Wave energy distribution at inlet channel margins as a function of ebb tidal delta morphology: Cananéia Inlet, São Paulo, Brazil.

Wave energy gradients between and along the margins of inlet channels play an important role in defining the inlet margins' evolutionary processes, mainly those related to spit erosion or accretion, and inlet migration. The aim of this study is to understand the wave power distribution along the margins of a tidal inlet (Cananéia inlet, São Paulo, Brazil), its variation over time, and the influences of the ebb tidal delta morphology on the incoming waves. To evaluate changes in bathymetry and morphology of submersed features, we apply geoprocessing techniques to analyze nautical charts from the Brazilian Navy from 1939, 1971, 1985 and 2004. The numerical model MIKE21 SW was applied to assess wave propagation and nearshore wave power. Hence, wave energy levels along the inlet margins were assessed in terms of decadal morphological changes. The results indicate a dynamic behavior of the inlet and ebb tidal delta, pointing to the ebb tidal delta as the main transforming agent of the waves that reach the inner portion of the channel. The morphological changes of the ebb tidal delta over the last decades are critical to define the action of waves on the margins of the inlet.

PP085. Hypertensive complication in pregnancy - HELLP syndrome - One year study (2012).

INTRODUCTION: HELLP syndrome is characterized by hemolysis with a microangiopathic blood smear, elevated liver enzymes, and low platelet count. It develops in 10-20% of women with severe preeclampsia/eclampsia. The syndrome is associated with maternal morbidities - DIC, renal failure, pulmonary edema and hepatic hematoma/rupture. Some need transfusions and others require laparotomies for intraabdominal bleeding. OBJECTIVES: Study the incidence and related risk factors of HELLP syndrome in Pregnancy, as well as the maternal/fetal outcome. METHODS: A retrospective study of admissions for HELLP syndrome in 2012.The statistical analysis was based on Excel 2007. RESULTS: In 55 admissions for hypertensive complications in pregnancy, 3 women had HELLP syndrome - 2 were black race and 1 was caucasian. The average maternal age was 29. None had relevant medical history. 2 of the women developed HELLP syndrome after severe preeclampsia. The fetal/neonatal outcomes were prematurity in 2 cases, birth weight average was 1798g and none had apgar-index below 7. There was no fetal death. Premature delivery occurred in 2 cases and all were by cesarean. Maternal complications that determined Intensive Care Unit Admission was recorded in one case - laparotomy for internal bleeding and transfusions were needed. No maternal death occured. CONCLUSIONS: HELLP syndrome is associated with many morbidities which risk increases with severity of symptoms/lab results. We had no aggresive/fatal outcomes.

PP086. Severe hypertensive complications in pregnancy - Two years study (2011-2012).

INTRODUCTION: There are major hypertensive disorders related to pregnancy-preeclampsia,eclampsia and HELLP syndrome. These women are at an increased risk for placental abruption,renal failure, cerebral hemorrhage,hepatic failure/rupture,pulmonary edema, DIC and of long-term cardiovascular disease. OBJECTIVES: Study the incidence, risk factors, maternal/fetal outcome of hypertensive complications that determined Intensive Care Unit admission. METHODS: A retrospective study of admissions in Intensive Care Unit for preeclampsia, HELLP syndrome and eclampsia in 2011-2012. RESULTS: There were 8 admissions in Intensive Care - 88% black women, average age was 20 years and all were nulliparous. 1 had an hypertension induced by pregnancy, but 63% had increased blood pressure in hospital admission. 50% had elevated liver enzymes, 25% proteinuria, 1 low platelet count and 1 had normal blood results. 50% of the admissions were due to eclampsia, 38% due to severe preeclampsia and 1 due to HELLP. Fetal/neonatal outcomes were prematurity in 25%, birth weight average was 2759g and none had apgar below 7. There was no fetal death. Vaginal delivery occurred in 25% and caesarian in 75%. Maternal complications were elevated blood pressure (75%), cardiorespiratory disorders (38%), encephalopathy (25%), renal disorder (13%) and convulsions (13%). There was no maternal death. CONCLUSION: The risk of adverse outcome increases with the severity of hypertension and organ damage. Early detection and appropriate management are essential.

Rede de atenção aos usuários de substâncias psicoativas: mapeamento de serviços e equipes de enfermagem / Network of attention of the user of psychoative substances: search of the services and nursing staff / Red de atención al usuario de substancia psicoativas: examen de servicio y conjunto de enfermaria

O uso de substâncias psicoativas no Brasil se constitui em um problema de saúde pública e, no Espírito Santo, a política de atenção ao dependente químico vem se modificando nas últimas décadas. O estudo objetivou mapear serviços e equipes de enfermagem de todas as instituições que desenvolvem ações de caráter preventivo e/ou curativo no Espírito Santo, nos anos de janeiro de 2004 a dezembro de 2005. Trata-se de estudo exploratório quali-quantitativo. Partiu-se da listagem do 1º levantamento estadual e através da técnica da bola de neve acrescidas novas instituições. Verificou-se que 59,4% encontram-se na macrorregião centro. Os GAMs representam 61,8% da oferta de tratamento nesta região e o tratamento ambulatorial (68,5%) é superior a internação (61,8%). A droga mais prevalente é o álcool (68,4%) e a maior concentração de instituições com equipe de enfermagem, situa-se na macrorregião centro e 80% das instituições não-governamentais não apresentam enfermagem na equipe. Conclui-se que existe escassez de serviços governamentais disponíveis para atendimento desta população, bem como déficit de recursos humanos da enfermagem, o que reflete baixa qualidade no atendimento prestado. Portanto, é necessário a implementação de políticas para acelerar a municipalização das ações bem como fixar recursos humanos qualificados nesta área.

This paper aims at accomplishing a search of specialized institutions in treatment in users of psychoactive substances and also a search of nursing staffs in Espírito Santo. The study involved restore and preventive institutions of 78 municipalities. The study started off from the first compilation in the state and through the snowball technique new institutions were added. In the data collection a semi-structured instrument was used containing data about the staff and the treatment. Quantitative and qualitative methods were used in the analysis. Most institutions are in the central macro region (59,4%). The GAMs represent 61, 8% of the treatment in that region and the outpatient clinic treatment (68,5%) outnumbers internment (61,8%). The prevailing drug is alcohol (68,4%) and the biggest concentration of institutions that have nursing staff is located in the central micro region and 80% of the non-government institutions did not have nursing in their staffs. There is a lack of government services to assist such population, as well as a deficit of human resources mainly as of nursing, which reflect the low quality service offered. Therefore, it is necessary the implementation of policies to speed actions as well as to settle down qualified human resources in this.

En lo Espírito Santo, la política del atencion al dependente químico esta se modificando en las últimas décadas. El trabajo realizou examen de servicios de las instituiciones de carácter preventivo y curativo en el tratamiento de usuarios de substancias psicoactivas y equipos de enfermería del Espírito Santo en los años de enero de 2004 a diciembre de 2005. A partir de la lista de 1ª investigación Estadual fueron agregadas nuevas utilizando la técnica de la bola de nieve. En la análisis fue usado los metodos cuantitativo y cualitativo. 59,4% de las instituiciones son de la macroregión centro. Los GAMs representan 61,8% de la oferta de tratamiento en esa región y el cuidado ambulatorial (68,5%) es superior a la internación (61,8%). La droga predominante es el alcohol (68,4%) y la concentración de instituiciones con equipos de enfermería están en la macroregión centro. 80% de las instituiciones no gobernamentales no ofrecen enfermería en el equipo. Por lo tanto existe escasez de servicios gobernamentales para atendimiento de esta población, déficit de recursos humanos de la enfermería, lo que refleja baja cualidad en el atendimiento siendo necesario la implementación de políticas para acelerar las acciones y mantener recursos humanos cualificados en esta area.