• Nenhum resultado encontrado

Amputação ou reconstrução da extremidade esmagada: utilização do Índice da Síndrome da Extremidade Esmagada.

N/A
N/A
Protected

Academic year: 2017

Share "Amputação ou reconstrução da extremidade esmagada: utilização do Índice da Síndrome da Extremidade Esmagada."

Copied!
4
0
0

Texto

(1)

$&7$25723%5$6

7UDEDOKRUHFHELGRHPDSURYDGRHP

$57,*225,*,1$/

5(6802

$SUHVHQWDPRVRVUHVXOWDGRVGDDSOLFDomRGRÌQGLFHGD6tQGURPH GD ([WUHPLGDGH (VPDJDGD 0DQJOHG ([WUHPLW\ 6\QGURPH ,QGH[ ²0(6,HPIUDWXUDVH[SRVWDVGHPHPEURVLQIHULRUHV$VH[WUH PLGDGHV FRQVLGHUDGDV HVPDJDGDV SHORV FULWpULRV GR0(6, HP XPWRWDOGHYLQWHIRUDPSRQWXDGDVHUHSUHVHQWDPDEDVHGHVWH HVWXGR'HDFRUGRFRPDHVFDODROLPLWHGHSRQWRVGHILQHVHD H[WUHPLGDGHGHYHRXQmRVHUSUHVHUYDGD$SHQDVGRLVPHPEURV IRUDPVXEPHWLGRVjDPSXWDomRSULPiULDHVFRUHVGHHH DSyVPHVHVHVWDYDPFRQIRUPDGRVFRPDGHFLVmRWRPDGD QmRXWLOL]DYDPyUWHVHVHGHDPEXODYDPFRPDX[tOLRGHPXOHWDV2V SDFLHQWHVTXHDSUHVHQWDUDPRVUHVXOWDGRVPDLVGHVDQLPDGRUHV QDUHDYDOLDomRREWLYHUDPHVFRUHVGHHSRQWRVHWLYHUDPR PHPEURSUHVHUYDGR&RQFOXLXVHTXHRVFULWpULRVGR0(6,OHYDUDP jGHWHUPLQDomRGRTXHpFKDPDGRGH6tQGURPHGD([WUHPLGDGH (VPDJDGD$SRQWXDomRGDVOHV}HVQmRIRLIHLWDFRPIDFLOLGDGHH GLILFLOPHQWHDWLQJLXRHVFRUHGHTXHGHWHUPLQDULDDDPSXWDomR SULPiULD (P QRVVD FDVXtVWLFD D SUHVHUYDomR GR PHPEUR FRP HVFRUHDEDL[RGHQmRVLJQLILFRXTXHDGHFLVmRWHQKDVLGRD PDLVDFHUWDGD

'HVFULWRUHV)UDWXUDVH[SRVWDV$PSXWDomR&ODVVLILFDomR

$0387$d®2285(&216758d®2'$(;75(0,'$'(

(60$*$'$87,/,=$d®2'2Ì1',&('$6Ì1'520(

'$(;75(0,'$'((60$*$'$

0$85,&,2:$1'(5/(<025$/6*$5%,$/%(5722)(1+(-0*27)5<'

7UDEDOKRUHDOL]DGRQR6HUYLoRGH2UWRSHGLDH7UDXPDWRORJLDGD6DQWD&DVDGH0LVHULFyUGLDGH6DQWRV

(QGHUHoRSDUDFRUUHVSRQGrQFLD5XDGD&RQVWLWXLomR6DQWRV63&(3(PDLOPRUDOVJDUEL#\DKRRFRPEU 'RXWRUHPFLrQFLDVSHODXQLYHUVLGDGHGH6mR3DXOR&KHIHGRVHUYLoRGH2UWRSHGLDH7UDXPDWRORJLDGD6DQWD&DVDGH6DQWRV 0pGLFRSyVJUDGXDQGRHP2UWRSHGLDH7UDXPDWRORJLDSHOD6DQWD&DVDGH6mR3DXOR

,1752'8d®2

$ H[WUHPLGDGH HVPDJDGD UHSUHVHQWD XP SURIXQGR GHVDILR DR FLUXUJLmR 4XDQWR PDLV VHYHUDV DV OHV}HV SLRUHV VmR RV UH

VXOWDGRVIXQFLRQDLVHPXLWDVYH]HVFRPSOH[RVSURFHGLPHQWRV

GHFLUXUJLDSOiVWLFDHYDVFXODUGHYHPVHUHPSUHJDGRV'HVWD

IRUPDSDFLHQWHVFRPIUDWXUDVH[SRVWDVGHWtELDJUDX,,,GH*XVWLOOR H$QGHUVRQGHYHPVHUWUDWDGRVHPKRVSLWDLVRQGHSURFHGLPHQWRV

PDLRUHVGHUHFRQVWUXomRSRVVDPVHUUHDOL]DGRV2VDOYDPHQWRGH

PHPEURVHVPDJDGRVFRPVHYHUDOHVmRGHSDUWHVPROHVGHYtWLPDV SROLWUDXPDWL]DGDVSRGHUHVXOWDUHPJUDYHVGLVW~UELRVPHWDEyOLFRV VHFXQGiULRVjVDOWHUDo}HVGHSRWiVVLRHFiOFLRVpULFRViFLGROiWLFR HPLRJORELQD+iDLQGDRULVFRGDGLVVHPLQDomRVLVWrPLFDGH LQIHFomROHYDQGRDRTXDGURGHVHSVH$OpPGLVVRDPSXWDo}HV

LQHYLWiYHLVPXLWDVYH]HVVmRSRVWHUJDGDVRFDVLRQDQGRRDXPHQWR GHGHVSHVDVILQDQFHLUDVSHVVRDLVHVRFLDLV

1DWHQWDWLYDGHWRUQDUREMHWLYDDFUtWLFDGHFLVmR´DPSXWDomRYHUVXV UHFRQVWUXomRµGLIHUHQWHVtQGLFHVIRUDPSURSRVWRVR0(6,0DQJOHG ([WUHPLW\6\QGURPH,QGH[R36,3UHGLFWLYH6DOYDJH,QGH[R0(66 0DQJOHG([WUHPLW\6HYHULW\6FRUHR/6,/LPE6DOYDJH,QGH[R 1,666$1HUYH,QMXU\,VFKHPLD6RIWWLVVXHFRQWDPLQDWLRQ6NHOHWDO

LQMXU\6KRFNDQG$JHHR+)6+DQQRYHU)UDFWXUH6FRUH2

REMHWLYRGRSUHVHQWHHVWXGRpDQDOLVDUDDSOLFDELOLGDGHGR0(6,HP SDFLHQWHVSRUWDGRUHVGHPHPEURVLQIHULRUHVHVPDJDGRV

0$7(5,$/(0e72'26

1RSHUtRGRFRPSUHHQGLGRHQWUHDJRVWRHGH]HPEURGHIRUDP HVWXGDGDVSURVSHFWLYDPHQWHIUDWXUDVH[SRVWDVGHPHPEURV LQIHULRUHVSDFLHQWHVWUDWDGDVHPQRVVRVHUYLoRSRUGLIHUHQWHV HTXLSHVGHSODQWmR2VDXWRUHVQmRSDUWLFLSDUDPGDVGHFLV}HV WRPDGDVQDFLUXUJLDGHXUJrQFLD5HDOL]RXVHHVWXGRGHWDOKDGR GDV GHVFULo}HV GDV FLUXUJLDV UDGLRJUDILDV IRWRJUDILDV H UHODWRV GRVFLUXUJL}HV$IDL[DHWiULDYDULRXGHDDQRVPpGLDGH DQRV +RXYH SUHGRPtQLR GR VH[R PDVFXOLQR SDFLHQWHV 2 PHFDQLVPRGHWUDXPDPDLVIUHTHQWHIRLDFLGHQWHDXWRPRELOtVWLFR VHJXLGRGHDWURSHODPHQWRTXHGDGHDOWXUDIH ULPHQWRSRUDUPDGHIRJRHIHULPHQWRSRUDUPDEUDQFD 3DFLHQWHVFRPOHV}HVGLJLWDLVLVRODGDVRXPHPEURVDPSXWDGRV QRPRPHQWRGDDYDOLDomRLQLFLDOIRUDPH[FOXtGRV

)RLXWLOL]DGRXPSURWRFRORVHPHOKDQWHDRGHVFULWRSRU*UHJRU\FRP

RPHVPRQ~PHURGHFDVRV$VIUDWXUDVIRUDPFODVVLILFDGDVDWUDYpV

$0387$7,21255(&216758&7,212)$60$6+('(1'86(2)7+( 0$1*/('(;75(0,7<6<1'520(,1'(;0(6,

6800$5<

+HUHZHSUHVHQWWKHUHVXOWVRIWKHXVHRIWKH0DQJOHG([WUHPLW\ 6\QGURPH,QGH[²0(6,LQRSHQIUDFWXUHVRIORZHUOLPEV7KH HQGVUHJDUGHGDVVPDVKHGDFFRUGLQJWR0(6,FULWHULDLQDWRWDORI WZHQW\KDYHEHHQVFRUHGDQGUHSUHVHQWWKHEDVLVIRUWKLVVWXG\ $FFRUGLQJWRWKHVFDOHWKHSRLQWVOLPLWGHWHUPLQHVZKHWKHUWKH HQGVKRXOGRUQRWEHSUHVHUYHG2QO\WZROLPEVZHUHVXEPLWWHGWR SULPDU\DPSXWDWLRQVFRUHVDQGDQGPRQWKVODWHUWKH\ ZHUHUHVLJQHGZLWKWKHGHFLVLRQPDGHDQGZHUHQRWZHDULQJRUWKR VLVDPEXODWLQJZLWKWKHDLGRIFUXWFKHV7KHSDWLHQWVSUHVHQWLQJWKH PRVWGLVDSSRLQWLQJRXWFRPHVDWUHDVVHVVPHQWDFKLHYHGVFRUHVRI DQGKDYLQJWKHLUOLPEVVSDUHG,WZDVFRQFOXGHGWKDW0(6, FULWHULDOHGWRWKHGHWHUPLQDWLRQRIZKDWLVFDOOHGDV0DQJOHG([WUHPLW\ 6\QGURPH,QMXULHVVFRULQJZDVQRWHDVLO\PDGHDQGKDUGO\UHDFKHG WKHVFRUHRISRLQWVZKLFKZRXOGGHWHUPLQHSULPDU\DPSXWDWLRQ ,QRXUFDVHVHULHVSUHVHUYDWLRQRIOLPEVVFRUHGEHORZGLGQRW PHDQWKDWWKHGHFLVLRQKDVEHHQWKHPRVWDSSURSULDWHRQH

.H\ZRUGV2SHQIUDFWXUHV$PSXWDWLRQ&ODVVLILFDWLRQ

&LWDomR6JDUEL0:0*RWIU\G$2$PSXWDomRRXUHFRQVWUXomRGDH[WUHPLGDGH HVPDJDGD XWLOL]DomR GR tQGLFH GD VtQGURPH GD H[WUHPLGDGH HVPDJDGD $FWD 2UWRS %UDV >SHULyGLFR QD ,QWHUQHW@ 'LVSRQtYHO HP 85/ KWWSZZZVFLHOREUDRE

(2)

$&7$25723%5$6

$VVRFLDWLRQIRUWKH$GYDQFHGRI$XWRPRWLYH0HGLFLQH$$$0UHYLVmRGHGLVSRQtYHOQDLQWHUQHWZZZWUDXPDRUJZZZDDDPRUJ GR0(6,4XDGURTXHOHYDHPFRQVLGH

UDomRTXDWURFULWpULRVPDLRUHVSHOHQHU YRDUWpULDHRVVRTXDWURPHQRUHVOHV}HV DVVRFLDGDVLGDGHGRHQoDVSUHH[LVWHQWHV HFKRTXHHR(VFRUHGH6HYHULGDGHGD ,QM~ULD,QMXU\ 6HYHULW\ 6FRUH ² ,66 2 0(6,GHILQHRPHPEURHVPDJDGRFRPR DTXHOHTXHSRVVXLFRPSURPHWLPHQWRGH QRPtQLPRWUrVFULWpULRVPDLRUHV $V OHV}HV WHJXPHQWDUHV QHUYRVDV H DUWHULDLVUHFHEHUDPSRQWXDomRGHD &DGDOHVmRYHQRVDDVVRFLDGDUHFHEHX SRQWR $V OHV}HV yVVHDV REWLYHUDP HVFRUHVTXHYDULDUDPHQWUHHSRQWRV 'DGRVDGLFLRQDLVGHPRUDQRWUDWDPHQWR GRHQoDVSUHH[LVWHQWHVHFKRTXHIRUDP LQFOXtGRVQDDYDOLDomRJHUDOGRSDFLHQWH 'RLVSRQWRVIRUDPGDGRVSDUDSDFLHQWHV TXHDSUHVHQWDUDPFKRTXHSUHVVmRDUWH ULDOVLVWyOLFDPHQRUTXHPP+J 2,66IRUQHFHXPDSRQWXDomRVLVWrPLFD SDUD SDFLHQWHV FRP P~OWLSODV OHV}HV 4XDGUR&DGDOHVmRpDVVLQDODGDHP XPD(VFDOD$EUHYLDGDGH/HV}HV$EEUH YLDWHG,QMXU\6FDOH²$,6HDORFDGDHP XPDGDVVHLVUHJL}HVFRUSyUHDVFDEHoD IDFH WyUD[ DEG{PHQ H[WUHPLGDGHV H SHOH$SHQDVRPDLRU$,6GHFDGDUHJLmR FRUSyUHDpLQFOXtGRQRVRPDWyULR$VWUrV SULQFLSDLV UHJL}HV FRUSyUHDV DIHWDGDV WLYHUDP VHXV HVFRUHV PXOWLSOLFDGRV DR TXDGUDGRHHQWmRVRPDGRVSDUDSURGX ]LUHPR,66TXHYDULDGHD2OLPLWH GHSRQWRVGHILQHVHRPHPEURGHYH RXQmRVHUSUHVHUYDGR&RPSDUDPRVD GHFLVmRGRFLUXUJLmRGHXUJrQFLDFRPD GHFLVmRTXHGHYHULDWHUVLGRWRPDGDGH DFRUGRFRPR0(6,2VDXWRUHVFULDUDP WDEHODGHUHDYDOLDomRGRVSDFLHQWHVVR EUHRSRQWRGHYLVWDFOtQLFRRUWRSpGLFR

SVLFROyJLFRHVRFLDO4XDGUR)LQDOPHQWHQRVVRVUHVXOWDGRV IRUDPFRPSDUDGRVDRVGDOLWHUDWXUD

5(68/7$'26

'RV SDFLHQWHV HVWXGDGRV WUrV DSUHVHQWDYDP GRLV PHPEURV IUDWXUDGRVFDVRVQƒHHXPDSUHVHQWRXWUrVPHPEURV IUDWXUDGRVFDVRQƒWRWDOL]DQGRIUDWXUDVH[SRVWDV9LQWHPHP EURVIRUDPFRQVLGHUDGRVHVPDJDGRVSRUSRVVXtUHPWUrVGRVTXDWUR FULWpULRVPDLRUHVGR0(6,RXSRU

WHUHP VLGR FODVVLILFDGRV FRPR *UDX,,,GH*XVWLOORH$QGHUVRQ

$VSRQWXDo}HVREWLGDVIRUDP HVHLVFDVRVHFLQFR FDVRVHTXDWURFDVRV HWUrVFDVRVXP FDVRHDSHQDVXPFDVRDO FDQoRXRHVFRUH7DEHOD 'RLVSDFLHQWHVFDVRVQƒH IRUDPDPSXWDGRVQRWHUoRPpGLR GD SHUQD HVFRUHV GH H 3XGHPRVUHDYDOLDUSDFLHQWHV PHPEURV 2V SDFLHQWHV TXHQmRSXGHUDQVHUUHDYDOLDGRV FRQWLQXDUDP R WUDWDPHQWR HP RXWURVHUYLoRFDVRVQƒH RXPXGDUDPGHFLGDGHHQGHUH oRWHOHIRQH FDVRV Qƒ H

2WHPSRPtQLPRGHUHDYDOLDomRIRL PHVHVHRPi[LPRVHQGRDPpGLD PHVHV7DEHOD

2WHPSRPpGLRGHLQWHUQDomRKRVSLWDODU IRL GLDV 2V SDFLHQWHV DPSXWDGRV FDVRVƒ H SHUPDQHFHUDP UHV SHFWLYDPHQWHHGLDVHPQRVVR KRVSLWDO 2 Q~PHUR GH SURFHGLPHQWRV FLU~UJLFRVLQFOXLQGROLPSH]DVHGHVEULGD PHQWRVYDULRXHQWUHGRLVFDVRVQƒ HHFDVRVQƒ H2VSDFLHQWHVDPSXWDGRVHYROXtUDP FRPLQIHFomRQRORFDOGDDPSXWDomRHIR UDPVXEPHWLGRVDFDVRQƒHFLQFR FDVRQƒLQWHUYHQo}HVHPDPELHQWHFL U~UJLFR7RGRVRVSDFLHQWHVFRQFRUGDUDP FRP D FRQGXWD VXJHULGD WHQKD VLGR R VDOYDPHQWRRXDDPSXWDomRGRPHPEUR &LQFR SDFLHQWHV QmR DSUHVHQWD UDP DOWHUDo}HV H[FHWR FLFDWULFLDLV QD UHDYDOLDomR GR PHPEUR HVPDJDGR $ FRPSOLFDomRPDLVIUHTHQWHIRLDULJLGH] GHWRUQR]HORSUHVHQWHHPRLWRSDFLHQWHV FDVRVQƒH $VGHPDLVFRPSOLFDo}HVIRUDPHGHPD FU{QLFR FODXGLFDomR DWURILD PXVFXODU XOFHUDomRLQIHFomRHSVHXGDUWURVH7UrV SDFLHQWHVFDVRVQƒHDSUHVHQ WDUDPDOWHUDo}HVQHXUROyJLFDVVHQVLWLYDV QRPHPEURDIHWDGR2VGRLVSDFLHQWHV DPSXWDGRV DSUHVHQWDUDP FRPSOHWD FL FDWUL]DomRGRFRWRGHDPSXWDomR 2VSDFLHQWHVTXHDSUHVHQWDUDPRVUH VXOWDGRVPDLVGHVDQLPDGRUHVREWLYHUDP SRQWXDomRGHHSRQWRVFDVRVQƒ HHWLYHUDPRPHPEURSUHVHUYDGR (VWDYDP FRP PHVHV SyVWUDXPD VHQGRWUDWDGRVSHORPpWRGRGH,OL]DURY FRPH[SRVLomRyVVHDLQIHFomRHSVHX GDUWURVH$PERVUHFXVDUDPDPSXWDomR VHFXQGiULDTXDQGRTXHVWLRQDGRVHPVXDV~OWLPDVUHDYDOLDo}HV

',6&866®2

$VIUDWXUDVH[SRVWDVGRVPHPEURVLQIHULRUHVHVWmRHQWUHDVFDXVDV PDLVIUHTXHQWHVGHDWHQGLPHQWRVHPWUDXPDWRORJLD'HVWDV DWLQJHPRVRVVRVGDSHUQD$FODVVLILFDomRGH*XVWLOORH$QGHU

VRQSDUDIUDWXUDVH[SRVWDVIDFLOLWDDSDGURQL]DomRGRWUDWDPHQWR

HpVLPSOHVSDUDDGLVFXVVmRGHFRQGXWDVHQWUHWUDXPDWRORJLVWDV &RQWXGRDVIUDWXUDVFODVVLILFDGDV FRPRWLSR,,,DRX,,,EPXLWDVYH ]HVOHYDPjGLItFLOGHFLVmRVHR PHPEURGHYHVHUSUHVHUYDGRRX DPSXWDGR

2 FRQFHLWR DWXDO SDUD LQGLFDomR DEVROXWDGHDPSXWDomRSULPiULD GH H[WUHPLGDGHV LQIHULRUHV LQFOXL DYXOVmR FRPSOHWD GR PHPEUR SHUGD QHXUROyJLFD LVTXHPLD TXHQWHPDLRUGRTXHKRUDVLP SRVVLELOLGDGHGHUHVWDEHOHFLPHQWR FLUFXODWyULRHJDQJUHQDJDVRVD

$OpPGLVVRHPOHV}HVGDSHUQD R FRQVHQVR p GH TXH D UXSWXUD GRQHUYRWLELDOFRPIDFHSODQWDU LQVHQVtYHO RX XPD JUDYH OHVmR SRU HVPDJDPHQWR FRP WHPSR GH LVTXHPLD WDPEpP VXSHULRU (VFRUHGH6HYHULGDGHGH,QM~ULD,66

!

7HJXPHQWR

*XLOKRWLQD

(VPDJDPHQWRTXHLPDGXUD $YXOVmRGHVOXYDPHQWR 1HUYR

&RQWXVmR

7UDQVHFomR

$YXOVmR

9DVFXODU $UWpULD

7UDQVHFomR

7URPERVH

$YXOVmR

9HLD

2VVR

6LPSOHV

6HJPHQWDU

6HJPHQWDU&RPLQXWLYD 6HJPHQWDU&RPLQXWLYDFRP SHUGDyVVHDFP

6HJPHQWDULQWUDH[WUDDUWLFXODU 6HJPHQWDULQWUDH[WUDDUWLFXODUFRP 3HUGDyVVHD!FP

3HUGDyVVHDPDLRUTXHFPDGLFLRQDU 7HPSRGHHVSHUDSRQWRDFDGDKRUDDSyVK ,GDGH

DQRV

DQRV

DQRV

'RHQoDSUHH[LVWHQWH

&KRTXH

4XDGUR™QGLFHGD6¶QGURPHGD ([WUHPLGDGH(VPDJDGD

)RQWH*UHJRU\

5HJLmR 'HVFULomRGDOHVmR $,6

7UrV SULQFLSDLV

OHV}HV &DEHoDH

SHVFRoR &RQWXVmRFHUHEUDO )DFH 6HPOHVmR

7yUD[ 7yUD[LQVWiYHO

$EG{PHQ &RQWXVmRKHSiWLFDPHQRUUXSWXUDFRPSOH[DGREDoR

([WUHPLGDGHV )UDWXUDGHIrPXU 3HOH 6HPOHVmR (VFRUHGHVHYHULGDGHGDLQM~ULD,66

)RQWH$VVRFLDomRSDUDR$YDQoRGD0HGLFLQD$XWRPRWLYD$VVRFLDWLRQIRU WKH$GYDQFHGRI$XWRPRWLYH0HGLFLQH$$$0UHYLVmRGH

(3)

$&7$25723%5$6

DKRUDVVmR LQGLFDo}HV GH DPSXWDomRSUL PiULD

1DVpULHDSUH VHQWDGD SHORV DXWRUHV HP SRXFR PDLV GH PHVHV IRUDP DWHQGL GDVHWUDWDGDV I U D W X U D V H[SRVWDV GH RVVRV GD SHU QD DPRVWUD VHPHOKDQWH j GD SXEOLFDomR RULJLQDOGDHV FDOD SURSRVWD SRU*UHJRU\HW DO R0(6,

$ F K D P D G D 6tQGURPH GR 0HPEUR (V

PDJDGR0DQJOHG([WUHPLW\6\QGURPHFDUDFWHUL]DGDSRU*UHJRU\ HWDOGHWHUPLQDRVPHPEURVTXHSRVVXHPWUrVGRVTXDWURWHFL

GRVSHOHQHUYRDUWpULDHRVVROHVDGRVQmRVHQGRGLItFLOSDUDXP FLUXUJLmRRUWRSpGLFRLGHQWLILFiORVHPFDUiWHUGHXUJrQFLD(PQRVVD VpULH FRPR QmR SDUWLFLSDPRV GR DWHQGLPHQWR GH XUJrQFLD GRV SDFLHQWHVIRLSUHFLVRDYDOLDUDQRWDo}HVGHSURQWXiULRVIRWRJUDILDV HFRPXQLFDo}HVSHVVRDLVVREUHRVFDVRV$VVLPGHFLGLPRVLQFOXLU WRGDVDVIUDWXUDVH[SRVWDVWLSR,,,SDUDSRQWXDomRSRUDSUHVHQWD UHPPDLRUSUREDELOLGDGHGDSUHVHQoDGHWHFLGRVHVPDJDGRV 2XVRGHHVFDODVSDUDDYDOLDomRGHPHPEURVHVPDJDGRVFRQGX] D REMHWLYDU H SDGURQL]DU FRQGXWDV SUHVHUYDGRUDV GR PHPEUR RXQmR([LVWHPGLYHUVRVPpWRGRVFULDGRVFRPHVWDILQDOLGDGH 'HFLGLPRVXWLOL]DUR0(6,SRUUHFHEHUGHVWDTXHQDOLHWUDWXUDRUWR SpGLFDDSHVDUGHQmRKDYHUFRQFHQVRVREUHDVHQVLELOLGDGHH

HVSHFLILFLGDGHGRPpWRGR

6REUHDDSOLFDomRGRVLVWHPDGHSRQWXDomR0(6,pLPSRUWDQWH GHVWDFDUTXHHUURVGHLQWHUSUHWDomRGHGDGRVFOtQLFRVHUDGLROy JLFRVSRGHPHOHYDURXGLPLQXLUDSRQWXDomRREWLGD'DVHWDSDV HPTXHHQFRQWUDPRVGLILFXOGDGHGHVWDFDPRVRFiOFXORGR,QMXU\ 6HYHULW\6FRUH,66TXHSRGHHOHYDUDSRQWXDomRHPDWp1D XUJrQFLDQmRDFKDPRVWDUHIDVLPSOHVID]rORHVSHFLDOPHQWHSHOD IDOWDGHSRSXODUL]DomRGRPpWRGRHPQRVVRPHLR7DEHODVGHYHP VHUFRQVXOWDGDVHYiULRVtQGLFHVVRPDGRVOHPEUDPRVTXHDGHFL VmRGDDPSXWDomRpIHLWDQDXUJrQFLDHPXLWDVYH]HVHPVLWXDo}HV FUtWLFDV$GHWHUPLQDomRHDSRQWXDomRGRFKRTXHWDPEpPIRL FRQWURYHUVD2FRQFHLWRGHFKRTXHHPDQRGDGLYXOJDomRGD

HVFDODpRPHV PRDWXDOPHQWH" 'HYHDKLSRWHQ VmRFDUDFWHUL]DU R FKRTXH" 6H JXQGR R SUR WRFRORGR$7/6 $ G Y D Q F H G 7UDXPD/LIH6X SSRUWGR&R

OpJLR$PHULFDQR GH &LUXUJL}HV V H J X L G R H P QRVVR VHUYLoR QmR GHYHPRV DJXDUGDU KLSR WHQVmRSDUDFD UDFWHUL]DUPRVR FKRTXH H VLP TXDOTXHU VLQDO GH KLSRSHUIX VmRWHFLGXDO 7DPEpP ILFD FODUR QR DUWL JR RULJLQDO TXH D SRQWXDomR GH GRLV PHPEURV HVPDJDGRV

GHYHP VHU VRPDGDV (VWD FRQGXWD DXPHQWD R HVFRUH ILQDO H FRQVHTHQWHPHQWHRQ~PHURGHDPSXWDo}HV$VVLPRFiOFXOR GR0(6,QRVFDVRVHIRLPRWLYRGHFRQWURYpUVLD2VYDORUHV SDUDFDGDH[WUHPLGDGHHVPDJDGDHSRQWRVQmRLQGLFDUDP DQHFHVVLGDGHGHDPSXWDomRSULPiULD1RHQWDQWRDVRPDGRV HVFRUHV SRQWRV VXJHUH TXH SHOR PHQRV XPD DPSXWDomR GHYHULDVHUHIHWXDGD(VWXGRVREUHDXWLOL]DomRGHRXWUDHVFDODR

0(66GHVFUHYHTXHFDVRVELODWHUDLVQmRGHYHPVHUVRPDGRVVRE RULVFRGHDPSXWDo}HVGHVQHFHVViULDV(QIDWL]DPRVWDPEpP

TXHRHVFRUHGDVIUDWXUDVGRVRVVRVGDSHUQDGHDFRUGRFRPD HVFDODRULJLQDOpUHDOL]DGRDWUDYpVGDVRPDGRVSRQWRVGDWtELDH GDItEXODRTXHOHYDDRDXPHQWRGRYDORUILQDOXPDIUDWXUDFRPL QXWLYDGDWtELDHPFRQMXQWRFRPDIUDWXUDFRPLQXWLYDGDItEXODOHYD jPDUFDGRVSRQWRV

(PFRQWUDVWHFRPRDUWLJRGH*UHJRU\HWDOHPTXHGRV

FDVRVHVPJDGRVDOFDQoDUDPRHVFRUHHIRUDPVXEPHWLGRVj DPSXWDomRSULPDULDQHVWDVpULHDSHQDVGRLVGRVSDFLHQWHV FRQVLGHUDGRV HVPDJDGRV IRUDP DPSXWDGRV FDVRV H 3RGHPRVFRQVLGHUDUGLYHUVDVFDXVDVSDUDHVWDGLVFUHSkQFLDGH FRQGXWDVRVWUDXPDWLVPRVGHQRVVRVSDFLHQWHVWHQKDPVLGRGH PHQRUJUDYLGDGHDVHVWUDWpJLDVGHDQWLELRWLFRWHUDSLDHRVUHFXUVRV SDUDUHFRQVWUXomRHVSHFLDOPHQWHRPpWRGRGH,OL]DURYWHQKDP

SURJUHGLGRPXLWRQRV~OWLPRVDQRVDOpPGHDPSXWDo}HVPHQRV OLEHUDLVHPQRVVRVSDFLHQWHVSRUIDWRUHVFXOWXUDLV

1RVVRVFDVRVDPSXWDGRVQDXUJrQFLDREWLYHUDPHSRQWRVH 4XDGUR3URWRFRORGHUHDYDOLD°¬RGHSDFLHQWHVSRUWDGRUHVGHH[WUHPLGDGHVHVPDJDGDV

1RPH 1~PHURGHRUGHP 7HPSRGHHYROXomRGHVGHRDFLGHQWH

6DWLVIDomRGRSDFLHQWH …([FHOHQWH…%RP …5HJXODU…5XLP 5HWRUQRDRWUDEDOKR …6LP …1mR

3UiWLFDGHHVSRUWHV …6LP …1mR

$WLYLGDGHVGLiULDV …6HPGRU …'RUJUDQGHVHVIRUoRV …'RUSHTXHQRVHVIRUoRV …'RUFRQVWDQWH 8VRGHPXOHWDVRXRXWURWLSRGHDSRLR…6LP …1mR4XDO

'LULJHDXWRPyYHLVPRWRELFLFOHWDHWF …6LP …1mR 1~PHURGHLQWHUQDo}HV 7RWDOGHGLDVLQWHUQDGRV 1~PHURGHSURFHGLPHQWRVFLU~UJLFRV

8VRGHPHGLFDPHQWRV …6LP …1mR 4XDO 5HSHUFXVVmRVRFLDOIDPLOLDUILQDQFHLUD

$PSXWDomR[VDOYDPHQWR

([DPHItVLFR

,QVSHomR 0DUFKD &RQGLo}HVGHSHOH 7URILVPRPHPEURLQIHULRU ,QIHFomR 3DOSDomR

3RQWRVGRORURVRV 0RELOLGDGHDWLYDHSDVVLYD 4XDGULO -RHOKR 7RUQR]HOR 1HXUROyJLFR 6HQVLELOLGDGH 0RWULFLGDGH

,66

,GDGH

7

1

$

9

2

'3

&+

0(6,

7DEHOD3RQWXD°¬RILQDOGHSDFLHQWHVFRPH[WUHPLGDGHVLQIHULRUHVHVPDJDGDV

(4)

$&7$25723%5$6 5()(5È1&,$6%,%/,2*5É),&$6

6KDUPD 6 'HYJDQ $ 0DU\D . 0 5DWKHH 1 &ULWLFDO HYDOXDWLRQ RI PDQJOHG H[WUHPLW\VHYHULW\VFRULQJV\VWHPLQ,QGLDQSDWLHQWV,QMXU\ +RRJHQGRRUQ-0:HUNHQ&*UDGH,,,RSHQWLELDOIUDFWXUHVIXQFWLRQDORXWFRPH

DQGTXDOLW\RIOLIHLQDPSXWHHVYHUVXVSDWLHQWVZLWKVXFFHVVIXOUHFRQVWUXFWLRQ ,QMXU\

*HRUJLDGLV *0 %HKUHQV )) -R\FH 0- (DUOH $6 6LPPRQV $/ 2SHQ WLELDO IUDFWXUHVZLWKVHYHUHVRIWWLVVXHORVV/LPEVDOYDJHFRPSDUHGZLWKEHORZWKH NQHHDPSXWDWLRQ-%RQH-RLQW6XUJ$P

3HOLVVLHU3%RLUHDX30DUWLQ'%DXGHW-%RQHUHFRQVWUXFWLRQRIWKHORZHUH[ WUHPLW\FRPSOLFDWLRQVDQGRXWFRPHV3ODVW5HFRQVWU6XUJ *UHJRU\57*RXOG5-3HFOHW0:DJQHU-6*LOEHUW'$:KHHOHU-5HWDO7KH PDQJOHGH[WUHPLW\V\QGURPH0(6DVHYHULW\JUDGLQJV\VWHPIRUPXOWLV\V WHPLQMXU\RIWKHH[WUHPLW\-7UDXPD

.DW]PDQ66'LFNVRQ.'HWHUPLQLQJWKHSURJQRVLVIRUOLPEVDOYDJHLQPDMRUYDV FXODULQMXULHVZLWKDVVRFLDWHGRSHQWLELDOIUDFWXUHV2UWKRS5HY *XVWLOOR5%$QGHUVRQ-73UHYHQWLRQRILQIHFWLRQLQWKHWUHDWPHQWRIRQHWKRX

VDQGDQGWZHQW\ILYHRSHQIUDFWXUHVRIORQJERQHV5HWURVSHFWLYHDQGSURVSHF WLYHDQDO\VHV-%RQH-RLQW6XUJ$P

/RXUHQ°R35%)UDQFR-6$WXDOL]D°¬RQRWUDWDPHQWRGDVIUDWXUDVH[SRVWDV

5HY%UDV2UWRS

6HHNDPS$5HJHO*+LOGHEUDQG)6DQGHU-7VFKHUQH+3DUDPHWHUVRIPXO WLSOHRUJDQG\VIXQFWLRQIDLOWRSUHGLFWVHFRQGDU\DPSXWDWLRQIROORZLQJOLPEVDO YDJHLQPXOWLSO\WUDXPDWL]HGSDWLHQWV,QMXU\

.UHWWHN&6HHNDPS$.¾QWRSS+7VFKHUQH++DQQRYHU)UDFWXUH6FDOHb oUHHYDOXDWLRQDQGQHZSHUVSHFWLYHVRIDQHVWDELOLVKHGH[WUHPLW\VDOYDJHVFR UH,QMXU\

*RWWVFKDON)$7UDXPDWLF$PSXWDWLRQV,Q%XFKRO]5:+HFNPDQ-'HGLWRUV 5RFNZRRG *UHHQ…VIUDFWXUHVLQDGXOWVWKHG/LSSLQFRWW:LOOLDPV :LONLQV S

2OVRQ6$)LQNHPHLHU&*0RHKULQJ+'2SHQIUDFWXUHV,Q%XFKRO]5:+H FNPDQ-'HGLWRUV5RFNZZRG *UHHQ…VIUDFWXUHVLQDGXOWVWKHG/LSSLQFRWW :LOOLDPV :LONLQVS

&XQKD)0%UDJD*)'UXPRQG-XQLRU61)LJXHLUHGR&72(SLGHPLRORJLDGH IUDWXUDVH[SRVWDV5HY%UDV2UWRS

$7/6o$GYDQFHG7UDXPD/LIH6XSSRUW6WXGHQW&RXUVH0DQXDOWKHG&KL FDJR$PHULFDQ&ROOHJHRI6XUJHRQV&RPPLWWHHRQ7UDXPD

*UDKHG+3.DUODGDQL$%%RQHGHEULGHPHQWDQGOLPEOHQJWKHQLQJLQW\SH,,, RSHQWLELDOVKDIWIUDFWXUHV$FWD2UWKRS6FDQG

1ƒ 6HJ 2S 7UDE (VS 'RU $SRLR ,QW 7, &LU 0HGLF 5HSHUF $[5 ,QVS 3DOS 4XDG -RHOKR 7RUQR] 1HXU

([F 6 1 3( 1 1 )DP 5 (G '3 2. 2. 5,* 2.

([F 6 1 6' 1 1 2. 5 2. 2. 2. 2. 2. 2.

% 6 1 *( 1 1 )LQ 5 &ODXG 2. 2. 2. 5,* 2.

([F 1 1 *( 6 6 2. 5 &ODXG 2. 2. 2. /))/ 2.

([F 1 1 *( 6 6 )LQ 5 (G 2. 2. 2. 2. 2.

% 6 1 *( 1 1 )LQ 5 2. 2. 2. 2. 5,* 2.

% 1 1 3( 6 1 )LQ6RF 5 (G '3 2. 2. 5,* 6HQVLW

([F 1 1 6' 6 6 )DP6RF 5 2. 2. 2. 2. /))/ 2.

([F 1 1 *( 6 6 )DP6RF $ 2. '3 2. 2. DPSXW 2.

5HJ 1 1 3( 1 6 )LQ 5 (G '3 /))/ /))/ 5,* 2.

% 1 1 3( 1 1 2. 5 (G 2. 2. 2. 2. 2.

([F 6 6 6' 1 1 )LQ 5 2. 2. 2. 2. 2. 2.

([F 1 1 6' 6 1 )DP $ $WU&ODXG 2. 2. 2. DPSXW 6HQVLW

5HJ 1 1 3( 6 6 )DP)LQ 5 8$WU,QI3VHX '3 2. /))/ 5,* 2.

5HJ 1 1 3( 6 6 )DP 5 8,QI3VHX '3 2. /))/ 5,* 6HQVLW

([F 1 1 *( 6 6 )DP 5 $WU 2. 2. 2. 5,* 2.

1ƒ Q~PHURGRFDVR6HJ VHJXLPHQWRPHVHV2S RSLQLmRTXDQWRjHYROXomRGRFDVR([F H[FHOHQWH% ERD5 UHJXODU7UDE UHWRUQRDRWUDEDOKR1 QmR6 VLP(VS DWLYLGDGHVHVSRUWLYDV'RU*( GRUDRVJUDQGHVHVIRUoRV3( GRUDRVSHTXHQRVHVIRUoRV6' VHPGRU$SRLR QHFHVVLGDGHGHDSRLR SDUDGHDPEXODomR,QW Q~PHURGHLQWHUQDo}HVKRVSLWDODUHV7, WHPSRWRWDOGHLQWHUQDomRGLDV&LU Q~PHURGHSURFHGLPHQWRVHPDPELHQWHFLU~UJLFR0HGLF XVRUHJXODUGHPHGLFDomRDQDOJpVLFD5HSHUF UHSHUFXVVmRVRFLDOIDPLOLDUILQDQFHLUD)DP SUHMXt]RIDPLOLDU6RF SUHMXt]RVRFLDO)LQ SUHMXt]RILQDQFHLUR$[ 5 RSLQLmRGRSDFLHQWHVREUHDPSXWDomRRXUHFRQVWUXomR,QVS LQVSHomR&ODXG FODXGLFDomR(G HGHPD$WU DWURILD8 XOFHUDomR,QI LQIHFomR3VHX SVHXGDUWURVH3DOS SDOSDomR4XDG TXDGULO/I OLPLWDomRjIOH[mRMRHOKR7RUQR] WRUQR]HORDPSXW DPSXWDomR5,* ULJLGH]1HXU QHXUROyJLFR 6HQVLW DOWHUDoRHVVHQVLWLYDV

7DEHOD5HDYDOLD°¬RGHSDFLHQWHVFRPH[WUHPLGDGHVLQIHULRUHVHVPDJDGDV

GHDFRUGRFRPDHVFDODQmRQHFHVVLWDULDPGHWDOUHFXUVR7RGDYLD DPERVDSUHVHQWDUDPHPFRQMXQWRFRPRHVPDJDPHQWROHV}HV YDVFXODUHV LUUHSDUiYHLV R TXH VHJXQGR DOJXQV DXWRUHV OHYDP DtQGLFHVGHDPSXWDo}HVGHD(PVLWXDomRFRQWUiULD

FLWDPRVRVFDVRVHHVFRUHVHUHVSHFWLYDPHQWHTXH WLYHUDPVHXVPHPEURVSUHVHUYDGRV$PERVHYROXtUDPFRPJUD YHOHVmRGHSDUWHVPROHVSVHXGDUWURVHHLQIHFomR$WpDXOWLPD DYDOLDomR WLQKDP VLGR VXEPHWLGRV j UHVSHFWLYDPHQWH H SURFHGLPHQWRVFLU~UJLFRVHLQWHUQDo}HVGHHGLDV$WXDO PHQWHHQFRQWUDPVHHPWUDWDPHQWRDPEXODWRULDOFRPXOFHUDo}HV JUDYHVDWURILDVORFDLVULJLGH]GHWRUQR]HORHSVHXGDUWURVHLQIHFWDGD 'HSRLVGHWRGRVHVWHVSURFHGLPHQWRVGHVJDVWHHPRFLRQDOGRV SDFLHQWHVHIDPLOLDUHVHDOWRVJDVWRVKRVSLWDODUHVDDPSXWDomR YHPVHQGRGLVFXWLGD

(PUHODomRDRWHPSRGHLQWHUQDomRKRVSLWDODU*HRUJLDGLVHWDOH

*UHJRU\GHVFUHYHP TXH D DPSXWDomR OHYD D PHQRU WHPSR GH

LQWHUQDomRHPHQRVSURFHGLPHQWRVFLU~UJLFRV2EVHUYDPRVXP JUDQGHQ~PHURGHFLUXUJLDVUHDOL]DGDVDSyVDXUJrQFLDWDQWRHP OHV}HVUHFRQVWUXtGDVTXDQWRDPSXWDGDVSULQFLSDOPHQWHGHYLGRj QHFHVVLGDGHGHIUHTHQWHVGHVEULGDPHQWRVFLU~UJLFRV

&ULDPRVXPSURWRFRORGHUHDYDOLDomRSDUDRVSDFLHQWHVFRP PHPEURV LQIHULRUHV FRQVLGHUDGRV HVPDJDGRV (VWXGDPRV R LPSDFWRGDUHFRQVWUXomRYHUVXVDPSXWDomRVRERSRQWRGHYLVWD FOtQLFRHPRFLRQDOWUDEDOKLVWDHHFRQ{PLFR6HJXQGRDRSLQLmR GRVSDFLHQWHVDSHQDVWUrVQmRFRQVLGHUDUDPRVUHVXOWDGRVERQV RX H[FHOHQWHV QR PRPHQWR GD UHDYDOLDomR 'HVWHV GRLV IRUDP DTXHOHV TXH WLYHUDP SUHVHUYDGRV VHXV PHPEURV JUDYHPHQWH HVPDJDGRVFDVRVH2VGRLVSDFLHQWHVTXHWLYHUDPRV PHPEURVDPSXWDGRVQDXUJrQFLDHVWDYDPVDWLVIHLWRVFRPDFRQ GLomRHPTXHVHHQFRQWUDYDPQDUHDYDOLDomR(VWDVUHDYDOLDo}HV LOXVWUDUDP FRPR D UHFRQVWUXomR QmR OHYRX REULJDWRULDPHQWH j VDWLVIDomRFRPRPpWRGR

&21&/86¯(6

2VFULWpULRVGR0(6,OHYDUDPjGHWHUPLQDomRGRTXHpFKDPDGR GH6tQGURPHGD([WUHPLGDGH(VPDJDGD

Referências

Documentos relacionados

Obedecendo ao cronograma de aulas semanais do calendário letivo escolar da instituição de ensino, para ambas as turmas selecionadas, houve igualmente quatro horas/aula

A disponibilização de recursos digitais em acesso aberto e a forma como os mesmos são acessados devem constituir motivo de reflexão no âmbito da pertinência e do valor

Sobretudo recentemente, nessas publicações, as sugestões de ativi- dade e a indicação de meios para a condução da aprendizagem dão ênfase às práticas de sala de aula. Os

José Arno Appolo do Amaral, Prefeito Municipal, no uso de suas atribuições legais e de acordo com o Processo nº 2808/2020 da Secretaria Municipal de

 A combinação desta referência com a referência do mandato, permitirá ao Banco do devedor fazer uma análise à instrução de cobrança antes de proceder ao

E assim, este trabalho, aplicado em uma empresa familiar, tem a intenção de contribuir com uma metodologia prática para auxiliar os profissionais que atuam em qualquer tipo de

Lista de preços Novembro 2015 Fitness-Outdoor (IVA 23%).. FITNESS

os atores darão início à missão do projeto: escrever um espetáculo para levar até as aldeias moçambicanas para que a população local possa aprender a usufruir e confiar