982 resultados para PELE


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Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

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A implementação de programas de LTPP – Long-Term Pavement Performance (avaliação do desempenho de pavimentos a longo prazo), ao criar um registo histórico sobre as características e a evolução do estado dos pavimentos da rede, revela-se uma ferramenta de valor acrescido no auxílio à tomada de decisões, no âmbito da conservação e da reabilitação de pavimentos, por parte das administrações das infraestruturas rodoviárias. O LTPP americano, dentre os existentes no mundo, é o projeto pioneiro e um dos que tem a maior quantidade de informação armazenada. Por isso, foi o escolhido no âmbito desta dissertação para estudar a evolução do estado dos pavimentos em várias secções classificadas no programa como SPS-5, incluídas no estudo de reabilitação de pavimentos betuminosos. A avaliação efetuada considera cerca de 15 anos de registos de dados, na Califórnia, no Texas e no Mississippi. Após uma breve apresentação de vários projetos LTPP existentes no mundo, descreve-se o modo como são recolhidos e estruturados os dados no LTPP americano, referindo os módulos, as tabelas e os campos considerados para estudo que se faz nesta dissertação. Os estados americanos escolhidos apresentam características climáticas que não reproduzem de forma muito próxima o que acontece em Portugal. Mesmo assim, procurou estabelecer-se um paralelo entre aquelas zonas, com base na temperatura do ar e na precipitação, de modo a poder inferir, de forma aproximada, tendências de evolução do estado dos pavimentos para Portugal Continental. A correspondência climática entre os estados americanos e as regiões portuguesas, resultou nos pares Califórnia/Beja, Texas/Lisboa e Mississippi/Porto. No que se refere ao desenvolvimento de patologias nos pavimentos, analisou-se a evolução do fendilhamento longitudinal, transversal, em bloco (ou malha) e por fadiga (ou pele de crocodilo), da desagregação superficial, do Índice de Irregularidade Internacional (IRI) e das rodeiras. O fendilhamento em bloco (ou malha) e a desagregação superficial não foram objeto de estudos estatísticos para determinação de modelos de previsão. A evolução do estado dos pavimentos, traduzida por indicadores relacionados com as patologias analisadas, foi apreciada em função de diversas variáveis associadas às técnicas de reabilitação, tais como a preparação da superfície de trabalho (realização de atividades de fresagem antes da nova camada), a espessura da camada de reforço (50 ou 125 mm) e o tipo de mistura utilizada (nova ou contendo cerca de 30% de material reciclado). Para as situações em que os dados existentes eram coerentes e em quantidade suficiente, apresentam-se análises de regressão multivariada, de modo a prever a evolução no tempo do estado dos pavimentos, tendo em conta um conjunto de variáveis explicativas relacionadas com as técnicas de reabilitação aplicadas e com o tráfego que solicitou os pavimentos. A análise agregada dos dados para cada um dos estados permitiu concluir que a preparação da superfície por fresagem, o aumento da espessura do reforço, e a utilização de misturas betuminosas novas ou com material reciclado, interferem na evolução das degradações. A influência daqueles fatores é variável em função dos diferentes tipos de patologias em análise.

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Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

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Includes his Thétis et Pelée, tragédie; Enée et Lavinie, tragédie; De l'origine des fables, Du bonheur, and Discours de la patience.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

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The study aimed to analyze the field of nursing diagnoses safety / protection of NANDA International present in patients in the Intensive Care Unit. This is a crosssectional study in intensive care complex of a university hospital in northeastern Brazil. The research took place in two stages. The first step was to collect data through an interview form and physical examination, with 86 patients admitted to the unit, during the months of December 2013 to May 2014. Spreadsheets were built in Microsoft Office Excel 2010 Software in which were marked by the researcher of this study, the presence or absence of defining characteristics, related factors and risk factors of the 31 studied diagnoses. In the second stage, held between July and August 2014, the sheets were sent to three diagnosticians, previously trained to perform the diagnostic inference. Data were analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%, using IBM SPSS version 20.0 for Statistic Windows.O project was approved by the 440/414 and Presentation Certificate for Ethics Assessment number 22955113 .2.0000.5292. The results indicated the presence of 29 field of nursing diagnoses safety / protection in hospital clientele in the Intensive Care Unit, of which five were present in 100% of patients, namely: Risk of contamination, injury risk, falls risk,risk of allergic response and risk of trauma. Diagnoses that presented more frequently than 50% were: Risk of infection, dry eye risk, poisoning risk, vascular trauma risk, impaired skin integrity, impaired dentition, bleeding risk, risk imbalance in body temperature, Risk perioperative positioning injury, impaired tissue integrity, peripheral neurovascular dysfunction Risk, Risk adverse response to contrast media with iodine, shock Hazard and Risk of aspiration. For these analyzes, we identified 35 risk factors, 11 defining characteristics and three related factors showed statistically significant association with the studied diagnoses. For diagnostics: Risk of contamination, injury risk, falls risk, allergic response risk, trauma Risk, Risk of infection, dry eye risk and risk poisoning there was no association with any of their risk factors. We conclude that most of the area of nursing diagnoses safety / protection feature is prevalent in critically ill patients, with special attention to the risk diagnoses. There was a significant association between these diagnoses and its components. It is noteworthy, therefore, that the lifting of this profile contributes relevant clues to the inference of the priority nursing diagnoses domain safety / protection in the study population, supporting the practice of nursing and stimulating knowledge on the subject.

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The Chronic Venous insufficiency is characterized as a set of physical changes including how most serious complication of venous ulcers, characterized by irregular and progressive loss of continuity of the skin. The occurrence of venous ulcers in people with chronic venous insufficiency generates dependence on them with health services, with long-term treatments that cause limitations and high-impact changes, affecting their quality of life, affecting the physical, psychological, social, cultural and spiritual as an important public health problem. This study aimed to describe the experience of having a venous ulcer, in the scenario of primary health care services to Health, which includes Primary Care Units and Family Health Strategy in the city of Natal / RN, based on the life histories of users. This is a qualitative study, exploratory and descriptive, with the Oral History of Life as a methodological framework. From the ponto zero was the recruitment of participants who formed the network, totaling six employees, of both sexes and aged between 57 and 79 years. After approval by the Research Ethics Committee - UFRN under the Protocol 653 788/2014 and CAAE 30408014.0.0000.5537 was held data collection, between the months of July and August, through interviews, using identification and characterization of the instrument employees and open questions. Interviews were recorded, transcribed, transcriadas and returned to employees for a conference. The narratives were subjected to Content thematic analysis technique, according to Bardin, allowing the construction of three themes that encompass categories, namely: Axis I - Perspectives on the changes: the impact wound in social relations (changes with ulcer venous, venous ulcer and social and family relationships); Axis II - Brands in body and soul: the story of being hurt (conceptions of the body injured; therapeutic itinerary in primary care services); and Axis III - Reconstruction of being hurt: coping mechanisms (redefinition of the wounded body, resilience to chronic wound). The impact of having a chronic venous ulcer generates impact of physical, psychological and social order. As aspects related to changes after the appearance of venous ulcers, survey participants reported the presence of pain, physical limitations, psychological distress, social and emotional isolation, incapacity, aesthetic discomfort and dependency on health services; the family was the aspect thatshowed no significant change after the occurrence of wound for most participants, an ally in the therapeutic process as a support network. The redefinition of the body and the wound are the main coping mechanism of chronic condition. The services in the Primary Care Network play a fundamental role in the rehabilitation of patients with venous ulcers, although there are difficulties in accessing appropriate treatment and need for expanded services, with permanent professional training of health teams and providing the resources managers to strengthen the comprehensive care of people with venous ulcers in Health Primary Care.

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In order to evaluate the effect of levels of dehydrated cane juice sugar (DCJS) (0.0, 1.5, 3.0 and 4.5%) in the diet of European quail (Coturnix coturnix coturnix) on performance on performance, carcass characteristics and economical at 22 days of age indices, 192 quails cutting, were distributed in a completely randomized design with four treatments and six replicates of eight birds each There was no significant difference to the performance of quail in any of the periods. Quadratic effects of levels of DCJS on carcass weight (y = 173.71 + 4.2767x – 1.2644x², R² = 0.99), thigh-thigh more about (y = 36,055 + 1,1263x – 0,2256x², R² = 0.91) and abdominal fat (y = 3,3295 - + 0.8903x 0,19x2, R ² = 0,97) where the optimum levels were estimated 1,69; 2.50 and 2.34%, respectively. There was a linear effect descending of DCJS levels on weight breast with skin (y = 66.267 – 0.5653x, R² = 0.83) and without skin (y = 60.286 – 0.7193x, R² = 0.58). In economic analysis, one can observe higher profit to the producer with the use of conventional feed. However, between the levels of inclusion of sugar cane juice is observed that the level of 1.5% DCJS obtained the best results in economic analysis, obtaining only a difference of relative gross margin of 0.47% compared to conventional. It is recommended 1.69 and 2.50% DCJS for higher carcass, thigh + drumstick weight and lower percentage of abdominal fat quails, respectively.

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Aim : To evaluate and to standardize surface electromyography (sEMG) normalization procedures for respiratory muscles by comparing muscle activation during Maximal Voluntary Isometric Contraction (MVIC) and Maximal Respiratory Pressures (MIP, MEP and sniff test). Methods: Healthy subjects were evalua ted regarding demographics, spirometry and sEMG during the five maneuvers: sniff test, MIP , MEP and Maximal Voluntary Isometric C ontraction (MVIC) of RA, SCM and SC A . For electrode placement, skin was prepared with abrasion, followed by shaving in the foll owing regions for acquisition of el ectromyographic signals: (1) SC M: lower third of the distance between the mastoid process and t he sternoclavicular joint; (2) SC A : 5 cm to the right from the sternoclavicular joint and at this point, up to 2 cm; and (3 ) RA: the level of umbilicus, 4 cm to the right. In electromyographic variables analysis , the data normality was assessed by Shapiro - Wilk test. Comparisons among studied maneuvers were performed by Friedman Test and Dunn’s post - hoc for multiple comparisons a mong inspiratory maneuvers, and Mann Whitney test for expiratory maneuvers. Subgroups differences between genders were performed by Student's t test or Mann - Whitney test according to data normality. Results: 35 subjects participated in the study, b ut 5 we re excluded (BMI> 25 kg/ m²). Sample consisted of 30 subjects (1 5 women), mean age 27.3±7.43 years, BMI 22.2 ± 1.69 kg/m² and spirometric indices within normal limits. Specific MVIC for SCM, SCA and RA showed the highest RMS. When we grouped sample into gender we found no difference among RMS values for the studied SCM maneuvers, while for SCA, MVIC SCM / SCA was the one with the highest RMS and for RA, MVIC RA in men. Once considering women, MVIC SCM/SCA showed the highest RMS for SCM, SCA and MVIC RA showed t he highest value for RA. Conclusion: MVIC for SCM, SCA and RA muscles showed the highest RMS values. When comparing RMS between the studied groups, there was no significant difference between men and women.

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Except the non-melanoma skin tumors, colorectal cancer is the second most common in the Southeastern Region of Brazil, the third most common in the Southern and Central Regions. It is also the forth most common in the Northern Region and it is the fifth one in the Northeastern. To assess pathological and clinical variables of colorectal Cancer is crucial to know the possible conclusions for the survival of patients and point out the characteristics in the progress of tumor, such as the profile of tumor invasion and its angiogenesis. This work focuses on analyzing clinically and pathologically some settings in colorectal cancer patients (CRC) in the city of Natal and its countryside through those variables as parameters of prognosis and determine the level of protein expression, for instance: E-cadherin (E-cad), beta- -catenin (β-cat), galectin-3 (gal-3), matrix metalloproteinases (MMP) 2 and 9 and vascular-endothelial growth factor alpha (α VEGF) in the tumor tissues. A retrospective study was done in colorectal cancer cases in the regions of Rio Grande do Norte state from 1995 to 2005, specifically in Natal city/RN/Brazil. The pathological and clinical variables, such as: age, gender, ethnicity, lifestyle, family history, the location of the primary tumor, level of differentiation, TDM staging, modified Dukes’, treatment and survival were analyzed. The pathological and clinical data were collected from medical records through a specific form and were filed on Excel. A total of 534 patients were selected from the Pathology Department file in this institution, however, 176 patients were excluded. 358 patients were included for Epidemiological analysis and its clinical and pathological correlations were selected. 180 patients were also selected for histological and immunohistochemical studies. The tumor progression of these selected proteins mentioned before were analyzed. The Paraffin blocks of these samples were treated by Microarray Tissue technique and its blades subjected to immunohistochemistry to test the intensity of these proteins in tumor tissues. The results of this analysis were correlated with clinicopathologic variables of patients. Statistical analysis using the chi-frame Pearson test and analysis of midlife by Kaplan-Meier curve was also utilized. P values < 0.05 were considered statistically significant. The average age of our sample was 58.8 years and 51.7 % were female. Alcohol consumption has increased by 1.71 time the risk of death by CCR (p = 0.034) and tobacco consumption increased 2.7 times the chance of developing tumors of high TNM stage (p = 0.001). Cancer patients had a family history of 3,833 times the chance of developing the CCR (p = 0.002). The expression of MMP-2 showed a significant association with tumors of high TNM stage (p <0.046) and mortality (p = 0.041). The α VEGF expression had statistically significant correlation with high TNM stage (p <0.009), degree of cell indifferentiation (p <0.025) and mortality (p <0.035). Expressions of E-cadherin and beta-catetina demonstrated tumor linked to high TNM stage (p = 0.0001) and Dukes› modified (p = 0.05), lesions in the rectum (p = 0.03 and p = 0.007, respectively), smoking (p = 0.05) and indifferentiation (p = 0.001). The expression of Gal-3 showed statistical significance with high TNM stage of patients (p = 0.01), smokers (p = 0.01), alcohol drinking (p = 0.03), indifferentiation (p = 0.0001) and mortality (p = 0.0001). Based on the results, therefore, we could realize that lifestyle and family history had correlation in the CCR prognosis, as well as MMP-2 expression, MMP-9, VEGF alpha, E-cadherin, Beta-catenin and Galectin-3 were important prognostic markers in tumor progression in colorectal cancer.