Recursos fisioterapêuticos tem sido utilizados no tratamento de úlceras de perna como a terapia a laser de baixa intensidade. A contaminação bacteriana dessas úlceras é freqüente constituindo-se numa importante complicação da cicatrização. Assim, busca-se investigar os efeitos dessa terapêutica frente às culturas de diferentes espécies bacterianas in vitro e in vivo. Utilizou-se aparelho laser modelo Theralase III-DMC (685 e 830 nm) e diferentes doses (1,2 e 4J). Foram utilizados bactérias, S. aureus ATCC 6538 (Gram+) e P. aeruginosa ATCC 15442 (Gram-), reativadas em B.H.I.Agar inclinado a 37 graus C/24h. Após as bactérias foram re-suspensas em B.H.I. caldo/37 graus Celsius/20h, centrifugadas 3x/15min/4.500rpm, seguida de lavagens e homogeneização. A suspensão foi diluída em placas de cultura celular de 96 poços, submetidas a diluições seriadas sucessivas, encontrando as diluições ideais de \'10 POT.-12\' bactérias/ml para S. aureus e \'10 POT.-15\' bactérias/ml para P. aeruginosa. As soluções bacterianas foram irradiadas com laser de diferentes comprimentos de onda (685 e 830 nm) e diferentes doses (1, 2 e 4J). Dez micro litros da solução bacteriana do último poço foram semeados em placa de petri nos meios Mc Conkey Agar e B.H.I.-Agar bactérias Gram positiva e negativa respectivamente para posterior contagem das unidades formadoras de colônia (U.F.C.´s.). Foram semeadas 10 placas para cada dose de diferente comprimento de onda e espécie bacteriana diferente e 10 placas para o grupo controle, ou seja, sem irradiação laser. Nos estudos in vivo, foram utilizados coelhos, machos, neozelandeses pesando aproximadamente 1,5 Kg. A anestesia foi feita com 1,5 ml/animal de ketamina 100 mg e xylzina 1,0 ml/animal. Foram feitas 6 feridas de 6 mm de diâmentro (punch) em cada orelha, constituindo-se cada animal, um grupo (n=12). As feridas foram previamente contaminadas com S. aureus (G+) e P. aeruginosa (G-). Os animais foram divididos em Grupo 1 (laser 685 nm + G+), Grupo 2 (laser 830 nm + G+), Grupo 3 (laser 685 nm + G-), Grupo 4 (laser 830 nm + G-), Grupo 5 (apenas laser 685 nm), Grupo 6 (apenas laser 830 nm), Grupo 7 (lasers 685 e 830 nm + G-), Grupo 8 (lasers 685 e 830 nm + G+). As úlceras foram fotografadas nos tempos de 24h, 3 dias, 7 dias, 10 dias, 13 dias e 16 dias e posteriormente analisadas com programa Image J, realizadas pelo mesmo indivíduo. Os resultados foram analisados pelo teste estatístico ANOVA e pós-teste de Bonferroni para múltiplas amostras não paramétricas. No experimento in vitro foi observado que todas as doses laser utilizadas tiveram efeito inibitório no crescimento bacteriano em ambas as espécies, sendo esse efeito maior na dose de 4 J/\'CM POT.2\', nos diferentes comprimentos de onda utilizados (685 nm e 830 nm), mesmo quando esses foram usados de forma consecutiva. In vivo, observou-se que no 3º dia pós cirúrgico houve uma diferença estatisticamente significante entre os grupos 1 e 6. No 7º dia a diferença estatística aconteceu entre os grupos 1 e 4. No 10º dia, não houve diferenças estatisticamente significante entre as áreas dos grupos. No 13º dia observou-se diferença estatística entre todos os grupos quando comparados com os grupos 7 e 8 (lasers 685 e 830 nm + G+). No 16º de segmento todas as feridas encontavam-se cicatrizadas. A terapia a laser de baixa intensidade apresentou efeito inibitório do crescimento bacteriano in vitro e nos estudos in vivo, mostrando-se capaz de acelerar o processo de cicatrização de feridas, mesmo contaminadas com diferentes espécies bacterianas. / Physical therapeutic resources have been used to treat leg ulcers, such as laser therapy of low intensity. Bacterial contamination of these ulcers often constitutes itself into a major complication of healing. Thus, search up to investigate the effects of this therapy off the cultures of different bacterial species in vitro and in vivo. It was used laser device model Theralase III-DMC (685 e 830 nm) in different doses (1, 2 e 4J). It was used bacteria S. aureus ATCC 6538 (Gram+) and P. aeruginosa ATCC 15442 (Gram-), reativated in tilted BHI-Agar to 37 Celsius degrees/24h. After the bacteria were re-suspended in broth B.H.I. to 37 Celsius degrees for 20h, centrifuged 3x/15min/4.500rpm, followed by washing and homogenization. The suspension was diluted in 96 wells cell culture plates, and submitted to successive serial dilutions, finding the ideas dilutions of \'10 POT.-12\' bacteria/ml for S. aureus and \'10 POT.-15\' bacteria/ml for P. aeruginosa. The bacterial solutions were irradiated with different wavelength of laser (685 e 830 nm) and different doses (1, 2 e 4J). Ten microliters of bacterial solution from the last well were sowed in Petri´s plate with Mc Conkey agar and BHI-agar to bacterias Gram positive and negative respectively for further counting of colony forming units (CFU´s). Ten plates for each dose of different wavelength and different bacterial species were sowed and 10 boards for the control group, without laser irradiation. In the in vivo studies were used New Zealand male rabbits, weighing approximately 1.5 Kg. Anesthesia was made with 1.5 ml of ketamine 100 mg and xylzina 1.0 mL/animal. Six punched wounds were made in each ear, and each animal constituted a group (n=12). The wounds were previously contaminated with S. aureus (G+) and P. aeruginosa (G-). The animals were divided in Group 1 (laser 685 nm + G+), Group 2 (laser 830 nm + G+), Group 3 (laser 685 nm + G-), Group 4 (laser 830 nm + G-), Group 5 (only laser 685 nm), Group 6 (only laser 830 nm), Group 7 (lasers 685 e 830 nm + G-), Group 8 (lasers 685 e 830nm + G+). The ulcers were photographed in times of 24h, 3, 7, 10, 13 and 16 days and then analyzed with ImageJ software, conducted by the same individual. The results were analyzed by non parametric ANOVA statistical test and post-test for multiple samples by Bonferroni´s test. In the in vitro experiments was observed that all the laser doses used presented an inhibitory effect on bacterial growth in both species, and this effect was greater using the dose of 4J in different wavelengths (685 nm, 830 nm), even when these were applied consecutively. In vivo, it was observed that in the 3rd day after surgery there was a statistically significant difference between groups 1 and 6. In the 7th day happened to statistical difference between groups 1 and 4. In the 10th day there was no statistically significant difference among the areas of groups. In the 13th day there was statistical difference between all groups when compared with groups 7 and 8 (685 and 830 nm lasers + G+). In the 16th to follow all the wounds had been healed. The laser therapy of low intensity showed inhibitory effect of bacterial growth in vitro and in vivo studies and it were able to accelerate the wound healing, even contaminated with different bacterial species.

O autor realizou um estudo anatômico da região lateral e proximal da perna por meio de dissecção anatômica em cadáver, de exame arteriográfico e de mapeamento com Doppler em pacientes, visando a descrição da artéria denominada fibular superior, que se origina no tronco tíbio-fibular em 70% dos casos, da artéria fibular, em 20% e da artéria tibial anterior, em 10% e participa na irrigação do músculo sóleo e gastrocnêmio. Este vaso possui características adequadas para a realização de micro-anastomose. Após a conclusão da parte anatômica-descritiva, o autor aplicou o retalho derivado da artéria fibular superior, denominado retalho súpero-lateral da perna, na reconstrução de defeitos cutâneos e defeitos complexos tridimensionais, localizados no pé e tornozelo, em 10 pacientes, obtendo bons resultados / The author performed an anatomical study of the proximal and lateral aspect of the leg, consisting of cadaver dissection, arteriogram and Doppler mapping, in order to disclose the features of a new vessel, denominated superior peroneal artery. It originates from the tibiofibular trunk in 70 % of times, from the peroneal artery, 20%, and from the anterior tibial artery, 10%. It contributes to nourish the soleous and the lateral gastrocnemius muscle. The superior peroneal vessels are also suitable for microanastomosis. Therefore, the flap derived from the superior peroneal artery, called superolateral leg flap (SLL), was used for lower leg reconstructions in 10 patients, in two of them as chimeric flap for complex tridimensional defects, with good results

Objetivo: Determinar a influência do resultado imediato da angioplastia infrainguinal no sucesso clínico em 24 meses. Métodos: Foi realizado um estudo observacional prospectivo, que avaliou 40 angioplastias percutâneas infrainguinais, realizadas no período de abril de 2007 a fevereiro de 2011. Foram incluídos somente os casos com sucesso técnico e angiográfico intraoperatório. Todos os pacientes eram portadores de isquemia crítica de membro inferior decorrente unicamente de obstrução arterial crônica infrainguinal. Ultrassom com Doppler colorido (UDC) foi realizado um dia antes da cirurgia e no pós-operatório imediato. Foram registradas as velocidades de pico sistólico (VPS) nas artérias tibial anterior, tibial posterior e fibular na topografia do tornozelo. O gradiente de VPS pré e pós-operatório (GVPS) foi analisado e comparado prospectivamente quanto à melhora clínica em 2 anos, conforme os padrões recomendados pela SVS/ISCS. Foram utilizados os valores da artéria com a melhor variação perioperatória e da média das 3 artérias. Sucesso clínico foi definido como ausência de dor de repouso ou cicatrização de lesão. Resultados: Fizeram parte do estudo 19 mulheres e 20 homens, com média de idade de 68,5 ± 8,1 anos. Após 2 anos de seguimento, 26/40 lesões tiveram sucesso clínico sem novas intervenções cirúrgicas. Tempo de cicatrização variou de 4 a 111 semanas (mediana = 21,5 semanas). Lesões TASC II A/B tiveram sucesso clínico maior que TASC II C/D em 1 ano de seguimento (p<0,05), mas não em 2 anos (p=0,11). Entre os 14 casos de insucesso clínico, 6 foram submetidos a nova angioplastia e 4 a enxerto arterial. Três pacientes com angioplastia pérvia não tiveram cicatrização de lesão. Um paciente teve recorrência da úlcera no retorno de 24 meses. A perviedade primária foi de 62,5% ± 7,7% em 2 anos; e o salvamento de membro, de 92,5% ± 4,2% no mesmo período. Houve aumento de VPS, no leito distal, identificado pelo UDC. A variação de VPS foi de 44,4 cm/s, na melhor artéria, e de 21,9 cm/s, na média das artérias, para os casos de sucesso clínico. Para os casos de insucesso clínico, a variação foi de 45,3 cm/s, na melhor artéria, e de 24,7 na média das artérias. A comparação por UDC pré-operatória e pós-operatória imediata, através de VPS, não mostrou diferença estatística entre o grupos em 2 anos de seguimento. Conclusão: o aumento de fluxo pela avaliação por UDC, no pós-operatório imediato, não está relacionado com a resolução dos sintomas em 24 meses / Purpose: to evaluate the impact of the initial result of Percutaneous angioplasty (PA), objectively assessed with duplex-ultrasound, in the two-years clinical outcome. Methods: Between February 2007 and April 2011 thirty-nine patients with femoropopliteal atherosclerotic disease successfully treated by PA were included (40 limbs). One patient had both limbs treated in different occasions, and was considered as 2 cases for analysis. All patients had critical ischemia with rest pain and ischemic ulcers due to infrainguinal obstructions alone. The patients were submitted to duplex-ultrasound examination on the day before and on the first or second day after the procedure. Peak systolic velocities (PSV) was recorded in the anterior tibial, posterior tibial and fibular arteries at the level of distal third of the leg. All patients were followed for 2 years. Comparison between good and bad groups were based on VPS, including the perioperative gradient (GPSV) of the artery with highest variation and the mean of the VPS in the 3 arteries. After 2-years good result were defined as good when the patient had no pain and complete healing of a previous ulcer or minor amputations. It was considered as bad result when a second intervention was required or when unhealed lesions were present at the end of the 2-year period. Results: Mean age was 68,5 ± 8,1 years-old. In 26 cases the long-term result was good. Healing time ranged from 4 to 111 weeks (median 21.5). Bad long-term results were observed in 14 cases. Three lesions had persisted unhealed despite patent angioplasty. One case has ulcer recurrence at 24 months appointment. In 10 cases a second procedure was carried out (redo angioplasty in 6 and bypass in 4). TASCII A/B registered better clinical success then TASCII C/D (p<0,05) at 1-year follow-up but not at 2-years (p=0,11). Two-year limb salvage was 92,5% ± 4,2%. Primary patency was 62,5% ± 7,7% in 2-years. GVPS was 44,4 cm/s (highest artery) and 21,9 cm/s (mean PSV) in success group. GVPS was 45,3 cm/s (highest artery), and 24,7cm/s (mean VPS). The quality of the initial result, as measured by GPSV, was not associated with a good or bad long-term success (p>0,05). Conclusion: once the procedure was successfully performed, the degree of increase in flow is not related to the long-term durability and ulcer healing

Recruitment of planktonic larvae into sedentary benthic populations regulates the population dynamics of marine invertebrates. The processes controlling recruitment, however, are poorly understood, and recruitment remains largely unpredictable, which complicates management of exploited shellfish resources. The mussels Perna perna, Choromytilus meridionalis and Mytilus galloprovincialis, found on the south coast of southern Africa, have planktonic larvae and sedentary adult stages. This thesis examines dispersal, settlement and early post-settlement growth and mortality, and their effect on recruitment and demography of intertidal mussel populations in the region of Algoa Bay on the south coast of southern Africa. Temporal and spatial variation in the body mass, density and size structure of mussels, the distribution of bivalve larvae on plankton grids in the nearshore zone and the distribution of a recently introduced invasive mussel, Mytilus galloprovincialis, were examined between 1989 and 1992. Furthermore, data on hourly or daily changes in wind strength and direction, air and sea surface temperatures and low and high tide levels in the study region, were obtained. There were 3-4 peaks in spawning (characterised by an abrupt decline in weight) and settlement activity annually. These peaks varied in exact timing, intensity and duration between sites and over time. However, at a site, spawning was followed by settlement 4-8 weeks later, and there was a significant (P < 0.05) direct correlation between spawning intensity prior to the appearance of a new cohort and the cohort density (settlement intensity). The stochastic spatial and temporal variation in breeding activity was superimposed on a more general pattern of a higher intensity of spawning and settlement in Algoa Bay than on the open coast, and a higher settlement intensity on coastal sandstone shores than on dune rock shores. Spawning was more frequent in winter and spring, and the probability of spawning and settlement peaked around the spring and autumn equinox, if temperature and wind conditions were suitable. Larval behaviour had little effect on their dispersal in the well-mixed nearshore region. Larvae were passively dispersed by currents, and their dispersal range and direction depended on prevailing winds and local topography. The sharp decline in density of recruit and adult M. galloprovincialis with increasing distance from the point of introduction, showed that some larvae were carried by wind generated currents over moderately long distances (-100 km). However, since most (76 %) M. galloprovincialis recruited within 4 km of the parent population, it is possible that larvae become trapped in small gullies and crevices around rocky shores, and have a limited dispersal range. This could explain the link between local patterns of spawning and settlement. The distribution and abundance of settlers on the shore was influenced by larval behaviour and the availability of settlement, substrata. Larvae preferred to settle primarily on foliose coralline algae and migrate to the adult mussel bed when they were larger (0.60-7 mm), but larvae also settled directly on adult mussels, possibly because the amount of coralline algae was limited. Both direct and secondary settlement were considered to be important in maintaining mussel populations since the rate of settlement was low(generally < 60 000.m-2). Cohort analyses showed that prior to maturity post-settlement growth (- 30 mm in 10 months) and mortality rates (60-100%) were high, but varied. When settlement intensity was low this variability uncoupled the relationship between spawning and recruitment intensity. Multiple regression analysis showed that together reproductive effort (gamete output), settlement intensity, growth and mortality prior to maturity, accounted for 76 % of the variance in recruitment into mature adult populations. The low settlement rate coupled with the short life span of mussels « 3 years), meant that populations underwent marked spatial and temporal variations in structure and abundance as settlement intensity varied, but there were consistent general differences between mussel populations on dune rock and sandstone shores in Algoa Bay and on the open coast. It was concluded from these results that, spawning intensity and post-settlement growth and mortality, rather than dispersal, regulated recruitment and the structure and abundance of intertidal P. perna and C. meridionalis populations along the south coast of southern Africa. On the basis of these results it is recommended that species with limited dispersal, variable recruitment and high natural mortality, such as P. perna, should be conserved by protecting a small part of the population in reserves, and controlling utilisation outside reserves to minimize disturbance to local brood stocks. Furthermore, since the potential for reseeding adjacent exploited areas is limited, several small reserves placed at regular intervals along the coast would be more effective than a single large reserve.

Organisms inhabit environments that have many dimensions, each of which can vary temporally and spatially. The spatial-temporal variations of environmental stressors and disturbances may have major but different effects on indigenous and invasive species, favouring either of them at different times and places. The invasive mussel Mytilus galloprovincialis invaded the South African coast 30 years ago and, on the south coast of South Africa, it now competes and co-exists with the indigenous Perna perna in the lower eulittoral zone (referred to here as the mussel zone) The invasive and indigenous species dominate the upper and the lower mussel zones respectively, while the two co-exist in the mid-zone. My results show that intertidal mussels experience, and respond to, spatial and temporal fluctuations of several biotic and abiotic stressors. The invasive and the indigenous species adopt different strategies when reacting to environmental factors and their physiological and behavioural responses vary in time and in different habitats as different pressures become of overriding importance. Attachment strength of both species decreased in summer and increased in winter, and was higher on the open coast than in bays for both species, showing a strong positive correlation with wave force in time and space. P. perna had significantly higher attachment strength than M. galloprovincialis but, contrary to previous studies, the difference in gonad index between the two species varied according to the habitat. In bay habitats, M. galloprovincialis had a higher maximum reproductive effort than P. perna, however, on the open coast, there was no significant difference between the two species, suggesting that for the invasive species wave action is a limiting factor not only in terms of the attachment strength but also of energy availability for reproductive tissue development. Major spawning events occurred during periods of low wave action while minor spawning coincided with periods of intense hydrodynamic stress. On the open coast, gonad index was negatively correlated with attachment strength for both species while, in bays, there was no correlation between these two factors for either. The two species also showed different behaviour. In the field, M. galloprovincialis moved significantly more than P. perna over a period of six months. The higher mobility of the invasive species was also confirmed in the laboratory where, in general, M. galloprovincialis formed clumps more readily than P. perna. Taken collectively, these results suggest that channelling more energy into attachment strength limits reproductive tissue development and that, while the indigenous species invests more in byssal production, the invasive species adopts a more dynamic strategy looking for aggregation or a safer arrangement. Higher endolithic infestation and a greater expression of heat shock proteins (Hsps) in mussel populations on the open coast than in bays indicate that this habitat is a more stressful environment not only in terms of wave action. Endolith damaged mussels had significantly lower attachment strengths and condition indices than clean mussels, probably due to the need to channel energy into shell repair. The constant shell repair and expression of Hsps typical of open coast populations are energetically demanding processes. These observations suggest that on the open coast, mussels are subjected to more severe energetic constraints than in bay habitats. Wave and sand stress fluctuated seasonally with the former having a greater effect on mussel mortality on the open coast and the latter a higher impact on bay populations. Overall, mussel mortality rates were higher on the open coast than in bays. My results show that populations on the open coast had fewer private haplotypes and less genetic endemism than those inside bays. Gene flow analysis showed the relatively stable bay habitats act as source populations with greater genetic migration rates out of bays than into them. These differences in genetic structure on scales of las of kilometers show that coastal configuration strongly affects selection, larval dispersal and haplotype diversity. Environmental gradients that are key factors in species distribution over large geographical scales can also be responsible for micro-scale distributions. My results show that M. galloprovincialis colonizes the upper mussel zone where temperature is high, but is less tolerant to this stressor and has to maintain a high expression of Hsps. This suggests that temperature is probably a limiting factor in its invasion towards the sub-tropical east coast. There are inter- and intra-specific differences in responses to the environment which highlight the efforts of M. galloprovincialis and P. perna to optimize resource utilization for survival and reproduction. Determining these differences is crucial to understanding patterns of co-existence between competing indigenous and invasive species.

Epibiosis is an ecological relationship that has been described as one of the closest possible associations in marine ecosystems. In the space limited rocky intertidal, mussel beds provide important secondary space for barnacles. The epibiotic relationship between mussels and barnacles on the south-east coast of South Africa was considered at different scales, from large-scale, natural patterns of epibiosis on the rocky shore, to fine-scale settlement choices of barnacles and the effects on the condition and growth rates of individual mussels. Mussel and barnacle assemblages were generally stable over a 12-month period. The tracking of individual mussels with and without barnacle epibionts resulted in a significant increase in mortality rate of mussels with epibionts over 12 months (two-way ANOVA, p = 0.028). Barnacles on rocks, as well as on mussels, were also tracked with no significant effect of substratum on mortality of barnacles (two-way ANOVA, p = 0.119). Prevalence and intensity of barnacle infestations was also examined in relation to coastline topography on two co-occurring mussel species, the indigenous Perna perna and invasive Mytilus galloprovincialis. The results were complex, but bay status had significant effects on prevalence and intensity for both mussel species, depending on the time and zone. The effect of bay in relation to time was particularly relevant for M. galloprovincialis (four-way nested ANOVA, Season X Site(Bay): p = 0.0002), where summer prevalence was higher than that of winter in bays, regardless of zone, while in open coast sites, the effect of season was only significant in the mid zone. Patterns of intensity generally showed higher values in summer. Substratum preference by barnacles was investigated by recording settlement, survival and mortality of Chthamalus dentatus barnacles on various treatments. There was a strong preference for the rock-like plastic substratum by primary settlers (pair-wise tests of PERMANOVA: Dead < Rock mimic (p = 0.0001); Replica < Rock mimic (p = 0.019) and Live < Rock mimic (p = 0.0001)). This indicates that barnacles settle on mussel shells only as a secondary choice and that micro-topography is an important variable in barnacle settlement. The effect of barnacle epibiosis on condition index and growth of P. perna and M. galloprovincialis was also examined as a direct indication of the health of mussels subjected to the biological stress of epibiosis. Although not significant (PERMANOVA: P. perna: p(perm) = 0.890; M. galloprovincialis: p(perm) = 0.395), growth for both mussel species was slower for barnacle-infested individuals in summer, which is the main growing season for mussels in the region. Results from condition index calculations, however, showed no negative impacts of epibiotic barnacles (three-way ANCOVA: P. perna: p = 0.372; M. galloprovincialis: p = 0.762). Barnacle epibionts create a new interface between the mussel and its environment and this interaction can affect other members of the community. The possibility of the barnacle epibiont causing increased drag also needs further investigation. Biological processes operating within a wide range of physical stressors drive the interactions on the rocky shore, such as epibiosis. Overall, the results of this study suggest that the epibiotic relationship between mussels and barnacles on the south-east coast of South Africa does not significantly affect the mussel species present and that barnacles only use mussel shells as a secondary choice of substratum.

Mussels play an important supplementary role in the diet of local communities on the Transkei coast in the Eastern Cape province of South Africa. The exploitation of mussels date back to about 1350 years ago, but in the last 3 decades, exploitation of the brown mussel Perna perna has become unsustainable with mussels collected as small as 30-40mm when they are only just sexually mature. Dye and Dyantyi (2002) developed a technique to rehabilitate areas denuded of adult mussels. The government sponsored Mussel Rehabilitation Project (MRP) to use this technique but only some sites have been successfully rehabilitated, reaching c. 80 % cover within a year whilst others only reach about 5%. At an unexploited site (Riet River), I tested the effects of mussel size and wave strength on the effectiveness of the rehabilitation technique, hypothesizing that different size classes may respond differently due to differences in their energy allocation (growth vs reproduction), while wave action determines food supply. Small (1-2cm) and large mussels (3-4cm) were deployed for rehabilitation at 2 exposed and 2 sheltered sites, separated by 100s m. A similar study was repeated in Coffee Bay where shores are exploited. Six sites were selected, 3 sites that had been successfully rehabilitated and 3 that were unsuccessful according to the MRP. Again, two size classes were used but these differed from the first experiment. Mussels of 3-4cm size were now rated as small and 5-6cm as large. Two methods were used to re-attach mussels, the original and the same method with the addition of mesh bags during mussel deployment. Treatments were examined on three occasions at approximately one month intervals. At Riet River, the sites chosen did not show differences in wave strength (measured using dynamometers) or water flux (measured using erosion of cement balls) so that water motion was excluded from the analyses. Small mussels grew faster and had weaker attachment than large mussels. There was no difference in condition index between small and large mussels, or in the numbers of recruits settling among the byssus threads of deployed mussels of the two size classes. In Coffee Bay, there was no relationship between rehabilitation success and maximum wave force, and no difference in bulk water flux among sites. Small mussels deployed using mesh bags survived better than non-meshed or large mussels of either treatment. There was no difference in condition index (CI) between mesh and no-mesh, or between small and large mussels. As in the case of Riet River, small mussels grew faster than large mussels, but large mussels attached stronger than small mussels, with no effect of mesh. Although the factors that improve reseeding of mussels can be identified (use of mesh, use of small mussels, choice of sites with high recruitment rates), successful long-term rehabilitation requires appropriate subsequent management of re-seeded sites.

Amputation is the traumatic or surgical loss of one or more limbs. Amputation causes physical, psychological and social damages which result in a decrease in quality of life (QV). Sports have been considered important tools for rehabilitation and social integration of amputees. The aim of this research was to assess quality of life, occupational performance, muscle strength and range of motion of adults with lower limb amputation athlete and non-athlete. The sample consisted of 45 amputees, divided into two groups: Athlete (GE, n = 23) and non-Athlete (GNE, n = 22). The collection was made in the cities of Curitiba, Aracaju and Maceió on December 2013, January and March of 2014. The tools used were The Short Form Health Survey Questionnaire (SF-36), the Canadian Occupational Performance Measure (COPM), the goniometry, and the Kendall´s muscle strength test. The tests Shapiro-Wilk, chi-squared and Mann-Whiney (p < 0.05) were used for statistical analysis. The quality of life variable showed significant differences in all eight areas tested: functioning, role limitations due to mental health emotional bodily pain, general health, vitality, social functioning, and between the groups, with the GE presented the best results, indicating better quality of life that the GNE. The Athlete group showed significant higher rates in occupational performance, muscle strength (flexor and extensor muscles of the hip) and range of motion (flexion and hip abduction). Therefore, it was concluded that there was a higher quality of life, occupational performance, muscle strength and range of motion for amputees who practice any sport. / Amputação consiste na perda ou remoção total ou parcial de um ou mais membros, de forma traumática ou cirúrgica, acarretando danos físicos, psicológicos e/ou sociais, que resultam em redução da qualidade de vida (QV). O esporte tem sido apontado como relevante ferramenta para a reabilitação e reintegração social de indivíduos amputados. O objetivo desta pesquisa foi analisar a qualidade de vida, desempenho ocupacional, força muscular e amplitude de movimento de adultos com amputação dos membros inferiores praticantes e não praticantes de esportes. A amostra foi constituída por 45 amputados, divididos em dois grupos: Esportista (GE, n = 23) e Não Esportista (GNE, n = 22). A coleta foi realizada em Curitiba, Aracaju e Maceió, no período de dezembro/2013, janeiro e março de 2014. Os instrumentos utilizados foram o questionário The Short Form Health Survey (SF-36), a Medida Canadense de Desempenho Ocupacional (COPM), a goniometria e o teste de força muscular de Kendall. Para a análise estatística, foram utilizados os testes de Shapiro-Wilk, qui-quadrado, T de Student e de Mann-Whitney (p < 0.05). Para a variável qualidade de vida, houve diferença significante em todos os oito domínios da avaliação SF-36: capacidade funcional, limitação por aspectos físicos, dor, estado geral de saúde, vitalidade, aspectos sociais, emocional e saúde mental entre os grupos, tendo o GE apresentado os melhores resultados, indicando melhor qualidade de vida que o GNE. O GE apresentou índices significantemente mais elevados de desempenho ocupacional, força muscular (para os músculos flexores e extensores do quadril) e amplitude de movimento (para flexão e abdução do quadril). Concluiu-se, portanto, que houve maior qualidade de vida, desempenho ocupacional, força muscular e amplitude de movimento para amputados que praticam alguma modalidade esportiva.

Made available in DSpace on 2014-07-29T15:04:30Z (GMT). No. of bitstreams: 1 dissertacao marleneandrade.pdf: 776220 bytes, checksum: 89f7e969fbef687591092b3ded9dd40a (MD5) Previous issue date: 2008-04-30 / Assessing patients with chronic wounds poses a challenge to professionals and doubts still persist concerning characterization of the wound infection status. We believe that the Basic Health Units are in places of reference for the public to submit chronic wounds and should have full attendance and resolution were objectives of this study: characterizing patients with chronic wounds attended as spontaneous demand in the bandage room; characterizing patients chronic wounds regarding the presence of classical signs and additional infection criteria; isolating and identifying aerobic bacteria and fungi in the samples of chronic wounds clinically signaling to infection; verifying strains susceptibility when isolated before antimicrobial agents often used in praxis as well as new antibiotics and analyzing the relationship of local factors with infection status. This is a cross-sectional study, carried out in ambulatory bandage rooms in basic health units with emergency service in the municipality of Goiânia. Data was collected from June to July, in 2007. Data was obtained through the use of structured interviews containing questions about characterization of patients and a check list for the assessment of chronic wounds through the signs and clinical symptoms indicating infection and analysis of wound samples by using swabs in accordance with Levine s technique. After consent and approval of the ethics committee, 46 patients were evaluated and 60 wound samples were assessed. Data bank was organized in Excel table and statistics analysis in SPSS- 15.0. The average age was 55 years, 37 (80.4%) male, 20 (43.5%) belonging to E social class, 23 (50%) retired people having basic sanitation items. 28 (61%) presented venous ulcerated lower limbs, 31 (67.4%) performed the bandage both in the BHU and at home. 45 (75%) out of 60 wounds were infected and 15 (25%) noninfected. Through bivariate analysis we verified an association of the infection status with the following characteristics: width depth of tissular damage, necrotic tissue and exudate amount. Among signs and symptoms, classical ones occurred in a frequency higher than 65% both in the infected and noninfected group. Regarding the additional ones, we verified variance in occurrence in both wound groups. Staphylococcus aureus was predominat in 65% of cases and was sensitive to most antibiotics tested. Among Gram-negative bacteria the most frequent were: Pseudomonas aeruginosa (23%), resistant to amoxylin +clavulanic acid, cefalexin and cefotaxim; Proteus mirabilis (16.6%) and Proteus vulgaris (15.0%), all sensitive to gentamicin, aztreonam, ciprofloxacin, and amicacin. These results indicate the need to structure an integrated net to treat patients with chronic wounds and evidence additional criteria to be employed in the elaboration of service protocols pursuing improvement of quality of assistance given in basic health units. / A avaliação de pacientes com feridas crônicas representa um desafio para os profissionais, e dúvidas, ainda persistem em torno da caracterização do status de infecção, nessas lesões. As Unidades Básicas de Saúde constituem-se locais de referência para a população portadora de feridas crônicas, onde deveriam ter atendimento integral e resolutividade. Objetivos deste estudo: caracterizar os pacientes com feridas crônicas, atendidos como demanda espontânea, na sala de curativos; caracterizar as feridas crônicas dos pacientes atendidos em relação à presença de sinais clássicos e critérios adicionais de infecção; isolar e identificar bactérias aeróbias e fungos das amostras de feridas crônicas, com indícios clínicos de infecção; verificar a susceptibilidade das cepas isoladas, frente aos antimicrobianos freqüentemente utilizados na prática e novos antibióticos, e analisar a relação de fatores locais, com o status de infecção. Trata-se de estudo transversal, realizado em Salas de Curativos Ambulatoriais de Unidades Básicas de Saúde (UBS), com atendimento de urgência do Município de Goiânia. Os dados foram coletados no período de junho a julho de 2007 e obtidos por meio de entrevista com roteiro estruturado, contendo questões de caracterização dos pacientes e de um check-list, para a avaliação das feridas crônicas, por meio dos sinais e sintomas clínicos indicativos de infecção, e análise de amostras de feridas utilizando o swab, mediante técnica de Levine. Após aprovação pelo Comitê de Ética e Consentimento, foram avaliados 46 pacientes, e analisadas amostras de 60 feridas. Os programas computacionais utilizados para organizar e analisar estatisticamente os dados foram: o Excel e o SPSS (versão 15.0), respectivamente. A média de idade foi de 55 anos, 37 (80,4%) eram do sexo masculino, 20 (43.5%) pertenciam à classe social E, 23 (50%) eram aposentados e possuíam itens de saneamento básico, 28 (61%) apresentaram úlceras venosas, localizadas nos membros inferiores, 31 (67,4%) realizavam o curativo nas UBS ou em domicílios. Das 60 lesões, 45 (75%) estavam infectadas e 15 (25%) não infectadas. Mediante análise bivariada, verificaram-se associação com o status de infecção as seguintes características: profundidade da extensão do dano tissular, quantidade de tecido necrótico e exsudato. Dentre os sinais e sintomas, os clássicos ocorreram numa freqüência superior a 65%, tanto no grupo de infectadas quanto não infectadas, e nos adicionais verificou-se variação na ocorrência, em ambos os grupos de feridas. Houve predominância do Staphylococcus aureus em 65% dos casos e a maioria sensível aos antibióticos testados. Entre as bactérias Gram-negativas, as mais freqüentes foram: Pseudomonas aeruginosa (23,3%), resistentes à amoxicilina+ácido clavulânico, cefalexina e cefotaxima; Proteus mirabilis (16,6%) e Proteus vulgaris (15,0%) sensíveis a gentamicina, aztreonam, ciprofloxacino e amicacina. Estes resultados indicam a necessidade de se estruturar uma rede integrada, para o atendimento dos pacientes com feridas crônicas. Também evidenciam critérios adicionais que podem ser empregados na elaboração do protocolo de atendimento, buscando a melhoria da qualidade da assistência prestada nas unidades básicas de saúde.