Avaliação das habilidades neurocognitivas em crianças e adolescentes sobreviventes da Leucemia Linfoide Aguda - LLA

The present study investigated the impact of the treatment modalities of Acute Lymphoblastic Leukemia on neurocognitive abilities of children and adolescents survivors, aged between 6 and 16 years of age, accompanied in pediatric oncology sectors of public health services in the cities of Campina Grande-PB and Natal-RN. The study included 52 children, 13 of these being children and adolescents diagnosed with leukemia and 39 healthy children matched in relation to the study group considering gender, age, school type and level of maternal education. Later the group of children with leukemia was subdivided into two subgroups depending on treatment modality which were submitted: Group 1A (only chemotherapy) and 1B (chemotherapy and radiotherapy). All participants were subjected to a battery of neuropsychological tests that investigated the following neurocognitive abilities: intellectual ability, memory system, attention, visuospatiality and visuoconstruction, processing speed and executive functions. Data were analyzed using descriptive and inferential measurements with the aid of the U test of Mann-Whitney and T test, considering the influence of the variables: sex, age at diagnosis, time since completion of treatment and level of schooling mothers, on the performance of children. Overall, it is concluded that the illness and the treatment of acute lymphoblastic leukemia significantly favors the emergence of cognitive deficits, particularly in terms of visuospatial skills, and executive skills visoconstrutivas. In turn, the treatment modality of radiotherapy is associated with the presence of more severe deficits, highlighting the significant impact on the speed of information processing. It is hoped that the results presented here will contribute to a better understanding of the nature and extent of neurocognitive effects arising ALL treatment

Escuta clínica e atitude fenomenológica no atendimento à pessoa surda: reflexões sobre um processo psicoterápico

Psychology uses listening as a work resource. When it comes to psychotherapy, listening establishes communication and makes psychologist-client dialogue easier. This qualitative research aims to discuss the clinic listening in phenomenological attitude in existential-phenomenological psychotherapy with deaf people. This perspective is based on the thinking of German philosopher Martin Heidegger, who considers humane a being-with and being-in-the-world, always unveiling meanings. Regarding the deaf people, Libras is currently the natural language of Brazilian deaf people. In this new language configuration, communication occurs in a visual-spatial modality. Thus, listening and speech gain new dimensions, demanding different ways of understanding in the field of psychotherapy. To the development of this research, we present excerpts from therapeutic sessions narratives with a deaf client, interpreted in the light of Heidegger s hermeneutics. We consider that it is possible for the psychotherapist to listen to deaf people in phenomenological attitude. Such position, which does not naturalize and limit the humane, helps so that the clients do not feel responsible for their existence and can hermeneutically converse in their language. In this context, the psychologist must be qualified to conduct the treatment in Libras. We hope that this research can, somehow, fill the existing gap of the scientific production about such theme in the field of Psychology and, mainly, instigate discussion in the context of Psychology courses on the importance and need to qualify psychologists for the management of clinical practice with deaf people

As pessoas com deficiência no mercado de trabalho: expressão das desigualdades sociais

This work was developed in the extent of the Post Graduation Program in Social Service of the Federal University of Rio Grande do Norte. It talks about the process of inclusion of the disabled people in the Job market in Mossoró-RN, bringing for the academic debate relevant thematic for the Brazilian society, for the profession of Social Service and similar areas and for the people with deficiency. It has the objective to apprehend the determiners that make possible the process of the disabled people's inclusion in the Job market in Mossoró, having as parameter the National Politics for the Integration of People Bearers of Deficiency. The critical theoretical perspective is backed in Marx's ideas for the understanding concerning the work, as well as in Pochamann, concerning the job market, regarding the exclusion/inclusion category is based in Martins, Yasbek and Sposati and on deficiency in the National Politics for the Integration of the Disabled People. The research is of qualitative nature and it took as subjects 26 (twenty-six) people, being 09 (nine) people with deficiency, inserted in the formal job and regulated market, and 17 (seventeen) managers of private companies and public institutions of the city of Mossoró-RN. For the collection of data we used techniques of nonsystemic observation, semi-structured interview and documental analysis. The results of the research mark that any modality of the human workforce used in the current context, they are functional to the capitalism and they move forward towards exploration, alienation and subordination of the work to the capital; the National Politics for the Integration of the People with Deficiency expresses and reproduces the contradictory dynamics of the class society, it reflects the neo liberal shades through the selectivity and of the articulation among the federated beings and organizations of the civil society for its operational system; there is a misproportion between the percentages of the quotas and the amount of people with deficiency inserted in the job market, just corresponding to a tiny numeric magnitude; the developed activities are of low social status and it is expressive the amount of workers that receives between one and two minimum wages. These data drive us to infer that the mentioned politics make possible, partly, the inclusion of the disabled people in the job market, though, such inclusion is executed in the selective or focused dimensions, marginal, precarious and unstable

Uso de membrana biossintética a base de celulose na regeneração tecidual guiada

Guided Tissue Regeneration (GTR) is a regenerative treatment modality that requires the placement of a physical barrier over a bone defect in such a way that the proliferation of the surrounding soft tissues into the barrier-protected area is prevented. Thereby in the guided osseous regeneration allowing bone-forming cells from the existent bone edges to invade the space and produce bone. The physical barriers should be biocompatible, allow cellular occlusion, maintain adequate space, tissue integration and facility in the application. They can be occlusive or permeable, absorbable or non-absorbable. Among various types of physical barriers in the market, the cellulose biosynthetic membrane is emphasizing by the necessary characteristics for GTR and to be a national product developed in low cost.

Um estudo sobre custos de elaboração de material didático e tutoria em EaD online em uma Instituição de Ensino Superior no Brasil

This study has as main objective to verify the proportionality of the costs with elaboration of didactic material and costs with tutelage and instruction incurred in a higher education institution, located in national territory, and that offers a degree course in the education area in the modality of EaD online. The purpose of the measurement of this proportionality of the costs was of answering these they are, among other, the relevant costs incurred by the institution research object. This is a research of exploratory stamp whose methodological procedure adopted for your development, in what it refers the collection, analysis of the data and the investigation means, it is the case study, as well as the documental and bibliographical research. The found results indicate that the costs with elaboration of didactic material and the costs with tutelage and instruction are relevant, however they are not the only ones considered as such. The costs involved with acquisition and operation of specific softwares they also constitute an relevant costs. The structure of the costs can be altered in agreement with the analyzed period and in agreement with the characteristics of synchronism of the offered course. It was also verified that the technology used in this education modality it ends up generating additional costs incurred with professionals of specific knowledge in technology

Sustentabilidade ambiental do cultivo intensivo de Tilápias (Oreochromis niloticus) em tanques-rede e a capacidade de suporte de quatro reservatórios em uma região semi-árida tropical

Intensive production of tilápias, in cages or net tanks, has been proposed as an alternative to increase fish production, that would generate income and offer animal protein in different tropical and subtropical countries. However, this system of production enriches the aquatic environment with nutrients, principally nitrogen and phosphor derived from the dejections of the metabolism of food and eventual food surpluses consumed by the fishes; the alimentation of the fishes in this production modality is dependent on fish food. The emission of these nutritions in levels above the limit that the system is capable metabolize can provoke a phenomenon called eutrofization, putting in risk the quality of water for public and for fish production activities. In this context the work had as a goal to evaluate the trófico state of the four reservoirs for intensive production of tilapias in net-tanks, in other words, he maximum fish production that the reservoirs are able to hold, keeping the desired quantity of nutrient concentrations in water for public use. The results of the four ecosystems in the Boqueirão de Parelhas reservoir showed that it s possible to have an intensive production of tilapias in net tanks, in this environment the annual average concentration of phosphor, was below the considered critical limits to deflagrate the process of eutrofization in semi-arid regions. The carrying capacity of the Boqueirão de Parelhas reservoir depends on the conversion of the feeding facts and phosphor content in the food but it should vary between 100 and 300 tons per year over a variation in the conversion feeding factor of 1,7 to 2,0:1 and a variation in the P in the food of 0,7 to 0,9%

Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Background and objectives Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil.Design, setting, participants, & measurements Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis.Results In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center.Conclusions Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities. Clin J Am Soc Nephrol 6: 1944-1951, 2011. doi: 10.2215/CJN.11431210

O esporte e suas implicações na saúde óssea de atletas adolescentes

A adolescência é um período fundamental para a aquisição da massa óssea. em adolescentes atletas, o pico de massa óssea pode apresentar maior incremento, em virtude do estresse mecânico imposto aos ossos pelo exercício físico praticado. O objetivo desta revisão foi investigar o papel do treinamento esportivo vigoroso e precoce sobre a saúde óssea de atletas adolescentes. Através da revisão da literatura científica, envolvendo adolescentes atletas de diferentes modalidades e de ambos os sexos, é possível inferir que a densidade mineral óssea é potencializada pelos exercícios, quando grupos de atletas são comparados com grupos de controle. Entretanto, muito se discute na literatura quanto à recomendação da intensidade adequada da prescrição de exercício físico para população adolescente, uma vez que, caso o treinamento se torne muito extenuante, os benefícios gerados pela atividade sobre a saúde dos ossos podem ser minimizados ou anulados. Embora muita controvérsia ainda envolva o tema, independente do tipo de esporte praticado, o aumento de intensidade do treinamento deve ser razoável e coerente com as metas, sendo enfatizado treinamento seguro e eficaz para cada uma das faixas de idade e momentos da maturação biológica, independente dos calendários competitivos.

Crítica ao fundacionismo cartesiano com base no argumento contra a linguagem privada

This assignment ains to prove the pertinency of using the wittgenstein´s argument against private language as a criticism to cartesian fundacionism. Therefore, I want to demonstrate in the first chaper the conceptual viability of facing the cartesian argument of cogito not as a simple silogism but as an exemple of a private experience (process of thinking). At the second chaper, the subordination of the argument against private language give us the idea that rules can only be followed by means of corrections givem by a linguistic community that is external to the private subject, in a way to be unviable the assumption that is possible to name an internal experience without searching external rules of the use of terms. At the chaper 3 the pertinency of the hypothesis raised by A. Kenny, about the overtaking of the argument against private language can be extended to the idea of epistemic and ontologic privacy that would lend validity to the fundacion present at the argument at the cartesian cogito. In oder to become evident the pertinency of use of Wittgenstein´s argument agaist Descartes´ fundation, it´s necessary, at the chaper 3, to demonstrate the impertinency of the objection to the A. Kenny´s hypothesis, based on the experiency of the thought of the brain at the recipient, to make clear the incompatibility existing between the cartesian idea of cogito and Wittgenstein´s notion that language is an activitie followed by rules, wich correction criterion may be external and intersubjective

O exercício físico potencializa ou compromete o crescimento longitudinal de crianças e adolescentes? Mito ou verdade?

A sociedade atual tem valorizado de forma significativa a aparência alta e esbelta. Essa constituição física tem sido reforçada desde a infância e atinge a população adolescente, que deseja enquadrar-se nos estereótipos, particularmente aqueles veiculados pela mídia. Nesse sentido, profissionais de saúde são questionados rotineiramente sobre os efeitos positivos que o exercício físico exerce sobre o crescimento longitudinal de crianças e adolescentes. Procurou-se revisar a literatura especializada a respeito dos principais efeitos que o exercício físico exerceria sobre a secreção e atuação do hormônio de crescimento (GH) nos diversos tecidos corporais, durante a infância e adolescência. Através dessa revisão, foi possível verificar que o exercício físico induz a estimulação do eixo GH/IGF-1. Embora muito se especule quanto ao crescimento ósseo ser potencializado pela prática de exercícios físicos, não foram encontrados na literatura científica específica estudos bem desenvolvidos que forneçam sustentação a essa afirmação. No tocante aos efeitos adversos advindos do treinamento físico durante a infância e adolescência, aparentemente, esses foram independentes do tipo de esporte praticado, porém resultantes da intensidade do treinamento. A alta intensidade do treinamento parece ocasionar uma modulação metabólica importante, com a elevação de marcadores inflamatórios e a supressão do eixo GH/IGF-1. Entretanto, é importante ressaltar que a própria seleção esportiva, em algumas modalidades, recruta crianças e/ou adolescentes com perfis de menor estatura, como estratégia para obtenção de melhores resultados, em função da facilidade mecânica dos movimentos. Através dessa revisão, fica evidente a necessidade de realização de estudos longitudinais, nos quais os sujeitos sejam acompanhados antes, durante e após sua inserção nas atividades esportivas, com determinação do volume e da intensidade dos treinamentos, para que conclusões definitivas relativas aos efeitos sobre a estatura final possam ser emanadas.

Family visitors and companions of hospitalized elderly and adults: analysis of the experience from the perspective of the nursing working process

Trata-se de estudo qualitativo, utilizando-se como referencial metodológico a Grounded Theory e como referencial teórico o Processo de Trabalho em Enfermagem, para compreender o papel assumido pelo enfermeiro perante as normas e rotinas hospitalares, relativas aos familiares visitantes e acompanhantes de adultos e idosos internados em um Hospital Universitário. A análise dos dados permitiu a identificação do tema: definindo-se a modalidade de apoio familiar durante a hospitalização, que reúne duas categorias principais: tornando-se familiar visitante e tornando-se familiar acompanhante. Por meio da análise, pôde-se aprofundar a compreensão do quanto as regras estabelecidas, com o objetivo de disciplinar e tornar eficiente o trabalho desenvolvido no hospital, podem explicitar o desprovimento de autonomia no processo de trabalho, para modificar as relações nesse contexto e o quanto a apropriação do familiar como parte da equipe de saúde, está distante de ser pensada no concreto das instituições.

Effects of meperidine or saline on thermal, mechanical and electrical nociceptive thresholds in cats

Objective To measure cutaneous electrical nociceptive thresholds in relation to known thermal and mechanical stimulation for nociceptive threshold detection in cats.Study design Prospective, blinded, randomized cross-over study with 1-week washout interval.Animals Eight adult cats [bodyweight 5.1 +/- 1.8 kg (mean + SD)].Methods Mechanical nociceptive thresholds were tested using a step-wise manual inflation of a modified blood pressure bladder attached to the cat's thoracic limb. Thermal nociceptive thresholds were measured by increasing the temperature of a probe placed on the thorax. The electrical nociceptive threshold was tested using an escalating current from a constant current generator passed between electrodes placed on the thoracic region. A positive response (threshold) was recorded when cats displayed any or all of the following behaviors: leg shake, head turn, avoidance, or vocalization. Four baseline readings were performed before intramuscular injection of meperidine (5 mg kg(-1)) or an equal volume of saline. Threshold recordings with each modality were made at 15, 30, 45, 60, 90, and 120 minutes post-injection. Data were analyzed using ANOVA and paired t-tests (significance at p < 0.05).Results There were no significant changes in thermal, mechanical, or electrical thresholds after saline. Thermal thresholds increased at 15-60 minutes (p < 0.01) and mechanical threshold increased at 30 and 45 minutes after meperidine (p < 0.05). Maximum thermal threshold was +4.1 +/- 0.3 degrees C above baseline at 15 minutes while maximum mechanical threshold was 296 +/- 265 mmHg above baseline at 30 minutes after meperidine. Electrical thresholds following meperidine were not significantly different than baseline (p > 0.05). Thermal and electrical thresholds after meperidine were significantly higher than saline at 30 and 45 minutes (p < 0.05), and at 120 minutes (p < 0.05), respectively. Mechanical thresholds were significantly higher than saline treatment at 30 minutes (p <= 0.05).Conclusion and clinical relevance Electrical stimulation did not detect meperidine analgesia whereas both thermal and mechanical thresholds changed after meperidine administration in cats.

Osteoconductive Properties of beta-Tricalcium Phosphate Matrix, Polylactic and Polyglycolic Acid Gel, and Calcium Phosphate Cement in Bone Defects

Extensive bone defects in maxillofacial region can be corrected with autogenous grafts; otherwise, the disadvantages of the therapeutics modality take the research for new bone substitutes. The aim of the study was to evaluate and compare the osteoconductive properties of 3 commercial available biomaterials. A total of 30 calvarial defects (5-mm diameter) were randomly divided into 5 treatment groups, with a total of 6 defects per treatment group (n = 6). The treatment groups were as follows: 500 to 1000 Km beta-tricalcium phosphate (beta-TCP), polylactic and polyglycolic acid (PL/PG) gel, calcium phosphate cement, untreated control, and autograft control. The evaluations were based on histomorphometric analysis at 60 postoperative days. The results have shown that beta-TCP and autograft control supported bone formation at 60 postoperative days. beta-Tricalcium phosphate showed the highest amount of mineralized area per total area and statistically significant compared with PL/PG, calcium phosphate cement, and untreated control groups. The PL/PG gel does not have osteoconductive properties and performed similar to empty control. Calcium phosphate cement showed higher number of multinucleated giant cells around the sites of the biomaterial and showed newly formed bone only at the edges of the biomaterial, without bone formation within the biomaterial. The findings presented herein indicate that bone formation reached a maximum level when rat calvarial defects were filled with beta-TCP at 60 postoperative days. Further studies should be conducted with beta-TCP to understand the potential of this biomaterial in bone regeneration.

Oral rehabilitation of severely worn dentition using an overlay for immediate re-establishment of occlusal vertical dimension

The aim of this study was to describe the treatment used in an elderly patient presenting with bruxism and dental erosion, with good gingival health and bone support, but with decreased occlusal vertical dimension (OVD). The oral rehabilitation of elderly patients presenting with bruxism in association with tooth erosion has been a great challenge for dentists. The loss of OVD, the presence of occlusal instability and the absence of an effective anterior guide due excessive dental wear, can damage stomatognathic system (SS) biology, the function and the aesthetics. In the first treatment stage, an overlay removable partial denture (ORPD) was fabricated for the immediate re-establishment of function and aesthetics. After a 2-month follow up, with the patient presenting no symptoms, a second rehabilitation stage was accomplished, with fixed and removable prostheses. Oral rehabilitation with an ORPD was able to re-establish the SS biology, but a correct diagnosis and treatment plan are essential for success. The ORPD is a non-invasive and reversible restoring modality for general dentists that allow the re-establishment of the patient's immediate aesthetics and function at low cost.

A survey of radiographic prescription in dental implant assessment

Objectives: To survey the current radiographic prescriptions in dental implant assessment amongst dentists in Brazil.Methods: Sixty-nine dentists were interviewed during a dental implant meeting by two calibrated graduate students, using a 19-question questionnaire, considering imaging modality options both for pre-operative implant site assessment and for follow-up, particularly with respect to cost, patient radiation dose, and broad coverage of facial bones and teeth. Epi-Info 6.04 software was used to analyse the database file.Results: Approximately 63.8% of the dentists prescribed only panoramic radiography for dental implant assessment and 28.9% ordered panoramic radiography plus periapical radiography and/or conventional tomography and/or computed tomography (CT). Only 7.2% of the dentists ordered conventional tomography or CT as a single examination, although 10.1% ordered it in combination with other imaging modalities. The main reasons given for prescribing panoramic radiography were broad coverage and cost (86.4%).Conclusions: This study has shown that most of the dentists in this study prescribe panoramic radiographs in dental implant assessment based on broad coverage and cost. They are not following the American Academy of Oral and Maxillofacial Radiology recommendations regarding cross-sectional imaging.