Desmame em recém-nascidos de muito baixo peso ao nascer no primeiro retorno ambulatorial após a alta hospitalar

Investigate intrahospital and neonatal determinants associated to the weaning of very low birth weight (VLBW) infants. Methods: 119 VLBW (<1500g) infants 81 were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Results: Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB) and 66 (75%) were weaned (partial breastfeeding or formula feeding). Univariate analysis found an association between weaning and lower birth weight, longer stays in the NICU and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. Conclusion: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants

Distribuição regional da ventilação pulmonar em indivíduos com insuficiência cardíaca crônica após serem submetidos a um programa de treinamento da musculatura inspiratória e sua correlação com dados funcionais

Introduction: Chagas Disease is a serious public health problem, with 5 million infected individuals in Brazil. Of these, approximately 30% develop chronic Chagas cardiomyopathy (CCC), where the main symptoms are fatigue and dyspnea. Objective: To correlate maximal exercise capacity with pulmonary function, inspiratory muscle strength and quality of life in patients with CCC. Methodology: Twelve individuals suffering from CCC were evaluated (7 men), with a mean age of 54.91± 8.60 years and the following inclusion criteria: functional class II and III according to the New York Heart Association (NYHA); left ventricle ejection fraction below 45%; clinical stability (> 3 months); symptom duration > 1 year, body mass index (BMI) < 35Kg/m2 and non-smokers or ex-smokers with a history of smoking <10 packs/day. All subjects were submitted to spirometry, manometer testing, maximal cardiopulmonary exercise testing (CPX) and a quality of life questionnaire (Minnesota). Results: A negative correlation was observed between VO2máx and MLHFQ scores (r=-0.626; p=0.03) and a positive association with MIP (r=0.713; p=0.009). Positive correlations were also recorded between MIP and spirometric variables [FEV1(r=0.825;p=0.001 ), FVC(r=0.66;p=0.01 and FEF25-75%(r=0.639;p=0.02)]. Conclusion: The present study demonstrated that in patients with CCC: VO2MAX is directly related to inspiratory muscle strength and quality of life, while deteriorating lung function is directly associated with respiratory muscle weakness

Análise da variabilidade da frequência cardíaca na síndrome dos ovários policísticos

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Análise cintilográfica da deposição pulmonar de radioaerossol após associação da nebulização através dos dispositivos mesh e jato com a ventilação não invasiva em indivíduos normais e com pneumopatias obstrutivas crônicas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Tratamento de fístulas enterocutâneas através de sistema a vácuo com alta pressão e dieta oral normal

Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/mortality, and increase in hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. Normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after five days, 16(22%) after 10 days and 4(5%) after 15 days. Treatment failed in 6(8%) patients, who subsequently underwent surgery. Only one patient with low-output did not close her fistula. The cost of the treatment was US$ 41.75/day and it was considered cost effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns

Freqüência e etiologia das dermatomicoses em pacientes atendidos no Hospital Giselda Trigueiro, Natal, RN

Dermatomycoses are fungal infections that attack the skin, hair and nails, in addition to the mucosal and cutaneous-mucosal zones. Objective: Observe the frequency of dermatomycoses, identify etiological agents and establish an association between the results and sex. Age, collection site, time and lesion location. Methods: Between February, 2002 and December, 2004, samples were collected from patients at Giselda Trigueiro Hospital in Natal, Brazil, by lesion scraping and hair removal, following 70% alcohol disinfection, and submitted to direct and culture examination. Results: Of the 817 lesions collected, 325 (39.8%) were fungus positive, with the hair collection site yielding the highest number of positive results (65.8%) and the scalp and hair representing the most frequent lesion sites (65.9%). Negative results occurred mainly in the lower limbs (78.6%). Of the species identified, 55.9% were yeasts, 41.6% dermatophytes and 2.5% Fusarium spp. Non-albicans Candida was the most isolated yeast (43.3%), mainly in females (61.7%) over the age of 40 years (56.4%). T. rubrum was the most isolated dermatophyte (67.9%),notably in males (59.2%) in the 0-20 age group (44.7%). With respect to collection site, 73.9% of the dermatophytes were present in the skin and 61.1% of the yeasts in the nails. When assessing the collection site, the inguinocrural regional was 22.6% positive for dermatophytes, and the nails and hands, 41.8% for yeasts. Conclusions: The results obtained verified that: most of the positive lesions were found in the hair, whereas skin and nail lesions yielded more negative results; T. rubrum was the most isolated dermatophyte and non-albicans candida the most commonly found yeast; positivity was greater in males in the 0-20 year age group at the skin site and in the inguinocrural region, while yeasts were more frequent in females in the over-40 age group at the nail sites

Análise das mutações C282Y e H63D no gene da proteína HFE em pacientes com hiperferritinemia

Hereditary Hemochromatosis (HH) is a genetic disease caused by high iron absorption and deposition in several organs. This accumulation results in clinical disturbances such as cirrhosis, arthritis, cardiopathies, diabetes, sexual disorders and skin darkening. The H63D and C282Y mutations are well defined in the hemochromatosis etiology. The aim of this paper was that of identifying the H63D and C282Y genetical mutations in the hemochromatosis gene and the frequency assessment of these mutations in the HFE protein gene in patients with hyperferritin which are sent to the DNA Center laboratory in Natal, state of Rio Grande do Norte. This paper also evaluates the HH H63D and C282Y gene mutations genotype correlation with the serum ferritin concentration, glucose, alanine aminotransferasis, aspartato aminotransferasis, gama glutamil transferasis and with the clinical complications and also the interrelation with life habits including alcoholism and iron overload. The biochemical dosages and molecule analyses are done respectively by the enzymatic method and PCR with enzymatic restriction. Out of the 183 patients investigated, 51,4% showed no mutation and 48,6% showed some type of mutation: 5,0% were C282Y heterozygous mutation; 1,1%, C282Y homozygous mutation; 31%, H63D heterozygous mutation; 8,7%, H63D homozygous mutation; and 3,3%, heterozygous for the mutation in both genes. As to gender, we observed a greater percentage of cases with molecular alteration in men in relation to women in the two evaluated mutations. The individuals with negative results showed clinical and lab signs which indicate hemochromatosis that other genes could be involved in the iron metabolism. Due to the high prevalence of hemochromatosis and taking into account that hemochromatosis is considered a public health matter, its gravity being preventable and the loss treatment toxicity, the early genetic diagnosis is indicated, especially in patients with high ferritin, and this way it avoids serious clinical manifestations and increases patients' life expectation. Our findings show the importance of doing such genetic studies in individuals suspected of hereditary hemochromatosis due to the high incidence of such a hereditary disease in our region

Desenvolvimento e validação de método analítico para determinação de teor de ácido gálico e catequina no fitoterápico sanativo® por cromatografia líquida de alta eficiência

The herbal medicine Sanativo® is produced by the Pernambucano Laboratory since 1888 with indications of healing and hemostasis. It is composed of a fluid extract about Piptadenia colubrina, Schinus terebinthifolius, Cereus peruvianus and Physalis angulata. Among the plants in their composition, S. terebinthifolius and P. colubrina have in common phenolic compounds which are assigned most of its pharmacological effects. The tannins, gallic acid and catechin were selected as markers for quality control. The aim of this study was the development and validation of analytical method by HPLC/UV/DAD for the separation and simultaneous quantification of gallic acid (GAC) and catechin (CTQ) in Sanativo®. The chromatographic system was to stationary phase, C-18 RP column, 4,6 x 150 mm (5 mm) under a temperature of 35 ° C, detection at 270 and 210 nm. The mobile phase consisted of 0.05% trifluoroacetic acid and methanol in the proportions 88:12 (v/v), a flow rate of 1 ml/min. The analytical method presented a retention factor of 0.30 and 1.36, tail factor of 1.8 and 1.63 for gallic acid and catechin, respectively, resolution of 18.2, and theoretical plates above 2000. The method validation parameters met the requirements of Resolution n º 899 of May 29, 2003, ANVISA. The correlation coefficient of linear regression analysis for GAC and CTQ from the standard solution was 0.9958 and 0.9973 and when performed from the Sanativo® 0.9973 and 0.9936, the matrix does not interfere in the range 70 to 110 %. The limits of detection and quantification for GAC and CQT were 3.25 and 0.863, and 9.57 and 2.55 mg/mL, respectively. The markers, GAC and CQT, showed repetibility (coefficient of variation of 0.94 % and 2.36 %) and satisfactory recovery (100.02 ± 1.11 % and 101.32 ± 1.36 %). The method has been characterized selective and robust quantification of GAC and CTQ in the Sanativo® and was considered validated

Nanopartíulas de magnetita com oxacilina obtida por moagem de alta energia para aplicações biomédicas

The drug targeting has been the subject of extensive studies in order to develop site-specific treatments that minimize side effects and become more effective anticancer therapy. Despite considerable interest in this class, drugs like antibiotics also have limitations, and have been neglected. Using new pharmaceutical technologies, the use of magnetic vectors appear as promising candidate for drug delivery systems in several studies. Small magnetic particles bound to the drug of interest can be modulated according to the orientation of a magnet outside the body, locating and holding in a specific site. In this work, we propose the use of High Energy Milling (HEM) for synthesis of a magnetic vector with characteristics suitable for biomedical applications by intravenous administration, and for the formation of an oxacillin-carrier complex to obtain a system for treating infections caused by Staphylococcus aureus. The results of the variation of milling time showed that the size and structural properties of the formed material change with increasing milling time, and in 60 hours we found the sample closest to the ideal conditions of the material. The vector-drug system was studied in terms of structural stability and antimicrobial activity after the milling process, which revealed the integrity of the oxacillin molecule and its bactericidal action on cultures of Staphylococcus aureus ATCC

Visões da cidade : da cidade histórica aos bairros da Cidade Alta e Ribeira em Natal-RN

The present work is an initiative of undertaking a perspective that values the aspects of the city in its diversity. The one that t intends is to discuss the urbanity starting from the aspect of the image, of the history, and about main point, to value the point of the individual's view that lives the urban space in its more several configurations: the house, the street, the neighborhood, and the city in wider scale. The described historical research defines the city as space of the human accomplishments. When analyzing the moments of the most recent history of the urban life the modernity/post-modernity notions they are explored in the sense of illuminating the wealth, continuity and it breaks of patterns of behavior, and on the other hand, to describe a I overfly in the several times of the city. The prominences of aspects of the archaeology and of the descriptive resource they are related, for its time, the most punctual perspective of the practical research, the instance of the neighborhood, specifically High City and Riverside, configuring an immersion in the daily more punctual of the city, valuing forms of being, aiming the perspective of the personal computer as point-of-view. The images of the city assume the paper of representing the documental about the current features of the urbanity. It is without a doubt that at the present time the photographic image already possesses a paper of prominence it is as research instrument, be as main source for a work on files of photos. The photographic images in the present work possess a prominence place, focusing specific places of the city in the time. Finally, the individual's voice valued under the perspective on as the person's knowledge that inhabits and live the urbanity he/she understands the knowledge of the life in the city and, more than in any other place, a middle where the loss of action models is pointed very easily tends in view the dynamic movement of the practices and renewal of new indications; in the same space in that becomes urgent to build marks starting from which the individual can shimmer the future. And in that space the individual's voice is valued as rich source of information on living the scenery of conflicts of the present time

Aqui, todo mundo é da mesma família : parentesco e relações étnicas entre os ciganos na cidade alta, Limoeiro do Norte CE

This study aims to understand how facing a context of Constant interaction whit the local population, the gypsies family Alves dos Santos, neighborhood residentes in uptown, Limoeiro do Norte Ce, maintain a sense of ethnic belonging. To that end, I analyze both the social relations between Gypsies and non-gypsies community, as it is from the contact that the social boundaries are delineated, as the discourses and social representations that are used to qualify them from stigma. So, I found that grounded in the notion of family, gypsies are seen as a group, searching the history / past nomadic origing and blood common elements that underlie its condition, and the language a cultural trait that makes it possible to establish objective distinctions among gypsies and other community residentes, becoming thus a diacritical mark.

Diferentes frações inspiradas de oxigênio em coelhos hipovolêmicos anestesiados com propofol e submetidos à ventilação mecânica

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeitos do enriquecimento com nutrientes (N e P) em diferentes condições de luz sobre o crescimento do fitoplâncton em um reservatório eutrófico no semi-árido brasileiro

The increasing of pollution in aquatic ecosystems in the last decades has caused an expansion of eutrophication and loss of water quality for human consumption. The increase of frequency and intensity of cyanobacteria blooms have been recognized as a major problem connected to water quality and eutrophication. The knowledge of environmental factors controlling these blooms is a key step towards the management for recovering aquatic ecosystems from eutrophic conditions. Primary productivity in aquatic ecosystems is dependent on light and nutrients availability. In the present work we evaluated the relative importance of the concentration of major nutrients, such as phosphorus and nitrogen, and light for phytoplankton growth in the main water reservoir of Rio Grande do Norte State, named Engenheiro Armando Ribeiro Gonçalves (EARG), which is an eutrophic system, dominated by potentially toxic cyanobacteria populations. Limitation of phytoplankton growth was evaluated through bioassays using differential enrichment of nutrients (N and/or P) under two light conditions (low light and high light) and monthly monitoring of chlorophyll-a and nutrients (total nitrogen and phosphorus) concentrations, and water transparency (Secchi depth) at the pelagic region. Our results confirm that EARG reservoir is an eutrophic system with a low water quality. Results of bioassays on the growth of phytoplankton limitation (N or P) were conflicting with the results predicted by the TN:TP ratios, which indicates that these ratios were not a good indicator of algal growth limitation. Nitrogen was the limiting nutrient, considering both frequency and magnitude. Light and hidrology affected phytoplankton response to nutrient enrichment. The extreme eutrophic conditions of this reservoir, dominated by cyanobacteria blooms, demand urgent managing strategies in order to guarantee the multiple uses for this system, including water supply for human population. Although nitrogen is the limiting nutrient, an effective management program must focus on the reduction of both phosphorus and nitrogen input

Análise dos remanescentes de mata atlântica do Estado do Rio Grande do Norte : uma perspectiva em alta resolução

The habitat loss and fragmentation are considered the main threats to the biodiversity. These threats operate at the landscape level, which drives the need to manage entire landscapes, not just its components. Although systematic monitoring of the Atlantic Forest biome has been ongoing since the late eighties, current data on forest fragmentation for the sub-region of Pernambuco are practically nonexistent. This study aimed to map out, with high spatial resolution, the remnants of Atlantic forest in Rio Grande do Norte, and conduct a landscape level analysis. The results show that the landscape is highly fragmented, where about 13.6% to 17% of biome remains. Most of the fragments is less than 10 ha, while a few fragments have area larger than 100 ha. Although the high degree of fragmentation, the average distance between fragments found was small (128 m), this estimate is lower than has been observed for the biome (1440m). There is evidence that abrupt changes in the quantification of landscape structure can occur when one observes the fragmentation at high spatial resolution. The results presented here can be used in management actions, in order to make the scenario more conducive to maintaining biodiversity.

Freqüência da fertirrigação da bananeira prata-anã com nitrogênio e potássio aplicados por microaspersão

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)