RESUMO Antecedentes: Após o advento da terapia antirretroviral combinada a infecção pelo vírus da imunodeficiência humana (HIV) deixou de ser uma doença devastadora, porém a neuropatia sensitiva consequente à permanência do vírus e ao efeito colateral do tratamento piora a morbidade desses pacientes. Objetivo: Investigar a qualidade de vida de 64 pacientes com HIV, 24 com neuropatia dolorosa (grupo caso) e 40 sem neuropatia dolorosa (grupo controle). Avaliou-se também o impacto de outros fatores relacionados e não relacionados ao HIV na qualidade de vida. Métodos: Para avaliação da neuropatia dolorosa foram utilizadas as escalas Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Douleur Neuropathique 4 (DN4) e Escore de Comprometimento Neuropático (ECN). Para avaliação da qualidade de vida foi utilizada a escala Short Form Health Survey (SF-36). Fatores relacionados e não relacionados ao HIV foram obtidos através da anamnese e análise de prontuário. Resultados: A qualidade de vida dos pacientes com dor neuropática foi pior em 6 dos 8 domínios da escala SF-36. O número de manifestações clínicas relacionadas ao HIV, tempo de carga viral detectável desde o diagnóstico, tempo de diagnóstico da infecção pelo vírus e tempo de uso de TARVC impactaram negativamente na qualidade de vida. Maior nível de CD4, da escolaridade e da renda familiar impactaram positivamente. Conclusões: A neuropatia dolorosa relacionada ao HIV é fator de piora da qualidade de vida dos pacientes infectados por esse vírus devendo ser incluída na avaliação clínica desses pacientes.

ABSTRACT Background: After the advent of combination antiretroviral therapy, infection with the human immunodeficiency virus (HIV) ceased to be a devastating disease, but sensory neuropathy resulting from the permanence of the virus and the side effects of treatment have worsened the morbidities of these patients. Objective: To investigate the quality of life of 64 HIV-positive patients: 24 with painful neuropathy (case group) and 40 without painful neuropathy (control group). The impact of other factors on quality of life was also assessed. Methods To assess painful neuropathy, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale, Douleur Neuropathique 4 (DN4) questions and Neuropathy Disability Score (NDS) were used. The Short Form Health Survey (SF-36) scale was used to assess quality of life. Factors related or unrelated to HIV were obtained through the medical history and analysis on medical records. Results: The quality of life of patients with neuropathic pain was worse in six of the eight domains of the SF-36 scale. The number of clinical manifestations related to HIV, length of time with detectable viral load since diagnosis, length of time since the diagnosis of HIV infection and length of time of HAART use had a negative impact on quality of life. Higher levels of CD4, education and family income had a positive impact. Conclusions: Painful neuropathy related to HIV is a factor that worsens the quality of life of patients infected with this virus and should be included in the clinical evaluation.

RESUMO Objetivo: Demonstrar os erros mais frequentes na técnica inalatória de pacientes com asma brônquica em tratamento em hospital terciário. Métodos: Estudo transversal, com amostra de conveniência de pacientes com asma, com 18 anos ou mais, em tratamento em ambulatório de pneumologia de um hospital terciário. A avaliação da técnica inalatória dos usuários dos dispositivos de pó seco Aerolizer ®, Aerocaps® ou Diskus®, ou de aerossóis dosimetrados teve como base as orientações da bula do fabricante de cada dispositivo inalatório. Os pacientes demonstraram a técnica inalatória com dispositivos inalatórios vazios, e ela foi considerada correta quando todas as etapas foram realizadas de forma apropriada, ou quando os equívocos provavelmente não interferiam no resultado do tratamento. Resultados: Entre os 71 participantes, 43 (60,5%) realizaram a técnica inalatória de forma incorreta. Dentre os usuários de aerossóis dosimetrados e dispositivos de pó seco, ocorreram erros de técnica inalatória em 84,2% e 51,9%, respectivamente (p=0,013). Os erros foram mais frequentes na etapa da expiração (67,4%), seguidos da aspiração (58,1%) e da apneia (51,2%). No grupo que usava dispositivos de pó seco, os erros mais comuns aconteceram na expiração e, nos que utilizavam aerossóis dosimetrados, a etapa mais comprometida foi a aspiração. Conclusão: Os erros foram mais frequentes entre os que usavam aerossóis dosimetrados em comparação com dispositivos de pó seco. Os equívocos foram mais comuns na etapa da expiração entre os usuários de dispositivos de pó seco e na aspiração entre os que usavam aerossóis dosimetrados.

ABSTRACT Objective: To demonstrate the most frequent errors in inhalation technique in patients with asthma undergoing treatment at a tertiary care hospital. Methods: A cross-sectional study with a convenience sample of asthma patients aged 18 years or over, treated at a pulmonology outpatient clinic of a tertiary care hospital. The assessment of inhalation technique of users of the dry powder inhalers Aerolizer®, Aerocaps and Diskus®, or metered-dose inhalers was based on the manufacturer's instructions for use of each inhaler device. Patients demonstrated the inhalation technique with empty inhaler devices, and it was considered correct when all stages were performed properly, or when errors probably did not interfere with the treatment outcome. Results: Among 71 participants, 43 (60.5%) performed inhalation technique incorrectly. Among metered-dose inhalers and dry powder inhalers users, inhalation technique errors were found in 84.2% and 51.9%, respectively (p=0.013). Errors were more frequent at the exhalation stage (67.4%), followed by breathing in (58.1%) and apnea (51.2%). In the group using dry powder inhalers, the most common errors occurred during exhalation and, for those using metered-dose inhalers, the most compromised stage was aspiration. Conclusion: Errors were more frequent among those using metered-dose inhalers compared with dry powder inhalers. Misconceptions are more common at the expiration stage among users of dry powder inhalers and in aspiration among those on metered-dose inhalers.

ABSTRACT CONTEXT AND OBJECTIVE: Treatment of asthma implies inhalation of specific drugs to reach high concentrations in the respiratory tree and ensure low drug bioavailability and few adverse effects. This study aimed to evaluate the effectiveness of the inhalation technique among outpatients with asthma. DESIGN AND SETTING: Tertiary-care hospital-based cross-sectional study in Rio de Janeiro. METHODS: We evaluated inhalation practices in a convenience sample. A questionnaire was used to investigate sociodemographic data and assess disease control level, duration of use of the inhalation device, length of treatment and previous instructions provided by the prescribing physician. Patients demonstrated their inhalation technique using empty devices, and their technique was considered correct when all steps were appropriately performed or when errors did not interfere with the treatment outcome. RESULTS: Among the 71 participants, 53 (74.7%) had been using the same inhaler device for at least two years and 41 (57.8%) had been under treatment for two years or more. Twelve (17.1%) said that they had been taught once and 57 (81.4%) at least twice, while one (1.4%) reported not having received any guidance regarding use of inhaler devices. Eighteen patients (25.3%) presented controlled asthma and 28 (39.5%) performed the inhalation technique correctly. Incorrect technique was associated with fewer evaluations of the inhalation technique (P =0.04) and uncontrolled asthma (P = 0.01). CONCLUSIONS: Less than half of the sample performed the inhalation technique correctly. Incorrect inhalation technique was related to lower number of evaluations of the use of the inhalation device and uncontrolled asthma.

Resumo Uma das principais controvérsias relativas à realização da Copa do Mundo no Brasil diz respeito à construção de novos estádios, sobretudo aqueles indicados como potenciais "elefantes brancos", como é o caso da Arena das Dunas, em Natal. O presente trabalho teve por objetivo avaliar os argumentos que constituem os diferentes discursos acerca da construção da Arena das Dunas. Para tal, acessamos três posições discursivas sobre o assunto: dos organizadores, da imprensa e da sociedade civil. Os dados foram coletados por meio de entrevistas, observação direta e documentos. O método adotado foi a arqueologia foucaultiana e sua análise de discurso. Como lente teórica, adotamos a teoria do pós-desenvolvimento. Nossos achados apontam para duas formações discursivas antagônicas: uma favorável e outra contestadora ao investimento feito na construção da arena.

Abstract One of the big controversies surrounding the holding of the World Cup soccer finals in Brazil involved the construction of new stadiums, especially those considered as potential "white elephants", such as the Arena das Dunas in Natal. The purpose of this study was to evaluate the arguments that constituted the different discourses relating to the construction of the Arena das Dunas. To this end, we looked at three different discursive positions on this subject: those of the organizers of the event, those of the media and those of civil society. The data was obtained through interviews, direct observation and documents. The method adopted was Foucauldian archeology and its discourse analysis. In opting for a theoretical perspective, we adopted post-development theory. Our findings pointed to two opposing discursive formations: one favorable and the other contrary to the investment made in the construction of the stadium.

Resumen Una de las mayores controversias en relación con el logro de la Copa del Mundo en Brasil se refiere a la construcción de nuevos estadios, especialmente los que se señalan como posibles "elefantes blancos", como el Arena das Dunas en Natal. Este estudio tuvo como objetivo evaluar los argumentos que constituyen los diferentes discursos sobre la construcción de la Arena das Dunas. Para esto, accedemos a tres posiciones discursivas sobre el tema: la de los organizadores, de la prensa y de la sociedad civil. Los datos fueron colectados a través de entrevistas, observación directa y documentos. El método utilizado fue la arqueología de Foucault y su análisis del discurso. Como lente teórica, adoptamos la teoría del post-desarrollo. Nuestros resultados apuntan a dos formaciones discursivas antagónicas: una favorable y otra contestadora de la inversión hecha en la construcción de la Arena.

ABSTRACT The use of chemical methods to assess the soil organic nitrogen (N) potentially available to plants is not a common practice in Brazil. However, associated with others, this tool might improve efficiency in the use of waste and nitrogen fertilizers. In our study, chemical methods were tested to assess potentially available soil N in samples of 17 representative soils of the western plateau of the state of São Paulo (10 Oxisols and 7 Ultisols). Available soil N was extracted from the collected soil samples using moderate (ISNT-Illinois Soil Nitrogen Test) and mild (hot water and heated solutions of 2 mol L-1 KCl and 0.01 mol L-1 CaCl2) extraction methods. The levels of potentially available N obtained from these chemical methods were correlated with dry matter (DM) and N uptake (Nup) by corn plants grown in pots in a greenhouse experiment carried out with the same 17 soil samples. The ISNT method showed the highest available N extraction capacity, whereas hot water showed the lowest capacity, followed closely by the hot 0.01 mol L-1 CaCl2 solution. Despite the differences among the quantities of available N extracted, the methods correlated with each other and with DM and Nup, but the values from the ISNT method showed the lowest correlation with plant variables (rDM = 0.67** and rNup = 0.81**). Procedures of extraction with water or 0.01 mol L-1 CaCl2 heated for 16 h, and 2 mol L-1 KCl heated for 4 h, resulted in similar correlation values (r) with plant DM and Nup. Thus, water (rDM = 0.77** and rNup = 0.90**) and 0.01 mol L-1 CaCl2 (rDM = 0.82** and rNup = 0.93**) heated for 16 h can be recommended as the best options for N extraction.considering the possibility for predicting N availability, lower generation of waste, and lower cost of analysis.

Este artigo tem como objetivo avaliar a eficiência das companhias aéreas brasileiras, através do uso de Análise de Envoltória de Dados (DEA). Essa ferramenta determina a eficiência relativa de cada unidade em análise, comparando-a com as demais e considerando a relação entre insumos (inputs) e produtos (outputs). O modelo DEA usado leva em conta os retornos de escala, através da comparação de cada companhia com as que operam em escala semelhante. São considerados os dados relativos ao transporte aéreo de passageiros nos anos de 1998, 1999 e 2000, e cada companhia é considerada como uma unidade diferente em cada um dos três anos. São calculados, para cada DMU, o seu índice de eficiência e seus alvos, estes segundo o enfoque DEA-Multiobjetivo, que permite a escolha de uma meta dentre um conjunto possível de empresas eficientes.

This paper aims to evaluate the efficiency of Brazilian air carriers. Data Envelopment Analysis (DEA) approach is used to determine the efficiency of each airline company, comparing its outputs with available inputs. Scale of operation is taken into account. The aim is to measure each company’s performance, comparing its relative efficiency to all others included in the group under investigation. It is possible to evaluate each carrier efficiency over the years (1998, 1999 and 2000), assuming that the same company is a different one in different years. Both efficiency index and targets choice are performed. The proposed approach, that uses a Multiobjective-DEA problem, allows choosing targets belonging to the feasible set of efficient companies.