ABSTRACT The use of a forest seedling bank has been recommended as an alternative to increase species richness in forest nurseries, as well as to produce seedlings of species that are diffi cult to propagate, especially those that belong to the late secondary and climax successional groups, which are not as commercially available. However, little is known about the impact of this method on forest dynamics. Thus, the present study aimed to examine the resilience and dynamics of a seedling bank in a remnant of a subtropical seasonal forest belonging to the Atlantic Forest Biome when subjected to different intensities of seedling removal. The experiment was conducted in a random block design in a factorial scheme (5 × 4), with treatments composed of fi ve intensities of removal of individuals from the seedling bank and the four seasons. The treatments were distributed into 18 blocks and the experimental units were composed of 1 m × 2.5 m plots. The resilience of the seedling community was assessed by examining effects of the fi ve removal intensities. The dynamics between the evaluation periods within each treatment were verifi ed by comparing the number of species and seedlings present before the treatments with those in the other evaluation periods. After one year, we found that tree-shrub vegetation had a partial capacity for restoration after withdrawal of individuals from the seedling bank. Our results show that the impact on the regeneration community can absorb the effects of up to 25% seedling removal. The technique of seedling transplantation may be recommended for species that have abundant regeneration, such as Actinostemon concolor, Eugenia rostrifolia, Trichilia claussenii and Nectandra megapotamica.

OBJETIVO: Relatar a segurança e os desfechos clínicos de procedimentos de descompressão intradiscal percutânea em pacientes com dor discogênica nos quais houve falha do tratamento conservador. Procedimentos cirúrgicos minimamente invasivos são uma tendência de tratamento. METODOS: Estudo retrospectivo com descrição dos desfechos clínicos de pacientes tratados com NucleoplastyTM e DeKompressorTM, com seguimento de 5 anos. RESULTADOS: Trinta e quatro (n = 34) pacientes foram submetidos a descompressão intradiscal com seguimento mínimo de 5 anos, 21 obtiveram resolução do quadro álgico, 8 foram submetidos a artrodese intersomática lombar, um foi submetido a discectomia cirúrgica e 4 apresentam dor lombar residual. Não ocorreram eventos adversos. CONCLUSÃO: Foi demonstrada a mesma segurança obtida em outros trabalhos que também avaliaram o uso da zona triangular de segurança para procedimentos percutâneos. O índice de sucesso com o procedimento percutâneo assemelha-se a outros estudos mais recentes publicados em uma metanálise. A realização de estudos comparativos, prospectivos e controlados será útil para definir melhor a efetividade dos procedimentos percutâneos.

OBJECTIVE: Report safety and clinical outcomes of percutaneous intradiscal decompression procedures in patients with discogenic pain that failed conservative treatment. Minimally invasive surgical treatments are a trend. METHODS: A retrospective study describing the clinical outcomes of patients treated with NucleoplastyTM and DeKompressorTM, with follow up of 5 years. RESULTS: Thirty-four (n=34) patients underwent intradiscal decompression with a follow-up period of 5 years, 21 had resolution of pain, eight underwent lumbar interbody arthrodesis, one underwent surgical discectomy and 4 had residual back pain. There were no adverse events. CONCLUSION: It was demonstrated the same safety obtained in other studies that also evaluated the use of triangular safety zone for percutaneous procedures. The success rate with the percutaneous procedure is similar to other studies published in a recent meta-analysis. The comparative studies, prospective and controlled will be useful to better define the effectiveness of percutaneous procedures.

OBJETIVO: Informe de la seguridad y los resultados clínicos de los procedimientos de descompresión intradiscal percutánea en pacientes con dolor de origen discal que fracasó el tratamiento conservador. Tratamientos quirúrgicos mínimamente invasivos son una tendencia está OK. METODOS: Estudio retrospectivo que describe los resultados clínicos de los pacientes tratados con NucleoplastyTM y DeKompressorTM, con un seguimiento de 5 años. RESULTADOS: Treinta y cuatro (n = 34) pacientes fueron sometidos a descompresión intradiscal y evaluados por período de 5 años, 21 tuvieron la resolución del dolor, 8 se sometieron a artrodesis lumbar intersomática, un paciente fue sometido a una discectomía quirúrgica y 4 tienen dolor lumbar residual. No hubo eventos adversos. CONCLUSIÓN: Se ha demostrado el mismo grado de seguridad alcanzado en otros estudios que también evaluaron el uso de la zona triangular de seguridad para procedimientos percutáneos. La tasa de éxito con el procedimiento percutáneo es similar a otros estudios publicados en un reciente meta-análisis. Los estudios comparativos, prospectivos y controlados serán útiles para definir mejor la eficacia de los procedimientos percutaneous.

FUNDAMENTO: A Disfunção Erétil (DE) se associa ao risco aumentado de Doença Arterial Coronariana (DAC). OBJETIVO: Avaliar a associação entre DE, determinada pelo Índice Internacional de Função Erétil Simplificado (IIFE-5), e DAC. MÉTODOS: Estudo de corte transversal que avaliou 263 hipertensos (55 [50 - 61] anos). A DE foi avaliada pelo IIEF-5 e a DAC, por meio da história de revascularização miocárdica prévia e/ou por cineangiocoronariografia. RESULTADOS: O IIFE-5 se correlacionou com o clearance de creatinina [ClCr] (Rho = 0,23; p < 0,001) e com a idade (Rho = -0,22; p < 0,001). Quarenta e dois pacientes apresentavam DAC; e o IIFE-5 foi capaz de discriminá-los (área sob a curva ROC = 0,63; p = 0,006). Os pacientes foram divididos em dois grupos: IIFE-5 < 20 (n = 140) e IIFE- 5 > 20 (n = 123); aqueles com menor IIFE-5 tinham idade mais elevada (57 [52 - 61] vs. 54 [45 - 60] anos; p = 0,002), maior prevalência de DAC (22% vs. 9%; p = 0,004), tabagismo (64% vs. 47%; p = 0,009) e do uso de inibidores dos canais de cálcio (65 % vs. 43%; p = 0,001), além de menor ClCr (67,3 [30,8 - 88,6] vs. 82,6 [65,9 - 98,2] ml/min; p < 0,001). O IIFE-5 < 20 se associou ao maior risco de DAC em regressão logística; tanto univariada (RR = 2,89 [IC 95% 1,39 - 6,05]), quanto após ajustes para idade, diabetes, ClCr, tabagismo, pressão arterial média e uso de anti- hipertensivos (RR = 2,59 [IC 95%: 1,01 - 6,61]). CONCLUSÃO: O IIFE-5 se associa ao diagnóstico de DAC e sua utilização pode agregar informação ao estadiamento do risco cardiovascular em pacientes hipertensos.

BACKGROUND: Erectile Dysfunction (ED) is associated with increased risk of coronary artery disease (CAD). OBJECTIVE: To evaluate the association between ED, determined by the Simplified International Index of Erectile Function (IIEF-5) and CAD. METHODS: This was a cross-sectional cohort study that evaluated 263 hypertensive patients (55 [50-61] years). ED was assessed through the IIEF-5 and CAD by the history of previous myocardial revascularization and/or coronary angiography. RESULTS: The IIEF-5 correlated with creatinine clearance [CrCl] (Rho = 0.23, p <0.001) and age (Rho = -0.22, p <0.001). Forty-two patients had CAD, and IIEF-5 was able to discriminate them (area under the ROC curve = 0.63, p = 0.006). Patients were divided into two groups: IIEF-5 < 20 (n = 140) and IIEF-5 > 20 (n = 123); those with lower IIEF-5 scores were older (57 [52-61] vs. 54 [45-60] years, p = 0.002), had higher prevalence of CAD (22% vs. 9%, p = 0.004), smoking (64% vs. 47%, p = 0.009) and use of calcium channel inhibitors (65% vs. 43.%, p = 0.001), as well as lower CrCl (67.3 [30.8 to 88.6] vs. 82.6 [65.9 - 98.2] ml/min, p <0.001). The IIEF-5 < 21 was associated with increased risk of CAD in the logistic regression, both univariate (RR = 2.89 [95%CI: 1.39 - 6.05]), and after adjusting for age, diabetes, CrCl, smoking, mean arterial pressure and use of antihypertensive drugs (RR = 2.59 [95% CI: 1.01 - 6.61]). CONCLUSION: The IIEF-5 is associated with the diagnosis of CAD and its use can add information to cardiovascular risk staging in hypertensive patients.

Analyze the statistical associations among nursing diagnoses identifi ed in patients with renal transplant and their socioeconomic factors. A cross-sectional study performed in a university hospital in Fortaleza, from December 2004 to April 2005. 38 nursing diagnosis were identifi ed. Ten diagnosis presented frequency above the 75th percentile: risk of Infection; disturbed sensory perception; visual; hearing; Sleep pattern disturbance; Imbalanced nutrition; fatigue; sexual dysfunction; disturbed sensory perception: acute pain, more than body requirements; The nursing diagnosis study contributes to increasing the knowledge of realty of these patients, which is a necessary step for the establishment of nursing assistance to the renal transplanted, as well as for the direction of outcomes to be reached aiming the improvement of life quality.

Analizar la asociación estadística entre diagnósticos de enfermería identificados en pacientes con trasplante renal y sus factores socio-económicos. Estudio transversal realizado en un hospital universitario en Fortaleza-CE, entre diciembre de 2004 a abril de 2005. Se identificaron 38 diagnósticos de enfermería. Diez diagnósticos presentaron frecuencias superiores al porcentaje 75: Riesgo de infección; percepción sensorial perturbada: visual; Modelo de sueño perturbado; Nutrición desequilibrada: por exceso; Fatiga; Disfunción sexual; Percepción sensorial perturbada: audición; Dolor agudo; Modelos sexuales ineficaces; Riesgo de desequilibrio nutricional: más de lo necesario. El estudio sobre los diagnósticos de enfermería ayudó a ampliar el conocimiento de la realidad de los pacientes, lo que es necesario para el establecimiento de cuidados de enfermería en el trasplante renal, y también para tratar de los resultados que vayan a desarrollarse buscando mejorar la calidad de vida.

Analisar a associação estatística entre diagnósticos de enfermagem identifi cados nos pacientes transplantados renais e seus fatores sócio-econômicos. Estudo transversal realizado em um hospital universitário em Fortaleza-CE, no período compreendido entre dezembro de 2004 a abril de 2005. Foram identifi cados 38 diagnósticos de enfermagem. Dez diagnósticos apresentaram freqüências acima do percentil 75: Risco de infecção; percepção sensorial perturbada: visual; Padrão de sono perturbado; Nutrição desequilibrada: mais do que as necessidades corporais; Fadiga; Disfunção sexual; Percepção sensorial perturbada: audição; Dor aguda; Padrões de sexualidade inefi cazes; Risco de nutrição desequilibrada: mais do que as necessidades. O estudo sobre diagnósticos de enfermagem ajudou a expandir o conhecimento da realidade dos pacientes, o que é necessário para o estabelecimento de cuidados de enfermagem ao transplante renal, bem como para abordar os resultados que vierem a ser desenvolvidas com o objetivo de melhorar a qualidade de vida.

Epilepsy (E) is a farreaching disorder to confront the humanity. Affects approximatly 2-4% of general population. Undoubtedly in diagnosis and treatment there are a lot of reaserch, even so technology of point, but is neccessary more progress predominantly in patients with E, that are not well control, ed and require more investigations in new medications and new neurosurgical strategies. Moreover, there is an area, that is out exploration, whith are a serial of obstacles to conquer, like psicosocial aspects of E, that is the interaction of patient withd society. Likewise,in this review, we highlight to need to increase education programs for patients and society, about E, and to know what kind of effects we can to observe in future in this people. Specilficaly we can to say, that attention to E, is approached in two areas, clinic, which the have a major progress, and psycosocial, in this is not a good advance, but is very important to pay attention. In this paper, in addition some historics and clinics are reviewed, and we to highlight the psicosocial factors, and the relevance that plays our society in this problem.

La epilepsia (E) es uno de los grandes problemas a los que se enfrenta la humanidad; se estima que afecta entre el 2 y el 4% de la población. No hay duda de los alcances que se han logrado en su diagnóstico y tratamiento, pero aún con la tecnología de punta se requiere de un mayor avance principalmente en los casos epilepsia de difícil control y fomentar la investigación de nuevos medicamentos y técnicas quirúrgicas. Además, existe un campo que no ha sido explorado, y en éste, se encuentran algunos obstáculos que vencer; por desgracia los menos abordados, y los más complejos de resolver como son los aspectos psicosociales, es decir, los relativos a la interacción del paciente con la sociedad. Asimismo, en este artículo también se resalta la necesidad de incrementar programas de educación a los pacientes y la sociedad acerca de la E, y de sus efectos que tendría en las personas con dicho trastorno. En concreto podemos decir que la atención de la epilepsia se ha enfocado a dos áreas: la médico-clínica, que es donde se ha avanzado más, y la psicosocial, en proporción comparada con la anterior, se observa que es muy escasa, pero no por ello deja de ser tan relevante su atención de parte de los profesionales. En este artículo además de revisar algunos aspectos históricos y clínicos, se resalta la importancia de los factores psico-sociales que aquejan a las personas con E, y el papel predominante que ejerce la sociedad.