bluuebunny/crossref_metadata_2025 huggingface dataset:
Perfil populacional de Grupo de Avaliação e Prevenção de Alterações de Linguagem (GAPAL)
Authors: Sideri Karolina Pessote , Botega Marilda Baggio Serrano , Chun Regina Yu Shon
Published: October 2015

RESUMOObjetivo Caracterizar e analisar o perfil dos usuários atendidos em um Grupo de Avaliação e Prevenção de Alterações de Linguagem (GAPAL) de uma clínica-escola.Métodos Pesquisa retrospectiva de banco de dados do GAPAL, do primeiro semestre/2002 ao primeiro semestre/2013. Foram analisados 261 usuários, quanto à idade, gênero, procedência, encaminhamentos e queixas apresentadas.Resultados Houve maior incidência de queixas relacionadas à linguagem no gênero masculino e na faixa etária de 25 a 30 meses de idade. A cidade com maior procedência de usuários foi Campinas. Quanto aos encaminhamentos, a maior parte foi realizada por profissionais de saúde, em sua maioria pediatras, sendo o relato mais ocorrente o de queixa de atraso de linguagem.Conclusão O estudo possibilitou a caracterização da população assistida, reiterando a importância de ações de promoção e prevenção das alterações de linguagem, principalmente junto às famílias. Também evidenciou limitações e dificuldades quanto ao registro dos dados, indicando a necessidade de readequação dos registros para nortear ações de (re)organização e gestão dos serviços na clínica de linguagem, tendo em vista o aprimoramento das ações de fonoaudiologia para esse grupo populacional.
A fluência na afasia progressiva primária logopênica
Authors: Santos Karoline Pimentel dos , Ribeiro Danieli Cristina , Santana Ana Paula
Published: October 2015

Esta pesquisa é um estudo de caso que tem como objetivo analisar, longitudinalmente, a fluência de um sujeito com Afasia Progressiva Primária (APP) Logopênica. O método de análise baseou-se em sete sessões de atendimento fonoaudiológico de uma paciente com 61 anos de idade, diagnosticada com APP. Os dados foram analisados de forma qualitativa, a partir da Neurolinguística Enunciativo-Discursiva. Os resultados sugerem que a paciente apresentava a variante Logopênica da APP, com as seguintes características: fala com estrutura gramatical reservada, manutenção da compreensão de palavras isoladas e de frases preservadas, durante a conversação na interação dialógica. As dificuldades de fluência referiram-se às ocorrências de repetição em palavras longas e menos cotidianas, parafasias fonológicas, pausas disfluentes e anomia. A análise também apontou modificação progressiva nos sintomas, com aumento do número de repetições e alteração de sua forma de ocorrência. Essas modificações parecem indicar uma relação inversamente proporcional entre fluência de fala e avanço da doença, em que a fluência tende à deterioração. Esse cenário assume aspecto relevante na linguagem do sujeito na medida em que influencia na sua interação e papel social, ou seja, quanto menos fluente é o discurso, mais essa condição afeta sua posição de falante.
Aleitamento materno e aspectos fonoaudiológicos: conhecimento e aceitação de mães de uma maternidade
Authors: Medeiros Andréa Monteiro Correia , Batista Bruna Gonçalves , Barreto Ikaro Daniel de Carvalho
Published: October 2015

Objetivo Investigar o conhecimento de mães sobre aleitamento materno e aspectos fonoaudiológicos, comparando mães internadas na Unidade Canguru e no Alojamento Conjunto, considerando tempo de internação; e verificar a aceitação sobre a intervenção grupal realizada.Métodos Estudo intervencionista e comparativo, com 163 mães de uma maternidade pública. As mães foram divididas em dois grupos (G1 e G2), conforme o tipo de internação (Unidade Canguru ou Alojamento Conjunto). Foi realizado o teste de assertividade com as mães, enfocando aspectos de aleitamento materno, linguagem, motricidade orofacial/fala e audição. Para caracterizar as afirmativas e comparar o conhecimento entre os grupos, foram aplicados, respectivamente, o modelo unidimensional de três parâmetros de Birnbaum, baseado na teoria de resposta ao item e o teste de Mann-Whitney, para nível de conhecimento estimado, com p<0,05. Foram realizadas orientações e aplicado o teste de aceitabilidade, considerando-se bem aceito valores ≥85%.Resultados Quanto à assertividade, o maior percentual de acertos foi em linguagem (98% do G1 e 95% do G2), seguido de motricidade orofacial/fala (72% de ambos os grupos), aleitamento materno (45% do G1 e 39% do G2) e audição (36% do G1 e 30% do G2). Não houve diferença entre tempo de internação e conhecimento desses aspectos abordados. Em aceitabilidade, o índice foi 97%.Conclusão A atividade de educação em saúde proporcionou acesso à informação, independente do tempo e tipo de internação dos sujeitos envolvidos. A boa aceitabilidade da intervenção permitiu inferir sobre a viabilidade de serem ampliadas práticas dessa natureza no ambiente hospitalar.
Anodization growth of self-organized ZrO2 nanotubes on zircaloy-4. Evaluation of the photocatalytic activity
Authors: Perillo Patricia María , Rodríguez Daniel Fabián
Published: October 2015

ABSTRACTZrO2nanotube arrays were prepared through anodic oxidation in glycerol organic electrolyte containing ammonium fluoride. The morphology of these nanotube arrays can be controlled by changing the preparation parameters such as applied voltage, fluoride ion concentration and time of anodization. While the oxidation voltage is the main factor that controls the diameter of nanotubes, the length of nanotubes is mainly depending on the oxidation time, and the crystal type is closely related to the annealing temperature. We also studied their photocatalytic performance. The photocatalytic activity of samples was calculated by the degradation of a model dye, under halogen light illumination.
Caracterización de semielaborados de aleaciones de titanio procesadas por extrusión y laminación perforación (proceso Mannesmann)
Authors: Bunte Claudio , Gomez Maximiliano
Published: October 2015

RESUMENPara la fabricación de tubos y caños sin costura se utilizan como materias primas, semielaborados huecos provenientes de procesos de deformación en caliente tales como extrusión y laminación perforación (proceso Mannesmann). A partir de los cuales y por medio de sucesivas reducciones de área a través de laminación o de trafilación se alcanzan las medidas finales solicitadas. El proceso de laminación perforación, por efecto Mannesmann, contempla la perforación de tochos cilíndricos, a través de una compresión diametral progresiva, que genera una fractura en el núcleo y facilita la perforación junto a la laminación transversal oblicua. En cambio la extrusión es un proceso por compresión en el cual el metal es forzado a fluir a través de una matriz para darle forma a su sección transversal. El presente trabajo de caracterización se realizó sobre semielaborados provenientes de ambos procesos, laminación perforación y extrusión, en aleaciones de titanio (Titanio Gr. 2 (Titanio Comercialmente Puro) y Titanio Gr. 5 (Ti-6Al-4V)). Se realizaron ensayos destructivos (tracción, aplastado y abocardado), no destructivos (inspección visual, videoscopía, dimensionales, rugosidad superficial y determinación de discontinuidades por tintas penetrantes) y macro y micro metalografías. También se evaluó la contaminación química provocada por la atmósfera del horno. Finalmente se analizaron los defectos característicos provenientes de cada proceso de deformación, su causa raíz y sus posibles soluciones.
Influencia de Ni y Ti en la respuesta a la corrosión marina simulada de un acero autopatinable A242
Authors: Artigas Alfredo , Bustos Oscar , Sipos Konstantin , Garza-Montes-de-Oca Nelson F. , Seco Rodrigo , Monsalve Alberto , Mena Juan
Published: October 2015

RESUMENExiste un gran interés en la industria siderúrgica por incorporar nuevos productos que superen las propiedades de los ya existentes. Dentro de estas propiedades, la resistencia a la corrosión es de gran importancia para los países que, al igual que Chile, tienen abundante litoral marino. En las zonas costeras los iones cloruro presentes en el aire producen deterioro por corrosión lo que disminuye la vida útil de las estructuras. Por esta razón es que es de vital importancia investigar la influencia de los distintos elementos aleantes y tratamientos que lleven a mejorar la resistencia de los aceros frente a la corrosión marina. Este trabajo apunta al estudio de aceros autopatinables ASTM A242 de baja aleación, específicamente con adición de Níquel a la aleación, y a la adición de Titanio como afinador de la microestructura, y su influencia sobre la resistencia a la corrosión atmosférica utilizando ensayos de corrosión acelerada producida en cámara de niebla salina con ciclos de humectación y secado. En las aleaciones estudiadas se determinó el espesor corroído de las muestras y la velocidad de corrosión. Los diferentes productos de corrosión, óxidos y oxihidróxidos de hierro se identificaron por rayos X. Los resultados muestran claramente que luego de 40 ciclos (960 horas) de tratamiento, en comparación con un acero ASTM A242, la velocidad de corrosión disminuye en forma significativa en el mismo acero con aleación de Níquel, y más aún con adición de Titanio como afinador de grano. Este resultado se ve también reflejado en una disminución del espesor corroído de los cupones, observándose el menor espesor corroído en el acero ASTM A242 con Ni y Ti.
Comportamiento a la corrosión atmosférica marina de aceros autopatinables con estructura ferrítico perlítica y ferrítico martensítica
Authors: Artigas Alfredo , Bustos Oscar , Sipos Konstantin , Garza-Montes-de-Oca Nelson F. , Monsalve Alberto , Mena Juan , Seco Rodrigo
Published: October 2015

RESUMENLa industria del acero se encuentra constantemente enfrentada al desafío del desarrollo de nuevos y mejores aceros para diversas necesidades, tales como la necesidad de aceros estructurales con mayor resistencia a la corrosión marina que los que existen en la actualidad, y que además posean una mayor resistencia mecánica. Por ello y en pos de lo anteriormente expuesto es evidente que, investigar en forma sistemática tanto la influencia de los elementos aleantes, como las variables del proceso de fabricación de aceros estructurales resistentes a la corrosión marina es relevante para el desarrollo del mercado acerero nacional.El presente trabajo tendrá por objetivo, la comparación de comportamiento a la corrosión atmosférica marina (espesor corroído en el tiempo) entre aceros de composición autopatinable (ASTM A242 y ASTM A588) con estructuras ferrítico-perlítica y ferrítico-martensítica. Para lo anterior se realizaron ciclos de humectación salina y secado. La humectación salina se realizó en cámara de niebla salina, de acuerdo a los requerimientos presentados en la norma ASTM B177, y el secado, en una mufla a 40 °C. Tras el retiro de muestras, se realizaron decapados químicos, según lo requerido en ASTM G1, para la determinación de espesor corroído.
Diseño de nuevos poliuretanos inspiradospor la estructura macromolecularde la seda de araña
Authors: Bidegain Borja Fernández-d´Arlas , Mendiguren Arantxa Eceiza
Published: October 2015

RESUMENEn este trabajo se presentan los resultados de la síntesis en masa y caracterización de copolímeros de poliuretano (PU) formados a partir de 1,6-hexametilen diisocianato (HDI) y N-metil dietanolamina (MDEA) y 1,4-butanodiol (BD) como glicoles de las fases flexibles y rígidas, respectivamente. Se compara las propiedades mecánicas y morfológicas de este tipo de PU con las de un PU convencional formado con un policarbonato de peso molecular intermedio. Los materiales se han caracterizado mediante calorimetría diferencial de barrido, espectroscopia infrarroja de transformada de Fourier y mecánicamente mediante tracción uniaxial. Se ha observado que las unidades de MDEA que, pese a tener la capacidad de asociarse por puentes de hidrógeno, presentan características elástoméricas similares a las de glicoles de mayor peso molecular y separación entre unidades donoras-aceptoras de enlaces de hidrógeno. El comportamiento de esta nueva serie de PU con alta densidad de puentes de hidrógeno puede resultar interesante en el desarrollo de materiales resilientes y tenaces tales como las sedas.
Hacia una reducción del contenido decobre en pinturas antiincrustantes
Authors: García Mónica Teresita , Pérez Miriam Cristina , Stupak Mirta Elena , Blustein Guillermo
Published: October 2015

RESUMENEl biofouling conduce al deterioro de las estructuras emplazadas en el mar acarreando graves pérdidas económicas. La aplicación de pinturas a base de óxido cuproso es el método más difundido para el control de las incrustaciones aún siendo nocivas para los ecosistemas marinos. Ante la necesidad de desarrollar formulaciones más inocuas se propone el uso de productos de origen natural que puedan reemplazar parte del cobre disminuyendo su aporte al medio ambiente.El timol se aísla de los aceites esenciales de numerosas plantas (tomillo, orégano, albahaca) y ha sido ampliamente estudiado por sus propiedades antimicrobianas. La hipótesis que se plantea es que inhibiría el proceso inicial del asentamiento de organismos incrustantes.El objetivo de este trabajo es reducir el contenido de cobre en las pinturas antifouling empleando al timol como aditivo.Se prepararon dos pinturas antifouling, una conteniendo 16% v/v de cobre y otra con 1,6% de cobre + 2% de timol. Las pinturas se aplicaron sobre paneles de acrílico y se sumergieron en el puerto de Mar del Plata. Luego de 6 meses los paneles se retiraron y observaron en el laboratorio bajo lupa binocular y microscopio óptico. La estimación de la fijación para cada especie sobre los paneles se evaluó con una grilla de 25 puntos al azar. Se trabajó por triplicado, con controles y se aplicaron test estadísticos.Las pinturas con cobre+timol presentaron una muy buena performance dado que disminuyeron el asentamiento del biofouling. No se registraron diferencias significativas en los porcentajes de cobertura entre las formulaciones con cobre y la pintura con cobre+timol (p>0,05). El timol empleado como aditivo en la formulación antiincrustante permitió reducir 90% el contenido de cobre manteniendo la efectividad en servicio.
Fabricación de vidrios metálicos base cobre: evolución de las fases durante el procesode aleación mecánica
Authors: Rojas Paula , Martínez Carola , Viancos Francisco , Aguilar Claudio , Guzmán Danny , Zelaya Eugenia
Published: October 2015

RESUMENEn este estudio se fabricaron diferentes materiales (base cobre) bajo las mismas condiciones de molienda: molino empleado fue un SPEX 8000D, atmósfera de argón, acido esteárico, RBP=10:1, con tiempos variables desde 1 hasta 120 horas, con el objetivo de comparar los cambios microestructurales durante el proceso de: Cobre puro, Aleaciones Cu-Ni, Aleaciones Cu-Zr y aleaciones Cu-Ni-Zr. Las muestras, tras la molienda, fueron analizadas mediante difracción de rayos X, microscopía electrónica de transmisión y calorimetría diferencial de barrido. De acuerdo a los resultados, el cobre al ser sometido al proceso alcanza un tamaño de cristalita que se hace asintótico a partir de las 5 horas, mientras que en el sistema Cu-Ni, en vez de apreciarse un refinamiento microestructural a ese mismo periodo, se advierte una total solubilización del níquel en cobre (40-60 y 50-50) y de cobre en níquel (60-40). Por su parte, en el sistema binario Cu-Zr, se encontró, también para 5 horas, que el sistema estaba prácticamente amorfizado (60-40 y 50-50) al igual que en el caso de las aleaciones ternarias Cu-Ni-Zr (60-10-30 y 50-10-40).
Influencia de la porosidad en las propiedades magnéticas de arreglos de nanohilos de Ni
Authors: Meneses Fernando , Bercoff Paula Gabriela
Published: October 2015

RESUMENSe estudiaron las propiedades de histéresis magnética de arreglos ordenados de nanohilos de Ni, electrodepositados éstos en una membrana de alúmina con un arreglo hexagonal de poros cilíndricos. Se analizó el efecto de la geometría de los nanohilos individuales (diámetro y longitud) y del ordenamiento y porosidad del arreglo sobre la coercitividad y la remanencia del conjunto. Las membranas de alúmina auto-ensambladas se sintetizaron por anodizado en dos pasos, usando una celda electroquímica y potencial eléctrico constante. Se variaron los diámetros de poro entre 20 nm y 40 nm (no así la distancia media entre ellos) sumergiendo las membranas en ácido fosfórico al 5% durante distintos tiempos. Estas membranas se caracterizaron por microscopía de barrido (SEM). Los nanohilos de Ni se obtuvieron por electrodeposición AC, a 20 V, 200 Hz y temperatura ambiente. Una vez sintetizados, los arreglos de nanohilos se caracterizaron estructuralmente por SEM y magnéticamente usando un SQUID. Se observa que las propiedades magnéticas de los arreglos son fuertemente dependientes de la relación largo/diámetro de los nanohilos, la que regula el valor de su anisotropía de forma, y también de la porosidad, que determina la magnitud del campo de interacción dipolar que percibe cada nanohilo por la presencia de sus vecinos en el arreglo. En particular, se encontró que la coercitividad decrece con la porosidad y que el parámetro ε, que regula la intensidad de las barreras de energía del sistema, debe ser variable y depender de la porosidad del arreglo para ajustar bien los datos experimentales.
Recubrimiento controlado de sustratosde vidrio con nanobastones metálicos
Authors: Gutiérrez Marina Verónica , Paredes María Yanela , Scarpettini Alberto Franco
Published: October 2015

RESUMENSe realizó la síntesis de nanobastones de oro monodispersos con una eficiencia superior al 80% sobre el total de nanopartículas, caracterizado por una resonancia plasmónica longitudinal cercana a los 800 nm. Se modificaron superficialmente sustratos de vidrio y se los recubrió con los nanobastones sintetizados, con control de la densidad superficial. Se monitoreó la dinámica del recubrimiento a través de espectros de extinción, y se observó una densidad máxima de saturación dada por repulsión electrostática y un tiempo característico del proceso. Luego de alcanzada la saturación de nanobastones por unidad de área se observa un ensanchamiento de las resonancias hacia el infrarrojo, debido a interacciones entre los nanobastones por producirse agregaciones sobre la superficie. Estos resultados tienen aplicación inmediata en el diseño y fabricación de dispositivos plasmónicos, por ejemplo en el sensado molecular.
Estudio de estructuras de cis- y trans-estilbeno mediante microscopiade fuerza atómica
Authors: Mendoza Sandra Marina , Passegg Mario César Guillermo , Ferrón Julio
Published: October 2015

RESUMENLa nanotecnología es un área multidisciplinaria que ha tenido un gran auge en los últimos años, principalmente debido al desarrollo de instrumental que permite "ver", estudiar y manipular la materia a nivel atómico y molecular. El estilbeno y algunos de sus derivados son moléculas orgánicas de origen natural, que presentan una estructura química de interés en la fabricación de nanoestructuras y bloques constituyentes de máquinas moleculares (potencialmente aplicables en tecnología de nanosensores, almacenamiento de datos, liberación controlada de fármacos, entre otros). Sin embargo todavía no han sido ampliamente exploradas como nanomateriales. El interés en este tipo de sistemas reside en sus aplicaciones en medicina, farmacia y biotecnología.Este trabajo presenta los primeros resultados obtenidos al estudiar formas isoméricas de estilbeno: cis- y trans-estilbeno, líquido y sólido a temperatura ambiente, respectivamente, con el objetivo de explorar sus propiedades, al estar las mismas en contacto con superficies policristalinas de oro (Au/mica) y grafito (HOPG).Se encontró que la inmovilización de trans-estilbeno sobre una superficie puede modificar el proceso de cristalización de estas moléculas orgánicas, cuya morfología depende del sustrato. Mientras que el trans-estilbeno forma "clusters" que originan cristales de forma pseudo-romboide sobre HOPG, sobre la superficie de Au/mica forma estructuras dendríticas con ramificaciones en ángulos a 90 º.Por otra parte, se observó que el cis-estilbeno a escala nanométrica forma también "clusters" sobre HOPG, comportándose de manera similar al trans-estilbeno. Un paulatino incremento en la cantidad de cis-estilbeno conlleva al crecimiento de dichos "clusters" y a su coalescencia en una fase amorfa. Por el contrario, la interacción molécula-sustrato de cis-estilbeno sobre Au/mica es más lábil que sobre HOPG y ya no resulta posible observar centros de nucleación o nanoestructuras estables. Un aumento en la cantidad de cis-estilbeno sobre Au/mica resulta en una especie de película delgada líquida.
Prevalence of upper respiratory tract infections at a tertiary care hospital in the city of São Paulo
Authors: Mouro Amilton , Hidal Luci Black Tabacow , Martino Marines Dalla Valle , Pasternark Jacyr
Published: October 2015

ABSTRACT Objective: To evaluate the prevalence of pathogens in the upper respiratory tract according to age at a tertiary care hospital in the city of São Paulo. Methods: A total of 6,144 biological material tests from upper respiratory airways were analyzed: 740 bacterial cultures, 726 virus screenings and 4,678 rapid tests for S. pyogenes. Results: The most frequently found etiological agent was respiratory syncytial virus (29.6%; 215/726). The main agents detected per age groups were: respiratory syncytial virus (25.34%; 184/726) in patients aged 28 days-3 years; S. pyogenes (9.5%; 70/740) in 3-12 year-old children; influenza virus (8.8%; 64/726) in adults (18-59 years). Conclusions: The etiologic agents of upper respiratory infections vary according to age and imply diverse clinical and therapeutic management.
Humanization according to cancer patients with extended hospitalization periods
Authors: Brito Natália Tatiani Gonçalves , Carvalho Rachel de
Published: October 2015

ABSTRACT Objective: To identify the concept of humanization and raise aspects that contribute towards and that hinder humanization of hospital care, according to the opinion of oncology patients. Methods: This is a descriptive-exploratory survey, with a qualitative-quantitative approach. The sample was made up of 10 patients hospitalized for more than 30 days at the Oncology Unit of Hospital Israelita Albert Einstein, who, after satisfying ethical and legal procedures, were interviewed and answered three questions in reference to humanization in oncology. Results: The factors that contributed more towards humanization were warmth in giving care, friendliness, and smiles, and the factors that hindered it were bad moods, noise, and not being promptly attended. Conclusions: Hospital humanization should be experienced and felt by all those who work at hospital and needs to be reflected in the care offered to the client and his/her family members. These aspects become vital in oncology in order to understand the difficult period the patient is going through during the hospital stay, showing an interest in his/her problems and struggles with an attitude of empathy and cordiality, always acting ethically and with professional responsibility.
Comparison of methods of measurement of the finger flexor muscles’ strength through dynamometry and modified manual sphygmomanometer
Authors: Lucareli Paulo Roberto Garcia , Lima Mário de Oliveira , Lima Fernanda Pupio Silva , Gimenes Rafaela Okano , Lucareli Juliane Gomes de Almeida , Garbelotti Junior Silvio Antonio , Fukuda Thiago Yukio , Pompeu José Eduardo
Published: October 2015

ABSTRACT Objective: To evaluate the reproducibility of the modified sphygmomanometer compared to hand dynamometer to measure muscle strength of the flexor muscles of fingers. Methods: We assessed 40 healthy volunteers of both genders, aged between 20 and 55 years, who underwent the muscle strength test in the finger flexor muscles on both hands using two instruments for which the comparison was made between them. Results: After statistical analysis by the paired Student's t test, there was no significant difference between the values obtained in modified sphygmomanometer and hand dynamometer tests in relation to right and left sides (p > 0.05). Pearson's coefficient of correlation observed good correlations between them. Conclusions: The modified sphygmomanometer proved to be a reproducible technique for measuring muscle strength of the finger flexor muscles.
Assessing knowledge of Medical undergraduate students on palliative care in end-stage disease patients
Authors: Moraes Sandra Alamino Felix de , Kairalla Maisa Carla
Published: October 2015

ABSTRACT Objective: To assess the knowledge on palliative care of undergraduate medical students of the 9th and 10th semesters at Universidade Nove de Julho. Methods: A self-applied and self-explanatory questionnaire was prepared with 9 objective questions and given to 50 undergraduate medical students of these semesters. The content was related to palliative care, addressing some topics, such as orthothanasia, dysthanasia, euthanasia and clinical cases. The questionnaire was applied from November 2007 to February 2008. Results: As to correct answers, the rates were 84%, 42%, 38% and 40% to questions 1, 2, 3 and 4, respectively. Question 7 was correctly answered by 84% and Question 8 by 30%. Question 9 achieved 100% correct answers. Regarding Question 5, there was no right or wrong answer, and 24% of the students chose alternative A, 32%, alternative B and 44%, alternative C. In Question 6, the students could tick more than one alternative, if necessary: 22% chose alternative A, 6%, alternative B, 2%, alternative C, 20% chose D and 6% responded alternative E; 36% opted for both alternatives B and D, and 6% of students answered alternatives B, C and D. Conclusions: Medical students that will conclude the undergraduate course are aware of the nature and the importance of palliative care, even when they have no previous experience during training at university.
Adverse drug events leading to emergency department visits in elderly: the role of inappropriate prescription
Authors: Farfel José Marcelo , Accorsi Tarso Augusto Duenhas , Franken Marcelo , Doudement Sueli Pinto , Moran Mariane , Iervolino Mauro , Bastos Neto Antônio Silva
Published: October 2015

ABSTRACT Objective: Adverse drug reactions are more incident among the elderly and are frequently associated to inappropriate prescription for this group. The objective of the current study was to investigate the incidence and the characteristics of emergency department visits, related to inappropriate prescription, at the Hospital Israelita Albert Einstein. Methods: Patients aged 60 years or older, admitted to the emergency department at Unidade Avançada Ibirapuera of Hospital Israelita Albert Einstein, were included in the study. Potentially inappropriate medication for the elderly was evaluated using updated 2003 Beers criteria. Results: Over a period of 6 months, 214 individuals were included in the study, being 53.7% male. The mean age was 70.8 years (60-107). A total of 48 registries of inappropriate prescription were recorded in 42 patients (19.6% of sample). An emergency visit related to adverse drug event was verified in 27 individuals (12.5% of the sample). From these patients, 34.5% were admitted to the emergency department because of an adverse event caused by an inappropriate medication. Conclusion: Inappropriate prescription is frequent among elderly patients admitted to emergency department. A surveillance system and a program to educate physicians on the most recent criteria of appropriate prescription may help reducing emergency visits and adverse drug events in the elderly population.
Financial incentives for generic drugs: case study on a reimbursement program
Authors: Inocencio Marcos , Amorim Maria Cristina Sanches , Guevara Arnoldo Jose de Hoyos , Vivo Bruna de
Published: October 2015

ABSTRACT Objective: To discuss the use of financial incentives in choice of medication and to assess the economic results concerning the use of financial incentives to promote the use of genetic medication in lieu of reference drugs in a company with a reimbursement program. Methods: A case study was carried out in a large supermarket. The data was obtained in the company responsible for managing medication. The study reached 83,625 users between August 2005 and July 2007. The data was submitted to regressions in order to analyze trends and hypothesis tests to assess differences in medication consumption. The results were compared with general data regarding medication consumption of five other organizations and also with data about the national consumption of generic medication in Brazil. Results: The use of financial incentives to replace brand medications for generics, in the company studied, increased the consumption of generic drugs without reducing the company expenses with the reimbursement programs. Conclusions: This study show the occurrence of unplanned results (increase in the consumption of medications) and the positive consequences of the reimbursement program concerning access to medication.
Urinary incontinence after vaginal delivery or cesarean section
Authors: Borges João Bosco Ramos , Guarisi Telma , Camargo Ana Carolina Marchesini de , Gollop Thomaz Rafael , Machado Rogério Bonassi , Borges Pítia Cárita de Godoy
Published: October 2015

ABSTRACT Objective: To assess the prevalence of stress urinary incontinence, urge incontinence and mixed urinary incontinence among women residing in the city of Jundiaí (São Paulo, Brazil), and the relation between the type of incontinence and the obstetric history of these women. Methods: A cross-sectional community-based study was conducted. A total of 332 women were interviewed; they were seen for whatever reason at the public primary healthcare units of the city of Jundiaí, from March 2005 to April 2006. A pre-tested questionnaire was administered and consisted of questions used in the EPINCONT Study (Epidemiology of Incontinence in the County of Nord-Trondelag). Statistical analysis was carried out using the χ2 test and odds ratio (95%CI). Results: Urinary incontinence was a complaint for 23.5% of the women interviewed. Stress urinary incontinence prevailed (50%), followed by mixed urinary incontinence (35%) and urge incontinence (15%). Being in the age group of 35-64 years, having a body mass index of 30 or greater and having had only vaginal delivery or cesarean section, with uterine contraction, regardless of the number of pregnancies, were factors associated with stress urinary incontinence. However, being in the age group of 55 or older, having a body mass index of 30 or greater and having had three or more pregnancies, only with vaginal deliveries, were factors associated with mixed urinary incontinence. Conclusions: One third of the interviewees complained of some type of urinary incontinence, and half of them presented stress urinary incontinence. Cesarean section, only when not preceded by contractions, was not associated with stress urinary incontinence. The body mass index is only relevant when the stress factor is present.
Comparative analysis of radical prostatectomy techniques using perineal or suprapubic approach in the treatment of localized prostate cancer
Authors: Amorim Gelbert Luiz Chamon do Carmo , Cruz Geraldo Magela Gomes da , Veloso Denny Fabrício Magalhães , Kartabil José David , Vieira José Carlos , Alves Paulo Roberto
Published: October 2015

ABSTRACT Objective: To compare the results of radical prostatectomy by perineal and suprapubic approaches as to operative time, procedure costs, and surgical site complications. Methods: The medical records of localized prostate cancer patients (PSA ≤ 10 ng/ml and Gleason score ≤ 6) were analyzed. Fifty-five patients were submitted to radical prostatectomy by perineal approach and 54 via suprapubic approach. Results: There were statistical differences between groups as to operative time (p < 0.05); for perineal approach it was in average 114 minutes (SD ± 0.03) and for suprapubic approach, an average of 167 minutes (SD ± 0.041). Prostatectomy via perineal approach resulted in 11 cases of surgical complications, and suprapubic approach, 3 cases. Conclusions: Radical prostatectomy via perineal approach took less time at a lower cost as compared to the suprapubic approach. However, there were more complications in patients submitted to perineal approach, mainly rectal lesions.
Denver II: evaluation of the development of children treated in the outpatient clinic of Project Einstein in the Community of Paraisópolis
Authors: Moraes Márcia Wanderley de , Weber Ana Paula Rodrigues , Santos Marcela de Castro e Oliveira , Almeida Fabiane de Amorim
Published: October 2015

ABSTRACT Objectives: To evaluate the neuropsychomotor development of children treated in an outpatient clinic, using the Denver Developmental Screening Test II (DDST-R). Methods: This was an exploratory descriptive research using a quantitative approach, conducted in the outpatient clinic of the Project Einstein in the Community of Paraisopolis (PECP), São Paulo, Brazil. The sample consisted of 35 children, from birth to 6 years of age, most of them from 1 to 3 years old (19; 54.3%). They underwent the Denver II Test, which assesses four neuropsychomotor development areas: gross motor, fine motor adaptive, language and personal-social. Results: Most of the children (24, 68.6%) had test results compatible with normal development, while 10 (28.6%) had a “risk” test and 1 (2.9%) was “untestable” due to refusal to carry out the proposed activities. As to the items evaluated in each area, 7 children (20%) showed a developmental “delay” (when the child does not perform the activity passed by more than 90% of the children of his/her age) and 18 (51%) required “attention” (when the child does not perform the activity passed by 75 to 90% of the children of his/her age), predominantly in the language area. Conclusions: Although most of the children (68.6%) presented normal development in the test, we point out that in the remaining children (31.4%), the number of items classified as “delay” or “attention”, and tests classified as “risk” or “untestable” suggest impairment in neuropsychomotor development. We underscore the importance of the routine administration of the DDST-R for an early detection of developmental disabilities and thus establish primary prevention programs.
Effects of dietary fiber intake on inflammation in chronic diseases
Authors: Lottenberg Ana Maria Pita , Fan Patricia Luriko Tomita , Buonacorso Vivian
Published: October 2015

ABSTRACT Chronic diseases such as obesity, type-2 diabetes, metabolic syndrome and cardiovascular diseases are associated with inflammation due the increase of TNF-α, IL-6 and C-reactive protein concentrations. Occidental life style, specially related to the changes in food habits as observed in the past years, have an important role in the development of these diseases. Among the life style changes identified as having an impact in the development of diseases, is the decrease in dietary fiber consumption. Some studies have shown the negative relationship between fiber ingestion and inflammatory markers in chronic diseases. Dietary fibers have an important and a well-known role in different physiologic functions such as intestinal peristalsis, weight reduction by acting on satiety mechanisms, preventing colon cancer, reducing cholesterol and post-prandial glycaemia.
Developed foot drop as a complication of bariatric surgery: case reports
Authors: Prado Marcelo Pires
Published: October 2015

ABSTRACT Two cases of patients with morbid obesity submitted to bariatric surgery and with considerable weight loss are presented. During follow-up, they complained of weakness in the legs and the physical examination showed reduction of ankle dorsiflexion muscle strength (foot drop). In these cases, the symptoms subsided spontaneously. A literature review is presented.
Indications of Sentinel Node Biopsy in Thin Melanoma
Authors: Silva Fernanda Braga , Oliveira Filho Renato Santos de , Iared Wagner , Atallah Álvaro Nagib , Santos Ivan Dunchee de Abranches Oliveira , Ferreira Lydia Masako
Published: October 2015

ABSTRACT Objective: To assess data on survival, recurrence and histological factors in positive and negative sentinel lymph nodes in thin melanoma cases. Methods: A systematic review was conducted on observational studies in four databases (Cochrane Library, Medline, Embase and Lilacs). Positive and negative micrometastases in sentinel lymph node biopsy were compared regarding the clinical outcomes – death and recurrence – and six histological factors – vertical growth phase, Breslow thickness, Clark level, ulceration, regression and mitosis rate. Results: Positive sentinel lymph node is statistically associated with greater risk of death in six studies (OR: 7.2; 95%CI [2.37-21.83]; I2 0%) and also to recurrence in three studies (OR: 30.7; 95%CI [12.58-74.92]; I2 36%). Comparing positive and negative groups, the histological factors predicting positive sentinel nodes and poor prognosis were: mitosis rate ≥ 5/mm2 (OR: 16.29; 95%CI [3.64-72.84]; I2 40%); VGP (OR: 2.93; 95%CI [1.08-7.93]; I2 59%); Breslow thickness ≥ 0.75mm (OR: 2.23; 95%CI [1.29-3.86]; I2 0%); and Clark level IV-V (OR: 1.61; 95%CI [1.06-2.44]; I2 34%). Conclusions: The statistically significant results associated with the presence of micrometastases in thin melanomas were Breslow thickness ≥ 0.75 mm, Clark level IV-V and mitoses ≥ 5/mm2, absence of regression. This histological factor of ulceration was associated, but not statistically significant.
Uncertainty in aiming movements and its association to hand function
Authors: Silva Flávia Priscila de Paiva , Freitas Sandra Maria Sbeghen Ferreira de , Comenalle Emelli da Silva , Alouche Sandra Regina
Published: October 2015

AbstractThe purpose of this study was to analyze the influence of the uncertainty of target location on the planning and execution of aiming movements performed towards the ipsilateral and contralateral directions by the right and left upper limbs. In addition, the association between the performance of aiming movements and the performance of functional manual tasks was investigated. Two tasks were proposed: with prior knowledge of the movement direction (simple reaction time) or not (choice reaction time). The grip strength and manual dexterity were measured. The choice option in response (i.e. uncertainty) influenced planning of the aiming movements, but not its execution, while movements performed towards the contralateral direction were worse in execution as compared to the ipsilateral direction. Manual dexterity was significantly correlated with reaction times, while the performance during movement execution was significantly correlated with handgrip/pinch strength.
Movement patterns during the process of standing up in children with spastic diplegia
Authors: Martins Elisabete , Fernandes Jorge , Cruz-Ferreira Ana
Published: October 2015

AbstractThe analysis of the movement patterns of children with spastic diplegia (SD) during the process of standing up can contribute to a better understanding of postural control. The purpose of this study was to describe the movement patterns during this task in children with SD and typical development and to analyze the differences according to their age group. Participated 40 children (38-154 months), 20 children with SD and 20 children with typical development. The participants were instructed to lie down in a supine position and quickly stand up (10 trials). Motor task sessions were videotaped and subsequently analyzed. Children with SD had more asymmetrical and less efficient movement patterns in the Upper Limbs (UL), Axial Region (AR) and Lower Limbs (LL). The oldest group of children with SD did not have more mature and efficient movement patterns, and the oldest children with typical development have more mature and efficient movement patterns in the UL and AR.
Different types of additional somatosensory information do not promote immediate benefits on gait in patients with Parkinson's disease and older adults
Authors: Lirani-Silva Ellen , Vitório Rodrigo , Barbieri Fabio Augusto , Baptista André Macari , Santos Paulo Cezar Rocha dos , Gobbi Lilian Teresa Bucken
Published: October 2015

AbstractPlantar cutaneous stimulation has been shown to improve gait in Parkinson's disease (PD), but the effects of different types of insoles have not been tested. We evaluated the immediate effect of different types of insoles on gait in PD patients and healthy older adults. Nineteen PD patients and nineteen healthy older adults performed and performed a walking task at their self-selected speed in three conditions: conventional insole, insole with a raised ridge around the foot perimeter, and insole with half-spheres. Plantar sensation was evaluated before and after the walking protocol. There were no differences between groups for plantar sensation before and after the walking task. PD patients demonstrated reduced stride length and stride velocity. There were no immediate benefits offered by the insoles on gait of either group. The increased plantar cutaneous stimulation does not promote immediate benefits on gait in PD patients and healthy older adults.
Can functional exercise capacity discriminate older individuals with poor postural control?
Authors: Oliveira Marcio R. , Vidotto Laís S. , Gil André W. , Merli Myriam Fernanda , Probst Vanessa S. , Silva Rubens A. da
Published: October 2015

AbstractPostural instability can be related to functional limitations as a result of the aging process. This study aimed to compare functional exercise capacity and postural control in older adults. Participants were allocated into three groups according to their functional exercise capacity based on the six minute walking test (6MWT): 1) Low performance group (LP: distance walked ≤ 80% of the predicted value n = 19), 2) Normal performance group (NP: distance walked 81-100% of the predicted value n = 21) and, 3) High performance group (HP: distance walked >100% of the predicted value n = 23). All groups performed three trials of a one-leg stance for 30s on a force platform. LP showed worse postural control in comparison to NP and HP, and significant differences (p < .05) were found between groups for area, velocity antero-posterior of center of pressure and time limit variables during the one-leg stance task. These results have implications for rehabilitation management with regard to exercise, balance assessment and intervention in older adults.
Stretch breaks in the work setting improve flexibility and grip strength and reduce musculoskeletal complaints
Authors: Martins Patrícia Fátima de Oliveira , Zicolau Evelin Alvares Aranda , Cury-Boaventura Maria Fernanda
Published: October 2015

AbstractThis study investigated the effect of a stretch break program (SBP) on the flexibility, strength and musculoskeletal complaints of storage (SW) and administrative (AW) sector workers. Twenty-six male workers were randomly selected: 16 workers from the storage sector and ten workers from the administrative sector. We applied the Physical Activity Questionnaire and Musculoskeletal Questionnaire and evaluated flexibility and grip strength before and after 6 months of the SBP. The SPB decreased the SW group members' complaints of paresthesias and numbness in the upper body and total body. The SPB reduced the AW group members' complaints of paresthesias and numbness in the upper body. Furthermore, the SPB improved cervical, trunk and left shoulder flexibility in the SW group and improved cervical and shoulder flexibility and grip strength in the AW group. The SBP contribute to improve flexibility and musculoskeletal complaints in the regions that are affected by higher rates of work-related injuries.
Improving aerobic capacity through active videogames: A randomized controlled trial
Authors: Brito-Gomes Jorge Luiz de , Perrier-Melo Raphael José , Wikstrom Erik Anders , Costa Manoel da Cunha
Published: October 2015

AbstractThe rate of peak workload improvement between different types of Active Video Games (AVG) in young sedentary adults was investigated. Aerobic capacity improvement after a 6-week intervention between AVG types was also compared. Twenty participants, after baseline assessments, were randomized into one of three parallel groups: structured AVG (n= 6), unstructured AVG (n= 7) and a control group (n= 7). Participants played their respective AVG 3 times a week for 6-weeks (30 minutes-session). The control group maintained normal activities. Both structured and unstructured AVG improved peak workload after four weeks but only the structured group maintained this improvement through week five and six. Aerobic capacity improved in the unstructured (Pre: 36.0 ± 5.2ml.kg.min-¹,Post: 39.7 ± 4.9ml.kg.min-¹, p = .038) and structured AVG (Pre: 39.0 ± 5.9ml.kg.min-¹,Post: 47.8 ± 4.3ml.kg.min-¹, p = .006) groups. Structured AVG provide greater health benefits to aerobic capacity and peak workload in young sedentary but otherwise healthy males relative to unstructured AVG.
Technical and tactical soccer players' performance in conceptual small-sided games
Authors: Lizana Cristian Javier Ramirez , Reverdito Riller Silva , Brenzikofer René , Macedo Denise Vaz , Misuta Milton Shoiti , Scaglia Alcides José
Published: October 2015

AbstractConceptual small-sided games (CSSGs) may be interesting as a methodology for training soccer players given its connection to the unpredictability that is inherent to soccer. Our aim was investigate, through videogrammetry, if the technical and tactical principles promoted through the adoption of distinct rules from two distinct CSSGs (maintaining ball possession; and progression to the target) would actually be achieved. The study included 24 athletes assigned to 6-player teams. Our data showed that the CSSGs' organising principles create situations with differing levels of difficulty that obey the propositions of maintaining ball possession and progression to the target, i.e., CSSGs permit systematic training on technical and tactical components in order to emphasize the concepts adopted in this study in games context. Our data credit the CSSGs for teaching technical and tactical lessons that, when coupled with adequate physical conditioning, can facilitate a player's capacity to merge thoughts and events in different situations.
Examining the validity of the personal-social responsibility questionnaire among athletes
Authors: Martins Paulo , Rosado António , Ferreira Vítor , Biscaia Rui
Published: October 2015

AbstractThe teaching personal-social responsibility (TPSR) model is a well-established approach for developing positive social behaviors. However, today's research community has diagnosed the need to gather greater empirical evidence regarding the consistency of the evaluation tool in measuring personal-social responsibility levels. Thus, this study was geared towards testing the validity and reliability of a two factor model of the Personal and Social Responsibility Questionnaire (PSRQ) among athletes. A questionnaire was administered to 517 athletes, distributed into two representative samples of different competitive levels, sports and regions. Exploratory and confirmatory factor analyses were used to examine the PSRQ's factor structure. The scale showed good psychometric properties and the factor structure was stable in the two samples, providing evidence of cross validity. Implications and research directions of these results are discussed.