Função autonômica em pacientes portadores de lipodistrofia generalizada congênita - sindrome de berardinelli - SEIP

A Síndrome de Berardinelli-Seip ou Lipodistrofia Generalizada Congênita (LGC) é uma doença rara, com transmissão autossômica recessiva, caracterizada principalmente pela ausência quase total de tecido adiposo. Os pacientes afetados apresentam resistência a insulina, dislipidemia e hipertensão arterial. Estudos têm evidenciado que estas alterações metabólicas interferem na modulação autonômica para o nó sinusal. O principal objetivo deste estudo foi investigar a modulação autonômica em pacientes portadores de LGC, através da variabilidade de freqüência cardíaca (VFC), pelo método linear de domínio de tempo na Eletrocardiografia Dinâmica de 24 horas e estabelecer um critério relativamente simples, não invasivo, para diagnóstico de disfunção autonômica nestes pacientes. Participou voluntariamente deste estudo transversal, um grupo de pacientes portadores de LGC (n=18) na faixa etária de 9,3 a 39,8 anos (21,3 ± 8,3) cuja variabilidade de freqüência cardíaca foi comparada com um grupo de pacientes controles (n=19) com idade de 9,3 a 39,1 anos (21,4 ± 7,8). Todos os voluntários foram submetidos à avaliação clínica, laboratorial, antropométrica e análise de VFC no domínio de tempo através de eletrocardiografia dinâmica de 24 horas. Para análise dos dados relativos aos índices temporais de VFC foram utilizados o MeanRR, SSDN e rMSSD. Pacientes com LGC apresentavam aumento da pressão arterial comparados com indivíduos do grupo controle (sistólica, 131,1 vs 106,3 mmHg, p<0,05); diastólica, 85,0 vs 68,2 mmHg, p<0,05) e 10 tinham critérios para diagnóstico de Hipertensão Arterial e Hipertrofia do Ventrículo Esquerdo. Os níveis de glicose, triglicerídeos, colesterol e HOMA-R eram elevados e 12 pacientes tinham critérios para diabetes mellitus tipo 2. Comparado com os controles, pacientes com LGC tinham diminuição dos índices MeanRR (639,8 vs 780,5 ms, p<0,001), SDNN (79,2 vs 168,5 ms, p<0,001), e rMSSD (15,8 vs 59,6 ms, p<0,001). Em pacientes com LGC, a redução da VFC foi independente de distúrbios metabólicos e hemodinâmicos. Os resultados de nosso experimento indicam que pacientes com LGC apresentavam modulação autonômica anormal caracterizada pelo aumento da freqüência cardíaca e pronunciada redução da VFC, independente de distúrbios metabólicos e hemodinâmicos observados nesta síndrome. O caráter multidisciplinar desse estudo fica contemplado pela interação de profissionais de diversas áreas como: cardiologia, endocrinologia, metabolismo, neurologia, nutrição, etc

Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

Efeitos do exercício físico aeróbio na modulação autonomica da frequência cardíaca de mulheres com sindrome dos ovários policisticos

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Marcadores genéticos associados com a resposta inflamatória na meningite bacteriana

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

FERRITINA: intervalos de referência para adultos no Estado do Rio Grande do Norte

Ferritin is a protein composed of heavy and light chains, non-covalently linked and which accommodates, in its core, thousands of atoms of iron. Furthermore, this protein represents the stock of iron in the body and it is characterized as an acute marker and predictor of diseases, such as iron deficiency anemia, hereditary hemochromatosis and others. Considering the variability of reference values and the analytical methods currently available, the aim of this work was to propose 95% confidence intervals for adults in the State of Rio Grande do Norte, Brazil, after determining the average concentration of serum ferritin for both sexes, beyond its correlation with the age. We analyzed 385 blood samples, collected by venipuncture from individuals residing in the State, after 12-14 hours of fast. The populational sample had 169 men and 216 women between 18-59 years old, which filled a questionnaire on socioeconomic, food habits and accounts about previous and current diseases. The sample collections were itinerant and the results of erythrogram, fasting glucose, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, urea, creatinine, leukocyte count and platelets, beyond C-reactive protein, were issued to each participant, so that, after selection of the apparently healthy individuals, the dosage of serum ferritin was carried out. Statistical analysis was performed using the softwares SPSS 11.0 Windows version, Epi Info 3.3.2 and Graf instant pad (version 3.02), and the random population sample was single (finite population), for which the test of linear correlation and diagram of dispersion were also made. After selection of individuals and determination of serum ferritin, the most discrepant outliers were disregarded (N = 358, Men = 154/Women = 207) and the average value determined for the masculine sex individuals was 167,18 ng / dL; for the feminine sex individuals, the average value obtained was 81,55 ng / dL. Moreover, we found that 25% of men had values < 90,30 ng / dL; 50% ≤ 156,25 ng / dL and 75% ≤ 229,00 ng / dL. In the group of women, 25% had values < 38,80 ng / dL; 50% ≤ 65,00 ng / dL and 75% ≤ 119,00 ng / dL. Through the correlation coefficient (r = 0,23 with p = 0,003), it is possible to suggest the existence of positive linear correlation between age and serum ferritin for men. The correlation coefficient for women (r = 0,16 with p = 0,025) also confirms the existence of positive linear correlation between serum ferritin and age. Considering the analysis carried out and specific methods corroborating with the proposed benchmarks, we concluded that the average value found for men is higher than that found for women. Furthermore, this scenario rises with age for both sexes, and the 95% confidence intervals obtained were 74 ng/dL ≤ μ ≤ 89 ng/dL and 152ng/dL ≤ μ ≤183ng/dL for the feminine and masculine sex individuals respectively

Soroprevalência da infecção pelo Trypanosoma cruzi no município de Caicó, RN, e caracterização genética por RAPD do parasito isolado de humanos e de triatomíneos no semiárido potiguar

Trypanosoma cruzi infection was evaluated in 390 resident individuals in different rural communities of Caicó municipality, State of Rio Grande do Norte (RN). Of 28 investigated communities the soroprevalence of T. cruzi infection was 2.8% in eight rural communities individuals. The epidemiological characteristics of seropositive shown that the age ranged from 22 to 64 years, being significantly raised from 31 years (90.9%). The female gender was predominant and low education degree. Those individuals reported that they never donated blood, but they had direct contact with triatomines bug. The isolation of the parasite was performed by blood culture and xenoculture methods to determine the genetic variability of the samples. Twenty seven T. cruzi isolates were analyzed by RAPD as genetic marker using three random primers (M13-40, gt11-F and L15996). The T. cruzi isolates showed 73.7% of shared bands considering the average obtained with the three primers, and were genetically well correlated. Using this marker it was possible to separate the populations of the parasite in three distinct groups. The first group composed by isolates obtained of triatomines and humans from four different districts (Caicó, Caraúbas, Serra Negra doNorte and Governador Dix-Sept Rosado); the second contained isolates obtained of triatomines of two different species (T. brasiliensis and P. lutzi) captured in Caraúbas and Serra Negra do Norte. The third grouped isolates obtained from humans of Angicos and Caicó municipalities. In different localities of distinct mesoregions, State of RN, a profile genetic well correlated was identified among all isolates and the presence of three distinct groups of the parasite circulating among vertebrate and invertebrate hosts

Análise da frequência alélica de 15 LOCI STR na população do Rio Grande do Norte

Human population have a significant number of polymorphic loci, whose use and applications range from construction of linkage maps, to study the evolution of populations, through the determination of paternity, forensic medicine and migration. Currently, STRs (Short Tanden Repeats) markers are considered the major markers for human identification, mainly due to its abundance and high variability because of the fact that they are easily amplifiable by PCR (Polymerase Chain Reaction), work with low amounts of DNA and be capable of automation processes involving fluorescence detection. The creation of regional databases containing allele frequencies of population provide subsidies to increase the reliability of the results of determining the genetic link. This paper aims to obtain a database of allele frequencies of 15 polymorphic molecular loci (D8S1179, D21S11, D7S820, CSF1PO, D19S433, vWA, TPOX, D18S51, D3S1358, TH01, D13S317, D16S539, D2S1338, D5S818 e FGA) in a population classifies as born in the State of Rio Grande do Norte, Brazil, totaling 1100 unrelated individuals. To evaluate the frequency, DNA samples were submitted to PCR amplification, followed by capilarry electrophoresis genetic sequencer. The frequencies identified in this study were compared with brazilian population in general and other states in Brazil. Except for the loci D21S11, D19S433 and D2D1338, the genotypes found were in Hardy-Weinberg equilibrium and no significant differences among the frequencies were found in the populations studied. The most informative loci was D2S1338 and D18S51, and the less informative is the locus TPOX

Aspectos de patogenicidade e relacionamento genético de isolados clínicos vaginas e anais de Candida albicans oriundos de pacientes com candidíase vulvovaginal

Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75% of women of reproductive age. The majority of cases (80 to 90%) are due to C. albicans, the most virulent species of the genus Candida. Virulence attributes are scarcely investigated and the source of infection remains uncertain. Objective: This study aimed to evaluate the virulence factors and genotypes of clinical isolates of C. albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Materials and methods: We analyzed 62 clinical isolates of C. albicans (36 vaginal and 26 anal strains). Direct examination of vaginal and anal samples and colony forming units (CFU) counts were performed. Yeasts were identified using the chromogenic media CHROMagar Candida® and by classical methodology, and phenotypically characterized regarding to virulence factors, including the ability to adhere to epithelial cells, proteinase activity, morphogenesis and biofilm formation. The genotypes of the strains were investigated with ABC genotyping, microsatellite genotyping with primer M13 and RAPD. Results: We found 100% agreement between direct examination and culture of vaginal samples. Filamentous forms were present in most of the samples of vaginal secretion, which presented CFU counts significantly higher than the samples of anal secretion. There was no statistically significant difference between virulence factors of infecting vaginal isolates and those presented by colonizing anal isolates; as well as for the comparison of the vaginal isolates from patients with different clinical conditions (sporadic or recurrent VVC). There was a decrease in the ability to adhere to HBEC, morphogenesis and biofilm formation of the vaginal isolates during the progress of infection. There was an association between the ability to express different virulence factors and the clinical manifestations presented by the patients. Genotype A was the most prevalent (93.6%), followed by genotype C (6.4%). We found maintenance of the same ABC genotype and greater prevalence of microevolution for the vaginal strains of C. albicans sequentially obtained. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient presented the same ABC genotype and high genetic relatedness. Conclusion: It is noteworthy that the proliferation of yeast and bud-to-hypha transition are important for the establishment of CVV. The expression of virulence factors is important for the pathogenesis of VVC, although it does not seem to be determinant in the transition from colonization to infection or to the installation of recurrent condition. Genotype A seems to be dominant over the others in both vaginal and anal isolates of patients with VVC. The most common scenario was microevolution of the strains of C. albicans in the vaginal environment. It is suggested that the anal reservoir constituted a possible source of vaginal infection, in most cases assessed

Imagens do medo na mídia: uma análise das representações da violência em Natal-RN

Social violence is one of the phenomena of human life that produce effects on the social imaginary as it is in it that are designed conflicting values concerning what is most vital to humans, such as respect for the strength and the fear of death, pleasure trespass for injury and pain, the rejection of injustice and anger that is born of revolt. The variability of feelings and reasons that constitute violence has required academic knowledge increasingly sensitive reflections that encompass the complexity of its manifestations. The feeling of fear and insecurity which constitute the collective social imagination has caused large changes in the behavior of both individuals and the society as a whole. This study aims to reflect on media representations the social violence in Natal-RN. Through a thematic survey and documentary analysis of three newspapers of Rio Grande do Norte - Tribuna do Norte, Novo Jornal and Jornal Metropolitano - was possible to list events and trace different discursive strategies that lead to receptors ideological interests of class, constitute social and spatial segregations and maximize violations of rights and of the human dignity, with important implications in the construction of social representations concerning the reality of violence

Efeitos de peixes zooplanctívoros e onívoros sobre a resposta de comunidades planctônicas à fertilização por nutrientes

The food chain theory predict that presence of omnivory prevent the trophic cascade and could be a strong stabilizing factor over resource and consumer community dynamics, and that the nutrient enrichment destabilize populations dynamics. Most of the freshwater tropical reservoirs are eutrophic, and strategies that seek improve the water quality through the control of phytoplankton biomass and nutrient input, become essential for the improvement and preservation of water quality. The aim of this study was test the zooplanktivory (when larvae) and omnivory (when young and adult) effects of Nile Tilapia over the structure and dynamics of plankton communities, in addition or absence of nutrients enrichment. For this, one field experiment was performed with a factorial design 2x3 resulting in six treatments: control, without fish and nutrient (C); with omnivorous fish (O); with zooplanktivorous fish (Z); without fish and with enrichment of nutrients (NP); with omnivorous fish and nutrients (ONP); and, with zooplanktivorous fish and nutrients (ZNP). The two planktivory types reduced the zooplankton biomass and increased the phytoplankton biomass, but the omnivory of filter-feeding fish attenuated the trophic cascade magnitude. The fertilization by nutrients increases the nutrient concentrations in water and the phytoplankton biomass, but the effect on zooplankton is dependent of the trophic structure. In a general way, the effects of the fish and nutrient addition were addictive, but significant interactions among those factors were observed in the answer of some zooplankton groups. The effects of omnivorous fish over the temporal variability of phytoplankton and zooplankton biomass were very variable, the increase or reduce in variability of the plankton depending of the level of nutrients and of the analyzed variable. With base in this study, we conclude that the planktivory type exercised by the fish and the concentrations of nutrients in the water affects the force of pelagic trophic cascades and probably the success of biomanipulation programs for the handling of water quality in lakes and tropical reservoirs

Influência das mudanças climáticas na estrutura funcional da comunidade fitoplanctônica em um reservatório da região do semiárido

The Brazilian Northeast is the most vulnerable region to climatic variability risks. For the Brazilian semi-arid is expected a reduction in the overall rates of precipitation and an increase in the number of dry days. These changes predicted by the IPCC (2007) will intensify the rainfall and droughts period that could promote the dominance of cyanobacteria, thus affecting the water quality of reservoirs, that are most used for water supply, in the semi-arid. The aim of this study was to evaluate the effects of increasing temperature combined with nutrient enrichment on the functional structure of the phytoplankton community of a mesotrophic reservoir in the semi-arid, in the worst case scenario of climate change predicted by the IPCC (2007). Two experiments were performed, one in a rainy season and another in the dry season. In the water sampled, nutrients (nitrate and orthophosphate) were added in different concentrations. The microcosms were submitted to two different temperatures, five-year average of air temperature in the reservoir (control) and 4°C above the control temperature (warming). The results of this study showed that warming and nutrient enrichment benefited mainly the functional groups of cyanobacteria. During the rainy season it was verified the increasing biomass of small functional groups of unicellular and opportunists algae such as F (colonial green algae with mucilage) and X1 (nanoplanktonic algae of eutrophic lake systems). It was also observed an increasing in total biomass, in the richness and diversity of the community. In the dry season experiment there was a greater contribution in the relative biomass of filamentous algae, with a replacement of the group S1 (non-filamentous cyanobacteria with heterocytes) for H1 (filamentous cyanobacteria with heterocytes) in nutrient- enriched treatments. Moreover, there was also loss in total biomass, species richness and diversity of the community. The effects of temperature and nutrients manipulation on phytoplankton community of reservoir Ministro João Alves provoked changes in species richness, the diversity of the community and its functional composition, being the dry period which showed the highest susceptibility to the increase in the contribution of potentially toxic cyanobacteria with heterocytes

Desenpenho aeróbio e controle autonômico cardíaco em idosas praticantes de tai chi chuan e sedentárias

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Sensibilidade interoceptiva e respostas psicofisiológicas ao exercício submaximo

The complex human behavior related to exercise involves cognitive, physical and emotional processing. The recent theories about exercise s intensity regulation have highlighted the role played by psychophysics aspects in controlling exercise s intensity. In this regard, recent evidences have shown that there is variability in human capacity in perceiving interoceptives clues. Thus, subjects more sensitive show higher physiological arousal to physical and/or emotional stress, and sensations with higher intensity. In fact, studies have evidenced that interoceptive feedback modifies behavior in exercise with free load. However, exercise recommendations are based in a constant load standard. Therefore, we aimed to analyze the influence of interoceptive sensibility on psychophysics responses during dynamic exercise performed with constant load. Twenty-four adult males were allocated into two groups accordingly with their interoceptive sensibility: high sensibility (n=11) and low sensibility (13). They underwent to an incremental test (IT) and then randomly to two sections of moderate and severe exercise intensity for 20 minutes. Heart rate (HR), rating of perceived exertion (RPE), affective feelings (AF), alert state (AS), and percentage of associative thoughts were collect during exercise. A two-way ANOVA with repeated measures was used to assess differences between psychophysics responses. There were differences between group in RPE, AF, and AS in moderate intensity. There was no difference in any measure in severe intensity. We conclude that subjects with high interoceptive sensibility feel dynamic moderate exercise more intense than the subjecs with low interoceptive sensibility

Efeito do treinamento resistido na função autônomica cardíaca, nos parâmetros bioquímicos e antropométricos de pessoas vivendo com HIV/AIDS

Introduction: The emergence of High Active Antiretroviral Therapy (HAART) increase the life expectancy of the persons living with HIV/AIDS (PLHIV), therefore the prolonged use cause metabolic implications and influences on body fat distribution and increase the cardiovascular diseases prevalence. Aims: Evaluate the effect of resistance training on heart rate variability, biochemical parameters and somatotype on PLHIV. Methods: Participated this study seven sedentary men, with age above 25 years old, living with HIV/AIDS, under HAART use. Were submitted a 16 week intervention with resistance training. Evaluated the heart rate variability, biochemical parameters and somatotype, before, after 8 weeks and 16 weeks, all in paired form. It was found the data normality by Shapiro-Wilk test and conducted the Anova one way combined with Tukey post hoc to samples in each evaluate moment, adopting significance level p<0,05. Also were calculated percentage change deltas. For somatotype was used the somatotype spatial distance (DES), obeying the significance value DES≥1. Results: Was found significance differences only in variable final heart rate delta 60s (p=0,01), however, is not showed changes on heart rate variability, biochemical parameters and somatotype components. Conclusion: 16 weeks of resistance training showed improvement on heart rate recovery after submaximal effort and, despite is not enough to produce significance differences on biochemical parameters and somatotype components, could be realize improvement on average value of fasting glucose and lipid profile, as well as reducing the endomorphic component

Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis