Características psicológicas do paciente obeso grave e suas implicações pós-operatórias na cirurgia bariátrica

Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach – Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compulsão Alimentar Periódica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group – and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.

Características dos programas de residência médica em cardiologia do estado do Rio Grande do Norte

The present study had as goal to evaluate Rio Grande do Norte state’s medical residency programs (MRP) in Cardiology. It’s a descriptive study, including a documental analysis of the program’s accreditation processes (PAP) of cardiology’s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident’s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book’s publications. The private institution presents a better Urgency’s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital’s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Coração Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences’ National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident’s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.

Proposta de um processador multithreading com características de previsibilidade

The real-time embedded systems design requires precise control of the passage of time in the computation performed by the modules and communication between them. Generally, these systems consist of several modules, each designed for a specific task and restricted communication with other modules in order to obtain the required timing. This strategy, called federated architecture, is already becoming unviable in front of the current demands of cost, required performance and quality of embedded system. To address this problem, it has been proposed the use of integrated architectures that consist of one or few circuits performing multiple tasks in parallel in a more efficient manner and with reduced costs. However, one has to ensure that the integrated architecture has temporal composability, ie the ability to design each task temporally isolated from the others in order to maintain the individual characteristics of each task. The Precision Timed Machines are an integrated architecture approach that makes use of multithreaded processors to ensure temporal composability. Thus, this work presents the implementation of a Precision Machine Timed named Hivek-RT. This processor which is a VLIW supporting Simultaneous Multithreading is capable of efficiently execute real-time tasks when compared to a traditional processor. In addition to the efficient implementation, the proposed architecture facilitates the implementation real-time tasks from a programming point of view.

LCD-OpenPACS: sistema integrado de telerradiologia com auxílio ao diagnóstico de nódulos pulmonares em exames de tomografia computadorizada

Lung cancer is one of the most common types of cancer and has the highest mortality rate. Patient survival is highly correlated with early detection. Computed Tomography technology services the early detection of lung cancer tremendously by offering aminimally invasive medical diagnostic tool. However, the large amount of data per examination makes the interpretation difficult. This leads to omission of nodules by human radiologist. This thesis presents a development of a computer-aided diagnosis system (CADe) tool for the detection of lung nodules in Computed Tomography study. The system, called LCD-OpenPACS (Lung Cancer Detection - OpenPACS) should be integrated into the OpenPACS system and have all the requirements for use in the workflow of health facilities belonging to the SUS (Brazilian health system). The LCD-OpenPACS made use of image processing techniques (Region Growing and Watershed), feature extraction (Histogram of Gradient Oriented), dimensionality reduction (Principal Component Analysis) and classifier (Support Vector Machine). System was tested on 220 cases, totaling 296 pulmonary nodules, with sensitivity of 94.4% and 7.04 false positives per case. The total time for processing was approximately 10 minutes per case. The system has detected pulmonary nodules (solitary, juxtavascular, ground-glass opacity and juxtapleural) between 3 mm and 30 mm.

Recomendações para um sistema de sinalização tátil a partir de abordagens ergonômicas e da percepção do deficiente visual para o Campus Parnamirim do IFRN

This study reports recommendations for a tactile and graphic wayfinding system aiming to offer more orientability and mobility for visually impaired people (blindness and low vision) at Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Norte (IFRN), Parnamirim Campus. It was necessary to focus on visual impaired people and approach concepts like orientation and accessibility at the built environment. In order to provide the comprehension of a complex social phenomenon and preserve the meaningful characteristics of the events, this research has developed a single case study in which elements of Post Occupation Evaluation have been used. Its purpose was to allow not only a technical analysis, but also the user perception about the space in use. The chosen tool to collect the user’s opinions and considerations was the Walk Together Method. The collected and analyzed information has demonstrated that, although Parnamirim Campus has implemented some interventions in relation to the spatial accessibility, they are still not enough to create an environment which arranges safety and autonomy for the visual impaired people and the other ones who attend there. This study suggests that it happened because the engineering interventions at the Campus have been based on Brazilian technical standards NBR 9050:2004, which is proper for the physical impaired people, but it does not offer enough information to respond to all the specific needs demanded by all the classifications of visual impairment.

Recomendações para um sistema de sinalização tátil a partir de abordagens ergonômicas e da percepção do deficiente visual para o Campus Parnamirim do IFRN

This study reports recommendations for a tactile and graphic wayfinding system aiming to offer more orientability and mobility for visually impaired people (blindness and low vision) at Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Norte (IFRN), Parnamirim Campus. It was necessary to focus on visual impaired people and approach concepts like orientation and accessibility at the built environment. In order to provide the comprehension of a complex social phenomenon and preserve the meaningful characteristics of the events, this research has developed a single case study in which elements of Post Occupation Evaluation have been used. Its purpose was to allow not only a technical analysis, but also the user perception about the space in use. The chosen tool to collect the user’s opinions and considerations was the Walk Together Method. The collected and analyzed information has demonstrated that, although Parnamirim Campus has implemented some interventions in relation to the spatial accessibility, they are still not enough to create an environment which arranges safety and autonomy for the visual impaired people and the other ones who attend there. This study suggests that it happened because the engineering interventions at the Campus have been based on Brazilian technical standards NBR 9050:2004, which is proper for the physical impaired people, but it does not offer enough information to respond to all the specific needs demanded by all the classifications of visual impairment.

Associação da imunoexpressão das proteínas XRCC1, TFIIH E XPF com características clinicopatológicas e sobrevida em carcinoma epidermoide de língua oral

DNA repair systems, genes and proteins are essential for genome integrity maintenance, avoiding serious diseases such as cancer. Deregulation in the expression of those proteins has been associated with both the risk of development and evolution of various human cancers, including oral squamous cell carcinoma. The purpose of this study was to analyze the immunoreactivity of the DNA repair proteins XRCC1, THIIF and XPF in oral tongue squamous cell carcinoma (OTSCC) and to investigate its association with clinical and histopathological parameters, outcome and 5-year survival rate. Seventy-four cases of OTSCC were analyzed semi-quantitatively through immunohistochemistry. We observed that DNA repair proteins were highly expressed in parenchymal cells; however, we only observed a significant association between XRCC1 high expression and better clinical staging (p=0,02). Cox regression showed that tumor size (p<0,01), lymph node involvement (p=0,04), tumor stage (p=0,02) and depth of invasion> 4mm (p=0,05) were prognostic factors. The results of this experiment suggest that XRCC1, TFIIH and XPF participate in the tumorigenic process, however, their immunoexpression may not be used as an independent prognostic indicator for OTSCC.

Associação da imunoexpressão das proteínas XRCC1, TFIIH E XPF com características clinicopatológicas e sobrevida em carcinoma epidermoide de língua oral

DNA repair systems, genes and proteins are essential for genome integrity maintenance, avoiding serious diseases such as cancer. Deregulation in the expression of those proteins has been associated with both the risk of development and evolution of various human cancers, including oral squamous cell carcinoma. The purpose of this study was to analyze the immunoreactivity of the DNA repair proteins XRCC1, THIIF and XPF in oral tongue squamous cell carcinoma (OTSCC) and to investigate its association with clinical and histopathological parameters, outcome and 5-year survival rate. Seventy-four cases of OTSCC were analyzed semi-quantitatively through immunohistochemistry. We observed that DNA repair proteins were highly expressed in parenchymal cells; however, we only observed a significant association between XRCC1 high expression and better clinical staging (p=0,02). Cox regression showed that tumor size (p<0,01), lymph node involvement (p=0,04), tumor stage (p=0,02) and depth of invasion> 4mm (p=0,05) were prognostic factors. The results of this experiment suggest that XRCC1, TFIIH and XPF participate in the tumorigenic process, however, their immunoexpression may not be used as an independent prognostic indicator for OTSCC.

Ajustando el cuerpo al sistema. Un análisis acerca del fit-body y la violencia simbólica en gimnasios fitness

Esta investigación pretende (re)pensar el fitness como práctica socio-cultural moderna, observando aquellos discursos que la atraviesan y constituyen. Entre otros, se destaca el análisis de significaciones que son particulares al contexto de los gimnasios, en los cuales se desarrollan ideales distintivos de belleza o de salud, métodos de entrenamiento que responden a ?escuelas? o tendencias empresariales, ?habilidades corporales? que son ponderadas o menospreciadas, sentidos y sensibilidades legitimadostransmitidos como valores o técnicas y prácticas específicas condicionadas por los materiales utilizados. Para ello se propone reflexionar acerca de la compañía internacional ?BodySystems?, indagando aquellas prácticas desarrolladas en sus sucursales de La Plata, a través de tres técnicas de recolección de datos: el análisis de los documentos que la empresa proporciona a sus instructores, el estudio de los discursos que se desprenden de las clínicas que la compañía dicta cada tres meses y la reflexión sobre las entrevistas realizadas a los profesionales que desempeñan sus actividades en estos establecimientos. Para ello, se ponen en juego dos categorías de análisis que son características de la cultura fitness: los agentes que participan en los gimnasios constituyéndose en clientes de un cuerpo yla construcción y reproducción del "fit-body" característico de las empresas gímnicas

Ajustando el cuerpo al sistema. Un análisis acerca del fit-body y la violencia simbólica en gimnasios fitness

Esta investigación pretende (re)pensar el fitness como práctica socio-cultural moderna, observando aquellos discursos que la atraviesan y constituyen. Entre otros, se destaca el análisis de significaciones que son particulares al contexto de los gimnasios, en los cuales se desarrollan ideales distintivos de belleza o de salud, métodos de entrenamiento que responden a ?escuelas? o tendencias empresariales, ?habilidades corporales? que son ponderadas o menospreciadas, sentidos y sensibilidades legitimadostransmitidos como valores o técnicas y prácticas específicas condicionadas por los materiales utilizados. Para ello se propone reflexionar acerca de la compañía internacional ?BodySystems?, indagando aquellas prácticas desarrolladas en sus sucursales de La Plata, a través de tres técnicas de recolección de datos: el análisis de los documentos que la empresa proporciona a sus instructores, el estudio de los discursos que se desprenden de las clínicas que la compañía dicta cada tres meses y la reflexión sobre las entrevistas realizadas a los profesionales que desempeñan sus actividades en estos establecimientos. Para ello, se ponen en juego dos categorías de análisis que son características de la cultura fitness: los agentes que participan en los gimnasios constituyéndose en clientes de un cuerpo yla construcción y reproducción del "fit-body" característico de las empresas gímnicas

Territorios culturales: un análisis comparativo de las características de la información periodística en la contemporaneidad

En este artículo proponemos la reflexión sobre la información periodística en el contexto contemporáneo a partir del análisis de las características del soporte del periódico, en una comparación entre dos periódicos de distintos países. A partir de los conceptos de espacialidad, visualidad y comunicabilidad, discutidos por Ferrara, considerando también el análisis de los componentes de paginación y diagramación de los periódicos, buscamos escudriñar los sentidos de la información y del conocimiento en este contexto de instrumentalización técnica

Las potencias subregionales en el sistema internacional de posguerra fría: ¿nuevos actores en la política internacional?

En trabajos anteriores, hemos avanzado en la identificación y diferenciación de tres categorías de potencias: potencias mundiales, potencias medias y potencias regionales. Pero, más allá de las potencias mundiales y las potencias medias que se encuentran en el centro del sistema-mundial, y las potencias regionales que se ubican en la semiperiferia, ¿es posible hablar de potencias que se encuentren en la periferia? Como se trata de Estados periféricos, ¿pueden ser calificados como “potencias”? ¿En qué radicaría su relevancia y envergadura? Dichas “potencias” ¿pueden ser agrupadas en una nueva categoría? De ser así ¿qué características compartirían? El objetivo de este documento es proponer una nueva  categoría de potencias en el sistema internacional: las potencias subregionales.

Caracterização do sistema vocálico do português culto falado em angola

O presente artigo situa-se nos domínios de especialidade da Fonética e Fonologia. Pretende-se, com efeito, destacar algumas características fonético-fonológicas do português culto falado em Angola, nomeadamente no domínio do vocalismo, identificadas e recolhidas de enunciados orais de cidadãos angolanos e residentes em Angola, estudantes e profissionais com nível de instrução médio-alto. No falar português desses indivíduos constam elementos que se opõem a determinados usos e hábitos linguísticos normativos do Português europeu, recomendados como usos e hábitos oficiais. Procura-se, assim, demonstrar que, pelo menos em relação ao sistema vocálico, o português angolano das camadas cultas da população difere do Português europeu.

Ajustando el cuerpo al sistema. Un análisis acerca del fit-body y la violencia simbólica en gimnasios fitness

Esta investigación pretende (re)pensar el fitness como práctica socio-cultural moderna, observando aquellos discursos que la atraviesan y constituyen. Entre otros, se destaca el análisis de significaciones que son particulares al contexto de los gimnasios, en los cuales se desarrollan ideales distintivos de belleza o de salud, métodos de entrenamiento que responden a ?escuelas? o tendencias empresariales, ?habilidades corporales? que son ponderadas o menospreciadas, sentidos y sensibilidades legitimadostransmitidos como valores o técnicas y prácticas específicas condicionadas por los materiales utilizados. Para ello se propone reflexionar acerca de la compañía internacional ?BodySystems?, indagando aquellas prácticas desarrolladas en sus sucursales de La Plata, a través de tres técnicas de recolección de datos: el análisis de los documentos que la empresa proporciona a sus instructores, el estudio de los discursos que se desprenden de las clínicas que la compañía dicta cada tres meses y la reflexión sobre las entrevistas realizadas a los profesionales que desempeñan sus actividades en estos establecimientos. Para ello, se ponen en juego dos categorías de análisis que son características de la cultura fitness: los agentes que participan en los gimnasios constituyéndose en clientes de un cuerpo yla construcción y reproducción del "fit-body" característico de las empresas gímnicas

Impactos del ENSO en la biogeoquímica del sistema de afloramiento frente a Perú central, febrero 2013 - diciembre 2015

El ecosistema de afloramiento frente a Perú, tiene características que le confieren propiedades únicas y relevantes en el contexto regional y global. Entre sus propiedades biogeoquímicas se destaca la presencia de i) una alta productividad consecuencia de aguas ricas en nutrientes, ii) una extensa y somera Zona de Mínimo Oxígeno (ZMO) y iii) un alto reciclaje y pérdida de nitratos, asociado a los procesos de productividad como a la remineralización de la materia orgánica. Todas estas características están inmersas en una alta variabilidad temporal, observándose cambios significativos a escala interanual asociados con el ciclo ENSO y su fase cálida El Niño y fría La Niña. En este contexto, desde el año 2013, la DGIOCC de IMARPE desarrolla el proyecto “Estudio integrado del Afloramiento Costero frente a Perú Central”, con la finalidad de caracterizar el afloramiento costero, sus forzantes y sus características físico- químicas y biológicas en una gradiente costa-océano. En este artículo, se presentan resultados de las condiciones químicas del afloramiento frente a Callao, poniendo en evidencia el impacto del ciclo El Niño Oscilación del Sur (ENSO) que se desarrolló entre los años 2013 y 2015.