Avaliação da desadaptação das selas de próteses parciais removíveis após 1 a 5 anos de uso

The non-adaptation of the removable partial prosthesis (RPP) base to fibromucosal tissue is caused by resorption of residual ridges (RRR). The onset of bone resorption, which occurs after tooth extraction and continues throughout life, is accelerated by local or systemic factors. Aim: Assess the degree of non-adaptation of removable partial prosthesis saddles and the factors that influence it. Methodology: A sectional study was conducted with 81 patients using RPP who had their prostheses installed between 2003 and 2007 (1 to 5 years of use) at the Faculty of Dentistry of the Universidade Federal do Rio Grande do Norte (UFRN). After anamnese and clinical examination, a cast was made with polyether-based material, using the base of the prosthesis to make the impression. The base of the saddle was loaded with the casting material and positioned in the mouth, applying pressure on the supports. After polymerization, the material was removed from the saddle and measurements were taken at 3 different points using a pachymeter. Results: The non-adaptation of the saddle increased significantly with years of use (p = 0.005). The tooth-tissue supported prostheses obtained higher mean non-adaptation values than those of tooth supported prostheses (p < 0.001). Flaccid mucosa showed the worst non-adaptation results, which were statistically different from resilient mucosa (p < 0.001). The greater the extension of the saddle, the greater the non-adaptation (p < 0.001). The natural tooth antagonistic arch yielded better results than did RPP and total prosthesis (p < 0.001). Saddle non-adaptation at the free end was less near the pillar tooth and greater in the more posterior region (p < 0.001). When adaptation of the supports to the niches was poor, greater saddle non-adaptation occurred than when it was good or fair (p < 0.001). Saddles located in the posterior region of the arch had greater non-adaptation than those in the anterior region (p = 0.023). Conclusion: The mean non-adaptation of the saddle to the residual ridges was 0.27 mm. It can be concluded that, even with the use of RPP, bone height reduction was slight within the 1-5-year period of use. The following are factors that influence adaptation of the RPP saddle base: years of use, age, force transmission path to the alveolar bone, location of the toothless area, antagonistic arch, type of mucosa, adaptation of supports to the niche and extension of the saddle

Influência da prática de yoga sobre os sintomas da menopausa

Yoga has been studied and practiced for over three thousand years and nowadays it is widely adopted as a mean to assist the health of individuals. Additionally, numerous benefits to the health rehabilitation and quality of life of elderly individuals has been attributed to this set of techniques. In women, the aging process is characterized by the interruption on ovarian follicular activity (menopause) characterized by a number of neuroendocrine and physiologic changes. Those changes are frequently accompanied by uncomfortable and occasionally debilitating symptoms. Although there is profuse clinical information about menopause, studies on the potential therapeutic application of yoga during the climacteric period are scarce. The objective of this research was to investigate the psychophysiological effects of 12 weeks of yoga practice in 88 postmenopausal women. The volunteers were divided into a control group (no intervention), exercise group and yoga group. Instruments were applied for the evaluation of climacteric syndrome, stress, depression, quality of life, and anxiety. In addition, the determination of hormonal levels of FSH, LH, estradiol, cortisol and progesterone, and biochemical levels of glucose, cholesterol, triglycerides, HDL, LDL, urea, creatinine, AST and ALT were conducted. Our results showed that the yoga group had significantly lower scores after the regular practice of yoga for menopausal symptoms. Besides, those changes were accompanied by a statistical significant improvement in the stress levels, decrease in depression scores, and higher scores in quality of life when compared with the control group and the exercise group. As well, the regular practice of yoga promoted the maintenance of cortisol levels compared to control group after 12 weeks. Regarding the biochemical parameters yoga practitioners presented lower levels of LDL in the blood. These results are supported by previous studies which found that regular practice of yoga improves quality of life of subjects, Thus, herein we propose that yoga can be a non-pharmacological alternative to management of menopausal symptoms and stress in postmenopausal women

Avaliação do comportamento termoanalítico e oxidativo do biodiesel de mamona

In this work biodiesel was gotten through the transesterification reaction using the oil of castor as source of triglycerides and using the methylic route for obtaining of esters. For the characterization of biodiesel and its mixtures with mineral diesel oil, physical chemical parameters and several analytical techniques had been used, as well as: gas chromatography (GC), nuclear magnetic resonance of proton (1H NMR), infrared spectroscopy (IR) and thermal analysis. The chromatography confirmed the complete reaction of esters in biodiesel presenting a 97,08% conversion. The 1H - NMR presented singlet in 3,6 ppm corresponding to the hydrogen of the group ester RCOO CH3. The infrared presented a strong band in 1741 cm-1 referring to stretching C=O of ester and an average band in 1175 cm-1 referring C O deformation. With the data of thermal analysis it was possible to observe the thermal and oxidative stability of the samples changing the atmospheres of synthetic air and nitrogen, where stages of the thermal decomposition had been verified and had been attributed to the volatilization and/or decomposition of the triacylglycerides. The thermal degradation of the samples was carried through 150 and 210°C during 1, 12, 24 and 48 hours and was observed change in the thermogravimetric profile, therefore an increase in the number of stages of the thermal decomposition also occurred indicating characteristic intermediate composites of polymerization, being this confirmed through the rheological study that presented brusque increase of viscosity. The kinetic study showed that the activation energy has the following order: biodiesel > mineral diesel oil > mixtures biodiesel/diesel

Caracterização de látices acrílicos em função da neutralização de seus grupos carboxilas

Latexes based on acrylic acid, acrylamide, ethyl methacrylate, and ethyl acrylate were synthesized via emulsion polymerization with different monomer compositions. The resultant latices were thickened with different molar ratios of NaOH to acrylic acid and were analyzed in terms of acid‐basis titrimetry, turbidimetry, rheology, and tensiometry. Titrimetry, turbidimetry, and rheometry were used to analyze factors such as carboxyl group availability and particle solubilization, tensiometry monitoring the influence of carboxyl neutralization on polymer‐surfactant interactions. For the acrylic acid content used in this work (20 wt%), the results indicated that as carboxyl groups distribution became more homogeneous, the process of latex thickening became more effective

Compósitos de borracha natural com polianilina

Compósitos de borracha natural (Hevea brasiliensis)-BN/polianilina - PANI, com diferentes composições foram obtidos através da polimerização por emulsão do monômero anilina na presença da BN e do ácido dodecilbenzeno sulfônico (DBSA). Filmes finos e homogêneos foram obtidos por prensagem a quente. Os compósitos foram caracterizados por condutividade elétrica, FTIR, UV-vis-NIR, DSC e difração de raios X. Compósito com condutividade elétrica cerca de 14 ordens de grandeza maior que a BN foi obtido. Este alto valor de condutividade é atribuído à formação da PANI no estado dopado no compósito, que foi verificado através das técnicas de UV-vis-NIR e FTIR. Os resultados obtidos com a técnica de DSC e difratometria de raios X indicaram que os polímeros são imiscíveis e que a presença da borracha não altera significantemente a fase cristalina da PANI-DBSA no compósito.

Aplicação da parafina e do óleo de linhaça como hidrofobizantes da vermiculita, para remoção de derivados de óleo diesel resentes em água produzida sintética

Produced water has lately aroused interest due to their high degree of salinity, suspended oil particles, chemicals added in various manufacturing processes, heavy metals and radioactivity sometimes. Along with oil and due to its high volume production, water production is one of the pollutants of most concern in the process of oil extraction. PAHs due to their ubiquity and their characteristics carcinogenic or mutagenic and teratogenic even have attracted the attention of every scientific society. Formed from the incomplete combustion of organic matter may be natural or anthropogenic. Some materials have been researched with the goal of cleaning up environmental matrices that may be contaminated by hydrocarbons. Among these materials researched various clays have been employed, of which highlights the vermiculite. The family of phyllosilicates, vermiculite for its potential and its high hydrophobic surface area has been a tool widely used in the decontamination of water in processes of oil spills. However, when it loses its capacity expanded hydrophobic having the necessity of using a hidrofobizante to make it organophilic. Among the numerous hidrofobizantes researched and used the linseed oil was the pioneer. In this study sought to evaluate the capacity of removal of PAHs using the vermiculite hydrofobized with linseed oil and wax also, for it was made use of the 24 full factorial design as the main tool for the experiments. We also evaluated the clay grain size (-20 +48 and -48 +80 #), the percentage of hidrofobizante applied (5 and 10%) and salinity of the water produced synthesized in our laboratory (35,000 and 55,000 ppm). The molecular fluorescence spectroscopy due to its sensitivity and speed was used to verify the adsorption capacity of clay, as well as gas chromatography served as an auxiliary technique to identify and quantify the PAHs in solution. In order to characterize the vermiculite was made use of X-ray fluorescence and X-ray diffraction. The infrared and thermogravimetry were essential to note hydrophobization and the amount of coating of clay. According to the fluorescence analysis showed that the test 12 was the best result in about 98% adsorption of fluorescent compounds, however the high salinity, the smallest particle size, the highest percentage of hidrofobizante and the use of linseed oil showed greater efficiency in the removal capacity of these hydrocarbons, in accordance with the trend followed by the analysis of the major factors of the factorial design. To verify the adsorption capacity of clay using a fixed volume of water produced synthetically, used as the test base 12, at their respective levels and factors. Thus, it was observed that after adding about 1 ½ liters of water solution produced synthetically, about 300 times its volume in mass, the vermiculite was able to adsorb 80% of fluorescent species present in solution

Caracterização de poliacrilamida parcialmente hidrolisada em regime concentrado

A partially hydrolyzed polyacrylamide (HPAM) is a copolymer composed of acrylamide and sodium acrylate. Due to its wide range of applications there are different methods for its quantification and characterization in solution systems. Evaluation of C* is important to describe the transition from dilute to semi-dilute, behavior, when the solution will have its characteristic viscosity at concentrations above C*. This dissertation describes the determination of the critical concentration of overlap C* by potentiometry of partially hydrolyzed polyacrylamide - HPAM under acidic conditions. Based on the law of mass action and the proper treatment of the constant of aggregate formation, polymer molecular weight, degree of polymerization and hydrolysis were calculated. The inflection point was determined by the intersection of the resulting equation and mathematical development, statistically satisfy the experimental points relating the number of moles of monomers (n), equilibrium constant of formation of the entanglements (K*), pH, C* and acidity constant of the polymer (Ka). The viscometric parameters of C* showed a percentage difference compared to potentiometers. The results for the determination of C*, and degree of copolymerization molar mass proved to be a simple alternative for the characterization of polymers with protonated monomers and water soluble

Partículas inteligentes de poli (nisopropilacrilamida), quitosana e poli (ácido acrílico): efeito da temperatura e do pH sobre suas propriedades em suspensões aquosas

The present study describes the stability and rheological behavior of suspensions of poly (N-isopropylacrylamide) (PNIPAM), poly (N-isopropylacrylamide)-chitosan (PNIPAMCS), and poly (N-isopropylacrylamide)-chitosan-poly (acrylic acid) (PNIPAM-CS-PAA) crosslinked particles sensitive to pH and temperature. These dual-sensitive materials were simply obtained by one-pot method, via free-radical precipitation copolymerization with potassium persulfate, using N,N -methylenebisacrylamide (MBA) as a crosslinking agent. Incorporation of the precursor materials into the chemical networks was confirmed by elementary analysis and infrared spectroscopy. The influence of external stimuli such as pH and temperature, or both, on particle behavior was investigated through rheological measurements, visual stability tests and analytical centrifugation. The PNIPAM-CS particles showed higher stability in acid and neutral media, whereas PNIPAM-CS-PAA particles were more stable in neutral and alkaline media, both below and above the LCST of poly (Nisopropylacrylamide) (stability data). This is due to different interparticle interactions, as well as those between the particles and the medium (also evidenced by rheological data), which were also influenced by the pH and temperature of the medium. Based on the results obtained, we found that the introduction of pH-sensitive polymers to crosslinked poly (Nisopropylacrylamide) particles not only produced dual-sensitive materials, but allowed particle stability to be adjusted, making phase separation faster or slower, depending on the desired application. Thus, it is possible to adapt the material to different media

Assinaturas antropogênicas de elementos maiores e traços em poeira urbana na cidade do Natal-RN

Although there are many studies on urban dust contamination by heavy metals in developed countries, little attention has been paid to this type of study in developing countries, including Brazil. Therefore, a series of investigations were performed to provide signatures of heavy metals in urban dust and assess the potential sources in the city of Natal - RN-Brazil. The fraction of these sediments was studied to pass through a sieve of 63 micrometers. For the study analyzed two groups of samples, one collected in September 2009 at the end of the rainy season (9 samples) and one collected in January 2010 in the dry season (21 samples). So in all, thirty sediment samples were collected from the street. Then, in Fluorescence Spectrometry X-rays were determined major elements SiO2, Na2O, K2O, Al2O3, MgO, P2O5, Fe2O3, MnO, TiO2 and CaO, and trace Rb, Cr, Ni, Cu, Zn, Sr and Pb by an ICPOES was determined Zn, V, Na, K, Ni, Mn, Mg, P, Fe, Cr, Cu, Pb, Ba, Ca and Al from leaching HCl 0.5 mol L-1 . The results of the concentrations of elements show that the greater presence of these occurs in the dry season, except for Si which is higher in the rainy season. Analyses by geoaccumulation Index (IGEO) Enrichment Factor (EF), Contamination Factor (CF), analysis correlation and Hierarchical Cluster, confirm that Zn, Cu and Pb is anthropogenic character. Zinc may be derived from various sources related to motor vehicles or the road signs and street grids. The elements Na, K, Mg and Ca may be related to droplets suspended in air containing cations and anions present in seawater (salty), common in Christmas throughout the year, brought by winds SE-NW. The elements Na, Mg, Ca and K are the most abundant in seawater and were analyzed in this study. This indicates that the source of these additional elements detected by analyzing the contamination factor may be the very sea. Moreover, Ni, Fe, Cr and Ba can be either as a source of anthropogenic geogênica. The source of Ca is different, because it comes in lime and paint (painting guides of buildings and streets) in construction materials, but may also be present in sediments in the fragments of shells or carbonate bioclasts common in the coastal area

Hidrofobização, caracterização e aplicação da vermiculita para remoção de óleo insolúvel em água

Among the various layered silicates, vermiculite has been used as one of the adsorbent material by presenting the ion exchange capacity which facilitates the removal of organic compounds which are potential pollutants in relation to the water surface. The importance of the modification of clay minerals by hydrophobization with carnauba wax establishes the increase in oil removal capacity in aqueous medium, it contributes to a better environment for life in ecosystems. The vermiculite when expanded decreases its hydrophobicity requiring the use of a hydrophobizing leaving - the organoclay. In this work were used in the process of modifying the particle sizes of vermiculite -18+16, -16 +20 and -20 +35 #. Samples of vermiculite hydrophobized with carnauba wax and clay mineral without hydrophobizing were characterized with physicochemical analyzes and analytical. Techniques were used: thermal analysis (thermogravimetry and derivative thermogravimetry), infrared spectroscopy, scanning electron microscopy, fluorescence rays - x adsorption tests. The TG / DTG was used to evaluate the thermal behavior of expanded vermiculite and carnauba wax and samples hidrofobizadas with percentages of 5, 10 and 15 % by weight of hydrophobizing. The results of FTIR confirmed increase of the characteristic signs of carnauba wax in samples hidrofobizadas as the greatest amount of hydrophobizing the clay mineral used in hydrophobization. Thermogravimetry and FTIR show based on the results that coating the surface of the vermiculite occur homogeneously. The data obtained by the technique of x-ray fluorescence with loss on ignition confirmed the results of thermogravimetric analysis in relation to the percentage of wax incorporated. The fluorescence indicates through information provided by the analysis shows that the material covered - is homogeneous. The mev inspection was used to texture and morphology of the clay mineral with and without carnauba wax. The scanning electron microscopy confirms the deposition of wax evenly over the surface of the mineral as indicated by the other techniques. To verify the adsorption capacity of the clay without hydrophobizing hydrophobized and used a fixed volume of water to 1 ½ liters in each experiment with 3 g to 50 g of oil sample. The results show that better extraction of oil for the material processed corresponds to 260 % relative to the weight of the sample coated and greater than 80 % of the oil drop in the system

Estudo da imobilização de proteases para a síntese de oligolisinas

Enzymatic synthesis of peptides using proteases has attracted a great deal of attention in recent years. One key challenge in peptide synthesis is to find supports for protease immobilization capable of working in aqueous medium at high performance, producing watersoluble oligopeptides. At present, few reports have been described using this strategy. Therefore, the aim of this thesis was to immobilize proteases applying different methods (Immobilization by covalent bound, entrapment onto polymeric gels of PVA and immobilization on glycidil metacrylate magnetic nanoparticles) in order to produce water-soluble oligopeptides derived from lysine. Three different proteases were used: trypsin, α-chymotrypsin and bromelain. According to immobilization strategies associated to the type of protease employed, trypsin-resin systems showed the best performance in terms of hydrolytic activity and oligopeptides synthesis. Hydrolytic activities of the free and immobilized enzymes were determined spectrophotometrically based on the absorbance change at 660 nm at 25 °C (Casein method). Calculations of oligolysine yield and average degree of polymerization (DPavg) were monitored by 1H-NMR analysis. Trypsin was covalently immobilized onto four different resins (Amberzyme, Eupergit C, Eupergit CM and Grace 192). Maximum yield of bound protein was 92 mg/g, 82 mg/g and 60 mg/g support for each resin respectively. The effectiveness of these systems (Trypsin-resins) was evaluated by hydrolysis of casein and synthesis of water-soluble oligolysine. Most systems were capable of catalyzing oligopeptide synthesis in aqueous medium, albeit at different efficiencies, namely: 40, 37 and 35% for Amberzyme, Eupergit C and Eupergit CM, respectively, in comparison with free enzyme. These systems produced oligomers in only 1 hour with DPavg higher than free enzyme. Among these systems, the Eupergit C-Trypsin system showed greater efficiency than others in terms of hydrolytic activity and thermal stability. However, this did not occur for oligolysine synthesis. Trypsin-Amberzyme proved to be more successful in oligopeptide synthesis, and exhibited excellent reusability, since it retained 90% of its initial hydrolytic and synthetic activity after 7 reuses. Trypsin hydrophobic interactions with Amberzyme support are responsible for protecting against strong enzyme conformational changes in the medium. In addition, the high concentration of oxirane groups on the surface promoted multi-covalent linking and, consequently, prevented the immobilized enzyme from leaching. The aforementioned results suggest that immobilized Trypsin on the supports evaluated can be efficiently used for oligopeptides synthesis in aqueous media

Interações entre a carboximetilcelulose, carbonato de cálcio e bentonita: repercussões sobre as propriedades dos fluidos de perfuração aquosos

The role of carboxymethylcellulose (CMC) in association to calcium carbonate particles (CaCO3) in most water-based drilling fluids is to reduce the fluid loss to the surrounding formation. Another essential function is to provide rheological properties capable of maintaining in suspension the cuttings during drilling operation. Therefore, it is absolutely essential to correlate the polymer chemical structure (degree of substitution, molecular weight and distribution of substituent) with the physical-chemical properties of CaCO3, in order to obtain the better result at lower cost. Another important aspect refers to the clay hydration inhibitive properties of carboxymethylcellulose (CMC) in drilling fluids systems. The clay swelling promotes an undesirable damage that reduces the formation permeability and causes serious problems during the drilling operation. In this context, this thesis consists of two main parts. The first part refers to understanding of interactions CMC-CaCO3, as well as the corresponding effects on the fluid properties. The second part is related to understanding of mechanisms by which CMC adsorption occurs onto the clay surface, where, certainly, polymer chemical structure, ionic strength, molecular weight and its solvency in the medium are responsible to affect intrinsically the clay layers stabilization. Three samples of carboximetilcellulose with different molecular weight and degree of substitution (CMC A (9 x 104 gmol DS 0.7), CMC B (2.5 x 105 gmol DS 0.7) e CMC C (2.5 x 105 gmol DS 1.2)) and three samples of calcite with different average particle diameter and particle size distribution were used. The increase of CMC degree of substitution contributed to increase of polymer charge density and therefore, reduced its stability in brine, promoting the aggregation with the increase of filtrate volume. On the other hand, the increase of molecular weight promoted an increase of rheological properties with reduction of filtrate volume. Both effects are directly associated to hydrodynamic volume of polymer molecule in the medium. The granulometry of CaCO3 particles influenced not only the rheological properties, due to adsorption of polymers, but also the filtration properties. It was observed that the lower filtrate volume was obtained by using a CaCO3 sample of a low average size particle with wide dispersion in size. With regards to inhibition of clay swelling, the CMC performance was compared to other products often used (sodium chloride (NaCl), potassium chloride (KCl) and quaternary amine-based commercial inhibitor). The low molecular weight CMC (9 x 104 g/mol) showed slightly lower swelling degree compared to the high molecular weight (2.5 x 105 g/mol) along to 180 minutes. In parallel, it can be visualized by Scanning Electron Microscopy (SEM) that the high molecular weight CMC (2.5 x 105 g/mol e DS 0.7) promoted a reduction in pores formation and size of clay compared to low molecular weight CMC (9.0 x 104 g/mol e DS 0.7), after 1000 minutes in aqueous medium. This behavior was attributed to dynamic of interactions between clay and the hydrodynamic volume of CMC along the time, which is result of strong contribution of electrostatic interactions and hydrogen bounds between carboxylate groups and hydroxyls located along the polymer backbone and ionic and polar groups of clay surface. CMC adsorbs on clay surface promoting the skin formation , which is responsible to minimize the migration of water to porous medium. With the increase of degree of substitution, it was observed an increase of pores onto clay, suggesting that the higher charge density on polymer is responsible to decrease its flexibility and adsorption onto clay surface. The joint evaluation of these results indicate that high molecular weight is responsible to better results on control of rheological, filtration and clay swelling properties, however, the contrary effect is observed with the increase of degree of substitution. On its turn, the calcite presents better results of rheological and filtration properties with the decrease of average viii particle diameter and increase of particle size distribution. According to all properties evaluated, it has been obvious the interaction of CMC with the minerals (CaCO3 and clay) in the aqueous medium

Obtenção de dispersões de complexos polieletrolíticos à base de quitosana e poli(ácido metacrílico) e análise de adsorção de albumina bovina sérica

Dispersions composed of polyelectrolyte complexes based on chitosan and poly(methacrylic acid), PMAA, were obtained by the dropping method and template polymerization. The effect of molecular weight of PMAA and ionic strength on the formation of chitosan/poly(methacrylic acid), CS/PMAA, complexes was evaluated using the dropping method. The increase in molecular weight of PMAA inhibited the formation of insoluble complexes, while the increase in ionic strength first favored the formation of the complex followed by inhibiting it at higher concentrations. The polyelectrolyte complexation was strongly dependent on macromolecular dimensions, both in terms of molecular weight and of coil expansion/contraction driven by polyelectrolyte effect. The resultant particles from dropping method and template polymerization were characterized as having regions with different charge densities: chitosan predominating in the core and poly(methacrylic acid) at the surface, the particles being negatively charged, as a consequence. Albumin was adsorbed on templatepolymerized CS/PMAA complexes (after crosslinking with glutardialdehyde) and pH was controlled in order to obtain two conditions: (i) adsorption of positively charged albumin, and (ii) adsorption of albumin at its isoelectric point. Adsorption isotherms and zeta potential measurements showed that albumin adsorption was controlled by hydrogen bonding/van der Waals interactions and that brushlike structures may enhance adsorption of albumin on these particles

Efeitos da efedrina sobre as funções cardiovascular e renal de cães sob anestesia com pentobarbital sódico

JUSTIFICATIVA E OBJETIVOS: Com a perspectiva criada por algumas pesquisas de ações diferenciadas da efedrina sobre a função renal, dependendo da dose utilizada, e considerando-se as controvérsias ainda existentes a respeito dos seus efeitos sobre a função renal, esta pesquisa experimental tem como objetivo verificar se doses diferentes de efedrina determinam efeitos hemodinâmicos e renais diferenciados. MÉTODO: em 32 cães anestesiados com pentobarbital sódico (PS), submetidos a preparação cirúrgica, cateterismo, monitorização, expansão do volume do fluido extracelular e respiração controlada, foi estudada a hemodinâmica cardiovascular e renal e a função renal. Os cães foram distribuídos aleatoriamente em quatro grupos: G controle (n = 8), com os cães permanecendo apenas sob o efeito do PS, G ef. 2 µg (n = 8), G ef. 10 µg (n = 8) e G ef. 100 µg (n = 8), com os cães recebendo efedrina nas doses respectivas de 2, 10 e 100 µg.kg-1.min-1. Os atributos cardiovasculares e renais foram estudados em 5 momentos: controle (M1 e M2), durante a infusão de efedrina (M3 e M4) e após a suspensão da infusão de efedrina (M5). RESULTADOS: Não houve diferença significante entre os grupos em relação aos atributos estudados. em G ef. 2 µg houve aumento significante de freqüência cardíaca, fluxo sangüíneo aórtico, débito urinário e excreção fracionária de sódio. em G ef. 10 µg houve aumento apenas da freqüência cardíaca e fração de filtração, enquanto em G ef. 100 µg ocorreu aumento de freqüência cardíaca, pressão arterial média, pressão venosa central, fluxo sangüíneo aórtico e hematócrito; por outro lado, ocorreu diminuição dos fluxos plasmático e sangüíneo renais e aumento da resistência vascular renal. CONCLUSÕES: A efedrina, dependendo da dose utilizada, apresenta ações hemodinâmicas e renais diferenciadas.

Implantação do Serviço de Avaliação Pré-Anestésica em Hospital Universitário: dificuldades e resultados

JUSTIFICATIVA E OBJETIVOS: A avaliação pré-operatória é a chave principal para um bom preparo pré-operatório e manuseio intra-operatório. Quando realizada em nível ambulatorial permite uma análise melhor, possibilitando investigações adicionais, melhorando a qualidade do preparo e diminuindo os custos hospitalares. O objetivo deste estudo foi analisar a implantação e o desenvolvimento do Serviço de Avaliação Pré-Anestésica (SAPAN) em Hospital Universitário, verificando quais foram as dificuldades e os resultados positivos encontrados. MÉTODO: Foram avaliados os dados relativos aos pacientes atendidos no ambulatório do SAPAN, pelos médicos em especialização com supervisão de um docente, nos primeiros nove meses de instalação. A consulta era feita seguindo uma ficha padronizada. Ao término, os pacientes eram liberados para o procedimento cirúrgico ou encaminhados para consulta com outros especialistas para controle de doenças específicas. Analisou-se o número de pacientes avaliados e o número de procedimentos cirúrgicos eletivos realizados nesse período e as diversas especialidades cirúrgicas, porcentagem de pacientes com intervenção cirúrgica suspensa por necessidade de controle de doenças, e as especialidades clínicas mais solicitadas. RESULTADOS: Realizaram-se 913 consultas ambulatoriais e 5.409 intervenções cirúrgicas eletivas. Várias clínicas não encaminharam seus pacientes para a avaliação. Por necessidade clínica, 11,9% dos pacientes tiveram o procedimento cirúrgico suspenso, e as clínicas envolvidas foram cardiologia (43,08%), pneumologia (25,74%), hematologia (21,65%) e endocrinologia (9,52%). CONCLUSÕES: Embora grande parte dos pacientes não tenha sido encaminhada pelas especialidades cirúrgicas, os dados iniciais do SAPAN permitiram demonstrar os benefícios de um serviço de preparo ambulatorial dos pacientes.