Obesidade e sobre peso pré-gestacionais: prevalência e principais complicações maternas

Objetive: The goal of this review is to present up-to-date information on the prevalence of overweight and obesity and to discuss the evidence regarding the impact of these conditions on the health of mother.Data Collection Method: We conducted a search for articles in the Medline, PubMed and Scielo databases covering the past 5 years, and reviewed the bibliographical references contained in the articles selected. Articles were selected by subjective evaluation in terms of methodology, sample size and year of publication. Summary of evidence: Current information points to a high and growing prevalence of overweight and obesity. We found strong evidence linking excess weight before pregnancy with the development of pregnancy-induced hypertension, gestational diabetes, pregnancy at 41 weeks or over, thromboembolism, cesarean section and puerperal infection. Conclusions: Excess weight in the pre-pregnancy is one of the most important risk factors of maternal health, whose importance increases because it is a modifiable risk factor. The obese pregnant woman should be considered at high risk and it is recommended that women be with the weight as close to normal as possible before conception.

Principais complicações perinatais da obesidade e do sobrepeso pré-gestacionais

Objetive: The goal of this review is to discuss the evidence regarding the impact of pre-pregnancy overweight and obesity on perinatal outcomes. Data Collection Method: We conducted a search for articles in the Medline, PubMed and Scielo databases covering the past 5 years, and reviewed the bibliographical references contained in the articles selected. Articles were selected by subjective evaluation in terms of methodology, sample size and year of publication. Summary of evidence: We found strong evidence linking excess weight before pregnancy with the development of birth defects, fetal and neonatal deaths and macrosomia,. Conclusions: Excess weight in the pre-pregnancy is an important risk factor for the health of the fetus, whose importance increases because it is a modifiable risk factor.

Incorporação de nanoemulsões de óleos essenciais de melaleuca, copaíba e limão em filmes de alginato de sódio para utilização como curativo

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação da dor crônica e locomoção de cães com displasia coxofemoral submetidos à acupuntura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da dor crônica e locomoção de cães com displasia coxofemoral submetidos à acupuntura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Práticas para a saúde: avaliação subjetiva de adolescentes

Este trabalho verificou as percepções sobre a satisfação com a vida, o corpo e a saúde de adolescentes, cujas práticas se refletem na saúde bucal. Por meio de pesquisa qualitativa, jovens de Barueri/São Paulo foram entrevistados pela técnica do grupo focal. Seus discursos foram analisados pela análise de conteúdo. Os resultados indicam que a alimentação desses jovens é pouco balanceada; o cuidado com o corpo é sinônimo de banho e esportes, e a saúde bucal foi limitada à escovação; recorrem ao convênio pela demora do atendimento no posto de saúde. O conhecimento da percepção dos jovens sobre esses eixos pode contribuir para o aprimoramento das ações e do acesso aos meios de prevenção, tratamento e manutenção da saúde bucal.

Análise de desconforto térmico local em ambientes cirúrgicos com o uso de manequim, medição de variáveis ambientais e avaliação subjetiva

Na avaliação de conforto térmico em ambientes interiores não basta analisar as condições de conforto para o corpo como um todo, pois há a necessidade de se analisar também as condições de desconforto térmico local. Em ambientes complexos, tais como os ambientes cirúrgicos, onde os membros da equipe cirúrgica ocupam diferentes posições no ambiente e desempenham atividades distintas, a análise de condições de desconforto térmico local torna-se ainda mais premente. No presente trabalho foram analisadas condições de desconforto térmico local devido a assimetrias da temperatura radiante, diferença vertical de temperatura do ar e risco de correntes de ar utilizando manequim, medição de variáveis ambientais e avaliação subjetiva. Resultados da avaliação subjetiva mostraram níveis de insatisfação de até 35 % dos anestesistas e enfermeiros com correntes de ar e de até 85% dos cirurgiões com o calor do foco cirúrgico. Resultados similares foram obtidos a partir da medição de variáveis ambientais e com o uso de manequim. Estes resultados ressaltam ainda mais a grande dificuldade de se prover condições de conforto térmico neste tipo de ambiente. Entretanto, a utilização de diferentes ferramentas de análise pode auxiliar na busca de se prover condições de conforto térmico as melhores possíveis para todos os membros da equipe cirúrgica.

Development of a continuum mechanics model of passive skeletal muscle

Skeletal muscle force evaluation is difficult to implement in a clinical setting. Muscle force is typically assessed through either manual muscle testing, isokinetic/isometric dynamometry, or electromyography (EMG). Manual muscle testing is a subjective evaluation of a patient’s ability to move voluntarily against gravity and to resist force applied by an examiner. Muscle testing using dynamometers adds accuracy by quantifying functional mechanical output of a limb. However, like manual muscle testing, dynamometry only provides estimates of the joint moment. EMG quantifies neuromuscular activation signals of individual muscles, and is used to infer muscle function. Despite the abundance of work performed to determine the degree to which EMG signals and muscle forces are related, the basic problem remains that EMG cannot provide a quantitative measurement of muscle force. Intramuscular pressure (IMP), the pressure applied by muscle fibers on interstitial fluid, has been considered as a correlate for muscle force. Numerous studies have shown that an approximately linear relationship exists between IMP and muscle force. A microsensor has recently been developed that is accurate, biocompatible, and appropriately sized for clinical use. While muscle force and pressure have been shown to be correlates, IMP has been shown to be non-uniform within the muscle. As it would not be practicable to experimentally evaluate how IMP is distributed, computational modeling may provide the means to fully evaluate IMP generation in muscles of various shapes and operating conditions. The work presented in this dissertation focuses on the development and validation of computational models of passive skeletal muscle and the evaluation of their performance for prediction of IMP. A transversly isotropic, hyperelastic, and nearly incompressible model will be evaluated along with a poroelastic model.

[Partial femur head necrosis in adults--results with intertrochanteric osteotomy and revascularization]

Osteotomy and revascularization have both been used for many years in the therapy of partial aseptic necrosis of the femoral head in the adult. We first attempted a combination of the two techniques in 1978. Stress on the necrotic sector was relieved by intertrochanteric osteotomy, and the necrotic part of the bone was revascularized with a pedicled iliac crest bone graft based on the deep circumflex iliac vessels. Long-term results are now available in 45 hips in 38 patients, with a mean follow-up time of 32 months. Clinically, 71% of the hips were rated very good or good, and among those classed as stage II before surgery the results were rated as very good or good in as many as 90%. Subjective evaluation of the hips by the patients confirmed these results: 85% of the hips were judged to be optimal or markedly improved compared with before operation. Radiological evaluation showed further flattening of the femoral head in one case. A segmental collapse of the femoral head, i.e. stage III lesion according to Ficat, occurred in 2 hips with stage II preoperatively. In 6 hips with stage III necrosis preoperatively secondary arthritis developed. Computerized tomograms taken of all 25 hips from which metal implants had been removed showed signs of integration of the graft in 68%. Scintigraphy with 99-Tc-diphosphonate showed a homogeneous uptake in 42.8% and a non-homogeneous uptake in the remaining 57.2% of the cases. So-called photopenia was not observed in any of the hip joints treated.(ABSTRACT TRUNCATED AT 250 WORDS)

Scintigraphic and radiographic appearance of the sacroiliac region in horses with gait abnormalities or poor performance

Nuclear bone scintigraphy is commonly used in the diagnosis of sacroiliac disease in horses. The aim of the present retrospective study was to determine if there was an association between radiopharmaceutical uptake pattern and radiographic appearance of the sacroiliac region in horses. Seventy-nine horses undergoing bone scintigraphy with Tc-99 m-HDP and radiography of the pelvis because of lameness or poor performance were studied. Subjective and semiquantitative methods were used to characterize and compare radiopharmaceutical uptake between horses. Ventrodorsal radiographs of the region were obtained and were evaluated. Subjectively, 70 horses (88.6%) had an abnormal uptake pattern. In nine horses, the sacroiliac region was normal (11.4%). There was no association between subjective evaluation of the scintigraphic images and semiquantitative methods. There was a significant association between radiopharmaceutical uptake and conformation (T- or Y-like form) and shape (butterfly-, wing-, leaf-, or horn-like) of the sacrum. The radiopharmaceutical uptake of the tubera sacralia was significantly higher in males (left side P = 0.002, right side P = 0.003). In conclusion, the conformation of the sacrum may play an important role in the scintigraphic appearance and may be the cause of increased radiopharmaceutical uptake.

Bildungsexpansion und Bildungsbeteiligung. Oder: warum immer mehr Schulpflichtige das Gymnasium besuchen

Die vorliegende Untersuchung ist ein Beitrag, die Frage zu klären, warum in der westdeutschen Nachkriegszeit immer mehr Schulpflichtige nach Abschluss der Grundschule das Gymnasium besuchen. Ausgehend von einem entscheidungstheoretischen Modell der subjektiven Werterwartung werden Mechanismen der elterlichen Bildungsentscheidung aufgezeigt. Dabei wird davon ausgegangen, dass sowohl zunehmende Bildungsmotivationen als auch Veränderungen in der subjektiven Bewertung von Kosten und Nutzen für eine höhere Bildung wichtige Voraussetzungen für die zunehmende Bildungsbeteiligung, aber auch Folgen der Bildungsexpansion waren. Die empirischen Analysen für drei Zeitpunkte in den 60er, 70er und 80er Jahren bestätigen diese Annahmen weitgehend. Ebenso wurde empirisch belegt, welch wichtige Rolle neben den Bildungsintentionen von Eltern und dem vorhergehenden Bildungsverlauf ihrer Kinder auch strukturelle Momente der Bildungsexpansion und ihre Eigendynamik beim tatsächlichen Bildungsübergang spielen. Schließlich gibt es Hinweise dafür, dass die Persistenz klassenspezifischer Bildungsungleichheiten auf einer konstanten Balance von Nutzen und Kosten zwischen den sozialen Klassen basiert.

Influence of the semantic content of urban sounds in the identity of outer spaces

This paper shows the influence of the semantic content of urban sounds in the subjective evaluation of outer spaces. The study is based on the analysis conducted in three neighboring and integrated urban spaces with a different form of social ownership in the city of Cordoba, Argentina. It shows that the type of sound source present at each site influence, by its semantic content, in the user´s identification and permanence in the place. The noise present in a soundscape is able to have a high semantic content, and therefore the sound has a particular meaning for the perceiver. Every particular social group influences the production of their own sounds and how they perceive them. This allows to consider the sound as one of the factors that define the sense of "place" or "no place" of a certain urban space. Evidently the sounds, and their ability to evoke and characterize the environment, cannot be ignored in the construction and recovery of anthropological sites. This urban culture is unique and specific to every society. Thepublic spaces, with their soundscape, are part of the construction of the urban identity of a city. It is shown that for identical general sound levels present in each of the spaces, the level of annoyance or discomfort, in relation to the subjective acoustic quality, is different. This is the result of the influence of semantic content of the sounds present in each urban space. Coinciding with other similar research, the level of discomfort or annoyance decreases as the presence of natural sounds such as water, the wind in the trees or the birds singing increases, even when the objective values of noise level of natural sounds are higher.

Vocal fold biomechanical analysis for the singing voice

Teaching the adequate use of the singing voice conveys a lot of knowledge in musical performance as well as in objective estimation techniques involving the use of air, muscles, room and body acoustics, and the tuning of a fine instrument as the human voice. Although subjective evaluation and training is a very delicate task to be carried out only by expert singers, biomedical engineering may help contributing with well - funded methodologies developed for the study of voice pathology. The present study is a preliminary study of exploratory character describing the performance of a student singer in a regular classroom under the point of view of vocal fold biomechanics. Estimate s of biomechanical parameters obtained from singing voice are given and their use i n the classroom is discussed.

Evaluación subjetiva de la diferenciación entre las respuestas impulsivas medidas y simuladas en diferentes recintos

Para estudiar la acústica en recintos se utilizan herramientas de modelado acústico de salas y la auralización de estos recintos. En muchos casos el mismo software de modelado genera las auralizaciones que simulan como se escucharía un determinado audio en un punto del recinto. En el presente trabajo se intenta estudiar la calidad de las respuestas impulsivas simuladas generadas por una de estas herramientas de modelado. El proyecto consiste en realizar una evaluación subjetiva de la diferenciación entre las respuestas impulsivas medidas y simuladas en diferentes recintos, comparándola con los parámetros acústicos objetivos que se han obtenido mediante una evaluación objetiva anterior. Para ello, se desarrolla una herramienta software que, con las respuestas impulsivas simuladas (generadas por un software de modelado acústico, ODEON) y las respuestas impulsivas medidas, genere: las auralizaciones correspondientes; un test de escucha para hacer la evaluación subjetiva de las auralizaciones obtenidas y una interfaz de usuario para interaccionar con los oyentes a evaluar; y que almacene los resultados del test de escucha. Además se llevará a cabo la evaluación subjetiva (test de escucha) con un grupo de oyentes, con los que posteriormente se obtendrán los resultados para poder comparar con los valores objetivos. A partir de los resultados del test de escucha, se estudiará la relación entre las diferencias de las respuestas impulsivas (medidas y simuladas) con respecto a: 1) parámetros objetivos (diferencias en valores de JND), 2) evaluación subjetiva (diferenciación subjetiva con el test de escucha) y, 3) comparación entre ambos. Finalmente, se obtendrán las conclusiones derivadas de este estudio. ABSTRACT. Tools of Room Acoustic Modeling and the auralization of these rooms have been used to study room Acoustics. In many cases, the modeling software itself generates the auralizations which simulate the sound of a particular audio in a particular position in a room. The quality of simulated impulse responses generated by a modelling tool has been studied in this project. The project carries out a subjective evaluation of the differences between measured and simulated impulse responses in different rooms, and in comparing them with objective acoustical parameters which have been obtained from the previous objective evaluation. For this, a software tool has been developed. This software, with simulated (generated by a modelling software, ODEON) and measured impulse responses generate: the correspondent auralizations, listening test (which carries out the subjective evaluation of the auralization) and a user interface to interact with listeners. This tool also stores the listening test results. In addition, the subjective evaluation (listening test) will be carried out with a group of listeners, from who we will get the results to compare subjective values. The differences between impulse responses (both measured and simulated) are obtained from the results of the listening test and these differences have been studied regarding: 1) objective parameters (difference in JND values); 2) subjetive evaluation (subjective differences with the listening test); 3) comparison between both. Eventually the conclussions derivative from this project will be obtained.

Acústica de las iglesias jesuíticas como parte del patrimonio integral en Córdoba y San Ignacio Miní

En esta investigación se aborda el tema del comportamiento acústico de las Iglesias Jesuíticas de la ciudad de Córdoba (Argentina) y San Ignacio Mini ubicada en la localidad de San Ignacio, provincia de Misiones (Argentina), construidas hace dos siglos atrás y declaradas Patrimonio de la Humanidad, con el objetivo de evaluar los parámetros que determinan la comprensión de la palabra y la aptitud de cada una de las iglesias para el canto y la música religiosa. En una primera etapa la investigación se orientó a profundizar en las características constructivas interiores de cada templo y a proponer una metodología de análisis para comparar los resultados de las mediciones objetivas, realizadas mediante la implementación de mediciones in situ, con los resultados de las apreciaciones subjetivas resultantes de la elaboración de encuestas, a los fines de caracterizar acústicamente cada espacio sonoro. Se seleccionaron, para la caracterización objetiva de cada templo, aquellos parámetros que permiten sintetizar las propiedades acústicas relacionadas con la música y la palabra, y aquellos que posibilitan medir la proporción efectiva de las primeras reflexiones, consideradas como índices subjetivos de la capacidad de distinción del sonido por parte del oyente. Se comparan los valores alcanzados con las preferencias subjetivas obtenidas en las encuestas de opinión. Se relevaron tiempos de reverberación altos en todas iglesias, fuera de los considerados óptimos para cada recinto. Se analizaron los índices de calidad y se comprobó cómo influyen los diferentes materiales en el comportamiento acústico de cada recinto. Para la evaluación subjetiva se implementó una encuesta ya validada en la que se privilegió la fácil asociación entre parámetros acústicos y psicoacústicos, esto posibilitó encontrar aquellos parámetros objetivos, simulados con público, que estuviesen fuertemente relacionados con el juicio subjetivo, así como aquellos con menor correlación. La búsqueda y relevamiento de material grafico, fotográfico y otros documentos históricos posibilitó la reconstrucción de cada iglesia para su modelización y la evaluación del comportamiento de todos los templos con la presencia de feligreses, no habiéndose podido realizar mediciones bajo esta condición. El interés por obtener datos acústicos más precisos de la Iglesia San Ignacio Mini, que actualmente se encuentra en ruinas, llevó a utilizar herramientas más poderosas de cálculo como el método de las fuentes de imagen “Ray Tracing Impact” por medio del cual se logró la auralización. Para ello se trabajó con un archivo de audio que representó la voz masculina de un sacerdote en el idioma jesuítico-guaraní, recuperando así el patrimonio cultural intangible. ABSTRACT This research addresses the acoustic behavior of the Jesuit Churches in Cordoba City (Argentina) and San Ignacio Mini (located in the town of San Ignacio, Misiones, Argentina), built two centuries ago and declared World Heritage Sites, with the objective to evaluate the parameters that determine the speech comprehension and the ability of each of the churches for singing of religious music. The first step of the work was aimed to further investigate the internal structural characteristics of each temple and to propose an analysis methodology to compare the objective results of in situ measurements with the subjective results of surveys, in order to characterize acoustically each sound-space. For the subjective characterization of each temple, those parameters that allow synthesizing the acoustic properties related to music & speech and measuring the subjective indices for the recognition of sounds, were selected. Also, the values were compared with the ones obtained from the surveys. High reverberation times were found in all churches, which is not considered optimal for the enclosed areas of the temples. The quality indices were analyzed and it was found how the different materials influence in the acoustic behavior of each enclosure. For subjective evaluation, a survey was implemented (that was previously validated) where the association between acoustic and psychoacoustic parameters was privileged; this allowed to find those objective parameters who were strongly related to the subjective ones, as well as those with lower correlation. Photographic and graphic material and other historical documents allowed the reconstruction of each church for its modeling, and also the evaluation of the performance of all the temples in the presence of their congregation. The interest in obtaining more accurate acoustic data of the San Ignacio Mini Church, which is now in ruins, led to the use of most powerful methods, as for example the image-sources "Ray Tracing Impact" method. For this, an audio archive was used, representing a male voice of a priest in the Jesuit-Guaraní language; recovering in this way intangible cultural heritage.