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To describe 26 cases of bulbar conjunctival sporotrichosis.Review of clinical records of patients with bulbar conjunctivitis due to culture-provenTwenty-six patients were identified. Median age was 25 years. Adults were more affected (53.8%), followed by adolescents (26.9%). There was a predominance of women (73.1%). Twenty-four patients (96%) reported contact with cats with sporotrichosis. Twenty-one patients (80.8%) presented a primary ocular sporotrichosis. Five patients presented associated eyelid lesions, and 21 (80.8%) tarsal conjunctivitis. Parinaud oculoglandular syndrome was observed in 17 (81%) patients. Eight patients (36.4%) reported the use of steroid drops before diagnosis was made. All patients but one were treated with oral itraconazole. Twenty-three patients (88.5%) were completely cured and three (11.5%) were lost to follow-up. Eight patients (34.8%) developed ocular sequelae.Bulbar conjunctivitis is an important clinical presentation of ocular sporotrichosis. It can lead to ocular sequelae. Sporotrichosis should be considered in the differential diagnosis of ophthalmic external diseases, especially in patients with cat contact history.

In critical patients after cardiac arrest, brain injury caused by ischemia/reperfusion may lead to long-term limitations and disabilities. The purpose was to estimate economic gains provided by HT technology (Arctic Sun®), resulting from reduction of neurological sequelae in critical patients after

Offshore oil/gas productions are power intensive and CO

Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico – CNPq Ao assumir a Psicologia Histórico-Cultural como base teórico-metodológica, compreendemos que a orientação profissional é um processo de promoção de desenvolvimento e não um fim, enquanto lugar a se chegar. Com essa compreensão, o presente estudo norteia-se pela seguinte pergunta: que estratégias o psicólogo pode utilizar na escola para contribuir com a reflexão dos jovens sobre futuro, trabalho e profissão? Assim, buscou-se investigar o potencial de ações do psicólogo na escola que se constituem como promotoras de reflexões sobre o mundo do trabalho e o futuro. Esta pesquisa-intervenção foi desenvolvida com estudantes do 1º ano do ensino médio de uma escola pública estadual, localizada na periferia de uma grande cidade no interior de São Paulo. Foram realizados encontros semanais que envolveram a apreciação e a produção de diferentes materialidades artísticas, a saber: filmes, fotografias, pinturas, músicas e desenhos; além de oficinas com profissionais que atuam em áreas de interesse dos estudantes. Os resultados revelam que as interações entre o psicólogo, a professora e os adolescentes, refletindo sobre as relações cotidianas presentes no espaço da escola pública, impactam na constituição do interesse e da participação dos alunos em suas atividades. A concepção de trabalho, para os jovens dessa pesquisa, esteve diretamente associada a uma visão pragmática, sobressaltando o esforço individual em detrimento do coletivo. Portanto, concluímos que o interesse não é adquirido, mas se desenvolve nas interações mediadas por elementos como a curiosidade, aproximação, disponibilidade, respeito, implicação e reconhecimento. O uso de diferentes expressões artísticas mostrou-se como potente instrumento de ação do psicólogo, capaz de produzir reflexões que resultam na ampliação da consciência. Assuming Vygotsky’s Cultural Historical Theory as the theoretical-methodological basis we comprehend counseling psychology as a process of promoting development rather than an end, as a place to reach. The present study is guided by the following question: what strategies can the psychologist use at school to contribute to the reflection of young people about future, work, and profession? We sought to investigate the potential of actions from psychologists in school that promote reflections about work and future. This intervention research was developed with students from the first year of high-school in a public state school, located on the outskirts of a large city in the interior of São Paulo. We organized weekly meetings that involved the appreciation and production of different artistic material, such as: films, photographs, paintings, drawings, and others; and, workshops with professionals who worked in areas chosen by students. The results reveal that the interaction among the psychologist, the teacher, and the adolescents, reflecting on the daily relations present in the public school space, impact on the constitution of the interest and participation of students in their activities. The conception of work for the youngsters of this research was directly associated with a pragmatic vision, which undermines the individual effort to the detriment of the collective. Therefore, we conclude that interest in not acquired but develops in interactions mediated by elements such as curiosity, approximation, availability, respect, implication, and recognition. The use of artistic expressions has proved to be a powerful instrument of action for the psychologist, capable of producing reflections that result in the expansion of consciousness.

O artigo apresenta um recorte de pesquisa, fundamentada nos pressupostos teórico-metodológicos da Psicologia Histórico-Cultural, que objetivou investigar a vivência do período pré-vestibular por adolescentes. As informações foram construídas em 15 encontros, mediados por expressões artísticas, com um grupo de estudantes que cursavam o terceiro ano do Ensino Médio de uma escola particular. Como resultado, evidenciou-se que muitos são os cenários que constituem as escolhas profissionais dos jovens e interferem na configuração dos seus modos de pensar o mundo e a si próprios, em relação à escolha da profissão e ao futuro. Há relevância do papel dos professores e da instituição escolar no direcionamento das escolhas dos adolescentes que parecem sucumbir à força exercida pelo social, afastando-se das possibilidades de protagonismo de suas histórias. Os encontros, mediados pela reflexão sobre suas condições de vida e futuro, se configuraram como possibilidade de ressignificação dessas relações.

Objective: This study aims to present the latest developments related to adhesive systems through a literature review. Material and Methods: A search was conducted in the LILACS and PubMed databases. The final sample consisted of 22 studies published between 2003 and 2016. Results: The adhesive systems available on the market can be classified into two categories: etch-and-rinse and those applied using self-etch strategies. Recently, some manufacturers have released more versatile adhesive systems that include both etch-and-rinse and self-etch options. The new materials are called universal or multi-mode adhesives. Conclusion: The results of the majority of the available studies suggest that universal adhesives perform no differently from previous generations of etch-and-rinse or self-etch adhesives. Objetivo: Apresentar, por meio de uma revisão de literatura, os mais recentes desenvolvimentos em relação aos sistemas adesivos. Material e Métodos: A seleção de artigos foi realizada por meio de uma busca nas bases de dados LILACS e PubMed/MEDLINE. A amostra final foi composta por 22 estudos publicados entre 2003-2016. Resultados: Os sistemas adesivos disponíveis no mercado podem ser classificados em duas categorias: convencionais ou autocondicionantes. Recentemente, foi lançada no mercado odontológico, uma nova categoria de sistemas adesivos que apresenta a versatilidade de poder ser aplicada sobre as estruturas dentárias tanto pela técnica convencional quanto pela autocondicionante. Estes novos adesivos foram denominados adesivos universais ou multimodais. Conclusão: Os estudos disponíveis sugerem que os adesivos universais não apresentam uma performance diferente daquelas apresentadas por gerações anteriores de adesivos convencionais e autocondicionantes.

O artigo visa a estimar o custo direto médico do tratamento hospitalar de pacientes idosos com fraturas de fêmur proximal, no Hospital Municipal Lourenço Jorge, na cidade do Rio de Janeiro. Estudo observacional, prospectivo, para estimar a utilização de recursos e custos diretos médicos associados à hospitalização por fratura de fêmur proximal em idosos, em 2007 e 2008, sob a perspectiva do prestador de serviços. Foi utilizado um instrumento de coleta de dados através do qual foram registrados recursos identificados na revisão prospectiva dos prontuários. Aos recursos utilizados foram atribuídos custos em reais (R$) baseando-se em valores do ano 2010. Foram realizadas análises descritivas dos custos e utilização de recursos, bem como avaliada a associação de variáveis clínicas e demográficas com o custo final observado. Foram incluídos 82 pacientes, 81,7% do sexo feminino, idade média de 76,96 anos, hospitalização média de 12,66 dias. A mediana de custo por paciente foi de R$ 3.064,76 (IC95%: 2.817,63 a 3.463,98). Hospitalização clínica e procedimento cirúrgico foram responsáveis por 65,61% e 24,94% dos custos, respectivamente. Pacientes submetidos ao tratamento cirúrgico até o quarto dia de hospitalização apresentaram mediana de custos menor do que pacientes submetidos após o quarto dia (R$ 2.136,31 e R$ 3.281,45, pThis paper aims to assess direct medical costs associated to hospital treatment of hip fractures in the elderly in the Municipal Hospital Lourenço Jorge (HMLJ), Rio de Janeiro. Observational, prospective study to assess resource utilization and direct medical costs associated to elderly hip fracture hospitalization in 2007 and 2008, under the health care provider perspective. A standard data collection instrument was used to register identified resources during prospective medical charts review. The resource utilization was converted into Brazilian Real (R$), based on 2010 prices. Descriptive analysis of costs and resource utilization and their association with clinical and demographic variables were performed. Eighty two patients were included, 81.7% female, mean age of 76.96 years, hospitalization mean time of 12.66 days. Median total costs per patient were R$ 3,064.76 (IC95%: 2,817.63 - 3,463.98). Clinical hospitalization and surgical procedure were responsible for 65.61% and 24.94% of costs, respectively. Median costs for patients submitted to surgical procedure until the fourth day of hospitalization were lower than median costs for patients submitted after the fourth day (R$ 2,136.45 and R$ 3,281.45, respectively, p

Libra Field is a giant oil and gas offshore field situated in Santos Basin, at 200 km from southeastern Brazil coast, 2200 m water depth and 5 km crust depth. The product of Libra is a 27°API oil with a remarkable characteristic: an impressive gas/oil ratio of approximately 600 sm/m with a CO2 content over 40%mol. The extraction of this oil obligates the processing of such CO2 rich gas, which must end with the reinjection of all CO2 into the field for environmental reasons and to sustain oil production. The removal of CO2 and adequate destination of specified gas with minimum footprint – due to space and weight constraints in offshore platforms – and energy consumption configure a central challenge in the Libra scenario. A strategy involves the separation of CO2 from natural gas at the platform and the transportation of the processed gas to shore via pipelines. Four alternatives of topside gas conditioning are assessed in terms of final gas quality and energy demand, using a professional process simulator. The conventional alternative (A) selects a Membrane Permeation (MP) train including TEG Dehydration and JT Expansion for respectively adjusting water dew-point and hydrocarbon dew-point. Case B is devised by using only a Supersonic Separator (3S) to treat the gas. The third alternative (C) uses 3S for dew points adjustment and MP for CO2 removal. Case D also involves TEG absorption and JT Expansion, however, CO2 removal is accomplished by a 3S. The results show that Case B could not completely specify the gas stream, practically not changing the CO2 content. Case C is considered an improvement of Case A, since it employed much less equipment and still presented a better quality natural gas, with 68% more liquid extraction and 18% less energy consumption. Both cases reduced CO2 content to nearly 20%mol. Case D confirms the potential application of 3S for CO2 removal from a dry gas at extremely low temperatures. The final gas CO2 content was slightly higher (24%mol) and the energy demand increased 23% regarding case A, due to the high pressure required. However, the CO2 rich stream in this case is at higher pressure, which means less compression power required for reinjection application.

Crude natural gas (NG) can contain a significant amount of contaminants that must be removed to guarantee safe transportation and sales specification. Water and hydrocarbon dew point (WDP and HCDP) adjustments are important for conditioning NG. In Brazil, Pre-Salt reservoirs have large amounts of NG with high CO2 content, which also must be adjusted by a suitable operation like Membrane Permeation (MP). Furthermore, offshore processing requires reduced footprints, which minimize inventories and, consequently, intensify propagation of feed disturbances to downstream units. The dynamic scenario is inherently related to riser oscillations caused by slug flow, that may cause operational problems, losses and environmental and safety issues. Hence, the process control system must be sufficiently robust to ensure stability within such context. This work approaches the dynamical analysis of an offshore NG treating process for a typical Pre-Salt feed with the following operations: phase separation, dehydration with triethylene glycol (TEG) absorption, HCDP adjustment via Joule-Thomson (JT) expansion and CO2 removal via MP. The objective is to assess the dynamic behaviour of the process and its control framework under slug flow oscillations within HYSYS simulation environment. As MP is not included in the simulator unit library, a dynamic unit operation extension (UOE-D) was developed. This UOE-D extension adequately reproduces MP response to disturbances allowing the entire process to be dynamically assessed. In general, results point to good process controllability and overall robustness despite the severe slug flow feed oscillations.

Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.

Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.