Avaliação clínica da resposta do tratamento periodontal não-cirúrgico (Full mouth desinfection) de pacientes diabéticos e não diabéticos

Tem sido demonstrado que o diabetes influencia no desenvolvimento e progressão da doença periodontal. Acredita-se ainda que há uma relação bi-direcional entre o Diabetes Mellito e a Doença Periodontal. Por isso, o tratamento periodontal pode responder de forma diferente em pacientes com e sem o quadro de diabetes. O objetivo desse estudo foi avaliar clinicamente o efeito da terapia periodontal não cirúrgica em pacientes com periodontite e diabetes mellito (grupo teste) e sem o quadro de diabetes (grupo controle). Para isso, realizou-se o tratamento periodontal não-cirúrgico FMSRP (Full mouth Scalling and Root Planing) e verificou-se os parâmetro clínicos periodontais (profundidade de sondagem, nível clínico de inserção, mobilidade, índice gengival e índice de placa) no início do estudo e após 3 meses. Na análise estatística, o paciente foi considerado como unidade de análise (p<0,05). Para as variáveis categóricas utilizou-se o teste de Fisher. Nas comparações inter-grupo, foi utilizado o Mann-Whitney Test e para comparações intra-grupo (baseline e três meses) utilizou-se o Teste de Wilcoxon. Participaram 26 pacientes no grupo controle e 14 no grupo teste. O índice de placa era 71,20% no início do estudo para o grupo teste e ficou 47,12% no fim; já no controle, os valores eram de 48,52% passando para 37,50%. E o índice gengival no grupo teste no baseline era 42,67 diminuindo para 26,81 e no grupo controle diminuiu de 41,36 para 30,62. A profundidade de sondagem foi no grupo teste 2,71mm passando para 2,40mm; já no controle, os valores foram de 2,84mm diminuindo para 2,55mm. O grupo controle ganhou 0,34 mm de inserção e o grupo teste perdeu 0,44mm de inserção. A recessão gengival aumentou 0,33mm no grupo teste e 0,04mm no grupo controle após os 3 meses. Houve diferença significativa inter-grupo para o índice de placa e gengival no baseline, também foi encontrado na recessão após 3 meses; já intra-grupo verificou-se diferença significativa para todas as variáveis, exceto para o nível clinico de inserção e mobilidade. Quando se categorizou a profundidade de sondagem em ≤3mm, >3 e≤6mm e >6mm, não foi encontrado diferença entre os grupos, mas verificou-se diferença significativa entre os períodos tanto para o grupo teste como para o controle. A hemoglobina glicada no grupo controle foi de 5,90% e no teste aumentou de 7,79% para 8,10%. Portanto, verifica-se que há uma melhora dos parâmetros clínicos periodontais em ambos os grupos, contudo não se verificou uma diferença significativa entre eles. Não obstante, o FMSRP promove um efeito benéfico em relação à condição de saúde periodontal, melhora dos parâmetros clínicos periodontais, em curto prazo (3 meses) tanto em indivíduos diabéticos como em não diabéticos, não sendo possível observar um melhor quadro glicêmico nos diabéticos

Eficácia do tratamento não-cirúrgico em indivíduos com mucosite peri-implantar

It has been shown that the development of peri-implant mucositis is associated with biofilm accumulation. It is believed that the therapeutic approaches used in periodontal disease may have a positive effect in the cases of peri-implant disease. The aim of this study was to evaluate the effectiveness of non-surgical treatment of peri-implant mucositis, with or without the use of chlorhexidine 0,12% in subjects rehabilitated with osseointegrated implants. Thus, patients were randomly divided into test group (chlorhexidine surgical therapy) and control (non-surgical treatment). This therapy consisted of an adaptation of the (Full Mouth scalling and Root Planing) nonoperative protocol FMSRP, but without the use of ultrasound. The visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), bleeding on probing (BOP) and keratinized mucosa clinical parameters were evaluated at baseline and at different times after treatment. The data were not normally distributed and the implant was considered the sampling unit. Data were analyzed using Fri edman and Wilcoxon chi-square (=5%), tests using the Statistical Package for Social Sciences 17.0 (SPSS). Thus, 119 implants were evaluated, 61 in the test group and 58 in the control group. The results showed statistically significant differences for the variables: average BTI implants in both groups (p<0,001), mean ISG implants both in the test group (p<0,001), and control (p= 0,006) of implants; PS for the test group (p< 0,001) and control (p = 0,015) and SS (p<0,001) in the two treatment groups. However, there was no statistically significant difference when the groups were compared. The PS and SS variables showed no statistically significant difference in any of independent interest to the study (age, sex, smoking, treatment group, keratinized mucosa at different times, peri-implant biotype, average VPI implants and GBI). Thus, it can be concluded that both the mechanical treatment isolated as its association with chlorhexidine mouthwash 0.12% can be used for the treatment of peri-implant mucositis. Moreover, the condition of oral h ygiene has improved between baseline and six months and the depth and bleeding on probing decreased after three and six months

Introdução da comunicação suplementar e alternativa na terapia com afásicos

Sabe-se que o tratamento fonoaudiológico de pacientes com afasia severa é limitado. A ausência de fala articulada, algumas vezes, impede o diagnóstico da afasia. O paciente grave pode não falar devido à inabilidade de articulação, como ocorre na disartria e/ou apraxia. Essa ausência de fala não permite afirmar se a linguagem está comprometida. O uso da comunicação suplementar e alternativa tem sido um método eficaz na reabilitação desses pacientes. Esse estudo visou descrever o uso da comunicação suplementar e alternativa associada a outras modalidades de linguagem (escrita, gestos), a partir do relato de dois casos de afasia. A análise dos dados foi composta por dois blocos: a introdução da comunicação suplementar e alternativa no diálogo; e o uso da leitura e escrita associado aos símbolos. A comunicação suplementar e alternativa foi um apoio para a oralidade, leitura e escrita dos pacientes.

Terapia de linguagem no espectro autístico: a interferência do ambiente terapêutico

OBJETIVO: Analisar o perfil funcional da comunicação de crianças e adolescentes com distúrbios do espectro autístico em dois ambientes de terapia de linguagem, que se diferenciam quanto ao aspecto físico. MÉTODOS: Participaram dez sujeitos com distúrbios do espectro autístico, seis do gênero masculino e quatro do gênero feminino, com idades entre 4 e 13 anos. Na coleta de dados, foram realizadas filmagens de oito sessões de terapia de linguagem individual com duração de 30 minutos, sendo quatro sessões em uma sala comum e quatro em uma sala com ambientação específica (sala NIC), intercaladamente, durante um mês. Para a análise dos dados foi empregado o Protocolo de Pragmática, e os resultados receberam tratamento estatístico. RESULTADOS: Verificou-se que não houve diferença significativa entre o perfil pragmático apresentado pelos dez sujeitos na sala comum e na sala NIC. CONCLUSÃO: O contexto físico aqui estudado não influenciou significativamente no perfil funcional da comunicação de indivíduos do espectro autístico, ainda que se tenha verificado tendências individuais apresentando melhor desempenho em uma sala ou em outra.

Beta: uma ferramenta para geração de testes de unidade a partir de especificações B

Formal methods and software testing are tools to obtain and control software quality. When used together, they provide mechanisms for software specification, verification and error detection. Even though formal methods allow software to be mathematically verified, they are not enough to assure that a system is free of faults, thus, software testing techniques are necessary to complement the process of verification and validation of a system. Model Based Testing techniques allow tests to be generated from other software artifacts such as specifications and abstract models. Using formal specifications as basis for test creation, we can generate better quality tests, because these specifications are usually precise and free of ambiguity. Fernanda Souza (2009) proposed a method to define test cases from B Method specifications. This method used information from the machine s invariant and the operation s precondition to define positive and negative test cases for an operation, using equivalent class partitioning and boundary value analysis based techniques. However, the method proposed in 2009 was not automated and had conceptual deficiencies like, for instance, it did not fit in a well defined coverage criteria classification. We started our work with a case study that applied the method in an example of B specification from the industry. Based in this case study we ve obtained subsidies to improve it. In our work we evolved the proposed method, rewriting it and adding characteristics to make it compatible with a test classification used by the community. We also improved the method to support specifications structured in different components, to use information from the operation s behavior on the test case generation process and to use new coverage criterias. Besides, we have implemented a tool to automate the method and we have submitted it to more complex case studies

Complicações da terapia anticoagulante com warfarina em pacientes com doença vascular periférica: estudo coorte prospectivo

OBJETIVO: Estudar prospectivamente a freqüência de complicações em pacientes tratados com warfarina e acompanhados no Ambulatório de Anticoagulação da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista. MÉTODOS: Pacientes sorteados entre os agendados para consulta de junho de 2002 a fevereiro de 2004. Na primeira consulta, foi preenchida ficha com dados de identificação e clínicos. A cada retorno, ou quando o paciente procurou o hospital por intercorrência, foi preenchida ficha com a razão normatizada internacional, existência e tipo de intercorrência e condições de uso dos antagonistas da vitamina K. RESULTADOS: Foram acompanhados 136 pacientes (61 homens e 75 mulheres), 99 com tromboembolismo venoso e 37 com doença arterial; 59 pacientes eram de Botucatu, e 77, de outros municípios. Foram registradas 30 intercorrências: nove não relacionadas ao uso da warfarina e 21 complicações hemorrágicas (38,8 por 100 pacientes/ano). Uma hematêmese foi considerada grave (1,9 por 100 pacientes/ano). As demais foram consideradas moderadas ou leves. Não houve óbitos, hemorragia intracraniana ou necrose cutânea. A única associação significante foi da freqüência de hemorragia com nível médio de razão normatizada internacional. CONCLUSÃO: Nossos resultados mostram a viabilidade desse tratamento em pacientes vasculares em nosso meio, mesmo em população de baixo nível socioeconômico, quando tratados em ambulatório especializado.

Usos e percepções de comunidades do entorno de uma unidade de conservação do semiárido nordestino: instrumentos para gestão?

The loss of Earth´s biodiversity is a major concern for the international scientific community and megadiverse countries like Brazil are paramount for discussions about the overall situation of the planet. The Caatinga biome is probably one of the most threatened in Brazil and the implementation of Conservation Units (CU) represents a measure for protecting its natural resources and biodiversity. The Station Ecological of Seridó (ESEC-Serido) is one of the few CU in the Caatinga of Rio Grande do Norte State (NE Brazil) and interacts with several neighboring communities and settlements. However the ESEC does not integrate environmental perception feedback from the local communities in its management plan. Considering this, the present articles aims at identifying the perceptions and concepts of such communities regarding environmental issues and biodiversity as well as indicate strategies to improve the administration of this CU. In order to achieve these goals, a review of the specialized literature was carried out and a research tool based on Environmental Perception was developed in the form of structured interviews applied to the persons from communities neighboring the ESEC. These interviews were later processed through content analysis. The concepts and perceptions obtained through this analysis show that the people from the environs are aware of the main problems faced by ESEC-Seridó, as well as the strategies to address them

Estudo das percepções ambientais e de ações educativas promotoras da biodiversidade em unidade de conservação no Rio Grande do Norte

Important issues involving the awakening to the need for conservation of biodiversity and the importance of establishing protected areas as a strategy in pursuit of environmental protection, are increasingly being developed in biological and social investigative fields. In this sense, this research aimed to emphasize the use of environmental perception of social agents are significant elements for the understanding of the man / nature, and develop educational activities aimed at raising awareness and changing attitudes towards environmental issues thus promoting reflections on Environmental Education (EE) as a critical and transformative tool for conservation of rich biological diversity. This research covers as a place of study, schools located in the Environmental Protection Area Jenipabu (APAJ), Rio Grande do Norte. Methodology in general, we highlight the use of questionnaires and mind maps as generators of the contents of empirical research, and execution of content analysis for the treatment of data collected. This dissertation has two chapters in the form of scientific articles, where the first is entitled: "Study of the perceptions and evaluation of interactions concerning environmental education in schools in a conservation area of Rio Grande do Norte - Brazil", obtaining thus a primary diagnosis for analysis about the visions that students and teachers from two schools located in APAJ have on the environment. The second article, entitled: "Effective and analysis of educational activities that promote biodiversity in a coastal area of Environmental Protection Northeast - Brazil" provides an analysis of the educational use of biodiversity as a way to raise awareness of the need for environmental conservation. It appears from research that there is a lack of training in EA by teachers, but there is a need for greater involvement of students in conservation areas, however, from the analysis of educational activities, we observed that the effectiveness of such actions acts to promote awareness and change in actors involved. Thus, environmental education needs to take into account the different perceptions found in each individual, and it can not be based solely on transmission of knowledge, so that we reach a model of conservation.

Culicídeos vetores em uma unidade de conservação da caatinga na região do seridó no Rio Grande do Norte aspectos da transmissão de doenças

The scarcity of occurrence records of culicid species, transmitting insects of etiologic agents for arboviruses, protozoan diseases and philarioses, and lack of information about their interactions with the forest environment make the Caatinga one of the most unknown biomes in Brazil. The aim of this study was to identify culicid species in a conservation unit located in a preserved area of the Caatinga and the possible associations with local abiotic factors, as well as characterize the natural and artificial ecotopes present in the Caatinga of Rio Grande do Norte state. The Ecological Station of Serido (ESEC-Seridó) is a Caatinga Conservation Unit located in a rural area of Rio Grande do Norte. The hot and dry climate of the Caatinga, along with a short rainy season, favor the adaptation and resistance of plants, resulting in completely distinct landscapes over the course of the year. The study took place over the course of one year, with monthly collections between 10h-12h, 14h-16h and 18h-20h. Adult mosquitoes were collected in a forest area using a manual suction trap with human bait as attractant at the three times and a Shannon trap for night collections. During the rainy season ovitraps were randomly distributed at different sites. The different capture sites were observed and photographed. Immature and adult insects captured were taken to the laboratory for identification. Of the 5081 insects collected in human-bait and Shannon traps, 75% were Mansonia wilsoni. In addition, Aedeomyia, Aedes, Anopheles, Coquillettidia, Culex, Haemagogus, Mansonia and Psorophora were identified. Of the 92 Haemagogus eggs found, 71 were collected on the banks of a reservoir. Mosquito larvae were found and photographed in an artificial breeding site of a neighboring rural area. Humidity had the greatest influence on culicid density in the Caatinga. Rain was important in the appearance of Haemagogus, Anopheles, Aedes and Psorophora. Temperature had a negative influence on Anopheles triannulatus. The occurence of important vector species of diseases in a little known preserved area of the Caatinga as well as environmental and sociocultural questions are factors that favor the emergence of transmitting insects, making these areas potential subject to the resurgence of diseases

Agroindústria canavieira e unidade de conservação: Impactos Sociais na comunidade de pescadores de Baía Formosa (RN)

The conservation unities emerged in response to the environmental damages. In the Atlantic Forest of the Brazilian Northeast, the most of the damages come from the sugar-cane agro-industry, especially by the deforestation for the introduction of sugar-cane fields and installation of the industry structure. Besides the damages over the biodiversity, there are critical social problems that affect the communities which survive using directly or indirectly the biome from the Atlantic Forest. The objective of this research is to analyze the social impacts on the fishermen of Baía Formosa/RN generated by the changes and socio-environmental transformations occurred starting the installation of a sugar-cane factory and the creation of a conservation area in the municipality of Baía Formosa/RN community. The research is based on a qualitative and diachronic perspective, for both approach, it was used the method of oral history in conjunction with the literature search and some technical and research tools such as direct observation, interview, records images and recordings . The results show that social and symbolic practices of the community in the conservation unit Mata Estrela last more strongly presented. Today fewer natural resources are used, due to factors such as limit access to forest and disappearance of some natural resources by deforestation. It is believed that the loss of free access to space for the community is the most significant negative impact, as promoted changes in the relationship of the community with the Star Forest that contributed to the fading of their social and symbolic practices. The loss of free access caused the decline in the practice of agriculture, which resulted in the loss of one of the means of social reproduction of the community

Avaliação de parâmetros métricos oculares pela fotografia digital da face: uso do diâmetro da íris como unidade de referência

Purpose: To evaluate reproducibility and precision of ocular measurements by digital photograph analysis, in addition to the transformation of the measures according to the individual iris diameter as an oculometric reference. Methods: Twenty-four eyes have been digitally photographed in a standardized way at two distances. Two researchers have analyzed these printed images using a caliper and these digital forms by ImageJ 1.37 (TM). Several external ocular parameters were estimated (mm and as iris diameter) and methods of measurement compared regarding their precision, agreement and correlation. Results: Caliper and digital analysis of oculometric measures provided significant agreement and correlation, nevertheless the precision of digital measures was higher. The estimates of numeric transformation from oculometric measures according to individual iris diameter resulted in great correlation to caliper measures and high agreement when compared to different distances of taking the photographs. Conclusions: Facial digital photographs allowed oculometric precise and reproducible estimates, endorsing clinical research usefulness. Using iris diameter as individual oculometric reference disclosed high reproducibility when facial photographs were taken at different distances.

Mapeamento digital de análogos a reservatórios petrolíferos: exemplos para depósitos fluviais da Unidade Açu-3 - Bacia Potiguar

In the current work are presented the results about the study of digital mapping of analogs referents the fluvial oil reservoirs in the Açu Formation. With the regional recognizing in the south corner of Potiguar Basin was selected a area of 150 Km square in the west of Assu city. In this area was chosen the outcrops for the digital mapping and from the data fields and remote sensors were done the depositional architectural for the fluvial deposits, which it was named coarse meandering fluvial systems. In the deposits were individualized 3 (three) fluvial cycles, which they was separated by bounding surface of fifth order. Such cycles are preferentially sandy, with fining-upward sequence finished in flood plain deposits. Inner of the sandy levels of the filling channels were characterized least cycles, normaly incomplete, constituted by braided sandy bodies and bounding surfaces of fourth order. In the mapped area was chosen a outcrop with great exposition, where it was possible to see tipical deposits of filling channel and was in this outcrop that was done the digital mapping. In this outcrop was used diverse technics and tools, which they integrated sedimentological, altimetric (GPS, Total Station), LIDAR (Light Detection and Ranging), digital photomosaic of high resolution and of the inner geometries (Ground Penetration Radar) data sets. For the integrating, interpretation and visualization of data was used software GoCAD®. The final product of the outcrop digital mapping was the photorealistic model of part of the cliff (or slope) because the observed reflectors in the radargrams were absents. A part of bar oblique accretion was modeled according to GPR gride of 200x200 meters in the alluvial Assu river probable recent analog. With the data of inner geometries was developed the three-dimentional sedimentary architectural, where it was possible characterize sand sheet deposits and many hierarchy of braided channels. At last, simulations of sedimentary geometries and architectures of the Potiguar Basin Fluvial Reservoirs were done with PetBool software, in order to understand the capacity of this program in simulations with a lot of numbers of conditioning wells. In total, 45 simulations was acquired, where the time and the channel numbers increase in relation of the conditioning wells quantity. The deformation of the meanders was detected from the change of simulated dominion dimensions. The presence of this problem was because the relationship between the simulated dominion and the width of the meander

Caracterização geológica tridimensional e monitoramento de dunas no litoral oriental do Rio Grande do Norte

This work presents geophysical and geological results obtained in a dunefield located in the east coast of Rio Grande do Norte State, with the aim to recognize the aeolian body depositional geometries to a future geologic modeling of the aeolian petroliferous reservoirs. The research, which was done in blowouts region situated at Nisia Floresta Municipally, included the characterization of external geometries with GPS and internal geometry analysis by GPR. Data was integrated in GoCAD software, where it was possible the three-dimensional characterization and interpretation of the studied deposits. The interpretation of GPR profiling allowed identifying: First-order bounding surfaces that separated the aeolian deposits of the Barreiras Formation rocks; Second-order bounding surfaces, which limit dune generations and Third-order bounding surfaces, a reactivation surface. This classification was based and adapted by the Brookfield (1977) and Kocurek (1996) propose. Four radarfacies was recognized: Radarfacies 1, progradational reflectors correlated to foresets of the dunes, Radarfacies 2, plain parallels reflectors related to sand sheets, Radarfacies 3, plain parallels reflectors associated to reworking of the blowout dune crest and Radarfacies 4, mounded reflectors associated to vegetated mound of sand or objects buried in subsurface. The GPR and GPS methods was also employed to the monitoring of dunefields susceptible to human activities in Buzios Beach, where the constructions along the blowout region and the tourism are changing the natural evolution of the deposits. This fact possibly to cause negative impacts to the coastal zone. Data obtained in Dunas Park, a unit environmental conservation, was compared with information of the Buzios Beach. There is a major tendency of erosion in Buzios, specifically in blowout corridor and blowout dune

Perfil dos beneficiários do Programa de Suplementação Alimentar de uma unidade básica de saúde de Botucatu, São Paulo

OBJETIVO: Este estudo objetivou apreender algumas características sócio-sanitárias do grupo de beneficiários do Programa de Suplementação Alimentar de unidade básica de saúde de um município de médio porte do interior paulista. Especificamente, buscou-se delinear o perfil deste grupo quanto aos fatores de risco para a desnutrição infantil a que estava exposto e dimensionar a utilização dos critérios de inclusão neste programa. MÉTODOS: A pesquisa é de cunho descritivo e se baseou em documentos oficiais vigentes para a definição dos fatores de risco a serem analisados. Foram avaliadas 290 crianças cujas mães ou responsáveis foram entrevistados, segundo um protocolo previamente estabelecido. RESULTADOS: O grupo de beneficiários caracterizou-se por ser heterogêneo quanto à freqüência e ao grau da exposição a fatores de risco para a desnutrição, denotando que há diferenças nos problemas socioeconômicos e sanitários apresentados, como também na combinação entre eles, em cada família. CONCLUSÃO: Para a otimização do programa, ainda vigente no município, sugere-se a padronização loco-regional de critérios de inclusão, conforme a proposta oficial central, com o registro claro dos mesmos e, também, a aplicação de métodos avaliativos periódicos, adequada capacitação da equipe de saúde e maior envolvimento da população usuária.

Tratamento do transtorno de pânico com terapia psicodramática de grupo

INTRODUÇÃO/OBJETIVOS: Há poucos trabalhos publicados sobre psicoterapia grupal para pacientes com transtorno de pânico (TP); além disso, esses estudos geralmente são restritos a abordagens cognitivo-comportamentais. O objetivo deste trabalho é relatar uma experiência de atendimento psicoterápico psicodramático grupal para portadores de TP, iniciada em 1996 na Faculdade de Medicina de Botucatu/Unesp, e discutir aspectos psicodinâmicos desse transtorno. MÉTODOS: Atende-se uma média de oito a dez pacientes em sessões mensais de duas horas de duração, nas quais se utilizam técnicas psicodramáticas. O uso associado de psicofármacos é a regra. A temática é aberta, centrando-se tanto em aspectos próprios do TP (sintomas mais comuns; peregrinação em serviços médicos até o diagnóstico; preocupações hipocondríacas; limitações e dependência; reações dos familiares; estratégias de exposição e enfrentamento; efeitos e reações dos medicamentos) quanto em problemas individuais específicos. RESULTADOS: A abordagem psicodramática favorece a identificação e a elaboração de aspectos psicodinâmicos. Entre estes, destacaram-se os sentimentos de desamparo e seus desdobramentos: insegurança; fragilidade e medo; raiva e culpa; sentimentos de desamor e rejeição; vergonha e inferioridade; isolamento e dificuldade de pedir ajuda; dificuldade de identificar e de expressar sentimentos - manifestados somaticamente -; e dificuldade de assumir o papel de cuidador e outras responsabilidades. CONCLUSÕES: Aspectos valiosos para o tratamento do TP, como apoio mútuo, companheirismo, confiança, modelo e estímulo, são favorecidos pelo contexto grupal homogêneo. O compartilhar de experiências e sofrimentos comuns propiciou rápida coesão e suporte grupal, melhora da capacidade de expressar sentimentos e da auto-estima e o aprimoramento de papéis sociais. Além da melhora dos sintomas, possibilitou-se a melhor compreensão e elaboração destes, que passam a ser integrados significativamente no contexto existencial.