Avaliação do risco de quedas em idosos que frequentam os Serviços de Fisioterapia do SESARAM, E.P.E

As quedas são um problema comum e devastador entre os idosos, causando um enorme número de situações de morbilidade, mortalidade e necessidade de recorrer a cuidados de saúde. As maiorias das quedas em idosos relacionam-se com um ou mais fatores de risco. A investigação tem demonstrado que ter em atenção a estes fatores poderá reduzir significativamente as quedas. Verifica-se anualmente um grande afluxo de idosos ao Serviço de Fisioterapia do SESARAM, E.P.E. devido a sequelas de quedas. O presente estudo, inserido no Método Quantitativo – Correlacional, Tranversal, teve como objetivo avaliar o risco de quedas em idosos que frequentaram o Serviço de Fisioterapia do SESARAM, E.P.E. entre o 2.º e o 3.º trimestre de 2011 e correlacionar os vários fatores de risco que contribuíram para as mesmas. Foi selecionada uma amostra não probabilística, de idosos com mais de 65 anos (n=75) à qual foi aplicado um questionário sobre fatores de risco para as quedas e a Escala de Equilíbrio de Berg (EEB), a Escala de Atividades de Vida Diária de Katz e a Escala de Atividades Instrumentais de Vida Diárias de Lawton & Brody (AIVD), a Escala de Tinetti (Risco de Quedas) e o Teste de Levantar e Sentar em 30 segundos. Resultados: Cerca de 93% dos idosos sofreram quedas nos últimos 6 meses das quais 48% resultaram numa fratura. As mulheres caíram mais do que os homens (M=21 DP=3,5) e os idosos mais jovens que apresentavam maior risco de quedas. Cerca de 52% dos idosos praticam atividade física. Os idosos da amostra possuíam força muscular dos membros inferiores baixa (M=6,97), com um risco de quedas moderado (M=20,8 DP=3,8) e eram moderadamente dependentes (M=18,5, DP=3,9) nas AIVD. Conclusões: Os idosos com mais força muscular apresentavam menor risco de queda pois o coeficiente de correlação foi positivo e significativo e do mesmo modo aqueles que apresentam mais força muscular estão associados a valores elevados de equilíbrio e menores nas AIVD. Face a estes resultados do estudo justiça-se, a presença de uma equipa multidisciplinar, com vista a diminuir os fatores de risco para as quedas e fomentando estratégias de equilíbrio/força. Com a intervenção desta equipa, os idosos poderão manter-se mais independentes e com melhor qualidade de vida.

Confiabilidade interobservador da escala do equilíbrio de Berg entre fisioterapeutas com extensa e escassa prática clínica

This study aimed at assessing the interobserver reliability of the Brazilian-Portuguese version of the Berg Balance Scale (BBS). The assessment was made by physiotherapists with extensive or little clinical experience in non-institutionalized elderly individuals. Participants comprised 12 elderly subjects (10 women and 2 men) with mean ages of 75.8 ± 8.4 years (range = 63-87) and 18 physiotherapists with varying clinical experience. Inter-examiner reliability obtained for each scale item yielded weighted kappa value > 0.75 in 11 of the 14 items (varying from 0.37 to 1.0). The intra-class correlation coefficient (ICC) for the total sum of BBS scores between the two groups of physiotherapists was 0.996 (95% confidence interval, 0.987 0.999) with a Cronbach alpha coefficient of 0.996. We found no difference between the rater groups when we compared the sum score means obtained with the student s T-test (p = 0.86). Although some items had low reliability values, in general our results suggest that the Brazilian Version of the BBS showed good levels of interrater reliability and agreement when used by physiotherapists with different clinical practice levels and without previous training on non-institutionalized elderly patients. We concluded that the BBS can be useful as an important evaluation instrument on a protocol for Rehabilitation clinics. It may be used by various health professionals, as: Physicians, Physical therapists, Physical educators, Occupational therapists, Nurses and Phonoaudiologists, so confirming the interdisciplinary character of this study

Avaliação da temperatura de cristalização da parafina em sistemas: parafina, solvente e tensoativo

The formation of paraffin deposits is common in the petroleum industry during production, transport and treatment stages. It happens due to modifications in the thermodynamic variables that alter the solubility of alkanes fractions present in petroleum. The deposition of paraffin can provoke significant and growing petroleum losses, arriving to block the flow, hindering to the production. This process is associated with the phases equilibrium L-S and the stages and nucleation, growth and agglomeration the crystals. That process is function of petroleum intrinsic characteristics and temperature and pressure variations, during production. Several preventive and corrective methods are used to control the paraffin crystallization, such as: use of chemical inhibitors, hot solvents injection, use of termochemistry reactions, and mechanical removal. But for offshore exploration this expensive problem needs more investigation. Many studies have been carried through Wax Appearance Temperature (WAT) of paraffin; therefore the formed crystals are responsible for the modification of the reologics properties of the oil, causing a lot off operational problems. From the determination of the WAT of a system it is possible to affirm if oil presents or not trend to the formation of organic deposits, making possible to foresee and to prevent problems of wax crystallization. The solvent n-paraffin has been widely used as fluid of perforation, raising the production costs when it is used in the removal paraffin deposits, needing an operational substitute. This study aims to determine the WAT of paraffin and the interference off additives in its reduction, being developed system paraffin/solvent/surfactant that propitiates the wax solubilization. Crystallization temperatures in varied paraffin concentrations and different solvents were established in the first stage of the experiments. In the second stage, using the methodology of variation of the photoelectric signal had been determined the temperature of crystallization of the systems and evaluated the interferences of additives to reduction of the WAT. The experimental results are expressed in function of the variations of the photoelectric signals during controlled cooling, innovating and validating this new methodology to determine WAT, relatively simple with relation the other applied that involve specific equipments and of high cost. Through the curves you differentiate of the results had been also identified to the critical stages of growth and agglomeration of the crystals that represent to the saturation of the system, indicating difficulties of flow due to the increase of the density

Avaliação e modelagem da absorção de H2S do gás natural em coluna de leito estagnado

Natural gas, although basically composed by light hydrocarbons, also presents contaminant gases in its composition, such as CO2 (carbon dioxide) and H2S (hydrogen sulfide). The H2S, which commonly occurs in oil and gas exploration and production activities, causes damages in oil and natural gas pipelines. Consequently, the removal of hydrogen sulfide gas will result in an important reduction in operating costs. Also, it is essential to consider the better quality of the oil to be processed in the refinery, thus resulting in benefits in economic, environmental and social areas. All this facts demonstrate the need for the development and improvement in hydrogen sulfide scavengers. Currently, the oil industry uses several processes for hydrogen sulfide removal from natural gas. However, these processes produce amine derivatives which can cause damage in distillation towers, can cause clogging of pipelines by formation of insoluble precipitates, and also produce residues with great environmental impact. Therefore, it is of great importance the obtaining of a stable system, in inorganic or organic reaction media, able to remove hydrogen sulfide without formation of by-products that can affect the quality and cost of natural gas processing, transport, and distribution steps. Seeking the study, evaluation and modeling of mass transfer and kinetics of hydrogen removal, in this study it was used an absorption column packed with Raschig rings, where the natural gas, with H2S as contaminant, passed through an aqueous solution of inorganic compounds as stagnant liquid, being this contaminant gas absorbed by the liquid phase. This absorption column was coupled with a H2S detection system, with interface with a computer. The data and the model equations were solved by the least squares method, modified by Levemberg-Marquardt. In this study, in addition to the water, it were used the following solutions: sodium hydroxide, potassium permanganate, ferric chloride, copper sulfate, zinc chloride, potassium chromate, and manganese sulfate, all at low concentrations (»10 ppm). These solutions were used looking for the evaluation of the interference between absorption physical and chemical parameters, or even to get a better mass transfer coefficient, as in mixing reactors and absorption columns operating in counterflow. In this context, the evaluation of H2S removal arises as a valuable procedure for the treatment of natural gas and destination of process by-products. The study of the obtained absorption curves makes possible to determine the mass transfer predominant stage in the involved processes, the mass transfer volumetric coefficients, and the equilibrium concentrations. It was also performed a kinetic study. The obtained results showed that the H2S removal kinetics is greater for NaOH. Considering that the study was performed at low concentrations of chemical reagents, it was possible to check the effect of secondary reactions in the other chemicals, especially in the case of KMnO4, which shows that your by-product, MnO2, acts in H2S absorption process. In addition, CuSO4 and FeCl3 also demonstrated to have good efficiency in H2S removal

Avaliação do crescimento de ocupação da bacia do rio Pitimbu com subsídios para estudos de possíveis impactos sobre os recursos hidricos

The Pitimbu River Watershed (PRW), belonging to Potiguar capital metropolitan area, State of Rio Grande do Norte, contributes, among other purposes, to human using and animal watering. This watershed is extremely important because, besides filling up with freshwater approximately 30% of the south part of Natal (South, East and West Zones), contributes to the river shore ecosystem equilibrium. Face to the current conjuncture, this study aims to evaluate the urban development dynamics in the PRW, applying Cellular Automata as a modeling instrument, and to simulate future urban scenarios, between 2014 and 2033, using the simulation program SLEUTH. In the calibration phase, urban spots for 1 984, 1992, 2004 and 2013 years were used, with resolution from 100 meters. After the simulation, it was found a predominance of organic growth, expanding the BHRP from existing urban centers. The spontaneous growth occurred through the fullest extent of the watershed, however the probability of effective growth should not exceed 21%. It was observed that, there was a 68% increase for the period between 2014 and 2033, corresponding to an expansion area of 1,778 ha. For 2033, the source of Pitimbu River area and the Jiqui Lake surroundings will increase more than 78%. Finally, it was seen an exogenous urban growth tendency in the watershed (outside-in). As a result of this growth, hydraulics resources will become scarcer

Avaliação da estimulação da medula espinhal como modelo de tratamento da doença de parkinson no primata Callithrix jacchus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Avaliação clínico-laboratorial de bovinos Nelore infectados experimentalmente com Trypanosoma vivax

Avaliaram-se as alterações clínico-laboratoriais de seis bezerros Nelore, de ambos os sexos, inoculados experimentalmente com 10(7) organismos viáveis de Trypanosoma vivax, isolados de bovinos da região de Poconé, Estado de Mato Grosso. Os animais foram observados diariamente, durante 30 dias, quanto aos parâmetros de temperatura retal, volume globular (VG), parasitemia, produção de anticorpos, coloração de mucosas, comportamento e apetite. Determinaram-se os níveis séricos de aspartato aminotransferase (AST), fosfatase alcalina (FA), gama glutamiltransferase (GGT), creatina kinase (CK), colesterol, uréia, creatinina, cálcio, fósforo e o perfil eletroforético das proteínas séricas aos 4, 8, 12, 16, 23 e 30 dias pós-inoculação (DPI). Durante os 6 meses seguintes, os animais foram observados semanalmente, avaliando-se a temperatura retal, o VG e a parasitemia. T. vivax foi evidenciado a partir do terceiro e quarto DPI em todos os bezerros e persistiu até o 30° DPI em cinco dos seis animais em estudo. Ocorreu um decréscimo significativo (p<0,05) do valor médio do VG (25%) aos dez DPI. Os animais não apresentaram qualquer alteração no quadro clínico, bem como na avaliação da bioquímica sérica durante o período experimental. A soroconversão ocorreu aos 6 e 8 DPI, permanecendo todos os animais soropositivos nos 30 dias experimentais. Bovinos nelores jovens, infectados experimentalmente com T. vivax, foram capazes de estabelecer um equilíbrio na relação hospedeiro-parasita.

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

Risco de queda em idosos da comunidade: avaliação com o teste Timed up and go

Risco de queda em idosos pode ser avaliado por meio de um teste simples de mobilidade. OBJETIVO: Avaliar o equilíbrio de idosos usando o teste Timed up and go. MÉTODO: Os indivíduos tiveram o tempo medido desde o momento em que se levantaram de uma cadeira, caminharam 3 metros para a frente e retornaram à cadeira. Os idosos também responderam questões sobre desequilíbrio, tontura e queda. RESULTADOS: Cerca de 69% dos sujeitos realizaram o teste em até 19 segundos. Houve correlação significativa entre desequilíbrio, tempo dispendido e queda, assim como entre tontura e queda. CONCLUSÃO: A maior parte dos idosos mostrou baixos valores no teste, o que sugere boa mobilidade funcional. Entretanto, um número expressivo de indivíduos com valores mais elevados estão, provavelmente, mais propensos a quedas e à dependência menor ou maior nas atividades da vida diária.

Avaliação clínica de duas ke0 no mesmo modelo farmacocinético de propofol: estudo da perda e recuperação da consciência

JUSTIFICATIVA E OBJETIVOS: A constante de equilíbrio entre o plasma e o sítio efetor (ke0) é utilizada pelos modelos farmacocinéticos para prever a concentração do fármaco em seu local de ação (Ce). Seria interessante que a Ce de propofol fosse semelhante na perda e na recuperação da consciência. O objetivo deste estudo foi avaliar o desempenho clínico de duas diferentes ke0 (rápida = 1,21 min-1 e lenta = 0,26 min-1) com relação à Ce durante a perda e a recuperação da consciência, usando o modelo farmacocinético de Marsh. MÉTODO: Participaram deste estudo 20 voluntários adultos sadios do sexo masculino. em todos os voluntários, administrou-se propofol em regime de infusão alvo-controlada, modelo farmacocinético de Marsh ke0 rápida e, em outra oportunidade, usou-se o mesmo modelo farmacocinético com a ke0 lenta. Inicialmente, o propofol foi infundido em concentração-alvo plasmática de 3,0µg.mL-1. A perda de consciência e a recuperação de consciência basearam-se na resposta ao estímulo verbal. A Ce foi anotada no momento da perda e da recuperação da consciência. RESULTADOS: Na perda e na recuperação da consciência a Ce pela ke0 rápida foi diferente (3,64 ± 0,78 e 1,47 ± 0,29µg.mL-1, respectivamente, p < 0,0001), enquanto com a ke0 lenta a Ce foi semelhante (2,20 ± 0,70 e 2,13 ± 0,43µg.mL-1, respectivamente, p = 0,5425). CONCLUSÕES: do ponto de vista clínico, a ke0 lenta (0,26 min-1) incorporada ao modelo farmacocinético de Marsh apresentou melhor desempenho que a ke0 rápida (1,21 min-1), uma vez que a concentração de propofol prevista em seu local de ação na perda e recuperação da consciência foi semelhante.

Análise do equilíbrio em pacientes hemiparéticos após o treino com o programa Wii Fit

OBJETIVO: A hemiparesia é um comprometimento parcial do hemicorpo que altera o equilíbrio, sendo este essencial para as atividades funcionais. OBJETIVO: Avaliar o equilíbrio em pacientes hemiparéticos submetidos ao treino de equilíbrio com o programa Wii Fit, que atuou como um recurso de biofeedback visual. MÉTODO: Foram selecionados 12 pacientes hemiparéticos pós AVE, 5 do sexo masculino e 7 do sexo feminino, com idade média de 58 ± 12,57 anos, divididos aleatoriamente em dois grupos. Um deles realizou a fisioterapia convencional (GC) pelo período de uma hora, o outro realizou por trinta minutos e mais trinta minutos de treino de equilíbrio com auxílio do Wii Fit (GW), duas vezes por semana durante cinco semanas, completando dez sessões. O equilíbrio foi avaliado antes e após as intervenções, por meio da aplicação da Escala de Equilíbrio de Berg (EEB) e pela estabilometria, que mensura a oscilação do centro de pressão (COP), nos eixos ântero-posterior (AP) e médio-lateral (ML), por uma plataforma de pressão em duas condições: de olhos abertos (OA) e olhos fechados (OF). RESULTADOS: de acordo com a EEB, os pacientes, tanto do GC quanto o do GW, obtiveram maior controle do equilíbrio estático e dinâmico. Na avaliação do COP no eixo ML, os indivíduos do GC e do GW tiveram diminuição na oscilação ML após a intervenção proposta para cada grupo, nas condições de OA e OF. No eixo AP do COP, o GC não teve diminuição na oscilação AP de OA e OF, e o GW apresentou diminuição na oscilação AP de OA e OF. CONLUSÃO: O presente estudo demonstra que a fisioterapia associada ao treino de equilíbrio com o Wii Fit apresenta resultados significantes na reabilitação dos indivíduos hemiparéticos, obtendo, assim, mais um recurso terapêutico na fisioterapia.

Avaliação da associação midazolam/droperidol na tranqüilização de suínos

Na presente pesquisa, avaliou-se a associação midazolam/droperidol na tranqüilização de 11 suínos da raça Landrace. Foram analisadas as frequências cardíaca, respiratória, temperatura retal e hemogasimetria arterial antes e após a administração do midazolam (0,4mg/kg IM) associado ao droperidol (0,4mg/kg IM). As anotações paramétricas e análises hemogasimétricas foram realizadas a intervalos de 10 minutos, durante uma hora após a administração das drogas. Concomitantemente efetuaram-se observações clínicas a respeito da eficácia da tranqüilização. Não ocorreram alterações significativas nos parâmetros de frequência cardíaca e equilíbrio ácido-base. A frequência respiratória diminuiu significativamente, quando comparada aos valores basais. O tempo médio de ação das drogas foi de 60 minutos, com período de latência de 3 minutos. Durante a tranqüilização houve relaxamento muscular, perda dos reflexos posturais, indiferença ao meio ambiente e manutenção dos reflexos protetores. A análise dos resultados permite indicar a associação midazolam/droperidol para a tranqüilização/sedação de suínos.

Avaliação do desempenho de tilápias (Oreochromis niloticus, Trewavas, 1983) em tanques-rede na represa de Jurumirim/Alto Rio Paranapanema

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Controle postural, equilíbrio funcional e estabilidade do ato de locomoção na neuropatia diabética periférica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)