Avaliação da eficiência do processo foto-fenton combinado com lodo ativado aplicado no tratamento do lixiviado do aterro de Santa Tecla em Gravataí - RS

A geração de lixiviado em aterros sanitários no Brasil tem sido amplamente discutida pela sociedade em geral, uma vez que são efluentes com elevadas cargas de poluentes recalcitrantes, de difícil degradação e de elevada toxicidade. Estes podem causar sérios impactos, tanto em solos, águas subterrâneas e organismos aquáticos de corpos hídricos. O presente trabalho descreve a aplicação do processo de oxidação avançada, método foto-fenton, combinado com tratamento por lodo ativado com etapa anóxica, como alternativa para o tratamento do efluente gerado no aterro Santa Tecla em Gravataí-RS. O modelo foi composto por um processo foto-fenton, para degradação de material recalcitrante e aumento da biodegradabilidade do efluente. Em seguida, um tratamento por lodo ativado, com etapa anóxica, para remoção da carga nitrogenada. O trabalho foi avaliado pela análise da eficiência remoção da demanda química (DQO) e bioquímica de oxigênio (DBO5), de nitrogênio total Kjeldalh e de toxicidade, pelo método de germinação e sementes de Lactuca sativa, (alface) em comparação com os resultados de no efluente bruto gerado no aterro, com vistas no enquadramento na legislação vigente de lançamento de efluentes em corpos receptores. O ensaio de tratamento por foto-fenton, mostrou uma eficiência de remoção de cor de 96,2%, DBO5 = 66,4%, DQO = 75,8 %, e Nitrogenio total kjeldalh = 30,2%, com dosagem de Fe+2 = 708 mg/L e razão molar H2O2/Fe+2 = 2,1. O tratamento combinação de foto-fenton com lodo ativado aeróbio, com etapa anóxica, mostrou uma eficiência de remoção de 87,5% na DQO, 89% na DBO5 e 80,2% no nitrogênio total kjeldahl. Em relação a toxicidade, para o lixiviado bruto, a taxa de germinação foi 100% na concentração de 12,5%, que corresponde a concentração em que não foi observado efeito inibitório. Nas concentrações de 25%, 50% e 100% a taxa de germinação foi zero. No efluente final, resultante do modelo de tratamento proposto, a germinação absoluta é de 93,33% para as concentrações de 25, 50 e 100% de efluente tratado, sendo as concentrações onde o efeito inibitório é observado. Os dados demonstram que o tratamento foto-fenton combinado com lodo ativado, com etapa anóxica, aplicado no tratamento do lixiviado do aterro de Santa Tecla, obteve remoções suficientes para enquadrar os parâmetros de lançamento na da legislação vigente, com uma perspectiva de baixo custo.The generation of leachate in landfills in Brazil has been widely discussed by society in general, since they are effluents with high loads of recalcitrant pollutants, difficult to degradation and high toxicity. These can cause serious impacts on both soil, groundwater and aquatic bodies of water bodies. The present work describes the application of the advanced oxidation process, photo-fenton method, combined with activated sludge treatment with anoxic step, as an alternative for the treatment of the effluent generated at the Santa Tecla landfill in Gravataí-RS. The model was composed by a photo-fenton process, for degradation of recalcitrant material and increase of the biodegradability of the effluent. Then, an activated sludge treatment, with an anoxic step, to remove the nitrogen load. The work was evaluated by the analysis of the chemical (COD) and biochemical oxygen demand (BOD5), total nitrogen Kjeldal, le toxicity by the germination method and Lactuca sativa seeds (lettuce) in comparison with the results of the gross effluent generated in the landfill, with a view to complying with the current legislation on the discharge of effluents into receiving bodies. The photo-fenton treatment assay showed a 96.2% color removal efficiency, BOD5 = 66.4%, COD = 75.8%, and total kjeldalh nitride = 30.2%, with Fe+2 = 708 mg/L and molar ratio H2O2 / Fe+2 = 2:1. The final treatment, combining photo-fenton with activated aerobic sludge, with an anoxic step, showed a removal efficiency of 87.5% in COD, 89% in BOD5 and 80,2% in total nitrogen kjeldahl. In relation to toxicity, the germination rate for the crude leachate was 100% at the concentration of 12.5%, which corresponds to the concentration in which no inhibitory effect was observed. At concentrations of 25%, 50% and 100% the germination rate was zero. In the final effluent, resulting from the proposed treatment model, the absolute germination is 93.33% for concentrations of 25, 50 and 100% treated effluent, the concentrations where the inhibitory effect is observed. The data demonstrate that the combined photo-fenton treatment with activated sludge, with an anoxic step, applied in the treatment of the leachate of the Santa Tecla landfill, obtained sufficient removals to fit the parameters of launch in the current legislation, with a low cost perspective

Evaluation of obstructive sleep apnea in non-cystic fibrosis bronchiectasis: A crosssectional study

The relationship between sleep disorders and bronchiectasis has not been well described. We hypothesize that, due to the irreversible dilatation of the bronchi, the presence of secretions, and airflow obstruction, patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousal. A cross-sectional observational study was performed involving 49 patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis (NCFB). All patients underwent clinical evaluation, spirometry, and polysomnography, and were evaluated for the presence of excessive daytime sleepiness (EDS) and risk of obstructive sleep apnea (OSA). The mean age of the participants was 50.3 +/- 13.6 years51.1% of patients were male and had a mean body mass index of 23.8 +/- 3.4 kg/m(2). The mean total sleep time (TST) was 325.15 +/- 64.22 min with a slight reduction in sleep efficiency (84.01 +/- 29.2%). Regarding sleep stages, stage 1 sleep and REM sleep were abnormal. OSA was present in 40.82% of the patients. The mean arousal index was 5.6 +/- 2.9/h and snoring was observed in 71.43% of the patients. The oxygen desaturation index (ODI) was 14.35 +/- 15.36/h, mean minimum oxygen saturation (SpO(2) nadir) was 83.29 +/- 7.99%, and mean TST with an SpO(2) less than 90% was 30.21 +/- 60.48 min. EDS was exhibited by 53.06% of the patients and 55.1% were at high risk of developing OSA. The patients infected by Pseudomonas aeruginosa had higher apnea-hypopnea indices, ODI, and TST with SpO(2) < 90%, and lower values of SpO(2) nadir. Adult patients with clinically stable NCFB, especially those infected by Pseudomonas aeruginosa, display EDS and a high prevalence of OSA, associated with considerable oxygen desaturation during sleep.Nove de Julho University (Sao Paulo, Brazil)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [313053/2014-6]JJUEAPASSCAPESSanta Casa Sao Paulo Sch Med Sci, FCMSCSP, Masters Degree & PhD Program Surg Res, Sao Paulo, SP, BrazilNove de Julho Univ UNINOVE, Rehabil Sci Masters Degree & PhD Program, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Pulm Rehabil Ctr, UNIFESP, Sao Paulo, BrazilNatl Res Council Italy, Inst Biomed & Mol Immunol Alberto Monroy, Palermo, SI, ItalyUniv Ctr Anapolis UniEVANGELICA, Med Sch, Anapolis, Go, BrazilUniv Fed Sao Paulo, Pulm Rehabil Ctr, UNIFESP, Sao Paulo, BrazilCNPq: 313053/2014-6Web of Scienc

37628 EFFECTS OF NEUROMUSCULAR ELECTRICAL STIMULATION ON THE MASTICATORY MUSCLES AND PHYSIOLOGIC SLEEP VARIABLES IN ADULTS WITH CEREBRAL PALSY: A NOVEL THERAPY APPROACH- PILOT STUDY

Cerebral palsy (CP) is a term employed to define a group of non-progressive neuromotor disorders caused by damage to the immature or developing brain, with consequent limitations regarding movement and posture. CP may impair orapharygeal muscle tone, leading to a compromised chewing function and to sleep disorders (such as obstructive sleep apnea). Thirteen adults with CP underwent bilateral masseter and temporalis neuromuscular electrical stimulation (NMES) therapy. The effects on the masticatory muscles and sleep variables were evaluated using electromyography (EMG) and polysomnography (PSG), respectively, prior and after 2 months of NMES. EMG consisted of 3 tests in different positions: rest, mouth opening and maximum clenching effort (MCE). EMG values in the rest position were 100% higher than values recorded prior to therapy for all muscles analyzed (p < 0.05); mean mouth opening increased from 38.0 ± 8.0 to 44.0 ± 10.0 cm (p = 0.03). A significant difference in MCE was found only for the right masseter. PSG revealed an improved in the AHI from 7.2±7.0/h to 2.3±1.5/h (p < 0.05); total sleep time improved from 185 min to 250 min (p = 0.04) and minimun SaO2 improved from 83.6 ± 3.0 to 86.4 ± 4.0 (p = 0.04). NMES performed over a two-month period led to improvements in the electrical activity of the masticatory muscles at rest, mouth opening, isometric contraction and sleep variables, including the elimination of obstructive sleep apnea events in patients with CP. Trial registration: ReBEC RBR994XFS http://www.ensaiosclinicos.gov.br.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

NEUROCIÊNCIA E TDAH: EXPLORANDO CONEXÕES CEREBRAIS E AVANÇOS EM INTERVENÇÕES TERAPÊUTICAS

The topic involving neuroscience and attention deficit hyperactivity disorder is complex and multifaceted, in addition to involving the understanding of the neural bases and how each region is affected and interfered, it is also possible to develop better and efficient therapeutic processes from this. that help to significantly improve the quality of life of each individual. Objective: To understand the relationship between neuroscience and ADHD, in addition to addressing the best therapeutic paths. Methodology: The bibliographic search to carry out the integrative review was conducted in specialized databases, PubMed and Scopus, using a combination of controlled and uncontrolled terms related to neuroscience, ADHD and therapeutic interventions, the Mesh used: “Attention Deficit Disorder with Hyperactivity ”; “Cognitive Neuroscience”; “Mental Health”. Results: The multiple neural systems and neurotransmitters affected in this process cause impacts on the nervous system and with this arises the importance of developing therapeutic approaches. Thus, the main points of impact are the prefrontal cortex, dopaminergic system, striatum nucleus and attentional network. Each affected region causes a series of changes confirming the theory that ADHD is a neurobiological condition.A temática envolvendo a neurociência e o Transtorno do déficit de atenção e hiperatividade é complexa e multifacetada, além de envolver o entendimento das bases neurais e como cada região é afetada e interferida, também é possível a partir disso desenvolver melhores e eficientes processos terapêuticos que ajudem na melhora significativa na qualidade de vida de cada indivíduo. Objetivo: Entender a relação entre a neurociência e o TDAH, além de abordar os melhores caminhos terapêuticos. Metodologia: A busca bibliográfica para realização da revisão integrativa foi conduzida em bases de dados especializadas, PubMed e Scopus, utilizando uma combinação de termos controlados e não controlados relacionados à neurociência, TDAH e intervenções terapêuticas, os Mesh usados: “Attention Deficit Disorder with Hyperactivity”; “Neurociencia Cognitiva”; “Mental Health”. Resultados: Os múltiplos sistemas neurais e&nbsp; neurotransmissores afetados nesse processo causam impactos no sistema nervoso e com isso surge a importância de desenvolvimento de abordagens terapêuticas. Desse modo, os principais pontos de impacto são córtex pré-frontal, sistema dopaminérgico, núcleo estriado e rede atencional. Cada região afetada causa uma série de mudanças confirmando a teoria que o TDAH é uma condição neurobiológica.&nbsp

Aspectos anatomopatológicos do paciente portador de Pneumonia: Anatomopathological aspects of the patient with Pneumonia

A pneumonia condiz a uma condensação inflamatória aguda dos alvéolos e/ou infiltração tecidual intersticial pulmonar que resulta da ação de células inflamatórias em resposta a injúrias de um determinado agente microbiano. A patologia conforme o local de aquisição, o padrão de comprometimento, o agente etiológico são determinantes para o quadro clínico, lesões e achados radiográficos. O seguinte artigo objetivou descrever através da revisão bibliográfica, os aspectos gerais da pneumonia com foco em abordar os aspectos anatomopatológicos desta enfermidade. Trata-se&nbsp; de&nbsp; um&nbsp; estudo qualitativo&nbsp; de&nbsp; revisão&nbsp; narrativa,&nbsp; elaborado&nbsp; para&nbsp; abordar&nbsp; sobre os aspectos anatomopatológicos do paciente portador de pneumonia.&nbsp; É composta por uma análise ampla da literatura, e com uma metodologia rigorosa e replicável ao nível de reprodução de dados e questões quantitativas para resoluções específicas. &nbsp;Conforme as informações disponíveis na literatura, elucida-se que os pulmões contam com um aparato de mecanismos de defesa. Mas, mediante injúrias e agentes agressores geram um desequilíbrios e posteriormente originam condições que favorecem doenças respiratórias. A pneumonia possui vários agentes etiológicos, e de acordo com este, distintos padrões de acometimento pulmonar e achados radiográficos irão se manifestar

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Análise da viabilidade econômica de implementação de nanocervejarias associadas a restaurantes em Niterói

Este trabalho tem o intuito de analisar a viabilidade econômica da implantação de uma nano cervejaria associada a um restaurante em Niterói-RJ. Para isso foi feito um levantamento do consumo médio mensal de cervejas especiais no município, então foi estipulado um valor base para os cálculos. A partir deste valor base, foi feita uma pesquisa para encontrar um valor de implementação da cozinha para esta produção. Também foram feitos os cálculos dos custos variáveis do processo como custos com insumos e custos energéticos. Após estes cálculos, foi feita uma avaliação utilizando matemática financeira, para determinar a viabilidade econômica desta implantaçãoThis work aims to analyze the economic viability of the implementation of a nanobrewery in a restaurant in the city of Niterói-RJ. In order to achieve this purpose, a research has been made to know the average consumption of beer in the city and, using this information, a brew equipment tat could supply this average consumption was researched. All variable costs of inputs for a recipe and energy expenses, were calculated and the economic viability of this installation was determined using economical mathematic