight and REMPI spectroscopy of radical salt clusters were investigated experimentally. The excited He atoms were generated in a corona discharge. Two strong neutral peaks were observed, accompanied by a prompt photon peak and a charged peak. All peaks were correlated with the pulsing of the discharge. The neutral hyperthermal and metastable atoms were formed by different mechanisms at different stages of the corona discharge. Positively charged helium droplets were produced by ionization of liquid helium in an electrostatic spraying experiment. The fluid emerging from a thin glass capillary was ionized by a high voltage applied to a needle inside the capillary. Fine droplets (less than 10 µm in diameter) were produced in showers with currents as high as 0.4 µA at 2-4 kV. The high currents resulting from field ionization in helium and the low surface tension of He I, led to charge densities that greatly exceeded the Rayleigh limit, thus resulting in coulombic explosion of the liquid. In contrast, liquid nitrogen formed a well-defined Taylor cone with droplets having diameters comparable to the jet (≈100 µm) at lower currents (10 nA) and higher voltages (8 kV). The metal-halide clusters of calcium and chlorine were generated by laser ablation of calcium metal in a Ar/CCl₄ expansion. A visible spectrum of the Ca₂Cl₃ cluster was observed from 651 to 630 nm by 1 +1' REMPI. The spectra were composed of a strong origin band at 15 350.8 cm^-1 and several weak vibronic bands. Density functional calculations predicted three minimum energy isomers. The spectrum was assigned to the ²B₂ ← X ²A₁ transition of a planar C_2V structure having a ring of two Cl and two Ca atoms and a terminal Cl atom. The ring isomer of Ca₂Cl₃ has the unpaired electron localized on one Ca²⁺ ion to form a Ca⁺ chromophore. A second electronic band of Ca₂Cl₃ was observed at 720 nm. The band is sharply different from the 650 nm band and likely due to a different isomer.

Label-free detection of single biological molecules using microtoroid optical resonators

Being able to detect a single molecule without the use of labels has been a long standing goal of bioengineers and physicists. This would simplify applications ranging from single molecular binding studies to those involving public health and security, improved drug screening, medical diagnostics, and genome sequencing. One promising technique that has the potential to detect single molecules is the microtoroid optical resonator. The main obstacle to detecting single molecules, however, is decreasing the noise level of the measurements such that a single molecule can be distinguished from background. We have used laser frequency locking in combination with balanced detection and data processing techniques to reduce the noise level of these devices and report the detection of a wide range of nanoscale objects ranging from nanoparticles with radii from 100 to 2.5 nm, to exosomes, ribosomes, and single protein molecules (mouse immunoglobulin G and human interleukin-2). We further extend the exosome results towards creating a non-invasive tumor biopsy assay. Our results, covering several orders of magnitude of particle radius (100 nm to 2 nm), agree with the `reactive' model prediction for the frequency shift of the resonator upon particle binding. In addition, we demonstrate that molecular weight may be estimated from the frequency shift through a simple formula, thus providing a basis for an ``optical mass spectrometer'' in solution. We anticipate that our results will enable many applications, including more sensitive medical diagnostics and fundamental studies of single receptor-ligand and protein-protein interactions in real time. The thesis summarizes what we have achieved thus far and shows that the goal of detecting a single molecule without the use of labels can now be realized.

Composição da matriz extracelular do ligamento cardinal de mulheres na pós-menopausa com e sem prolapso uterino

O prolapso uterino tem sua incidência aumentada na pós-menopausa. O objetivo deste estudo é identificar as alterações na matriz extracelular do ligamento cardinal associadas à menopausa e ao prolapso uterino. Ligamento cardinal de três diferentes grupos de mulheres, pré-menopausa, prolapso uterino e pós-menopausa, foram identificados e biopsiados durante 57 histerectomias abdominais ou vaginais. As amostras foram processadas por métodos bioquímicos para caracterização e quantificação de glicosaminoglicanos sulfatados e colágeno. As concentrações relativas de glicosaminoglicanos foram obtidas por eletroforese. Procedimentos histológicos foram feitos para identificar fibras elásticas (Weigert), distribuição de colágeno (Picro Sirius) e decorin (imunohistoquímica). Nossos resultados mostraram aumento na concentração de GAG de 72,2%, redução na concentração de colágeno de 37% e diminuição de 22% de fibras elásticas no grupo de prolapso uterino quando comparado ao grupo da pós-menopausa (p<0,05, p<0,04 e p<0,05 respectivamente). As concentrações relativas de glicosaminoglicanos sulfatados para condroitin sulfato, heparan sulfato e dermatan sulfato não mostraram diferenças entre os três grupos. A organização do colágeno foi similar entre os três grupos e a marcação do decorin pareceu estar diminuída no grupo de prolapso uterino. Nossos resultados indicam alterações no metabolismo do tecido conjuntivo. O ligamento cardinal da mulher na pós-menopausa possui uma matriz extracelular mais densa. Esta alteração não ocorre na mulher com prolapso uterino.

MEMS for Diabetic Retinopathy

As the worldwide prevalence of diabetes mellitus continues to increase, diabetic retinopathy remains the leading cause of visual impairment and blindness in many developed countries. Between 32 to 40 percent of about 246 million people with diabetes develop diabetic retinopathy. Approximately 4.1 million American adults 40 years and older are affected by diabetic retinopathy. This glucose-induced microvascular disease progressively damages the tiny blood vessels that nourish the retina, the light-sensitive tissue at the back of the eye, leading to retinal ischemia (i.e., inadequate blood flow), retinal hypoxia (i.e., oxygen deprivation), and retinal nerve cell degeneration or death. It is a most serious sight-threatening complication of diabetes, resulting in significant irreversible vision loss, and even total blindness.

Unfortunately, although current treatments of diabetic retinopathy (i.e., laser therapy, vitrectomy surgery and anti-VEGF therapy) can reduce vision loss, they only slow down but cannot stop the degradation of the retina. Patients require repeated treatment to protect their sight. The current treatments also have significant drawbacks. Laser therapy is focused on preserving the macula, the area of the retina that is responsible for sharp, clear, central vision, by sacrificing the peripheral retina since there is only limited oxygen supply. Therefore, laser therapy results in a constricted peripheral visual field, reduced color vision, delayed dark adaptation, and weakened night vision. Vitrectomy surgery increases the risk of neovascular glaucoma, another devastating ocular disease, characterized by the proliferation of fibrovascular tissue in the anterior chamber angle. Anti-VEGF agents have potential adverse effects, and currently there is insufficient evidence to recommend their routine use.

In this work, for the first time, a paradigm shift in the treatment of diabetic retinopathy is proposed: providing localized, supplemental oxygen to the ischemic tissue via an implantable MEMS device. The retinal architecture (e.g., thickness, cell densities, layered structure, etc.) of the rabbit eye exposed to ischemic hypoxic injuries was well preserved after targeted oxygen delivery to the hypoxic tissue, showing that the use of an external source of oxygen could improve the retinal oxygenation and prevent the progression of the ischemic cascade.

The proposed MEMS device transports oxygen from an oxygen-rich space to the oxygen-deficient vitreous, the gel-like fluid that fills the inside of the eye, and then to the ischemic retina. This oxygen transport process is purely passive and completely driven by the gradient of oxygen partial pressure (pO₂). Two types of devices were designed. For the first type, the oxygen-rich space is underneath the conjunctiva, a membrane covering the sclera (white part of the eye), beneath the eyelids and highly permeable to oxygen in the atmosphere when the eye is open. Therefore, sub-conjunctival pO₂ is very high during the daytime. For the second type, the oxygen-rich space is inside the device since pure oxygen is needle-injected into the device on a regular basis.

To prevent too fast or too slow permeation of oxygen through the device that is made of parylene and silicone (two widely used biocompatible polymers in medical devices), the material properties of the hybrid parylene/silicone were investigated, including mechanical behaviors, permeation rates, and adhesive forces. Then the thicknesses of parylene and silicone became important design parameters that were fine-tuned to reach the optimal oxygen permeation rate.

The passive MEMS oxygen transporter devices were designed, built, and tested in both bench-top artificial eye models and in-vitro porcine cadaver eyes. The 3D unsteady saccade-induced laminar flow of water inside the eye model was modeled by computational fluid dynamics to study the convective transport of oxygen inside the eye induced by saccade (rapid eye movement). The saccade-enhanced transport effect was also demonstrated experimentally. Acute in-vivo animal experiments were performed in rabbits and dogs to verify the surgical procedure and the device functionality. Various hypotheses were confirmed both experimentally and computationally, suggesting that both the two types of devices are very promising to cure diabetic retinopathy. The chronic implantation of devices in ischemic dog eyes is still underway.

The proposed MEMS oxygen transporter devices can be also applied to treat other ocular and systemic diseases accompanied by retinal ischemia, such as central retinal artery occlusion, carotid artery disease, and some form of glaucoma.

O uso do boto-cinza (Sotalia guianensis) como sentinela da poluição continental por compostos organoclorados (DDT, PCB, HCH, HCB e Mirex) em baías costeiras do Estado do Rio de Janeiro

Concentrações de compostos organoclorados (DDTs, PCBs, HCHs, Mirex e HCB) foram determinadas em camadas externas e internas do tecido adiposo subcutâneo de 17 botos-cinza (Sotalia guianensis) da região Sudeste do Brasil. Não houve diferenças estatísticas significativas entre os estratos, relativo aos 37 compostos determinados, assim como ΣDDT, ΣPCB, ΣHCH, e as razões p,p-DDE/ΣDDT e ΣDDT/ΣPCB. Entretanto, foram observadas diferenças significativas nas concentrações de alguns compostos organoclorados de animais encalhados ou capturados acidentalmente quando comparados com animais biopsiados remotamente, sendo assim as comparações entre esses dois conjuntos de dados, devem ser vistas com cuidado. No presente estudo, as concentrações dos compostos organoclorados foram determinadas em biópsias de botos-cinza obtidas de 2007 a 2009, nas baías de Sepetiba (n=13) e Ilha Grande (n=11), Sudeste do Brasil. As concentrações (ng/g de lipídio) variaram de

Avaliação da influência do material de confecção das matrizes no teste de conversão monomérica por espectrometria no infravermelho de um compósito

Este estudo teve por objetivo avaliar, in vitro, a influência do material de confecção das matrizes, traçando um perfil da conversão monomérica de um compósito micro-híbrido, além de avaliar qual dos materiais testados mais se assemelha a uma matriz de dentina. A avaliação foi feita através da análise do grau de conversão (GC). Foram confeccionadas 3 matrizes bipartidas, sendo estas de teflon negro, tefon branco e aço inoxidável, ambas com 10mm de diâmetro e 2 mm de profundidade. Para o grupo controle foi utilizado um incisivo central bovino, o qual teve sua face vestibular aplainada em uma lixadeira sob refrigeração constante, com o auxílio de uma lixa de carbeto de silício, número 800. Após, este dente foi preparado com uma broca diamantada número 2294 (KG Sorensen) em alta rotação, própria para a preparação de cavidades padronizadas para ensaios de laboratório, apresentando um limitador de penetração. Em seguida, com um motor de baixa rotação foi realizado o acabamento das paredes, obtendo-se uma cavidade de 2,0 mm de profundidade por 9,0 mm de diâmetro. Pela palatina desse dente, com uma broca carbide cilíndrica de numeração 2056 (KG Sorensen), fez-se uma penetração até se obter uma parede de dentina extremamente fina, porém sem que esta fosse rompida. Assim, com uma agulha, fez-se uma pequena perfuração no centro dessa dentina para que este instrumental servisse como um pino para remoção do corpo de prova de dentro da matriz de dente. Os corpos de prova (CP) foram obtidos a partir da inserção do compósito no interior da perfuração das matrizes em um único incremento e cobertos na superfície externa com uma matriz de poliéster mais uma lamínula de vidro. Os CP foram fotopolimerizados por 40 s pela fonte de luz halógena Optilux 501 (Demetron), com 500 mW/cm. Imediatamente após a polimerização, os corpos de prova eram submetidos no topo e na base para a análise de espectrometria no infravermelho para a determinação da profundidade de polimerização, pela técnica do filme vazado para o compósito não polimerizado e pela técnica da pastilha de brometo de potássio (KBr) para o compósito polimerizado. Foram confeccionados 5 CP de cada grupo. Em cada grupo, o compósito da base e do topo das amostras foi moído até se obter de 1,5 a 2,0 mg de pó e misturado com 70 mg de KBr, para obtenção da pastilha de KBr. Foi feita a análise de espectrofotometria no infravermelho por Transformada de Fourier (FTIR). As absorções selecionadas para o cálculo foram 1610 cm-1 e 1637 cm-1, os picos dos espectros das ligações dos carbonos aromáticos e alifáticos, respectivamente. Os dados obtidos foram tratados estatisticamente. Os grupos Gr1B, Gr2B, Gr3B e Gr4B representam, respectivamente, as bases dos CP confeccionados pelas matrizes de DB, TN, TB e AI. Já os Gr1T, Gr2T, Gr3T e Gr4T representam os topos. Médias (%) e DP: Gr1T (46,461,99), Gr2T (39,864,51), Gr3T (44,053,44) e Gr4T (38,045,08). Gr1B (40,441,49), Gr2B (36,153,81), Gr3B (40,093,18) e Gr4B (35,593,35). Em posse dos resultados, pôde-se concluir que os grupos do teflon negro, teflon branco e aço inoxidável não apresentaram diferenças entre o grau de conversão do topo e da base, enquanto que o grupo da dentina apresentou maior conversão do topo. Comparando as matrizes entre elas, pôde-se perceber que no topo, o GC do dente bovino é maior que o GC do aço inoxidável e do que o de teflon negro, o GC do teflon branco é maior que o GC do aço inoxidável e do que o de teflon negro. Já o topo dos grupos de dente bovino e teflon banco foram semelhantes. Nas bases dos CPs, não houve diferença significativa entre os grupos testados. De acordo com os resultados obtidos no experimento, pôde-se concluir que nos grupos do teflon negro, teflon branco e aço inoxidável não houve diferença entre 0 e 2 mm, ou seja, topo e base, o que mostra que o material de confecção da matriz não influênciou o grau de conversão do compósito. Já para o grupo da matriz de dentina, o topo apresentou valor de conversão monomérica maior, mostrando que, neste caso, o material da matriz interferiu no grau de conversão. Pode-se perceber também que existe uma tendência da matriz de teflon branco se assemelhar mais a matriz de dentina, pois foi o único grupo que apresentou semelhança nos valores de conversão monomérica no topo das amostras. Porém analisando a base das amostras, percebe-se que todos os grupos se comportaram de forma semelhante, obtendo valores do grau de conversão sem diferença significante.

Aplicabilidade da Norma Regulamentadora 32: visão dos trabalhadores de enfermagem de um hospital público do RJ

Pesquisa de natureza descritiva e abordagem quantitativa de dados sobre a Aplicabilidade da Norma Regulamentadora-32 (NR 32) do Ministério do Trabalho e Emprego (MTE), visando mobilizar os trabalhadores de enfermagem para reduzir a exposição aos riscos inerentes do trabalho em estabelecimentos de saúde. Problema de pesquisa: Quais os fatores que interferem na implantação da Norma Regulamentadora-32 nas enfermarias de um Hospital Público Estadual do Rio de Janeiro, na visão dos trabalhadores de enfermagem? Teve como objetivo geral analisar os fatores que interferem na aplicabilidade da NR 32 pela enfermagem, em um hospital público do Rio de Janeiro. A população foi composta de 138 trabalhadores de enfermagem das enfermarias de clínica médica, cirúrgica e ortopédica. Utilizou-se para a coleta de dados um questionário estruturado com perguntas fechadas. Os dados foram coletados no período de 28 de janeiro a 14 de fevereiro de 2009, e analisados através do Programa Statical Package for the Social Sciences (SPSS) versão 13 for Windows e Microsoft Office Excel 2003. Os resultados apontaram que os trabalhadores de enfermagem desse hospital estão, em sua maioria, na faixa etária de 30-49 anos, com pelo menos 1 ano de atuação no mesmo setor e formaram-se há 15 anos ou mais, além disso, 68,1% são estatutários. Constatou-se que há recomendações da NR-32 e precauções-padrão não são seguidas pelos participantes da pesquisa. Os fatores que interferem no cumprimento da atual legislação vão desde o desconhecimento dos riscos ocupacionais e comportamento dos trabalhadores, até a falta de uma ação efetiva de Educação Continuada e da Comissão de Controle de Infecção Hospitalar (CCIH). Destacaram-se, entre outros, o uso de adornos (51,8%); calçado aberto (48,9%); alimentação no posto de trabalho (46,3%); uso da pia para outras finalidades (44,9%), reencape ou desconexão manual de agulhas (36,4%); sair do local de trabalho com uniforme ou Equipamento de Proteção Individual - EPI (21%); limite de recipiente de descarte de perfurocortantes não respeitado (11,8%), falta de uso de EPI quando auxilia no exame com Raios-X (32,6%) e na manipulação de quimioterápicos (7,8%). A instituição não fornece uniformes nem calçados. Outros fatores institucionais foram a falta de equipamentos, a falta de um política de prevenção e promoção da saúde, inexistência de serviço de saúde ocupacional e instalações físicas inadequadas. Tal descumprimento expõe, de forma excessiva, os trabalhadores de enfermagem aos mais variados fatores de riscos ocupacionais, podendo refletir na sua saúde e no processo de trabalho. Recomenda-se um trabalho efetivo e integrado dos Programas de Educação Continuada e CCIH para esclarecimento dos trabalhadores de enfermagem, e implantação do Serviço de Saúde do Trabalhador. Sugere-se aos gestores expandirem este estudo para os demais setores das unidades hospitalares e outras instituições públicas de saúde para o conhecimento da situação de trabalho, bem como a criação de espaços de discussão para a busca de soluções dos problemas com a participação dos trabalhadores.