Avaliação do desempenho diagnóstico e do valor de corte para o índice de respiração rápida e superficial na predição do insucesso da extubação

OBJETIVO: Avaliar o desempenho diagnóstico do índice de respiração rápida e superficial (IRRS) na predição do insucesso da extubação de pacientes adultos em terapia intensiva e verificar a adequação do valor de corte clássico para esse índice. MÉTODOS: Estudo prospectivo realizado na unidade de terapia intensiva de adultos do Hospital das Clínicas da Faculdade de Medicina de Botucatu, através da avaliação do IRRS em 73 pacientes consecutivos considerados clinicamente prontos para extubação. RESULTADOS: O IRRS com valor de corte clássico (105 ciclos/min/L) apresentou sensibilidade de 20% e especificidade de 95% (soma = 115%). A análise da curva receiver operator characteristic (ROC) demonstrou melhor valor de corte (76,5 ciclos/min/L), o qual forneceu sensibilidade de 66% e especificidade de 74% (soma = 140%), e a área sob a curva ROC para o IRRS foi de 0,78. CONCLUSÕES: O valor de corte clássico do IRRS se mostrou inadequado nesta casuística, prevendo apenas 20% dos pacientes com falha na extubação. A obtenção do novo valor de corte permitiu um acréscimo substancial de sensibilidade, com aceitável redução da especificidade. O valor da área sob a curva ROC indicou satisfatório poder discriminativo do índice, justificando a validação de sua aplicação.

Aplicação de sensoriamento remoto e sistema de informação geográfica na determinação da vulnerabilidade natural e ambeintal do Município de Guamaré(RN): simulação de risco às atividades da indústria petrolífera

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Análise multitemporal dos elementos geoambientais da região da Ponta do Tubarão, área de influência dos campos petrolíferos de Macau e Serra, município de Macau/RN

The study area is inserted in Ponta do Tubarão region, Macau City, setentrional littoral of Rio Grande do Norte State, composed of Tertiary and Quatemary sedimentary rocks and sediments. This region is characterized for the intense action of the coastal processes, causing the morphologic instability in part of the area, beyond the interference of human activities, as the Petroliferous Industrial Polo, salt companies and shrimp farms. This justifies the integration of multidisciplinary and multitemporal detailed scientific studies dealing with the evaluation of the changing behavior of this coastal environment by geoenvironments elements characterization, identifying protected and recuperation areas, mainly those under socioeconomic intervention. The main objective was the coastal monitoring using geoprocessing techniques to prepare thematic maps useful for oil spilling environment risk areas survey. The methodology was based on multitemporal interpretation of remote sensing images and field checking, integrated in a Geographical Information System (GIS). The Geologic, Geomorphologic, Vegetation, Soil and Land Use maps were prepared, and later on they allowed the generation of the Natural Vulnerability and Environmental Vulnerability maps. These maps had been classified in accordance with vulnerability degrees: very low, low, medi um, high and very high. Beyond these maps the GIS allowed the analysis of the shoreline evolution for 10 distinct dates, using Landsat 5 TM and 7 ETM+ and SPOT-HRVIR images. This analysis made possible the attendance of the coastal morphodynamic evolution, where the results had been represented by areasof erosion and accretion (or deposition) of sediments, pointing critical areas under erosive process to the petroliferous industry (Macau and Serra fields). The GIS also provided to prepare the Environmental Sensitivity Maps of Oil Spill (SAO Maps) in operational scale (1: 10.000), according to the norms ofthe Ministério do Meio Ambiente (MMA 2002). The SAO Map in operational scale was based on IKONOS images mosaic where the ESI (Environmental Sensitivity Index) was represented according with two tides phases of theregion. Therewere recognizedfiveESI (3, 4,7,9, 1O) for the low tide; to the high tide the ESI number increased to seven (3, 4, 5, 7, 8, 9, 10). All these information are necessary to the decisions making about oi! spill and its derivatives containment. These techniques application makes possible the optimization and implantation ofnew socioeconomics activities of low environmental impact, indicates areas for better productivity and security exploration, and benefits local communities with fauna and flora preservation. The development of these activities is inserted in the scope of Monitoramento Ambiental de Áreas de Risco a Derrames de Petróleo e Seus Derivados Cooperation Project (Rede 05/01 - PETRORISCO, FINEP/CTPETRO/PETROBRAS) of multidisciplinary and interinstitucional characteristics dealing with subjects involving the environmental monitoring and the petroliferous activity

Sistemas de dunas do parque das Dunas e Barreiras do Inferno/Natal (RN: levantamento geológico /geofísico, elaboração do modelo deterministico e avaliação da vulnerabilidade/suscetibilidade

The current work was developed on the dune systems of the Parque das Dunas and Barreira do Inferno. These places are located in the cities of Natal and Parnamirim (RN, Brazil), respectively. This project has the purpose of developing the deterministic model on a specific blowout at Parque das Dunas, based in the geophysical interpretations of the lines gotten with the Ground Penetration Radar and the planialtimetric acquisitions of the topographical surface of the land. Also analyses of the vulnerability/susceptibility of these dune systems had been done in relation to the human pressures. To develop its deterministic model, it is necessary to acquire inner and outer geometries of the cited blowout. In order to depict inner geometries underneath the surface are used the GPR observing the altimetric control for topographical correction of the GPR lines. As for the outer geometries, the geodesic GPS gives us the planialtimetric points (x, y and z points) with milimetric precision, resulting in high-resolution surfaces. Using interpolation methods of the planialtimetric points was possible create Digital Elevations Models (DEM´s) of these surfaces. As a result, 1,161.4 meters of GPR lines were acquired on the blowout at the Parque das Dunas and 3,735.27 meters on the blowout at the Barreira do Inferno. These lines had been acquired with a 200 MHz antenna, except the 7 and 8 lines, for which we had been used a 100 MHz antenna. The gotten data had been processed and interpreted, being possible to identify boundary surfaces of first, second and third order. The first order boundary surface is related with the contact of the rocks of the Barreiras Group with the aeolian deposits. These deposits had been divided in two groups (Group 1 and Group 2) which are related with the geometry of stratum and the dip of its stratifications. Group 1 presented stratum of sigmoidal and irregular geometries and involved bodies where the reflectors had presented dips that had varied of 20 to the 28 degrees for the Parque das Dunas blowout and of 22 to the 29 degrees for the Barreira do Inferno blowout. Usually, it was limited in the base for the first order surface and in the top for the second order surface. Group 2 presented stratum of trough, wedge or lens geometries, limited in the base for the second order vi surface, where the corresponding deposits had more shown smoothed reflectors or with dips of low angle. The Deterministic and Digital Elevation Models had been developed from the integration and interpretation of the 2D data with the GOCAD® program. In Digital Elevations Models it was possible to see, for the localities, corridor or trough-shaped blowouts. In Deterministic Model it was possible to see first and second order boundary surfaces. For the vulnerability/susceptibility of the dune systems it was applied the methodology proposal by Boderè al (1991); however the same one did not show adequate because it evaluates actual coastal dunes. Actual coastal dunes are dunes that are presented in balance with the current environmental conditions. Therefore, a new methodology was proposal which characterizes the supplying and activity sedimentary, as well as the human pressures. For the methodology developed in this work, both the localities had presented a good management. The Parque das Dunas was characterized as a relic dune system and the Barreira do Inferno was characterized as a palimpsestic dune system. Also two Thematic Maps had been elaborated for the environmental characterization of the studied dune systems, with software ArcGis 8.3, and its respective data bases

Identificação de indivíduos vulneráveis no entorno de um hospital universitário: conectando vulnerabilidade, solidariedade e saúde

No entorno de um hospital universitário do interior do estado de São Paulo há pessoas dormindo, se alimentando ou descansando nos gramados e arredores, permanecendo nestes locais durante horas. Este estudo objetivou identificar e caracterizar indivíduos vulneráveis em área externa deste hospital, oferecendo ajuda. A coleta dos dados foi realizada no período de novembro de 2007 a outubro de 2008, semanalmente, em dias e horários sorteados. Identificaram-se pessoas que permaneciam nesses locais, sendo entrevistados 52 sujeitos. Esses indivíduos são, predominantemente, do sexo feminino (67,3%), brancos (51,9%), casados (59,6%), com escolaridade de até quatro anos de estudo (44,2%) e sem profissão definida (84,6%). A maioria aguardava o horário do ônibus da prefeitura de seu município de origem; o tempo médio de espera foi de aproximadamente 90 minutos e grande parte dos sujeitos apresentou necessidades durante os períodos de espera. Foi oferecida ajuda a 15 pessoas que referiram necessidades no momento da entrevista. Concluiu-se que esses indivíduos se encontram em situação de vulnerabilidade individual, social e programática, destacando-se a vulnerabilidade sócio-econômica, apresentam capacidade de autodeterminação reduzida, submetendo-se a condições desfavoráveis por dependerem dos serviços públicos.

Desenvolvimento de um sistema computacional para geração automática de mapas de vulnerabilidade como ferramenta de auxílio às ações de prevenção ao derramamento de óleo em áreas costeiras

The northern portion of the Rio Grande do Norte State is characterized by intense coastal dynamics affecting areas with ecosystems of moderate to high environmental sensitivity. In this region are installed the main socioeconomic activities of RN State: salt industry, shrimp farm, fruit industry and oil industry. The oil industry suffers the effects of coastal dynamic action promoting problems such as erosion and exposure of wells and pipelines along the shore. Thus came the improvement of such modifications, in search of understanding of the changes which causes environmental impacts with the purpose of detecting and assessing areas with greater vulnerability to variations. Coastal areas under influence oil industry are highly vulnerable and sensitive in case of accidents involving oil spill in the vicinity. Therefore, it was established the geoenvironmental monitoring of the region with the aim of evaluating the entire coastal area evolution and check the sensitivity of the site on the presence of oil. The goal of this work was the implementation of a computer system that combines the needs of insertion and visualization of thematic maps for the generation of Environmental Vulnerability maps, using techniques of Business Intelligence (BI), from vector information previously stored in the database. The fundamental design interest was to implement a more scalable system that meets the diverse fields of study and make the appropriate system for generating online vulnerability maps, automating the methodology so as to facilitate data manipulation and fast results in cases of real time operational decision-making. In database development a geographic area was established the conceptual model of the selected data and Web system was done using the template database PostgreSQL, PostGis spatial extension, Glassfish Web server and the viewer maps Web environment, the GeoServer. To develop a geographic database it was necessary to generate the conceptual model of the selected data and the Web system development was done using the PostgreSQL database system, its spatial extension PostGIS, the web server Glassfish and GeoServer to display maps in Web

Vulnerabilidade ambiental da zona costeira de Pititinga, Rio do Fogo, Rio Grande do Norte

This work presents a study on the environmental vulnerability of the coastal region of Pititinga, Rio do Fogo/RN. The coastal erosion of Pititinga beach was analyzed and considerated as one more process that produces environmental vulnerability in the area of study, taking into account its human and natural environment and establishing the relation between them, to understand the arrangement that produced its spatial configuration. The natural environment was expressed by thematics maps with geology, geomorphology, vegetation and soil themes, while the human environment was expressed by the use and occupation of the soil map. The coastal erosion was put in an erosion vulnerability map. The methodological procedure to generate the thematics maps, vulnerability maps and of the erosion coastal involved the bibliographic research, field visits with check-list form fill, collect and analysis of sediment sample, photo-interpretation techniques, integration of the information in a database, data store and spatial analysis in a Geographic Information System (GIS) ambient. The natural vulnerability map shows a predominancy of environments with low (29,6%) or medium (42,4%) vulnerability, pointed the frontal and mobile dune as the areas with the highest vulnerability. The environmental vulnerability map, presents a predominancy of environments with low vulnerability (53,8%), with the high vulnerability concentrated on Pititinga community. The coastal erosion vulnerability presented distinct behaviors on three sections among the coastal line according each one characteristics. Where there are frontal and transgressive dunes, vulnerability are, generally, medium or low, respectively, and in the absence of them, as what occurs in Pititinga community, the vulnerability is predominately very high

Modelagem de vulnerabilidade de sistemas ambientais no municípo de Guadalupe/PI

In the Guadalupe city, with the arrival of the Boa Esperança Hydroelectric, the landscape of the municipal district lived important transformations. Those transformations continue growing today, now together with new vectors of territorial ordering, especially the agricultural industry. In front of the context of stability-instability of the environmental systems, it original of its natural vulnerability to the instability and of the transformations in the territorial dynamics of Guadalupe, the present research it analyzed and it mapped that municipal territory with relationship to the degrees of vulnerability of the environmental systems. Therefore, working a leaning methodology in a systemic perspective of the landscape and in the geoprocessing technique, the dissertation showed with thematic mapping, the most vulnerable and less vulnerable parts of the municipal district of Guadalupe, looking for a strategic vision of the problem.

As praças públicas de Natal/RN no âmbito dos problemas socioambientais urbanos

This paper presents the public square as a subsystem of the city for the potential integration of elements 'natural' and built environment. But sometimes the suitability of projects and the social processes involved are not compatible and favorable to their real functions in urban space. The city of Natal, with a population of 803,739 inhabitants has 253 public parks not uniformly distributed in the urban area, but mostly in central areas and their absence in some peripheral neighborhoods. In this sense, the objective of this paper is to analyze the quality and spatiality of the city's public squares within the urban socio-environmental problems. For this, use of simple random sampling to define the sample and the proportional allocation of districts, totaling 168 squares to be raised. We prepared a form to collect data on the field that includes aspects of leisure, infrastructure and environment. For each square sampled was calculated Square Quality Index (PQI), then calculating the average per IQP neighborhood. The rates found were crossed with census data and Municipal Public Administration by neighborhood, using multivariate analysis. We generated maps, charts and tables, considered appropriate to each question format, focused comparison. The public square appears as an indicator of environmental challenges present in intra-urban spaces of the city. Their spatial distribution is not consistent demand population, both by disposition and by how much. In terms of quality are characterized by different levels of inadequacy and degradation aspects of leisure, environmental and infrastructure, often causing disfigurement, abandonment and improper occupation in such spaces. Multivariate analysis point to a central concentration and their problems in certain administrative units, not only as regards the public squares, but also to aspects of education, income, and other violence, perpetuating the problem. The various levels of inadequacy and degradation of public squares have been more blatant in the poorest neighborhoods of the city, pointing to a structural pattern associated with the intrinsic characteristics of the neighborhood and the socioeconomic profile of the local population. These are problems of social and environmental dimensions, threaded in and influenced the political, economic and broader social process of transformation of the city and the urban. Based on an uneven process in which space necessarily reflect the contradictions inherent in the active forces and interests. Thus evidencing the importance of managing the necessary public effectively engaged with the problems that are present there, in order to equate them, without being prioritized certain areas of the city at the expense of others

Desenvolvimento territorial e a política nacional de água em Moçambique: o caso do distrito de Chibuto

The development has been a phenomenon in constant discussion today, whose fundamental importance should be to promote the welfare of humanity. Thus, the development becomes an element that adds political, economic, social and environmental values . In Mozambique the development model adopted by the State prioritizes the economic dimension, in this case favoring the growth of capitalist structure production. Thus , the basic conditions for human survival still leaves much to be desired and the Mozambican population in general and the district of Chibuto , in particular , continue to face several difficulties to have access to such conditions, and the lack of potable water is a that most of the problems afflicting this population . The water was always a factor related to the socio-economic development of the population, where great civilizations and major economic marks were always influenced by water availability, and today this feature is present in all sectors of production. In Mozambique, much effort has been made by the government, national and international organizations to enhance and guarantee the supply of potable and drinking water, and despite all this effort, most of the population does not have access to this precious resource. In this sense, this work presents an analysis of the effects of the National Water Policy in the study area, analyzes the shortage of potable water in the district of Chibuto, discusses the design and development contained in the official discourse of the state and, opposes the idea of human development. For such issues that help to understand the phenomenon under study, such as territory, public policy and criticism of hegemonic conception of development are addressed. To make the desired approach, we performed a characterization of the District of Chibuto, addressing the issue of poverty, with a brief discussion of this concept, from different approaches, and analyze the impact of the PARPA (Action Plan for the Reduction of Absolute Poverty) in fighting poverty in Mozambique, and became a description of the scenario of poverty and vulnerability in Chibuto district with the construction of Territorial Human Development Index. Research also brings up a discussion about territory and technicization which describes the senary of the water supply system in the District and territorial dynamics of Chibuto, from the analysis and description of existing structures and other technical objects that structure the territory under study. Thus, it was found that the development should be summarized in the satisfaction of human needs, and should be the cornerstone of the new type of development that is intended for the purpose of triggering urgently actions to overcome or combat bleak misery suffered by the majority of inhabitants of the District of Chibuto

Fragilidade ambiental da bacia hidrográfica do Rio Punaú (RN) e área litorânea adjacente

Hydrographic basins always exercised a big fascination over humankind that attracted for its scenery beauty or for its richness in natural resources, had been acting in order to modify these important ecosystems without, therefore, considering the possible consequences of these changes. The attributed importance to the coast ecosystems, in eminence to the hydrographic basin of Punaú river and adjacent areas, is had when it s verified the diversity of the ecosystems that contemplate it. Hydrographic basin in evidence in Rio Grande do Norte state, occupies an area of nearly 652.71 km², being it sited in the homogeneous micro-region Litoral Nordeste, with a regional population estimated in nearly 75,188 inhabitants, according to the Anuário Estatístico do Rio Grande do Norte 2004. The region of the researched basin is formed by seven municipal districts related as it follows: Maxaranguape, Pedra Grande, Pureza, Rio do Fogo, São Miguel de Touros, Taipu and Touros, but Maxaranguape, Rio do Fogo, Touros and Pureza have a direct participation in the basin. Basin in study have it lands evaluated according to the agriculturist aptitude by the conventionally methodology practiced in the country, having as objective, then, a compara-tive analysis between the ambient unities, Aeolian littoral and coast tray, identified in the researched area. From the characterization of the physic way of the area in study and owning the kept data, it was proceeded the integrated analysis of the structural elements of the landscape which were evidenced that the fragile areas are associated with the areas of agriculture cultivation, such as the ones of irregular occupation. About the degradation, the ambient diagnostic of the basin indicated that the equivalent to the Aeolian Littoral Ambient Unit correspond to the bigger pledging of the ambient quality, in other words, high ambient fragility, being this result due to the use and occupation of the soil, propitiating this way, vulnerability in the vegetal cover of the area, despite it disposes of a low agriculture cultivation percentage. Already in the Coast Ambient Tray, is emphasized the medium ambient fragility, despite of the high index of cultivated area. In a general way, the total area of the hydrographic basin of Punaú river and adjacent areas presented ambient impacts over the tolerance limit, indicating the necessity of a review of the practices of use and handling of the soil, reforesting of the water courses edges, control of erosion and contamination of the aqueous in the perspective to reduce the effects of the impacts due to the use and occupation of the basin in regard. The present search evaluated the ambient impacts diagnosised in the hydrographic basin of Punaú river and adjacent areas, pointing the causes and the probable consequences of the damages caused by these impacts to the basin ambient. From the analysis of these data, if was possible to become explicit how they are fundamental as key elements in the process of decision taking in the ambient questions

Hipertensão arterial experimental e prenhez em ratas: repercussões no peso da placenta e no índice placentário

Objetivo: estudar as repercussões da hipertensão sobre o peso da placenta e índice placentário. Métodos: foram utilizadas 82 ratas virgens da linhagem Wistar em idade de reprodução. Após a indução da hipertensão arterial experimental (Modelo Goldblatt I -- 1 rim-1 clipe) as ratas foram sorteadas para compor os 4 grandes grupos experimentais (controle, manipulação, nefrectomia e hipertensão). A seguir, as ratas foram distribuídas por sorteio em 8 subgrupos, sendo quatro prenhes (P) e quatro não-prenhes. Após acasalamento, dos quatro grupos prenhes obtivemos com o nascimento dos recém-nascidos (RN) os seguintes grupos: RN-C, RN-M, RN-N e RN-H, respectivamente, controle, manipulação, nefrectomizado e hipertenso. Resultados: quanto ao peso da placenta, o do grupo RN-C foi estatisticamente maior que o de todos os demais grupos. Por outro lado, verifica-se que o peso das placentas provenientes do grupo RN-M foi maior que o dos grupos RN-N e RN-H, os quais não diferiram entre si. Os índices placentários dos grupos P-C (Md = 0,1085) e P-M (Md = 0,1110) não diferiram entre si, mas foram menores que os dos grupos P-N (Md = 0,1175) e P-H (Md = 0,1211), os quais também não diferiram entre si. Conclusões: a hipertensão e a nefrectomia unilateral determinaram redução do peso das placentas e aumento do índice placentário, evidenciando repercussões no desenvolvimento placentário e fetal.

Adaptação do índice de alimentação saudável ao guia alimentar da população brasileira

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Prevalência de oclusopatias e comparação entre a Classificação de Angle e o Índice de Estética Dentária em escolares do interior do estado de São Paulo - Brasil

INTRODUÇÃO: as oclusopatias estão entre os principais problemas de saúde bucal em todo o mundo, juntamente com a cárie dentária e a doença periodontal, e vários índices têm sido utilizados para registrá-las. OBJETIVOS: verificar a prevalência de oclusopatias utilizando a Classificação de Angle e o Índice de Estética Dentária (DAI), sua severidade e a necessidade de tratamento ortodôntico registradas pelo DAI, e comparar os resultados de ambos os índices, visando correlacionar o padrão dos dados coletados e a viabilidade de utilizá-los de forma conjunta. MÉTODOS: a amostra consistiu de 734 escolares com idade de 12 anos, de ambos os sexos, da rede pública do município de Lins/SP. Foram realizados exames nos pátios das escolas com utilização de sondas IPC a olho nu. RESULTADOS: pela Classificação de Angle, encontrou-se 33,24% das crianças com oclusão normal e 66,76% com má oclusão. Pelo DAI, observou-se que 65,26% das crianças apresentavam-se sem anormalidades ou com más oclusões leves. A má oclusão definida esteve presente em 12,81%, a má oclusão severa foi observada em 10,90% e a muito severa ou incapacitante em 11,03%. A maioria das crianças (70,57%) apresentou relação molar normal, e o overjet maxilar anterior foi a alteração mais frequentemente observada. No cruzamento dos índices houve semelhanças e divergências. CONCLUSÃO: o DAI não foi sensível a alguns problemas de oclusão detectados pela Classificação de Angle, e a recíproca foi verdadeira, demonstrando que ambos os índices possuem pontos distintos na detecção das oclusopatias, podendo ser utilizados de forma reciprocamente complementar.

Avaliação do Índice de Remanescente Adesivo utilizando braquetes com e sem tratamento na base e a interação com três sistemas de colagem

OBJETIVO: avaliar o Índice de Remanescente Adesivo (IRA) em dentes bovinos após a descolagem de braquetes com e sem tratamento na base. METODOLOGIA: foram utilizados três sistemas de colagem ortodôntica para os dois padrões de base. Os dentes bovinos foram divididos em seis grupos de 40, de acordo com a base do braquete e o sistema de colagem. Vinte e quatro horas após a colagem foram realizados os testes de compressão em uma máquina de ensaios. A avaliação do IRA foi realizada em um estereomicroscópio por três examinadores calibrados. Foi utilizado o teste não paramétrico de Kruskal-Wallis, seguido do método de Dunn, para fazer as comparações múltiplas entre todos os grupos. RESULTADOS E CONCLUSÕES: observou-se que o tratamento das bases dos braquetes com óxido de alumínio não foi determinante para o aumento da adesividade entre o braquete e o adesivo. O grupo em que se utilizou braquetes com tratamento na base e adesivo TXT (3M-Unitek) + Transbond Plus SEP (3M-Unitek) apresentou a maior parte das fraturas na interface dente-adesivo (escore 4).