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Mulheres com risco cardiovascular após pré-eclâmpsia: há seguimento no Sistema Único de Saúde?
(Universidade de São Paulo (USP), 2014-01) Silva, Maria de Lourdes Costa da; Galvão, Ana Cristina Araújo de Andrade; Souza, Nilba Lima de; Azevedo, George Dantas de; Jerônimo, Selma Maria Bezerra; Araújo, Ana Cristina Pinheiro Fernandes de
Objetivos: identificar mulheres com risco cardiovascular, cinco anos após a pré-eclâmpsia, e averiguar o seguimento dessas mulheres no Sistema Único de Saúde, em Natal, Rio Grande do Norte. Métodos: estudo exploratório, quantitativo, realizado na Maternidade Escola Januário Cicco, em Natal. A amostra foi de 130 mulheres, 65 com pré-eclâmpsia e 65 normotensas. Resultados: constatou-se diferença estatística significativa no que se refere ao índice de massa corpórea, peso, histórico familiar de doenças cardiovasculares e complicação cardiovascular entre as mulheres com pré-eclâmpsia prévia e as normotensas. Os grupos desconheciam os fatores de risco cardiovasculares e, além disso, referiam dificuldades de acesso aos serviços de atenção primária. Conclusões: as mulheres com histórico de pré-eclâmpsia possuíam risco aumentado de desenvolver doenças cardiovasculares, desconheciam as complicações tardias dessa doença e não recebiam seguimento ambulatorial diferenciado em relação às normotensas
Interprofessional education as an approach for reforming health professions education in Brazil: emerging findings
(Taylor and Francis, 2014-01-02) Costa, Marcelo Viana da; Vilar, Maria José Pereira; Azevedo, George Dantas de; Reeves, Scott
Interprofessional education (IPE) is an important issue to insert in the debate on the reform of the education of health professions in Brazil. This paper provides details on an emerging study, based in Brazil, whose aim is to explore the use of IPE as a strategy to reform health professional education to become more collaborative in nature. The study has adopted a sequential mixed-methods approach, and will conduct focus groups, individual interviews and surveys with students, teachers and administrators based in two universities. Initial findings have indicated that, at present, participants were not aware of systematic strategies to bring students from different courses together for IPE, which has created problems for the development of knowledge and skills for collaborative work. Further data will be gathered to expand this analysis. Nevertheless, there is already clear evidence that there is a need to integrate and strengthen the use of IPE in Brazil, as a key route forward to strengthening the process of reorientation training of health professionals
HIF-1alpha expression profile in intratumoral and peritumoral inflammatory cells as a prognostic marker for squamous cell carcinoma of the oral cavity
(Public Library of Science, 2014-01-09) Mendes, Suzanny Oliveira; Santos, Marcelo dos; Peterle, Gabriela Tonini; Maia, Lucas de Lima; Stur, Elaine; Agostini, Lidiane Pignaton; Carvalho, Marcos Brasilino de; Tajara, Eloiza Helena; Louro, Iúri Drumond; Trivilin, Leonardo Oliveira; Silva-Conforti, Adriana Madeira Álvares da
The HIF-1 transcriptional complex is responsible for controlling transcription of over 100 genes involved in cell hypoxia response. HIF-1alpha subunit is stabilized in hypoxia conditions, creating the HIF-1 nuclear transcription factor. In inflammatory cells, high HIF-1alpha expression induces lymphocytic immunosuppression, decreasing tumoral antigen recognition, which promotes tumor growth. The present work investigated the relationship between HIF-1alpha expression in lymphocytes populating the intratumoral and peritumoral region of 56 patients with oral cancer. Our data indicates a prognostic value for this expression. High HIF-1alpha expression in peritumoral inflammatory cells is significantly related to worse patient outcome, whereas high expression in the intratumoral lymphoid cells correlates with a better prognosis. A risk profile indicating the chance of disease relapse and death was designed based on HIF-1alpha expression in tumoral inflammatory cells, defining low, intermediate and high risks. This risk profile was able to determine that high HIF-1alpha expression in peritumoral cells correlates with worse prognosis, independently of intratumoral expression. Low HIF-1alpha in tumor margins and high expression in the tumor was considered a low risk profile, showing no cases of disease relapse and disease related death. Intermediate risk was associated with low expression in tumor and tumor margins. Our results suggest that HIF-1alpha expression in tumor and peritumoral inflammatory cells may play an important role as prognostic tumor marker
Uterine leiomyoma: understanding the impact of symptoms on womens’ lives
(BMC, 2014-01-30) Brito, Luiz Gustavo Oliveira; Panobianco, Marislei Sanches; Sabino-de-Freitas, Maurício Mesquita; Barbosa, Hermes de Freitas; Azevedo, George Dantas de; Brito, Luciane Maria Oliveira; Candido-dos-Reis, Francisco José
Background: most women report negative experience about the symptoms of uterine leiomyoma (UL) in their lives, such as abnormal uterine bleeding and pelvic pain. Many studies have been conducted about efficacy of UL treatment, but little research has been performed about womens health related quality of life (HRQL). Methods: this is a semi-structured, descriptive, observational, qualitative study that was performed during eight months. Focus group (FG) interviews were performed with women attending at a tertiary hospital in Brazil, who were consecutively included in the study. Seventy women with symptomatic UL were recruited to this study. FG duration was one hour with mediators with 5-6 women at each group. Collected data from discussions was processed according to thematic analysis and stored at a qualitative software. Results: women were negatively influenced by the presence of symptomatic UL. The major themes that were noticed during analysis were: beliefs and attitudes towards UL; limitation to social and professional activities; sensation of fear/unfairness/discouragement towards the symptoms and adverse effects during treatment with GnRH analogs. Conclusions: symptomatic UL has a negative impact on womens HRQL. Health providers should consider such impact when counseling women on their treatment options, since it may have an important influence in these patients’ decision-making process. While current pharmacological treatments may improve disease specific outcomes, such as bleeding intensity and tumor volume, they fail on actually improving quality of life
Impacto da inserção da temática saúde sexual e reprodutiva na graduação de Medicina
(Thieme Open, 2014-03) Medeiros, Robinson Dias de; Azevedo, George Dantas de; Maranhão, Técia Maria de Oliveira; Oliveira, Ana Katherine da Silveira Goncalves de; Barros, Yasha Emerenciano; Araújo, Ana Cristina Pinheiro Fernandes de; Lima, Stênia Lins Leão
Objetivo: avaliar o impacto da inserção da temática saúde sexual e reprodutiva na graduação de Medicina em uma universidade pública do Brasil. Métodos: foi desenvolvido instrumento de avaliação cognitiva em saúde sexual e reprodutiva com base nos temas abordados no componente curricular optativo Saúde Reprodutiva, resultando em prova objetiva de múltipla escolha contendo 27 itens. Os temas selecionados foram: direitos humanos, sexuais e reprodutivos (DHSR), sexualidade, violência institucional, gênero, violência sexual, concepção, contracepção, aborto/interrupção legal da gestação, mortalidade materna e doenças sexualmente transmissíveis (DSTs) – HIV/AIDS. Os temas foram agrupados em três dimensões do conhecimento: DHSR, legal/institucional e biomédica. Na análise de covariância, dois modelos multivariados foram ajustados. Resultados: participaram do estudo 183 alunos, 127 do grupo que cursou o componente curricular eletivo saúde reprodutiva (Grupo SR) e 56 do grupo que não cursou (Grupo Não SR). Noventa e seis alunos (52,5%) eram do sexo masculino e 87 (47,5%) do sexo feminino. A média de idade foi de 24,7±1,9 anos no Grupo SR e de 24,4±2,6 no Não SR. O desempenho médio do Grupo SR foi superior ao Não SR nos temas DHSR, sexualidade, violência institucional, violência sexual, aborto/interrupção legal e DSTs – HIV/AIDS. Não houve diferença no desempenho dos sexos masculino e feminino, com a exceção do tema mortalidade materna, no qual o grupo masculino foi inferior (6,9±0,2 e 7,8±0,2, respectivamente; p<0,05). Conclusões: a participação dos estudantes no componente curricular eletivo Saúde Reprodutiva mostrou-se associada com melhor desempenho em algumas dimensões da avaliação cognitiva, o que sugere um impacto positivo dessa iniciativa na formação médica generalista
Abortion: a review of women's perception in relation to their partner's reactions in two brazilians cities
(Associação Médica Brasileira, 2014-07) Nonnenmacher, Daniele; Benute, Gláucia Rosana Guerra; Nomura, Roseli Mieko Yamamoto; Azevedo, George Dantas de; Dutra, Elza Maria do Socorro; Rebouças, Melina Séfora Souza; Luci, Mara Cristina Souza de; Francisco, Rossana Pulcineli Vieira
Objective: to analyze women’s perception in relation to their partner’s reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. Methods: semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p < 0.05. Results: in both capitals, the women who induced an abortion referred to the partner as the person who could not find out about the abortion (p<0.01 in Natal; p = 0.02 in São Paulo-SP) and, simultaneously, as the one who could have avoided it (p < 0.01 in Natal; p = 0.03 in São Paulo). In Natal-RN, induced abortion was associated with the partner’s absence at the time pregnancy was confirmed (p = 0.02) and, in Sao Paulo-SP, with their negative reaction to news of the pregnancy (p = 0.04) and lack of participation in the abortion process (p < 0.01). Conclusion: despite having achieved independence, women still regard male participation in the abortion process as an important factor. The specifics of each capital denote the influence of the geographic and cultural dimension, indicating the need to take into account the particulars of each region in Brazil while considering a holistic approach to women’s health
Aqueous leaf extract of Jatropha gossypiifolia L. (Euphorbiaceae) inhibits enzymatic and biological actions of Bothrops jararaca snake venom
(Public Library of Science, 2014-08-15) Félix-Silva, Juliana; Souza, Thiago; Menezes, Yamara A. S.; Cabral, Bárbara; Câmara, Rafael Barros Gomes da; Silva-Junior, Arnóbio Antonio da; Rocha, Hugo Alexandre de Oliveira; Rebecchi, Ivanise Marina Moretti; Langassner, Silvana Maria Zucolotto; Fernandes-Pedrosa, Matheus de Freitas
Snakebites are a serious public health problem due their high morbi-mortality. The main available specific treatment is the antivenom serum therapy, which has some disadvantages, such as poor neutralization of local effects, risk of immunological reactions, high cost and difficult access in some regions. In this context, the search for alternative therapies is relevant. Therefore, the aim of this study was to evaluate the antiophidic properties of Jatropha gossypiifolia, a medicinal plant used in folk medicine to treat snakebites. The aqueous leaf extract of the plant was prepared by decoction and phytochemical analysis revealed the presence of sugars, alkaloids, flavonoids, tannins, terpenes and/or steroids and proteins. The extract was able to inhibit enzymatic and biologic activities induced by Bothrops jararaca snake venom in vitro and in vivo. The blood incoagulability was efficiently inhibited by the extract by oral route. The hemorrhagic and edematogenic local effects were also inhibited, the former by up to 56% and the latter by 100%, in animals treated with extract by oral and intraperitoneal routes, respectively. The inhibition of myotoxic action of B. jararaca reached almost 100%. According to enzymatic tests performed, it is possible to suggest that the antiophidic activity may be due an inhibitory action upon snake venom metalloproteinases (SVMPs) and/or serine proteinases (SVSPs), including fibrinogenolytic enzymes, clotting factors activators and thrombin like enzymes (SVTLEs), as well upon catalytically inactive phospholipases A2 (Lys49 PLA2). Antiinflammatory activity, at least partially, could also be related to the inhibition of local effects. Additionally, protein precipitating and antioxidant activities may also be important features contributing to the activity presented. In conclusion, the results demonstrate the potential antiophidic activity of J. gossypiifolia extract, including its significant action upon local effects, suggesting that it may be used as a new source of bioactive molecules against bothropic venom
Caracterização dos acidentes com exposição a material biológico envolvendo a equipe de enfermagem de um hospital universitário
(Universidade Vale do Rio Verde (UNINCOR), 2014-09-30) Amorim, Ingrid Gurgel; Bispo, Miclécia de Melo; Ribeiro, Luciana Melo; Mendonça, Ana Elza Oliveira de; Morais, Rafael Otavio Bezerra de; Amorim, Érico Gurgel
Objetivou-se no presente estudo caracterizar os acidentes com exposição a material biológico envolvendo a equipe de enfermagem de um hospital universitário em Natal/RN e propor medidas para a prevenção e redução dos acidentes ocupacionais. Trata-se de um estudo descritivo e retrospectivo, com abordagem quantitativa. A população foi composta por 62 profissionais de enfermagem que se acidentaram com material biológico no período de 2008 a 2012 e que foram registrados em fichas de notificação e investigação de acidente de trabalho com exposição à material biológico. A coleta de dados foi realizada através do programa TabWin, no Sistema de Informação de Agravos Notificáveis (SINAN-NET). Dentre os acidentes notificados a equipe de enfermagem foi a mais acidentada (76,54%); com maior registro para os técnicos de enfermagem (74,07%); do sexo feminino (95%); geralmente nas segundas (48,39%) e terceiras décadas de vida (32,26%). O sangue foi a matéria orgânica mais presente nos acidentes (83,87%), cujas circunstâncias envolveram a administração de medicação por via subcutânea (26,92%), o reencape de agulha (25%) e o descarte inadequado no chão (15,38%). Dentre os profissionais expostos a materiais biológicos, 71,15% faziam uso de luvas e 90,32% possuíam registro de esquema vacinal para hepatite B
In vitro anticoagulant and antioxidant activities of Jatropha gossypiifolia L. (Euphorbiaceae) leaves aiming therapeutical applications
(BMC, 2014-10-20) Félix-Silva, Juliana; Souza, Thiago; Câmara, Rafael Barros Gomes da; Cabral, Bárbara; Silva-Júnior, Arnóbio Antônio da; Rebecchi, Ivanise Marina Moretti; Zucolotto, Silvana Maria; Rocha, Hugo Alexandre de Oliveira; Fernandes-Pedrosa, Matheus de Freitas
Background: Jatropha gossypiifolia L. (Euphorbiaceae) is a medicinal plant largely used in folk medicine. Teas from the leaves are popularly used as an antithrombotic agent and the branches are frequently employed as a “thick blood” agent. Considering that the anticoagulant activity associated with antioxidant properties could be beneficial for various cardiovascular diseases, this study’s aim is the evaluation of anticoagulant and antioxidant activities of J. gossypiifolia leaves, seeking new therapeutic purposes for this plant. Methods: The aqueous leaf crude extract (CE) was prepared by decoction and was fractionated by liquid-liquid partition with solvents of increasing polarity. The phytochemical analysis was performed by thin layer chromatography (TLC) and by the spectrophotometric quantification of sugars, proteins and phenolic compounds. The anticoagulant activity was evaluated by prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests. The capacity to act in the fibrinolytic system (fibrinolytic and fibrinogenolytic activities) was also assessed. The antioxidant activity was evaluated by total antioxidant capacity, reducing power, copper chelating activity, iron chelating activity, hydroxyl radical scavenging activity and superoxide radical scavenging assays. The potential toxicity was evaluated using hemolytic assay and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay on HEK-293 cells. Results: CE showed significant anticoagulant activity in aPTT test, while no action was observed in PT test, suggesting a preferential action toward the intrinsic and/or common pathway of coagulation. No effect was observed in the fibrinolytic system. Using the aPTT test, it was observed that the residual aqueous (RA) fraction was the most active, being two times more active than CE. RA presented very significant antioxidant activity in all models tested comparable to or even higher than CE. Regarding the safety, CE and RA did not produce significant cytotoxicity in both tests employed. Phytochemical analysis revealed the presence of alkaloids, flavonoids, proteins, tannins, steroids and/or terpenoids and sugars. Conclusions: CE and RA possessed significant anticoagulant and antioxidant activity and absence of cytotoxic effect in vitro, thus showing the potential of the plant, especially RA fraction, as a new source of bioactive molecules for therapeutic purposes, with particular emphasis on the treatment of cardiovascular diseases
Proteolysis, NaOH and ultrasound-enhanced extraction of anticoagulant and antioxidant sulfated polysaccharides from the edible seaweed, Gracilaria birdiae
(MDPI, 2014-11-13) Fidelis, Gabriel Pereira; Câmara, Rafael Barros Gomes da; Queiroz, Moacir Fernandes; Costa, Mariana Santana Santos Pereira; Santos, Pablo Castro; Rocha, Hugo Alexandre de Oliveira; Costa, Leandro Silva
The sulfated polysaccharides (SP) from the edible red seaweed, Gracilaria birdiae, were obtained using five different extraction conditions: Gracilaria birdiae 1 (GB1)-water; GB1s-water/sonication; GB1sp-water/sonication/proteolysis; GB2s-NaOH/sonication; and GB2sp-NaOH/sonication/proteolysis. The yield (g) increased in the following order: GB2sp > GB1sp > GB2s > GB1s > GB1. However, the amount of SP extracted increased in a different way: GB2sp > GB1 > GB1sp > GB1s > GB2s. Infrared and electrophoresis analysis showed that all conditions extracted the same SP. In addition, monosaccharide composition showed that ultrasound promotes the extraction of polysaccharides other than SP. In the prothrombin time (PT) test, which evaluates the extrinsic coagulation pathway, none of the samples showed anticoagulant activity. While in the activated partial thromboplastin time (aPTT) test, which evaluates the intrinsic coagulation pathway, all samples showed anticoagulant activity, except GB2s. The aPTT activity decreased in the order of GB1sp > GB2sp > GB1 > GB1s > GB2s. The total capacity antioxidant (TCA) of the SP was also affected by extraction condition, since GB2s and GB1 showed lower activity in comparison to the other conditions. In conclusion, the conditions of SP extraction influence their biological activities and chemical composition. The data revealed that NaOH/sonication/proteolysis was the best condition to extract anticoagulant and antioxidant SPs from Gracilaria birdiae
Produtividade do maxixeiro cultivado em substrato e fertirrigado com soluções nutritivas
(Associação Brasileira de Horticultura, 2014-12) Oliveira, Francisco A.; Oliveira, Mychelle K. T.; Medeiros, José F.; Silva, Otaciana M. P.; Paiva, Emanoela P.; Maia, Priscila de Melo Evangelista
O cultivo em substrato vem se expandindo consideravelmente entre os horticultores. No entanto, ainda são escassos estudos para muitas culturas. Este trabalho foi desenvolvido com o objetivo de avaliar a produtividade do maxixeiro cultivado em fibra de coco e fertirrigado com diferentes soluções nutritivas. Os tratamentos foram constituídos pelas soluções nutritivas, tomando-se como base as soluções recomendadas para as culturas do meloeiro e do pepino para o cultivo hidropônico no sistema NFT, utilizando-se três soluções a partir da solução recomendada para o meloeiro (S1: 50%, S2: 100% e S3: 150%) e três soluções a partir da recomendação para o pepino (S4: 50%, S5: 100% e S6: 150%), além de uma solução obtida a partir dos valores médios das soluções nutritivas para o meloeiro e pepino (S7: média de S2 e S5). Utilizou-se o delineamento inteiramente casualizado, com sete tratamentos e quatro repetições. Foram realizadas cinco colheitas em intervalos semanais, sendo a primeira aos 60 dias após a semeadura. Foram avaliados os seguintes parâmetros de produtividade: número de frutos por planta, massa média de frutos, diâmetros transversal e longitudinal e a produção de frutos por planta. Existe potencial para o cultivo do maxixeiro em substrato com o uso de fertirrigação, utilizando solução nutritiva com concentração iônica correspondente a 100% da recomendação para a cultura do meloeiro ou em concentração maior que 50% em relação à solução recomendada para o pepineiro
Relação intensidade-duração-frequência para precipitação extrema em Mossoró – RN
(Instituto Federal de Educação, Ciência e Tecnologia Goiano - Campus Rio Verde, 2014-12-30) Barreto, Herlon Bruno Ferreira; Pereira, Geraldo Magela; Barreto, Flavinícius Pereira; Freire, Francisco Gilliard Chaves; Maia, Priscila de Melo Evangelista
Os recursos hídricos vêm recebendo atenção especial, a precipitação e a vazão dos rios estão entre os principais fatores que exercem diversos efeitos na prática agrícola. O presente trabalho teve por objetivo: ajustar a função cumulativa de probabilidade de Gumbel aos dados de precipitação máxima diária anual e obter a equação de intensidade-duração-frequência, por meio da desagregação da chuva de 24h, para cidade de Mossoró - RN. Foram utilizados dados de precipitação pluviométrica máxima anual de 1970 a 2007, procedeu-se o ajuste da distribuição teórica e foram aplicados, os seguintes testes de aderência: Qui-Quadrado, Kolmogov-Smirnov e Anderson-Darling, realizou-se também a desagregação da chuva de um dia em chuvas de menores durações, e obteve-se a equação que representa a relação intensidade-duração-frequência. Observou-se boa adequação do modelo à série, sendo significativo para todos os testes realizados. A equação gerada permitiu o cálculo da intensidade máxima de chuvas com diferentes durações e períodos de retorno, por exemplo, em cada dez anos (T = 10) é esperado que a chuva máxima em 60 minutos (t = 60) seja igualada ou superada em 55,68 mm/h
Single nucleotide polymorphisms in immune system genes and their association with clinical symptoms persistence in dengue-infected persons
(Elsevier, 2015) Dettogni, Raquel Spinassé; Tristão-Sá, Ricardo; Santos, Marcelo dos; Silva, Franciane Figueiredo da; Louro, Iúri Drumond
This study was undertaken to determine the prevalence of dengue clinical symptom persistence during 60 days of disease follow up, in patients of Espírito Santo state (ES)-Brazil and to evaluate the relation of single nucleotide polymorphisms (SNPs) in FccRIIa, CD209, VDR, TNF-a, IL-4, IL-6 and IFN-c genes with symptom persistence. During 2012–2013, 96 blood samples from individuals diagnosed with symptomatic dengue were collected. Clinical symptom persistence in 60 days of follow-up was assessed by a clinical and epidemiological questionnaire filled in 4 interviews. SNP genotyping was performed by polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). In two months of monitoring the dengue infection, we observed that symptoms persisted in 38.5% (37/96) of dengue patients at the end of the first month (D30) and in 11.5% (11/96) of dengue patients at the end of the second month (D60). Our results show an association between FccRIIa, TNF-a and IL-6 gene SNPs and symptom persistence and an association trend with CD209, IL-4 and IFN-c gene SNPs. Our findings may increase the knowledge on the pathophysiological mechanisms of persistent symptoms of infection with the dengue virus (DENV) and thus help the clinical management of patients
Physiotherapy: a historical analysis of the transformation from an occupation to a profession in Brazil
(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2015) Oliveira, Ana Luiza Oliveira e; Nunes, Everardo Duarte
Background: Analyzing the historical and social path of an occupation using the sociology of professions and the perspective of scientific knowledge promotes an understanding of the origin of physical therapy in Brazil and of discussions of the profession in its contemporary context. Objective: The aim of this paper was to discuss the professionalization process of physical therapy in São Paulo. The authors tried to analyze bath therapy, massage therapy, and physical therapy as occupations involving distinct expertise and as part of the group of occupations that evolved into the profession of physiotherapy in the first half of the twentieth century. Method: The analysis undertaken was a qualitative study based on an analysis of historical documents. Eighty-six professional records from the Service of Inspection of Professional Practice in the state of São Paulo and healthcare legislation from the 1930s and 1940s were analyzed. Results: The distinction between physical therapy practitioner and profession of physiotherapy can be seen by examining registration requirements for rank-and-file nurses with expertise in interactions; this distinction suggests the emergence of specialized expertise that was clearly a part of neither medicine nor nursing and contributed to expertise in physical therapy since the 1950s. Conclusion: The regulation of physiotherapy practices, the recognition of expertise, the accreditation of practical nurses by the State, and the institutionalization of a course for physical therapy practitioners in 1951 are key elements of the professionalization process for the physical therapy profession in Brazil
O conceito de paternidade dos adolescentes da rede pública de ensino de Natal/RN
(UNIFACEX, 2015) Braga, Liliane Pereira; Ferreira, Ana Caroline de Lima Silva; Medeiros, Carolina Lucena; Pimentel, Fernanda Lima; Sousa, Suzani Gabrielli de Lima e; Maia, Eulália Maria Chaves
Durante a adolescência, os indivíduos empenham-se em construir sua identidade, sendo que a estruturação da identidade sexual é parte relevante desse processo, já que os papéis de gênero masculino e feminino são os mais importantes do ponto de vista sociocultural. Optou-se por questionar os adolescentes sobre seus conceitos de paternidade. Realizou-se um estudo exploratório analítico de corte transversal, com 196 adolescentes entre 10 e 19 anos matriculados em escolas públicas de Natal/RN. Foi utilizado um questionário estruturado envolvendo questões sociodemográficas e sobre o conceito de paternidade. Os resultados revelaram que a paternidade foi caracterizada pela aquisição e assunção de responsabilidades da vida adulta. Tal conceituação encontra respaldo na literatura científica que afirma que, para jovens de classes populares, o projeto de autonomia e ascensão social se concretiza pela constituição da própria família e pela capacidade de cuidar e sustentá-la
Gestantes tardias de baixa renda: dados sociodemográficos, gestacionais e bem-estar subjetivo
(Universidade Presbiteriana Mackenzie (UPM), 2015-01-22) Oliveira, Maria Aurelina Machado de; Sousa, Welyton Paraíba da Silva; Pimentel, Julianne Dantas de Oliveira; Santos, Kadidja Suelen de Lucena; Azevedo, George Dantas de; Maia, Eulália Maria Chaves
Estudo transversal descritivo e correlacional cujos objetivos foram traçar o perfil sociodemográfico e gestacional, avaliar o bem-estar subjetivo (BES) e relacionar os indicadores do BES com as variáveis idade, escolaridade e renda. Participaram 80 gestantes com 35 anos ou mais (grávidas tardias) de baixa renda. Os instrumentos de pesquisa foram questionário estruturado e escala de bem-estar subjetivo. Os dados são apresentados na forma de análises descritivas e correlacionais, conforme a natureza das variáveis. A maioria das gestantes vivia com o companheiro, não tinha renda pessoal, pois tratava-se de donas de casa, e não planejou a gestação; e o bem-estar subjetivo apresentou valores equivalentes às médias para cada indicador (afetos positivos, afetos negativos e satisfação com a vida), enquanto as correlações significativas obtidas foram fracas. Conclui-se que, para o grupo avaliado, a baixa escolaridade e a baixa renda familiar foram variáveis associadas à satisfação com a vida das gestantes entrevistadas
The study of cardiovascular risk in adolescents – ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in brazilian adolescents
(BMC, 2015-02-07) Bloch, Katia Vergetti; Szklo, Moyses; Kuschnir, Maria Cristina C.; Abreu, Gabriela de Azevedo; Barufaldi, Laura Augusta; Klein, Carlos Henrique; Vasconcelos, Maurício T. L. de; Veiga, Glória Valéria da; Figueiredo, Valeska C.; Moraes, Ana Julia Pantoja; Souza, Ana Luiza Lima; Oliveira, Ana Mayra Andrade de; Schaan, Beatriz D’Argord; Tavares, Bruno Mendes; Oliveira, Cecília Lacroix de; Cunha, Cristiane de Freitas; Giannini, Denise Tavares; Belfort, Dilson Rodrigues; Ribas, Dulce Lopes Barboza; Santos, Eduardo Lima; Leon, Elisa Brosina de; Fujimori, Elizabeth; Oliveira, Elizabete Regina Araújo; Magliano, Erika da Silva; Vasconcelos, Francisco de Assis Guedes; Azevedo, George Dantas de; Brunken, Gisela Soares; Dias, Glauber Monteiro; Correa Filho, Heleno R.; Monteiro, Maria Inês; Guimarães, Isabel Cristina Britto; Faria Neto, José Rocha; Oliveira, Juliana Souza; Carvalho, Kenia Mara B. de; Gonçalves, Luis Gonzaga de Oliveira; Santos, Marize M.; Muniz, Pascoal Torres; Jardim, Paulo César B. Veiga; Montenegro Jr., Renan Magalhães; Gurgel, Ricardo Queiroz; Vianna, Rodrigo Pinheiro; Vasconcelos, Sandra Mary; Matta, Sandro Silva da; Martins, Stella Maris Seixas; Goldberg, Tamara Beres Lederer; Silva, Thiago Luiz Nogueira da; Ferreira, Pedro Antônio Muniz
Background: the Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”) is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA. Methods/Design: participants answered a self-administered questionnaire using an electronic device, in order to obtain information on demographic and lifestyle characteristics, including physical activity, smoking, alcohol intake, sleeping hours, common mental disorders and reproductive and oral health. Dietary intake was assessed using a 24-hour dietary recall. Anthropometric measures (weight, height and waist circumference) and blood pressure were also be measured. Blood was collected from a subsample of approximately 44,000 adolescents for measurements of fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glycated hemoglobin and fasting insulin. Discussion: the study findings will be instrumental to the development of public policies aiming at the prevention of obesity, atherosclerotic diseases and diabetes in an adolescent population.
Polycystic Ovary Syndrome: aggressive or protective factor for the retina? Evaluation of macular thickness and retinal nerve fiber layers using high-definition optical coherence tomography
(Hindawi, 2015-02-11) Souza Júnior, José Edvan de; Garcia, Carlos Alexandre de Amorim; Soares, Elvira Maria Mafaldo; Maranhão, Técia Maria Oliveira; Lemos, Telma Maria Araujo Moura; Azevedo, George Dantas de
Objective. To compare macular thickness (MT) and retinal nerve fiber layers (RNFL) between women with polycystic ovary syndrome (PCOS) and healthy women. Materials and Methods. The study included 45 women with PCOS and 47 ovulatory women undergoing clinical-gynecological and ophthalmic evaluations, including measurement of MT, RNFL, and optic disc parameters using optical coherence tomography. Results. The superior RNFL around the optic nerve was significantly thicker in PCOS than in healthy volunteers (𝑃 = 0.036). After stratification according to insulin resistance, the temporal inner macula (TIM), the inferior inner macula (IIM), the nasal inner macula (NIM), and the nasal outer macula (NOM) were significantly thicker in PCOS group than in control group (𝑃 < 0.05). Both the presence of obesity associated with insulin resistance (𝑃 = 0.037) and glucose intolerance (𝑃 = 0.001) were associated with significant increase in the PC1 mean score, relative to MT. A significant increase in the PC2 mean score occurred when considering the presence of metabolic syndrome (𝑃 < 0.0001). There was a significant interaction between obesity and inflammation in a decreasing mean PC2 score relative to macular RNFL thickness (𝑃 = 0.034). Conclusion. Decreased macular RNFL thickness and increased total MT are associated with metabolic abnormalities, while increased RNFL thickness around the optic nerve is associated with hormonal changes inherent in PCOS
Adolescentes em acolhimento provisório: uma análise investigativa sobre a vulnerabilidade ao HIV
(Universidade Federal do Estado do Rio de Janeiro (UNIRIO), 2015-03-31) Cavalcanti, Lilian Joane; Silva, Richardson Augusto Rosendo da; Nelson, Ana Raquel Cortês; Prado, Nanete Caroline da Costa; Holanda, José Rebberty Rodrigo; Costa, Mayara Mirna do Nascimento
Objetivo: analisar as percepções dos adolescentes em acolhimento provisório quanto a sua a vulnerabilidade ao HIV. Métodos: estudo descritivo e exploratório de natureza qualitativa. Realizado com adolescentes institucionalizados na Casa de Passagem III localizada em Natal, no estado do Rio Grande do Norte, mediante a técnica do Grupo Focal (GF). Resultados: Foram abordados elementos referentes aos conhecimentos sobre HIV/Aids; autoproteção e responsabilização na esfera sexual; comportamentos e valores; e contribuição da instituição na prevenção do HIV/Aids. Conclusão: as percepções dos adolescentes em relação à vulnerabilidade ao HIV refletem outros problemas sociais, evidenciando a necessidade da intervenção baseada em múltipla direção, principalmente em resposta a necessidades sociais desses adolescentes.
Efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres com fibromialgia
(Elsevier, 2015-05) Lisboa, Lilian Lira; Sonehara, Elisa; Oliveira, Katia Cristina Araújo Nogueira de; Andrade, Sandra Cristina de; Azevedo, George Dantas de
Objetivo: avaliar e comparar o efeito da cinesioterapia na qualidade de vida, func ̧ão sexuale sintomas climatéricos em mulheres climatéricas com e sem fibromialgia.Métodos: Participaram 90 mulheres climatéricas, divididas em dois grupos: fibromialgia (47)e controle (43). As pacientes foram avaliadas nas variáveis: qualidade de vida (Utian Qualityof Life [UQOL]), função sexual (questionário do quociente sexual/versão feminina [QS-F]) e intensidade dos sintomas climatérios (Índice Menopausal de Blatt-Kupperman [IMBK]). Os grupos fizeram cinesioterapia para o assoalho pélvico, composto de 20 sessões, duas vezes por semana. Análise estatística foi feita por meio dos testes t de Student pareado, análise de variância de delineamento misto e Kappa de Cohen. Resultados: na qualidade de vida, foi observada melhoria em ambos os grupos para todos os domínios avaliados. Na análise intergrupo foi evidenciada diferença nos domínios emocional (p = 0,01), saúde (0,03) e sexual (p = 0,001) com ganhos mais expressivos para o grupo controle. Na função sexual, foi verificada melhoria nos grupos, após a intervenção; na análise intergrupo as fibromiálgicas apresentaram escores inferiores ao grupo controle (p < 0,001).Em relação aos sintomas climatéricos não houve diferença na análise intergrupo pós-intervenção (p = 0,73). Entretanto, ambos os grupos apresentaram redução significativa das intomatologia após a intervenção (p < 0,001).Conclusões: a cinesioterapia do assoalho pélvico exerce efeito benéfico sobre os domínios da qualidade de vida, função sexual e sintomatologia climatérica em mulheres com e semfibromialgia na fase do climatério. Entretanto, a fibromialgia parece ser fator limitante para melhores resultados em alguns aspectos avaliados

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