A double-blind, randomized, controlled crossover trial of glutamine supplementation in home parenteral nutrition

Objective: Studies suggest clinical benefit of glutamine-supplemented parenteral nutrition. The aim was to determine if the inclusion of 10 g of glutamine as part of the nitrogen source of home parenteral nutrition (HPN) reduces infectious complications. Subjects/Methods: Thirty-five patients on HPN were recruited and 22 completed the study. Patients were randomized to receive either standard HPN or glutamine-supplemented HPN. Patients were assessed at randomization, 3 and 6 months later then they were crossed over to the alternative HPN and reassessed at 3 and 6 months. Assessments included plasma amino acid concentrations, intestinal permeability and absorption, nutritional status, oral and parenteral intake, quality of life, routine biochemistry and haematology. Results: No difference was seen between the groups at randomization. No difference was detected between the treatment phases for infective complications (55% in the standard treatment phase and 36% in the glutamine-supplemented phase P 0.67). There were no differences in nutritional status, intestinal permeability, plasma glutamine concentrations or quality of life. Conclusion: Although limited by the sample size, the study has shown that glutamine as part of the nitrogen source of parenteral nutrition can be given to patients on HPN for 6 months without any adverse effects.

Schistosoma mansoni: In vitro schistosomicidal activity of piplartine

Schistosomiasis is one of the world`s greatly neglected tropical diseases, and its control is largely dependent on a single drug, praziquantel. Here, we report the in vitro effect of piplartine, an amide isolated from Piper tuberculatum (Piperaceae), on Schistosoma mansoni adult worms. A piplartine concentration of 15.8 mu M reduced the motor activity of worms and caused their death within 24 h in a RPMI 1640 medium. Similarly, the highest sub-lethal concentration of piplartine (6.3 mu M) caused a 75% reduction in egg production in spite of coupling. Additionally, piplartine induced morphological changes on the tegument, and a quantitative analysis carried out by confocal microscopy revealed an extensive tegumental destruction and damage in the tubercles. This damage was dose-dependent in the range of 15.8-630.2 mu M. At doses higher than 157.6 mu M, piplartine induced morphological changes in the oral and ventral sucker regions of the worms. It is the first time that the schistosomicidal activity has been reported for piplartine. Published by Elsevier Inc.

Las actividades comunicativas en los materiales didácticos

The ability to communicate orally in a foreign language is fundamental and highly evaluated by both students and teachers. Therefore it is important that educational materials can provide communicative activities that improve this ability. A study of educational materials for young French learners revealed that the activities aimed to practice oral communication in fact were not really communicative. This investigation analyzes three educational materials for beginners in Spanish. The purpose is to see which kinds of activities the materials can offer for practice of oral and interactive communication, to compare them with educational theories and the Swedish curriculum and to detect similarities with the former study. The results show that the majority of the activities used in the materials, are not really communicative, they are mostly based on prepared phrases and there are few possibilities for creativity.

Fahrenheit 451, de Ray Bradbury e de François Truffaut : da alienação pós-moderna à oralidade homérica

Este trabalho analisa o Fahrenheit 451 de Ray Bradbury e o de François Truffaut, em sua proposição de utilizar a oralidade (discurso oral) como forma de manutenção do literário e resistência à imposição e à censura ideológica. Efetua também uma análise comparatista das Utopias Negativas do século XX (obras Distópicas). Ao longo deste projeto, é feita uma análise do surgimento da escrita (alfabético-fonética), e sua estreita relação com o discurso oral. Tenta-se reproduzir a trajetória traçada pelo discurso oral, passando pelo desenvolvimento da tecnologia escrita, assim como a produção cultural tanto no meio oral quanto no escrito, junto com suas conseqüências e influências sobre pensamento humano. Da oralidade dos poemas homéricos à oralidade advinda com o desenvolvimento de aparelhos eletrônicos como o telefone, que, em plena modernidade, voltam a valorizar o discurso oral. Neste projeto a oralidade é vista como algo cíclico.

O desenvolvimento verbal e motor da criança institucionalizada e posteriormente adotada

O presente estudo visa a levantar alguns aspectos relevantes relacionados com o estudo de carência da criança institucionalizada. Pretende-se ensaiar uma avaliação do atraso verbal e motor que tal situação acarreta, bem como da recuperação correspondente que a adoção permite. A escassez de tentativas congêneres em nosso meio, visando a trazer à luz dados de realidade sobre este campo, foi o suporte que originou e motivou o presente trabalho. Para esse fim, procedeu-se preliminarmente a uma revisão à literatura, objetivando fundamentar no plano teórico o trabalho não só à luz da psicologia do desenvo1vimento, bem como a luz da legislação relativa à adoção. Realizou-se um estudo exploratório formulando-se o testando-se hipóteses operacionais extraídas da hipótese geral, de haver diferença significativa, em termos do atraso motor e verbal no desenvolvimento e na recuperação motora e verbal em relação a idade inicial e final, bem como a duração da permanência, da criança institucionalizada e posteriormente adotada. As hipóteses foram testadas em termos estatísticos, através do coeficiente de correlação de Pearson adotando um nível de significância de 0,05 para rejeição da hipótese nula.

Câncer de boca e orofaringe: tendências e análise de sobrevida em Natal (RN)

Introduction: Mouth cancer is classified as having one of the ten highest cancer incidences in the world. In Brazil, the incidence and mortality rates of oral cancer are among the highest in the world. Intraoral cancer (tongue, gum, floor of the mouth, and other non-specified parts of the mouth), the accumulated survival rate after five years is less than 50%. Objectives: Estimate the accumulated survival probability after five years and adjust the Cox regression model for mouth and oropharyngeal cancers, according to age range, sex, morphology, and location, for the city of Natal. Describe the mortality and incidence coefficients of oral and oropharyngeal cancer and their tendencies in the city of Natal, between 1980 and 2001 and between 1997 and 2001, respectively. Methods: Survival data of patients registered between 1997 and 2001 was obtained from the Population-based Cancer Record of Natal. Differences between the survival curves were tested using the log-rank test. The Cox proportional risk model was used to estimate risk ratios. The simple linear regression model was used for tendency analyses of the mortality and incidence coefficients. Results: The probability after five years was 22.9%. The patients with undifferentiated malignant neoplasia were 4.7 times more at risk of dying than those with epidermoid carcinoma, whereas the patients with oropharyngeal cancer had 2.0 times more at risk of dying than those with mouth cancer. The mouth cancer mortality and incidence coefficients for Natal were 4.3 and 2.9 per 100 000 inhabitants, respectively. The oropharyngeal cancer mortality and incidence coefficients were, respectively, 1.1 and 0.7 per 100 000 87 inhabitants. Conclusions: A low survival rate after five years was identified. Patients with oropharyngeal cancer had a greater risk of dying, independent of the factors considered in this study. Also independent of other factors, undifferentiated malignant neoplasia posed a greater risk of death. The magnitudes of the incidence coefficients found are not considered elevated, whereas the magnitudes of the mortality coefficients are high

Estudo de polimorfismos em genes relacionados ao metabolismo do ácido fólico e sua associação com o desenvolvimento de fendas orais não-sindrômicas

The congenital facial clefts are characterized by incomplete formation of the structures that separate the oral and nasal cavity. It is known that several environmental and genetic factors are involved in its development, among these, polymorphisms associated with folic acid metabolism have been investigated. In this sense, the objective was to observe the frequency of polymorphisms C677T and A1298C methylenetetrahydrofolate reductase gene (MTHFR), methionine synthase A2756G of (MTR), A66G of methionine synthase reductase (MTRR) A80G and the reduced folate carrier (RFC1) in patients with non-syndromic oral clefts, trying to match them with their development. Methods: We studied 140 patients with non-syndromic oral clefts and their mothers and 175 control subjects with their mothers, who underwent a questionnaire to obtain family information. Were collecting blood for DNA extraction from patients and their mothers to identify the genotypes of both by PCRRFLP, in addition to carrying out the determination of glucose, AST, ALT and serum creatinine, folic acid and vitamin B12 Serum and plasma homocysteine, and the hemogram. Results: Most patients have cleft lip and palate (55.8%), followed by isolated cleft palate (24.2%) and cleft lip (20%). Regarding gender, 62% of patients were male and 48% female and, after subdivision of the type of screwdriver according to sex was found a prevalence of males in the cracks of the type lip and palate (69 %) and lip (69.2%) and in the case of cleft palate was a female predominance (59%). The average concentration of serum folate in the group of mothers of cleft patients was significantly lower (13.8 ± 2.4 ng / mL) compared with the group of mothers of control subjects (18.8 ± 3.4 ng / mL) This was also observed for the group of cleft children as compared to controls, the dosage of folic acid had a significant difference with values of 15.6 ± 0.6 (ng / mL) and 17.9 ± 0.6 (ng / mL), respectively. For the biochemical measurements of glucose, AST, ALT and creatinine were not statistically different, nor was observed for haematological parameters performed. In assessing the frequency of polymorphisms C677T and A1298C MTHFR, A2756G MTR, MTRR A66G and A80G of the RFC1 there was no statistically significant difference in genotype distribution between cases and controls both for mothers and in the cleft. Conclusion: Although not observed association of polymorphisms with the development of cracks, the decrease in serum folate in the group of cleft patients and their mothers may reflect a disturbance in the metabolism of this metabolite, necessitating further studies such as studies methylation and expression to further elucidate the involvement of folate in the development of oral clefts

Histórias e relatos sobre Pipa: a praia internacional do Rio Grande do Norte

The overwhelming gear that boosted tourism as the main economic activity of Pipa a district formerly agricultural and fishery, that belongs to the municipality of Tibau do Sul/RN produced significant changes in the social, economic and cultural rights of the native population of the place where social relations were narrow and justified in some cases, the line of kinship in an environment where all residents knew each other. However, we can not observe the emergence of this activity just as voracious disarticulator of old local forms of sociability that in a linear process, destroys the old, replacing it with the new. New compositions are generated by merging elements of past and present. Overcoming opposition to simplistic positive or negative impacts of tourism sought especially in this dissertation, review the history of Pipa (told in narrative form), showing how slowly this district has become a major international tourist destination and how its residents were being swallowed by the "whirlwind" that led to this reality. The research used qualitative methodology and was based on photographic, literature and survey, observation, experience, oral and written reports acquired in the field. We conducted in-depth interviews (oral history) with subjects that are the living memory of the place local residents (mostly natives). We found that before the process of "modernization" resulting from the pressure of globalization itself and the capital investment in tourism resulting from the native population is not passive. On the contrary, natives resist, creating mechanisms of material and symbolic reformulations. The present moment is always dynamic. Because of that, the identity of a place is not the crystallization of its past. Many landscapes still reveal materialities of yesteryear, such as registration of social practices in the construction of the place

Devido processo penal: uma análise acerca dos direitos fundamentais sob a perspectiva do processo eletrônico

The current study presents an analysis about the automation of the lawsuits in Brazil, which opens a new direction to be followed by the National Secretary of Justice, applied indistinctively to the civil, criminal and labor lawsuits, as well as to the special court houses at any degree of juridisdiction. It treats, specifically, about the transition from the classic lawsuit with bureaucratic aspects to the electronic one, based on the simplicity of the functions, the quality of the oral and the readiness. The light of the constitutional principle of the reasonable duration of the lawsuit, while fundamental rigth of the defendant and, under de protection of the democratic guarantee, it investigates, from the theory of the fundamental rights to the reform movement of the lawsiut, in the scenery of the alien law and national law, the latter, mostly because it has the automation as a necessary improvement claimed by modernity, yet without forgetting of the humane character inherent to the criminal lawsuit. It faces the issue of of the disruption of the paradigm of the written formality of the Brazilian lawsuit, the problem of the resistance to the new automized method, the use of the video conference for the inquest of the witnesses as well as for the questioning of the defendant, the advancements of the virtual lawsuit on the Superior Courts, Federal Supreme Court and Superior Court of Justice, it treats also about the role of the National Council of Justice - CNJ - to uniformize the legal proceedings in the country. Without neglecting the effective respect to the fundamental rights, it focuses the cultural change necessary so that the electronic technology can be, in fact, in the indictment system, the means to reach with excellency the citizenship by the simplification of the legal proceedings, transposing the baseless bureaucracy and assuring an effective judicial service assistance in order to have a better quality of life

A história escolar e a teoria da atividade: relações e possibilidades formativas no ensinar e aprender

This study investigates the manner in which the Activity Theory by Alexei Nikolaevich Leontiev contributed to the performance of a teacher who teaches History at the 8th year of elementary school, Escola Estadual Coronel Fernandes, in Luís Gomes - RN city. Her goal is to analyze the contributions of this theory in her teaching practice. It was opted by collaborative approach as formative strategy and was used as procedures for training of knowing the courses of study and thoughtful reflection sessions. It was used as techniques in the development of these cycles, the semistructured interview and the reflection sessions, the autoscopy and observation in real life. Regarding the theoretical foundation, held in these cycles, the teacher demonstrated to have appropriated some contributions from Activity Theory, besides relating them to her practice and understanding her importance to the improvement of teaching and learning of History. Concerning to the reflection sessions, the analysis showed that the participant has used of constructions of this theory and improved their practice, developing lessons of History so as to encourage student participation in oral and promote his integral development. The educational process, carried out on the practice of teacher, has shown an increase in her conscious learning that contributed to the improvement in their professional development. Before these findings, as needs for new thinking, this research recommends, especially the organization of teaching activities, based on this theory, which allows the teacher to improve the teaching and learning process contributing to student's full education

Objetivos e conteúdos no ensino de física para adultos: um estudo de caso

The dissertation presents the learning, production and results of a study with a group of adult students of a high school level class in a night time public school at the Zona Oeste district of Natal-RN. As a teacher of Physics of these adult students, whose age is between 17 and 65 years, we felt the need to deepen our knowledge about the specifics of these students and build ways of teaching which would lead to a more significant educational process beside them. Among these ways of teaching, we emphasize, first, the performance of an extra-class activity that triggered the students' oral narratives about their life stories. Such narratives have led us to prioritize, as goals of teaching: socialization and the rescue of the search for a permanent learning, self-esteem and skills development to promote the exercise of autonomy. The students' previous contacts with the country life showed to be extremely significant for their memories and motives, suggesting the theme "Nature" to be adopted as a matrix for generative themes to be adopted during the teaching and learning moments with them. Considering these results, we construct a teaching proposal for continued work with the class, with which we chose the "Climate" as a guiding theme of this proposal, here presented and analyzed. In addition to a movement between problematizations developed in a thematic framework - through the initial questions of the students -, and those in a more conceptual approach - that we induced -, we have adopted as central methodological aspect the use of oral and written language, both as an exercise of dialogue, Freire's perspective, such as a structural element of cognitive processes, the perspectives of Vygotsky and Bakhtin. The development of the proposal was registered by audio and teacher and students´ regular written records, for 1 month and a half. As positive outcomes of the proposal, we emphasize the changing attitudes of students, showing a significant increase of their initiative in participating of the classes, besides a creative and critical use of arguments during the situations studied

As construções adverbiais em mente: análise funcionalista e implicações para o ensino de língua materna

This research aims at investigating the constructions with adverbials in ly, based on the view of contemporaneous linguistic functionalism, such as proposed by Givón, Hopper, Thompson, Traugott, Furtado da Cunha, as well as the cognitivist notion of language, through construction grammar support upon the patterns of Goldberg and the prototypes theory. The cognitive functional approach adopted here considers the change as a proper and inherent phenomenon of language and understands the linguistic phenomenon as resulting from effective use of language. Another aspect to be considered to the realization of this study is the fact that the formation adjective + ly is a word construction mechanism really productive, which generates interests on linguistic description. In a particular way, our leading objective is to exam the constructions with adverbials in ly in the context of language in use, in its oral and written forms, looking for to apprehend the meaning multiple manifestations forged in the use. Bearing this in mind, we worked with data from the Corpus Discurso & Gramática (Natal). There are, in the data, adverbs ended in ly that take the signification of mode, as foreseen in traditional models, but there are also other significations, for instance, the modalizador in its different manifestations. The results show that this adverb is a linguistic mark that carries in its constitution the multissêmico and multifunctional character, which interferes extremely in the ordination of this category, assuming a position sometimes pre-verbal, sometimes post-verbal. Other aspect observed refers to the relationship between the adverb and the verb, with emphasis on the compatibility or restriction between them, option which is related to the semantic aspect. The data in analysis legitimate the use in different constructions with adverb ended in ly in various genres, as follows: personal experience narrative, retold narrative, local description, proceeding account, opinion account, both in oral as in written language

A aula de português no ensino médio: o ensino que se deseja, o ensino que se faz

Settled within the realm of a problematization towards teaching and learning the Portuguese language, this study aims to investigate the way how the Portuguese Language discipline is dealt with in Secondary School. We propose specifically to analyze the orientations of the official documents concerning the educator practice, examining the way the PCNEM proposal is approached in the didactic book, identifying the treatment given to language questions, analyzing the way the teacher uses the didactic book and verifying the relations between the official approach and the pedagogical practice. The analysis takes into account the several discourses concerning school literacy, considering the various political-educational instances which institutionalize the teaching of the mother tongue - where we locate the teaching that is wanted . In what teachers and students say in their activities and concerning them - the realm of the teaching that is performed - we presuppose that there are signs of the principles - or conceptions - that orientate what they understand by language, teaching and learning. Such evidences are considered within the interrelation of the enunciative places where this literacy is promoted: the public policies concerning education - focusing the language questions - the academic researches about those questions, the educator formation and capacitation and the very school practices in the complexity of their discoursive inter-subjectivity. The principles - or conceptions - are pursued in what is said (or not) about what is done (or not) in the classroom when dealing with the Portuguese Language. The corpus is made up of oral and written texts produced in Portuguese classes in the Secondary School at a public school in the city of Natal, Rio Grande do Norte, Brazil. Situated in the realm of Applied Linguistics, the research is conducted in a qualitative and interpretative perspective, following the ethnography of communication procedures and the contributions of the Functional Linguistics. In the observations, language conceptions were discerned, among others, besides beliefs and representations where the theoretical and practical aspects, professional roles, expectations and uncertainties were diluted.

Marcadores da organização do padrão discursivo narrativo: uma abordagem funcional centrada no uso

This thesis has as its object the Markers Organization Standard Narrative Discourse (MON), from its occurrence in oral and written corpora of different realizations of narrative discourse, considering its locus of occurrence in the narrative and discursive functioning. The research is guided by the Functional Linguistic Usage-Based, approach to which the organization of language is directly linked to the user experience, so that grammar is shaped by discourse. We examined only the narrative portions of Experience Reports, Tales and Legends in the oral and written, as follows: 3 inquiries Corpus Reports Remaining Quilombo (RN); 11 Corpus Legends legends of the Amazon, 14 Tales of Corpus Tales Brazilians and 21 Reports of experiences of Corpus and Discourse Grammar, with about 10,000 words in each corpus. A total of 22 markers were identified, which were: (1) classified according to the locus of occurrence in the narrative structure, as Labov (1972), (2) associated, according to the type of pattern that occur in narrative discourse, (3) described from the discursive function they perform. The research has relevance to the extent it is based speech analysis and offers proposals for productive teaching of mother tongue in which students and teachers can, grounded in language studies, consider living language, as an object of study, based on the National Curriculum Guidelines (OCN) and making use of New Technologies of Information and Communication (NTIC)

Treinamento muscular inspiratório para asma: revisão sistemática com metanálise

In asthmatic, the lung hyperinflation leaves the inspiratory muscle at a suboptimal position in length-tension relationship, reducing the capacity of to generate tension. The increase in transversal section area of the inspiratory muscles could reverse or delay the deterioration of inspiratory muscle function. Objective: To evaluate the evidence for the efficacy of inspiratory muscle training (IMT) with an external resistive device in patients with asthma. Methods: A systematic review with meta-analysis was carried out. The sources researched were the Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov and reference lists of articles. All databases were searched from their inception up to November 2012 and there was no restriction on the language of publication. Randomised controlled trials that involved the use of an external inspiratory muscle training device versus a control (sham or no inspiratory training device) were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated risk of bias in studies and extracted data. Results: A total of five studies involving 113 asthmatic patients were included. Three clinical trials were produced by the same group. The included studies showed a significant increase in maximal inspiratory pressure (MD 13.34 cmH2O, 95% CI 4.70 to 21.98), although the confidence intervals were wide. There was no statistically significant difference between the IMT group and the control group for maximal expiratory pressure, peak expiratory flow rate, forced expiratory volume in one second, forced vital capacity, sensation of dyspnea and use of beta2-agonist. There were no studies describing exacerbation events that required a course of oral and inhaled corticosteroids or emergency department visits, inspiratory muscle endurance, hospital admissions and days of work or school. Conclusions: There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma, once the evidence was limited by the small number of studies included, number of participants in them together with the risk of bias. More well conducted randomized controlled trials are needed, such trials should investigate respiratory muscle strength, exacerbation rate, lung function, symptoms, hospital admissions, use of medications and days off work or school. IMT should also be assessed in the context of more severe asthma