Avaliação da estimulação da medula espinhal como modelo de tratamento da doença de parkinson no primata Callithrix jacchus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Tontura em idosos institucionalizados da cidade do NATAL/RN: Um estudo caso-controle em vestibulopatas e não-vestibulopatas

the institutionalized elderly presents for being more fragile a lot of body balance s changes, which can induce falls and health frailty. One of the consequences of it is the appearance of dizziness, vestibular or not. This study aims to identify the risk factors related to dizziness in institutionalized elderly, with and without vestibular disorders, in the city of Natal-RN. Method: a case-control study realized in 12 regulated by Health Surveillance Long Term Care Institutions for the elderly in Natal-RN. Elected seniors with good cognitive level and able to walk, totaling 115 individuals, and of these, 102 were selected according to the presence of dizziness in the last year (n = 51) and their controls (n = 51), paired by sex and age. The 51 elderly patients with dizziness were divided into 3 groups case: case one, for elderly with dizziness and without vestibulopathy (n=38); case two, for elderly with dizziness and vestibulopathy (n=13) and case three, for all the seniors with dizziness, or added to the case 1 case 2 (n=51). The 51 seniors who served as controls were also divided into three groups, according to the number of individuals of each case: control 1, n = 38, control 2, n = 13 control and 3 (sum of 1 control with control 2), n = 51. As possible risk factors were analyzed variables related to characteristics of the institution, to the habits of life of older people and those concerned with the health of the elderly. For statistical analysis, we used the chi-square or Fisher exact test for a significance level of 5% and calculating the association magnitude between variables by measuring the Odds Ratio. Results: as risk factors for dizziness without vestibular disorders were found the presence of hypertension and cardiovascular disease, as well as the presence of three or more disorders for elderly and use of gastric protector drugs. For the elderly group from case two were found no associated risk factor. For elderly patients with dizziness in the case group three, we observed the same risk factors found for the elderly in the case group one, plus the presence of osteoarthritis pathology, which was also significant for this group. Conclusion: dizziness in institutionalized elderly is associated with systemic common diseases in this age group and the vestibulopathy presents itself as pathology on an isolated way, not being possible, with our data, associate it with non-risk factors

Fatores de riscos cardiovasculares em adolescentes da cidade do Natal-RN

Estudos têm demonstrado elevada prevalência de fatores de risco cardiovascular em adolescentes a redor do mundo, entretanto, é possível que esses fatores de risco se comportem de modo diferente em diferentes localidades. Objetivos: Examinar a prevalência do sobrepeso/obesidade e sua associação com outros fatores de risco cardiovasculares, em adolescentes, da cidade do Natal-Brasil. Métodos: Estudo observacional de delineamento transversal, realizado em 626 adolescentes (10 a 19 anos) de ambos os sexos. Foram estudadas as variáveis: peso, idade, gênero, cor, escolaridade, renda familiar, hábitos de vida, história familiar, peso, estatura, índice de massa corporal, relação cintura/quadril, pressão arterial, perfil lipídico, Glicose e Insulina de jejum e pós Dextrosol. Resultados: Foram avaliados 273 (43,6%) adolescentes do sexo masculino e 353 (56,4%) feminino. 26,4% dos adolescentes apresentaram sobrepeso/obesidade. A presença de obesidade familiar foi relatada por mais de 30 % da nossa amostra. Na análise de regressão logística múltipla; Idade, renda familiar, percentil de pressão sistólica, história familiar de hipertensão e obesidade, triglicerídeos, HDL colesterol, e HOMA RI mostraram-se associados com sobrepeso/obesidade. A relação cintura quadril apresentou-se mais elevada nas mulheres, e encontramos 10,9 % dos adolescentes com percentil de pressão sistólica (PAS) 95, e 7,4 % com percentil de pressão diastólica (PAD) 95. As dosagens de triglicerídeos, colesterol HDL e HOMA-RI alterados foram mais prevalentes nos que apresentavam IMC aumentado. As alterações do xi colesterol total, triglicerídios, glicemia pós dextrosol e HOMA teste, tiveram maior prevalência no gênero feminino. Na regressão logística binária, foram observadas associações do sobrepeso / obesidade com idade; OR 0,85, IC de 95% (0,78-0,92); p<0,001, pressão arterial sistólica; OR 2,65, IC de 95% (1,18- 5,94); p< 0,020, renda familiar; OR 2,34, IC de 95% (1,53-3,58); p< 0,001, história familiar de hipertensão arterial; OR 1,76, IC de 95% (1,15-2,71); p< 0,009, história familiar de obesidade; OR 1,50, IC de 95% (1,09-2,27); p< 0,04, aumento dos trigliceridios; OR 2,74, IC de 95% (1,69-4,43); p< 0,001, redução do colesterol; HDL OR 0,58, IC de 95% (0,38-0,87); p< 0,009 e o aumento do HOMA OR 3,16, IC de 95% (1,64 - 6,02); p<0,001. Conclusão: A prevalência de fatores de risco cardiovascular em Natal – Brasil se constitui em grave problema de saúde pública, atingindo níveis que se igualam ou até superam os de outras cidades tanto no Brasil, como em outros países

Influência das medidas antropométricas sobre a pressão arterial sistêmica de hipertensos cadastrados nas unidades de saúde da família no município de João Pessoa - PB

Este trabalho objetiva avaliar a influência das medidas antropométricas sobre a pressão arterial sistêmica de uma coorte de hipertensos atendidos nas Unidades de Saúde da Família (USF) no município de João Pessoa-PB durante o período de 2008 a 2011. Para verificar as diferenças de níveis pressóricos entre as medidas realizadas nas consultas referentes ao cadastro, e a ultima pressão obtida no período de acompanhamento foram utilizadas informações sobre a identificação, dados clínicos do paciente, fatores de risco e doenças concomitantes. Testes estatísticos de comparabilidade entre grupos foram empregados. Para investigar os padrões de associação dos fatores de risco das variáveis antropométricas e sociodemográficas com a hipertensão dos pacientes, foi empregado o Modelo de Regressão Logística. Foram encontradas associações significativas (p<0,005) da hipertensão com a obesidade e o sedentarismo. Com os resultados desta pesquisa pretende-se: fornecer indicadores sobre a efetividade da Estratégia Saúde da Família; avaliar a qualidade das informações antropométricas; contribuir para a definição de estratégias que garantam o melhoramento dos acompanhamentos dos hipertensos e fornecer elementos científicos de apoio para outras USF e instituições governamentais.

Prevalência da síndrome metabólica e seus componentes nos estágios pubertários de escolares do sexo feminino norte-rio-grandenses

The diagnosis of nutritional status is extremely re levant in clinical practice and population assessment, due to the association betwe en body fat and metabolic alterations. The aim of this study is to analyze th e prevalence of metabolic syndrome (MS) and its components in the pubertal stages of f emale students in Rio Grande do Norte state, Brazil, in accordance with Internation al Diabetes Federation criteria. This is a cross-sectional study with 449 students aged betw een 8 and 19 years, stratified into pubertal stages systematized by Marshal and Tanner (1969), as follows: 27.6% prepubertal, 44.3% pubertal and 28.1% postpubertal, with mean ages of 9.4±1.27, 12.4±2.23 and 15.1±1.88 years, respectively. Preval ences were analyzed using distribution of frequencies and their respective 95 % confidence intervals, while the chi- square test and odds ratio were applied to analyze the associations between variables. The general prevalence of MS was 3.3% (CI: 2% - 5%) , without occurrences in the prepubertal stage, observing that it emerges from t he pubertal stage onwards with a prevalence of 2.5% (CI 95% 0.1% - 5%), 1% (CI 95% 0.4% - 2.3%) of cases with overweight and 1.5% (CI 95% -0.1% - 3.2%) with obes e individuals, while in the postpubertal stage the prevalence is 7.9% (CI 95% 3 .2% - 12.6%), 0.8% (CI 95% -0.8% - 2.3%) normal weight cases, 4% (CI 95% 0.6% - 7.4% ) overweight and 3.1% (CI 0.1% - 6.2%) obese individuals. There was an association (p<0.02) between pubertal stages and MS ( x 2 =5.2), with an OR of 3.3 (CI: 1.2 - 5), showing tha t postpubertal adolescents are more prone to SM than pubertals, while the OR i n obese individuals was 2.1 (CI: 2– 2.2) compared to the overweight. Body mass index (B MI) ( x 2 = 29.4; p<0.001) and age range ( x 2 = 13.1; p<0.001) showed a significant linear assoc iation with MS. Of the adolescents with MS, those aged ten years or younge r exhibited higher %G. The most prevalent components in all the stages were altered waist circumference (27.2% [CI 23% - 31%]) and low HDL cholesterol (39.6% [CI 35% – 44%]), which, coupled with hypertension, displayed significant differences in the postpubertal stage in relation to the other stages. The results show that MS emerges from the pubertal stage onwards in proportion to excess childhood body fat, a fact tha t calls for prevention strategies using an educational approach, reducing the large demand on the National Health System. Keywords: Metabolic syndrome, pubertal stages, risk factors.

Autoeficácia e qualidade de vida de pessoas com úlcera venosa

Venous ulcers (UV) are the result of deep venous insufficiency or obstruction leading to venous hypertension in the lower limbs and lesions. Self-efficacy is the belief in the ability to successfully perform a given task or exhibit behavior that leads to a desirable outcome. Nursing needs to know and explore the influence of self-efficacy on quality of life (QOL) of people with UV, seeking to exercise holistic care. Thus, this study aimed to analyze the correlation of self-efficacy for pain control and functionality with the QOL of people with UV in primary health care. It is a cross-sectional, analytical, quantitative study with people with UV in family health strategy and mixed units in Natal / RN. We used the instruments: sociodemographic and health questionnaire, domains self-efficacy for pain control and self-efficacy for functionality of Scale of Self-Efficacy for Chronic Pain (SFCD) and the Charing Cross Venous Ulcer Questionnaire (CCVUQ). The sample included 101 people in the self-efficacy scale for functionality and 89 in self-efficacy for pain, for twelve patients reported no pain at the time of collection, and therefore were excluded from the application of the scale of selfefficacy for pain. The project was approved by the ethics committee of the Federal University of Rio Grande do Norte (CAAE No. 07556312.0.0000.5537), serving Resolution 466/12. Women predominated (66.3%), elderly (61.4%), married or in a stable relationship (63.4%), low income (90.1%) and education (85.1%), inactive (75.2%), associated chronic diseases (60.4%), more than six hours of sleep / day (82.2%), non-drinkers / smokers (80.2%), chronic injury (73.3%) and moderate to severe pain (76.2%). Self-efficacy for pain (mean 67.3, SD 26.6) was less committed to the self-efficacy for functionality (mean 59.4 SD 25.9), with statistical difference (pvalue = 0.011). No significant associations were found between self-efficacy for pain control and functionality with the sociodemographic and health characteristics. When considering the total mean CCVUQ (mean 52.1, SD 16.6), QOL of respondents tended to worsen, with the aesthetic domain the most committed (mean 57.6, SD 24.0), followed by emotional state (mean 57.0, SD 25.7), social interaction (mean 48.4, SD 21.4) and household activities (mean 43.6, SD 23.3) . We found negative and significant correlations between self-efficacy for pain and CCVUQ total score (r = -0,324; p = 0,001), the social interaction domain (r = -0,278; p = 0,008), household activities (r = - 0,285; p = 0,007) and state emotional (r = -0,247; p = 0,019). Likewise, between selfefficacy for functionality and the CCVUQ total score (r = -0,553; p < 0,001), the social interaction domain (r = -0,553; p < 0,001), household activities (r = -0,594; p < 0,001) and emotional status (r = -0,259; p = 0,009). The aesthetic domain showed negative correlation but weak and not significant with self-efficacy for pain (r = -0, 155; p = 0,147) and functionality (r = -0,189; p = 0,058). It became evident the correlation between self-efficacy for pain control and functionality and the domains social interaction, household activities and emotional state, the quality of life of people with UV

Determinantes genéticos e ambientais das doenças hipertensivas da gravidez

The development of complex diseases such as preeclampsia are determined by both environmental and genetic factors, but there is also interaction among these factors. Preeclampsia is a pregnancy-specific disorder characterized by de-novo hypertension and proteinuria after 20th week of gestation. There is a broad spectrum of clinical presentations related to hypertensive disorders of pregnancy (HDP) that can range from mild preeclampsia to eclampsia (seizures) or HELLP syndrome (Hemolysis, Elevation of Liver enzymes, Low Platelets). Those clinical outcomes might be linked to different pathological mechanisms. Our work aims to identify factors (i.e. genes and environmental) associated with the HDP’s clinical spectrum. Using a case-control approach, we selected a total of 1498 pregnant women for epidemiological and genetic studies, encompassing 755 normotensive (control); 518 preeclampsia; 84 eclampsia; and 141 HELLP. Women were genotyped for 18 SNPs across 5 candidate genes (FLT1, ACVR2A, ERAP1, ERAP2 and LNPEP). For the environmental factors, we found maternal age, parity status and pre-gestational body mass index as important risk factors associated with disease. Genes were associated in a phenotype-specific manner: ACVR2A with early preeclampsia (rs1424954, p=0.002); FLT1 with HELLP syndrome (rs9513095, p=0.003); and ERAP1 with eclampsia (rs30187, p=0.03). Our results suggest that different genetic mechanisms along with specific environmental factors might determine the clinical spectrum of HDP. In addition, phenotype refinement seems to be an essential step in the search for complex disease genes

Trajetória de vida dos pescadores vítimas de lesão medular por mergulho: experiências, representações sociais e estresse

Spinal cord injury causes permanent disabling manifestations, affecting the anatomic integrity, bodily changes and functional limitations related to the disability state. It was aimed to analyze the social representation, stress level and experiences of fishermen victims of spinal cord injury caused by diving accident in the Northern beaches of Brazil. It is a descriptive - exploratory study with quantitative, qualitative and representational data developed i n fishermen’s villages in nine beaches of Northern shore/RN, between October 2013 to August 2014, after the approval of the Ethics Committee in Research of the Universidade Federal do Rio Grande do Norte, under the number 431.891/2013, CAAE 20818913.0.0000 .5537. The sample was composed by 44 fishermen with spinal cord injury, defined from inclusion and exclusion criteria of the participants. It was used as instrument to collect the data a semi structured interview. Quantitative data was analyzed by descrip tive statistics, showing the data through table, boxes and graphics by Microsoft Excel. Data from interviews were submitted to the software called Analyse Lexicale par Contexte d’un Ensemble de Segments de Texte (ALCESTE) using the analysis of the Social R epresentation Theory and Center Core Theory. It is shown the outcomes of the research through four articles, following the normative recommendations of the journals. Participants of the study were all male, age mean 49,6 years, elementary school (68,2%), m arried (77,3%); paraplegia sequel (50,0%). Most of them showed stress (75,0%), almost in the exhaustion stage (33,3%), prevalent insomnia symptoms (95,5%) in the last hours; hypertension (97,7%) in the last week and sexual troubles (95,5%) in the last mont h). Decompressive illness caused spinal cord injury (57,1%), occurred prevalently in low summer (75,0%), northern shore (96,4%), having as main consequences the paresthesia and pain in the upper and lower limbs (67,9%), followed by death (25,0%). Interview analysis under the understanding of Social Representation of spinal cord injury allowed the appearance of seven categories: Treatment: limitation and expectative; Spinal Cord injury: before and after; Retirement: reality yet to come; Disability: dependenc y, incapacity, vulnerability; Overcoming and autonomy; Self feelings: physics losses and new start; Life and labor: impediments, plans and changes. The center core of the representation is found in the first category by the expectative and limitation on th e treatment, meanwhile the outskirt elements are in seventh and third categories. Physics limitation for fishing activities and retirement expectative is the most outstanding of the structure. Social representation concerning spinal cord injury is found in a transaction moment between before and after with the prevented fishing activity, coping of the situation with the potential remaining. The anchoring is established in the desire for changes related to the improvements of life and health conditions exper ienced day by day through faith. This study finishes pointing out the range of the objectives, which topic is relevant for public health of fishermen. It is suggested prevention measures, promotion and health recovery of fishermen, besides safe, healthy an d worthy conditions as a compromise of social and health politics.

Avaliação da atividade anti-inflamatória do extrato aquoso, frações e compostos identificados nos frutos de Hancornia Speciosa Gomes (Apocynaceae)

Hancornia speciosa Gomes (Apocynaceae), popularly known as ‘mangabeira’, has been used in folk medicine to treat inflammatory disorders, hypertension, dermatitis, diabetes, liver diseases and stomach disorders. Regarding the Hancornia speciosa fruits, the ethnobotany indicates its use especially for treating inflammation and tuberculosis. However, no study has been done so far to prove such biological activities. The objective was evaluation anti-inflammatory activity from the fruits of Hancornia speciosa Gomes (mangabeira). Aqueous extract was prepared by decoction, subsequently submitted the liquid-liquid fractionation. The secondary metabolites were identified by high performance liquid chromatography coupled with detector diode array (HPLC-DAD) and liquid chromatography diode array detector coupled with mass spectrometry (LC-DAD-MS). The anti-inflammatory properties of the aqueous extract, dichloromethane (CH2Cl2), ethyl acetate (EtOAc) and n-butanol (n-BuOH) fractions of the fruits from H. speciosa, as well as rutin and chlorogenic acid were investigated using in vitro and in vivo models. In vivo tests comprised the xylene-induced ear edema that was measured the formation of edema, carrageenan-induced peritonitis was evaluated the total leukocytes at 4h and zymosan-induced air pouch was measured the total leukocytes and differential cell count at 6, 24 and 48 hours, whereas in vitro tests were evaluated levels of cytokines IL-1β, IL-6, IL-12 and TNF-α using ELISA obtained of carrageenan-induced peritonitis model. The results showed the presence of rutin and chlorogenic acid were detected in the aqueous extract from H. speciosa fruits by HPLC-DAD and LC-DAD-ME. Furthermore, the aqueous extracts and fractions, as well as rutin and chlorogenic acid significantly inhibited the xilol-induced ear edema and reduced cell migration in the animal models such as carrageenan-induced peritonitis and zymosan-induced air pouch. In addition, reduced levels of cytokines IL-1β, IL-6, IL-12 and TNF-α were observed. This is the first study that demonstrated the anti-inflammatory effect of aqueous extract from Hancornia speciosa fruits against different inflammatory agents in animal models, suggesting that their bioactive molecules, especially rutin and chlorogenic acid contributing, at least in part, to the anti-inflammatory effect of aqueous extract. These findings support the widespread use of Hancornia speciosa in popular medicine and demonstrate that this aqueous extract has therapeutic potential for the development of a herbal drugs with anti-inflammatory properties.

Prevalência e fatores associados à diminuição da função pulmonar em obesos em pré-operatório de cirurgia bariátrica

Introduction: Obesity shows changes in pulmonary function and respiratory mechanics, however, little is known regarding the prevalence of worsening respiratory function when considering the increase in central or peripheral adiposity or general obesity. Objectives: To analyze the association between anthropometric adiposity and decreased lung function in obese. Materials and Methods: Patients eligible for this study obese individuals (IMC≥30kg/m2) in pre-bariatric surgery and referred for Treatment Clinic of Obesity and Related Diseases, located at the University Hospital Onofre Lopes (HUOL), from October 2005 and July 2014. The evaluation included clinical information and measurement of anthropometric measures (body mass index (BMI), body fat index (BFI) and waist circumference (WC) and neck (NC)) and spirometric. The prevalence and analysis by Poisson regression was performed considering the following outcome variables: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and Maximum Voluntary Ventilation (MVV) and as predictor variables were considered: BMI, IAC, WC and NC and as control variables: age, gender, smoking history and comorbidities (diabetes mellitus, dyslipidemia and hypertension). Statistical analysis was performed using Statistical Package for Social Sciences software (SPSS - version 20.0). Results: We analyzed 384 individuals, 75% women, mean BMI: 46.6 (± 8.7) kg/m2, IAC: 49.26 (± 9.48)%, WC: 130.84 (± 16.23) cm and NC: 42.3 (± 4.6) cm. The higher prevalence of FVC and FEV1 <80% was observed in individuals with NC above 42 cm, followed those with a BMI above 45 kg/m2. Multivariate analysis using Poisson regression showed as risk factors associated with FVC <80%, the variables: NC above 42 cm (odds ratio (OR) 2.41) and BMI over 45Kg/m2 (OR 1.71 ). As for FEV1 <80% predicted, all predictor variables were associated, with the largest odds presented by the NC (3.40). MVVV was not associated with any studied varaible. Conclusion: Individuals with NC above 42 cm had higher prevalence of reduced lung function and the NC was the measure with the highest association with reduced lung function in obese.

Telessaúde como ferramenta de apoio à atenção primária à saúde: um olhar sobre as teleconsultorias em cardiologia

In order to qualify Primary Health Care in Brazil, the Ministry of Health implemented the Brazilian Telehealth Program to provide health support (telecare) and permanent health education (tele-education). In this respect, one of the primary services offered is teleconsultation. As part of the national expansion of the program, a local Telehealth Center, called Telehealth/RN, was created in Rio Grande do Norte state. The aim of this study was to describe the implementation of cardiological teleconsultations at Telehealth/RN, and analyze the characteristics of the teleconsultations in cardiology requested. Formative Second Opinions in cardiology, available at the web site of the Brazilian Telehealth Program, were also examined. This is a quantitative study with a descriptive, observational design. A total of 56 Formative Second Opinions in cardiology were identified, a majority related to hypertension (29%), focused on treatment support (30%), and requested by doctors (59%). At Telehealth/RN, 47 teleconsultations in cardiology were carried out, a majority also related to hypertension (50%), requested by community health workers (45%) and focused directly on treatment (52%). Cardiological teleconsultation, implemented at the Telehealth/RN in April 2014, is a practical and efficient strategy capable of ensuring health services and reaching those who live in remote areas. Knowing the demand for teleconsultations is extremely important, given that they provide the information needed to correct existing inadequacies related to care, management and/or education, as well as providing the basis for public policies that meet the demands of teleconsultation.

Análise do perfil de encaminhamento da atenção primária para pré-natal de alto risco: desafios para o ensino de competências em saúde materno-infantil

OBJECTIVE: to identify a profile of the main causes of inappropriate referrals from primary care to specialized services, as strategy for the curriculum development of core competencies related to maternal health. METHODS: a cross-sectional study was performed using document analysis of all referrals of pregnant women from primary care to the high-risk pregnancy service, state of Rio Grande do Norte, Brazil. All pregnant women referred from June to December 2014 (n = 771) were included. According to their causes the referrals were categorized as adequate, inadequate or inconclusive. RESULTS: a total of 188 referrals were classified as inadequate (24.4%) and 93 inconclusive (12.1%) totalizing 36.5% of inappropriate referrals. The main causes identified in these inappropriate referrals were: low-risk pregnancy (12.8%), unconfirmed hypertension (12.1%), risk of abortion (8.9%), teenage pregnancy (7.1%) , toxoplasmosis (5.3%), Rh incompatibility (4.6%) and urinary tract infection (4.3%). These data contributed to the formulation of the following products: 1) a continuing education program for health professionals working in primary care, undergraduate students and residents; and 2) development of a virtual platform to support professionals who need to refer patients to high-risk pregnancy service. CONCLUSION: the results of this study are relevant in the current context of education of health professionals, with potential for positively impact not only in the development of skills related to maternal health in undergraduate and graduate education, as well as contributing for improvement of the health care of the population.

Trabalho e saúde: análise da relação entre condições de trabalho e motivação no emprego e suas interfaces com a saúde dos profissionais nos hospitais públicos

Health results from the interaction of biological, social, economic, political and cultural factors. Under this perspective, we aim to analyze the relationship among working in public emergency hospitals and the health-sickness of the professionals who work there. We are based in a quantitative and qualitative research, in which 240 health professionals (doctors, nurses, social workers, psychologists, dentists, nutritionists, audiologists, physiotherapists and occupational therapists) answered a survey. All of them recognize the importance of work to guarantee favorable conditions to good health. However, they highlight its physical and mental wear effects on workers like stress, absence of a healthy life-style, high blood pressure, musculoskeletal, gastrointestinal and sleep disorders. It becomes urgent to face this reality, to enhance professionals' health and, consequently, the quality of user’s assistance, since the illness of health workers is strongly correlated with the existing health model in society.

Irregularidade do ciclo menstrual no Menacme como marcador para fatores de risco cardiovasculares na pós-menopausa

A associação entre fatores de risco cardiovascular (FRCV) na pósmenopausa e o antecedente de irregularidade menstrual no menacme foi avaliado em estudo caso-controle envolvendo 414 mulheres na pósmenopausa com idade de 60,4 ± 5,5 anos e IMC de 25,3 ± 4,7 kg/m2. As variáveis consideradas foram: caracterização do ciclo menstrual entre 20 e 35 anos (independente) e relato atual sobre ocorrência de hipertensão arterial, dislipidemia, diabetes mellitus e doença arterial coronariana (dependentes). Utilizou-se o teste qui-quadrado e modelos de regressão logística, ajustados para outras variáveis implicadas no risco para doenças CV, com nível de significância 5%. Observou-se que mulheres que relataram irregularidade menstrual prévia estiveram associadas com risco aumentado para ocorrência de algum FRCV [odds ratio ajustado (OR)= 2,14; IC-95%= 1,02–4,48], quando comparadas àquelas com ciclos regulares. Análise estratificada demonstrou as seguintes associações significativas com o antecedente de irregularidade menstrual: hipertensão arterial (OR= 2,4; 95% IC= 1,39–5,41), hipercolesterolemia (OR= 2,32; 95% IC= 1,17–4,59), hipertrigliceridemia (OR= 2,09; 95% IC= 1,10–4,33) e angioplastia coronariana (OR= 6,82; 95% IC= 1,44–32,18). Os dados sugerem que o antecedente de irregularidade menstrual, indicativo da ocorrência da síndrome dos ovários policísticos na idade reprodutiva, pode estar relacionado com aumento do risco para doenças CV na pós-menopausa __________________________________________________ABSTRACT Menstrual Cycle Irregularity as a Marker of Cardiovascular Risk Factors at Postmenopausal Years.To evaluate the association between cardiovascular risk factors (CVRF)during postmenopausal years and previous menstrual irregularity during reproductive years, we performed a case-control study in 414 postmenopausal women (mean age 60.4 ± 5.5 years; BMI 25.3 ± 4.7 kg/m2). The variables assessed were: menstrual cycle characteristics at age 20–35y (independent) and records of arterial hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (dependent). Statistical analysis used the chi-square test and logistic regression, adjusting for potential confounders for cardiovascular risk, with significance set at 5%. Women reporting previous menstrual irregularity were associated with increased risk for some CVRF [adjusted odds ratio (OR) 2.14; CI-95%= 1.02–4.48], when compared with those reporting regular menstrual cycles. Stratified analysis demonstrated significant associations of previous menstrual irregularity with: arterial hypertension [OR= 2.74; CI-95%= 1.39–5.41), hypercholesterolemia (OR= 2.32; CI-95%= 1.17–4.59), hypertriglyceridemia (OR= 2.09; CI-95%=1.10–4.33), and coronary angioplasty (OR= 6.82; CI-95%= 1.44–32.18). These data suggest that a prior history of menstrual irregularity, as indicative of polycystic ovary syndrome, may be related to increased risk for CVD during postmenopausal years

Incidência e fatores de risco da retinopatia diabética em pacientes do Hospital Universitário Onofre Lopes, Natal-RN

Estudar a incidência e fatores de risco (tempo de doença e presença de hipertensão arterial sistêmica) para retinopatia diabética em 1002 pacientes encaminhados pelo Programa de Diabetes do Hospital Universitário Onofre Lopes no período de 1992 – 1995. Métodos: Estudo retrospectivo de pacientes com diagnóstico de diabetes mellitus encaminhados ao Setor de Retina do Departamento de Oftalmologia pelo Programa de Diabetes do Hospital Universitário e submetido, sob a supervisão do autor, a exame oftalmológico, incluindo medida da acuidade visual corrigida (tabela de Snellen), biomicroscopia do segmento anterior e posterior, tonometria de aplanação e oftalmoscopia binocular indireta sob midríase(tropicamida 1% + fenilefrina 10%). Foi realizada análise dos prontuários referente ao tempo de doenças e diagnostico clínico de hipertensão arterial sistêmica. Resultados: Dos 1002 diabéticos examinados (em 24 deles a fundoscopia foi inviável), 978 foram separados em 4 grupos: sem retinopatia diabética (SRD), 675 casos (69,01%); com retinopatia diabética não proliferativa (RDNP), 207 casos (21,16%); com retinopatia diabética proliferativa (RDP), 70 casos (7,15%); e pacientes já fotocoagulados (JFC), 26 casos (2,65%). Do total, 291 eram do sexo masculino (29%) e 711 do sexo feminino (71%). Os 4 grupos foram ainda avaliados quanto ao sexo, a faixa etária, a acuidade visual, tempo de doença, presença de catarata e hipertensão arterial sistêmica e comparados entre si. Com relação ao tipo de diabetes, 95 eram do tipo I (9,4%), 870 pacientes eram do tipo II (86,8%), e em 37 casos(3,7%) o tipo de diabetes não foi determinado. Conclusões: Comprovou-se que os pacientes com maior tempo de doença tinham maior probabilidade de desenvolver retinopatia diabética, e que a hipertensão arterial sistêmica não constituiu fator de risco em relação à diminuição da acuidade visual nos pacientes hipertensos