Objetivo: Este estudo avalia a estrutura do IDATE (Inventário de Ansiedade Traço-Estado) utilizando a análise psicométrica de Rasch, propondo-se ao refinamento e redução do instrumento. Métodos: Consiste em estudo transversal em amostra de 900 pacientes em perioperatório de cirurgias eletivas, com idade variando de 18 a 60 anos e ASA I-III. Informações demográficas foram coletadas empregando-se um questionário estruturado. O instrumento de mensuração IDATE foi aplicado na tarde que antecedia a cirurgia, antes da sedação pré-operatória. Resultados: As escalas de estado e traço de ansiedade foram analisadas separadamente pelo modelo de Rasch. A análise demonstrou invariância no nível de ansiedade traço e estado no formato original de ambas as escalas, resultando em instabilidade no desempenho dos itens. Subsequentemente, a escala refinada foi retestada em duas amostras randomizadas de 300 sujeitos cada, sendo confirmados os resultados. O desempenho foi adequado, independentemente do gênero. Na análise, alguns itens da escala estado foram eliminados (itens 3,4,9,10,12,15 e 20) devido à inadequação ao modelo estatístico. Os itens restantes mostraram unidimensionalidade, independência local e adequado índice de consistência interna. Na escala original de traço, identificaram-se muitas falhas. Primeiro, a escala de resposta tipo Likert 4 pontos provou ser inadequada, e desordens threshold foram encontradas nos 20-itens. A escala original de traço mostrou insuficiente interação e muitos itens individuais mal ajustados. Seguindo a análise e retestando a segunda amostra randomizada, alguns itens foram excluídos (itens 4, 6, 11, 14, 15 e 19). A versão refinada obteve independência local, unidimensionalidade e adequados modelos estatísticos para a fase de sedação pré-operatória. Discussão: Os resultados indicam que a aplicação do modelo de Rasch conduz ao refinamento das escalas clássicas de IDATE estado e traço, sugerindo também que as versões sucintas apresentam desempenho psicométrico mais adequado e estão livres de desordens no limiar de resposta (threshold) e DIF (funcionamento diferencial de itens). / Objetive: This study evaluates the STAI structure using a Rasch psychometric approach and it proposes a refined and shorter STAI version. Methods: A cross-sectional study was performed with 900 inpatients scheduled for elective surgery. Age varied from 18 to 60 years (ASA physical status I-III). Demographic information was collected using a structured questionnaire. The measuring instrument (the State-Trait Anxiety Inventory) was applied to all patients in the afternoon before the surgery, before of the patients Results: Rasch analysis of the state and trait anxiety scales was performed separately. This analysis demonstrated that the original format of state and trait scales fails to show invariance across the trait-state anxiety level, which results in the unstable performance of items. The refined scale was retested in two subsequent random samples of 300 subjects each, and the results were confirmed. The performance was adequate regardless of gender. In the analysis, some items of the state scale (items 3,4,9,10,12,15 and 20) were deleted due to poor fit statistics. The remaining 13 items showed unidimensionality, local independence, and adequate index of internal consistency. Also, the original trait scale displayed several weaknesses. First, the 4 point Likert response scale proved to be inadequate, and threshold disorders were found in all twenty items. Also, the original trait scale showed insufficient item-trait interaction and several individual item misfits. Following the rescoring process, and retesting in a second random sample, items were excluded (namely items 4, 6, 11, 14, 15 and 19). The refined version showed local independence, unidimensionality and adequate fit statistics.receive preoperative sedatives. Discussion: The results indicate that the application of the Rasch Model led to the refinement of the classic state and trait STAI scales. In addition, suggest that these shorter versions present more adequate psychometric performance and are free of threshold disorders and differential item functioning problems.

Made available in DSpace on 2015-04-14T13:53:49Z (GMT). No. of bitstreams: 1 440855.pdf: 1485245 bytes, checksum: ff2f2be9961e9b5370d1793ebde1d602 (MD5) Previous issue date: 2012-07-13 / Introduction: the growth of the elderly population worldwide presents a challenge for active aging with quality of life. As a consequence of increased life expectancy, several organs of the human body age, including the skin. Therefore, the aging population is also a challenge for dermatologists, since the demographic transition also increases skin diseases and changes which need to be managed. This study is justified by the scarceness of epidemiological studies among us, regarding the prevalence of skin manifestations that affect the elderly and their importance as a foundation for the care of geriatric patients. Objectives: To study dermatological problems in elderly residents at a Long Stay Institution (LSI) and in those seen at an Outpatient Clinic and in a ward of a Geriatric Center of Reference in Porto Alegre, state of Rio Grande do Sul (RS), Brazil. Methods: cross-sectional, descriptive and analitcs study performed between August/2010 and May/2011. The people invited to participate in the study were all the elderly residents of a long-stay institution of Porto Alegre from August/2010 to October/2010, all the elderly patients of the Geriatrics Ambulatory of Hospital S?o Lucas from October 2010 to May /2011, and all the elderly hospitalized at the Geriatrics Unit Care of Hospital S?o Lucas from December/2010 to May/2011, 60 years old or over. Data on age, sex, race, schooling, associated illnesses and medications used were surveyed in the patients files. The elderly person or their representative was asked about the family history of skin diseases, and the dermatological manifestations were collected by dermatological exam (inspection and palpation), complemented by the dermatoscopic and histopathological exams when necessary. The descriptive analysis of the data was done by frequencies, means, medians and standard deviations. The Chi-square test was used to compare the frequencies of dermatological manifestations to the frequencies of demographic characteristics and to the frequencies of co-morbidities. Results: Three hundred and twelve elderly people participated in the study, 30.1% male and 69.9% female. The age varied from 60 to 103 years, the mean was 78.4 years (SD=8.9), and the median 79 years. Out of the total number, 60.9% were white, 55.0% had not completed elementary school, 94.6% had associated co-morbidities, and 94.2% used some kind of medication. One hundred and twenty-eight dermatological manifestations were observed, comprising skin, nail and hair changes. The mean number of dermatological manifestation per person was calculated as 18.5 (SD=3.7) and the margin of variation was from 7 to 28 manifestations per elderly person surveyed. Solar melanosis, guttate hypomelanosis, cherry hemangioma, longitudinal striae on the nails, wrinkles, melanocytic nevi, seborrheic keratosis, male androgenetic alopecia, cutaneous xerosis, telangiectasias, absent lunula, interdigital intertrigo of the toes, skin atrophy and poichilodermia were present in over 50% of the participants in this study. Actinic keratosis, white hair, hirsurtism, rhomboid skin, supraciliary madarosis, onycholysis, purpura, onicodystrophy, stellar scar, ochre dermatitis, acrochordon, dermatosis papulosa nigra, comedo and keratosis of the elbows and knees were present in 30 to 50% of the subjects in this study. Dilated pores, female androgenetic alopecia, hypertrichosis of the ears, seborrheic eczema, milium cysts, melasma, plantar callosities, different types of scar, plantar calluses, leukonychia, folliculitis and sebaceous hyperplasia were found in 10 to 30% of the elderly who participated in this study. Solar melanosis was the most prevalent manifestation (97.8%). Seborrheic keratosis (75.0%) was less prevalent among blacks (P=0.006) and in the elderly with DPOC (P=0.047). Cutaneous xerosis was present in 70.8% of the people researched. Guttate hypomelanosis (82?.7%), poichilodermia (50.3%), dilated pores (26.6%) and melasma (15.4%) were less prevalent in LSI (Long Stay Institutions for the Elderly) (P<0.001), and purpura (38.1%) was more frequent in hospitalization (P<0.001). Interdigital intertrigo of the toes (52.6%) occurred more frequently in males (P=0.001), in the brown and black races (P=0.001) and in those with diabetes (P=0.011). Actinic keratosis (46.5%) was more prevalent in the white race (P<0.001) and its prevalence increased with the older age groups (P<0.001). Most frequent ungueal changes were longitudinal striae (81.2%), more prevalent in the LSI (P<0.001), in males ((P=0.003), in the brown race (P=0.,032) and in the older age groups (P<0.001). Supraciliary madarosis (40.1%) was more prevalent in hospitalized patients (P=0.036), in the older age groups (P=0.001) and in those vascular encephalic accident (P=0.011) and pneumonia (P=0.002). Seborrheic eczema (22.4%) was more frequent in males (P<0.001) and in those with dementia (P=0.020). Plantar callosities (12.8%) were less prevalent in hospitalization (P=0.058) and in diabetes (P=0.022). On the other hand, plantar callosities (14.7%) were more prevalent in the Outpatient Clinic (P<0.001). Folliculitis (11.2%) was more prevalent in men (P<0.001). Sebaceous hyperplasia(10.6%) was more prevalent in elderly cancer patients (P=0.030). Conclusion: the variety of dermatological manifestations found in this study reminds one of the need to include skin care in the broad geriatric assessment and in integral care of the elderly. The presence of manifestations secondary to skin aging, infectious lesions, both pre-malignant and malignant, that can be prevented justify measures of Education for Health of the Elderly, for the caregiver, the health teams and the young age groups of the population Considering the skin manifestations observed, the high prevalence of ungueal involvement and the association between sebaceous hyperplasia and cancer in our work, it is suggested that further research be done in this field. / Introdu??o: o aumento da popula??o de idosos em todo o mundo, traz o desafio do envelhecimento ativo com qualidade de vida. Como consequ?ncia ao aumento da expectativa de vida, v?rios ?rg?os do corpo humano envelhecem, inclusive a pele. Logo, o envelhecimento populacional ? um desafio tamb?m enfrentado pelos dermatologistas, pois a transi??o demogr?fica aumenta as doen?as e altera??es cut?neas que necessitam ser manejadas. A escassez de estudos epidemiol?gicos em nosso meio sobre a preval?ncia das manifesta??es cut?neas que acometem o idoso e a import?ncia destes para embasar o atendimento ao paciente geri?trico justificaram a realiza??o desta pesquisa. Objetivos: estudar as manifesta??es dermatol?gicas em idosos residentes em uma Institui??o de Longa Perman?ncia para Idosos (ILPI) e naqueles atendidos no Ambulat?rio e na Interna??o de um Centro de Refer?ncia em Geriatria de Porto Alegre RS. M?todos: estudo transversal, descritivo e anal?tico, realizado entre agosto/2010 e maio/2011. Foram convidados todos os idosos residentes em uma ILPI de Porto Alegre no per?odo de agosto/2010 a outubro/2010, todos os idosos internados no ambulat?rio de refer?ncia em geriatria do Hospital S?o Lucas no per?odo de outubro/2010 a maio/2011 e todos os idosos atendidos na enfermaria geri?trica do Hospital S?o Lucas no per?odo de dezembro/2010 a maio/2011, com 60 anos de idade ou mais. Dados referentes ? idade, ao sexo, ? ra?a, ? escolaridade, ?s doen?as associadas e medica??es em uso foram pesquisados nos prontu?rios dos pacientes. O hist?rico familiar de doen?as de pele foi indagado ao idoso ou seu representante e as manifesta??es dermatol?gicas foram coletadas atrav?s do exame dermatol?gico (inspe??o e palpa??o) complementado pelos exames dermatosc?pico e histopatol?gico, quando necess?rio. A an?lise descritiva dos dados foi feita atrav?s de frequ?ncias, m?dias, medianas e desvios padr?es. Para compara??o das frequ?ncias das manifesta??es dermatol?gicas, com as frequ?ncias das caracter?sticas demogr?ficas e com as frequ?ncias das comorbidades foi utilizado o teste do qui quadrado. A pesquisa iniciou ap?s aprova??o pelo Comit? de ?tica e Pesquisa e os idosos ingressaram no estudo ap?s concord?ncia e assinatura do Termo de Consentimento Livre e Esclarecido. Resultados: participaram da pesquisa 312 idosos (103 da ILPI, 104 do Ambulat?rio e 105 da Interna??o), 30,1% do sexo masculino e 69,9% do feminino. A idade variou dos 60 aos 103 anos, sendo a m?dia de 78,4 anos (DP=8,9) e a mediana de 79 anos. Do total, 60,9% eram brancos, 55,0% n?o haviam completado o n?vel fundamental, 94,6% apresentavam doen?as associadas e 94,2% usavam algum tipo de rem?dio. Foram observadas 128 manifesta??es dermatol?gicas, compreendendo altera??es de pele, unhas e pelos. Calculando-se a m?dia do n?mero de manifesta??es dermatol?gicas por idoso, seu valor foi de 18,5 (DP=3,7) e a margem de varia??o de 7 a 28 manifesta??es dermatol?gicas por idoso pesquisado. Melanose solar, hipomelanose gotata, nevo rubi, estrias longitudinais das unhas, rugas, nevos melanoc?ticos, ceratose seborreica, alopecia androgen?tica masculina, xerose cut?nea, telangiectasias, aus?ncia de l?nula, intertrigo interdigital dos podod?ctilos, atrofia cut?nea e poiquilodermia estiveram presentes em mais de 50% dos participantes deste trabalho. Ceratose act?nica, can?cie, hirsutismo, pele romboidal, madarose supraciliar, onic?lise, p?rpura, onicodistrofia, cicatriz estelar, dermatite ocre, acroc?rdon, dermatose papulosa nigra, comed?o e ceratose de cotovelos e joelhos estiveram presentes entre 30 e 50 % dos sujeitos deste estudo. Poros dilatados, alopecia androgen?tica feminina, hipertricose das orelhas, eczema seborreico, cistos de millium, melasma, calosidades plantares, diferentes tipos de cicatrizes, calos plantares, leucon?quia, foliculite e hiperplasia seb?cea foram constatadas entre 10 e 30 % dos idosos que fizeram parte desta pesquisa. Melanose solar foi a manifesta??o mais prevalente (97,8%). Ceratose seborreica (75,0%) foi menos prevalente na ra?a negra (P=0,006) e nos idosos com DPOC (P=0,047). Xerose cut?nea esteve presente em 70,8% dos pesquisados. Hipomelanose gotata (82,7%), poiquilodermia (50,3%), poros dilatados (26,6%) e melasma (15,4%) foram menos prevalentes na ILPI (P<0,001) e a p?rpura (38,1%) foi mais frequente na Interna??o (P<0,001). Intertrigo dos podod?ctilos (52,6%) foi mais frequente nos homens (P=0,001), nas ra?as parda e negra (P=0,001) e naqueles com diabetes (P=0,011). Ceratose act?nica (46,5%) foi mais prevalente na ra?a branca (P<0,001) e aumentou sua preval?ncia de acordo com o aumento das faixas et?rias (P<0,001). As altera??es ungueais mais frequentes foram as estrias longitudinais (81,2%), mais prevalentes na ILPI (P<0,001), no sexo masculino ((P=0,003), na ra?a parda (P=0,032) e nas faixas et?rias mais altas (P<0,001). Madarose supraciliar (40,1%) foi mais prevalente na interna??o (P=0,036), nas faixas et?rias mais altas (P=0,001) e naqueles com AVE (P=0,011) e pneumonia (P=0,002). Eczema seborreico (22,4%) foi mais frequente no sexo masculino (P<0,001) e naqueles com dem?ncia (P=0,020). Calo plantar (12,8%) foi menos prevalente na Interna??o (P=0,058) e no diabetes (P=0,022), j? a calosidade plantar (14,7%) foi mais prevalente no Ambulat?rio (P<0,001). Foliculite (11,2%) apresentou maior preval?ncia nos homens (P<0,001). A hiperplasia seb?cea (10,6%) foi mais prevalente nos idosos com c?ncer (P=0,030). Conclus?o: a variedade de manifesta??es dermatol?gicas presentes nesta pesquisa remete ? necessidade de inserir o cuidado com a pele na avalia??o geri?trica ampla e no atendimento integral ? sa?de do idoso. A presen?a de manifesta??es secund?rias ao envelhecimento cut?neo, les?es infecciosas, pr?-malignas e malignas pass?veis de preven??o justificam medidas de Educa??o para a Sa?de ao idoso, ao cuidador, ?s equipes de sa?de e ?s faixas et?rias mais jovens da popula??o. Face ?s manifesta??es dermatol?gicas observadas, ? elevada preval?ncia de acometimento ungueal e ? associa??o entre hiperplasia seb?cea e c?ncer em nosso trabalho, sugere-se a realiza??o de futuras pesquisas nesta ?rea.

This thesis presents a theoretical and historical account of how artists have responded to politics of democracy since the late-1980s. Three questions guide the direction of this analysis. Firstly: why, during its apparent apotheosis in recent years, have numerous artists critiqued democracy as the political, critical and aesthetic frame within which to identify their work? Secondly: how have artists undertaken this critique? Thirdly, and most importantly: what aesthetic and political discourses have artists proposed in lieu of the democracy that they critique? Particular case studies of art from Europe help us to address these questions, for Europe has been an important crucible for vociferous, and often fraught, arguments about democracy in recent aesthetic, philosophical and political discourses. The first chapter of this thesis rigorously contextualises these discourses in relation to historical mobilisations of democracy since the Iron Curtain??s collapse. Relying on writings by Pat Simpson, Slavoj ??i??ek, Alain Badiou and Mario Tronti, I chart the significant imbrications of political ideology, philosophy and what I call ??aesthetics of democratisation?? from the end of European communism, through the democratisations of postcommunism to the militarised democratisations of Iraq and Afghanistan after 2001. Notions of democracy shift and change during this period, becoming what ??i??ek calls a problematic ??transcendental guarantee?? of assumed values and self-legitimation. These shifting values in turn propel the concurrent critiques of democracy that are the subjects of the five subsequent chapters: Ilya Kabakov??s ??total?? installations; Neue Slowenische Kunst??s mimicry of the nation-state during the 1990s; Thomas Hirschhorn??s large-scale works from the late-1990s onwards; Christoph B??chel and Gianni Motti??s collaborative ventures; and the co-operative practices of Dan and Lia Perjovschi. Through examination of the artists?? installations and voluminous writings, and based primarily on archival research and interviews, this thesis examines how their aesthetic politics emerge from the remobilisation of nonconformist art histories, through self-instituted contexts and alternative models for art production, exhibition and interpretation. These models, I argue, counter our usual understandings of art practice and its politics in Europe. They cumulatively assert ??postsocialist aesthetics?? as an impertinent, yet urgent, prism through which to analyse contemporary art.

This thesis presents a theoretical and historical account of how artists have responded to politics of democracy since the late-1980s. Three questions guide the direction of this analysis. Firstly: why, during its apparent apotheosis in recent years, have numerous artists critiqued democracy as the political, critical and aesthetic frame within which to identify their work? Secondly: how have artists undertaken this critique? Thirdly, and most importantly: what aesthetic and political discourses have artists proposed in lieu of the democracy that they critique? Particular case studies of art from Europe help us to address these questions, for Europe has been an important crucible for vociferous, and often fraught, arguments about democracy in recent aesthetic, philosophical and political discourses. The first chapter of this thesis rigorously contextualises these discourses in relation to historical mobilisations of democracy since the Iron Curtain??s collapse. Relying on writings by Pat Simpson, Slavoj ??i??ek, Alain Badiou and Mario Tronti, I chart the significant imbrications of political ideology, philosophy and what I call ??aesthetics of democratisation?? from the end of European communism, through the democratisations of postcommunism to the militarised democratisations of Iraq and Afghanistan after 2001. Notions of democracy shift and change during this period, becoming what ??i??ek calls a problematic ??transcendental guarantee?? of assumed values and self-legitimation. These shifting values in turn propel the concurrent critiques of democracy that are the subjects of the five subsequent chapters: Ilya Kabakov??s ??total?? installations; Neue Slowenische Kunst??s mimicry of the nation-state during the 1990s; Thomas Hirschhorn??s large-scale works from the late-1990s onwards; Christoph B??chel and Gianni Motti??s collaborative ventures; and the co-operative practices of Dan and Lia Perjovschi. Through examination of the artists?? installations and voluminous writings, and based primarily on archival research and interviews, this thesis examines how their aesthetic politics emerge from the remobilisation of nonconformist art histories, through self-instituted contexts and alternative models for art production, exhibition and interpretation. These models, I argue, counter our usual understandings of art practice and its politics in Europe. They cumulatively assert ??postsocialist aesthetics?? as an impertinent, yet urgent, prism through which to analyse contemporary art.

Made available in DSpace on 2014-12-17T14:48:18Z (GMT). No. of bitstreams: 1 AdlaKDS_DISSERT.pdf: 6516382 bytes, checksum: bb93b728f29a7dc065eda95971bed62b (MD5) Previous issue date: 2014-05-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The search for cultural heritage preservation should be a constant, in order to minimize the lost of historical and cultural identity of a country. As part of this cultural heritage, highlights the importance of historical buildings. For the principles of restoration are met its important to know the state of conservation and the existing materials. Given the above, this work aims to study the pathological manifestations of the mortar coating from the Grupo Escolar Augusto Severo. For this, was conducted historical survey of the building, on-site visits with visual observation, collecting samples of mortar coating and characterization through visual and laboratory analysis, XRF, XRD, TG/DTG, OM and SEM-EDS. From the observations, pathological manifestations were found as: cracks, detachment of the coating, dirt, use of inappropriate material basis of cement, efflorescence, mold and mildew and also incompatible material base of cement. It was found that the pathological manifestations were intensified due to lack of coverage in some spots and especially the abandonment of the building, that many years does not have restoration or any other type of preventive and corrective maintenance. The results of laboratory tests indicated that the mortars studied are based on lime, with calcitic nature, and siliceous aggregate, with the presence of clay in two samples. From the samples collected, two are composed of lime, sand and clay and two by lime and sand. In this regard, it is important to conduct periodic inspections and maintenance, as well as carrying out restoration with use of material compatible with the original / A busca pela preserva??o do patrim?nio cultural deve ser uma constante, para que n?o haja a perda da identidade hist?rica e cultural de um pa?s. Como parte deste patrim?nio cultural, destaca-se a import?ncia das edifica??es hist?ricas. Para que os princ?pios de restauro sejam atendidos ? de suma import?ncia conhecer o estado de conserva??o desses bens e os materiais existentes. Diante do exposto, este trabalho tem como objetivo estudar as manifesta??es patol?gicas presentes nos revestimentos argamassados, bem como caracterizar as argamassas, de maior valor patrimonial, do Grupo Escolar Augusto Severo. Para isso, foi realizado um levantamento hist?rico da edifica??o, visitas in loco com observa??o visual e registro fotogr?fico, coleta de amostras de argamassas de revestimento e caracteriza??o por meio de an?lise visual e laboratorial, FRX, DRX, TG/DTG e MEV-EDS. A partir das observa??es realizadas, foram identificadas manifesta??es patol?gicas como: fissuras, desprendimento do revestimento, sujidade, efloresc?ncia, mofo e bolor, al?m da utiliza??o de material inadequado ? base de cimento. Constatou-se que as manifesta??es patol?gicas foram intensificadas devido ? falta de cobertura em alguns pontos e, sobretudo pelo abandono da edifica??o, que h? muitos anos n?o passa por restaura??o ou qualquer outro tipo de manuten??o preventiva e corretiva. Os resultados das t?cnicas em laborat?rio indicaram que as argamassas estudadas s?o ? base de cal, de natureza calc?tica, e agregado silicoso, com presen?a de argila em duas amostras. Das amostras coletadas, duas s?o compostas por cal, areia e argila e duas por cal e areia. Neste sentido, ressalta-se que ? de relevante import?ncia a realiza??o de inspe??es e manuten??es peri?dicas, bem como a realiza??o de restaura??o com a utiliza??o de material compat?vel com o original

Made available in DSpace on 2014-12-17T15:32:18Z (GMT). No. of bitstreams: 1 EmelineNAL.pdf: 2548007 bytes, checksum: d30f88fa3814f13a0bc3ee25b49d05fb (MD5) Previous issue date: 2010-02-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Bone marrow transplantation (BMT) is currently the best therapeutic option for patients with hematologic diseases, solid tumors or autoimmune disorders. It is characterized by intravenous infusion of hematopoietic stem cells in order to restore marrow function. However, this procedure requires concomitant immunosuppression treatment, which favors the development of certain complications, often manifested in the oral cavity. This study aimed to evaluate the incidence of oral changes in patients undergoing BMT and to correlate these results with clinical aspects related to the patients and the transplants performed. This is a prevalence study, with cross-sectional design, carried out in a BMT service at the Institute of Onco-Hematology of Natal (ION) and Natal Hospital Center. Data collection was based on questionnaires, clinical examination of the oral cavity and consultation in the medical records. The sample consisted of 51 patients undergoing BMT. After the analysis, was found a general status with good health conditions and presence of oral changes in about half of patients who composed the sample. The manifestations observed were, in decreasing order of frequency: mucositis; gingival alteration and thrombocytopenic purpura; mucosal pigmentation; lichenoid reaction and candidiasis. The oral changes were observed more frequently in cases of allogeneic TMO, in different periods post-transplant, without significant differences related to the source of cells. It was found statistically significant association between the presence of graft-versus-host disease (GVHD) and oral changes (p < 0,001). Therefore, it is concluded that there is a relatively high incidence of changes in oral cavity of patients receiving bone marrow transplantation, a fact which confirms the need to consider this site for examination, diagnosis, treatment and prognosis of possible complications of BMT / O transplante de medula ?ssea (TMO) atualmente constitui a melhor op??o terap?utica para pacientes com doen?as hematol?gicas, tumores s?lidos ou desordens autoimunes. Caracteriza-se pela infus?o intravenosa de c?lulas progenitoras hematopo?ticas com o objetivo de restabelecer a fun??o medular. No entanto, esse procedimento requer tratamento concomitante de imunossupress?o, o que favorece o desenvolvimento de determinadas complica??es, as quais freq?entemente se manifestam na cavidade oral. Este estudo objetivou avaliar a incid?ncia de altera??es orais em pacientes submetidos ao TMO e correlacionar esses resultados com aspectos cl?nicos referentes aos pacientes e aos transplantes realizados. Trata-se de um estudo de preval?ncia, com desenho do tipo seccional, realizado no servi?o de TMO do Instituto de Onco-Hematologia de Natal (ION) e Natal Hospital Center. A coleta de dados baseou-se em aplica??o de question?rio, exame cl?nico da cavidade oral e consulta de informa??es nos prontu?rios m?dicos. A amostra foi constitu?da por 51 pacientes submetidos ao TMO. Ap?s a an?lise, constatou-se quadro geral com boas condi??es de sa?de e presen?a de altera??es orais em aproximadamente metade dos pacientes que compunham a amostra. As manifesta??es observadas foram, em ordem decrescente de frequ?ncia: mucosite; altera??o gengival e p?rpura trombocitop?nica; pigmenta??o da mucosa; rea??o liquen?ide e candid?ase. As altera??es orais foram mais frequentes em casos de TMO alog?nico, em diferentes per?odos p?s-transplantes, sem diferen?a significativa quanto ? origem das c?lulas. Constatou-se associa??o estatisticamente significante entre a presen?a de doen?a do enxerto contra hospedeiro (DECH) e altera??es orais (p < 0,001). Portanto, conclui-se que h? uma incid?ncia relativamente alta de altera??es na cavidade oral de pacientes transplantados de medula ?ssea, fato que confirma a necessidade de se considerar a import?ncia desse s?tio para exame, diagn?stico, tratamento e progn?stico de poss?veis complica??es do TMO

Made available in DSpace on 2014-12-17T14:20:16Z (GMT). No. of bitstreams: 1 GekbedeDS.pdf: 1872852 bytes, checksum: b9b86e10655c0476b2efd2d05810e0d4 (MD5) Previous issue date: 2006-09-21 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Barra do Camaratuba belongs to Mataraca city, nearby the boarder between Para?ba and Rio Grande do Norte states. It was the chosen community to develop this research, objectifying to study the set of practical of the cultural manifestations and the implications of the local tourist activity, considering the cultural dynamics. We tried to reconstruct stories from the narratives of the oldest inhabitants, natives, among others that they had lived, some how, individual and collective experiences related to the popular tricks and the traditional parties, considering what they speak and imagine about their experiences and its culture. The Lapinha, the Pastoril, the viola s songs, the Balls of Concertina, the Jo?o Redondo, the Ox of Kings, the wheel of Coconut were common practical perceivable through the communitarian bonds. Among these manifestations, the only one that resisted for a longer time was the wheel coconut. The S?o Pedro s fest is another popular manifestation that appears on the current scene like the padroeiro party, while others cultural practical compose the spectacle s scenery. These questions cover many of the narratives of the interviewed ones in the interlaced thing between memory, tourism and tradition. Therefore, we tried to build our research from the memory, participant observation, orality, techniques of the life history, personal depositions, among others basic methods for the reconstruction of a collective memory . Speaking about the past of Barra do Camaratuba is to live again the parties, the blood relations, the ter?o , the work in the ro?ados , in the flour house, the fishing, the leisure and the habits of the daily life. In this community, there is the presence of conflicts of social and cultural order, caused for the hegemonic classes that sponsor the parties. In the padroeiro party we perceive that the mercantile logic has started, very recently, to transform the religious factor into an excuse to put into motion the local economy. This way, a community originated from artisan fishers and agriculturists, having the fishing practical as a way of subsistence and the tricks as a reference, they had started to compose a new social picture with the arrival of the others and with the presumption and recent tourist development. We perceive social, environmental and cultural impact transformations, exemplified by a non planned activity or a predatory tourism. The changes will always be pointed and compared with other passing in a sphere of relations lived by the natives, local players and fishers / Barra do Camaratuba, pertencente ao munic?pio de Mataraca, pr?xima ? divisa da Para?ba com o Rio Grande do Norte, foi a comunidade escolhida para desenvolvermos este trabalho, objetivando estudar o conjunto das pr?ticas das manifesta??es culturais e as implica??es da atividade tur?stica local, considerando a din?mica cultural. Procuramos reconstruir hist?rias a partir das narrativas dos moradores mais antigos , nativos, entre outros que vivenciaram, de alguma forma, experi?ncias individuais e coletivas relacionadas ?s brincadeiras populares e ?s festas tradicionais, levando em considera??o o que falam e imaginam sobre o vivido e sobre sua cultura. A Lapinha, o Pastoril, as Cantorias de Viola, os Bailes de Sanfona, o Jo?o Redondo, o Boi de Reis, o Coco de Roda, eram pr?ticas comuns percept?veis atrav?s dos v?nculos comunit?rios. Dentre essas manifesta??es, a ?nica que resistiu por mais tempo foi o coco de roda. A festa de S?o Pedro ? outra manifesta??o popular que aparece no cen?rio atual como a festa de padroeiro, enquanto outras pr?ticas culturais v?o compondo o cen?rio do espet?culo. Estas quest?es percorrem muitas das narrativas dos entrevistados no entrela?ado entre mem?ria, turismo e tradi??o. Portanto, procuramos construir nosso trabalho a partir da mem?ria, da observa??o participante, da oralidade, das t?cnicas da hist?ria de vida, depoimentos pessoais, entre outros m?todos fundamentais para a reconstru??o de uma mem?ria coletiva . Falar sobre o passado de Barra do Camaratuba ? reviver as festas, as rela??es de parentesco, o ter?o, o trabalho nos ro?ados, na casa de farinha, as pescarias, o lazer e os h?bitos da vida cotidiana. Nessa comunidade h? presen?a de conflitos de ordem social e cultural, causados pelas classes hegem?nicas que patrocinam as festas. Na festa de padroeiro percebemos que a l?gica mercantil come?ou, muito recentemente, a transformar o fator religioso num pretexto para movimentar a economia do local. Dessa forma, uma comunidade originada a partir de pescadores artesanais e agricultores, tendo a pesca como meio de subsist?ncia e as brincadeiras com refer?ncia de divers?o, passaram a compor um novo quadro social com a chegada de outros e com o suposto e recente desenvolvimento tur?stico. Percebemos transforma??es de impactos s?cioambientais e culturais, exemplificados por uma atividade n?o planejada ou um turismo predat?rio. As mudan?as sempre ser?o apontadas e comparadas a outras passadas numa esfera de rela??es vivenciadas pelos nativos, brincantes e pescadores locais

Made available in DSpace on 2014-12-17T15:32:17Z (GMT). No. of bitstreams: 1 AndreaFS.pdf: 584148 bytes, checksum: 1823dffba43267f037cb07f5493ee540 (MD5) Previous issue date: 2004-12-20 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Regarding the morbidity potential of oral complications in patients with leukemia, it evaluated the cl?nical and microbiologic changes of oral mucosal in children with LLA, with age range of O to 15 years old, undergone the chemotherapy antineoplastic and for the use prophylactic of chlorhexidine gluconate 0,12% during ten days, that was utilized in each chemotherapy treatment stage. The collect for rnicrobiological study was obtained preferentiality in intensification stage at the end prophylatic treatment. The study grouup had 20 children, where it observed clinically decrease in frequency of mucositis, with 8 cases (40%) only. In microbiological examination observed one reduced incidence of pathogenic microorganisms with Staphylococcus coagulase- negative (40%), Klebsiella pneumoniae (5%), Escherichia coZi enteropathogenic (15%), Stenotrophomonas maltophilia (5%) e Candida albicans (35%). The findings obtained in the present trial suggest that the use of chlorhexidine gluconate 0,12% can be responsible for incidence reduced of mucositis, but it wasn t possible to make correlation between isolated pathogenic microorganisms and mucositis development / Considerando o potencial de morbidade das complica??es orais em pacientes com leucemia, procurou-se avaliar as altera??es clinicas e microbiol?gicas da mucosa, em crian?as com LLA. na faixa et?ria de O a 15 OOos, submetidas a quimioterapia antineopl?sica e ao uso profil?tico do gluconato de clorexidina a 0,12%, durante dez dias, o qual era administrado em todas as fases do tratamento quimioter?pico. A coleta para o estudo microbiol?gico foi obtida, preferencialmente, na fase de intensifica??o, ao t?rmino do tratamento profil?tico. A amostra foi constituida por 20 crian?as, na qual evidenciou-se em nivel clinico, uma freq??ncia reduzida de mucosite, com 8 ocorr?ncias (40%) apenas. No exame microbiol?gico, constatou-se a presen?a de reduzido n?mero de microrganismos patog?nicos, como Staphylococcus coagulase-negativo (40%), Klebsiella pneumoniae (5%), Escherichia coli-enteropatog?nica (15%), Stenotrophomonas maltophilia (5%) e Candida albicans (35%). Diante dos resultados, sugeriu-se que o uso do referido antiss?ptico contribuiu para a reduzida ocorr?ncia de mucosite, no entanto, n?o foi possivel estabelecer correla??o entre os microrganimos isolados e o desenvolvimento da mucosite

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2015-11-17T23:09:48Z No. of bitstreams: 1 Disserta??o Anderson Final Corre??es Banca Impress?o.pdf: 1523045 bytes, checksum: 814474d8f39dbb0905905b6e3a5d0af2 (MD5) / Made available in DSpace on 2015-11-17T23:09:48Z (GMT). No. of bitstreams: 1 Disserta??o Anderson Final Corre??es Banca Impress?o.pdf: 1523045 bytes, checksum: 814474d8f39dbb0905905b6e3a5d0af2 (MD5) Previous issue date: 2013-03-23 / After the discovery of the Human Immunodeficiency Virus (HIV), in the 1980s, the clinical and epidemiological characteristics of Acquired Immunodeficiency Syndrome (AIDS) have changed over the years, mainly from the second half of the 1990s, with the emergence of new drugs for its treatment. Objective: to investigate the oral condition and the HIV infection condition factors associated in individuals living with HIV/Aids. Method: a cross-sectional, descriptive, exploratory study. Single examiner used a data collection instrument in Assistance Specialized Services (SAE - STD/HIV/Aids) users in three municipalities in the Bahia State. The information derived from primary data (interviews and oral clinical examination) and secondary data (clinical records). Socio-demographic, lifestyle and health condition characteristics, HIV/Aids infection and oral condition were researched. Individuals registered in these services, with age greater than or equal to eighteen years old, gender both and that participate accepted voluntarily in the research were evaluated. Sample size was determined by convenience, from the data collection availability time. For statistical analysis, the Stata 10 statistical package used, the Chi-square test was used for categorical variables, with 5% significance level. Results: preliminary results in 228 individuals showed that the majority was male gender, browns, with a mean age 41.6 years old and the average HIV infection diagnosis time was 5.4 years. The HIV/Aids infection condition, as assessed by CD4 T-lymphocyte count showed statistically significant association with: current occupation, antiretroviral drugs use duration, last viral load determination and intra-oral injury presence. As for the oral condition, in relation to dental caries, the following factors significantly associated: age, race, current occupation, family income, average number of cigarettes per day, total and / or partial prosthesis use, prosthesis dental use, gingivitis and flossing. For intra-oral lesion presence was associated with age, educational level, current smoking, antiretroviral medications duration, dosage last viral load last count CD4 + T lymphocytes, CD4/CD8 ratio, gingivitis , periodontitis and flossing. Regarding the periodontitis, the following factors were associated: sex, residence county, past smoking, current smoking and flossing. Conclusions: the preliminary findings point to association between socio-demographic, lifestyle characteristics and HIV infection condition and oral condition, suggesting the need for better understanding of the influence of these variables in the individuals living with HIV/Aids monitoring, contributing to preventive measures, treatment and survival of the infection diagnosed individuals. / Ap?s a descoberta do V?rus da Imunodefici?ncia Humana (HIV), na d?cada de 1980, as caracter?sticas cl?nicas e epidemiol?gicas da S?ndrome da Imunodefici?ncia Adquirida (Aids) se modificaram ao longo dos anos, principalmente a partir da segunda metade da d?cada de 1990, com o surgimento de novos medicamentos para seu tratamento. Objetivo: Investigar fatores associados ? condi??o bucal e ? condi??o de infec??o pelo HIV em indiv?duos vivendo com HIV/Aids. M?todo: Foi realizado estudo do tipo transversal, de car?ter explorat?rio, atrav?s da coleta de dados com o uso de um instrumento de coleta aplicado por um ?nico examinador em usu?rios de Servi?os de Assist?ncia Especializada (SAE ? DST/HIV/Aids) de tr?s munic?pios do Estado da Bahia. As informa??es foram provenientes de dados prim?rios (entrevista e exame cl?nico bucal) e de dados secund?rios (prontu?rios cl?nicos). Foram pesquisadas caracter?sticas s?cio-demogr?ficas, relacionadas ao estilo de vida, ? condi??o de sa?de, ? infec??o HIV/Aids e ? condi??o bucal. Duzentos e vinte e oito indiv?duos cadastrados nesses Servi?os, com idade igual ou superior a dezoito anos, de ambos os sexos e que aceitaram, voluntariamente, participar da pesquisa foram avaliados. O tamanho da amostra foi determinado por conveni?ncia, a partir da disponibilidade de tempo para a coleta de dados. Para a an?lise estat?stica, foi utilizado o pacote estat?stico Stata 10, empregando-se o teste de Qui-quadrado para vari?veis categ?ricas, com n?vel de signific?ncia de 5%. Resultados: Os resultados preliminares mostraram que a maioria dos indiv?duos avaliados era do sexo masculino, pardos, com m?dia de idade de 41,6 anos e com tempo m?dio de diagn?stico da infec??o pelo HIV de 5,4 anos. A condi??o de infec??o HIV/Aids, avaliada pela contagem de linf?citos T CD4+ mostrou associa??o estatisticamente significante com: ocupa??o atual, tempo de uso de medica??es antirretrovirais, ?ltima dosagem de carga viral e presen?a de les?o intra-oral. Quanto ? condi??o bucal, em rela??o ? presen?a de c?rie dent?ria, os seguintes fatores apresentaram associa??o estatisticamente significante: idade, ra?a/cor, ocupa??o atual, renda familiar, quantidade m?dia de cigarros por dia, uso de pr?tese dent?ria total e/ou parcial, necessidade de uso de pr?tese dent?ria, presen?a de gengivite e uso de fio dental. Para a presen?a de les?o intra-oral, houve associa??o com: idade, n?vel de escolaridade, tabagismo atual, tempo de uso de medica??es antirretrovirais, ?ltima dosagem de carga viral, ?ltima contagem de linf?citos T CD4+, rela??o CD4/CD8, presen?a de gengivite, presen?a de periodontite e uso de fio dental. Com rela??o ? presen?a de periodontite, os seguintes fatores apresentaram associa??o: sexo, munic?pio de resid?ncia, tabagismo no passado, tabagismo atual e uso de fio dental. Conclus?o: Os achados preliminares apontam para a associa??o entre fatores s?cio-demogr?ficos e de estilo de vida ? condi??o de infec??o HIV e ao estado bucal, sugerindo a necessidade de melhor conhecimento da influ?ncia destas vari?veis no acompanhamento dos indiv?duos que vivem com HIV/Aids, contribuindo para medidas preventivas, tratamento e sobrevida daqueles com diagn?stico da referida infec??o.

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