Este estudo tem como objetivo introduzir um debate sobre as questões relacionadas à legislação voltada para o trabalhador de enfermagem aquaviário, com ênfase na proteção da saúde deste trabalhador de enfermagem inserido em plataformas e navios de exploração de petróleo da costa brasileira. O método utilizado é a análise documental. É característica da pesquisa documental definir a fonte de coleta de dados, que deve estar restrita a documentos, escritos ou não, constituindo o que se denomina de fontes primárias. Analisou-se, inicialmente, como fonte primária, os seguintes documentos jurídicos da legislação trabalhista: as Normas Regulamentadoras do Trabalho Urbano (NR 30 e NR 32), a Resolução COFEN-146 e o Decreto N 2.671, DE 15 DE JULHO DE 1998 do COFEN e a NORMAM. Ainda, como fontes internacionais, destacam-se as Convenções 164 e 147 da OIT. Constatou-se que dezesseis das normas estudadas (72,7%) têm sua vigência definida a partir dos anos noventa, embora existam desde 1910, conforme a Convenção Internacional para Unificação de Certas Regras em Matéria de Abalroamento, Assistência e Salvamento Marítimo Bruxelas (23 de setembro de 1910). Contudo, a maioria absoluta destes dispositivos não se refere ao trabalhador de enfermagem aquaviário, à exceção do Código Brasileiro de Ocupações, uma norma complementar que define apenas algumas competências do enfermeiro de bordo. Concluiu-se que existe escassez de instrumentos legais para este setor e a necessidade de mobilização para a criação de normas mais específicas para o enfermeiro aquaviário e, conseqüentemente, relativas à proteção da saúde deste profissional. / This study aims to introduce a debate on issues related to legislation focused on the worker of nursing aquaviário, with emphasis on the protection of the health of workers in nursing inserted into platforms and ships of oil exploration of the Brazilian coast. The method used is the document analysis. It is characteristic of desk research to define the source of collecting data, which should be limited to documents, written or not, is what is called primary sources. Examined is, initially, as primary source, the following legal documents labor legislation: the Rules Regulamentadoras Labor Urban (NR-30 and NR-32), the resolution COFEN-146 and Decree No. 2671, of 15 July 1998 of COFEN and NORMAM. Still, as international sources, it is the Conventions 164 and 147 of the ILO. It was noted that sixteen of the standards studied (72.7%) have defined his life from the nineties, although there since 1910, according to the International Convention for Unification of Certain Rules in Respect of Abalroamento, Assistance and Rescue Marine-Brussels ( on September 23, 1910). However, the absolute majority of these devices does not refer to the worker of nursing aquaviário, with the exception of the Brazilian Code of Occupations, a standard that defines only a few complementary skills of the nurses board. It is concluded that there is a shortage of legal instruments to this sector and the need to call for the creation of more specific rules for the nurses aquaviário and, consequently, on the protection of the health of this training.

Downsizing in cars lead to higher noise emissions through the addition of turbo-/superchargers. These noise emissions must be counteracted and cancelled in order to contribute to the overall quality feel of a car. This project follows a product development method in order to research if a new type of silencers are applicable in air induction systems in order to dampen noise emissions. The project also cover how to manufacture the new type of silencers, traditionally used as acoustic insulation in offices. The project covered everything from literature review on silencers, noise regulations, downsizing and traditional plastic manufacturing methods. After the analysis of the results, it stood clear that the new silencers are more effective than conventional solutions. A manufacturing process was also determined, which needs further research in order to derive what the manufacturing cost would be. The project resulted in strong indicators that the new silencers are promising but also opened up to new research questions.

Cette étude s'intéresse à la fissuration des structures multi-perforées, soumises à des sollicitations pouvant aller de la plasticité confinée à la plasticité généralisée. Le cas d'étude considéré est celui des chambres de combustion des turbomachines aéronautiques. Le matériau utilisé est le Haynes 188, un superalliage à base de Cobalt, spécialement conçu pour ce type d'applications. La fissuration des structures multi-percées a été souvent étudiée dans des conditions de plasticité confinée. Ces études doivent être étendues au domaine de la plasticité généralisée.Afin d'étudier les interactions entre fissures et perçages, une éprouvette originale a été conçue. Dans le but de reproduire un motif de base simplifié correspondant aux trous de refroidissement des chambres de combustion, l'éprouvette est percée en son centre par trois trous. Des essais de fissuration isotherme à 900°C sous des chargements de fatigue ont été réalisés avec des niveaux de chargement allant de la plasticité confinée à la plasticité généralisée. Ces essais ont permis d'étudier la durée de vie du motif de base. A partir des résultats expérimentaux de contrainte et de déformation, les essais ont été modélisés à une échelle dite macroscopique avec un modèle de fissuration en énergie. Dans le but d'améliorer la description des essais, la modélisation a été ensuite réalisée à une échelle intermédiaire, dite mésoscopique, à partir de calculs par éléments finis. / The purpose of this study is to investigate crack growth of multi-perforated structures when loading can vary from small scale yielding to large scale yielding conditions. In this study we focus on combustion chambers of aerospace engines. The material used in crack growth tests is the Haynes 188, a cobalt based superalloy, specially developed for this type of applications. Studies on crack growth of multi-perforated structures are often made in small scale yielding conditions. These studies have to be extended to large scale yielding conditions.In order to study interactions between cracks and perforations, an original specimen has been developed. The specimen is perforated in the center by three holes inspired by cooling holes of combustion chambers. Fatigue crack growth tests at 900°C have been conducted with loads from small scale to large scale yielding conditions. These tests were used to study life of a base pattern. Using experimental stresses and strains, tests were modeled at a macroscopic scale with an energy based crack growth model. In order to improve experimental results description, tests were modeled at an intermediate mesoscopic scale using finite element calculations.

Orientadores: Nelson Adami Andreollo, Gustavo Pereira Fraga / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T11:46:22Z (GMT). No. of bitstreams: 1 Mantovani_MarioEduardodeFaria_M.pdf: 2190658 bytes, checksum: 28ff02547b7c53885ee4d4bbd2ae71fa (MD5) Previous issue date: 2014 / Resumo: Lesões traumáticas do esôfago têm ocorrência rara, seu diagnóstico é difícil, e estão associadas a significativos níveis de morbidade e mortalidade. O objetivo deste estudo foi analisar epidemiologicamente essas lesões, os métodos diagnósticos, e identificar fatores preditivos relacionados a maior morbidade e mortalidade nos pacientes acometidos por este tipo de lesão. Foi realizado estudo retrospectivo, entre 1994 e 2012, com 25 pacientes operados por perfuração esofágica traumática nesse período. Mecanismo de trauma, parâmetros fisiológicos, localização, grau da lesão esofágica, presença de lesões associadas e índices de trauma foram analisados. O sexo masculino foi o mais acometido (88%), com faixa etária entre 15 e 65 anos (média de 29,2 anos), tendo FPAF como principal etiologia (68%) e acometendo principalmente o esôfago cervical (68%). Em 17 pacientes, a confirmação diagnóstica ocorreu por meio de exames subsidiários, sendo que os mais realizados foram Endoscopia Digestiva Alta e Tomografia Computadorizada. Nos demais 8 casos o diagnóstico foi intra-operatório. O intervalo de tempo entre o trauma e a cirurgia foi inferior a 6 horas em 40% dos traumas penetrantes e inferior a 24 horas em 80% dos casos, independente do mecanismo. A sutura acompanhada da drenagem foi o tratamento cirúrgico mais frequente (92% dos casos). A morbidade global foi 72%, sendo a pneumonia a complicação mais prevalente, e 48% decorrentes de complicações relacionadas diretamente à lesão esofágica, sendo a infecção de ferida operatória e a fístula as mais comuns. A mortalidade foi 16%, e ocorreu por choque hipovolêmico (2 casos) ou por sepse (2 casos). Valores de ISS maiores que 25 e grau da lesão OIS > 3 foram preditores para a ocorrência de fístula (24% dos casos). Não foi observado nenhum fator que isolado concorreu para o aparecimento de complicações em geral. Pacientes com idade superior a 54 anos, PAS na admissão inferior a 90 mmHg e TRISS menor que 0,5, foram identificados com maior mortalidade. Conclui-se que os fatores descritos estão associados a maior ocorrência de fístula e mortalidade, porém, por se tratar de casuística retrospectiva e pequena, novos estudos serão necessários para validação dessas informações / Abstract: Injuries to the esophagus are rare, with difficult diagnosis, and are commonly associated with significant morbidity and mortality. The aim of this study was to analyze the epidemiology of these lesions, diagnostic methods, trying to identify predictive factors related to increased morbidity and mortality in this specific population. A retrospective study of 25 patients submitted to surgery with traumatic penetrating esophageal injuries from 1994 to 2012 was performed. Mechanism of injury, physiologic measures, injury location, esophageal injury grade, presence of associated injuries and trauma scores were evaluated. Male patients were the most affected accounting for 88% of the cases, with ages between 15 and 65 years (mean 29.2 years). Gunshot injuries were the main etiology (68%) and happened more often in the cervical topography of the esophagus (68%). In 17 patients ancillary tests were performed to confirm the diagnosis, among these, the most performed tests were Upper Digestive Endoscopy and CT scan. In 8 cases, esophageal injuries were diagnosed intraoperatively. The length of time between trauma and surgery was less than 6 hours in 40% of the penetrating injuries and less than 24 hours in 80% overall, despite the mechanism of injury. The suture followed by drainage was the most frequent surgical method performed (92% of cases). The overall morbidity was 72%, with pneumonia as the most prevalent. 48% of the complications were directly related to the esophageal injury, and operative wound infection and fistula were the most common. Mortality was 16% and occurred in patients with hypovolemic shock (2 cases) or sepsis (2 cases). ISS values greater than 25 and the injury AAST-OIS grade > 3 were predictors for the occurrence of fistula (24% of cases). No other isolated factors were observed to contribute to the surge of general complications. Patients over 54 years old, SBP lower than 90 mmHg and TRISS lower than 0.5 on admission were identified with higher mortality. In conclusion, the factors described herein are associated with higher incidence of fistula and mortality, but due to a small and retrospective case series, further studies are required to validate this information / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências

Die Nekrotisierende Enterokolitis (NEK) und die Fokale Intestinale Perforation (FIP) sind schwere Erkrankungen, die in den ersten Lebenswochen von Frühgeborenen auftreten können und durch den Grad der Unreife (niedriges Gestationsalter und Geburtsgewicht) gefördert werden. Als weitere Einflussfaktoren werden insbesondere die Ernährung, Medikamente (prä- und postnatale Steroide, Antibiotika, H2-Blocker, Morphin, Indometacin, Ibuprofen) sowie perinatale Faktoren (Tokolyse, vorzeitiger Blasensprung, AIS und andere Infektionen der Mutter) kontrovers diskutiert. Diese Variablen und das resultierende Outcome wurden anhand der am UKL im Zeitraum von Januar 2008 bis Dezember 2014 geborenen Frühgeborenen mit einem Geburtsgewicht von unter 750 g retrospektiv untersucht. In die Analyse eingeschlossen wurden 168 Kinder, von denen 21 Kinder (12,5 %) eine NEK und 9 Kinder (5,4 %) eine FIP entwickelten. Die Analyse der Einflussfaktoren auf die Kinder und ihr weiteres Leben wurde in die Analyse der Gesamtpopulation (alle 138 gesunden Kinder gegenüber den 30 erkrankten Kindern), sowie mehrere Subpopulationen (alle vor der vollendeten 25. SSW geborenen Kinder und ein Vergleich der an NEK mit den an FIP erkrankten Kindern) aufgeteilt. Ein niedriges Geburtsgewicht sowie ein jüngeres Gestationsalter zur Geburt sind entscheidende Einflussfaktoren auf die untersuchten Erkrankungen. Ebenso zeigt sich ein vermehrtes Auftreten von NEK/FIP bei niedrigem Nabelschnur-pH-Wert (Mittelwert NEK/FIP: 7,22; Mittelwert gesund: 7,28), niedrigem Hämatokritwert (Mittelwert NEK/FIP: 40,5; Mittelwert gesund: 46,4), schlechter respiratorischer Situation sowie Ibuprofen- und Opioideinsatz. Kein Einfluss ließ sich durch die pränatale Steroidgabe, ein AIS, den Einsatz von Tokolyse, einen vorzeitigen Blasensprung, den Apgar-Wert sowie durch eine Pantoprazol- oder Antibiotikaverabreichung nachweisen. Erkrankte Kinder hatten eine um 7 % erhöhte Mortalität, verbrachten eine längere Zeit im Krankenhaus (im Schnitt 36 Tage länger), hatten ein höheres Entlassungsgewicht (rund 630 g mehr) und wurden erst später voll enteral ernährt (im Mittel 21 Tage später) als nicht erkrankte Kinder. Die erste Fütterung erhielten die später erkrankten Kinder 6 Stunden später als Kinder, die nicht erkrankten. Ebenso erhielten die später an einer NEK/FIP erkrankten Kinder länger Glucose, bevor sie Frauenmilch gefüttert bekamen und schieden seltener aus (Stuhlgang und Erbrechen/Spucken). Der Einsatz postnataler Steroide hatte einen Einfluss auf die Auftretenswahrscheinlichkeit einer FIP (67 %), aber nicht einer NEK (19 %). Weitere Studien zur klareren Differenzierung der neu gefundenen Faktoren Nabelschnur-pH-Wert und Hämatokritwert sind nötig, um die Erkrankungen gegebenenfalls früher zu erkennen, entsprechend zu therapieren und damit die Mortalität zu reduzieren. Die vorliegenden Daten verdeutlichen, dass die FIP und die NEK im Hinblick auf das klinische Management zusammen analysiert werden können.

Idag, nästan 40 år efter att Miljonprogrammet stod klart, är renovering och ombyggnation av fastigheterna högaktuellt. White Arkitekter har som ett led i detta tilldelats ett renoverings- och ombyggnadsprojekt i Norra Stockholm som innefattar två fastigheter uppförda under Miljonprogrammet. Detta examensarbete behandlar återvinning av de befintliga plåtfasaderna på ovannämnda fastigheter. White Arkitekter vill undersöka möjligheterna att genom återvinning använda ursprungsmassan för tillverkning av nya fasader i perforerad plåt till samma fastigheter. Syftet är att redovisa materialets livscykel med hänsyn till miljön samtidigt som anknytningen till Miljonprogrammet bevaras. För att besvara frågeställning har en bit av fasadplåten undersökts i syfte att identifiera plåtmaterialet. Genom att ta reda på plåtens densitet har aluminium fastställts som material. Kontakt har tagits med flertalet företag som är involverade i återvinningsprocessen – från slätplåt till perforerad plåt. I rapporten redovisas alla aktörer och steg i processen. Idén grundas på Cradle to Cradle som är en teori utvecklad av den tyske kemisten Michael Braungart och den amerikanske arkitekten William McDonough. Teorins grundtanke baseras på att eliminera avfall som koncept och istället se det som näring till antingen teknologiska- eller biologiska processer. Aluminium och andra metaller är exempel på material i den teknologiska cykeln. Med dagens återvinningsprocesser förlorar de dock sitt värde och kan inte användas till samma syfte. Återvinning av aluminium besparar dessutom hela 95 % av den energi som åtgår vid tillverkning av primäraluminium. Då Cradle to Cradle ännu inte fått någon större genomslagskraft i Sverige har flera hinder stötts på. I rapporten framgår att det inte finns något smältverk i Sverige som separerar olika aluminiumlegeringar från varandra. Allt aluminium som återvinns i Sverige blir i slutändan till gjutgods. För att nå önskade resultat och påvisa den faktiska möjligheten med projektet kontaktades ett skrotbaserat smält- och valsverk i Norge. Sammanfattningsvis är projektet fullt genomförbart både i teorin och i praktiken, det gäller bara att hitta rätt samarbetspartners. / Approximately 40 years since the completion of the Swedish Million Programme, renovation and rebuilding of the real estates are highly prioritized. White Architects has been assigned a renovation and rebuilding project in Northern Stockholm which encompasses two real estates completed during the Million Programme. This thesis examines the recycling of existing sheet metal facades on the mentioned properties. White Architects want to explore the possibilities of using the original material to produce new facades through recycling. The aim is to present the material’s lifecycle, while considering environmental conditions, in connection to the Million Programme. To answer the question at hand, a sample of the sheeting has been investigated in order to identify the material. The material has been determined as aluminum through the identification of the plate’s density. A number of companies, which have been involved in the recycling process of going from plain sheet to perforated sheet, have been contacted. This thesis presents the different stakeholders and stages in the recycling process. The idea is based on Cradle to Cradle which is a theory developed by the German chemist Michael Braungart and American architect William McDonough. The theory's basic concept is based on eliminating waste by seeing waste as fuel for technological or biological processes. Aluminium and other metals are examples of materials that can be used in the technological cycle. With today's recycling processes they lose their value and cannot be reused for the same purposes. Recycling aluminum saves up to as much as 95% of the energy which is consumed in the primary production. When the Cradle to Cradle theory had yet to have any significant impact in Sweden, several obstacles were encountered. This report shows that there is no smelter in Sweden which separates the different aluminum alloys. All aluminum recycled in Sweden will end up as castings. To achieve the desired results and demonstrate the real possibility of the project, a scrap based smelting and rolling mill in Norway was contacted. To summarize, the project is entirely feasible both in theory and in practice, as long as the right collaboration partners are involved.

No description available.

Einleitung: Strukturelle Defekte der gastrointestinalen Hohlorgane stellen ein allgegen-wärtiges Problem im klinischen Alltag dar. Sie entstehen meist auf dem Boden einer ent-zündlichen oder tumorösen Grunderkrankung und können außerdem traumatisch sowie durch medizinische Eingriffe hervorgerufen werden. In der Folge kommt es zur Kontami-nation des umliegenden Gewebes mit Magen- bzw. Darminhalt, wodurch deletäre Folgen wie eine systemische Infektion, also eine Sepsis mit Multiorganversagen drohen können. Vor diesem Hintergrund sind gastrointestinale Defekte immer als potenziell lebensbedroh-lich für den Patienten zu betrachten. Die adäquate und kausale Behandlung erfolgt je nach Ätiologie und Zustand des Patienten durch eine Operation oder eine endoskopische Inter-vention. Hierzu stehen zahlreiche etablierte, operative und interventionelle Therapieme-thoden zur Verfügung. In manchen Fällen stoßen die etablierten Techniken jedoch an ihre Grenzen. Bei Patienten mit schwerwiegenden Komorbiditäten oder im Rahmen neuer me-dizinischer Verfahren sind Innovationen gefragt. Die Grundidee der vorliegenden Arbeit ist die Entwicklung einer biotechnologischen Therapieoption zur Versorgung gastrointesti-naler Hohlorganperforationen. Methoden: Zur Durchführung einer Machbarkeitsstudie wurden zehn Göttinger Mi-nischweine in zwei Gruppen mit jeweils 5 Tieren aufgeteilt. Den Tieren der Experimental-gruppe wurden Hautbiopsien entnommen und daraus Fibroblasten isoliert, welche vo-rübergehend konserviert wurden. Unter Verwendung von azellularisiertem Schweinedarm erfolgte die Herstellung von Implantaten nach den Prinzipien des Tissue Engineerings. Die Tiere beider Gruppen wurden einer Minilaparotomie und einer ca. 3cm-Inzision der Ma-genvorderwand unterzogen. Die anschließende Versorgung wurde in der Experimental-gruppe durch Implantation der neuartigen Konstrukte erzielt. In der Kontrollgruppe wur-de im Sinne des Goldstandards eine konventionelle Naht durchgeführt. Anschließend wurden die Tiere für vier Wochen beobachtet. Eine bzw. zwei Wochen nach dem pri-mären Eingriff wurde bei allen Tieren beider Gruppen eine Laparoskopie bzw. Gastrosko-pie durchgeführt. Am Ende der klinischen Observationsphase wurden die Versuchstiere getötet und die entsprechenden Magenareale zur histologischen Untersuchung explantiert. Ergebnisse: Die Herstellung der Implantate konnte auf der Basis standardisierter zellbio-logischer Methoden problemlos etabliert werden. Alle Tiere beider Gruppen überlebten den Primäreingriff sowie das vierwöchige Nachbeobachtungsintervall und zeigten dabei keine klinischen Zeichen möglicher Komplikationen. Die durchgeführten Laparoskopien und Gastroskopien ergaben bei keinem der Tiere Hinweise auf Leckagen oder lokale Infek-tionsprozesse. Die histologische Aufarbeitung zeigte im Bereich des ursprünglichen De-fekts eine bindegewebige Überbrückung sowie ein beginnendes Remodeling der Magen-schleimhaut in beiden Gruppen. Schlussfolgerungen: Durch die Verknüpfung von Einzelprozessen der Zellkultur und dem Großtier-OP konnte ein neues Verfahren zum Verschluss gastrointestinaler Defekt erfolgreich demonstriert und etabliert werden. Das Projekt konnte reibungslos durchge-führt werden und lieferte Ergebnisse, die dem Goldstandard nicht unterlegen waren. Auf-grund der kleinen Fallzahl und weiterer methodischer Limitationen sind jedoch nur einge-schränkt Schlussfolgerungen möglich, weshalb die Durchführung größerer und gut geplan-ter Studien notwendig ist. Die Erkenntnisse dieser Pilotstudie liefern eine solide Basis für die Planung weiterführender Untersuchungen. / Introduction: Structural defects of the gastrointestinal hollow organs are a common problem in clinical routine. They mostly arise from inflammatory or malignant patholo-gies as well as trauma or medical procedures. Contamination of adjacent tissue with fae-ces is a consequence of this, which can lead to systemic infection e.g. sepsis with multiple organ failure. Bearing this in mind gastrointestinal defects are always potentially life-threatening for the patient. Considering the aethiology and the patient’s general condition an appropriate therapy namely operation or endoscopic intervention will be performed. Though, these techniques have limitations in certain cases. For example there are patients with severe comorbidities or history of previous operations. And there are also new sur-gical procedures emerging. Therefore, innovations are needed in this field. The main purpose of the present study is the fabrication of a new biotechnological method for therapy of gastrointestinal hollow organ perforation. Methods: A feasibility study with Göttinger Minipigs was perforemd. Ten animals were randomly split up in two groups regarding closure technique . Skin biopsies were ob-tained from the animals of the experimental group (n=5) in order to obtain dermal fibro-blasts. Using acellularised porcine small intestine seeded with the autologous dermal fi-broblasts implants were manufactured following the principles to tissue engineering. All animals underwent laparotomy and a 3cm gastrical incision. Subsequently, animals of the experimental group received a novel implant in order to close the defect. Animals of the control group received a conventional suture as a gold standard technique. All animals were observed for four weeks. One and two weeks after primary surgery all animals un-derwent laparoscopy and gastroscopy respectively. Observation was completed after four weeks and all animals were euthanized. Relevant specimens of the gastric wall were ex-planted for histological examination. Results: Fabrication of the implants was based on well-established cell cultural methods. All animals survived within four weeks after primary surgery and showed no signs for possible complications. Neither laparoscopy nor gastroscopy revealed leakage or local infection in both groups. Histological examinations showed connective tissue in the de-fect-area predominantly but also initial remodeling of gastric mucosa. Conclusions: In this trial, a novel method based on cell culture methods and surgery were combined creating a new technique for closure of gastrointestinal defect. The pro-ject was carried out smoothly and results showed non-inferiority compared with the gold standard. Though, evidence generated from this study is limited due to the small scaled design and methodological issues. Thus, further investigations with larger animal groups and proper planning are required. Nevertheless, this pilot study will contribute to im-provement of trial designs in the future.

Nos últimos anos, houve uma tendência na busca por substâncias reguladoras que pudessem otimizar o processo de cicatrização de membranas timpânicas (MTs) perfuradas. Objetivos: Determinar os efeitos da utilização da insulina tópica e da biomembrana de látex natural, de forma isolada e em associação, no processo de cicatrização de perfurações traumáticas de MTs. Materiais e Métodos: MTs de 61 ratos Wistar foram perfuradas nas porções anterior e posterior ao cabo do martelo. Os animais foram divididos em quatro grupos: Controle, Insulina, Látex e Insulina+Látex. No grupo Insulina, as perfurações foram tratadas com uso tópico de insulina regular. No grupo Látex, tratadas com biomembrana de látex natural. No grupo Insulina+Látex, tratadas com associação da insulina e da biomembrana de látex. As MTs foram avaliadas por técnicas histológicas com três, cinco e sete dias após sua perfuração traumática. Foram analisadas as morfometrias das espessuras das camadas epitelial, fibrosa e mucosa; tamanho da perfuração; área de secção transversal da MT; avaliação semiquantitativa e qualitativa da produção de colágeno por microscopia de polarização; e avaliação imuno-histoquímica das células epiteliais, dos miofibroblastos e da vascularização. Resultados: A insulina e a biomembrana de látex anteciparam o fechamento das perfurações traumáticas de MTs (p<0,01); estimularam precocemente o aumento da espessura da camada epitelial externa (p<0,01); promoveram aumento precoce da espessura da camada fibrosa (p<0,01); contribuíram para a maior identificação do anticorpo anti-panqueratina como marcador epitelial (p<0,05); aumentaram a marcação do anticorpo anti-alfa-actina de músculo liso (p<0,05), caracterizando maior proliferação de miofibroblastos. A insulina, isoladamente, provocou maior formação do colágeno tecidual (p<0,05), com fibras colágenas mais espessas e melhor organizadas (p<0,05). Conclusão: A insulina e a biomembrana de látex natural, de forma isolada e em associação, aceleraram o processo de cicatrização de perfurações traumáticas de MTs. / In recent years, there has been a tendency to search for regulatory substances that can optimize the healing process of perforated tympanic membranes (TMs). Objectives: To determine the effects of using topical insulin and natural latex biomembrane, alone or in combination, in the healing process of traumatic perforations of TMs. Methods: TMs of 61 Wistar rats were perforated in two sections, anterior and posterior to the malleus. The rats were divided into 4 groups: Control, Insulin, Latex, and Insulin+Latex. The Insulin group was treated with topical regular insulin. The Latex group was treated with natural latex biomembrane. The Insulin+Latex group was treated with a combination of insulin plus latex biomembrane. The TMs were histologically examined 3, 5, and 7 days post-perforation through morphometric analysis of the thickness of the epithelial, fibrous, and mucosal layers; size of the perforation; cross sectional area of the TM; semiquantitative and qualitative evaluation of the collagen production by polarization microscopy, and immunohistochemical evaluation of epithelial cells, myofibroblasts, and vascularization markers. Results: Insulin and latex biomembrane accelerated the healing process of the perforated TMs (p<0.01); stimulated early thickening of the outer epithelial layer (p<0.01); promoted premature increase in the thickness of the fibrous layer (p<0.01); contributed to a larger identification of anti-pankeratin antibody as epithelial marker (p<0.05); increased labeling of anti-alpha smooth muscle actin antibody (p<0.05), indicating greater proliferation of myofibroblasts. When insulin was used alone, it resulted in greater formation of collagen tissue (p<0.05), with thicker and better-organized collagen fibers (p<0.05). Conclusion: Insulin and natural latex biomembrane, used alone or in combination, accelerated the healing process of traumatic perforations of TMs.

No description available.