Simulador radiográfico antropomórfico de mama humana

Mammography is a diagnostic imaging method in which interpretation depends on knowledge of radiological aspects as well as the clinical exam and pathophysiology of breast diseases. In this work a mammography phantom was developed to be used for training in the operation of mammographic x-ray equipment, image quality evaluation, self-examination and clinical examination of palpation. Polyurethane was used for the production of the phantoms for its physical and chemical properties and because it is one of the components normally used in prostheses. According to the range of flexibility of the polyurethane, it was possible to simulate breasts with higher or lower amount of adipose tissue. Pathologies such as areolar necrosis and tissue rejection due to surgery reconstruction after partial mastectomy were also simulated. Calcifications and nodules were simulated using the following materials: polyethylene, poly (methyl methacrylate), polyamide, polyurethane and poly (dimethyl silicone). Among these, polyethylene was able to simulate characteristics of calcification as well as breast nodules. The results from mammographic techniques used in this paper for the evaluation of the phantoms are in agreement with data found in the literature. The image analyses of four phantoms indicated significant similarities with the human skin texture and the female breast parenchyma. It was possible to detect in the radiographic images produced regions of high and low radiographic optical density, which are characteristic of breasts with regions of different amount of adipose tissue. The stiffnesses of breast phantoms were adjusted according to the formulation of the polyurethane which enabled the production of phantoms with distinct radiographic features and texture similar to human female breast parenchyma. Clinical palpation exam of the phantoms developed in this work indicated characteristics similar to human breast in skin texture, areolar region and parenchyma

Abordagem inicial de lesões mamárias por biopsia helicóide: estudo experimental

OBJECTIVE: Evaluating the kit-Bh performance in carrying out of breast biopsies. METHODS: They were randomly selected a sample of 30 patients with breast cancer undergoing mastectomy, based on the results of a pilot study from February 2008 to April 2010. They were excluded women with had not palpable, stone-hard consistency tumors, previous surgical manipulation or that contains liquid. Using the helicoid biopsy Kit (kit Bh) and an equipment Core biopsy with cannula and needle and 14 gauge respectively, it was collected a fragment of sound equipment in the area and in tumors in each specimen, totaling 120 fragments for histological study. For data analysis, it was defined a 95% confidence level and used the SPSS-13 version, the Kappa index and the parametric Student t test. RESULTS: Mean age of patients was 51.6 years (± 11.1 years). The infiltrating ductal carcinoma showed a higher incidence, 26 cases (86.7%). The Core biopsy had a sensitivity of 93.3%, specificity of 100% and accuracy 96.7%, while the helicoid biopsy had a sensitivity of 96.7%, specificity of 100% and accuracy 98.3%. By comparing the histology of tumors and the fragments of biopsies, there was high degree of agreement in diagnoses (kappa of 0.93 with p <0.05) CONCLUSION: Both devices provided the histological diagnosis of lesions with high accuracy. Results of this study showed that the helicoid biopsy is a reliable alternative in 22 the preoperative diagnosis of breast lesions. Further studies in vivo better will define the role of Kit Bh in the diagnosis of these lesions

Segurança e eficácia da tibolona na transição menopausal: um ensaio clínico randomizado, duplo-cego e controlado com placebo

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Causes of death of thoroughbred racehorses at Octavio Dupont Veterinary Hospital, Brazilian Jockey Club, Rio de Janeiro

Existem poucas pesquisas que abordam estudos epidemiológicos de mortes em cavalos de corrida de uma forma ampla. A maioria restringe-se a uma afecção ou procedimento específico. O Brasil não possui um programa de monitoramento de mortes instituído. Através de um estudo descritivo em associação a metodologia multivariada de análise, realizou-se um estudo epidemiológico de causa mortis relacionadas com afecções musculosqueléticas (MS), gastrointestinais (GI), sistema respiratório (RES), neurológico (NEU) e mortes súbitas (SD) durante os anos de 2002 a 2008 no Hospital Octavio Dupont, Rio de Janeiro. Os machos representaram o sexo mais afetado e a causa mortis relacionada com a taxa geral de mortalidade por grandes grupos de causas determinadas apresentou a seguinte ordem decrescentemente: MS>GI>SD>NEU>RES. A maioria dos óbitos registrados foi de cavalos na faixa etária de quatro a cinco anos (ID4-ID5). Seguidamente, observaram-se as seguintes relações de correspondência: (Triênio = SM-ID>5-SD; ID>5-GI; ID4-5-MS; SF-ID<4-RES/NEU); (Quatriênio = SM - ID>5 - GI; SF - ID<4 - NEU; ID4-5 - MS; GI - ID>5). O presente estudo aponta a importância e necessidade de estudos epidemiológicos sobre lesões em cavalos atletas, objetivando o diagnostico, reconhecimento de fatores predisponentes e prevenção.

Os saberes dos professores da escola fundamental: concepções sobre as abordagens geográficas / Márcia Maria Dias

El presente trabajo, intitulado, Los saberes de los profesores de la Escuela Fundamental: concepciones sobre los abordajes geográficos objetiva investigar los saberes del profesor de los años iniciales de la Escuela Fundamental en relación a la naturaleza especifica de los abordajes geográficos y reflexionar como en el proceso de investigación colaborativa los profesores aprendieron los saberes específicos de los abordajes geográficos vinculando sus asimilaciones teóricas a un determinado nivel de concepción . Buscamos con base en la investigación cualitativa del tipo colaborativa y en la aplicación de diferentes procedimientos técnicos-metodológico, responder a nuestras cuestiones de estudio: ¿Cuales los saberes geográficos que los profesores construyeron en la trayectoria de sus formaciones? ¿Cómo, en el proceso de investigación colaborativa, los profesores aprendieran los saberes específicos de los abordajes geográficos? Conforme principios de la perspectiva socio-histórica. Así, utilizamos específicamente las narrativas tópicas (orales y escritas) con base en los ejes norteadores Como aprendí y lo que aprendí referentes a los saberes geográficos constituidos en la trayectoria de formación, para realizar el diagnostico de los conocimientos previos de los profesores. El proceso reflexivo y la profundización del estudio ocurrieron, respectivamente, por medio de los Seminarios de Estudios Reflexivos y de los Ciclos de Estudios Reflexivos indicando la concepción de aprehensión de los saberes propuestos en esa construcción científica. Los postulados teóricos de Ferreira (2007), Charlot (2000, 2005), Tardif (2002), Tonine (2003), Soares (2000), Moraes (2005), Pimenta (2007), entre otros, proporcionaron comprensión sobre la temática en estudio. La pesquisa ocurrió en una acción colaborativa en la escuela pública de la ciudad de Natal/RN, en el Barrio de Nova Descoberta, en el turno matutino, con tres colaboradores, que participaron voluntariamente de ese proceso: Angico, Jacarandá y Carvalho desarrollaron sus prácticas pedagógicas, en los 1ºs y 4ºs años de la Enseñaza Fundamental. Los resultados obtenidos de los análisis, apuntaron un alcance descriptivo de las concepciones de los colaboradores sobre los saberes de los abordajes geográficos, que se refieren a enumeración de los aspectos característicos del fenómeno concebido, aunque nos haya empeñado para los alcances transformadores de nuestras concepciones

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

Hipertensão arterial e fatores de risco em servidores atendidos pelo departamento de assistência da Universidade Federal do Rio Grande do Norte

Systemic arterial hypertension is a multifactorial disease that contributes to the country´s high cardiovascular morbi-mortality rates. Considering that hypertension affects individuals in their most productive age while facing work and living risk factors, it is important to investigate its occurrence and predisposing factors in different occupational segments. The objective of this study was to identify the prevalence of hypertension among workers attended to in a medical service of a public university, their hypertension levels, the risk factors present, and their knowledge of the factors that influence the arterial pressure. The epidemiologic study was conducted in the Health Department of the Federal University of Rio Grande do Norte with 102 workers that sought care in the medical clinic during the months of March to May 2009. Data were collected by means of a questionnaire and measurements of systolic and diastolic arterial pressure (SAP and DAP) that were classified in stages according to the Brazilian Society of Hypertension and the degree of risk for cardiovascular events according to the criteria of the Brazilian Society for Cardiology. Data were analyzed using descriptive statistics. The workers were, on average, 54 years of age; the majority (67%) was male and had primary or middle educational level; they worked mainly in supplemental units and deanship offices conducting different functions such as security guards, administrative assistants, health auxiliaries and constructions workers; 48 (47%) of the workers identified themselves as hypertensive for 8 years on average, with the majority executing hard labor and administrative functions. Among the workers with hypertension, the number of the pressure levels classified as pre-hypertensive, stage I and II were: (12% in the SAP and 20% in the DAP); (16% in the SAP and 9% in the DAP); and (15% in the SAP and 5% in the DAP), respectively. The workers that did not identify themselves as hypertensive presented classifications with greater frequencies were: normal (16% in the SAP and 30% in the DAP); and pre-hypertensive (21% in the SAP and 16% in the DAP). The risk factors identified in more than 50% of the workers were: tobacco smoking, alcohol consumption and indices of being overweight, although physical activities are also present. Of the 48 workers diagnosed as hypertensive, those that had 5 risk factors present and limitrophic pressure levels (12%), in stage I hypertension (16%) and stage II hypertension (15¨%) were categorized as being in high risk for vascular events. The number of workers that indicated they had knowledge of the factors that influence their hypertension was less than 39% for each factor. It is concluded that there is a high prevalence of systemic arterial hypertension in the university workers, even amongst those already under treatment. They constitute a population at risk considering their age group, their work functions, and their inadequate life habits. Health care of these hypertensive workers that seek attention in the Health Department is an important aspect of the internal workers health policy in the institution. Educational interventions are recommended for the improvement of quality of life and of work in these workers

Trajetória de vida de mulheres mastectomizadas integrantes de um grupo de auto ajuda a luz da História Oral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Diagnóstico sócio-produtivo-econômico da comunidade de catadores de resíduos sólidos do município de Codó-MA: um estudo de caso

The research was carried out in the urban area in Codó-MA, a small city the east part of Maranhão, which has 4,228.000 km2 (IBGE, 2000) and population of 113,768 hab. (IBGE, 2008). The city is also inside Codó-MA micro-region. The city is located in one of the lacking area in Brazil, where the Human Development Index (IDH) is approximately 0,558. It does not present an adequate model of management when talking about solid residue collecting. All of the solid residue produced and collected in the city is stored in an open area that they call lixão , which is located in a residence area in the suburbs. Because of that, a problem that involves public health and environmental areas, we understand it is necessary to investigate the way the local government treats and manages the solid residue collecting, as well as, the social, economical and productive reality of those who are directly involved in the collecting itself, its productive chain of the material, including the handling, transportation and its final destiny. It means a social, productive, economical diagnosis, that in a such way,the local society and the organs of inspection can act in a better way to control the problems that include solid urban residue and come from a bad administration. That way, this work proposes to carry out a study that has as result a diagnosis with feasible alternatives on management, taking as basis, social and economical aspects that compound this productive chain. This work can bring great contributions to a better local reality through the introduction of an integrated and supported system of management of solid residue that includes a selective collecting and the creation of a sanitary area. Taking that into consideration, we can contribute to minimize the environmental impacts in Codó Novo, caused by the garbage

Técnicas neuronais de agrupamentos aplicadas à detecção de anomalias em mamogramas digitais

This work proposes the development of an intelligent system for analysis of digital mammograms, capable to detect and to classify masses and microcalcifications. The digital mammograms will be pre-processed through techniques of digital processing of images with the purpose of adapting the image to the detection system and automatic classification of the existent calcifications in the suckles. The model adopted for the detection and classification of the mammograms uses the neural network of Kohonen by the algorithm Self Organization Map - SOM. The algorithm of Vector quantization, Kmeans it is also used with the same purpose of the SOM. An analysis of the performance of the two algorithms in the automatic classification of digital mammograms is developed. The developed system will aid the radiologist in the diagnosis and accompaniment of the development of abnormalities

Prevalência de doença arterial obstrutiva periférica (DAOP) e alterações sensoriais em pacientes diabéticos tipo 2: impacto da DAOP sobre a qualidade de vida, nível de atividade física e composição corporal

Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rhô= -0,26), diabetes duration (p=0,02; rhô= -0,28) and blood pressure (p= 0,0007; rhô= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population

Caracterização de aspectos da cognição social, habilidades sociais e funções executivas de crianças diagnosticadas com transtorno autista e transtorno de asperger

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

Detecção e diagnóstico de falhas não-supervisionados baseados em estimativa de densidade recursiva e classificador fuzzy auto-evolutivo

In this work, we propose a two-stage algorithm for real-time fault detection and identification of industrial plants. Our proposal is based on the analysis of selected features using recursive density estimation and a new evolving classifier algorithm. More specifically, the proposed approach for the detection stage is based on the concept of density in the data space, which is not the same as probability density function, but is a very useful measure for abnormality/outliers detection. This density can be expressed by a Cauchy function and can be calculated recursively, which makes it memory and computational power efficient and, therefore, suitable for on-line applications. The identification/diagnosis stage is based on a self-developing (evolving) fuzzy rule-based classifier system proposed in this work, called AutoClass. An important property of AutoClass is that it can start learning from scratch". Not only do the fuzzy rules not need to be prespecified, but neither do the number of classes for AutoClass (the number may grow, with new class labels being added by the on-line learning process), in a fully unsupervised manner. In the event that an initial rule base exists, AutoClass can evolve/develop it further based on the newly arrived faulty state data. In order to validate our proposal, we present experimental results from a level control didactic process, where control and error signals are used as features for the fault detection and identification systems, but the approach is generic and the number of features can be significant due to the computationally lean methodology, since covariance or more complex calculations, as well as storage of old data, are not required. The obtained results are significantly better than the traditional approaches used for comparison

Otimização de imagens mamográficas

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)