Avaliação da capacidade de caminhar do portador de obesidade m��rbida utilizando teste de caminhada de 6 minutos

Introduction: The ability to walk is impaired in obese by anthropometric factors (BMI and height), musculoskeletal pain and level of inactivity. Little is known about the influence of body adiposity and the acute response of the cardiovascular system during whole the 6-minute walk test (6mWT). Objective: To evaluate the effect of anthropometric measures (BMI and WHR waist-to-hip ratio), the effort heart and inactivity in ability to walk the morbidly obese. Materials and Methods: a total 36 morbidly obese (36.23 + 11.82 years old, BMI 49.16 kg/m2) were recruited from outpatient department of treatment of obesity and bariatric surgery in University Hospital Onofre Lopes and anthropometric measurements of obesity (BMI and WHR), pulmonary function, pattern habitual physical activity (Baecke Questionnaire) and walking capacity (6mWT). The patient was checking to measure: heart rate (HR), breathing frequency (BF), peripheral oxygen saturation, level of perceived exertion, systemic arterial pressure and duplo-produto (DP), moreover the average speed development and total distance walking. The data were analysed between gender and pattern of body adiposity, measuring the behavior minute by minute of walking. The Pearson and Spearmam correlation coefficients were calculated, and stepwise multiple Regression examined the predictors of walking capacity. All analyses were performed en software Statistic 6.0. Results: 20 obese patients had abdominal adiposity (WHR = 1.01), waist circumference was 135.8 cm in women (25) and 139.8 cm in men (10). Walked to the end of 6mWT 412.43 m, with no differences between gender and adiposity. The total distance walked by obesity alone was explained by BMI (45%), HR in the sixth minute (43%), the Baecke (24%) and fatigue (-23%). 88.6% of obese (31) performed the test above 60% of maximal HR, while the peak HR achieved at 5-minute of 6mWT. Systemic arterial pressure and DP rised after walking, but with no differences between gender and adiposity. Conclusion: The walk of obese didn��t suffers influence of gender or the pattern of body adiposity. The final distance walked is attributed to excess body weight, stress heart, the feeling of effort required by physical activity and level of sedentary to obese. With a minute of walking, the obeses achieved a range of intensity cardiovascular trainning

Reabilita����o cardíaca na insufici��ncia cardíaca cr��nica: efeitos de 12 semanas de treinamento intervalado x cont��nuo na função cardiopulmonar e qualidade de vida

Background: Cardiac Rehabilitation (CR) has effect on mortality in patients with heart failure (HF) chronic, and the exercise of the treatment of this patient. The most common exercise is ongoing training. Recently we have been studying the effects of interval training, but there is no consensus on the optimal dose of exercise. Objective: To evaluate the effects of interval aerobic training are superior to continuous aerobic training in patients with chronic HF. Methods: The clinical trial evaluated patients through cardiopulmonary test (CPX) and quality of life before and after the RC (3 times / 12 weeks). Patients were randomized into Group Interval Training (GTI - 85% of heart rate reserve - FCR), Continuous Training Group (GTC - 60% of HRR) and control group (CG) who received guidelines. Results: 18 patients were evaluated (mean age 44.7 �� 13.2 years and 35.2 �� 8.9% of left ventricular ejection fraction [LVEF]). Both groups were efficient to increase the peak VO2 and 15.1% (P = 0.02) in GTI and 16.1% (P = 0.01) GTC. As for the quality of life the GTI GTC showed improvement compared to the control group (P = 0.006). Hemodynamic mismatch events during the CPX were reduced after training in more GTC (patients 1 to 4) than in the GTI (5 to 3). Cardiac risk also decreased in the GTC (3 patients left the severe risk to take after training). Conclusion: Continuous training becomes more appropriate for improving fitness with little chance of developing cardiac event patients with chronic HF.

Avaliação da suplementa����o com vitamina E, na forma natural ou sint��tica, em mulheres no p��s-parto imediato e sua concentra����o no colostro

The Vitamin E consists of eight chemically homologous forms, designated alpha, beta, gamma and delta tocopherols and tocotrienols. Biologically, the alpha-tocopherol (α-TOH) is the most important. Commercially, are found two types of α-TOH a natural (RRR-alpha-tocopherol) and another synthetic (all-rac-alpha-tocopherol). Both forms are absorbed in the intestine, the liver is a preference in favor of forms 2R, due to transfer protein α-TOH. It has higher affinity to these stereoisomers. Newborns are considered high risk for vitamin E deficiency, mainly premature, these have breast milk as a food source for maintenance of serum α-TOH. Clinical signs such as thrombocytosis, hemolytic anemia, retrolental fibroplasia, intraventricular hemorrhage, bronchopulmonary dysplasia and spinocerebellar degeneration can be found in case of a low intake of α-TOH. Thus, maternal supplementation on postpartum with α-TOH can be an efficient way to increase levels of vitamin E in breast milk and thus the consequently increase the supply of micronutrient for the newborn. However, most studies with vitamin E supplementation have been conducted in animals and little is known about the effect of maternal supplementation in humans, as well as on its efficiency to increase levels of α-TOH in human milk, depending on the shape natural or synthetic. The study included 109 women, divided into three groups: control without supplementation (GC) (n=36), supplemented with natural capsule (GNAT) (n=40) and the synthetic capsule (GSINT) (n=33). Blood samples were collected for determination of maternal nutritional status, and colostrums at initial contact and after 24 hours post-supplementation. Analyses were performed by High Performance Liquid Chromatography. Values of α-TOH in serum below 499.6mg/dL were considered deficient. We used the Kruskal-Wallis test and Tukey test to confirm the increase of alpha-tocopherol in milk and efficiency of administered capsules. Daily consumption of α-TOH was based on daily intake of 500 mL of colostrum by the newborn and compared with the nutritional requirement for children from 0 to 6 months of age, 4 mg / day. The mothers had mean concentration of serum α-TOH in 1016 �� 52, 1236 �� 51 and 1083 �� 61 mg / dL, in CG, GNAT and GSINT respectively. There were no women with deficiiency. The GC did not change the concentrations of α-TOH in colostrum. While women supplemented with natural and synthetic forms increased concentrations of α-TOH colostrum in 57.6% and 39%, respectively. By comparing supplemented groups, it was observed a significant difference (p=0.04), the natural capsule more efficient than the synthetic, approximately 49.6%. Individually, 21.1% of the women provided below 4mg/day of α-TOH, after supplementation for this index declined4.1%. Thus, maternal supplementation postpartum raised the levels of alpha-tocopherol in colostrum, and increased efficiency was observed with the natural form

Avaliação bioqu��mica e hostol��gica de f��gado de ratas wistar diab��ticas e tratadas com tamoxifeno

Tamoxifen (TX), a drug used in the treatment of breast cancer, may cause hepatic changes in some patients. The consequences of its use on the liver tissues of rats with or without diabetes mellitus (DM) have not been fully explored. The purpose of this multidisciplinary study was to evaluate the correlation between plasma hepatic enzyme levels and the presence of iron overload in the hepatic tissue of female Wistar rats with or without streptozotocin-induced DM and using TX. Female rats were studied in control groups: C-0 (non-drug users), C-V (sorbitol vehicle only) and C-TX (using TX). DM (diabetic non-drug users) and DM-TX (diabetics using TX) were the test groups. Sixty days after induced DM, blood samples were collected for glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST) alkaline phosphatase (ALP) and bilirubin measures. Hepatic fragments were processed and stained with hematoxylin and eosin (H&E), Masson s trichrome, Perls. The hepatic iron content was quantified by atomic absorption spectrometry. AST, ALT and ALP levels were significantly elevated in the DM and DM-TX groups, with unchanged bilirubin levels. Liver iron overload using Perls stain and atomic absorption spectrometry were observed exclusively in groups C-TX and DM-TX. There was positive correlation between AST, ALT and ALP levels and microscopic hepatic siderosis intensity in group DM-TX. In conclusion, TX administration is associated with liver siderosis in diabetic and non-diabetic rats. In addition, TX induced liver iron overload with unaltered hepatic function in 2 non-diabetic rats and may be a useful tool for investigating the biological control of iron metabolism

Avaliação do desenvolvimento neuropsicomotor em crian��as na rede b��sica de sa��de utilizando o teste de Denver II: identifica����o de fatores de risco materno

Alterations in the neuropsychomotor development of children are not rare and can manifest themselves with varying intensity at different stages of their development. In this context, maternal risk factors may contribute to the appearance of these alterations. A number of studies have reported that neuropsychomotor development diagnosis is not an easy task, especially in the basic public health network. Diagnosis requires effective, low-cost, and easy - to-apply procedures. The Denver Developmental Screening Test, first published in 1967, is currently used in several countries. It has been revised and renamed as the Denver II Test and meets the aforementioned criteria. Accordingly, the aim of this study was to apply the Denver II Test in order to verify the prevalence of suspected neuropsychomotor development delay in children between the ages of 0 and 12 months and correlate it with the following maternal risk factors: family income, schooling, age at pregnancy, drug use during pregnancy, gestational age, gestational problems, type of delivery and the desire to have children. For data collection, performed during the first 6 months of 2004, a clinical assessment was made of 398 children selected by pediatricians and the nursing team of each public health unit. Later, the parents or guardians were asked to complete a structured questionnaire to determine possible risk indicators of neuropsychomotor development delay. Finally the Denver II Developmental Screening Test (DDST) was applied. The data were analyzed together, using Statistical Package for Social Science (SPSS) software, version 6.1. The confidence interval was set at 95%. The Denver II Test yielded normal and questionable results. This suggests compromised neuropsychomotor development in the children examined and deserves further investigation. The correlation of the results with preestablished maternal risk variables (family income, mother s schooling, age at pregnancy, drug use during the pregnancy and gestational age) was strongly significant. The other maternal risk variables (gestational problems, type of delivery and desire to have children) were not significant. Using an adjusted logistic regression model, we obtained the estimate of the greater likelihood of a child having suspected neuropsychomotor development delay: a mother with _75 4 years of schooling, chronological age less than 20 years and a drug user during pregnancy. This study produced two manuscripts, one published in Acta Cir��rgica Brasileira , in which an analysis was performed of children with suspected neuropsychomotor development delay in the city of Natal, Brazil. The other paper (to be published) analyzed the magnitude of the independent variable maternal schooling associated to neuropsychomotor development delay, every 3 months during the first twelve months of life of the children selected.. The results of the present study reinforce the multifactorial characteristic of development and the cumulative effect of maternal risk factors, and show the need for a regional policy that promotes low-cost programs for the community, involving children at risk of neuropsychomotor development delay. Moreover, they suggest the need for better qualified health professionals in terms of monitoring child development. This was an inter- and multidisciplinary study with the integrated participation of doctors, nurses, nursing assistants and professionals from other areas, such as statisticians and information technology professionals, who met all the requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte

Sensibilidade da cin��tica do zinco e avaliação nutricional em crian��as submetidas ao teste venoso de toler��ncia ao zinco

Objective: The purpose of this study was to investigate the kinetics of this micronutrient in schoolchildren between the ages of 6 and 9 years, of both sexes, and to verify its sensitivity in detecting alterations in body zinc status. Methods: Nutritional assessment was performed by body mass index. Food intake, venous zinc tolerance test and zinc kinetics were carried out before and after 3-month oral zinc supplementation. Results: Of the 42 children studied, 76.2% had healthy weight. Only energy, calcium and fiber intake were suboptimal before and after oral zinc supplementation. Serum zinc and total-body zinc clearance, although at normal levels, increased significantly after zinc supplementation. Conclusion: We concluded, therefore, that kinetics is a sensitive tool for detecting changes in body zinc status, even in children without a deficiency of this mineral. Furthermore, kinetics showed a positive response to supplementation and may be a sensitive parameter to evaluate the efficacy of this therapy

Função auton��mica em pacientes portadores de lipodistrofia generalizada cong��nita - sindrome de berardinelli - SEIP

A S��ndrome de Berardinelli-Seip ou Lipodistrofia Generalizada Cong��nita (LGC) �� uma doen��a rara, com transmiss��o autoss��mica recessiva, caracterizada principalmente pela aus��ncia quase total de tecido adiposo. Os pacientes afetados apresentam resist��ncia a insulina, dislipidemia e hipertens��o arterial. Estudos t��m evidenciado que estas altera����es metab��licas interferem na modula����o auton��mica para o n�� sinusal. O principal objetivo deste estudo foi investigar a modula����o auton��mica em pacientes portadores de LGC, atrav��s da variabilidade de freq����ncia cardíaca (VFC), pelo m��todo linear de dom��nio de tempo na Eletrocardiografia Din��mica de 24 horas e estabelecer um crit��rio relativamente simples, n��o invasivo, para diagn��stico de disfunção auton��mica nestes pacientes. Participou voluntariamente deste estudo transversal, um grupo de pacientes portadores de LGC (n=18) na faixa et��ria de 9,3 a 39,8 anos (21,3 �� 8,3) cuja variabilidade de freq����ncia 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 volunt��rios foram submetidos �� avaliação cl��nica, laboratorial, antropom��trica e an��lise de VFC no dom��nio de tempo atrav��s de eletrocardiografia din��mica de 24 horas. Para an��lise dos dados relativos aos ��ndices temporais de VFC foram utilizados o MeanRR, SSDN e rMSSD. Pacientes com LGC apresentavam aumento da press��o arterial comparados com indiv��duos do grupo controle (sist��lica, 131,1 vs 106,3 mmHg, p<0,05); diast��lica, 85,0 vs 68,2 mmHg, p<0,05) e 10 tinham crit��rios para diagn��stico de Hipertens��o Arterial e Hipertrofia do Ventr��culo Esquerdo. Os n��veis de glicose, triglicer��deos, colesterol e HOMA-R eram elevados e 12 pacientes tinham crit��rios para diabetes mellitus tipo 2. Comparado com os controles, pacientes com LGC tinham diminui����o dos ��ndices 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 redu����o da VFC foi independente de dist��rbios metab��licos e hemodin��micos. Os resultados de nosso experimento indicam que pacientes com LGC apresentavam modula����o auton��mica anormal caracterizada pelo aumento da freq����ncia cardíaca e pronunciada redu����o da VFC, independente de dist��rbios metab��licos e hemodin��micos observados nesta s��ndrome. O car��ter multidisciplinar desse estudo fica contemplado pela intera����o de profissionais de diversas ��reas como: cardiologia, endocrinologia, metabolismo, neurologia, nutri����o, etc

Fatores preditivos da dor em pacientes submetidos �� cirurgia cardíaca

A identifica����o de fatores que interferem na dor p��s-operat��ria �� ��til para minimizar o sofrimento desnecess��rio e favorecer a uma interven����o analg��sica adequada, evitando generaliza����es nas condutas terap��uticas. O prop��sito dessa investiga����o foi identificar os fatores preditivos da dor em pacientes submetidos �� cirurgia cardíaca e a rela����o existente entre dor, analgesia e personalidade. Trata-se de um estudo prospectivo e anal��tico, aprovado pelo comit�� de ��tica da UFRN (175/06), o qual proporcionou uma abordagem multidisciplinar ao envolver ��reas distintas como: fisioterapia, psicologia, m��dica e enfermagem (interdisciplinaridade) na elucida����o do objeto de estudo relacionado a fatores preditivos da dor. Para caracteriza����o geral dos pacientes foi utilizada uma ficha de avaliação fisioterap��utica; a dor p��s-operat��ria foi avaliada pela escala num��rica de dor e question��rio para dor McGill e o Invent��rio Millon de Estilos de Personalidade (MIPS) foi utilizado para identificar e avaliar as manifesta����es das caracter��sticas comportamentais e de personalidade. Foram acompanhados, do 1�� ao 5�� dia de p��s-operat��rio (DPO), 160 pacientes submetidos �� cirurgia cardíaca, 57,5% do sexo masculino, com idade m��dia de 56,8��14,4 anos, sendo inclu��dos no estudo aqueles que se queixaram de dor no p��s-operat��rio em pelo menos um dos dias de avaliação e assinaram termo de concentimento livre e esclarecido (TCLE). Os dados foram submetidos ao teste Qui-quadrado, regress��o log��stica multivariada, teste de correla����o de Spearman, teste t e ANOVA. Ao serem submetidos �� an��lise de regress��o foram encontrados seis fatores preditivos da dor: tempo cir��rgico > 3 horas, dreno mediastinal e lateral, tosse, v��mitos, tempo de dreno > 24 horas e sexo feminino. Estes fatores apresentaram uma correla����o positiva e significava com a intensidade dolorosa referida pelos pacientes na escala num��rica de dor e os pacientes que apresentaram mais fatores preditivos da dor referiram mais dor. 23 J�� em rela����o ao McGill n��o se obteve diferen��a significativa entre os pacientes com mais e menos fatores preditivos. Observou-se que foram administrados diferentes tipos de analg��sicos, isolados ou associados, sendo estes: paracetamol, paracetamol associado �� code��na, dipirona, tramadol, toradol e tilatil. A percep����o dolorosa apresentou magnitudes variando de leve a moderada do 1�� ao 5�� DPO e ao ser relacionada com as caracter��sticas de personalidade, nos pacientes com menos dor, observou-se os fatores: preserva����o, individualismo, introvers��o e os com mais dor foram: prote����o, extrovers��o, retraimento, discrep��ncia, afetividade, acomoda����o, comunicabilidade e firmeza. Evidenciou-se que o comportamento doloroso p��s-cirurgia cardíaca �� multifatorial e que a determina����o da exist��ncia de fatores preditivos da dor permite ao profissional da ��rea de sa��de fazer o uso adequado dos analg��sicos, haja vista que o al��vio da dor �� responsabilidade de todos os profissionais da sa��de. Os aspectos psicol��gicos enquanto caracter��sticas de personalidade podem influenciar padr��es de comportamento como os observados.

Elabora����o e validade do teste de rastreio de doen��a da Alzheimer com prov��rbios (TRDAP) para indiv��duos a partir de sessenta anos

A escassez de instrumentos para a avaliação e a triagem da doen��a de Alzheimer, (DA), notadamente denominados de rastreio, com caracter��sticas de padroniza����o e validados para o Nordeste, motivou este Estudo. Visando �� triagem de uma etapa mais leve da doen��a e encaminhamento precoce ao tratamento multidisciplinar foi elaborado o Teste de Rastreio da Doen��a de Alzheimer com Prov��rbios (TRDAP), a partir de um Jogo de Mem��ria de Prov��rbios, constru��do como recurso terap��utico ocupacional. Est�� composto de tr��s etapas conforme a função neuropsicol��gica avaliada, a A (mem��ria de curto prazo), B (fun����es executivas e linguagem) e C (mem��ria epis��dica), al��m do reconhecimento de prov��rbios. O Estudo foi realizado em uma amostra de conveni��ncia, com 91 idosos (28 DA e 63 controles), a partir de 60 anos, com um ou mais anos de escolaridade. Foram controladas as vari��veis, como doen��as intercorrentes ou d��ficits 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 Depress��o Geri��trica EDG (validade discriminante), Lista de Palavras, Flu��ncia Verbal, Span de D��gitos, Figura Neuropsi, Teste do Rel��gio, Atividade de Vida Di��ria e Instrumental. Os resultados confirmaram a validade de construto convergente e discriminante, assim como a rela����o significativa (p<0,005) com todos os testes, exceto com o EDG. Quanto �� validade concorrente, n��o houve discord��ncia com o crit��rio da avaliação m��dica observou-se consist��ncia interna aceit��vel, conferindo confiabilidade no instrumento, o que n��o ocorreu com MEEM. Tais resultados permitem afirmar que o TRDAP possui caracter��sticas psicom��tricas, adequadas ao rastreio da fase leve da DA para popula����o estudada

Avaliação do desempenho funcional de crian��as com paralisia cerebral de acordo com n��veis 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

Identifica����o e avaliação de propriedades de polissacar��deos sulfatados de diferentes fontes naturais que possibilitem sua aplicabilidade biotecnol��gica

Sulfated polysaccharides (SP) are widely distributed in animals and seaweeds tissues. These polymers have been studied in light of their important pharmacological activities, such as anticoagulant, antioxidant, antitumoral, anti-inflammatory, and antiviral properties. On other hand, SP potential to synthesize biomaterials like as nanoparticules has not yet been explored. In addition, to date, SP have only been found in six plants and all inhabit saline environments. However, the SP pharmacological plant activities have not been carrying out. Furthermore, there are no reports of SP in freshwater plants. Thus, do SP from marine plants show pharmacological activity? Do freshwater plants actually synthesize SP? Is it possible to synthesize nanoparticles using SP from seaweed? In order to understand this question, this Thesis was divided into tree chapters. In the first chapter a sulfated polysaccharide (SPSG) was successfully isolated from marine plant Halodule wrightii. The data presented here showed that the SPSG is a 11 kDa sulfated heterogalactan contains glucose and xylose. Several assays suggested that the SPSG possessed remarkable antioxidant properties in different in vitro assays and an outstanding anticoagulant activity 2.5-fold higher than that of heparin Clexane�� in the aPTT test; in the next chapter using different tools such as chemical and histological analyses, energy-dispersive X-ray analysis (EDXA), gel electrophoresis and infra-red spectroscopy we confirm the presence of sulfated polysaccharides in freshwater plants for the first time. Moreover, we also demonstrate that SP extracted from E. crassipes root has potential as an anticoagulant compound; and in last chapter a fucan, a sulfated polysaccharide, extracted from the brown seaweed was chemically modified by grafting hexadecylamine to the polymer hydrophilic backbone. The resulting modified material (SNFuc) formed nanosized particles. The degree of substitution for hydrophobic chains of 1H NMR was approximately 93%. SNFfuc-TBa125 in aqueous media had a mean diameter of 123 nm and zeta potential of -38.3 �� 0.74 mV, measured bydynamic light scattering. Tumor-cell (HepG2, 786, H-S5) proliferation was inhibited by 2.0 43.7% at SNFuc concentrations of 0.05 0.5 mg/ mL and RAEC non-tumor cell line proliferation displayed inhibition of 8.0 22.0%. On the other hand, nanogel improved CHO and RAW non-tumor cell line proliferation in the same concentration range. Flow cytometric analysis revealed that this fucan nanogel inhibited 786 cell proliferation through caspase and caspaseindependent mechanisms. In addition, SNFuc blocks 786 cell passages in the S and G2-M phases of the cell cycle

An��lise da variabilidade da frequ��ncia cardíaca na s��ndrome dos ov��rios polic��sticos

Conselho Nacional de Desenvolvimento Cient��fico e Tecnol��gico

Atividade f��sica e outros fatores associados �� função sexual em mulheres de meia idade

Este estudo teve por objetivo avaliar os fatores associados �� disfunção sexual em mulheres de meia idade. Realizou-se um estudo descritivo transversal, que compreendeu 370 mulheres, entre 40 a 65 anos, atendidas nas Unidades B��sicas de Sa��de de cada distrito sanit��rio (Norte, Sul, Leste e Oeste) da cidade de Natal, no estado do Rio Grande do Norte, Brasil. Para avaliar a função sexual utilizou-se o Female Sexual Function Index (FSFI). A sintomatologia climat��rica foi avaliada por meio do Menopause Rating Scale (MRS). O ��ndice de Blatt-Kupperman (IMBK) foi utilizado para avaliação quantitativa global da ocorr��ncia de sintomas/queixas. A atividade f��sica foi avaliada pelo question��rio International Physical Activity Questionnaire - IPAQ (vers��o curta). A avaliação da qualidade de vida geral se deu pelo WHOQOL-Bref. A an��lise estat��stica foi realizada utilizando o programa estat��stico MINITAB version16. Al��m de an��lises descritivas das vari��veis categorizadas, utilizou-se o teste qui-quadrado de Person com o intuito de verificar poss��veis associa����es entre as vari��veis sociodemogr��ficas, comportamentais, cl��nicas, n��veis de atividade f��sica, sintomatologia climat��rica, qualidade de vida e a função sexual das mulheres estudadas. Desenvolveu-se a regress��o log��stica para verificar a influ��ncia dessas vari��veis sobre a disfunção sexual. Considerou-se o n��vel de signific��ncia de 5% para todos os testes. Os resultados mostraram que a m��dia de idade das mulheres estudadas foi de 49,8 (��8,1) anos. Do total dessas mulheres, 67% apresentaram disfunção sexual. Observou-se que 54,5% delas se encontravam na pr��-menopausa. Avaliando a influ��ncia das vari��veis sobre a função sexual; faixa et��ria (56-65) (p<0,001), estado civil (divorciada/separada) (p < 0,001), escolaridade (baixa) (p=0,017), menopausa (p < 0,001), histerectomia (p = 0,016), n��vel de atividade f��sica (sedent��ria) (p=0,002), sintomas do climat��rio (forte) (p<0,001) e qualidade de vida (baixa) (p<0,001), estiveram associados �� disfunção sexual em mulheres de meia idade. Concluiu-se neste estudo que fatores sociodemogr��ficos, cl��nicos, comportamentais, n��veis de atividade f��sica, sintomatologia climat��rica e qualidade de vida influenciam significativamente a função sexual na mulher de meia idade

Avaliação neuropsicol��gica de crian��as com hemiparesia cong��nita e adquirida

A hemiparesia consiste no d��ficit da for��a muscular, com consequente debilidade na m��o e no p��, afetando um dos lados do corpo. A literatura mostra poucos estudos enfocando detalhadamente as fun����es cognitivas e emocionais de crian��as afetadas por essa condi����o neurol��gica. Este estudo teve como objetivo realizar avaliação neuropsicol��gica de 23 crian��as e adolescentes, de ambos os g��neros, com idades entre 5 anos e 4 meses e 16 anos e 6 meses, com hemiparesia cong��nita e adquirida. Aplicou-se uma bateria de testes espec��fica para avaliação de fun����es cognitivas superiores incluindo processos intelectuais, aten����o, função perceptiva, função motora, praxias, gnosias, linguagem, mem��ria e função visuomotora. Em rela����o aos aspectos emocionais, foi usado o teste do desenho da figura humana, visando-se a avaliação da percep����o da imagem corporal dos pacientes. Os resultados mostraram que a hemiparesia da crian��a conduz a d��ficits em fun����es neuropsicol��gicas importantes, al��m de d��ficit motor e altera����es na esfera emocional, mais precisamente aquelas relacionadas com a representa����o da imagem corporal. A abrang��ncia multidisciplinar, envolvendo a neurologia pedi��trica e a psicologia, engrandeceu o trabalho, referendando os resultados obtidos em todos os seus aspectos

Avaliação da efic��cia analg��sica no p��s-operat��rio de revasculariza����o do mioc��rdio: ensaio cl��nico randomizado controlado

A analgesia p��s-operat��ria eficaz �� especialmente importante ap��s cirurgias tor��cicas, pois, al��m de aliviar a dor, facilita a retomada de atividades normais, incluindo a deambula����o, a respira����o e a tosse. Dessa forma, os objetivos deste estudo s��o: avaliar a efic��cia analg��sica da associa����o entre anestesia geral e raquianestesia com morfina e ropivaca��na mais esquema multimodal em rela����o �� anestesia geral e esquema multimodal em cirurgia de revasculariza����o do mioc��rdio; analisar a efic��cia analg��sica da inje����o subcut��nea de lidoca��na e analgesia multimodal na remo����o de tubos tor��cicos em cirurgia de revasculariza����o do mioc��rdio. A metodologia consiste em ensaio cl��nico randomizado, controlado, envolvendo 58 pacientes, de ambos os sexos, com idade m��dia de 59,8 &#61617; 8,9 anos, estado f��sico ASA II e III. Os participantes foram alocados em dois grupos, sendo o GI composto por indiv��duos submetidos �� anestesia geral combinada �� raquianestesia com morfina 400&#956;g e 6 ml (30mg) a 8 ml (40mg) de ropivaca��na a 0,5% e analgesia multimodal; j�� o GII foi composto por indiv��duos submetidos �� anestesia geral associada �� analgesia multimodal. Foi avaliada a dor, ao despertar, nas primeiras 24 horas, e ao realizar exerc��cio respirat��rio, ao retirar drenos de tor��cicos e o tempo para extuba����o. A an��lise estat��stica foi realizada pelos testes do Qui-quadrado e Teste t de Student e o teste de Fisher. O resultado obtido foi o seguinte: o GI apresentou menor intensidade de dor ao despertar (p= 0,001), nas primeiras 24 horas (p= 0,001) e durante a realiza����o dos exerc��cios respirat��rios (p= 0,004). Houve maior necessidade de analgesia complementar no grupo GII, com maior consumo de morfina (p= 0,05), e os efeitos colaterais leves, como n��useas (p= 0,001), v��mito (p= 0,002), prurido (p= 0,030), predominaram no GI. N��o houve diferen��a estatisticamente significante entre os grupos (P= 0,47), em rela����o �� intensidade de dor na remo����o dos drenos. Ap��s as observa����es feitas, o estudo sugere que a anestesia geral combinada �� raquianestesia com morfina associada �� ropivaca��na oferece melhor efeito analg��sico no p��s-operat��rio de cirurgia cardíaca. Adicionalmente, o estudo sugere que o efeito analg��sico da inje����o subcut��nea de lidoca��na 1% associado �� analgesia multimodal n��o �� eficaz