Avaliação do cortisol, dehidroepiandrosterona sulfato e dos perfis lipídico e imunológico e suas correlações com a sensibilidade dolorosa, depressão e funcionalidade em mulheres com fibromialgia na pós-menopausa

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome characterized by widespread musculoskeletal pain with palpable tender points, muscle stiffness, fatigue, and sleep disturbances. Patients with FM have hormonal changes that are directly correlated with symptoms of the syndrome. The neuroendocrine regulation may be impaired, with abnormalities in the hypothalamus-pituitary-adrenal (HPA) axis with various hormones showing changes in their levels. In women in fertile period, various gonadal hormones are associated with symptoms of the syndrome, but studies focusing only a population of women in post-menopausal period who do not use hormone replacement are rare. We developed an analytical cross sectional study to assess the plasma levels of cortisol and dehidroepiandrosterona sulfate (DHEA-S) with quimioluminescence method in a group of 17 women with FM and 19 healthy women in post-menopause who do not use hormone replacement and observe the correlation with the symptoms of pain through algometry, depression and physical functional capacity measured from the Beck Depression Index (BDI) and the Fibromyalgia Impact Questionnaire (FIQ). Three blood samples were collected in the morning (between 8:00 9:30) with an interval of 24 hours for the measurements of hormonal levels and biochemical profile. There were no immunological or lipid changes in patients with FM. Comparing the two groups, there is no difference in levels of cortisol and a tangential effect for DHEA-S (p=0,094) with the lowest levels in the FM. DHEA-S also correlated with pain threshold (r=0,7) and tolerance (r=0,65) in group FM. We found the presence of depressive state and low physical functional capacity in FM. It was also evident that women in post-menopausal period, DHEA-S should influence the symptoms of increased sensitivity to pain, but not the presence of depressive status and low physical functional

Humanização hospitalar, ambiente físico e relações assistenciais :a percepção de arquitetos especialistas

The creation of the Humanization Program of Hospital Care and the increasing number of academic works and journal articles that discuss more humane practices in the health care services express the emphasis given to the theme in Brazil. In these discussions, however, it is not usual to find reference to architecture as a relevant factor in the humanization of hospitals, even though it is known that the physical structure of the building may help the recovering of the patients; elements such as gardens, the use of colors and open spaces may soften the impact caused by the hospital routine on patients. Considering the contribution the architectural project may bring to the humanization of hospitals, the aim of this study was to verify how the architects perceive the hospital humanization process. Besides having searched for subsides in informal interviews with health professionals, in visits to hospitals and in related seminars, the study was based on semi-structured interviews with architects of Natal, Rio Grande do Norte, who are specialists in this kind of projects. The content analysis of the interviews showed that physical space and attendance are essential to the humanization process. Those professionals see two humanization tendencies: while private hospitals have the structural physical appearance considered as humanized, public hospitals emphasize the humanization in attendance, fact that illustrates the contradictions in Brazilian health system. The interviewees consider the post-occupancy evaluation of the building as a learning exercise that contributes to new projects, but surprisingly they do not mention the patients opinion as part of it. Two annoying facts have emerged from the interviews, as also seen in preliminary stages of the study: rare are the works that focus on the person-environment relationship, and the definition of humanized hospital environments is still broad and inaccurate. This suggests the need of new studies in order to better understand how the two factors shown in this study attendance and physical space interact towards a true hospital humanization

Avaliação da variação sedimentológica em uma área da plataforma continental sob a atuação da indústria petrolífera

Petroleum exploration activity occurs on the offshore Potiguar Basin, from very shallow (2-3 m) until about 50 m water depth, extending from Alto de Touros (RN) to Alto de Fortaleza (CE). Take in account the biological importance and the heterogeneity of sediments on this area, it is necessary the understanding of the sedimentological dynamics, and mainly the changes generated by petroleum exploration to prevent possible damages to environment. Despite the intense activity of oil exploration in this area, research projects like these are still rare. In view to minimize this gap, this study was developed to evaluate sedimentological, mineralogical and geochemical changes in the vicinity of a exploration well, here designated as well A, located on the Middle continental shelf, near the transition to Outer shelf. The well selected for this study was the first one drilled with Riserless Mud Recovery technology (RMR) in Brazil. The main difference from this to the conventional method is the possibility of drilling phase I of the well with return of drilling material to the rig tank, minimizing fluid and gravel discharging around the vicinity, during this phase. Monitoring consisted of three surveys, first of them done before start drilling, the second one done 19 days after the end of drilling and the third one done one year after then. Comparison of the studied variables (calcium carbonate and organic matter content, sediment size, mineralogy and geochemistry) was done with their average, median and coefficient of variation values to understand the changes after drilling activity. Because operating company technical reasons, the well location was changed after the first survey (C1), resulting in a shift of the sampled area on the two last surveys (C2 e C3). Nevertheless, the acquired data presented a good correlation, with no loss to the mean goal of the study. The sedimentological, mineralogical and geochemical analyzes were done at Federal University of Rio Grande do Norte (UFRN). The results indicated a predominantly sandy environment along the three surveys. It was noticed that the first survey (C1), presented different values for all the studied variables than to the second (C2) and third (C3) surveys, which had similar values. Siliciclastic sediments are prevalent at all surveys, and quartz is the main component (more than 80%). Heavy minerals (garnet, turmaline, zircon and lmenite), rock fragments and mud aggregates also was described. Bioclastic sediments are dominated by coralline algae (more than 45%) and mollusks (more than 30%), followed by benthic foraminifera, bryozoans and worm tubes. More rarely was observed ostracoda and spike of calcareous sponge. Because the low changes of the sediments at the studied area and by the using of RMR method in the drilling, it was possible to conclude that drilling activity did not promote significant alteration on the local sediment cover. Changes in the studied variables before and after drilling activity could be influenced by the changing in the sampling area after survey 1 (C1).

Relação do polimorfismo BDNF val66met e níveis periféricos de BDNF com a doença de Parkinson e sua sintomatologia

Neurodegenerative diseases are frequently studied due to the increasing number of cases associated with the populational ageing and to the impact on the conditions on the quality of life. Parkinson’s disease (DP) is the second most frequent neurodegenerative disease. Despite the fact that its etiology is not completely understood, it is known that DP is caused by environmental and genetic factors. Thus, the investigation of etiologic factors and mechanisms responsible for the changes that lead to DP may help early diagnostic and prevention. A possible association between DP and the common polymorphism of Brain Derived Neurotrophic Factor (BDNF) G196A (Val66Met) has been suggested by different studies with contrasting results. For this reason, the aim of this study is to investigate if the BDNF Val66Met polymorphism is related to susceptibility to DP in a cohort of Brazilian patients. Additionaly, we verify if the presence of the polymorphism implies in alterations in the BDNF whole blood concentrations, as well as variations in symptomatology. The sample comprised Brazilian patients accompanied by the neurology service of the Onofre Lopes University Hospital (HUOL) and healthy controls (CTRL). The motor aspects of DP were evaluated by Hoehn e Yahr Scale (HY), Unified Parkinson’s Disease Rating Scale (UPDRS) and Schwab & England Scale (SE). For the evaluation of non-motor symptoms were used the following instruments: Frontal Assessment Battery (BAF), Mini-Mental State Examination (MEEM), Beck Depression Inventory (IDB) and the Beck Anxiety Inventory (IAB). Blood samples were collected for BDNF Val66Met polymorphism genotyping and BDNF whole blood measurement. As expected, DP patients performed worse in motor, cognitive and emotional battery of questionnaires. Alleles distribution between DP and CTRL was not significantly different, but the A/G genotype was significantly associated with a protector factor for DP. In contrast, the G/G genotype was significantly associated with depression and anxiety development in DP patients. However, BDNF concentrations were not different between genotypes or groups. This is the first study of genetic association of this polymorphism with DP in Brazilian subjects and the first one that associate A/G genotype with protection against DP.

Síndrome de Guillain-Barré: epidemiologia, prognóstico e fatores de risco

Introduction. Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy and the principal cause of acute neuromuscular paralysis. The most prominent GBS subtypes are: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor-sensory axonal neuropathy (AMSAN) and Fisher syndrome (FS). Differences in geographical distribution of variants have been reported. In Brazil, there are few studies describing the characteristics of GBS, but none on the frequency of GBS variants and their clinical manifestations. Infection-induced aberrant immune response resulting from molecular mimicry and formation of cross-reacting antibodies, contribute to complement activation. Functional biallelic polymorphism in immunoglobulin receptors that influence the affinity of IgG subclasses and the type of immune response have been described, suggesting genetic susceptibility to developing disease. It remains unclear whether individuals carrying different FCGR alleles have differential risk for GBS and⁄or disease severity. The goals of this study were: (1) To characterize GBS and describe the clinical findings in a cohort of patients with GBS from the state of Rio Grande do Norte, Brazil; (2) to determine whether polymorphism in FCGR were associated with development of GBS, and (3) to tease out whether the global gene expression studies could be a tool to identify pathways and transcriptional networks which could be regulated and decrease the time of disease. Methods. Clinical and laboratory data for 149 cases of GBS diagnosed from 1994 to 2013 were analyzed. Genomic DNA and total RNA were extracted from whole blood. Antigangliosides antibodies were determined in the sera. In addition, we also assessed whether FCGR polymorphism are present in GBS (n=141) and blood donors (n=364), and global gene expressions were determined for 12 participants with GBS. Blood samples were collected at the diagnosis and post-recovery. Results. AIDP was the most frequent variant (81.8%) of GBS, followed by AMAN (14.7%) and AMSAN (3.3%). The incidence of GBS was 0.3 ⁄ 100,000 people for the state of Rio Grande do Norte and cases occurred at a younger age. GBS was preceded by infections, with the axonal variant associated with episodes of diarrhea (P = 0.025). Proximal weakness was more frequent in AIDP, and distal weakness predominant in the axonal variant. Compared to 42.4% of cases with AIDP (P<0.0001), 84.6% of cases with the axonal variant had nadir in <10 days. Individuals with the axonal variant took longer to recover deambulation (P<0.0001). The mortality of GBS was 5.3%. A worse outcome was related to an axonal variant (OR17.063; P=0.03) and time required to improve one point in the Hughes functional scale (OR 1.028; P=0.03). The FCGR genotypes and allele frequencies did not differ significantly between the patients with GBS and the controls (FCGR2A p=0.367 and FCGR3A p=0.2430). Global gene expression using RNAseq showed variation in transcript coding for protein isoforms during acute phase of disease. Conclusions. The annual incidence of GBS was 0.3 per 100,00 and there was no seasonal pattern. A predominance of the AIDP variant was seen, and the incidence of the disease decreased with age. The distribution of weakness is a function of the clinical variants, and individuals with the axonal variant had a poorer prognosis. Early diagnosis and variant identification leads to proper intervention decreasing in long-term morbidity. FCGR polymorphisms do not seem to influence susceptibility to GBS in this population. This study found deregulated genes and signs of transcriptional network alterations during the acute and recovery phases in GBS. Identification of pathways altered during disease might be target for immune regulation and with potential to ameliorate symptoms.

Efeito tardio do kinesio taping na função do membro inferior e no desempenho neuromuscular do quadríceps femoral de mulheres saudáveis: ensaio clínico e randomizado

Introduction: Kinesio Taping (KT) has been used in healthy people to improve neuromuscular performance, however, few studies have evaluated its chronic effects, despite being suggested. Objective: To analyze the chronic effects of KT on neuromuscular performance of the quadriceps, the oscillation of the center of pressure and lower limb function in healthy women. Methods: blinded, randomized, controlled trial, composed of 60 women (mean age 21.9 ± 3.3 years and BMI 22.3 ± 2.2 kg / m2) submitted to the evaluation of oscillation of the center of pressure through the baropodometry, the lower limb function by the hop test, isokinetic knee performance, the electromyographic activity of the vastus lateralis (VL) and joint position sense of the knee (JPS). Then, participants were randomly divided into three groups of twenty: control - did not apply the KT; placebo - application of KT without tension on the quadriceps; Kinesio Taping - application of KT with tension in the same muscle group. The evaluations were conducted in five moments: prior to application of KT, immediately after the application, 24h, 48h after application and 24 hours after its removal (72h). SPSS 20.0 was used for statistical analysis. The KS test was used to verify the data normality, the Levene test for homogeneity of variances and a mixed-model ANOVA 3x5 to check intra and inter-group differences. Results: there was no difference in peak torque, the power, nor the electromyographic activity or SPA (p> 0.05) between groups. The displacement speed of center of pressure reduced immediately after the application on kinesio taping group (p <0.001), but with no differences between the groups (p = 0.28). There was a reduction in the time of peak torque among the three groups in the evaluations after KT application (p <0.001) and an increase in single hop in all groups (p <0.001), but with no differences between them. Conclusion: KT can not change, in a chronic way, the lower limb function, the oscillation of the center of pressure, the isokinetic performance, the JPS of the knee and the electromyographic activity of VL muscle in healthy women.

Manutenção da Heterozigosidade em populações de plantas autógamas

Neste trabalho objetivou-se verificar, teoricamente , a possibilidade de manutenção de heterozigotos, em populações de plantas autógamas, na presença e na ausência de seleção dependente de frequência (SDF). Considerou-se apenas um loco com dois alelos. Utilizou-se a dedução algébrica de formulas referentes a alguns modelos de populações e um programa para simular a sucessão das gerações em uma calculadora científica avançada. Comparou-se os resultados do modelo com os dados obtidos experimentalmente por Allard e Workman (1963) e por Harding, Allard e Smeltzer (1966). Os coeficientes de determinação foram 0,9653 e 0,9166 para a primeira e a segunda comparação, respectivamente. Estes coeficientes indicam que o modelo D representa de modo bastante fidedigno as variações observadas em populações experimentais de plantas predominantemente autógamas

Ética na pesquisa em Administração

Ethics on scientific research is approached and often discussed in several areas of knowledge connected to health. In the Administration area there are very few studies which approach the topic of ethics on research. The present paper tried to fill in this gap in the production of knowledge about the topic, investigating how the ethical principles found in the literature and in the codes of conduct are noticed and taken into account in Administration research activities developed by acting researchers in Administration Post Graduation Programs. Theoretically speaking, the study was based mainly on the approaches by Creswell (2007) and Bell and Bryman (2007), which discuss the research ethical principles. Methodologically speaking it was all about an exploratory kind of study, with qualitative research approach. Upon data collection, personal interviews were made aiming at its depth and focus groups were formed. The first stage had interviews with four experienced researchers who took part on a teaching and researching event and on the second stage we used the focus group technique. The focus groups were done in four college institutions along with the post graduation programs in Administration in the states of Rio Grande do Norte, Paraíba and Pernambuco, in Brazil. The results suggest the existence of general principles and parameters for the scientific research recommended in the literature and on official resolution. However, in the Administration area, there are only a few recommendations of good practices when it comes to submitting articles for scientific publications but we found no guidance with ethical principles and parameters which cover all the activities in the scientific research and which specifically meet the research particularities in Administration. The main ethical dilemma pointed by the researchers refers to ethical questions which arise at the time of data collection and on disclosing the results. Most researchers do not know the guidelines and the ethical norms on ethics about research that we have in our country neither do they send in their projects to the research ethics committee. When dilemma arises, they decide the ethical question based on their values and common sense. These elements confirm the thesis that the researcher s procedure in the research activities in Administration is predominantly signed by personal values or by common sense and less by ethical principles, whether by not knowing the normative instruments related to ethics or by disagreeing with any disciplining rules on ethical behavior in the research

Recursos intangíveis de um destino turístico: um estudo de desempenho da cidade de Natal tendo como base a teoria das capacidades dinâmicas

O objetivo desta tese foi analisar os recursos intangíveis de um destino turístico. Foi feito um estudo de desempenho da cidade de Natal tendo como base a teoria das capacidades dinâmicas. Inicialmente, foi desenvolvido um instrumento de pesquisa para oportunizar a construção de um modelo de medida com vistas à captação de variáveis latentes para os recursos intangíveis existentes no setor do turismo em Natal-RN. Em seguida, foi realizada uma análise dos recursos intangíveis que são evidenciados pelos turistas acerca da cidade. Finalmente, foi feita a investigação de um modelo de estrutura que estabeleceu as relações entre as variáveis latentes dos recursos intangíveis e a percepção de desempenho do turismo na cidade de Natal. Procedeu-se uma revisão de literatura para construção de um modelo inicial acerca dos ativos intangíveis dentro da teoria das capacidades e foram relacionados dez recursos, quais sejam: recursos humanos prestadores de serviços; recursos humanos como gestores; cultura local; conservação do meio ambiente; know-how empresarial; inovação empresarial; tecnologia; marca; preço; e promoção. Estes dez recursos, em conjunto, seriam responsáveis pelo desempenho do destino turístico. Após ser realizada uma análise de equações estruturais, apenas quatro recursos manifestaram relações com o desempenho: marca; cultura; conservação do meio ambiente; e preço. Análisando dos dados, verificou-se que a variável desempenho positivo da cidade na ótica do turista se manifestou fortemente e foi influenciada de forma forte pela cultura local, marca e conservação do meio ambiente em conjunto. O preço foi influenciado pelo desempenho positivo mostrando que o turista sente que o preço pago foi satisfatório diante dos atributos do destino Provavelmente, isso seja um ponto positivo muito forte para o destino turístico de Natal, pois, em termos de recursos intangíveis e de juntos formarem capacidades, eles são inimitáveis, raros e são capazes de se ajustarem às mudanças organizacionais e ambientais, para reconfigurar os ativos e as estruturas de um destino, corroborando, assim, com a teoria das capacidades dinâmicas. Esses recursos da cidade de Natal, como destino turístico, são únicos e provavelmente têm um peso muito maior para o desempenho da cidade do que problemas existentes na localidade. Logo, esses atributos devem ser estimulados a continuar crescendo e se modificando de acordo com as exigências atuais e futuras de consumo

Do modelo geométrico ao modelo físico: o tridimensional na educação do arquiteto e urbanista

In the teaching practice of architecture and urbanism in Brazil, educational legislation views modeling laboratories and workshops as an indispensable component of the infrastructure required for the good functioning of any architectural course of study. Although the development of information technology at the international level has created new possibilities for digital production of architectural models, research in this field being underway since the early 1990s, it is only from 2007 onwards that such technologies started to be incorporated into the teaching activity of architecture and urbanism in Brazil, through the pioneering experience at LAPAC/FEC/UNICAMP. It is therefore a recent experiment whose challenges can be highlighted through the following examples: (i) The implementation of digital prototyping laboratories in undergraduate courses of architecture and urbanism is still rare in Brazil; (ii) As a new developing field with few references and application to undergraduate programs, it is hard to define methodological procedures suitable for the pedagogical curricula already implemented or which have already been consolidated over the years; (iii) The new digital ways for producing tridimensional models are marked with specificities which make it difficult to fit them within the existing structures of model laboratories and workshops. Considering the above, the present thesis discusses the tridimensional model as a tool which may contribute to the development of students skills in perceiving, understanding and representing tridimensional space. Analysis is made of the relation between different forms of models and the teaching of architectural project, with emphasis on the design process. Starting from the conceptualization of the word model as it is used in architecture and urbanism, an attempt is made to identify types of tridimensional models used in the process of project conception, both through the traditional, manual way of model construction as well as through the digital ones. There is also an explanation on how new technologies for digital production of models through prototyping are being introduced in undergraduate academic programs of architecture and urbanism in Brazil, as well as a review of recent academic publications in this area. Based on the paradigm of reflective practice in teaching as designed by Schön (2000), the experiment applied in the research was undertaken in the integrated workshop courses of architectural project in the undergraduate program of architecture and urbanism at Universidade Federal do Rio Grande do Norte. Along the experiment, physical modeling, geometric modeling and digital prototyping are used in distinct moments of the design process with the purpose of observing the suitability of each model to the project s phases. The procedures used in the experiments are very close to the Action Research methodology in which the main purpose is the production of theoretical knowledge by improving the practice. The process was repeated during three consecutive semesters and reflection on the results which were achieved in each cycle helped enhancing the next one. As a result, a methodological procedure is proposed which consists of the definition of the Tridimensional Model as the integrating element for the contents studied in a specific academic period or semester. The teaching of Architectural Project as it is developed along the fifth academic period of the Architecture and Urbanism undergraduate program of UFRN is taken as a reference

Avaliação demográfica, clinico-laboratorial e genética de indivíduos com lupus eritematoso sistêmico e artrite reumatóide residentes em região tropical

The aetiology of autoimmunes disease is multifactorial and involves interactions among environmental, hormonal and genetic factors. Many different genes may contribute to autoimmunes disease susceptibility. The major histocompatibility complex (MHC) genes have been extensively studied, however many non-polymorphic MHC genes have also been reported to contribute to autoimmune diseases susceptibility. The aim of the present study was to evaluate the influence of SLC11A1 gene in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Ninety-six patients with SLE, 37 with RA and 202 controls enrolled in this case-control study, were evaluated with regard to demographic, genetic, laboratorial and clinical data. SLE mainly affects females in the ratio of 18 women for each man, 88,3% of the patients aged from 15 to 45 years old and it occurs with similar frequency in whites and mulattos. The rate of RA between women and men was 11:1, with 77,1% of the cases occurring from 31 to 60 years. The genetic analysis of the point mutation -236 of the SLC11A1 gene by SSCP did not show significant differences between alleles/genotypes in patients with SLE or RA when compared to controls. The most frequent clinical manifestations in patients with SLE were cutaneous (87%) and joint (84.9%). In patients with RA, the most frequent out-joint clinical manifestation were rheumatoid nodules (13,5%). Antinuclear antibodies were present in 100% of the patients with SLE. There was no significant relation between activity of disease and presence of rheumatoid factor in patients with RA, however 55,6% of patients with active disease presented positive rheumatoid factor. Significant association between alleles/genotypes of point mutation -236 and clinical manifestations was not found