Made available in DSpace on 2014-10-09T12:43:12Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:56:29Z (GMT). No. of bitstreams: 1 06480.pdf: 11629965 bytes, checksum: bb8ef426792486d33f67cd7e2123cc6a (MD5) / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Bakgrund: Venösa bensår är ingen sjukdom utan ett symtom som orsakas av bakomliggande faktorer. Det är framförallt äldre personer som har en ökad risk för sårbildning. Sjuksköterskan är ansvarig för att utföra en bedömning av såret inför val av behandling. Syfte: Att beskriva sjuksköterskors bedömning av venösa bensår hos patienter inom hemsjukvården. Metod: Studien är en kvalitativ intervjustudie med induktiv ansats. Data samlades in genom sex semistrukturerade intervjuer. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier: Sjuksköterskans tillvägagångssätt vid bedömning, sjuksköterskan och patienten tillsammans i en bedömning, sjuksköterskans behov av erfarenhet, stöd och utveckling i bedömning. Sårets egenskaper och fastställande av bakomliggande orsak var av stor betydelse. Likaså poängterades vikten av att göra en helhetsbedömning av patienten, vilket visade sig både ha positiva och negativa sidor relaterat till patientens hemmiljö. Kontinuerlig utbildning och stöd från kollegor ansågs vara till stor hjälp vid bedömning av patienter med venösa bensår. Slutsats: Det konstaterades att bedömningen av venösa bensår upplevs svår, innehåller flera moment samt att praktiken inte alltid stämmer överens med teorin. För att försäkra att patienten får de bästa förutsättningarna till en god sårläkning bör sjuksköterskan se till hela människan och varje patients enskilda behov. / Titel: Nurse's assessment of venous leg ulcers in home based care Background: Venous leg ulcers is not an illness, but a symptom caused by underlying factors. It is mostly elderly people which have an increased risk for ulceration. The nurse is responsible for making the assessment of the ulcer, before choice of treatment. Aim: To describe nurse's assessment of venous leg ulcers in patients within home based care. Method: The study is qualitative interview study with an inductive approach. Data was collected through six semi- structured interviews. The material was analysed with qualitative content analysis. Results: The analysis resulted in three categories: Nurses approach to assessment, the nurse and the patient together in an assessment, nurses needs for experience, support and development in assessment. The ulcer's characteristics and determination of underlying cause were of great importance. Similarly, the importance of making a comprehensive assessment of the patient was emphasized, which proved to have both positive and negative sides related to the patient's home environment. Continuous education and support from colleagues were of great help in assessing patients with venous ulcers. Conclusion: It was confirmed that the assessment of venous leg ulcers is experienced complex, containing several moments, and that practice and theory are not always consistent. To ensure that the patient gets the best prerequisites for good wound healing, the nurse should look after the entire person and patient's individual needs.

Orientador: Joel Mesa Hormaza / Resumo: A úlcera péptica é provocada pelo desequilíbrio entre fatores lesivos e protetores das mucosas gástrica e duodenal, em consequência a fatores endógenos ou exógenos aos tecidos. Para seu tratamento, algumas plantas são popularmente empregadas e demonstram eficácia semelhante ou superior aos fármacos geralmente utilizados, ocasionando menores efeitos adversos. Apesar de várias pesquisas na área, a compreensão do mecanismo gastroprotetor dos compostos fitoterápicos ainda não é completa. Assim, com o objetivo de contribuir para a compreensão da ação farmacológica dos extratos de três plantas medicinais (Alchornea glandulosa, Davilla elliptica e Davilla nitida), foi realizada uma análise da distribuição elementar dos constituintes das amostras de mucosas gástricas de ratos tratados com os extratos vegetais e que tiveram úlceras gástricas induzidas por álcool ou por droga anti-inflamatória não-esteroidal (DAINE). O experimento foi realizado no Laboratório Nacional de Luz Síncrotron (LNLS) e permitiu a análise dos elementos Cl, Ca, Mn, Fe, Cu e Zn que contem relação com a formação ou neutralização das úlceras pépticas. De acordo com os mapas da distribuição dos elementos, foi possível detectar alta concentração de Fe, Cu e Zn no interior da lesão das amostras de úlcera induzida por DAINE, e de Cu, Zn e Cl no interior da lesão das amostras induzidas por álcool. Nas amostras de úlcera induzida por DAINE e tratadas com Alchornea glandulosa, as concentrações de Ca, Cu e Fe aumentaram. N... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The peptic ulcer is caused by the imbalance between harmful and protective factors of the gastric and duodenal mucosa, as a consequence of factors endogenous or exogenous to the tissues. For its treatment, some plants are popularly employed and demonstrate efficacy akin or superior to the drugs normally used, leading to less adverse effects. Although much research has been conducted in the field, the understanding of the gastroprotective mechanism of phytotherapic compounds is still not complete. Therefore, aiming to advance the understanding of the pharmacological action of the extracts of three medicinal plants (Alchornea glandulosa, Davilla elliptica e Davilla nitida), we conducted an analysis of the elemental distribution of constituents within samples of gastric mucosa from rats treated with phytoterapic extracts and affected with peptic ulcers induced by alcohol or nonsteroidal anti-inflammatory drugs (NSAIDs). The experiment was performed at the Brazilian Synchrotron Light Laboratory (LNLS) and allowed for the analysis of the elements Cl, Ca, Mn, Fe, Cu and Zn that are connected to peptic ulcers development or inhibition. According to the elemental distribution maps, it was possible to detect high concentrations of Fe, Cu and Zn inside the lesion from the NSAID-induced ulcer samples, and of Cu, Zn and Cl inside the lesion from the alcohol-induced ulcer samples. In NSAID-induced ulcer samples treated with Alchornea glandulosa, Ca, Cu and Fe concentrations were augmented... (Complete abstract click electronic access below) / Doutor

This study attempted to investigate the impact of new technology, specifically tele-advice on community nurses' care of leg ulcers. Firstly, a stratified randomised controlled study was designed to measure the impact of using this technology on their levels of wound knowledge and confidence. An individual self-test questionnaire and an attitudinal scale measured nurses' knowledge and confidence respectively both pre and post-intervention. Secondly, a new visual wound assessment tool was designed to represent the state of the wound by a single numerical value; the State of the Wound Index (SWI). Thirdly, the impact of nurses' knowledge, confidence and patient variables was explored to assess their impact on the state of the wound as represented by SWI. The sample consisted of thirty-eight registered primary care nurses from two local NHS trusts in South Wales and their corresponding 38 patients with venous leg ulcers. Nurses were stratified according to their qualifications into experimental or control groups. Both groups were shown to have comparable levels of knowledge and confidence pre-intervention. Nurses in the experimental group received expert tele-advice by a Clinical Nurse Specialist (CNS) over a 12 week period regarding the care of their patient's leg ulcer, whilst those in the control group continued to care for their leg ulcer patients in the traditional way. hi the experimental group, nurses' level of knowledge increased significantly (p=0.02) whilst no improvement was observed for the control group. In terms of confidence, the experimental group reached near significance when extremely positive statements were excluded with no improvement observed for the control group. Results show that the intervention had a positively significant impact on nurses' wound care knowledge and level of confidence. A set of 18 tele-transmittable wound factors was identified by a panel of wound experts. These factors were ranked by another independent panel of leg ulcer experts and no significance could be established in their order of importance. These factors were then examined for their highest and lowest possible estimates for every wound in the sample both pre and post intervention using a Visual Analogue Scale (VAS). These estimated values formed the basis for 95% confidence interval estimates from which 100 virtual nurse assessed values were generated. These values were then used to generate SWI. This new index ranged from 0 (best possible state) to 100 (worse possible) and was seen to reliably increase when the wound deteriorated and decrease as the wound improved. Linear regression models were built to establish the relationship between SWI, patient variables and nurses' knowledge and confidence levels pre and post-intervention. These indicated that knowledge and confidence can have a positive impact on the healing process. This study has shown that there is great potential for the use of tele-advice in community nurses' care of leg ulcers. For this to succeed, it is recommended that further pre and post registration nurse training is provided to enhance their knowledge in wound care, especially in the areas of physiology and wound assessment.

Magister Chirurgiae Dentium - MChD / Oral ulcers and oral thrush could be indicative of serious illnesses such as oral cancer, HIV and other sexually transmitted infections (STIs), among others. There are many different health care workers that can be approached for advice and/or treatment for oral ulcers and oral thrush (sometimes referred to as mouth sores by patients), including pharmacists. In fact, the mild and intermittent nature of oral ulcers and oral thrush may most likely lead the patient to present to a pharmacist for immediate treatment. In addition, certain aspects of access are exempt at a pharmacy such as long queues and waiting times, the need to make an appointment and the cost for consultation. Thus pharmacies may serve as a reservoir of undetected cases of oral cancer, HIV and other STIs. Aim: To determine how community pharmacists in the Western Cape manage oral ulcers and oral thrush. Objectives: The data set included the prevalence of oral complaints confronted by pharmacists, how they manage oral ulcers, oral thrush and mouth sores, their knowledge about these conditions, and the influence of socio-economic status (SES) and metropolitan location (metro or non-metro) on recognition and management of the lesions. Method: A cross-sectional survey of community pharmacists in the Western Cape was conducted. A random sample of pharmacies was stratified by SES (high and low), and metropolitan location. A structured questionnaire was used to conduct a telephonic interview. The questionnaire was faxed to pharmacists 24 hours prior to the interview. Pharmacists were also telephoned 24 hours prior to the interview, but after the questionnaire was faxed, in order to gain informed consent for participation in the study, and to confirm a convenient time to conduct the interview. Results: Two thirds (63%) of pharmacists managed oral problems nearly everyday, and 30% managed these more than once a week. More pharmacists in high SES (73%) areas managed oral problems nearly everyday (Fisher Exact, p=0.0005). Just over half (56%) and 49.2% of pharmacists said that ulcers and thrush, respectively, was the most common oral problem that they encounter. The prevalence of oral thrush was significantly higher in non-metro areas (58%) (RR=0.7 (0.5-1.0) ChiSquared=4.0, p=0.04), and it was also significantly lower in low SES areas (RR=1.6 (1.1-2.4), Chi Squared=6.5, p=0.01). Half the pharmacists reported that they would manage the patient comprehensively. Most would take a history but the quality of the history is poor, thereby compromising their ability to manage these cases appropriately. Only a third would refer a simple oral ulcer, thrush or mouth sore to a doctor/dentist but all pharmacists would have referred a longstanding ulcer to a doctor/dentist. In terms of knowledge, only 33% of pharmacists were aware that oral ulcers and thrush could be indicative of HIV infection, and only 8% linked oral ulcers with oral cancer. There was no discernable pattern of management of oral ulcers and thrush, or of knowledge of the link between these lesions with underlying diseases, by SES and metropolitan locations (Chi Squared, Fisher Exact, p>0.05). Conclusion: The result of this study strengthens the current view of pharmacists as oral health advisors as they encounter oral problems regularly, most commonly oral ulcers and oral thrush. Therefore, the pharmacist can play an important role in the early detection of HIV and oral cancer. However many pharmacists fail to refer these cases to a dentist. Most pharmacists lacked specific knowledge about the relationship of oral ulcers and thrush with underlying conditions, which may explain why many pharmacists are not managing these cases correctly. There is a definite need to train pharmacists at both an under- and post-graduate level with specific emphasis on the proper management of oral ulcers, oral thrush and mouth sores, as well as comprehensive training that outlines why vigilant management of oral ulcers and oral thrush is necessary. / South Africa

Thesis objectives: The diploma thesis deals with the issue of prevention of skin lesions in perioperative care. In the theoretical part, the current state of knowledge is presented concerning the pressure ulcers identification due to the persisting real problems in differential diagnostics in clinical practice. Further, the thesis deals with the issue of wet and thermal lesions, which occur also during the perioperative care. In the empirical part of the diploma thesis, the first objective was to find the frequency of documented occurrence of decubital lesions in connection with the surgery in Jihlava Hospital for a period of one year. The second objective of the thesis was to find out whether, and what barriers exist when using specific preventive measures. The last aim of the diploma thesis was to compare the efficiency of preventive measures from the point of view of perioperative nurses and nurses from service units. Three hypotheses were formulated to meet the objectives of the thesis. Method for achieving the objectives: The set objectives were achieved through a retrospective analysis of the hospital information system data and a quantitative questionnaire survey. The study included nurses working in surgery, orthopaedics, traumatology, intensive care units and perioperative nurses in Jihlava Hospital. The total number of respondents was 140. Scientific benefits of the thesis: The research implies that the use of prophylactic aids in pre-operative preparation contributes significantly to reducing the risk of skin lesions. The addressed set of nurses did not indicate any serious barriers to their application and, on the contrary, considered it to be very effective. The results of the thesis can be used in practice, especially in a specific health facility for further care improvement. The findings and conclusions: On the research group we have verified that the declared use of preventive strategies in the area of prevention of lesions in perioperative care differs according to the type and focus of the workplace; (p = 0.000) the least frequent use was declared by the general nurse from orthopaedics, however, the methods used did not differ (p = 0,220). In addition, we found out that there was a statistically significant difference in the opinion on efficiency of prophylactic covering in lesion prevention (p = 0.001, the worst evaluation was by the respondents from orthopaedics) but only 2 respondents stated negative experience with their use.

Submitted by FERNANDO CHRISTIANO GABRIEL MORELLI null (fcgmorelli@yahoo.com.br) on 2016-02-12T17:49:35Z No. of bitstreams: 1 Fernando - Tese versão final Repositório UNESP.pdf: 1900802 bytes, checksum: a8c9044a1f5a46e203d3432398fc0a07 (MD5) / Approved for entry into archive by Sandra Manzano de Almeida (smanzano@marilia.unesp.br) on 2016-02-15T11:32:07Z (GMT) No. of bitstreams: 1 morelli_fcg_dr_araca.pdf: 1900802 bytes, checksum: a8c9044a1f5a46e203d3432398fc0a07 (MD5) / Made available in DSpace on 2016-02-15T11:32:07Z (GMT). No. of bitstreams: 1 morelli_fcg_dr_araca.pdf: 1900802 bytes, checksum: a8c9044a1f5a46e203d3432398fc0a07 (MD5) Previous issue date: 2016-02-01 / Erosões e úlceras são achados comuns no abomaso e causam preocupação econômica nos mais variados sistemas de produção de gado. Muitos fatores podem predispor ao aparecimento de úlceras e acúmulo de gases no abomaso, incluindo alimentos grosseiros, estresse ambiental, deficiências de vitaminas e minerais e infecções bacterianas. Essas úlceras podem ser subclínicas, sendo descobertas nas necropsias ou após o abate do animal, ou levarem à redução da motilidade do órgão, prejudicando o fluxo do seu conteúdo e causando transtornos digestivos graves e até ao aparecimento de síndromes semelhantes à indigestão vagal. Existem informações a respeito da resposta do sistema imune na maior parte das mucosas do trato gastrintestinal de não-ruminantes e ruminantes, porém são raras a respeito do abomaso. Os objetivos desse estudo foram detectar os níveis de citocinas (IL-17A, IFN-γ, TNF-α, IL-10, IL-6, IL-4, IL-2) no conteúdo abomasal em bovinos de corte, determinar o perfil Th1 ou Th2 dessas citocinas em animais com úlceras de grau 1 e 2 na região cárdica abomasal e comparar esses valores com os níveis de citocinas de animais sem úlceras (controle), em amostras colhidas em abatedouro, para auxiliar na compreensão da fisiopatologia do processo inflamatório local. A avaliação macroscópica e a classificação das úlceras foi realizada por meio de exames visual e histológico em amostras de tecidos da parede da região cárdica abomasal ulcerada. Os níveis de citocinas produzidas do líquido abomasal dos animais com ou sem úlceras foram avaliados por citometria de fluxo (método Cytometric Bead Array). As citocinas citadas foram detectadas no líquido do abomaso dos bovinos. Não houve diferença na liberação das citocinas entre os grupos com úlceras e o grupo sem úlcera, indicando um equilíbrio entre perfis Th1 e Th2 da resposta inflamatória. / Erosions and ulcers are common findings in the abomasum and cause economic concern in several livestock production systems. Many factors may predispose to ulcers and bloat in the abomasum, including roughage, environmental stress, deficiencies of vitamins and minerals and bacterial infections. These ulcers may be subclinical and are found during necropsy or after slaughter, or lead to reduction of abomasal motility, hindering the flow of your content and causing serious digestive disorders and even the appearance of syndromes similar to vagal indigestion. There are some studies evaluating the immune system response in most of the mucous membranes of the gastrointestinal tract of non-ruminants and ruminants, but rarely related to the abomasum. The aims of this study were to investigate the levels of cytokines (IL-17A, IFN-γ, TNF-α, IL-10, IL-6, IL-4, IL-2) in the abomasal fluid of beef cattle, to determine the Th1 or Th2 profile of these cytokines in animals with types 1 or 2 ulcers located in the abomasal cardic region and to compare these levels with those of animals without ulcers (controls), in samples collected in an abbatoir, to help to the understand the pathophysiology of the local inflammatory process. Ulcers from the abomasal cardic region were macroscopicaly evaluated, then classified by histology. Cytokine levels in the abomasal fluid from animals with or without ulcers were evaluated by flow cytometry (Cytometric Bead Array). Cytokines were detected in the abomasum fluid of cattle. There was no difference in the release of cytokines between groups, indicating a balance between Th1 and Th2 profiles of the inflammatory response.

Background: Most patients with leg-ulcers are managed within primary- and community care and a main part of district nurses' duties is to provide leg-ulcer care. Leg-ulcers have an impact on patients' quality of life, health services and society. Previous studies have shown that district nurses have a poor knowledge and fail to work evidence-based within this field. It is therefore of great interest to explore the district nurses' experiences of this matter, as an evidence-based approach is essential to optimize wound-healing and prevent re-occurrence. Aim/ objective: The aim of this study was to explore district nurses' experiences of working evidence-based whilst caring for patients with venous leg-ulcers. Method: The study has a qualitative design with an inductive approach. Data has been collected from members in a closed web-site group on social media, containing nurses countrywide, with experience of leg-ulcer care. A questionnaire with open and closed questions was used. Data from the 55 responses received were analysed using qualitative content analysis, which resulted in two main areas related to Competence and Working environment. Results: The main findings concerned the lack of co-operation with other professional groups, shortage of continuous training, unavailability of time, continuity and other resources, inability of patients to comply, and a need for improved management support. Discussions with more experienced nursing colleagues for advice was regarded as highly important and useful. Conclusions: The result shows that organizational structures hindered the district nurses to work evidence-based. This study can contribute to inspiration and increase the awareness in the different levels within the working organization regarding the importance of working evidence-based on this topic.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Gastric ulcer is a world widespread illness that affectes a great number of people and it is correlated to life style, food intake, alcohol and smoke in association or not to stress behavior. The lesions are in association with oxygen reactive species (ROS) production. It is been know that some elements, selenium and zinc, shows great effect scavenger in detoxification of ROS production, avoiding many damages caused by ROS. Based on these considerations, the present study intend to investigate the effect of oral administration of diphenyl diselenide (PhSe)2 and zinc chloride (ZnCl2) in an experimental model of gastric lesion induced by oral administration of ethanol 70% in rats and, particularly the involvement of oxidative stress. For this propose we measured TBARS production, reactive species (RS) levels, ascorbic acid content, total e non-protein thiol groups, superoxide dismutase (SOD) and catalase (CAT) activities from stomach and intestine of rats exposed to ethanol additionally, damage in tissues were measure by micro and macroscopic histopathology analyses. The model of gastrointestinal lesions induced by ethanol is widely used by many authors because it is a model that causes various changes in gastric tissue, exacerbated ROS formation, imbalance in antioxidant defenses and modification of the activity of several enzymes involved in ROS detoxification. In this study, oral ethanol 70% was administered in rats to cause gastric lesions and to enhance oxidative stress. Stomach´s micro and macroscopic analyses showed that (PhSe)2 at low doses (0.01 and 1.0 mg/kg) protected and reverted gastric lesions and attenuated the oxidation alterations caused by ethanol. Similar results could be verified when ZnCl2 (27 mg/kg) was administered orally. ZnCl2 demonstrated to be efficient in to protect and reverse the injuries against gastrointestinal damage caused by ethanol. These elements restored the biochemical parameters to normal values. Macroscopic analyses revealed that both elements, selenium and zinc, could protect and re-epithelialize the stomach. Pre- and post-treatment with (PhSe)2 showed benefic effects against lipid peroxidation measured by TBARS production, wich diminished, even as an enhancement of ascorbic acid content and stomach SOD activity when compared to ethanol. It was also verified for ZnCl2 (27 mg/kg), an ability to protect and to reverse against gastrointestinal damages caused by ethanol, even though this element was able to restore biochemical parameters to control values. Macroscopic analyses showed that ZnCl2 had positive results in prevent and re-epithelialize the mucosa against lesions. ZnCl2 significantly protected and reversed gastrointestinal TBARS and RS production that were enhanced by ethanol as well as prevented and reversed for total SH groups. However, ZnCl2 only protected the diminished in gastrointestinal ascorbic acid content and prevented and restored the decreased of stomach and intestine CAT activity. Therefore, this study is a promising field to development of new drugs and new therapies and also can take to a better understanding of mechanism of action involved in the gastric antioxidant process, even though to enhance the research about elements effects in gastrointestinal ulcers. / A úlcera gástrica é uma doença que afeta um grande número de pessoas no mundo, sendo conseqüência do estilo de vida, dos hábitos alimentares, do alcoolismo e tabagismo associados ou não ao estresse. Essas lesões estão intimamente associadas à produção de espécies reativas de oxigênio (EROs). Sabe-se que elementos como o selênio e o zinco apresentam grande eficiência em eliminar as EROs, evitando assim uma série de danos causados pela formação das mesmas. Assim, o objetivo desse trabalho foi investigar o efeito da administração oral do disseleneto de difenila (PhSe)2 e do cloreto de zinco (ZnCl2) no modelo experimental de lesão gastrointestinal induzido oralmente por etanol 70% em ratos, avaliando o envolvimento do estresse oxidativo. Foram avaliados a produção de espécies reativas ao ácido tiobarbitúrico (TBARS), os níveis de espécies reativas (RS), o conteúdo de ácido ascórbico e de grupos tióis (SH) totais e não protéicos, a atividade da enzima superóxido dismutase (SOD) e da catalase (CAT), bem como os danos teciduais através de análises micro/macroscópicas e histopatológicas do tecido gastrointestinal. O modelo de indução de lesões gastrointestinais por etanol é bastante utilizado por diversos autores, pois causa diversas alterações no tecido gástrico; formação exacerbada de EROs, desequilíbrio nas defesas antioxidantes e modificação na atividade de diversas enzimas responsáveis pela detoxificação das EROs. Nesse trabalho, o etanol 70% foi administrado aos ratos por via oral a fim de induzir lesões gástricas e aumentar o estresse oxidativo no tecido gastrointestinal. Os resultados mostram que nas análises macro e microscópicas de estômago o (PhSe)2, em baixas doses (0,01 à 1,0 mg/kg), reverteu e protegeu o tecido gástrico frente às lesões. O pré- e o pós-tratamento com (PhSe)2 apresentaram efeitos benéficos contra a peroxidação lipídica através da medida dos níveis de TBARS os quais diminuíram, bem como um aumento no conteúdo de ácido ascórbico e aumento na atividade da SOD de estômago de ratos quando comparados ao etanol. O mesmo ocorreu para o ZnCl2 que na dose de 27 mg/kg demonstrou ser eficaz na proteção e reversão das injúrias gastrointestinais causadas pelo etanol, uma vez que restaurou os parâmetros bioquímicos analisados a níveis normais. Na análise macroscópica, o ZnCl2 apresentou resultados positivos na proteção e na re-epitelização do tecido gástrico frente as lesões. O ZnCl2 protegeu e reverteu significativamente os níveis de TBARS e de RS gastrointestinais que foram aumentados pelo etanol, também preveniu e restaurou o decréscimo nos níveis de grupos SH totais de estômago e intestino. Entretanto, o ZnCl2 somente protegeu a diminuição no conteúdo de ácido ascórbico gastrointestinal. O decréscimo na atividade da CAT de estômago e de intestino foi prevenido e restaurado pelo zinco frente às lesões. Portanto, este trabalho trata de um campo promissor para o desenvolvimento de novos fármacos e de novas terapêuticas e poderá nos levar a uma melhor compreensão dos mecanismos de ação envolvidos no processo antioxidante gástrica, bem como contribuir no avanço das pesquisas contra lesões gastrointestinais.

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-06-28T16:55:27Z No. of bitstreams: 1 DissLCCG.pdf: 2545106 bytes, checksum: c1b366332bbc6ade417f933af65b4e9b (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-07-03T19:12:44Z (GMT) No. of bitstreams: 1 DissLCCG.pdf: 2545106 bytes, checksum: c1b366332bbc6ade417f933af65b4e9b (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-07-03T19:12:50Z (GMT) No. of bitstreams: 1 DissLCCG.pdf: 2545106 bytes, checksum: c1b366332bbc6ade417f933af65b4e9b (MD5) / Made available in DSpace on 2017-07-03T19:17:01Z (GMT). No. of bitstreams: 1 DissLCCG.pdf: 2545106 bytes, checksum: c1b366332bbc6ade417f933af65b4e9b (MD5) Previous issue date: 2017-02-10 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / The development of pressure ulcers (PU) in people with spinal cord injury (SCI) is a relevant factor and directly affects the health. Several preventive methods in a wheelchair have been researched for pressure relief, health promotion and disease prevention, such as PU. Some methods such as seating positioning system, different cushions and variable positions as tilt and recline seating systems, are most commonly used to relieve the pressure, and have been studied and achieved significant results for people with SCI in wheelchair. This study aims, thus, to evaluate the pressure redistribution buttock interface / cushion in areas susceptible to UP (sacrum, ischia) for the positions of tilt and recline in the wheelchair, in people with tetraplegia by spinal cord injury. In order to proceed to the research, we analyzed five people of both sexes with tetraplegia by LM, between 18 and 60 years. Was used a characterization form, a wheelchair simulator, ROHO ®High Profile Quadtro Select ™ cushion, a pressure mapping system, adaptations to the simulator and a questionnaire of satisfaction with the use of tilt and recline systems. As results, the pressure relief in the buttocks was better in higher angles, such as 10 ° tilt with 120 ° of recline, 20 ° tilt with 120 ° of recline and 30° tilt with 120° recline. But, even the smaller angulation positions resulted in pressure relief. Therefore, our results indicate that a greater angle of tilt and recline is needed to improve pressure redistribution compared to smaller angles. A position of 30° tilt combined with 120° recline is effective in relieving pressure on the ischial tuberosities and the buttocks. / O desenvolvimento de lesões por pressão em pessoas com lesão medular (LM) é um fator relevante e afeta diretamente o estado de saúde. Diversos métodos preventivos em cadeira de rodas (CR) têm sido pesquisados para alívio de pressão, promoção de saúde e prevenção de doenças como a lesão por pressão. Alguns métodos, como adequação postural, material para a almofada adequada e posições variáveis, como sistemas de assentos tilt e recline são mais comumente utilizados, e têm sido estudados e alcançado resultados significativos para as pessoas com LM em CR. Buscou-se, então, avaliar a distribuição de pressão na interface nádega/almofada em áreas suscetíveis à lesão por pressão (sacro, ísquios) durante as posições de tilt e recline em pessoas com tetraplegia por lesão na medula espinal. Para tanto, participaram desta pesquisa 5 pessoas de ambos os sexos com tetraplegia por LM, entre 18 e 60 anos. Foi utilizado um formulário de caracterização do participante, um simulador de CR, almofada ROHO ®High Profile Quadtro Select™, um sistema de mapeamento de pressão, adaptações para o simulador e um questionário de satisfação quanto ao uso dos sistemas tilt e recline. Como resultados, obteve-se que o alívio de pressão na região das nádegas foi melhor em posições com maiores ângulos, como 20°de tilt com 120° de recline e 30° de tilt com 120° de recline. Mesmo as posições de angulações menores resultaram em alívio de pressão. Portanto, nossos resultados indicam que um maior ângulo de tilt e recline é necessário para melhorar a distribuição de pressão na região das nádegas em comparação com ângulos menores. Uma posição de 30° de tilt combinado com 120° de recline é eficaz no alívio da pressão nas tuberosidades isquiáticas e na região das nádegas.