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Este trabalho apresenta possibilidades de projeto em um vazio urbano na cidade de Campos dos Goytacazes. Os projetos tiveram como premissa princípios de sustentabilidade e ordenamento urbano, como, baixa ocupação do solo, mobilidade sustentável, densidade compatível com a estrutura urbana, distribuição equilibrada de áreas verdes e áreas institucionais, divisão em quadras convencionais e superquadras, hierarquia viária e definição de áreas de preservação. O objetivo do trabalho foi verificar o potencial de ocupação de um vazio urbano seguindo a Legislação de Parcelamento do Solo de Campos dos Goytacazes. Em relação à metodologia utilizada foram feitos estudos de caso, pesquisa da legislação urbanística e normas de acessibilidade, integração do sistema viário existente com o proposto. Foram definidos os tipos e tamanhos das vias, a divisão dos lotes nas quadras respeitando a Lei de Uso e Ocupação do Solo. A preservação do Parque Urbano definido pelo zoneamento municipal foi mantido e delimitado por novas vias. E para manter a continuidade viária do projeto, foi proposto um túnel passando por debaixo do parque com a preocupação de manter essa área preservada. Foi elaborado conceito com desenhos esquemáticos e posteriormente o projeto final em AutoCAD. O resultado segue a legislação urbanística e ambiental integrando o meio ambiente natural ao construído. Conclui-se que a área de estudo tem grande potencial de ocupação para projetos com características sustentáveis, assim destacamos que o poder público deve utilizar dos instrumentos da política urbana federal, como o parcelamento compulsório, para a disponibilização destas áreas que não atendem a função social da propriedade, para urbanização e ordenamento do território.

Background: In vivo study of the mechanical behavior of tendons may bring advances in evaluating the impact of intervention programs for flexibility and strength, in clinical practice and sports. Objective: The aim of this study was to quantify the relative strain and slackness of achilles tendons during passive mobilization, for four ankle joint angles and two knee angles. Methods: The displacement of the muscle-tendon junction was quantified by means of ultrasound images acquired during passive ankle mobilization, with the aid of an electrogoniometer and an electromyograph to ensure the achievement of the required angles and muscle inactivity, respectively. Results: The strain values ranged from 4.28%±2.37 to -0.94%±1.58 for the fully extended knee, and from 2.38%±1.63 to -2.32%±2.16% for the flexed knee. Conclusions: The values found in this study confirm those in the literature and demonstrate how the Achilles tendon participates in length changes in the muscle-tendon unit during passive movement. These results suggest that the mechanical properties of tendinous tissues affect the relationship between the length of muscle fibers and the joint angle, even during this type of movement. [ABSTRACT FROM AUTHOR]

O objetivo foi avaliar a qualidade microbiológica e parasitária de filés de peixes Panga (Pangasius sp.) comercializados no Estado de Mato Grosso. Foram colhidas 25 amostras de filés de Pangasius sp. comercializadas em oito cidades do Estado de Mato Grosso, no período de julho a agosto de 2014. Para a análise microbiológica, foi realizada contagem de Staphylococcus coagulase positiva; pesquisa de Salmonella sp.; enumeração de coliformes totais, termotolerantes e Escherichia coli pelo método de número mais provável (NMP). Não obstante, procedeu-se a análise parasitológica através da pesquisa de estruturas morfológicas parasitárias. Estirpes de Staphylococcus coagulase positiva foram isoladas em duas amostras (2/25) com contagem de 3,8 x 104 e 1,4 x 105 UFC/g. Em uma amostra (1/25), foram obtidos valores de 23 NMP/g para coliformes totais, 4 NMP/g para coliformes termotolerantes e 4 NMP/g para E. coli. Não foram isoladas cepas de Salmonella sp.. Não foi observada estrutura parasitária. De acordo com a Resolução - RDC n° 12, de 2 de janeiro de 2001, duas amostras foram consideradas impróprias para o consumo humano, por apresentarem contagens de Staphylococcus coagulase positiva acima de 10³ UFC/g. Embora, 92% (23/25) dos filés de Panga estejam de acordo com o estabelecido pela legislação brasileira vigente, devem-se estabelecer medidas que visem a melhoria da qualidade dos produtos da pesca, com boas práticas de fabricação e manipulação a fim de reduzir o risco de enfermidades transmitidas por alimentos. [ABSTRACT FROM AUTHOR]

Infectious aneurysms are about 1-3% of all aneurysms of the infrarenal aorta. Its treatment is challenging and the best strategy is far from consensual. The authors report a case of a HIV + patient with multiple other co-morbidities, which was seen in the emergency department with fever and left back pain. These symptoms would prove to be in relation to a ruptured infectious aneurysm of the abdominal aorta. Facing this situation it was decided to select an endovascular technique with implantation of an aorto uni - iliac stent graft with a right-left femoro-femoral cross-over using a 8 mm PTFE graft and exclusion of the left common iliac . The patient didn't have any complication from the situation or the procedure, but died 18 months postoperatively because of a pneumonia caused by Pneumocystis jiroveci. Although it is not the ideal solution for the treatment of infectious elective aneurysms, we believe that endovascular treatment seems to be a viable option and should be taken into account in a subgroup of patients that for their co-morbidities are not good candidates for conventional surgery and for those in rupture, either as a bridge or as a final solution.

Terminal chronic kidney disease courses with high mortality and is a serious public health problem on a global scale. In Portugal, it involves about 14,000 patients of whom 5,000 are transplanted. The remaining require permanent renal replacement techniques. Every year, there are 2,200 new cases and the mortality rate is around 20%. One of the most important determinants for the survival of hemodialysis patients is the quality of vascular access. The role of the vascular surgeon is to planify and to do the best access possible, monitoring and fight for its patency and thereby improve not only the quality of life but also to combat mortality associated with complications of vascular access - first cause of hospital admission of these patients. The authors report 10 clinical cases in which the limits of the hemodialysis surgery were tested and where it was necessary commitment and imagination to prevent the vascular access loss. The management of some complications is a challenge for the vascular surgeon and currently it is necessary to find hybrid/complementary solutions. Examples of some complications and challenges are steal syndromes, venous hypertension, vascular access in unusual places and 'total' failure of vascular access. Focusing on maintaining vascular access working improves the quality of dialysis, quality of life for patients, saves vascular capital for future access and in extreme cases, saves lifes.

The prognosis for patients with chronic coronary artery disease and severe left ventricular dysfunction is poor, despite advances in different therapies. The assessment of myocardial viability has become an important aspect of the diagnosis, prognosis and management of patients with ischemic cardiomyopathy. Patients with left ventricular dysfunction, with a substantial amount of severely ischemic myocardium are at highest risk, and are likely to benefit from coronary revascularization. Patients with predominantly scar tissue should be treated medically. Multiple imaging techniques have been developed to assess viable and nonviable myocardium by evaluating perfusion, cell membrane integrity, glucose metabolism, fibrosis and contractile reserve. PET FDG-F18, myocardial perfusion scintigraphy (with (201)Tl and (99m)Tc), dobutamine stress echocardiography and more recently magnetic resonance have been extensively evaluated for assessment of viability and prediction of clinical outcome after coronary revascularization. In general, nuclear imaging techniques have a higher sensitivity for the detection of viability, whereas techniques evaluating contractile reserve have higher specificity (with lower sensitivity). Magnetic resonance has a high diagnostic accuracy for assessment of the transmural extent of myocardial scar tissue. The aim of this article is to review the role of Nuclear Medicine in assessing myocardial viability and risk stratification in patients with advanced left ventricular dysfunction, and to compare it with other imaging modalities.

The author started in the year 2000, in the St Marta Hospital, a consultation for congenital vascular malformations, that was extrapolated to the Pulido Valente Hospital - CHLN where he continues to see multiple patients with this type of pathology, mainly located to the extremities.The Klippel Trenaunay syndrome, which was described as a set of anomalies constituted by the presence of a cutaneous angiomatous malformation ( port wine stain ), varicose veins and gigantism of the limbs, is undoubtedly the most common malformations that he is asked to treat. So he thought that it would be interesting to undertake an actual review of this pathology.After analyzing the various components in question he concludes that the condition is undoubtedly a set of malformations ranging from a cutaneous component, to the venous and lymphatic malformations and clear the osseous component, that causes the bone dysmorphic appearance, and that is essential a multidisciplinary approach to achieve a final satisfactory therapeutic result.

Hypothenar hammer syndrome (HHS) is a rare condition and is a term used to described an aneurysm or thrombosis of the ulnar artery. It is considered an occupational or recreational injury and usually results of repetitive trauma to the hypothenar region, where th unique anatomy after the artery leaves the Guyon canal, allows the arterial injury. Clinical manifestations are more often unilateral, involving the dominant hand. However, some authors report the existence of a previous arteriopathy, predisposing to the injury, after repetitive palmar trauma.The authors report the clinical case of a 60 year-old woman, with an ulnar aneurysm in the non dominant hand, without evident existence of repetitive trauma. The pathological examination of the artery revealed muscular hyperplasia, without the characteristics of muscular fibrodysplasia. The authors believe that this case, once again, demonstrates the existence of an autonomous and "previous" arteriopathy associated to the traumatic lesion.

Objective: To evaluate the protective role of breastfeeding against diarrhea in children younger than one year of age in the city of Feira de Santana, Brazil, in 2001., Methods: A cross-sectional study was carried out. Questionnaires were applied to mothers by 104 university students on the national vaccination day in 44 health units (71.0%) selected by simple stratification. 2,319 children were evaluated (24.3% of the estimated population). The prevalence ratio was calculated and considered significant if p< or =0.05 with a 95% confidence interval., Results: Diarrhea occurred in 11.6% of the sample, with greater frequency after the sixth month (63.3%). The chance for presenting diarrhea was 64% higher in children younger than six months who were not breastfed vs. breastfed children (p<0.02). When compared to the children who were exclusively breastfed, the chance for presenting diarrhea increased to 82% in children who were not breastfed (95% CI 1.11-3.01)., Conclusions: Breastfeeding and exclusive breastfeeding were a protective factor against diarrhea in the first six months of life.

Three cases of subcutaneous phaeohyphomycosis from the state of Pará, Brazil are reported. This is the first time that this form of phaeohyphomycosis is described in northern Brazil. The etiologic agents could not isolated, and the diagnosis in all cases was established only on histopathological basis, particularly through the demonstration of fungal elements in tissue sections. Hyphal fragments and vesicular cells were very numerous and conspicuous in special (Grocott and Fontana-Masson methods) stained sections, in contrast to their apparent scarcity in routine hematoxilin-eosin preparations. The difference was certainly due to the aspect in the latter of the invasive tissue forms: the thin-walled and light brown pigmented organisms stained poorly and were very difficult to distinguish from the tissue components.

Between November 1977 and April 1992, thirty patients carrying several forms of renal artery fibrodysplasia underwent surgical treatment. The series is composed of thirteen male and seventeen female, aged between 1 and 51 years (mean age 32). All patients had arterial hypertension, which was not relieved by medical therapy, consisting in the administration of an average of 2.9 antihypertensive drugs per patients. Bilateral renal artery lesions were diagnosed in ten patients (33.3%). The remaining twenty patients (66.6%) had unilateral lesions, one of which involved a congenital single kidney, making a total of forty renal arteries affected by the disease. Surgical procedures consisted in renal artery revascularization in thirty-one kidneys, in aneurysmectomy alone or associated with aorto-renal bypass in six cases, and in a nephrectomy as a single procedure in one case. Three kidneys were considered lost and were left untouched. There was no operative mortality. Evaluated between 1 and 173 months following the operation (mean 79 months/6.6 years) twenty-six patients (86.6%) were classified as either cured or improved. Only two patients (6.6%) did not get any improvement with the surgical treatment. Two patients whose condition after the operation was considered satisfactory were lost to follow-up. The results of this experience are compared with other series published in the international literature, as well as with the percutaneous transluminal angioplasty which has been regarded as an alternative to arterial reconstructive surgery.

In this article the authors present an overview of training of the labor force in health in Brazil. The analysis focuses on nursing services, as there is a need to train professionals to work in the area of nursing. To date, nursing has been exercised to a large extent by lay personnel, who do not have specific training, to the detriment of the population seeking medical services. The article highlights a project (Projeto Larga Escala) aimed at turning mid- and elementary-level personnel into professionals through on-the-job training. Such training integrates education and evaluation into the workers' day-to-day activities. This type of education also benefits nurses with high-level training, who become educators. In preparing for that new role, they undergo a process similar to a refresher course, renewing their technical skills.

The authors have done a morphometric study by determination of mastocyte population of cutaneous wound's granulation tissue of parotidectomized rats and rats which were submitted to daily administration of 25 mg of 6-propyl-2-thiouracil (hypothyroid). The animals were sacrificed after four, eight and 12 post-operative days. The results analysis permitted to observe a statistically significant diminution of mastocyte population in the hypothyroid and parotidectomized animals granulation tissue in the fourth and 12th postsurgical days.