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.

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Desempenho físico em idosos com diferenciados perfis epidemiológicos: análise do estudo IMIAS International Mobility in Aging Study sob a perspectiva do curso da vida e de biomarcadores da inflamação e do estresse

O crescimento demográfico de idosos é um fenômeno mundial e exerce influência sobre o desenvolvimento e funcionamento das sociedades. Fatores sociais, econômicos, ambientais, biológicos e culturais influenciam o processo de envelhecimento, que pode vir acompanhado de contínua perda na capacidade de adaptação do indivíduo ao meio ambiente, de maior vulnerabilidade ao estresse, limitações funcionais e diminuição da qualidade de vida do indivíduo. Todavia, ao longo do curso da vida, o indivíduo vivencia múltiplas exposições adversas à saúde, e o declínio da mobilidade surge como um dos primeiros sinais do envelhecimento, repercutindo na saúde física e mental do indivíduo. Para contribuir com o conhecimento sobre os desfechos relacionados ao envelhecimento e mobilidade, o estudo IMIAS investiga idosos em quatro países com diferentes perfis epidemiológicos. O presente estudo abordou os possíveis fatores associados ao declínio físico em idosos de distintas sociedades, sobre a perspectiva epidemiológica do curso da vida e dos biomarcadores da inflamação e do estresse. Objetivos: 1) Analisar as relações entre as adversidades sociais e econômicas, vivenciadas durante a infância, a fase adulta e a velhice, com o baixo desempenho físico em populações idosas, de diferentes contextos sociais, econômicos e culturais. 2) Verificar a associação entre os níveis elevados da proteína c-reativa (PCR) com o desempenho físico em idosos de diferentes populações. 3) Avaliar se a desregulação nos níveis de cortisol diurno exerce influência sobre o desempenho físico em idosos com distintos perfis epidemiológicos. Métodos: Foram utilizados dados da linha de base do IMIAS – Estudo Internacional de Mobilidade no Envelhecimento, composto por 1.995 indivíduos entre 65 e 74 anos de idade, residentes em comunidades de quatro países (Albânia, Brasil, Canadá, Colômbia). O desempenho físico foi avaliado através do Short Physical Performance Battery (SPPB) e da força de preensão manual. As adversidades durante o curso da vida foram estimadas a partir de eventos e exposições sociais, econômicas e culturais ocorridas durante a infância, fase adulta e velhice. Para avaliar o percurso biológico e suas associações com a mobilidade, a proteína c-reativa e o cortisol foram considerados como biomarcadores da inflamação e do estresse, respectivamente. No sentido de responder as questões de investigações, foram conduzidas análises de estatística descritiva, bivariada e multivariada, mediante técnicas de distribuição de frequências, teste qui-quadrado, odds ratio e regressões logística, linear e multinível. Resultados: O desempenho físico foi menor nos participantes que vivem na Colômbia, Brasil e Albânia do que nos que vivem no Canadá, mesmo quando ajustados por idade, sexo e adversidades durante o curso da vida. O baixo nível de desempenho físico (SPPB < 8) foi associado a ter sofrido adversidade social e econômica na infância, ter tido ocupação semiqualificada na fase adulta, morar sozinho e possuir renda insuficiente na velhice. A PCR esteve associada com a baixa força de preensão manual e com o SPPB<8. Entretanto, a associação entre a PCR e a força de preensão manual não se manteve quando ajustada por fatores socioeconômicos e hábitos de saúde. As associações negativas entre SPPB e PCR permaneceram significativas mesmo após ajustes por idade, sexo, escolaridade, local de pesquisa e condições de saúde. O baixo desempenho físico (SPPB ≤ 8) foi associado com uma significativa diminuição nos níveis de cortisol ao acordar, em comparação com os níveis de cortisol de idosos com bom desempenho físico (SPPB > 8), mesmo após modelos controlados por local de estudo, sexo, depressão, hábitos de saúde, uso de psicotrópicos e índice de massa corporal. Conclusões: Os resultados evidenciaram associação entre a inflamação, o estresse e as desigualdades sociais e econômicas na infância, sobre o desempenho físico de idosos com diferenciados perfis epidemiológicos. Enfatizamos que a promoção do envelhecimento saudável requer considerar políticas e práticas que favoreçam o bem-estar econômico e social para crianças, adultos e idosos.

Uso do índice de pobreza hídrica (WPI) através da análise de componentes principais

To contribute in the performance of policies and strategies formulated by development agencies, indexes have been created in anticipation of expressing the multiple dimensions of water resources in an easily interpretable form. Use of Hydro Poverty Index ( WPI) is spreading worldwide , with the same formed by the combination of sub - indices Resource, access, capacity , use and environment. S ome critics a s to its formation have emerged, a mong them stands out the allo cation of weights of sub - indexes , made by an arbitrary process attributing subjectivity to the selection criteria. By involving statistical analysis, when considering the characteristics of the variables generated by the Principal Component Analysis (PCA), it turns out that it is able to solve this problem. The objective of this study is to compare the results of the original WPI with content generated by Principal Com ponent Analysis (PCA) for the indicati on of the weights of sub - indec es applicable in the Seridó River hydrographic Basin . We conclude that the use of Principal Component Analysis in the allocation of weights of Water Poverty Index has identified the sub - indices Resources, Access and Environment are the most representative for the river basin Seridó , and that this new index, WPI' , presented the most comprehensive ranges of values , allowing more easily identify disparities among municipalities. In addition, t he evaluation of the sub - indec es in the study area has great potential to inform the decision - maker in the management of water resources, the most critical locations and deserve greater investments in the aspects analyzed, as the index itself can not cap ture this information.

Síntese e reatividade de derivados de quinoxalina visando aplicações como quimiossensores e estudo cinético por análise de imagens

Synthesis of heterocyclic compounds, as quinoxaline derivatives, has being shown to be relevant and promissor due to expressive applications in biological and technological areas. This work was dedicated to the synthesis, characterization and reactivity of quinoxaline derivatives in order to obtain new chemosensors. (L)-Ascorbic acid (1) and 2,3-dichloro-6,7- dinitroquinoxalina (2) were explored as synthetic precursors. Starting from synthesis of 1 and characterization of compounds derived from (L)-ascorbic acid, studies were performed investigating the application of products as chemosensors, in which compound 36 demonstrated selective affinity for Cu2+ íons in methanolic solution, by naked-eye (colorimetric) and UVvisible analyses. Further, initial analysis suggests that 39 a Schiff’s base derived from 36 also presents this feature. Five quinoxaline derivatives were synthesized from building block 2 through nucleophilic aromatic substitution by aliphatic amines, in which controlling the experimental conditions allows to obtain both mono- and di-substituted derivatives. Reactivity studies were carried out with two purposes: i) investigate the possibility of 47 compound being a chemosensor for anion, based on its interaction with sodium hydroxide in DMSO, using image analysis and UV-visible spectroscopy; ii) characterize kinetically the conversion of compound 44 into 46 based on RGB and multivariate image analysis from TLC data, as a simple and inexpensive qualitative and quantitative tool.

Utilização da espectroscopia no infravermelho próximo para o controle de qualidade do camarão (Litopenaeus vannamei)

This work was developed with the objective of proposing a simple, fast and versatile methodological routine using near-infrared spectroscopy (NIR) combined with multivariate analysis for the determination of ash content, moisture, protein and total lipids present in the gray shrimp (Litopenaeus vannamei ) which is conventionally performed gravimetrically after ashing at 550 ° C gravimetrically after drying at 105 ° C for the determination of moisture gravimetrically after a Soxhlet extraction using volumetric and after digestion and distillation Kjedhal respectively. Was first collected the spectra of 63 samples processed boiled shrimp Litopenaeus vannamei species. Then, the determinations by conventional standard methods were carried out. The spectra centered average underwent multiplicative scattering correction of light, smoothing Saviztky-Golay 15 points and first derivative, eliminated the noisy region, the working range was from 1100,36 to 2502,37 nm. Thus, the PLS models for predicting ash showed R 0,9471; 0,1017 and RMSEP RMSEC 0,1548; Moisture R was 0,9241; 2,5483 and RMSEP RMSEC 4,1979; R protein to 0,9201; 1,9391 and RMSEP RMSEC 2,7066; for lipids R 0,8801; 0,2827 and RMSEP RMSEC 0,2329 So that the results showed that the relative errors found between the reference method and the NIR were small and satisfactory. These results are an excellent indication that you can use the NIR to these analyzes, which is quite advantageous, since conventional techniques are time consuming, they spend a lot of reagents and involve a number of professionals, which requires a reasonable runtime while after the validation of the methodology execution using NIR reduces all this time to a few minutes, saving reagents, time and without waste generation, and that this is a non-destructive technique.

Transplantes de córneas no estado do Rio Grande do Norte: aspectos epidemiológicos e clínicos

This study aimed to characterize in a clinical and epidemiological way the patients who are on a waiting list for transplantation and the patients transplanted with corneal tissue in a corneal transplants reference service in the state of Rio Grande do Norte. It is an epidemiological study of a quantitative approach, with cross-sectional, descriptive and analytical cut including all patients on the waiting list for transplantation (population A) and the patients already transplanted with a corneal tissue (population B) in a reference service. In population A, there was a census conducted of patients on the waiting list for corneal transplantation (n=62 patients). In population B, the sample was non-probabilistic and corresponded to all corneal transplants performed in the service in the period from 2010 to 2014 (n=258). This study is approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in Opinion 876 177 and CAAE 37533014.8.0000.5537. Data were collected in full in the period from January to April 2015, by two instruments built to systematize the necessary data collection. After being coded and tabulated, data were analyzed using the Statistical Package for Social Sciences software, version 20.0. The definition of variables and their distribution patterns were presented as frequencies and measures of central tendency while, for multivariate analysis, the effect of magnitude measures were applied (prevalence ratio) and measures of association (chi-square test or Fisher's exact test) for a 0.05 significance level. The results are shown in two scientific articles coming from the field survey data. It was found that the epidemiological profile of patients on the waiting list (n=62) showed a prevalence of individuals aged over 50 years old, female (54.84%) and residents of the middle region of East Rio Grande do Norte (66.13%). The clinical profile of patients with corneal transplantation (n=258) was characterized by being male (51.16%) with an average age of 49.33 years old and 57.75% were coming from East Rio Grande do Norte. The average time on the waiting list was 172.63 days in elective transplants and 9.03 days in urgent transplants. Keratoconus was the main indicator condition to perform the transplant. For patients on the waiting list, the variable “type of disorder of the cornea” showed statistically significant association with gender and age. For patients with corneal transplants, the variable "type of disorder of the cornea" was associated with the variables gender, age, previous surgery, failure of previous graft, classification of the eye and glaucoma. By characterizing the clinical and epidemiological profile of corneal transplants, it is possible to question the reality, pointing about the care that should be offered and develop targeted interventions to collective and individual needs intrinsic to patients who need this surgery as a treatment option.

Quedas em idosos assistidos na estratégia saúde da família: frequência e fatores associados

The growth of the elderly population is a global phenomenon and, in Brazil, this transformation is happening in a very rapid rhythm. With the current population aging, this emerging age group will need more health care and attention. One of the characteristics of the population aging is the progressive accumulation of disabilities, which makes it more vulnerable to falls. This study was developed with the purpose of knowing the episode falls in the scope of an elderly population treated at a Family Health Unit. It is a research with cross-sectional nature, and its sample was composed by 121 elderly. The research was approved by the Ethics Committee of HUOL, with Opinion nº 816.022. We applied a questionnaire to the participants, and the results were statistically analyzed by using Chi-square test and Fisher’s exact test to verify the association between variables. In order to perform a multivariate analysis, we used the method of the Binomial Logistic Regression. For both tests, we accepted significance p<0,05 and CI of 95%. The results prove that the majority belongs to the female gender (76,9%); the age group of elderly reaches 88,4% and 11,6% is over-aged; regarding the marital status, 35,3% are married and 29,4% widowed; 92,1% with family income between one and two minimum wages; and 91,8% live with their partners and/or children. Regarding the frequency of falls, we found that 61,2% of the surveyed elderly suffered one or more falls in 2014. As associated factors, it became clear that 73,8% were due to extrinsic factors, 6,4% to intrinsic factors and 21,4% to both factors. As a consequence of the fall, we found that 89,2% have fear of falling again, 37,3% showed anxiety and 13,3% had their ambulation affected. Concerning the exposure to the risk factors, the most prevalent places were: street/avenue (31,0%), pavement (19,0%), living room (14,3%) and courtyard/backyard (10,7%). The study has proven a statistically significant association among female gender (p=0,001), rubble/objects in the backyard (p=0,015) and furniture that may cause accidents (p=0,005). It was evident among the elderly people surveyed, 72.7% receive little information about falls, being a risk factor for falls. We conclude that there is a high frequency of falls in the surveyed elderly, thereby constituting a worrisome data because this event in the elderly population is a serious matter, which raises the need to ensure them a safe environment in their homes and, above all, outside them. The information provided by the Family Health Strategy team are important to avoid these occurrences, which reinforces the need for developing health education activities together with the population as a way to prevent and reduce the occurrence of falls, thereby improving the quality of life of elderly.

Prevalência e fatores associados à síndrome da fragilidade em idosos: inquérito populacional em Campina Grande-PB

The frailty syndrome is a geriatric medical condition of vulnerability resulting in the decline of physiological reserves, characterized by high-risk consequences as falls, disability, hospitalization, institutionalization and death. Although the presence of comorbidities is not always accompanied by fragility, this presence could also indicate an increased risk of adverse health events, taking the elderly to a greater likelihood of becoming brittle due to the physical limitations that may occur with emergence of diseases, which are strongly predictive of Fragility Syndrome. This study aimed to assess the prevalence of frailty syndrome in the elderly and associated factors. The specific objectives were to identify the prevalence of frailty syndrome in the elderly and their associations with demographic, economic, health, functional and psychological; identify the reasons for the prevalence of frailty syndrome with the demographic profile, health problems, use of legal drugs and problems with sleep of older people. The study was cross-sectional and composed of 385 elderly aged 65 or more. Multivariate Poisson regression models were used to check conditions associated with fragility and determine the prevalence ratio (α = 0.05). The prevalence of fragility was 8.7% and pre-fragility of 50.4%. Fragile and pre-frail elderly presented, bigger and increasing prevalence ratio for marital status, difficulty in performing instrumental activities of daily living, old age, involuntary loss of stool, depression and negative affect. Elderly people who do not work have a higher prevalence of fragility, as well as those who reported having had a stroke / stroke / ischemia, those who suffered falls in the last 12 months and those with sleep problems. It is considered that the results, together with other available in the literature, can contribute to the understanding of the fragility epidemiology and also in the implementation of specific programs aimed at reducing the prevalence of frailty, optimizing the quality of life. It is suggested that future programs have special attention to the profiles of elderly people who have not yet developed fragility, i.e., pre-fragile. This could prevent the elderly from becoming frail.

Correlação entre força muscular do assoalho pélvico, função sexual e qualidade de vida em mulheres de meia idade

Introduction: Menopause is characterized by the depletion of ovarian follicles and the gradual decline in estradiol levels, which ends with the definitive cessation of menstrual periods (menopause). As a result of hypoestrogenism, characteristic symptoms, such as hot flashes, night sweats, vaginal dryness, dyspareunia, insomnia, mood swings and depression can be observed. There is also the weakening of the pelvic floor muscles (MAP) as a result of progressive muscle-aponeurotic and connective atrophy with consequent decreased sexual function. Objective: To evaluate the strength of MAP, sexual function and quality of life of menopausal women. Methodology: This is an observational, analytical, cross-sectional design. The sample consisted of 55 women (35 postmenopausal and 20 perimenopausal), aged between 40 and 65, who were assessed by muscle strength and perineometry test. For the assessment of sexual function and quality of life, used the Female Sexual Function Index (FSFI) and Utian Quality of Life (UQOL), respectively. Statistical analysis was performed using Pearson's correlation and multivariate analysis. Results: The mean age was 52.78 (± 6.47 years). Sexual dysfunction presented, 61.8% of participants (43.62% of postmenopausal and perimenopausal 18.17%). Muscle strength test and the maximum perineometry had a median of 3.00 (Q25: 2 e Q75: 4) and 33,50 cmH20 (Q25: 33,5 e Q75: 46,6), respectively. No correlation was found between sexual function and muscle strength (r = 0.035; p = 0.802) and between sexual function and perineometry (r = 0.126; p = 0.358). The mean total score of UQOL was 74.45 (± 12.23). Weak positive correlation was found between sexual function and quality of life (r = +0.422 p = 0.001). Multivariate analysis identified associations between sexual function and variables: quality of life, climacteric symptoms, physical activity and education level. Conclusions: These results suggest that the climacteric symptoms, quality of life, physical activity and level of education are associated with sexual function in menopausal women. However, the muscular component of sexual function needs to be further investigated in this context.

Análise da variabilidade climática sobre a produtividade da soja no município de Bom Jesus (PI)

The climate is still main responsible for the variations soybean productivity (Glycine max (L.) Merrill), exerting a limiting action on these agricultural systems. The bomjesuense cerrado, this culture has proved, over the years, an increase of cultivated areas, however, productivity does not keep the same pace, going through periods of oscillations. Thus, although the crop is added to high technology, culture has great vulnerability to climatic adversities. Thus, the present study aims to analyze possible trends in meteorological variables, which can influence the soybean yield in Bom Jesus. For this purpose, different datasets were used, as follows: i) two periods of daily data (1984-2014 and 1974-2014), both obtained from the National Meteorological Institute (INMET); ii) climate normals from 1961-1990 as defined by INMET; iii) local agricultural production data of soybean-year (1997/1998 to 2012/2013) obtained from the Municipal Agricultural Production (PAM) dataset, which is management by Brazilian Institute of Geography and Statistics (IBGE). The analysis procedures included calculations of climate normals for 1984 to 2014 period and some statistical applications, as follows: i) the Wilcoxon test, used to evaluate differences between climate normals (1961 to 1990 and 1984 to 2014); ii) the Mann-Kendall nonparametric test, in order to analyze the linear trend of agrometeorological variables (rainfall, maximum temperature, minimum temperature and diurnal range of temperature; iii) cluster analysis by Ward method and the Spearman correlation test (rs) to identify the relationship between agrometeorological variable and soybean annual productivity. We adopted a statistical significance level of 5%. The results indicate changes in seasonality of the 1984-2014 climatology with respect to past climatology for all variables analyzed, except for insolation and precipitation. However, the monthly analysis of precipitation indicate negative trend during October and positive trend in December, causing a delay in start of rainy season. If this trend is persistent this result must be considered in futures definitions of the soybean crop sowing date over the region studied. With Mann-Kendall test was possible to identify positive trends with statistical significance in maximum temperature for all month forming part of soybean cycle (from November to April), which in turn tends to cause adverse effects on crop physiology, and consequently impacts on the final yield. Was identified a significant positive correlation between soybean yield and precipitation observed in March, thus precipitation deficit in this month is harmful to the soybean crop development. No statistically significant correlation was identified among maximum temperature, minimum temperature, and DTR with annual soybean productivity due these range of meteorological variables are not limiting factors in the final soybean yield in Bom Jesus (PI). It is expected that this study will contribute to propose planning strategies considering the role of climate variability on soybean crop final yield.

Foraminíferos, ostracodes e microfauna associada da plataforma continental equatorial norte-rio-grandense, NE Brasil: área Porto do Mangue a Galinhos

This study was conducted in the adjacent Brazilian equatorial inner shelf to Rio Grande do Norte, between the region of Porto do Mangue and Galinhos. The main objective is the characterization of biogenic sediments, especially foraminifera and ostracod collected on the surface of the seafloor. The methodology involved standard procedures including literature, surveys, processing of samples in the laboratory and identification of foraminifera and ostracods by genera or species under stereo microscopy and scanning electron microscopy (SEM). Multivariate statistical analyzes and study of ecological indexes were also applied to the study of foraminifera. Three transects, from inner shelf to slope were sampled: profile 01 (east, near Galos), profile 02 (center, near the city of Macau) and profile 03 (west, near Ponta do Mel). Results indicated the predominance of benthic foraminifera and little plankton occurrence. Benthic foraminifera genera observed in abundance were Quinqueloculina, Textularia, Globigerina and Pyrgo, Quinqueloculina, Textularia, Pyrgo, Ammonia, Elphidium, Pseudononion, Peneroplis, Bolivina and Poroeponides, occurred more frequently. Less frequently been described Amphistegina, Archaias, Bigenerina, Cibicides, Cassidulina, Amphicorina, Cornuspira, Paterina, Hopkunsina, Oolina, Uvigerina, Fusenkoina, Nonionella, Amphisorus, Wiesrella, Reussella, Reophax, Nodosaria, Marginulina and Cyclogyra. Six genera of ostracods were also identified: Puriana variabilis / P. convoluted?, Loxoconcha sp, Bairdiidae, Xestoleberis sp, Hemicytheridae and Ruggiericythere sp. Groups of organisms found in the studied shelf presented chemical composition of Ca, C, O, Na, Cl, Al, Mg, and Si. The proportions of chemical elements may vary according to the type of biogenic sediment, with the highest values identified as Ca, C, Cl, Na and O. The absolute dating by carbon 14 method indicated sediments of different colors (light and dark), correspond to a single age from 3000 to 6000 years BP, related to the Quaternary. These data intend to complement information about biogenic sediments in the Brazilian continental shelf, especially in the Northeast, where there is a lack of such studies.

Foraminíferos, ostracodes e microfauna associada da plataforma continental equatorial norte-rio-grandense, NE Brasil: área Porto do Mangue a Galinhos

This study was conducted in the adjacent Brazilian equatorial inner shelf to Rio Grande do Norte, between the region of Porto do Mangue and Galinhos. The main objective is the characterization of biogenic sediments, especially foraminifera and ostracod collected on the surface of the seafloor. The methodology involved standard procedures including literature, surveys, processing of samples in the laboratory and identification of foraminifera and ostracods by genera or species under stereo microscopy and scanning electron microscopy (SEM). Multivariate statistical analyzes and study of ecological indexes were also applied to the study of foraminifera. Three transects, from inner shelf to slope were sampled: profile 01 (east, near Galos), profile 02 (center, near the city of Macau) and profile 03 (west, near Ponta do Mel). Results indicated the predominance of benthic foraminifera and little plankton occurrence. Benthic foraminifera genera observed in abundance were Quinqueloculina, Textularia, Globigerina and Pyrgo, Quinqueloculina, Textularia, Pyrgo, Ammonia, Elphidium, Pseudononion, Peneroplis, Bolivina and Poroeponides, occurred more frequently. Less frequently been described Amphistegina, Archaias, Bigenerina, Cibicides, Cassidulina, Amphicorina, Cornuspira, Paterina, Hopkunsina, Oolina, Uvigerina, Fusenkoina, Nonionella, Amphisorus, Wiesrella, Reussella, Reophax, Nodosaria, Marginulina and Cyclogyra. Six genera of ostracods were also identified: Puriana variabilis / P. convoluted?, Loxoconcha sp, Bairdiidae, Xestoleberis sp, Hemicytheridae and Ruggiericythere sp. Groups of organisms found in the studied shelf presented chemical composition of Ca, C, O, Na, Cl, Al, Mg, and Si. The proportions of chemical elements may vary according to the type of biogenic sediment, with the highest values identified as Ca, C, Cl, Na and O. The absolute dating by carbon 14 method indicated sediments of different colors (light and dark), correspond to a single age from 3000 to 6000 years BP, related to the Quaternary. These data intend to complement information about biogenic sediments in the Brazilian continental shelf, especially in the Northeast, where there is a lack of such studies.

Prevalência, fatores associados e efeitos da violência doméstica na mobilidade em idosos: evidências do estudo imias (international mobility in aging study) sob a perspectiva epidemiológica do curso da vida

A capacidade de mover-se com independência e segurança é fundamental para a execução das atividades de vida diária e manutenção da qualidade de vida do indivíduo. Diversos fatores, dentre eles o envelhecimento podem contribuir para seu declínio. Estudos têm demonstrado associação entre experiências de violência doméstica (VD) e diversos problemas de saúde física e mental. Até o momento, não há estudos que tenham avaliado a associação entre experiências de VD no curso de vida e limitações de mobilidade na senescência. OBJETIVOS: estimar a prevalência da VD (física e psicológica) em idosos, e avaliar o impacto da VD no curso de vida na limitação de mobilidade. MATERIAIS E MÉTODO: Estudo observacional analítico a partir da primeira coleta de dados do estudo longitudinal International Mobility in Aging Study (IMIAS). Idosos (n = 1995) de ambos os sexos entre 65 e 74 anos de cinco localidades distintas (Kingston e Saint-Hyacinthe, Canadá; Tirana, Albânia; Maniazales, Colômbia; e Natal, Brasil) participaram do estudo. Dados sobre variáveis sociodemográficas, econômicas, condições de saúde e experiências de VD (física e psicológica) durante o curso de vida foram coletados. A limitação de mobilidade na senescência foi avaliada pelo Short Physical Performance Battery (SPPB) e pela dificuldade de andar 400 metros e/ou subir um lance de escadas. As prevalências foram avaliadas mediante frequências absolutas e relativas das exposições à VD, limitação de mobilidade e co-variáveis. Diferenças de gênero, bem como entre cidades foram analisadas utilizando o teste de qui-quadrado. Associação entre exposição à VD e limitação de mobilidade foi avaliada utilizando a regressão logística binária multivariada, ajustando pelas co-variáveis. Análise de mediação foram utilizadas, para avaliar possíveis caminhos entre a exposição à VD no curso de vida e a limitação de mobilidade. RESULTADOS: A violência física foi rara, com valores entre 0,63 e 0,85%. Relatos de violência psicológica variaram entre 3,2% e 23,5% (homens) e de 9% para 26% (mulheres). Mulheres experimentaram mais violência do que os homens em Saint-Hyacinthe (homens: 3,2% vs mulheres: 14%, p <0,001), Tirana (homens: 4,3% vs mulheres: 10,3%, p = 0,017), em Manizales (homens: 8,3 % vs mulheres: 18,3%, p = 0,004) e Natal (homens: 11,1% vs mulheres: 26%, p = 0,002). Em geral, o baixo suporte social pelo parceiro foi associado com a VD. Estar trabalhando foi associado a vitimização entre os homens, enquanto o oposto foi verdade para as mulheres. Arranjos de vida Multi-familiares e baixo suporte pelos parceiros, filhos e família foram associados com a VD. Baixo suporte social foi da maior importância para as mulheres do que os homens. A VD física foi associada tanto com o SPPB < 8 (OR 1,623 95%IC 1,161-2,269) como com a dificuldade para andar 400 metros e/ou subir um lance de escadas (OR 1,394 95%IC 1,063-1,829). A limitação de mobilidade decorrente da violência física no curso de vida pelo parceiro íntimo foi mediada pelas condições crônicas (efeito 25,56% 95%IC 0,036-0,277) e depressão (efeito 33,05% 95%IC 0,087-0,333). No caso da violência física por outros familiares, a limitação de mobilidade foi mediada pelas condições crônicas (efeito 20,85% 95%IC 0,022-0,202), não adesão à prática de atividades físicas (efeito 34,14% 95%IC 0,076-0,351) e depressão (efeito 44,40% 95%IC 0,144-0,315). CONCLUSÕES: A violência doméstica no curso de vida é uma realidade, que pode acarretar consequências que favorecem a limitação de mobilidade em idosos. São necessárias políticas públicas que combatam efetivamente a violência doméstica, garantindo um envelhecimento mais digno e independente funcionalmente.

Hepatite C crônica em serviço de referência no nordeste do Brasil: um estudo retrospectivo de dezoito anos de acompanhamento

Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.