Avaliação da eficácia de um programa de "Escola de Coluna" para lombalgia crônica inespecífica

The Back School has been used to prevent and to treat back pain since 1969, however its effectiveness still is controversy in literature. The objective of this study was to evaluate the effectiveness of a program of "Back School" in patients with nonspecific chronic low back pain, directed by rheumatologists and orthopedic doctors to Physiotherapy School Clinic of Universidade Potiguar (UnP) Natal/RN- Brazil, in period of May/2002 to December/2003. Seventy patients, with age varying from 18 to 60 years, were randomized in two groups: Experimental group (group A) with 34 patients, which was subdivided in groups with 6 to 8 components. This group participated of a theoretician and practical program of Back School with 4 lessons, one day per week, with 60 minutes of duration; to the Control group (group B), with 36 patients, was explained that the group should stay four months in a waiting list . Both groups, had been carried through three evaluations, by a blind, to patient group, independent observer: initial evaluation, after four and sixteen weeks. The following variables were analyzed: pain intensity, measured by analog visual scale (AVS), functional disability, measured by disability questionnaire of Roland and Morris and the spinal mobility measured by Schöber s method. In statistical analysis it was used variance analysis ANOVA, the test of Newman-Keuls multiple comparations, and the Pearson correlation coefficient, with significance level p<0.05. Thirteen patients (18,6%) didn t complete the evaluations, (5 from experimental group and 8 from control group). At last, 57 patients were studied, (29 from Experimental group and 28 from Control group), it was observed a significant statistical improve just for Experimental group in variables pain intensity (p=0,0001), functional disability

Identificação e fatores de virulência de Candida spp isoladas da cavidade bucal de transplantados renais do hospital universitário Onofre Lopes em Natal-RN

Despite Candida species are often human commensals isolated from various oral sites such as: tongue, cheek and palatal mucosa plus subgingival region, there are some properties linked to the organism commonly known as virulence factors which confer them the ability to produce disease. Oral candidiasis is one of the main oral manifestations reported in literature related to kidney transplant patients. The objectives of the present study were to identify and investigate virulence factors of yeasts isolated from the oral cavity of kidney transplant recipients admitted at the Hospital Universitário Onofre Lopes, in Natal RN. Seventy Candida species isolated from 111 kidney transplant recipients were investigated in this study. Identification of the isolates was performed by using the evidence of germ tube formation, hypertonic broth, tolerance to grow at 42°C, micromorphology and biochemical profiles. We observed a high rate of isolation of yeasts from the oral cavity of kidney transplant recipients (63.1%) being C. albicans was the most prevalent species. Oral candidiasis was diagnosed in 14.4% of transplant recipients. We evaluated virulence properties of the isolates regarding to: biofilm formation on polystyrene microplates as well as XTT reduction, adherence to acrylic resin and human buccal epithelial cells and proteinase activity. Most isolates were able to form biofilm by the method of adhesion to polystyrene. All isolates of Candida spp. remained viable during biofilm formation when analyzed by the method of XTT reduction. The number of CFU attached to the acrylic resin suggested high adherence for C. parapsilosis. C. albicans isolates showed higher median adherence to human buccal epithelial cells than non-C. albicans Candida isolates. Nevertheless, this difference was not statistically significant. C. dubliniensis showed low ability to adhere to plastic and epithelial cells and biofilm formation. Proteolytic activity was observed for all the isolates investigated, including the unique isolate of C. dubliniensis. There was a statistically significant association between proteinase production and the presence of oral candidiasis. Studies related to oral candidiasis in renal transplant recipients are limited to clinical and epidemiological data, but investigations concerning Candida spp. virulence factor for this group of individuals are still scarce. We emphasize the importance of studies related to virulence factors of yeasts isolated from this population to contribute to the knowledge of microbiological aspects of oral candidiasis

Investigação das alterações citogenéticas em pacientes pediátricos com leucemia linfóide aguda do Rio Grande do Norte

Leukemia is a heterogeneous group of hematologic malignancies that result from partial or total transformation of the blast cells. The Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in childhood, especially in male, Caucasian children younger than 14 years. Several criteria are adopted to classify ALL, including the cell morphology, cytochemistry, immunophenotyping and cytogenetic analysis. Cytogenetic studies allow a more detailed analysis to detect chromosomal abnormalities of leukemic cells. These modifications will determine the diagnosis, classification, stage characterization, remission assessment and prognosis. In this study were evaluated 30 patients, aged from four months to seventeen years, of both sexes and various ethnicities. The age distribution showed that 67% of patients had between one and ten years (with mean age of XX years old), the most prevalent ethnic was Caucasian (50%) and 57% were males. According to immunophenotype, 93% of patients had B-cells progenitor ALL and 7% early lineage T. Considering the total studied population, the most frequent medical findings were lymphadenopathy (37%), hepatomegaly (77%) and splenomegaly (70%), where one patient could present more than one of these medical findings. Regarding the CBC, the majority of patients had hemoglobin below 10 g / dl (73%), leukocyte count less than 10.000/μL (60%) and platelet count below 150.000/μL (83%). Chromosomal abnormalities were observed in 64% of all patients, where hyperdiploidy was the most common numerical change (67%), followed by hypodiploid (33%). All these data are in agreement with the literature. Moreover, complexes structural and/or number changes not yet described in literature were observed, which indicated poor prognosis. Finally, we concluded that this study demonstrated the importance of cytogenetic study in the diagnosis and identification of prognostic factors in pediatric patients with ALL in Rio Grande do Norte. The results obtained in this study are extremely useful and emphasizes that surveys of this nature must be conducted more frequently in our state

Caracterização térmica (TG/DTG, DTA, DSC, DSC-fotovisual) de Hormônios bioidênticos (estriol estradiol)

Bioidentical hormones are defined as compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body. It is believed that the use of hormones may be safer and more effective than the non-bioidentical hormones, because binding to receptors in the organism would be similar to the endogenous hormone. Bioidentical estrogens have been used in menopausal women, as an alternative to traditional hormone replacement therapy. Thermal data of these hormones are scarce in literature. Thermal analysis comprises a group of techniques that allows evaluating the physical-chemistry properties of a drug, while the drug is subjected to a controlled temperature programming. The thermal techniques are used in pharmaceutical studies for characterization of drugs, purity determination, polymorphism identification, compatibility and evaluation of stability. This study aims to characterize the bioidentical hormones estradiol and estriol through thermal techniques TG/DTG, DTA, DSC, DSC-photovisual. By the TG curves analysis was possible to calculated kinetic parameters for the samples. The kinetic data showed that there is good correlation in the different models used. For both estradiol and estriol, was found zero order reaction, which enabled the construction of the vapor pressure curves. Data from DTA and DSC curves of melting point and purity are the same of literature, showed relation with DSC-photovisual results. The analysis DTA curves showed the fusion event had the best linearity for both hormones. In the evaluation of possible degradation products, the analysis of the infrared shows no degradation products in the solid state

Avaliação da expressão das moléculas HLA de classe I não clássicas HLA-G E HLA-E em espécimes gástricas de pacientes acometidos com a bactéria Helicobacter Pylori

The expression of human leukocyte antigen G (HLA-G) and human leukocyte antigen E (HLA-E) in physiological and pathological processes remains unknown, it is believed that these molecules play a fundamental role in the establishment and maintenance of immune tolerance by inhibiting the functions of immunocompetent cells. In literature we found no published study involving the bacterium Helicobacter pylori (H. pylori) with expression of HLA-G and HLA-E. The objective this study is investigated the expression of this protein in gastric biopsies of patients with the bacterium H. pylori. Sixty-four biopsies of the patients with diagnosis of infection by H. pylori were evaluated to expression of HLA-G and HLA-E. The samples were stratified according to the presence of carcinoma or peptic ulcers. Patients without H. pylori were used to control. To investigate the expression of this protein were used immunohistochemistry technique with monoclonal antibody anti-HLA-G and anti-HLA-E. Other criteria such as analysis of the inflammatory infiltrate (hematoxylin-eosin) and identification of H. pylori (Giemsa) were analyzed. We detected HLA-G and HLA-E molecules in the most samples containing ulcer and gastric carcinoma. In negative control group was not detected the presence of HLA-G and HLA-E. The presence of H. pylori seems modulate the expression of HLA-G and HLA-E, favoring the evolution of infection, giving different degrees of gastric lesion in epithelium of these patients

Caracterização ultrassonográfica das estruturas flexoras musculotendíneas e ligamentares da porção distal dos membros de novilhas cruzadas

Caracterizaram-se, por meio da ultrassonografia, as estruturas flexoras da porção distal dos membros de bovinos utilizando-se peças anatômicas da porção distal dos membros torácicos e pélvicos, provenientes de 20 novilhas mestiças da raça Nelore, com idades entre 24 e 36 meses. Para análise ultrassonográfica, foram estabelecidas cinco zonas de avaliação no plano transversal, denominadas, respectivamente, de zonas A, B, C, D e E, e duas em plano sagital, F-III e F-IV. Na face flexora, foram avaliados os tendões flexores digitais superficial e profundo, o músculo interósseo, o ligamento acessório do tendão flexor digital profundo e a manica flexoria, quanto à forma, limites, posição, ecogenicidade e mensurações das áreas transversais em cm². Sendo os resultados apresentados na forma descritiva e em tabelas, foi possível a caracterização das estruturas flexoras, identificando e determinando planos ultrassonográficos apropriados para a observação de imagens adequadas destes tecidos, além da obtenção de valores e parâmetros que possam ser utilizados como referência para esta espécie.

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Análise não-linear de treliças pelo método dos elementos finitos posicional

This work presents the positional nonlinear geometric formulation for trusses using different strain measures. The positional formulation presents an alternative approach for nonlinear problems. This formulation considers nodal positions as variables of the nonlinear system instead of displacements (widely found in literature). The work also describes the arc-length method used for tracing equilibrium paths with snap-through and snap-back. Numerical applications for trusses already established in the literature and comparisons with other studies are provided to prove the accuracy of the proposed formulation

Educação corporativa para Micro e Pequenas empresas: aplicação do MADEC em empresas do setor supermercadista

This study searches to supply an existing gap in the empirical research about the performance of controllers of Micron and Small Companies (MSCs) in the context of corporative education (EC) through the Method of Support of Decision in Corporative Education (MSDCE). In the context of MCSs, this is a pioneering work, for other works related to this thematic searched in literature are limited to conjecture the possibility of its implantation via cooperation between companies; moreover, they do not apply any type of diagnosis method or viability. The object of study is an association of supermarkets of the city of Natal/RN, composed by 16 stores, of what 14 had been searched. The main objective of this work was to apply the first stage of the MSDCE and to verify the possibility of implanting the Corporative Education in the searched MSCs. As a result, it was obtained the profile of the companies and the validation of the above-mentioned Method. The phase of diagnosis conceived through the implantation of the first stage occurred through visits to the stores, interviews, application of questionnaires and place observation. The first stage - strategical analysis for professional education - was divided in two phases: analysis of the current corporative situation and available identification of the involved difficulties and resources. The implantation of the first stage of the MSDCE in the Association of Supermarkets Parceiros da Economia demanded a mapping of abilities and demonstrated how the education management works, the main difficulties and limitations of the MCSs of the supermerket branch of Natal/RN. Beyond the technological aspects, it was verified that cultural and educational aspects need to be worked to reach efficiency in the process of implantation of a corporative education program

Reconhecimento de voz através de unidades menores do que a palavra, utilizando Wavelet Packet e SVM, em uma nova estrutura hierárquica de decisão

The automatic speech recognition by machine has been the target of researchers in the past five decades. In this period have been numerous advances, such as in the field of recognition of isolated words (commands), which has very high rates of recognition, currently. However, we are still far from developing a system that could have a performance similar to the human being (automatic continuous speech recognition). One of the great challenges of searches for continuous speech recognition is the large amount of pattern. The modern languages such as English, French, Spanish and Portuguese have approximately 500,000 words or patterns to be identified. The purpose of this study is to use smaller units than the word such as phonemes, syllables and difones units as the basis for the speech recognition, aiming to recognize any words without necessarily using them. The main goal is to reduce the restriction imposed by the excessive amount of patterns. In order to validate this proposal, the system was tested in the isolated word recognition in dependent-case. The phonemes characteristics of the Brazil s Portuguese language were used to developed the hierarchy decision system. These decisions are made through the use of neural networks SVM (Support Vector Machines). The main speech features used were obtained from the Wavelet Packet Transform. The descriptors MFCC (Mel-Frequency Cepstral Coefficient) are also used in this work. It was concluded that the method proposed in this work, showed good results in the steps of recognition of vowels, consonants (syllables) and words when compared with other existing methods in literature

Seleção seqüencial de descritores por análise da semântica para recuperação de imagens baseada no conteúdo

With the rapid growth of databases of various types (text, multimedia, etc..), There exist a need to propose methods for ordering, access and retrieve data in a simple and fast way. The images databases, in addition to these needs, require a representation of the images so that the semantic content characteristics are considered. Accordingly, several proposals such as the textual annotations based retrieval has been made. In the annotations approach, the recovery is based on the comparison between the textual description that a user can make of images and descriptions of the images stored in database. Among its drawbacks, it is noted that the textual description is very dependent on the observer, in addition to the computational effort required to describe all the images in database. Another approach is the content based image retrieval - CBIR, where each image is represented by low-level features such as: color, shape, texture, etc. In this sense, the results in the area of CBIR has been very promising. However, the representation of the images semantic by low-level features is an open problem. New algorithms for the extraction of features as well as new methods of indexing have been proposed in the literature. However, these algorithms become increasingly complex. So, doing an analysis, it is natural to ask whether there is a relationship between semantics and low-level features extracted in an image? and if there is a relationship, which descriptors better represent the semantic? which leads us to a new question: how to use descriptors to represent the content of the images?. The work presented in this thesis, proposes a method to analyze the relationship between low-level descriptors and semantics in an attempt to answer the questions before. Still, it was observed that there are three possibilities of indexing images: Using composed characteristic vectors, using parallel and independent index structures (for each descriptor or set of them) and using characteristic vectors sorted in sequential order. Thus, the first two forms have been widely studied and applied in literature, but there were no records of the third way has even been explored. So this thesis also proposes to index using a sequential structure of descriptors and also the order of these descriptors should be based on the relationship that exists between each descriptor and semantics of the users. Finally, the proposed index in this thesis revealed better than the traditional approachs and yet, was showed experimentally that the order in this sequence is important and there is a direct relationship between this order and the relationship of low-level descriptors with the semantics of the users

Análise de Agrupamentos Com Base na Teoria da Informação: Uma Abordagem Representativa

Currently, one of the biggest challenges for the field of data mining is to perform cluster analysis on complex data. Several techniques have been proposed but, in general, they can only achieve good results within specific areas providing no consensus of what would be the best way to group this kind of data. In general, these techniques fail due to non-realistic assumptions about the true probability distribution of the data. Based on this, this thesis proposes a new measure based on Cross Information Potential that uses representative points of the dataset and statistics extracted directly from data to measure the interaction between groups. The proposed approach allows us to use all advantages of this information-theoretic descriptor and solves the limitations imposed on it by its own nature. From this, two cost functions and three algorithms have been proposed to perform cluster analysis. As the use of Information Theory captures the relationship between different patterns, regardless of assumptions about the nature of this relationship, the proposed approach was able to achieve a better performance than the main algorithms in literature. These results apply to the context of synthetic data designed to test the algorithms in specific situations and to real data extracted from problems of different fields

Estimação de componentes de co-variância para pesos corporais do nascimento aos 365 dias de idade de bovinos Guzerá empregando-se modelos de regressão aleatória

Um total de 19.770 pesos corporais de bovinos Guzerá, do nascimento aos 365 dias de idade, pertencentes ao banco de dados da Associação Brasileira dos Criadores de Zebu (ABCZ) foi analisado com os objetivos de comparar diferentes estruturas de variâncias residuais, considerando 1, 18, 28 e 53 classes residuais e funções de variância de ordens quadrática a quíntica; e estimar funções de co-variância de diferentes ordens para os efeitos genético aditivo direto, genético materno, de ambiente permanente de animal e de mãe e parâmetros genéticos para os pesos corporais usando modelos de regressão aleatória. Os efeitos aleatórios foram modelados por regressões polinomiais em escala de Legendre com ordens variando de linear a quártica. Os modelos foram comparados pelo teste de razão de verossimilhança e pelos critérios de Informação de Akaike e de Informação Bayesiano de Schwarz. O modelo com 18 classes heterogêneas foi o que melhor se ajustou às variâncias residuais, de acordo com os testes estatísticos, porém, o modelo com função de variância de quinta ordem também mostrou-se apropriado. Os valores de herdabilidade direta estimados foram maiores que os encontrados na literatura, variando de 0,04 a 0,53, mas seguiram a mesma tendência dos estimados pelas análises unicaracterísticas. A seleção para peso em qualquer idade melhoraria o peso em todas as idades no intervalo estudado.

Identificação não linear usando uma rede fuzzy wavelet neural network modificada

In last decades, neural networks have been established as a major tool for the identification of nonlinear systems. Among the various types of networks used in identification, one that can be highlighted is the wavelet neural network (WNN). This network combines the characteristics of wavelet multiresolution theory with learning ability and generalization of neural networks usually, providing more accurate models than those ones obtained by traditional networks. An extension of WNN networks is to combine the neuro-fuzzy ANFIS (Adaptive Network Based Fuzzy Inference System) structure with wavelets, leading to generate the Fuzzy Wavelet Neural Network - FWNN structure. This network is very similar to ANFIS networks, with the difference that traditional polynomials present in consequent of this network are replaced by WNN networks. This paper proposes the identification of nonlinear dynamical systems from a network FWNN modified. In the proposed structure, functions only wavelets are used in the consequent. Thus, it is possible to obtain a simplification of the structure, reducing the number of adjustable parameters of the network. To evaluate the performance of network FWNN with this modification, an analysis of network performance is made, verifying advantages, disadvantages and cost effectiveness when compared to other existing FWNN structures in literature. The evaluations are carried out via the identification of two simulated systems traditionally found in the literature and a real nonlinear system, consisting of a nonlinear multi section tank. Finally, the network is used to infer values of temperature and humidity inside of a neonatal incubator. The execution of such analyzes is based on various criteria, like: mean squared error, number of training epochs, number of adjustable parameters, the variation of the mean square error, among others. The results found show the generalization ability of the modified structure, despite the simplification performed

Caracterização numérica de antenas para aplicações RFID utilizando o método das ondas - WCIP

In recent years, the radio frequency identification technology (RFID) has gained great interest both industrial communities as scientific communities. Its ability to locate and monitor objects, animals and persons with active or passive tags allows easy development, with good cost-benefice and still presents undeniable benefits in applications ranging from logistics to healthcare, robotics, security, among others. Within this aspect what else comes excelling are RFID tags and the antennas used in RFID readers. Most tags have antennas omnidirectional and are usually manufactured as dipoles modified printed. The primary purpose of a project of antenna for tag is to achieve the required input impedance to perform a good marriage impedance with the load impedance of the chip. Already the objective principal in project of antennas for readers is to achieve reduced sizes and structures with good data transmission capacity. This work brings the numerical characterization of antennas for RFID applications, being these divided into tags RFID and antennas for RFID readers. Three tags RFID and two antennas for RFID readers, found in literature, are analyzed. The analysis of these structures is made using the Method of Waves - WCIP. Initial results found in the literature are compared with those obtained through simulations in WCIP with objective to show that the Method of Waves is able to analyze such structures. To illustrate the results obtained in simulations is presented the behavior of electric and magnetic fields. It also performed a literature review on the characteristics and principles of RFID technology. Suggestions for continuity to this work are presented