O gerenciamento dos resíduos dos serviços de saúde de uma amostra de hospitais nacionais

O presente trabalho constitui o Relatório Final de um projeto de pesquisa financiado pelo Núcleo de Pesquisas e Publicações da FGV-EAESP. Analisam-se nele os Planos de Gestão de Resíduos de Serviços de Saúde PGRSS de uma amostra de 70 hospitais nacionais, elaborados em 2003, como resultado de um curso de educação a distância, ministrado por um consórcio formado entre a Universidade Federal de Santa Catarina e a Fundação Getulio Vargas. O curso foi sugerido pela UNESCO e financiado por bancos internacionais, com intermediação do REFORSUS. Para cada Plano, foram tabulados, em planilha EXCEL, 164 itens, sendo 12 informações gerais sobre o hospital, 141 relativas à infra-estrutura e aos procedimentos atualmente usados e 11 referentes ao plano futuro de gestão de resíduos. Diagnosticou-se a situação desses hospitais no tocante ao manejo dos resíduos, classificados como infectantes, químicos, radioativos, comuns e perfurocortantes, desde a coleta, o armazenamento e o tratamento interno até a remoção, o tratamento externo e a disposição final. A água, desde a fonte de suprimento até seu consumo, os efluentes líquidos e as emissões gasosas também foram objeto de investigação. Foram avaliados ainda, sob os aspectos técnico e econômico, os planos elaborados pelos hospitais para a gestão futura dos seus resíduos. Os resultados da pesquisa indicam que os hospitais estudados se encontram em sua maioria numa fase incipiente em matéria de gestão dos seus resíduos, carecendo de infra-estrutura, recursos financeiros e humanos e gerenciamento, existindo considerável distância entre a gestão atual dos resíduos e as exigências legais que os hospitais devem cumprir nas áreas sanitária e ambiental.

Correlação entre achados colposcópicos e diagnóstico histológico segundo a Classificação Colposcópica da Federação Internacional de Patologia Cervical e Colposcopia de 2002

Objetivo: Avaliar a acurácia da colposcopia utilizando a Classificação Colposcópica Internacional de 2002. Métodos: 3040 pacientes de população geral foram rastreadas para patologia cervical através de exame citopatológico, captura híbrida para HPV de alto risco e inspeção cervical. As colposcopias que resultaram em biópsia (n=468) executadas no rastreamento e acompanhamento destas pacientes foram gravadas, revistas por dois colposcopistas cegados e incluídas para análise. Resultados: Os observadores apresentaram excelente concordância (Kappa=0.843) no relato dos achados pela nova nomenclatura. A colposcopia apresentou sensibilidade de 86% e especificidade de 30.3% em diferenciar colo normal de colo anormal (LSIL, HSIL ou carcinoma); quando a colposcopia objetivava diferenciar colo normal ou LSIL de HSIL ou carcinoma, apresentou sensibilidade de 61.1% e especificidade de 94.4%. Os achados colposcópicos classificados como “maiores” pela nova classificação apresentaram valores preditivos positivos elevados para HSIL. Presença do achado colposcópico na zona de transformação e tamanho da lesão estavam associados a HSIL. Bordas externas definidas, associação de múltiplos achados distintos e presença de zona iodo negativa não estavam relacionados à gravidade das lesões. Conclusão: A colposcopia utilizando a Classificação Internacional de 2002 mostra-se um bom método de rastreamento, mas como método diagnóstico apresenta falhas, não podendo substituir a avaliação histológica. A categorização em achados colposcópicos “maiores” e “menores” apresentada pela nova classificação é adequada. Na realização da colposcopia, é importante também que a lesão seja situada em relação à zona de transformação e que seu tamanho seja indicado, já que estes foram fatores associados a lesões de alto grau.

The ileum as a determinant organ of the functional liver cell mass in rats

PURPOSE: To evaluate if the ileum resection changes the functioning liver cell mass, the hepatic metabolism and the biodistribution of radiopharmaceutical in rats. METHODS: Twelve Wistar rats weighing 285g±34g were randomly divided into the ileum resection group (n = 6) and sham group rats (n = 6). After 30 days, they were anesthetized and 0.1mL of 99m-Tc-phytate(0.66MBq) was injected via femoral vein. After 30 minutes, blood samples were collected for red blood cells radioactive labeling and serum ALT, AST and gammaGT. Liver samples were used for 99m-Tc-phytatepercentage of radioactivity/gram of tissue and histopathology. Student’s t test was used with significance 0.05. RESULTS: There was a higher uptake of 99m-Tc-phytate in the liver of sham rats, compared to the ileum resection group (p<0.05). GammaGT, ALT and AST were increased in ileum resection rats compared to sham (p<0.05). The he patocytes count was significantly lower in ileum resection group than in sham (p<0.05). Liver: body mass ratio was lower in experimental animals than in sham group (p<0.05). CONCLUSION: These data support that the ileum has important role in liver function and liver mass regulation, and they have potential clinical implications regarding the pathogenesis of liver injury following lower bowel resection.

Adição de resíduo cerâmico em pastas geopoliméricas para cimentação de poços de petróleo

The development of activities the of oil and gas sector have promoted the search for suitable materials for cementing oil wells. In the state of the Rio Grande do Norte, the integrity of the cement sheath tends to be impaired during steam injection, a procedure necessary to increase oil recovery in reservoirs with low-viscosity oil. The geopolymer is a material that can be used as alternative cement, since it has been used in the production of fire-resistant components, building structures, and for the control of toxic or radioactive residues. Geopolymers result from condensation polymer alkali aluminosilicates and silicates resulting three-dimensional polymeric structures. They are produced in a manner different from that of Portland cement, which is made an activating solution that is mixed with geopolymer precursor. Among the few works studied allowed us to conclude that the pastes prepared with metakaolin as precursor showed better performance of its properties. Several studies show the addition of waste clay as a means of reducing cost and improving end of the folder properties. On this basis, the goal is to study the influence of the addition of ceramic waste in geopolymer paste. To develop the study of rheology tests were carried out, filtered, thickening time, compressive strength, free water, specific gravity and permeability, according to the American Pretoleum Institute (API). The results for all formulations studied show that the folders have high mechanical strength to a light paste; low filtrate volume, absence of free water, very low permeability, slurry, consistent with a light paste, and thickening time low that can be corrected with the use of a retardant handle. For morphological characterization, microstructural, physical, chemical and thermal tests were carried out by XRD, MEV, DTA, TG, FTIR. In the trial of XRD, it was found that geopolymer is an amorphous material, with a peak of crystalline kaolinite. In tests of TG / DTA, revealed the presence of a significant event, which represents the mass loss related to water, and also observed the reduction of weight loss by increasing the concentration of ceramic waste. In the trial of MEV, we found a uniform matrix without the presence of other phases. In the trial of FT-IR, we observed the presence of the band related to water. From all results it was determined that the optimum concentration range of use is between 2.5 and 5% of waste ceramic

Aditivação de pastas geopoliméricas com tetraborato de sódio e látex não iônico para cimentação de Poços de Petróleo

The development of activities in the oil and gas sector has been promoting the search for materials more adequate to oilwell cementing operation. In the state of Rio Grande do Norte, the cement sheath integrity tend to fail during steam injection operation which is necessary to increase oil recovery in reservoir with heavy oil. Geopolymer is a material that can be used as alternative cement. It has been used in manufacturing of fireproof compounds, construction of structures and for controlling of toxic or radioactive waste. Latex is widely used in Portland cement slurries and its characteristic is the increase of compressive strength of cement slurries. Sodium Tetraborate is used in dental cement as a retarder. The addition of this additive aim to improve the geopolymeric slurries properties for oilwell cementing operation. The slurries studied are constituted of metakaolinite, potassium silicate, potassium hydroxide, non-ionic latex and sodium tetraborate. The properties evaluated were: viscosity, compressive strength, thickening time, density, fluid loss control, at ambient temperature (27 ºC) and at cement specification temperature. The tests were carried out in accordance to the practical recommendations of the norm API RP 10B. The slurries with sodium tetraborate did not change either their rheological properties or their mechanical properties or their density in relation the slurry with no additive. The increase of the concentration of sodium tetraborate increased the water loss at both temperatures studied. The best result obtained with the addition of sodium tetraborate was thickening time, which was tripled. The addition of latex in the slurries studied diminished their rheological properties and their density, however, at ambient temperature, it increased their compressive strength and it functioned as an accelerator. The increase of latex concentration increased the presence of water and then diminished the density of the slurries and increased the water loss. From the results obtained, it was concluded that sodium tetraborate and non-ionic latex are promising additives for geopolymer slurries to be used in oilwell cementing operation

Estudo comparativo da variação temporal da comunidade fitoplanctônica do açude Cruzeta inserido no bioma caatinga, Rio Grande do Norte

The Cruzeta impoundment, situated in the city of Cruzeta, hinterland of the state of the Rio Grande do Norte state has significant importance to the municipality as it represents the only source of supplying water to the region. It was hypothesized that the regional consequence of the global warming and the warming of surface water could substantially contribute the significant growth of the aquatic macrophytes in the years 2008-2009. The growth of these vegetation believed to be improved the degree of water transparency and as a consequence of the improved growth of phytoplankton species and chlorophyll biomass. At the same time the aquatic macrophyte could interact and compete potentially for the dissolved inorganic nutrients resources and the phytoplankton community. This study presents a comparison of years 2004-2005 when it did not have the expressive presence of the aquatic macrophyte community or restricted to the littoral region. In contrast, the years 2008-2009 showed a significant growth of the aquatic macrophyte in the Cruzeta/RN impoundments. The present study is an attempt to elucidate the significant presence of the aquatic macrophyte, Eichhornia crassipes, Ceratophyllum submersum, Nymphea sp and Pistia sp, and its interference on the ecology of phytoplankton. The samplings had been carried out from September of 2008 to April of 2009 and consistently between 10:00 h and 12:00 h with the aid of Van Dorn bottle and the plankton net of mesh size 20 Qm. The collections were made in three depths ie., surface, mid-column and bottom. The Physical-Chemical parameters such as pH, temperature, electrical conductivity and dissolved oxygen had been analyzed in situ. The samples for analysis of nutrients and chlorophyll were kept under refrigeration for posterior analysis in the laboratory. Phytoplankton samples were preserved in Lugol-iodine and kept for sedimentation for quali-quantitative analysis of phytoplankton. Enumeration of cells, colonies and filaments was done with the aid of Sedgwick-Rafter counting chamber and expressed as numbers/ml. Chlorophyll a was analyzed as a functional component of phytoplankton biomass and extracted with cold 90% acetone. The results indicate that the chlorophyll concentration varied between 5,65-8,08 Qg.L-1 for the dry period and 5,09-6,23 Qg.L-1 for the rainy period and showed considerable reduction when compared to the values to the 2004-2005 study period. The temperature was always presented higher in relation to the 2004-2005 study. Phytoplankton species showed a relative abundance of the Cyanophyceae for both the period of dry and rainy. The predominance species are filamentous Leptolymbya geophila Borzi (Planctolyngbya sp), Anabaena plankctônica Brunnthaler, Oscillatória limosa Ag. and Cylindrospermopsis raciborskii (Wolosz). The concentration of the nutrients such as nitrate and orto-phosfato had always presented higher values during the rainy period and the ammoniacal nitrogen retained moderate values in the dry period and a slight increase in rainy season. The main conclusions are the reduction of the concentration of chlorophyll, diversity of phytoplankton, and the increase in temperature and transparency of the water during the period of the study

Hydroalumination of Thioacetylenes: A Versatile Generation and Reactions of -Aluminate Sulfides Intermediates

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

ESR dating of pleistocene mammal teeth and its implications for the biostratigraphy and geological evolution of the coastal plain, Rio Grande do Sul, southern Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Hipotireoidismo iatrogênico em eqüino decorrente de excesso de iodo: relato de caso

Relata-se o caso de um eqüino com sinais clínicos clássicos e avaliação hormonal compatível com hipotireoidismo primário, decorrente do uso sistêmico contínuo de iodeto de potássio, na dosagem de 60g/dia. O tratamento consistiu na simples remoção da fonte de iodo, o que reduziu, gradualmente, as manifestações clínicas. Este relato de caso contribui com o estudo do hipotireoidismo iatrogênico em eqüinos adultos e, dessa forma, alerta para os possíveis efeitos colaterais indesejáveis de terapias à base de iodo.

Pitiose cutânea equina de localização atípica tratada topicamente com solução de anfotericina B e DMSO

Background: Cutaneous lesions by Pythium insidiosum infection are commonly observed in horses, especially in those living at flooded environments. Equine pythiosis is characterized by the development of tumoral masses that are frequently located at distal limbs, ventral abdomen, thorax, breast and face. The lesions are usually granulomatous, serosanguineous and ulcerated, most often destroyed by self-mutilation due to the intense pruritus. The proposed treatment includes surgical excision followed by antifungal drugs administration, which can be done systemically or topically. Amphotericin B and dimethyl sulfoxide (DMSO) in association has been successfully used for cutaneous pythiosis topical treatment due to the DMSO property to carry any substance through plasmatic membranes.Case: The present report concerns a 12-year-old mixed breed gelding presenting with self-mutilation of a tumoral mass located at the left flank. The owners reported that the horse had initially presented a small wound that had evolved to a 20-cm in diameter mass in 4 weeks. Tissue samples were collected, processed and stained by the Gomori's methenamine silver (GMS) method. The histopathological analysis revealed Pythium insidiosum hyphae in a granulomatous tissue, especially located at peripheral region, where kunkers were present. Surgical excision of the mass followed by cauterization was indicated as initial treatment, and due to financial reasons, the owners elected only the topical antifungal therapy to control the fungus infection after surgery. Flunixin meglumine was also administrated for five days aiming the control of pain and inflammation. The wound was cleaned with povidone-iodine solution and rinsed with a solution containing, 50 mg, of amphotericin B in 10 mL of sterile water and 10 mL of DMSO. This procedure was carried Out twice a day. The wound healed fast due to an excellent centripetal epithelialization. and the horse was discharged after 64 days showing only 5% of the initial wound area. The owner reported by telephone the complete healing and hair growth 10 days after discharge.Discussion: Despite the atypical location of the tumoral lesion described at the present report, the history and clinical manifestations, especially the intense pruritus, showed similarity with other characteristic reports of equine cutaneous pythiosis. The diagnosis was confirmed by the histopathological examination showing hyphae structures, as described to be evidences of the presence of Pythium insidiosum in the tissue. The surgical procedure was the first step to provide remission of clinical signs, and one day after surgery the pruritus desapeared. After excision of the granulomatous tissue and cauterization, daily topical administration of amphotericin B associated with DMSO was effective in destroying the infectious agent, as observed by the excellent epithelization. A pink granulation tissue grew up providing an ideal surface for epithelial migration and the healing process progressed quickly. Centripetal epithelialization reduced the wound area until 3% of the initial area in 64 days of treatment, when the remaining wound was found almost completely healed and covered with hair. At the present report, the horse presenting pythiosis was only topically treated. The recommended therapy using amphotericin B and DMSO solution was effective, economically viable and low risk, considering that the systemic antifungal therapy usually suggested is expensive and extremely nephrotoxic. The atypical location of the lesion on the left flank shows that any anatomical region can be affected by the fungus, since the conditions for its development were present.

Efeito da adição de óleos mineral e vegetal a acaricidas no controle do ácaro-da-leprose dos citros Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpide)

Com a finalidade de esclarecer os efeitos da adição de óleo vegetal e mineral aos acaricidas foi conduzido um ensaio de campo em 1994 no município de Viradouro, SP, utilizando-se de Assist, Triona e Natur'l Óleo, na dosagem de 500 mL por 100 litros de água, adicionados aos acaricidas: pyridaben nas formulações 200 CE e 750 PM, nas dosagens de 75 mL e 20 g; propargite 720 CE a 100 mL; óxido de fenbutatina 500 SC a 80 mL e cyhexatin 500 PM a 50 g. O delineamento estatístico adotado foi o de blocos casualizados. As aplicações foram feitas com pulverizador tipo pistola. Após a preparação da calda, foi determinado o pH. Empregou-se máquina de varredura e microscópio estereoscópico para as avaliações da população acarina. A adição de Natur'l Óleo pode afetar negativamente a eficiência do pyridaben 200 CE e 750 PM e cyhexatin 500 PM, no controle do ácaro-da-leprose. Triona e Assist não afetaram as eficiências dos acaricidas testados. Pelo índice de iodo, mediu-se o grau de insaturação das misturas dos acaricidas com Natur'l Óleo, concluindo-se que houve incorporação das moléculas dos acaricidas pelas ligações insaturadas do óleo; porém, isto não explica o diferente comportamento dos produtos no controle do ácaro da leprose dos citros.

Análise da influência de superfícies refletivas nas perdas de calor de sistema térmicos

The use of reflective surfaces functioning as thermal insulator has grown significantly over the years. Reflective thermal insulator are materials that have several characteristics such as low emissivity, low absorptivity and high reflectivity in the infrared spectrum. The use of these materials has grown a lot lately, since it contains several important radioactive properties that minimize the heat loss of thermal systems and cooling systems that are used to block the heat on the roof of buildings. A system made of three surfaces of 316 stainless steel mirror was built to analyze the influence of reflective surfaces as a way to reduce the heat loss and thereby conserve the energy of a thermal system. The system was analyzed both with and without the presence of vacuum, and then compared with a system that contained glass wool between the stainless steel mirror walls, since this isolator is considered resistive and also broadly used around the world in thermal systems. The reflectivity and emissivity of the surfaces used were also measured in this experiment. A type K thermocouple was fixed on the wall of the system to obtain the temperature of the stainless steel mirror surfaces and to analyze the thermal behavior of each configuration used. The results showed an efficiency of 13% when the reflective surfaces were used to minimize the heat loss of the thermal system. However, the system with vacuum had the best outcome, a 60% efficiency. Both of these were compared to the system made of glass wool as a thermal insulator

Estudo tribológico de biolubrificantes com adição de nanopartículas de óxidos (zinco e cobre)

Currently, vegetable oils have been studied for bio-lubricants base that fits the new environmental standards. Since, in a world full of finite natural resources, mineral oils bring consequences to the environment due to its low biodegradability and toxicity, also it is important to consider that synthetic oils have a high cost The aim of this work is to obtain a biolubricant additived with oxide nanoparticles (ZnO and CuO) for better resistance to friction and wear, which is not toxic to the environment and have better adherence under boundary lubrication. The methodology consisted in the synthesis of bio-lubricants (soybean and sunflower base) by epoxidation reaction. Then, some physical-chemical analysis in bio-lubricants are made to characterize theses lubricants, such as, density, acidity, iodine value, viscosity, viscosity index. Later, the lubricants were additive with nanoparticles. The tribological performance was evaluated by the equipment HFRR (High Frequency Reciprocating Rig) consisting of a wear test ball-plan type. The characterization of wear analysis was performed by SEM / EDS. The results show that bio-lubricants may be synthesized by reaction of epoxidation with good conversion. Tribological point of view, the epoxidized oils are more effective than lubricant additived with the oxide nanoparticles, they had lower coefficients of friction and better rate of film formation in the study. However, because they are environmentally friendly, bio-lubricants gain the relevant importance in tribological field

Preparação de poliuretana à base de óleo de mamona

Polyurethanes are very versatile macromolecular materials that can be used in the form of powders, adhesives and elastomers. As a consequence, they constitute important subject for research as well as outstanding materials used in several manufacturing processes. In addition to the search for new polyurethanes, the kinetics control during its preparation is a very important topic, mainly if the polyurethane is obtained via bulk polymerization. The work in thesis was directed towards this subject, particularly the synthesis of polyurethanes based castor oil and isophorone diisocianate. As a first step castor oil characterized using the following analytical methods: iodine index, saponification index, refraction index, humidity content and infrared absorption spectroscopy (FTIR). As a second step, test specimens of these polyurethanes were obtained via bulk polymerization and were submitted to swelling experiments with different solvents. From these experiments, the Hildebrand parameter was determined for this material. Finally, bulk polymerization was carried out in a differential scanning calorimetry (DSC) equipment, using different heating rates, at two conditions: without catalyst and with dibutyltin dilaurate (DBTDL) as catalyst. The DSC curves were adjusted to a kinetic model, using the isoconversional method, indicating the autocatalytic effect characteristic of this class of polymerization reaction