999 resultados para Circulação forçada
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
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In asthmatic, the lung hyperinflation leaves the inspiratory muscle at a suboptimal position in length-tension relationship, reducing the capacity of to generate tension. The increase in transversal section area of the inspiratory muscles could reverse or delay the deterioration of inspiratory muscle function. Objective: To evaluate the evidence for the efficacy of inspiratory muscle training (IMT) with an external resistive device in patients with asthma. Methods: A systematic review with meta-analysis was carried out. The sources researched were the Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov and reference lists of articles. All databases were searched from their inception up to November 2012 and there was no restriction on the language of publication. Randomised controlled trials that involved the use of an external inspiratory muscle training device versus a control (sham or no inspiratory training device) were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated risk of bias in studies and extracted data. Results: A total of five studies involving 113 asthmatic patients were included. Three clinical trials were produced by the same group. The included studies showed a significant increase in maximal inspiratory pressure (MD 13.34 cmH2O, 95% CI 4.70 to 21.98), although the confidence intervals were wide. There was no statistically significant difference between the IMT group and the control group for maximal expiratory pressure, peak expiratory flow rate, forced expiratory volume in one second, forced vital capacity, sensation of dyspnea and use of beta2-agonist. There were no studies describing exacerbation events that required a course of oral and inhaled corticosteroids or emergency department visits, inspiratory muscle endurance, hospital admissions and days of work or school. Conclusions: There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma, once the evidence was limited by the small number of studies included, number of participants in them together with the risk of bias. More well conducted randomized controlled trials are needed, such trials should investigate respiratory muscle strength, exacerbation rate, lung function, symptoms, hospital admissions, use of medications and days off work or school. IMT should also be assessed in the context of more severe asthma
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obesity affects rightly functional capacity diminishing the cardiovascular system efficiency and oxygen uptake (VO2). Field tests, such as, Incremental Shuttle Walking Test (ISWT) and Six Minute Walk Test (6MWT) has been employed as alternative of Cardiopulmonary Exercise Test (CPX), to functional assessing for conditions which transport of oxygen to peripheral is diminished. Nevertheless, the knowing about metabolic variables response in real time and it comparing among different maximal and submaximal tests in obese is absent. Aim: to compare cardiopulmonary, metabolic response during CPX, ISWT and 6MWT and to analyse it influence of adiposity markers in obese. Material e Method: crosssectional, prospective study. Obese included if: (BMI>30Kg/m2; FVC>80%), were assessed as clinical, anthropometric (BMI, body adiposity index-BAI, waist-WC, hip- HC and neck-NC circumferences) and spirometry (forced vital capacity-FVC, Forced expiratory volume-1°second-FEV1, maximal voluntary ventilation-MVV) variables. Obese performed the sequence of tests: CPX, ISWT and 6MWT. Throughout tests was assessed breath-by-breath by telemetry system (Cortex-Biophysik-Metamax3B) variables; oxygen uptake on peak of activity (VO2peak); carbon dioxide production (VCO2); Volume Expiratory (VE); ventilatory equivalents for VO2 (VE/VO2) and CO2 (VE/VCO2); respiratory exchange rate (RER) and perceived effort-Borg6-20). Results: 15 obese (10women) 39.4+10.1years, normal spirometry (%CVF=93.7+9.7) finished all test. They have BMI (43.5+6.6kg/m2) and different as %adiposity (BAI=50.0+10.5% and 48.8+16.9% respectively women and men). Difference of VO2ml/kg/min and %VO2 were finding between CPX (18.6+4.0) and 6MWT (13.2+2.5) but not between ISWT (15.4+2.9). Agreement was found for ISWT and CPX on VO2Peak (3.2ml/kg/min; 95%; IC-3.0 9.4) and %VO2 (16.4%). VCO2(l/min) confirms similarity in production for CPX (2.3+1.0) and ISWT (1.7+0.7) and difference for 6MWT (1.4+0.6). WC explains more the response of CPX and ISWT than other adiposity markers. Adiposity diminishes 3.2% duration of CPX. Conclusion: ISWT promotes similar metabolic and cardiovascular response than CPX in obese. It suggesting that ISWT could be useful and reliable to assess oxygen uptake and functional capacity in obese
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The development of epidemiological practices in the last years of the nineteenth and early twentieth century was characterized by both an influence of medical geography and the emergence of microbes and vectors of diseases. Both theories were used to explain outbreaks in Rio Grande do Norte specially in Natal. In this process were organized new institutions linked to public health, unhealthy spaces and prescribed hygiene measures. The redefinitions of the spaces were linked to updated elements of Hippocratic medicine such as aerism and emphasis on medical topography. How the physicians of the town were organized in the face of new meanings and fields of expertise in the demarcation of diseases and regulation of their own practices against the illegal medical practitioners? Likewise, the very occurrence of epidemics mobilized people, urban institutions and apparatuses. But how the Hippocratic legacy that leads to the idea of bad air originated by swamps from the eighteenth and nineteenth century has been linked to new microbial assumptions and disease vectors in the early twentieth century? How an invader from Africa, (the mosquito A. gambiae) mobilized transnational efforts to combat malaria and redefined the epidemiological practices? The aim of this work is to understand how epidemiological practices redefine the way we define spaces, practices and disease from both an approach influenced by a relational history of spaces and a theoretical synergy which includes topics in Science Studies, Post Structuralist Geography and some elements of Feminist Studies. Documentary research were surveyed in the reports of the provincial presidents, government posts to the Provincial Assembly, specialized medical articles and theses, and documents from the Rockefeller Foundation and national and international journals. In this regard shall be given to both material and discursive aspects of space-related practical epidemiological that Natal as much (in general) Rio Grande do Norte between bad air and malaria.
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Backland¹ are not only geographic spaces limited by physically established borders. It is a space composed by events, experiences, behavior, symbology, manners related to how to live and see the world. It is developed from historical processes and layers of discourses that contact each other, compete among themselves, establish agreement, promote consensus which define, resignify and update them over time. The present paper seeks to analyze and discuss the forms in which discourses produced by cordel literature² sold and consumed in popular locations, from backlands to coast cities, during the first four decades of 20th century, represented the environment, habits, moral codes, cultural traits, social types, rites and beliefs, related to northeastern backlands. The paper also aims to investigate the forms on how discourses produced by representations contributed to the constitution of backlands as a space culturally constructed. Poems from the poet and editor João Martins de Athayde will be used to establish dialogues between discourses produced by cordel and others discursive modalities, such as, newspapers, prose literature, painting, texts of memoirists and historiography, about backlands, analyzing how those representations circulated, were consumed and absorbed by backlands and other spaces inhabitants, contacted and agreed with other types of discourse, supporting the establishment of backlands as a space and countryside people as a social type
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This research has as object of study the city of Caicó, Rio Grande do Norte State, between the middle part of the decade of 1920 and the beginning of 1930. It intended to perceive the projects thought to the city of Caicó as well as the challenges due to the new ideas of modernity that were circulating around the contemporary world. So it consists in an important historical exercise about the relation between history and space in to the extent that itself comes to surface a city deals by diverse angles whose perspectives can be read in several "fragments of memory", such as newspapers, trials-crime, reports, memories, books, etc., those show the tension between the traditional and the modern way of life one. In this way, it´s tried to transform the space, giving it a new reference, inspired in what occurs in the Brazilian big cities and around the world, through the use of the techniques, of the electricity, of the movies, of the press, cars, medicine and so on. At the same time in that is necessary-itself deal with the permanencies such as the old manners and the droughts and theirs "flagellated" people. Therefore, it is in this difficult phase that is tried legitimize the city of Caicó as the "Capital of the Seridó", in the threshold between the refusal and the seduction
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The study of manual preference is a widely used approach to investigate cerebral laterality in nonhuman primates. However, in New World primates, little is known about the ontogenesis of hand use asymmetry, in both forced and spontaneous activities, as well as how they correlate with sexual hormones. Accordingly, a longitudinal study was conducted on the manual preference of 6 female and 4 male common marmosets (Callithrix jacchus). The study included the record of forced tests to reach for the food using only one hand (forced activity) and activities such as grooming (auto and social), scratching, grasping the food and hanging, in weekly sessions from the infantile (4 months) to the early adult phase (15 months). Feces samples were also collected, at least once a week, to evaluate the level of gonadal steroids and their influence on these behaviors. In the forced activity, the results confirm the influence of the development period on manual preference during feeding, shown by the increase in lateral stability when grasping the food between the juvenile and adult phases. During this period, a sexual hormone effect on development was also observed, mainly of progesterone in females and androgen in males, but no difference between sexes was found. In the females, progesterone also influenced the manual preference index, with a proportional increase in the degree of manual asymmetry during puberty. With respect to spontaneous activities, the animals showed proportional use of both hands when scratching, hanging, holding the food and grooming. A positive correlation was also found between the preference for holding the food in forced activities and in spontaneous activities
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The lost of phase relationship between rhythms and behaviour can, and often do, undesirable consequences. The purpose os study was to ascertain the effect of circadian desynchronization in T22 about metabolism of wistar rats. The subjects consisted of 24 animals separated in two groups: control (n=12) T24 with 8 weeks of aged and experimental group (n=12) T22, also with 8 weeks of aged. Both the groups were subject to register of locomotor actitivity, body temperature, body weight and food intake in all the experiment. And more, both the groups were subject to food deprivation, running in treadmill and forced swimming. The results show rhythm of locomotor activity and body temperature desynchronized. Dont exist diference in body weight between both the groups (T24 = 386,75±40,78g e T22 380,83±44,28g) . However, the food intake was different between the phases, light and dark, in intergroup and intragroup. The body temperature was not different in food deprivation. The same ocurred for running in treadmill and forced swimming. Since similar alterations occur in shift workers, it is proposed that the experimental paradigm presented in this manuscript is a useful model of shift work. That is, alterations in activity/rest cycles and consummatory behavior can affect the health of organism
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Marmosets, Callithrix jacchus, are strictly diurnal animals. The motor activity rhythmicity is generated by the circadian timing system and is modulated by environmental factors, mainly by photic stimuli that compose the light-dark cycle. Photic stimuli can reset the biological oscilators changing activity motor pattern, by a mechanism called entrainment. Otherwise, light can act directly on expressed rhythm, without act on the biological oscillators, promoting the masking. Thus, photic stimuli can synchronize the circadian activity rhythm (CAR) by two distinct mechanisms, acting isolated or at a combined way. Among the elements that can influence photic synchronization, the duration and time of photic exposure is pointed out. If in the natural environment the marmoset can choose places of different intensity illumination and is synchronized to light-dark cycle (LD), how the photic synchronization mechanism can be evaluated in laboratory by light self-selection? With objective to response this question, four adult male marmosets were studied at two conditions: with and without sleeping box. The animals were submitted to a LD cycle (12:12/ 350:2 lx) and constant light (LL: 350 lx) conditions in individual cages with an opaque sleeping box, that permitted the light self-selection. At the room, the temperature was 25.6 ºC (± 0.3 ºC) and humidity was 78.7 (± 5%). The motor activity was recorded at 5 min bins by infrared movement sensors installed at the top of the cages. The motor activity profile was distinct at the two conditions: without the sleeping box protection against light, the activity frequency was higher at CT 11-12 (ANOVA; F(3.23) = 62.27; p < 0.01). Also, the duration of the active phase (α) was prolonged of about 1 h (t test, p < 0.05) and the animals showed a significant delay on the activity onset and offset (t test, p < 0.05) and at the acrophase (confidence intervals of 5%) of CAR. In LL, the light continuous exposure prolonged the active phase and influenced the endogenous expression of the circadian activity rhythm period. From the result analysis, it is concluded that the light self-selection can modify several parameters of CAR in marmosets, allowing the study of the synchronization mechanism using the burrow model. Thus, without sleeping box there was a phase delay between the CAR and LD (entrainment) and an increase of activity near lights off (positive masking). Furthermore, in LL, the light continuous exposure modifies α and the endogenous expression of CAR. It is suggested that the light self-selection might be take into account at investigations that evaluate the biological rhythmicity in marmosets
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Music can be found in peculiar historical and social context with distinct functions, such as religious rituals, ethic-esthetic education of subjects, therapeutic elements, critic and maintenance of established patterns, among others. Considered as language, music acts on dialogue dimensions of the body, the senses, the affectionate-cognitive and of social interactions. Their uses reveal the social forces that cross the culture and constitution of subjectivities. The attribution of senses by the subjects to musical production reveals the cultural voices in dialogue, that circumscribe determined social places to them. Our aim in this work is to investigate the child musical appreciation, with children about 7 to 9 years old, and, by attributing uses and senses to music, unveil the voices that settle the places intended and assumed by infancy in contemporaneity The child constructs its musical appreciation through cultural access and mediation, possible by circulation in several socializing groups like family, school, church, infant groups, community groups and, more recently, publicity and media These last two spheres, enabled by the development of the technological means of communication, contributed to the dissemination of the set of consume ideas and for the emergence of the cultural industry, characteristic of the capitalistic production way in its present configuration. They develop new possibilities of perception of the world, in which the limits between childhood and adulthood are not anymore the same that have been established in previous centuries. So, the child musical appreciation is constituted by homogeneity regarding the senses built and disseminated by cultural industry and by the logical merchandizing, and singularities, associated to the construction of senses in interaction with global, local, and multiple contexts, through which the subject circulates and constitutes himself polyphonically
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O objetivo deste trabalho foi monitorar o desempenho de remoção de nitrogênio amoniacal no tratamento das águas residuárias da produção intensiva de tilápia nilótica em sistema com recirculação de água. O sistema foi constituído por um sedimentador convencional e um reator aeróbio de leito fluidizado trifásico com circulação, operados com tempos de detenção hidráulica de 176.4 e 11.9 minutos respectivamente. O meio suporte utilizado no reator foi o carvão ativado granular com densidade aparente de 1.64 g/cm3 e tamanho efetivo de 0.34 mm; a concentração do meio suporte no reator foi mantida constante em 80 g/L. A eficiência média de remoção do nitrogênio amoniacal total foi de 41.2%. O sistema avaliado é uma alternativa efetiva para o reuso da água em sistemas de recirculação para aqüicultura. Embora a variabilidade das concentrações do nitrogênio amoniacal afluente cujo valor médio foi de 0.136 mg/L, o efluente do reator conservou as características de qualidade da água estáveis, com concentrações médias de nitrogênio amoniacal de 0.079 mg/L e do oxigênio dissolvido de 6.70 mg/L, recomendáveis para a criação dos peixes e nas faixas de valores permitidos pela legislação Brasileira (Resolução CONAMA No. 357 de março 5 de 2005) para lançamento de efluentes finais nos corpos de água receptores.
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The purpose of this work is to map the family and community social supports for adolescents and young students from Bom Pastor Distric, West Zone of Natal/RN, as well as to describe how such resources are used by these individuaIs in that community. Social support refers not only to formal activities or organizations, but also to spontaneous or informal forms of support - friendship and solidarity nets available in the community, affective relations that are meaningful in the lives of children and young people. Our discussion is based on a research performed with 382 adolescents and young students from Jean Mermoz Public School (students from 5th to 11th grades, aged 13 to 14). We emphasized the situations of violence derived from family or community spheres faced by these students. In relation to this specific aspect, we observed the participants more frequently look for help from the informal social supports, mostly from their friends, which indicates that the formal ones are not considered to be effective instruments for social assistance. The search for informal social supports shows the relations informally established in the streets (for instance when they look for help from friends, rei atives or neighbors) have more effect and play an important role in which there are values and affections exchange. Thinking the strengthening of these social links is of extreme importance and leads to the weakening of the hegemonic logics focused on the production of subjects as private identities, and to the amplification of an ethics committed to the disassembly of a sociability anchored to fear, impotence, intolerance, discrimination, and reduction of spaces for circulating and confronting mechanisms of social exclusion. It is crucial that we concentrate our attention to building friendship as a system of reciprocity and affective exchanges, as a space for political actions and production of forms of lives that are potent against social anesthesia
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OBJETIVO: Avaliar qualidade do serviço prestado aos pacientes de cirurgia cardíaca no período hospitalar, em serviço do SUS, identificando as expectativas e percepções dos pacientes. Relacionar qualidade de serviço com gênero, faixa etária e circulação extracorpórea. MÉTODOS: Estudaram-se 82 pacientes (52,4% do sexo feminino e 47,6% do masculino) submetidos a cirurgia cardíaca eletiva, operados por toracotomia médio-esternal, idade: 31 a 83 anos (média 60,4 ± 13,2 anos), período: março a setembro de 2006. Avaliou-se a qualidade do serviço em dois momentos: expectativas no pré-operatório e percepções do atendimento recebido no 6º dia de pós-operatório; mediante aplicação da escala SERVQUAL modificada (SERVQUAL-Card). O resultado foi obtido pela diferença da somatória das notas das percepções e expectativas por meio de análise estatística. RESULTADOS: A escala SERVQUAL-Card foi validada estatisticamente, apresentando adequado índice de consistência interna. Encontrou-se maior frequência de revascularização do miocárdio 55 (67,0%); primeira cirurgia cardíaca 72 (87,8%) e utilização de CEC 69 (84,1%). Verificaram-se altos valores para expectativas e percepções, com resultados significantes (P<0,05). Observou-se relação significante entre qualidade de serviço com gênero, na empatia (P=0,04) e faixa etária, na confiabilidade (P=0,02). Não se observou significância entre CEC e qualidade de serviço. CONCLUSÃO: A qualidade dos serviços foi satisfatória. O paciente demonstrou expectativa alta ao serviço médicohospitalar. Mulheres apresentaram maior percepção da qualidade na empatia, jovens na confiabilidade. A utilização de CEC não está relacionada com qualidade do serviço nesta amostra. Os dados obtidos sugerem que a qualidade deste serviço de saúde pode ser monitorada pelo emprego periódico da escala SERQUAL.
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OBJETIVO: Avaliar o efeito da utilização de um programa de treinamento específico dos músculos respiratórios sobre a função pulmonar em indivíduos tabagistas. MÉTODOS: Foram estudados 50 indivíduos tabagistas assintomáticos com idade superior a 30 anos, nos seguintes momentos: A0 - avaliação inicial seguida do protocolo de exercícios respiratórios; A1 - reavaliação após 10 minutos da aplicação do protocolo; e A2 -reavaliação final após duas semanas de treinamento utilizando o mesmo protocolo três vezes por semana. A avaliação foi realizada através das medidas de pressões respiratórias máximas (PImax. e PEmax.), picos de fluxo respiratórios (PFI e PFE), ventilação voluntária máxima (VVM), capacidade vital Forçada (CVF) e Volume expiratório forçado no primeiro segundo (VEF1). RESULTADOS: Não houve melhora na CVF e VEF1 da avaliação inicial para a final. Houve aumento significativo das variáveis PFI, PFE, VVM e PImax nas avaliações A1 e A2. A variável PEmax. aumentou somente na avaliação A2. CONCLUSÃO: A aplicação de protocolo de exercícios respiratórios com e sem carga adicional em indivíduos tabagistas produziu melhora imediata na performance dos músculos respiratórios, mas esta melhora foi mais acentuada após duas semanas de exercício.
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Os eventos de isquemia-reperfusão desencadeiam uma resposta inflamatória sistêmica que pode levar a lesões celulares e até falência de órgãos. Tais repercussões são notadas no pós-operatório de cirurgias, em especial, com o uso de circulação extracorpórea. Sabe-se, atualmente, que os leucócitos exercem importante papel neste processo. Assim, este estudo aborda o papel dos leucócitos na fisiopatologia das lesões de isquemia-reperfusão e a ativação das cascatas inflamatórias por esse processo e procura auxiliar na compreensão destes mecanismos assim como trazer contribuições acerca das abordagens terapêuticas que possam atenuá-los. Esta revisão bibliográfica retrospectiva foi realizada a partir de documentos científicos publicados nos últimos dez anos, em português e inglês, indexados em bases de dados internacionais Medline e SciELO e de textos clássicos relacionados. Os descritores pesquisados foram: isquemia-reperfusão, leucócitos, resposta inflamatória, circulação extracorpórea, efeitos adversos e apoptose.