Custos e benefícios de um programa de exercício aeróbios na doença pulmonar obstrutica crônica: ensaio cliníco aleatório controlado

Pulmonary Rehabilitation, especially due to aerobic exercise, positive impact in reducing morbidity/mortality of patients with COPD, however the economic impact with costs of implementing simple programs of aerobic exercise are scarce. This is a blind randomized clinical trials, which aimed to evaluate the costs and benefits of a simple program of aerobic exercise in individuals with COPD, considering the financial costs of the Public Health System and its secondary endpoints. We evaluated lung function, the distance walked during six minutes of walking, the respiratory and peripheral muscle strength, quality of life related to health (QLRH), body composition and level of activity of daily living (ADL) before and after eight weeks of an aerobic exercise program consisting of educational guidance for both groups, control and intervention and supervised walks to the intervention group. The health costs generated in both groups were calculated following table Brazilian Public Health System. The sample consisted of forty patients, two being excluded in the initial phase of desaturation during the walk test six minutes. Were randomized into control and intervention group thirty-eight patients, three were excluded from the control group and one was excluded from the intervention group. At the end, thirty-four COPD comprised the sample, 16 in the control group and 18 in the intervention group (FEV1: 50.9 ± 14% pred and FEV1: 56 ± 0.5% pred, respectively). After for intervention, the intervention group showed improvement in meters walked, the sensation of dyspnea and fatigue at work, BODE index (p <0.01) in QLRH, ADL level (p <0.001) as well as increased strength lower limbs (p <0.05). The final cost of the program for the intervention group was R $ 148.75, including: assessments, hiking supervised by a physiotherapist and reassessments. No patient had exacerbation of IG, while 2 patients in the CG exacerbated, generating an average individual cost of R $ 689.15. The aerobic exercises in the form of walking showed significant clinical benefits and economic feasibility of its implementation, due to low cost and easy accessibility for patients, allowing them to add their daily practice of aerobic exercises

A formação e o desenvolvimento de arranjos cooperativos sob a ótica da imersão social e da economia dos custos de transação: um estrudo de caso na Coopercam e na Unipesca

The current study analyzes the birth and development of two strategic alliances established between shrimp producers in Rio Grande do Norte: the Unipesca and the Coopercam. To achieve this aim, two approaches which, at first sight, could be considered contradictory were used: the Transactional Costs Economy and Embeddedness. The first approach is fundamentally based in the studies of Williamson (1985; 1991; 1996; 1999; 2000; 2002). Embededness, on the other hand, went through the review of a series of authors, such as Burt (1992), Granovetter (1973; 1985), Uzzi (1997), Gulati (1994; 1995; 1997; 1998; 1999; 2000), Nielsen (2005), Ring (2002), Ring and Van de Ven (1994), Zafirovski (2002), among others. To analyze the birth and development of the cooperatives in this study, Gulati s work (1998) was used. This study shows the steps to be studied for a better comprehension of an alliance: the decision of starting an alliance and the choice of the partners, the decision about the governance structure, the evolution of the alliance and the development of the companies which established this partnership. To carry this study out, a study case accordingly to Yin s proposal (2001) was adopted. Semi-structured interviews with pre-defined plots were conducted in two phases: in the beginning of 2006 and in the beginning of 2007. The subjects from the research were, in 2006, representative members of the main associations and corporations, besides the shrimp producers from the state, when the context of the activity was set. In the second phase, in 2007, representative members from the two cooperatives that were listed above were interviewed the president from Coopercam and the marketing manager from Unipesca. Besides these two members, directors from two important organizations in each of these cooperatives were also interviewed, giving out the necessary information for the research. Secondary data was also collected from the Brazilian Association of Crab producers website, as well as from news from important newspapers in RN, such as Tribuna do Norte. The primary data was analyzed in terms of quality, accordingly to the documental analysis technique. Thus, through the data that was collected, it can be concluded that the reasons that motivated the companies to cooperate can be explained in terms of the transactional costs economy. However, the choice of partners is more connected to aspects approached by the social embededness. When aspects related to development and evolution were analyzed, it could be seen that both aspects from TCE and Embededness were vital to explain the development of the cooperatives mentioned

Inserção de fornecedores locais como fonte de desempenhos em custos de transação e legitimidade: estudo de caso na cadeia produtiva do petróleo e gás do Rio Grande do Norte

The inclusion of local suppliers in production chains has considerable impact on its performance, but most notably in its main actors. The results of this process may be of different kinds and can be analyzed from economic or institutional approaches. This study aimed to verify the existence of different performances of Petrobras due to the inclusion of local suppliers in the oil and gas production chain in the state of Rio Grande do Norte, from the viewpoints of transaction costs and the Institutional Theory. In order to this, were made the characterization of the PROMINP, the description of its actions and results, the mapping of its institutional context of reference, and identification of results obtained by Petrobras in terms of transaction costs and legitimacy. The theoretical framework is based on authors dealing with industrial concentration, as like Marshall, Krugman, Porter and Schmitz, from the sociological perspective of neoinstitucional theory, as like DiMaggio and Powell and Scott and Meyer, and transaction costs, as like Williamson. This is a qualitative research, with data collection done by consulting secondary fonts and semi-structured interviews with nineteen actors of three groups, namely: actors involved in actions of the program, representatives of enterprises and representative of Petrobras. To analyze the content was used the Suchman s model (1995) for categories associated with strategies of legitimation and fourteen variables associated with the three variables assets specificity, bounded rationality and opportunism (Williamson, 1995, 1989) in the case of transaction costs. The results indicate that PROMINP has achieved its objectives by encouraging the increased participation of local companies in the oil and gas production chain, reflecting in the economic development of the state. The Redepetro/RN, fostered and built upon the interaction of the participants, is presented as a solution of continuity to the participation of enterprises in the chain, after the closure of the actions of the program. PROMINP demands responses to coercive, legislative and regulatory pressures of the organizational field, whose institutional context of reference is wide. From the point of view of legitimacy, through strategies to gain cognitive legitimacy and maintaining pragmatic legitimacy, Petrobras can manipulate the environment, ensuring the compliance of the constituents to their technical and institutional demands. Enterprises, in turn, respond to the demands through compliance with technical demands, mainly through the certification of processes, and cultural changes. There aren t clear gains related to the transaction costs, however, gains in legitimacy can be seen as a cumulative capital that can serve as a competitive differential that generates economic gains. In terms of theoretical findings, it was found that, due to its explanatory power for actions that are difficult to explain only in economic terms, Institutional Theory may be used as theoretical support concurrent with other theories. TCE model has limitations in explaining the program actions. In the case, it s emphasized that Petrobras doesn t seek only economic efficiency, but has in its mission the commitment to social development.

Tecendo vivências e sentidos do câncer infantil : família, doença e redes de apoio social em Natal-RN

This paper discusses the experiences related to the treatment of children´s cancer which had children, their mothers and families as their main characters. They were mainly originated from areas in the countryside and urban poor areas in the State of Rio Grande do Norte. The non-governmental organization Grupo de Apoio à Criança com Câncer (GACC) was the privileged ethnographic location. In this setting, the mother, which was called acompanhante (companion), and the children, defined as pacientes (patients), were often sheltered in reason of therapeutic practices and the treatment undertaken by children in a nearby hospital. This study aims to focus on the therapeutic itinerary, beyond the children´s suffering, dealing with the family as a whole, since the moral values from these popular families imply the complete involvement of the family in relation to the illness and its treatment. Therefore, it is experienced as a family problem. We also intend to understand the construction of meanings to the illness, dealing with the ideological continuity in the relationships between the families and the GACC. These meanings were built in the intersection of these two spheres, which refer particularly to medical, religious and emotional explanations. Ethnographic methods were applied in this research at the entity and another social contexts, such as the family households. I also tried to retrieve the process of treatment outside the GACC, visiting the family context, when doing dense interviews or just having conversations with informants. It was found that the GACC, as a non-governmental organization, generates a negotiation of identities, which develops, then, through the family as a whole, but also through the child and especially the mother, affecting, in some way, their internal organization. Furthermore, the meanings of the experience of illness appeared to be shaped by the family sphere as well as by the logic of public health structures

Atividade antiplasmódica e toxicológica de plantas medicinais usadas popularmente no Brasil : uma abordagem etnobotânica

Malaria is a disease of global distribution, recognized by governments around the world as a serious public health problem, affecting more than 109 countries and territories and endangering more than 3.3 billion people. The economic costs of this disease are also relevant: the African continent itself has malaria-related costs of about $ 12 billion annually. Nowadays, in addition to chloroquine, Plasmodium falciparum is resistant to many drugs used in the treatment of malaria, such as amodiaquine, mefloquine, quinine and sulfadoxine-pyrimethamine; resistance of Plasmodium vivax to treatments, although less studied, is also reported. Nature, in general, is responsible for the production of most known organic substances, and the plant kingdom is responsible for the most of the chemical diversity known and reported in the literature. Most medicinal plants commercialized in Brazil, however, are of exotic origin, which makes the search for endemic medicinal plants, besides a patent necessity, a fascinating subject of academic research and development. This study aimed to: (i) verify the antimalarial activity of ethanolic and hydroalcoholic extracts of Boerhavia paniculata Rich. And acetonic extract of Clethra scabra Pers. in Swiss albino mice infected by Plasmodium berghei NK65, (ii) observe possible combined effects between the course of infection by P. berghei NK65 and administration of these extracts in Swiss albino mice, and (iii) conduct a preliminary study of the acute toxicity of these extracts in Swiss albino mice. All extracts notable pharmacological activities - with parasite infections inhibitions ranging from 22% to 54%.These characteristics suggest that the activities are relevant, although comparatively lower than the activity displayed by the positive control group (always above 90%). The general framework of survival analysis demonstrates an overall reduction in survival times for all groups. Necroscopy has not pointed no change in color, shape, size and/or consistency in the evaluated organs - the only exception was the livers of rats submitted to treatment to hydroalcoholic extracts: these organs have been presented in a slightly congestive aspect with mass increasing roughly 28% higher than the other two groups and a p-value of 0.0365. The 250 mg/Kg ethanolic group has been pointed out by the Dunn s post test, as the only class with simultaneous inequalities (p<0.05) between positive and negative control groups. The extracts, notably ethanol extract, have, in fact, a vestigial antimalarial activity, although well below from the ones perceived to chloroquine-treated groups; nevertheless, the survival times of the animals fed with the extracts do not rise by presence of such therapy. Both the toxicopharmacological studies of the synergism between the clinical course of malaria and administration of extracts and the isolated evaluation of toxicity allow us to affirm the absence of toxicity of the extracts at the level of CNS and ANS, as well as their non-influence on food and water consumption patterns, until dosages of 500 mg/Kg. Necroscopic analysis leads us to deduct a possible hepatotoxic effect of hydroalcoholic extract at dosages of 500 mg/Kg, and an innocuous tissue activity of the ethanol extract, in the same dosage. We propose a continuation of the studies of these extracts, with protocol modifications capable of addressing more clearly and objectively their pharmacological and toxicological aspects

Análise fractal da vasculatura arteriolar e venular da retina em pessoas sem doença ocular

Although it has been suggested that retinal vasculature is a diffusion-limited aggregation (DLA) fractal, no study has been dedicated to standardizing its fractal analysis . The aims of this project was to standardize a method to estimate the fractal dimensions of retinal vasculature and to characterize their normal values; to determine if this estimation is dependent on skeletization and on segmentation and calculation methods; to assess the suitability of the DLA model and to determine the usefulness of log-log graphs in characterizing vasculature fractality . To achieve these aims, the information, mass-radius and box counting dimensions of 20 eyes vasculatures were compared when the vessels were manually or computationally segmented; the fractal dimensions of the vasculatures of 60 eyes of healthy volunteers were compared with those of 40 DLA models and the log-log graphs obtained were compared with those of known fractals and those of non-fractals. The main results were: the fractal dimensions of vascular trees were dependent on segmentation methods and dimension calculation methods, but there was no difference between manual segmentation and scale-space, multithreshold and wavelet computational methods; the means of the information and box dimensions for arteriolar trees were 1.29. against 1.34 and 1.35 for the venular trees; the dimension for the DLA models were higher than that for vessels; the log-log graphs were straight, but with varying local slopes, both for vascular trees and for fractals and non-fractals. This results leads to the following conclusions: the estimation of the fractal dimensions for retinal vasculature is dependent on its skeletization and on the segmentation and calculation methods; log-log graphs are not suitable as a fractality test; the means of the information and box counting dimensions for the normal eyes were 1.47 and 1.43, respectively, and the DLA model with optic disc seeding is not sufficient for retinal vascularization modeling

Mortalidade da população em idade ativa (PIA) por doença cardiovascular e câncer nas capitais e nas regiões metropolitanas brasileiras: associação com indicadores socioeconômicos

Universidade Estadual do Rio Grande do Norte

Sintomatologia depressiva e avaliação de níveis de TNFα IL-2 em indivíduos idosos e com doença pulmonar obstrutiva crônica

The aim of the present study was to assess the presence of depressive symptomatology among elderly residents in long-stay institutions (LSI) and in the community of Recife, Brazil. In total, 81 long-stay elderly patients (mean age of 75.55 ± 9.18 years) and 132 elderly (mean age of 73.14 ± 8.27 years) individuals from the community were evaluated. Depressive symptomatology was assessed by the Geriatric Depression Scale (GDS-15), cognitive status by the Mini Mental State Examination (MMSE) and capacity to perform the activities of daily living (ADL) by the Katz Index. Comorbities and the use of medication were recorded. The LSI elderly exhibited more depressive symptoms (p < 0.001) and more dependency (p< 0.001). We observed no differences in MMSE (p = 0.058). The elderly in the community displayed more comorbidities and the LSI elderly consumed more medication (p < 0.001 and p < 0.001, respectively). According to multivariate analysis (logistic regression), being male, having no spouse and having a low schooling level are risk factors for depressive symptoms. In conclusion, most elderly with depressive symptoms received no medication fordepression.

Elaboração e validade do teste de rastreio de doença da Alzheimer com provérbios (TRDAP) para indivíduos a partir de sessenta anos

A escassez de instrumentos para a avaliação e a triagem da doença de Alzheimer, (DA), notadamente denominados de rastreio, com características de padronização e validados para o Nordeste, motivou este Estudo. Visando à triagem de uma etapa mais leve da doença e encaminhamento precoce ao tratamento multidisciplinar foi elaborado o Teste de Rastreio da Doença de Alzheimer com Provérbios (TRDAP), a partir de um Jogo de Memória de Provérbios, construído como recurso terapêutico ocupacional. Está composto de três etapas conforme a função neuropsicológica avaliada, a A (memória de curto prazo), B (funções executivas e linguagem) e C (memória episódica), além do reconhecimento de provérbios. O Estudo foi realizado em uma amostra de conveniência, com 91 idosos (28 DA e 63 controles), a partir de 60 anos, com um ou mais anos de escolaridade. Foram controladas as variáveis, como doenças intercorrentes ou déficits sensoriais que pudessem comprometer o desempenho dos pacientes, nos testes. O protocolo constou de oito testes selecionados por especialistas: Miniexame do Estado Mental (para validade convergente), Escala de Depressão Geriátrica EDG (validade discriminante), Lista de Palavras, Fluência Verbal, Span de Dígitos, Figura Neuropsi, Teste do Relógio, Atividade de Vida Diária e Instrumental. Os resultados confirmaram a validade de construto convergente e discriminante, assim como a relação significativa (p<0,005) com todos os testes, exceto com o EDG. Quanto à validade concorrente, não houve discordância com o critério da avaliação médica observou-se consistência interna aceitável, conferindo confiabilidade no instrumento, o que não ocorreu com MEEM. Tais resultados permitem afirmar que o TRDAP possui características psicométricas, adequadas ao rastreio da fase leve da DA para população estudada

Estado nutricional antropométrico, perfil lipídico e consumo alimentar como fatores de risco para doença cardiovascular em adolescentes

The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents

Tradução, adaptação cultural e análise das propriedades psicométricas do activities of daily living questionnaire - ADLQ - para avaliação funcional de pacientes com a doença de alzheimer

O Activities daily living questionnaire - ADLQ foi elaborado para avaliar atividades básicas e instrumentais em pacientes com a doença de Alzheimer. O objetivo principal deste estudo consistiu em realizar a tradução do ADLQ para a língua portuguesa, adaptação transcultural e análise das suas propriedades psicométricas. A amostra foi composta por 60 pacientes e os respectivos 60 cuidadores. O estudo iniciou-se com a tradução do instrumento pela técnica de retrotradução associada ao método bilíngüe. A versão traduzida foi respondida pelo cuidador e o Mini Exame do Estado Mental (MEEM) aplicado ao paciente. A análise psicométrica foi realizada através da validade das medidas do instrumento. Os resultados verificaram uma correlação inversamente significativa (r=-0,793;p<0,05) entre os instrumentos avaliados, com uma explicação da variância total de 62%. A coerência interna do instrumento foi realizada através da correlação com os resultados do MEEM sugerindo uma versão condensada do ADLQ. Avaliando-se através do teste t para amostras correlacionadas, as médias do ADLQ-versão traduzida e versão condensada não apresentaram diferenças significativas, demonstrado assim que a simplificação do instrumento não alterou os valores do nível de dependência funcional observados. A análise fatorial realizada através da rotação Varimax indicou seis dimensões. Atividades como; comer, vestir-se, banho, necessidades fisiológicas, tomar comprimidos, participação em grupos, administrar finanças, manusear dinheiro, locomover pela vizinhança, usar telefone, compreensão, dentre outras, são os mais importantes preditores da capacidade funcional, no grupo estudado. Atividades com desempenho pouco comum a ambos os sexos, e no desempenho de papéis sociais enquanto gênero na sociedade brasileira (afazeres domésticos, consertos e manutenção em casa), na amostra estudada, não demonstraram ter importância na determinação da capacidade funcional com o paciente com a Doença de Alzheimer. O presente estudo disponibiliza uma nova ferramenta de avaliação funcional, visando contribuir para a mensuração mais cuidadosa do estado funcional do paciente por todos os profissionais da área da saúde

Risco de doença cardiovascular em mulheres com história de distúrbio hipertensivo da gravidez

OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pré-eclâmpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbuminúria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 (± 4.8) while this ratio in normotensive women was of 23.5 (± 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension

Doença cardiovascular em mulheres com histórico de pré-eclâmpsia e seguimento no sistema único de saúde

The aim of the present study was to analyze cardiovascular risk of women with a history of preeclampsia, as well as its follow-upin the National Health System.This is a cross-sectional quantitative research conducted at the Januário Cicco Maternity School. The study population was composed of 573 women selected from a databank belonging to the Women s Health Research Group of the Gynecology Department at Universidade Federal do Rio Grande do Norte, with a history of preeclampsia, and normotensives who gave birth at this institution five years before. The final sample consisted of 147 women, 64 in the group with a history of PE and 83 normotensives. Data were collected on a questionnaire containing the following: sociodemographic aspects, anthropometric measures, life habits, personal and family history of pregnancy-induced hypertension, family history of cardiovascular diseases and frequency of measuring current blood pressure levels. In relation to the association between cardiovascular risk and altered blood pressure (≥130x85 mmHg), the likelihood of exhibiting the latter condition was significantly higher in women with a history of preeclampsia (CI 95% 4.12-38.92), the overweight and obese (CI 95% 1.70-20.75), and in those with a family historyof CVD and personal history of PIH (CI 95% 0.78-47.07 and CI 95% 3.20-25.39) respectively. Likewise, the probability of having altered blood pressure was higher in women with fasting glycemia ≥100mg/dL (CI 95% 2.09-24.73), as well as in those with triglycerides ≥150mg/dl (CI 95% 1.72-9.66). After fitting the logistic model, diagnosis previous preeclampsia and altered triglycerides remained as explanatory variables.The women with a history of preeclampsia five years before exhibited altered blood pressure levels, clinical and laboratory manifestations suggestive of elevated risk for cardiovascular disease, as well as family and personal history of hypertension. There is no differential treatment or adequate outpatient follow-up for this population in basic health care units

Rastreamento populacional para Doença de Gaucher em Tabuleiro do Norte-CE

Background. Gaucher Disease (GD) is a hereditary lysosomal storage disorder characterized by the accumulation of glucosylceramide, mainly in the cells of the reticuloendothelial system, due to a deficiency of the enzyme acid β-glucosidase (GBA). Diagnosis is usually based on measurement of GBA activity in peripheral leukocytes. The purpose of this study was to evaluate the ability of screening for GBA and chitotriosidase activity using Dried Blood Spots on Filter Paper (DBS-FP) to identify individuals at high risk for GD in high-risk populations such as that of Tabuleiro do Norte, a small town in Northeastern Brazil. Methods. Between June 1, 2007 and May 31, 2008, 740 consented residents and descendants of traditional families from Tabuleiro do Norte were submitted to screening with DBS-FP. Subjects with GBA activity <2.19 nmol/h/mL were referred to analysis of GBA and chitotriosidase activity in peripheral leukocytes and in plasma, respectively. Subjects at highest risk for GD (GBA activity in peripheral leukocytes <5.6 nmol/h/mg protein) were submitted to molecular analysis to confirm diagnosis. Results. Screening with DBS-FP identified 135 subjects (18.2%) with GBA activity <2.19 nmol/h/mL, 131 of whom remained in the study. In 10 of these (7.6%), GBA activity in leukocytes was 2.6 5.5 nmol/h/mg protein. Subsequent molecular analysis confirmed 6 cases of heterozygosity and 4 normals for GD. Conclusion. DBS-FP assay was shown to be an effective initial GD screening strategy for high-prevalence populations in developing regions. Diagnosis could not be established from GBA activity in leukocytes alone, but required confirmation with molecular analysis

Influência dos aspectos clínicos e assistenciais na qualidade de vida das pessoas com doença venosa crônica com e sem úlcera venosa

Conselho Nacional de Desenvolvimento Científico e Tecnológico