Manejo clínico de úlceras venosas na atenção primária à saúde

OBJETIVO: Discutir o manejo clínico de úlceras venosas realizado na atenção primária à saúde, com base na visão dos usuários que convivem com esta afecção. MÉTODOS: Estudo de natureza qualitativa exploratório, descritivo, realizado com 25 usuários adultos em tratamento nas Unidades de Saúde da Família. Os dados foram coletados no segundo semestre de 2008, utilizando-se um formulário estruturado com questões de caracterização sociodemográfica, tipo de limpeza, coberturas, uso de terapia compressiva, medicamentos e orientações prescritas. RESULTADOS: São usados para a limpeza produtos que agridem o tecido de granulação, como coberturas com várias substâncias, dentre elas o óleo de girassol e pomadas antibióticas; a maioria dos usuários não utiliza medidas para controle do edema. CONCLUSÃO: fazem-se necessárias a elaboração e a adoção de protocolos clínicos para o cuidado com úlceras venosas, bem como a capacitação permanente dos profissionais de saúde.

Assessment of functional capacity of the elderly associated with the risk for pressure ulcer

OBJECTIVE: To characterize the elderly with physical limitations; to assess functional capacity as it relates to physical mobility, cognitive status and level of functional independence in activities of daily living, and to relate functional capacity to the risk for pressure ulcers. METHODS: A quantitative cross-sectional approach, conducted in households in the city of João Pessoa (PB) with seniors who presented physical limitation. Fifty-one elderly were investigated in a two-stage cluster sampling design. RESULTS: There was evidence of impairments in functional capacity of the elderly aged 80 years or more, with more severe physical limitations, cognitive impairment and a higher level of dependency for activities. Significant differences were observed between the level of functional independence in performing activities of daily living and the risk of pressure ulcers. CONCLUSION: This study allowed for the identification of the elderly in functional decline and at risk for developing pressure ulcers, supporting the implementation of preventive actions at the household level.

Composition and seasonal variation of brachyura and anomura (Crustacea, Decapoda) associated with brown mussel farms at Praia da Cocanha, Brazil

The composition and seasonal variation of brachyuran and anomuran species associated with mussel farms were evaluated at Praia da Cocanha, São Paulo between May 2007 and February 2008. Nine mussel ropes were sampled at random in each quarter, and 1,208 organisms were identified, comprising five families and 28 species. The most numerous species was the porcellanid Pachycheles laevidactylus (18.5%), followed by the xanthids Acantholobulus schmitti (16.6%), Hexapanopeus paulensis (11.3%), Panopeus americanus (10.2%), and Menippe nodifrons (8.4%). The exotic crab Charybdis hellerii was recorded throughout the study period. The ecological descriptors, except Pielou evenness index, varied significantly over the time. The highest abundance and diversity of the species were recorded during November and February. This pattern was reversed for Berger-Parker dominance, with the lowest values recorded in February. The development of epifauna was correlated with the different stages of the mussel farms, since the mean size of mussels and consequently the abundance of epibiotic organisms and the structural complexity on the mussel ropes increased from May (seeding) until February (harvest). Despite this, the temporal population variations in recruitment patterns of the different epibionts should not be overlooked. The results indicated that the mussel farms provided favorable conditions for the development of these crustacean groups, which could be used in environmental monitoring programs and / or be exploited for the aquarium trade.

Emissão de gases de efeito estufa (GEE) pela pecuária: situação e perspectivas para criação de um mercado de crédito de carbono

O mercado mundial de carbono desenvolveu-se rapidamente com a ratificação do Protocolo de Quioto, sendo considerado como base para a implantação deste mercado. O objetivo do presente estudo foi analisar a situação e perspectivas da emissão de gases de efeito estufa (GEE) pela pecuária, e a possível criação de um mercado de crédito de carbono. Pelos dados levantados, pode-se afirmar que o Brasil tem um grande potencial para a criação deste mercado, por possuir o maior rebanho bovino comercial do mundo e importante participação na emissão de GEE, principalmente o metano. Com um horizonte de crescimento para o setor, a melhora da eficiência técnica e a utilização dos preceitos de sustentabilidade são fatores importantes para quem almeja um desenvolvimento sólido e sustentável.

One-repetition maximum test and isokinetic leg extension and flexion: correlations and predicted values

The most typical maximum tests for measuring leg muscle performance are the one-repetition maximum leg press test (1RMleg) and the isokinetic knee extension/flexion (IKEF) test. Nevertheless, their inter-correlations have not been well documented, mainly the predicted values of these evaluations. This correlational and regression analysis study involved 30 healthy young males aged 18-24y, who have performed both tests. Pearson's product moment correlation between 1RMleg and IKEF varied from 0.20 to 0.69 and the more exact predicted test was to 1RMleg (R2 = 0.71). The study showed correlations between 1RMleg and IKEF although these tests are different (isotonic vs. isokinetic) and provided further support for cross determination of 1RMleg and IKEF by linear and multiple linear regression analysis.

Compressão pneumática intermitente na prevenção de trombose venosa profunda em pacientes cirúrgicos: revisão sistemática e metanálise

Introdução: Trombose Venosa Profunda (TVP) é o resultado de inúmeros fatores, incluindo estase venosa, injuria endotelial e hipercoagulação do sangue. O embolismo pulmonar é a maior complicação da TVP e ocorre quando um trombo ou um coágulo sangüíneo desloca-se em direção aos pulmões. O tromboembolismo é um sério problema de saúde e é responsável por um considerável número de mortes súbitas e por significantes custos de hospitalizações em todo o mundo. Entre os métodos profiláticos usados na prevenção da TVP, há os classificados como mecânicos e os farmacológicos. Ambos são efetivos e podem ser usados sempre que necessário, tendo sido recomendados por consenso internacional. Objetivos: Avaliar a incidência da TVP em pacientes cirúrgicos através da Compressão pneumática Intermitente CPI (coxa/perna ou perna/pé) contra nenhuma forma de profilaxia ou contra fármacos. Métodos: Revisão sistemática de ensaios clínicos randomizados, utilizando a metodologia Cochrane, através de buscas eletrônica e manual. Foram incluídos pacientes cirúrgicos, de ambos os sexos, cuja intervenção foi o uso de aparelhos de compressão pneumática intermitente. Resultados: 4269 pacientes cirúrgicos investigados por 31 ensaios submetidos a um número de intervenções cirúrgicas, incluindo cirurgia ortopédica (joelho e quadris), geral, ginecológica, urológica e neurológica. Dados combinados demonstraram efeitos de tratamento virtualmente iguais entre CPI e abordagens farmacológicas [0.95 (95%CI 0.82, 1.10)], em relação à incidência de TVP. Entretanto, o risco de hemorragia foi maior e estatisticamente significante em pacientes tratados com intervenções farmacológicas [0.37(95%CI 0.20, 0.69)]. Conclusão: Comparações entre as estratégias farmacológicas e mecânicas indicam que ambas são similares na prevenção de trombose venosa profunda. Entretantio, a evidência atual suportaria a escolha das abordagens mecâncias, uma vez que o risco de eventos hemorrágicos favorece os métodos mecânicos.

Estudio comparativo entre toracotomía axilar y videotoracoscopia en el tratamiento del neumotórax espontáneo primario

Programa de doctorado: Patología quirúrgica, Reproducción humana y Factores psicológicos y el proceso de enfermar.

Strategie di Social Media Marketing delle società sportive professionistiche: un indice di esposizione applicato ai teams NBA.

L’obiettivo di questo studio è analizzare in che misura e con quali modalità le società di un mercato ricco ed importante come quello della National Basketball Association stiano sfruttando i canali messi a disposizione dal Web 2.0 e dai cosiddetti nuovi media. Il progetto si propone quindi di rispondere ai seguenti tre quesiti di ricerca:
 1 Quali sono gli strumenti attualmente a disposizione delle società NBA per promuovere il loro “prodotto” relativamente all’utilizzo delle tecnologie del Web 2.0 e dei Social Media?
 2 Quali vantaggi e quali cambiamenti hanno portato queste nuove tecnologie nella comunicazione e nelle relazioni tra impresa sportiva ed i suoi fan?
 3 E' possibile individuare un indice di esposizione su Web e Social Media applicato ai teams NBA in grado di fornire una stima di quanto e come una società stia usando questi mezzi? Il progetto inizia con un’analisi dello stato dell’arte, partendo dal settore più generale del marketing e del management dello sport, passando per l’utilizzo dei Social Media nel settore sportivo fino a focalizzarsi sugli studi specifici relativi al mondo NBA. Successivamente lo studio segue tre fasi: una prima introduttiva dove sono descritti i principali mezzi disponibili per le società in termini di Social Media Marketing e gli effetti benefici che questi possono avere; una seconda fase in cui viene definito l’indice nei suoi diversi parametri, ed infine un’ultima fase in cui vengono raccolti i dati relativi ad un campione di squadre NBA ed analizzati per elaborare i risultati ottenuti. L’elaborazione dei risultati porta poi ad individuare trend comuni, punti di forza e debolezza ed eventuali migliorie future per le strategie delle società NBA.

High Resolution Transmission Spectroscopy as a Diagnostic for Jovian Exoplanet Atmospheres: Constraints from Theoretical Models

We present high resolution transmission spectra of giant planet atmospheres from a coupled 3-D atmospheric dynamics and transmission spectrum model that includes Doppler shifts which arise from winds and planetary motion. We model jovian planets covering more than two orders of magnitude in incident flux, corresponding to planets with 0.9 to 55 day orbital periods around solar-type stars. The results of our 3-D dynamical models reveal certain aspects of high resolution transmission spectra that are not present in simple 1-D models. We find that the hottest planets experience strong substellar to anti-stellar (SSAS) winds, resulting in transmission spectra with net blue shifts of up to 3 km s−1, whereas less irradiated planets show almost no net Doppler shifts. Compared to 1-D models, peak line strengths are significantly reduced for the hottest atmospheres owing to Doppler broadening from a combination of rotation (which is faster for close-in planets under the assumption of tidal locking) and atmospheric winds. Finally, high resolution transmission spectra may be useful in studying the atmospheres of exoplanets with optically thick clouds since line cores for very strong transitions should remain optically thick to very high altitude. High resolution transmission spectra are an excellent observational test for the validity of 3-D atmospheric dynamics models, because they provide a direct probe of wind structures and heat circulation. Ground-based exoplanet spectroscopy is currently on the verge of being able to verify some of our modeling predictions, most notably the dependence of SSAS winds on insolation. We caution that interpretation of high resolution transmission spectra based on 1-D atmospheric models may be inadequate, as 3-D atmospheric motions can produce a noticeable effect on the absorption signatures.

THE EFFECTS OF IRRADIATION ON HOT JOVIAN ATMOSPHERES: HEAT REDISTRIBUTION AND ENERGY DISSIPATION

Hot Jupiters, due to the proximity to their parent stars, are subjected to a strong irradiating flux that governs their radiative and dynamical properties. We compute a suite of three-dimensional circulation models with dual-band radiative transfer, exploring a relevant range of irradiation temperatures, both with and without temperature inversions. We find that, for irradiation temperatures T irr lsim 2000 K, heat redistribution is very efficient, producing comparable dayside and nightside fluxes. For T irr ≈ 2200-2400 K, the redistribution starts to break down, resulting in a high day-night flux contrast. Our simulations indicate that the efficiency of redistribution is primarily governed by the ratio of advective to radiative timescales. Models with temperature inversions display a higher day-night contrast due to the deposition of starlight at higher altitudes, but we find this opacity-driven effect to be secondary compared to the effects of irradiation. The hotspot offset from the substellar point is large when insolation is weak and redistribution is efficient, and decreases as redistribution breaks down. The atmospheric flow can be potentially subjected to the Kelvin-Helmholtz instability (as indicated by the Richardson number) only in the uppermost layers, with a depth that penetrates down to pressures of a few millibars at most. Shocks penetrate deeper, down to several bars in the hottest model. Ohmic dissipation generally occurs down to deeper levels than shock dissipation (to tens of bars), but the penetration depth varies with the atmospheric opacity. The total dissipated Ohmic power increases steeply with the strength of the irradiating flux and the dissipation depth recedes into the atmosphere, favoring radius inflation in the most irradiated objects. A survey of the existing data, as well as the inferences made from them, reveals that our results are broadly consistent with the observational trends.

Tratamiento de úlceras venosas de piernas : revisión bibliográfica

Fil: Vidal, Jorgelina Natalí. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatología

Hidden impacts of ocean acidification to live and dead coral framework

Cold-water corals, such as Lophelia pertusa, are key habitat-forming organisms found throughout the world's oceans to 3000 m deep. The complex three-dimensional framework made by these vulnerable marine ecosystems support high biodiversity and commercially important species. Given their importance, a key question is how both the living and the dead framework will fare under projected climate change. Here, we demonstrate that over 12 months L. pertusa can physiologically acclimate to increased CO2, showing sustained net calcification. However, their new skeletal structure changes and exhibits decreased crystallographic and molecular-scale bonding organization. Although physiological acclimatization was evident, we also demonstrate that there is a negative correlation between increasing CO2 levels and breaking strength of exposed framework (approx. 20-30% weaker after 12 months), meaning the exposed bases of reefs will be less effective 'load-bearers', and will become more susceptible to bioerosion and mechanical damage by 2100.

Magnetization reversal signatures in the magnetoresistance of magnetic multilayers

The simultaneous determination of magnetoresistance and vectorial-resolved magnetization hysteresis curves in a spin valve structure reveals distinct magnetoresistive features for different magnetic field orientations, which are directly related to the magnetization reversal processes. Measurements performed in the whole angular range demonstrate that the magnetoresistive response originates from the intrinsic anisotropic angular dependence of the magnetization orientation between the two ferromagnetic layers. This also provides direct proof that the spin-dependent scattering in the bulk of the magnetic layers is at the origin of the magnetoresistive signal.

The role of secretion systems and small molecules in soft-rot enterobacteriaceae pathogenicity

Soft-rot Enterobacteriaceae (SRE), which belong to the genera Pectobacterium and Dickeya, consist mainly of broad host-range pathogens that cause wilt, rot, and blackleg diseases on a wide range of plants. They are found in plants, insects, soil, and water in agricultural regions worldwide. SRE encode all six known protein secretion systems present in gram-negative bacteria, and these systems are involved in attacking host plants and competing bacteria. They also produce and detect multiple types of small molecules to coordinate pathogenesis, modify the plant environment, attack competing microbes, and perhaps to attract insect vectors. This review integrates new information about the role protein secretion and detection and production of ions and small molecules play in soft-rot pathogenicity.