Segurança e efetividade no tratamento do pterígio usando infiltração de 5-fluoruracila no intraoperatório

OBJETIVO: Avaliar a segurança e a efetividade do uso do 5-fluoruracila (5-FU) como tratamento adjuvante do pterígio, aplicado sob a forma de infiltração subconjuntival, no período intraoperatório. MÉTODOS: Foram avaliados prospectivamente 125 indivíduos (125 olhos) portadores de pterígio. Os indivíduos foram operados segundo a técnica de retalho de deslizamento e receberam, ao final do procedimento, injeção subconjuntival de 0,2 mL de 5-FU (25 mg/mL). Foram anotados os dados do paciente como idade, sexo, profissão, características da lesão (primário ou recidivado, tamanho, carnoso ou involutivo) e feito seguimento pós-operatório, aos 7, 21, 60 e 180 dias. Os dados foram submetidos à avaliação estatística. RESULTADOS: Não foram observados casos de complicação decorrente do uso do 5-FU em injeção no intraoperatório do pterígio. A taxa de recidiva geral observada aos 180 dias de pós-operatório foi de 35,8%, sendo de 35,7% para os pterígios primários e de 36,4% para os recidivados. CONCLUSÃO: A aplicação do 5-FU no período intraoperatório sob a forma de infiltração subconjuntival é segura. Entretanto, ainda resulta em altas taxas de recidiva e novos estudos devem ser realizados a fim de conhecer a concentração/dose ideal que permitirá menores chances de recidiva da lesão.

Influência da suspensão na segurança e no conforto de um pulverizador autopropelido

Para avaliar o comportamento da suspensão do pulverizador autopropelido, foram desenvolvidos modelos físicos e matemáticos em função da excitação ocasionada pelas irregularidades do solo. Neste trabalho, estas irregularidades são representadas por obstáculos de uma pista normalizada segundo a norma ISO 5008. As equações do movimento são obtidas a partir dos modelos matemáticos de meio veículo. As simulações numéricas são executadas nos softwares Matlab® e Simulink®. A partir da entrada conhecida, podem-se determinar as características dos elementos da suspensão para obter níveis desejáveis de conforto e segurança. Foram analisadas quatro diferentes configurações do sistema, variando-se a relação de rigidez a partir de um modelo considerado padrão. Constatou-se que o aumento da relação de rigidez resulta na redução da aceleração vertical e no aumento do curso da suspensão, melhorando o conforto e diminuindo a segurança.

Repercussões do Programa Bolsa Família no município de Araraquara, SP: um olhar sobre a segurança alimentar e nutricional dos beneficiários

Cette étude évalue les implications de la Bolsa Familia dans les éléments du thème de la sécurité alimentaire, en prenant comme paramètres des bénéficiaires de la ville de Araraquara, SP. Des formulaires de demande de semi-structurés avec les bénéficiaires et les observations de terrain, le diagnostic a été réalisée dans le but de l'évaluation théorique des politiques publiques.

A política empresarial: a responsabilidade social como mecanismo de segurança

Neste ensaio, tomamos como problema as ações da política empresarial no Brasil, em específico a política de responsabilidade social das empresas, por entender que existe nessa iniciativa um status de inovação tecnológica que precisa ser interrogado, pois se inscreve no interior de uma racionalidade que objetiva o governo das populações e tem como instrumento técnico, para realizar esse fim, uma sociedade controlada por mecanismos de segurança. Para tanto, partimos da análise de três procedimentos efetivados por alguns projetos sociais desenvolvidos por empresas brasileiras - a pesquisa científica, o protagonismo juvenil e a metodologia participativa. A referência de análise são textos de diversas naturezas, veiculados por esses projetos e disponíveis ao acesso público.

Segurança no trabalho de preparo de calda no tanque de 2.000l do turbopulverizador com formulações líquidas de agrotóxicos registradas para a cultura de goiaba

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Segurança das condições de trabalho de tratorista em aplicações de herbicidas em soja e amendoim e eficiência de equipamentos de proteção individual

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Aplicação preliminar do método QRAM para avaliação de riscos para segurança ocupacional na construção civil

A segurança ocupacional é imprescindível na indústria da construção civil e a análise e avaliação de riscos para a segurança ocupacional (AARSO) é o primeiro e fundamental passo para alcançá-la, baseado na definição e implementação de programas de prevenção. A AARSO é um processo complexo, que implica a consideração e análise de muitos parâmetros quantitativos e/ou qualitativos que são difíceis de quantificar. As metodologias AARSO utilizadas na indústria da construção civil são baseadas em informação sujeita a incerteza (sendo tratada por técnicas probabilísticas e/ou estatísticas), difusa, imprecisa e/ou incompleta. Isso implica algumas limitações, como, por exemplo, obrigar os analistas a estimar parâmetros ou efetuar comparações com outros canteiros de obras (o que afasta do sistema real em estudo). O objetivo inicial deste estudo foi efetuar a pré-validação de um método AARSO, o QRAM, em duas cidades brasileiras, de médio e grande porte.

Desenvolvimento de uma Lista de Verificação em Comunicação e Linguagem para os Transtornos do Espectro Autístico

A Lista de Verificação em Comunicação e Linguagem aqui apresentada foi elaborada para avaliar as especificidades de dois grupos distintos: os transtornos do espectro autístico e outras alterações de desenvolvimento da linguagem. Com essa finalidade foi aplicada em 60 participantes, divididos em dois grupos: 20 portadores de transtornos do espectro autístico (M=7, 11) e 40 portadores de outras alterações de desenvolvimento da linguagem (M=4, 10). Foi utilizado o teste do Qui-Quadrado para avaliar a validade do conteúdo e determinar quais questões deveriam ser retiradas do instrumento por não serem significativas. Os outros testes utilizados foram o Índice de Concordância Kappa e o teste de Mann-Withney. A Lista também apresentou uma sensibilidade de 90% e uma especificidade de 97,5%, o que demonstra a viabilidade de sua utilização como instrumento auxiliar na detecção de transtornos do espectro autístico.

Eficácia e segurança do uso inalatório da adrenalina-L na laringite pós-intubação utilizada em associação com a dexametasona

Objective: to assess the efficacy and safety of the use of nebulized L-epinephrine associated with dexamethasone in post-intubation laryngitis. Method: we carried out a prospective, randomized, double-blind, placebo controlled study with two cohorts of patients with postintubation laryngitis graded 3 to 6 by Downes and Raphaely score and during two years. Our population was divided into two groups: A and B; both groups received intravenous dexamethasone and nebulized saline with (group B) and without (group A) L-epinephrine. The efficacy was assessed by Downes and Raphaely's score. The side effects of epinephrine were evaluated according to occurrence of arrhythmia, to increased blood pressure, and to average heart rate of group B in comparison to group A. Results: twenty-two patients were included in group A (average score = 4.8) and 19 in group B (average score = 5.2). During treatment, 3 patients in group A presented a score of 8 and were reintubated. This group also showed higher clinical scores than group B during the first two hours of the protocol; these results were not statistically significant. No side effects were observed due to epinephrine. The gasometric parameters were adequate in both groups, but better in the control group. Conclusions: we did not observe increased efficacy for the treatment of post-intubation laryngitis when nebulized L-epinephrine was used simultaneously with intravenous dexamethasone. Some indicators, however, did present a favorable trend when combined therapy was used and should be submitted to further evaluation.

Utilização de índices de estabilidade transitória para a avaliação de segurança dinâmica

Indices that report how much a contingency is stable or unstable in an electrical power system have been the object of several studies in the last decades. In some approaches, indices are obtained from time-domain simulation; others explore the calculation of the stability margin from the so-called direct methods, or even by neural networks.The goal is always to obtain a fast and reliable way of analysing large disturbance that might occur on the power systems. A fast classification in stable and unstable, as a function of transient stability is crucial for a dynamic security analysis. All good propositions as how to analyse contingencies must present some important features: classification of contingencies; precision and reliability; and efficiency computation. Indices obtained from time-domain simulations have been used to classify the contingencies as stable or unstable. These indices are based on the concepts of coherence, transient energy conversion between kinetic energy and potential energy, and three dot products of state variable. The classification of the contingencies using the indices individually is not reliable, since the performance of these indices varies with each simulated condition. However, collapsing these indices into a single one can improve the analysis significantly. In this paper, it is presented the results of an approach to filter the contingencies, by a simple classification of them into stable, unstable or marginal. This classification is performed from the composite indices obtained from step by step simulation with a time period of the clearing time plus 0.5 second. The contingencies originally classified as stable or unstable do not require this extra simulation. The methodology requires an initial effort to obtain the values of the intervals for classification, and the weights. This is performed once for each power system and can be used in different operating conditions and for different contingencies. No misplaced classification o- - ccurred in any of the tests, i.e., we detected no stable case classified as unstable or otherwise. The methodology is thus well fitted for it allows for a rapid conclusion about the stability of th system, for the majority of the contingencies (Stable or Unstable Cases). The tests, results and discussions are presented using two power systems: (1) the IEEE17 system, composed of 17 generators, 162 buses and 284 transmission lines; and (2) a South Brazilian system configuration, with 10 generators, 45 buses and 71 lines.

Eficácia e segurança da atorvastatina no tratamento de pacientes com hipercolesterolemia primária

Introduction: Hypercholesterolemia is an important risk factor for cardiovascular disease, the first cause of death and third reason for hospital admissions in Brazil. The reduction of serum cholesterol levels reduces morbidity and mortality from cardiovascular disease. The present study evaluated the efficacy and safety of atorvastatin in the treatment of Brazilian patients with primary hypercholesterolemia (types IIA and IIB dyslipidemias). Patients and methods: After a 4-week wash-out period, 152 patients were treated with atorvastatin at the initial dose of 10 mg/day. According to treatment efficacy within the first 8 weeks this dose could be increased to 20 mg/day. Treatment lasted for a total of 16 weeks, and its efficacy was evaluated by the reduction of serum levels of LDL-cholesterol, total cholesterol, HDL-cholesterol, and triglycerides, as well as by the propotion of patients that achieved the target levels recommended by the National Cholesterol Education Program - Adult Treatment Panel II (NCEP ATP II) Results: The analysis of efficacy was conducted in 145 patients. Atorvastatin led to significant reductions in the levels of LDL-cholesterol after 8 and 16 weeks of treatment (P<0.001 for both comparisons). The relative reduction of such levels was 38% (P<0.001 after 8 and 16 weeks). Atorvastatin also led to significant reductions of total cholesterol and triglycerides. At the end of the study, 81% of patients achieved the target LDL-cholesterol levels recommended by NCEP ATP II. Treatment was well tolerated, and was interrupted due to creatine phosphokinase elevation in only one patient. Conclusion: Atorvastatina is efficacious and safe in the treatment of patients with primary hypercholesteromia. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Segurança e defesa no Cone Sul: Transições com transformações?

The new conditions of international security don't only attach importance to sovereignty and interstate relations. This new framework has led to changes in the scope and requirements for Politics of Defense. Countries of the Southern Cone seek to establish new parameters in the definition of their policies, but need to define between dissuasive policies, as in the past, or establish mechanisms for cooperation with their neighbors. Furthermore, these policies, by their nature and size, are not exclusively militaries. The purpose of this article is to examine the definitions constraints on strategic deterrence and cooperation in international security, and identify the degree of autonomy and the nature of the concepts derived from the armed forces in shaping Politics of Defense. Finally, we try to check the level of civil policy direction in defining those policies.

Farmacovigilância no Brasil: A relação entre polimorfismo de fármacos, efetividade e segurança dos medicamentos

In spite of the stated Brazilian policy on medicines that their quality, effectiveness and safety should be ensured at reasonable cost, hospitals in the ANVISA Surveillance Network have been receiving notifications of technical complaints, adverse reactions and suspected therapeutic ineffectiveness (STI) of medicines. The purpose of this study was to identify the medicines notified for suspicion of therapeutic ineffectiveness, at a university hospital participating in the national Surveillance Network, and to investigate the existence of polymorphs of any of the drugs involved, by examining the literature. There were 31 notifications of STI in a period of 18 months, concerning 11 different drugs, all of which were 'similar' drugs (neither original nor licensed by originator); five of these could contain polymorphs, according to the literature. However, this does not mean that the other drugs could not contain some unknown polymorphs, more studies being needed on polymorphism, especially in the cases of reported therapeutic ineffectiveness. Therefore, tests of polymorphism should be made part of the routine quality control of the raw materials during the development of medicines and in the studies of pharmaceutical equivalence to 'reference' medicines (innovative brands). The stability test should also involve a study of polymorphism, in order to confirm the solid state stability of the drug. All these measures will assure the effectiveness of medicines, since the reproducibility in the quality of pharmaceutical products could be monitored, as well as the equivalence of each production batch with the batch selected to determine the bioequivalence with the reference brand.

Ensaios biológicos para avaliação de segurança de produtos cosméticos

Despite efforts to the contrary, some cosmetic products can cause undesirable side effects in the users. These may often be due to individual factors or inappropriate use of the product. Thus, biological assays to assess the safety of a new cosmetic must precede its being placed on the market. Historically, these tests have always been carried out in vivo, in animals, since such tests can be used to evaluate many of the potential risks, such as irritation, allergy or systemic effects; but, recently, some research centers have been adopting in vitro alternatives, in order to replace the animal tests. This review emphasizes the need to employ biological assays to test the safety of cosmetic products, and reviews the main in vivo and in vitro tests used, focusing on the need to develop and use alternatives to the in vivo assays of product safety, so as to offer the consumers the maximum safety with the least possible risk, while ensuring the best conditions of use of the product.

Verificação da atividade antibacteriana de sabonete líquido contendo extrato glicólico de Dimorphandra mollis Benth.

Dimorphandra mollis Benth., Compositae, false barbatimão, has been used topically as a healing, astringent and antibacterial. In this study, antibacterial activity was verified on liquid soap containing glycolic extract of D. mollis (DGE) at different concentrations (8, 15 and 20%) and at different pH levels (6 and 8). Five soap formulations (F) were prepared: F1 - tryclosan (0.1%), F2 - DGE (8%), F3 - DGE (15%), F4 - DGE (20%) and F5 - without preservatives. Bark of D. mollis were dried in a circulating air oven and ground. The rude extracts were prepared by turbo extraction with ethanol. After screening, the extract were concentrated in rotating evaporator, lyophilized and resuspended in propileneglycol to obtain the glycolic extract. The antimicrobial activity was verified by diffusion in agar method, using cylinder in plate. Plates containing Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli were incubated at 37°C for 24 hours. After incubation, the results were analysed with a pachymeter, observing the bacterial grouth inhibition halo diameter. It was verified that the liquid soap containing tryclosan caused on inhibition of bacterial growth at both pH levels; the soaps without preservatives and containing DGE, independently of the concentration and pH levels used, did not present antibacterial activity.