Incidência e fatores de risco da retinopatia diabética em pacientes do Hospital Universitário Onofre Lopes, Natal-RN

Estudar a incidência e fatores de risco (tempo de doença e presença de hipertensão arterial sistêmica) para retinopatia diabética em 1002 pacientes encaminhados pelo Programa de Diabetes do Hospital Universitário Onofre Lopes no período de 1992 – 1995. Métodos: Estudo retrospectivo de pacientes com diagnóstico de diabetes mellitus encaminhados ao Setor de Retina do Departamento de Oftalmologia pelo Programa de Diabetes do Hospital Universitário e submetido, sob a supervisão do autor, a exame oftalmológico, incluindo medida da acuidade visual corrigida (tabela de Snellen), biomicroscopia do segmento anterior e posterior, tonometria de aplanação e oftalmoscopia binocular indireta sob midríase(tropicamida 1% + fenilefrina 10%). Foi realizada análise dos prontuários referente ao tempo de doenças e diagnostico clínico de hipertensão arterial sistêmica. Resultados: Dos 1002 diabéticos examinados (em 24 deles a fundoscopia foi inviável), 978 foram separados em 4 grupos: sem retinopatia diabética (SRD), 675 casos (69,01%); com retinopatia diabética não proliferativa (RDNP), 207 casos (21,16%); com retinopatia diabética proliferativa (RDP), 70 casos (7,15%); e pacientes já fotocoagulados (JFC), 26 casos (2,65%). Do total, 291 eram do sexo masculino (29%) e 711 do sexo feminino (71%). Os 4 grupos foram ainda avaliados quanto ao sexo, a faixa etária, a acuidade visual, tempo de doença, presença de catarata e hipertensão arterial sistêmica e comparados entre si. Com relação ao tipo de diabetes, 95 eram do tipo I (9,4%), 870 pacientes eram do tipo II (86,8%), e em 37 casos(3,7%) o tipo de diabetes não foi determinado. Conclusões: Comprovou-se que os pacientes com maior tempo de doença tinham maior probabilidade de desenvolver retinopatia diabética, e que a hipertensão arterial sistêmica não constituiu fator de risco em relação à diminuição da acuidade visual nos pacientes hipertensos

Achados fundoscópicos em crianças portadoras de anemia falciforme no estado do Rio Grande do Norte

Detectar os principais achados fundoscópicos em crianças portadoras de hemoglobinopatias falciformes. Métodos: Foram estudados 26 pacientes com hemoglobinopatias falciformes, no Serviço de Oftalmologia do Hospital Universitário Onofre Lopes, Natal, RN, que foram submetidos a protocolo de pesquisa pré-estabelecido. Os resultados foram avaliados estatisticamente pelo teste qui-quadrado. Resultados: A idade média foi de 10,6 anos, com acuidade visual igual ou melhor que 20/25 na maioria, excetuando-se 3 olhos, que apresentavam outras doenças associadas. O tipo mais freqüente foi o SS com 57,7% (15/26) dos casos, seguido pelos SC e SA com 15,4% (4/26) cada, e pelo S-Thal com 11,5% (3/26). A freqüência da retinopatia por células falciformes foi maior após os 10 anos de idade, sendo mais freqüente, em valores relativos, no tipo S-Thal (100% dos casos) e, em valores absolutos, no tipo SS (9 casos). Os dois achados mais comuns foram tortuosidade venosa (12/26) e “black sunburst” (7/26). Conclusões: Observamos que a incidência de retinopatia por células falciformes aumentou após os 10 anos de idade e não evidenciamos achados da doença proliferativa. Portanto, enfatizamos a necessidade do exame oftalmológico precoce nos portadores de anemia falciforme, como forma de prevenir futuras complicações oculares

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals

Vacinação: o fazer da enfermagem e o saber das mães e/ou cuidadores

Observa-se na prática das unidades de saúde, ainda hoje, o pouco conhecimento das mães sobre o processo de vacinação e pouco envolvimento do enfermeiro nesse processo, principalmente na área de educação em saúde. O objetivo é identificar as ações de enfermagem na sala de vacina e descrever o conhecimento das mães/cuidadores acerca da vacinação infantil. Estudo exploratório-descritivo com abordagem quantitativa. A população foi composta por 43 mães e/ou cuidadores e 10 profissionais de enfermagem. Ocorreu em duas Unidades de Saúde da Família, na Zona Oeste de Natal/RN, em novembro e dezembro/2008. A maioria das mães (88,4%) conhece a importância de vacinar a crianças, embora não saibam quais as vacinas estão sendo dadas e para quais doenças são destinadas. A maioria dos profissionais prioriza mais a técnica do que a atividade educativa. Percebe-se, portanto, que há lacunas no saber das mães/cuidadores e nas ações de enfermagem que visem um trabalho promocional na sala de vacinação

Processo de implantação de um sistema integrado de gestão em uma organização pública à luz da teoria da hospitalidade :um estudo de caso

In the present time, public organizations are employing more and more solutions that uses information technology in order to ofer more transparency and better services for all citizens. Integrated Systems are IT which carry in their kernel features of integration and the use of a unique database. These systems bring several benefits and face some obstacles that make their adoption difficult. The conversion to a integrated system may take years and, thus, the study of the adoption of this IT in public sector organizations become very stimulant due to some peculiarities of this sector and the features of this technology. First of all, information about the particular integrated system in study and about its process of conversion are offered. Then, the researcher designs the configuration of the conversion process aim of this study the agents envolved and the moments and the tools used to support the process in order to elaborate the methodology of the conversion process understood as the set of procedures and tools used during all the conversion process. After this, the researcher points out, together with all the members of the conversion team, the negative and positive factors during the project. Finally, these factors were analysed through the Hospitality Theory lens which, in the researcher opinion, was very useful to understand the elements, events and moments that interfered in the project. The results consolidated empirically the Hospitality Theory presumptions, showing yet a limitation of this theory in the case in study

Modos projetuais de simulação: uso de ferramentas de simulação térmica no processo projetual de arquitetura

This thesis aims to describe and demonstrate the developed concept to facilitate the use of thermal simulation tools during the building design process. Despite the impact of architectural elements on the performance of buildings, some influential decisions are frequently based solely on qualitative information. Even though such design support is adequate for most decisions, the designer will eventually have doubts concerning the performance of some design decisions. These situations will require some kind of additional knowledge to be properly approached. The concept of designerly ways of simulating focuses on the formulation and solution of design dilemmas, which are doubts about the design that cannot be fully understood nor solved without using quantitative information. The concept intends to combine the power of analysis from computer simulation tools with the capacity of synthesis from architects. Three types of simulation tools are considered: solar analysis, thermal/energy simulation and CFD. Design dilemmas are formulated and framed according to the architect s reflection process about performance aspects. Throughout the thesis, the problem is investigated in three fields: professional, technical and theoretical fields. This approach on distinct parts of the problem aimed to i) characterize different professional categories with regards to their design practice and use of tools, ii) investigate preceding researchers on the use of simulation tools and iii) draw analogies between the proposed concept, and some concepts developed or described in previous works about design theory. The proposed concept was tested in eight design dilemmas extracted from three case studies in the Netherlands. The three investigated processes are houses designed by Dutch architectural firms. Relevant information and criteria from each case study were obtained through interviews and conversations with the involved architects. The practical application, despite its success in the research context, allowed the identification of some applicability limitations of the concept, concerning the architects need to have technical knowledge and the actual evolution stage of simulation tools

Do modelo geométrico ao modelo físico: o tridimensional na educação do arquiteto e urbanista

In the teaching practice of architecture and urbanism in Brazil, educational legislation views modeling laboratories and workshops as an indispensable component of the infrastructure required for the good functioning of any architectural course of study. Although the development of information technology at the international level has created new possibilities for digital production of architectural models, research in this field being underway since the early 1990s, it is only from 2007 onwards that such technologies started to be incorporated into the teaching activity of architecture and urbanism in Brazil, through the pioneering experience at LAPAC/FEC/UNICAMP. It is therefore a recent experiment whose challenges can be highlighted through the following examples: (i) The implementation of digital prototyping laboratories in undergraduate courses of architecture and urbanism is still rare in Brazil; (ii) As a new developing field with few references and application to undergraduate programs, it is hard to define methodological procedures suitable for the pedagogical curricula already implemented or which have already been consolidated over the years; (iii) The new digital ways for producing tridimensional models are marked with specificities which make it difficult to fit them within the existing structures of model laboratories and workshops. Considering the above, the present thesis discusses the tridimensional model as a tool which may contribute to the development of students skills in perceiving, understanding and representing tridimensional space. Analysis is made of the relation between different forms of models and the teaching of architectural project, with emphasis on the design process. Starting from the conceptualization of the word model as it is used in architecture and urbanism, an attempt is made to identify types of tridimensional models used in the process of project conception, both through the traditional, manual way of model construction as well as through the digital ones. There is also an explanation on how new technologies for digital production of models through prototyping are being introduced in undergraduate academic programs of architecture and urbanism in Brazil, as well as a review of recent academic publications in this area. Based on the paradigm of reflective practice in teaching as designed by Schön (2000), the experiment applied in the research was undertaken in the integrated workshop courses of architectural project in the undergraduate program of architecture and urbanism at Universidade Federal do Rio Grande do Norte. Along the experiment, physical modeling, geometric modeling and digital prototyping are used in distinct moments of the design process with the purpose of observing the suitability of each model to the project s phases. The procedures used in the experiments are very close to the Action Research methodology in which the main purpose is the production of theoretical knowledge by improving the practice. The process was repeated during three consecutive semesters and reflection on the results which were achieved in each cycle helped enhancing the next one. As a result, a methodological procedure is proposed which consists of the definition of the Tridimensional Model as the integrating element for the contents studied in a specific academic period or semester. The teaching of Architectural Project as it is developed along the fifth academic period of the Architecture and Urbanism undergraduate program of UFRN is taken as a reference

Casas modernas na orla marítima de João Pessoa 1960 a 1974

This paper studies modern houses built in the neighborhoods of Cabo Branco, Tambaú and Manaíra by the seafront in Joao Pessoa, built between 1960 and 1974. We start from the already widespread notion that Brazilian Modern Architecture was inspired by foreign ways, mainly European but also American here recast, adapted, often innovating repertoire and ideas received (Y. BRUAND, 2005; H. SEGAWA, 2002; C. E. COMAS, 2002; C. E. COMAS, 2002; M. M. ACAYABA e S. FICHER, 1982; M. B. C. ARANHA, 2008; F. C. L. LARA, 2001; R. V. ZEIN, 2005; L. E. AMORIM, 1999, C. V. STINCO, 2010). With this look, after a field study, we collected 61 specimens in the collection of the Central Archive of João Pessoa City Hall, in order to identify which reformulations, adaptations or innovations would exist in modern houses built along the coast in João Pessoa. As we try to analyze the houses by what the bibliography had suggested (G. C. ARGAN, 1992; L. CORBUSIER, 2002; C.E.D. e M. ADRIÀ, 2007; K. FRAMPTON, 1997; H. H. HITCHCOCK, 1976; L. BENEVOLO, 2004; R. DE FUSCO, 1992, N . PEVSNER, 2002; M. RAGON, 1986; B. RISEBERO, 1982; E. ROBBINS, 1997; W. J. R. CURTIS, 1982; V. SCULLY, 2003; B. ZEVI, 1984; D. DUNST, 1999; A. COLQUHOUN, 2002; R. WESTON, 2005; A. IÑAKI, 2006; J. PETER, 1994) the starting idea seemed to us not sufficiently developed. So we decided, first, to undertake a literature review comparing speech and image of modern houses most often cited by international and national literature, following a script freely inspired the Vitruvian triad: the functional and spatial (sectorization, guidance, spatiality, movement); constructive aspects (structural elements, modulation, deck, sealing), and aesthetic aspects (composition, apertures, ornaments) (Cap.1), then cast a look under this same route in 61 specimens obtained initially, trying to verify any specificities they would have (Cap.2). Failing to deepen the analysis of all these examples, we chose 10 projects which were redesigned and described in more detail to which we supplement with the aspects of place - location / lot location, access, axiality. (E. C. MAHFUZ, 2002; J. C. MIGUEL, 2000; E. C. CHEREGATI, 2007; M. COTRIM, 2007). (Cap. 3). The documentation and description resulting allowed us to approach some related questions about the canonical transcripts hybridizing, adoptions and any vernacular innovations of modern houses along the coast, We conclude that the appellants and anachronistic elements isolates found in each of the studied bind to the Brazilian Modern Architecture

Aparências da forma e forma do espaço: análise da configuração espacial de residências unifamiliares dos anos 1970 em João Pessoa PB

Assuming that the form of a building shell and its content the spatial form are distinct dimensions of architecture - however indivisible and interdependent -, this study focus, in the light of the Social Logic of Space (HILLIER; HANSON, 1984), on the intrinsic properties through which domestic space was structured in a sample of single-family dwellings built in João Pessoa (PB) during the 1970s - when the vocabulary of modern architecture still prevailed in Brazil though sharing the urban scene with other architectural trends -, in order to investigate regularities or divergences underlying their conception. These dwellings were originally classified (ARAÚJO, 2010a) in five categories defined according to the form of their building shells and to their prevailing construction techniques: (1) Brazilian modern legacy (considered as truly Brazilian modern style); (2) Paulista architecture (that refers to the modern production of São Paulo, Brazil, from the 1950s through the 1970s); (3) experiences of rationalization and prefabrication ; (4) experiences of adaptation to the climate (referring to a design strongly influenced by the hot and humid climate of North-eastern Brazil); and (5) hybrid (to account for a kind of stylistic hybridism that includes formal attributes, which evoke our colonial past). This study aims to determine, through the analyses of nineteen cases that represent each category, whether this taxonomy corresponds to distinct modes of spatial configuration. This research therefore proposes an approach to the classification of domestic architecture based on topological properties. The dwellings spatial organization was represented, quantified and analyzed, their spatial properties explored in consonance with one another and with the literature. Results pointed out that there is no evidence of a reciprocal relationship between the formal look of the built shells and their respective spatial structures

A organização do processo de projeto de arquitetura no meio profissional: uma análise da produção em escritórios

This paper examines, through case studies, the organization of the production process of architectural projects in architecture offices in the city of Natal, specifically in relation to building projects. The specifics of the design process in architecture, the production of the project in a professional field in Natal, are studied in light of theories of design and its production process. The survey, in its different phases, was conducted between March 2010 and September 2012 and aimed to identify, understand, and analyze comparatively, by mapping the design process, the organization of production of building projects in two offices in Natal, checking as well the relationships of their agents during the process. The project was based on desk research and exploration, adopting, for both, data collection tools such as forms, questionnaires, and interviews. With the specific aim of mapping the design process, we adopted a technique that allows obtaining the information directly from employee agents involved in the production process. The technique consisted of registering information by completing daily, during or at the end of the workday, an individual virtual agenda, in which all agent collaborators described the tasks performed. The data collected allowed for the identification of the organizational structure of the office, its hierarchy, the responsibilities of agents, as well as the tasks performed by them during the two months of monitoring at each office. The research findings were based on analyses of data collected in the two offices and on comparative studies between the results of these analyses. The end result was a diagnostic evaluation that considered the level of organization and elaborated this perspective, as well as proposed solutions aimed at improving both the organization of the process and the relationships between the agents under the lens analyzed

Uma cidade em transformação: a influência da atividade do crediário nas mudanças da paisagem urbana de Tenente Ananias-RN

Studies on the urban landscape and on the changes of the urban space are relevant, since they reveal the economic dynamics and the way of life in the cities. Research on small towns, in particular, can display particular aspects and by so doing broaden the comprehension of this theme. The purpose of this research is to analyze the changes in the urban landscape and in the way of life of the inhabitants of the town of Tenente Ananias-RN that have been taking place since the 1990s up to the present (2013) and which result mainly from the commercial activity of crediário. The study is, therefore, a reflection on the impact of crediário economy on the urban landscape and on the way of life of a small town located in the hinterland of the State of Rio Grande do Norte. For this reason, it was necessary to study the landscape and the way of life found in Tenente Ananias in two moments: a) before the rise of the crediário, a period of time ranging from the town‟s initial emergence until the beginning of the 1990s; b) during the progress of crediário activity, from the beginning of the 1990s, when it starts, up to the present (2013). For this research, primary data (interviews, local survey visits) and secondary data (books, articles, reports, census data) were used. As a result of this study, it was possible to conclude that crediário plays a fundamental role for the explanation of the changes taking place in Tenente Ananias-RN, especially in the urban landscape and in the way of life of people. We have attempted, through this research, to contribute to the studies of a historical, social and economic process related to the urban landscape and space of a small town in the State of Rio Grande do Norte

Caldo do caldo: memória do espetáculo de dança paraibano caldo da cana

This research investigated the dance piece Caldo da Cana which premiered in João Pessoa-PB, in September 1984. It problematizes theoretical and practical way to make dance history, investigating this possibility through the dance itself. Arises from the fact that the dance has specific characteristics that can not be neglected by the historical account. In this sense, it was initiated by the raising of a theoretical framework that speaks to the indicated issues and unfolds through a field study, which included collecting testimonies from people who participated in the show, documentary research, gathering material traces and finally consists a practical part by transposing elaborated historical knowledge into the body through a creative process, resulting on this moment, in the construction of a duo dance

Clonagem e expressão do gene que codifica o inibidor de quimotripsina de Erythrina velutina WILLD. - caracterização e avaliação de seu potencial farmacológico

Proteinases are enzymes distributed widely founded in several organisms and perform many different functions, from maintaining homeostasis to the worsening of some diseases such as cancer, autoimmune diseases and infections. The proteins responsible of controlling the action of these enzymes are the inhibitors, that are classified based on their target proteases and are founded since simple organisms, such as bacteria, to higher organisms, such as larger plants and mammals. Plant proteinase inhibitors act by reducing or inactivating the activity of target proteases, thus, these proteins have been studied as potential tools in the treatment of diseases related to protease activities. In this context, an inhibitor of chymotrypsin from Erythrina velutina, called EvCI was previously purified and it was observed that this protein plays in vitro anticoagulant activity and anti-inflammatory activity in in vivo model. Aiming to reduce the environmental impact caused by the purification EvCI in high amounts and to facilitate the process of obtaining this protein, the recombinant chymotrypsin inhibitor from Eryhrina velutina was produced after cloning and expression in Escherichia coli. The bacteria were grown in LB medium and after induction of the expression this material was subjected to procedures for cell lysis and the product was applied on Nickel-affinity column. The proteins adsorbed were digested by thrombin and applied on Chymotrypsin-Sepharose affinity column, obtaining the purified inhibitor, named recEvCI. After electrophoresis, the recombinant inhibitor showed an approximately molecular mass of 17 kDa, and reduced the chymotrypsin and elastase activities in vitro. The recombinant inhibitor was sequenced and was found similar amino acids residues when compared to other inhibitors deposited in the database, with some modifications. recEvCI showed high stability under pH variations and reducing conditions, maintaining its activity around 80%. This protein increased the blood coagulation time in vitro by acting on the intrinsic pathway and did not show cytotoxicity against strains of mouse 3T3 fibroblasts and RAW 264.7 macrophages. recEvCI showed microbicide activity related to release of nitric oxide and consequently the activation of macrophages, futhermore having proinflammatory effects assessed by increased release of TNF-α. These results indicate that recEvCI can be biotechnologically used as a new tool in the control of coagulation-related diseases as well as can be an activating agent of the immune system in immunosuppressed individuals

Avaliação da ação bioinseticida de SBTI e vicilina de Erythrina velutina em enzimas digestivas e membrana peritrófica de larvas de Plodia interpunctella (Lepidoptera: Pyralidae)

Plodia interpunctella (Indian meal moth) is a cosmopolitan pest that attacks not only a wide range of stored grain as well other food products. Due to its economic importance several researches have focused in a method with ability to control this pest with few or no damage to the environment. The study of digestive enzymes inhibitors, lectins and chitin-binding proteins, has often been proposed as an alternative to reduce insect damage. In this study we report the major classes of digestive enzymes during larval growth in P. Interpunctella, being those proteinases actives at pH 9.5 and optimum temperature of 50 oC to both larvae of the 3rd instar and pre-pupal stage of development. In vitro and zymogram assays presented the effects of several inhibitors, such as SBTI, TLCK and PMSF to intestinal homogenate of 3rd instar larvae of 62%, 92% and 87% of inhibition and In pre-pupal stage of 87%, 62 % and 55% of inhibition, respectively. Zymograms showed inhibition of two low molecular masses protein bands by TLCK and that in presence of SBTI were retarded. These results are indicative of predominance of digestive serine proteinases in gut homogenate from Plodia interpunctella larvae. This serine proteinase was then used as a target to evaluate the effect of SBTI on larvae in in vivo assay. Effect of SBTI on mortality and larval mass was not observed at until 4% of concentration (w/w) in diets. Chitin, another target to insecticidal proteins, was observed by chemical method. Moreover, optic microscopy confirmed the presence of a peritrophic membrane. Established this target, in vivo effect of EvV, a chitin binding vicilin, evaluated during the larval development of P. interpunctella and was obtained a LD50 of 0,23% and WD50 of 0,27% to this protein. Mechanism of action was proposed through of the in vivo digestibility of EvV methodology. During the passage through the larval digestive tract was observed that EvV was susceptible to digestive enzymes and a reactive fragment, visualized by Western blotting, produced by digestion was recovered after dissociation of the peritrophic membrane. The bound of EvV to peritrophic membrane was confirmed by immunohystochemical assays that showed strong immunofluorescent signal of EvV-FITC binding and peritrophic membrane. These results are a indicative that vicilins could be utilized as potential insecticide to Plodia interpunctella and a control methods using EvV as bioinsecticide should be studied to reduce lost caused by storage insect pests

Atenuação de ruídos coerentes utilizando decomposição em modos empíricos

The seismic processing technique has the main objective to provide adequate picture of geological structures from subsurface of sedimentary basins. Among the key steps of this process is the enhancement of seismic reflections by filtering unwanted signals, called seismic noise, the improvement of signals of interest and the application of imaging procedures. The seismic noise may appear random or coherent. This dissertation will present a technique to attenuate coherent noise, such as ground roll and multiple reflections, based on Empirical Mode Decomposition method. This method will be applied to decompose the seismic trace into Intrinsic Mode Functions. These functions have the properties of being symmetric, with local mean equals zero and the same number of zero-crossing and extremes. The developed technique was tested on synthetic and real data, and the results were considered encouraging