Índices de obesidade central e fatores de risco cardiovascular na síndrome dos ovários policísticos

Fundamento: A obesidade abdominal apresenta elevada prevalência em mulheres com síndrome dos ovários policísticos (SOP) e está associada a um aumento do risco cardiovascular. Objetivo: Verificar a acurácia da circunferência da cintura (CC), da relação cintura-quadril (RCQ), da relação cinturaestatura (RCEST) e do índice de conicidade (índice C), no que se refere à detecção de fatores de risco cardiovascular (FRCV) em mulheres com SOP. Métodos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 ± 5 anos) com diagnóstico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicerídeos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia após teste oral de tolerância à glicose (TOTG) e a pressão arterial (PA) foram avaliados em todas as pacientes, além das variáveis antropométricas. Resultados: A relação cintura-estatura foi o marcador que apresentou correlações positivas significativas com o maior número de FRCV (PA, TG e glicemia após TOTG), destacando-se ainda a correlação negativa com HDL-C. Todos os marcadores antropométricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correlação positiva também com TG. No tocante à acurácia para detecção de FRCV, os indicadores antropométricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Conclusão: A RCEST demonstrou ser o indicador antropométrico com a melhor acurácia para a predição de FRCV. Nesse sentido, propõe-se a inclusão desse parâmetro de fácil mensuração na avaliação clínica para o rastreamento de mulheres com SOP e FRCV----------------------ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. Objective: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. Methods: The present transversal study allocated 102 women (26.5 ± 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. Results: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. Conclusion: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF

Prevalência e fatores associados da síndrome de Osgood-Schlatter em uma amostra populacional de adolescentes brasileiros

Osgood-Schlatter (O-S) syndrome, a pathology of the musculoskeletal system, exhibits high incidence in adolescence, a phase of accelerated bone growth. Detection of physiopathological mechanisms that may cause disorders and dysfunctions in bone growth must be taken into account when planning physical activities, in order to promote normal physiological growth patterns. The aim of this epidemiological investigation was to identify and analyze the relationships between sociodemographic, anthropometric and clinical aspects and O-S. A cross-sectional design was used, with a representative sample of 956 subjects: 474 (49.6%) males and 482 (50.4%) females. Age range varied between 12 and 15 years (mean = 13.7±1.04). We used a battery of tests, previously applied in a pilot study, which met the aims of the investigation. Descriptive statistics (frequency, mean and standard deviation) were used and the odds ratio was calculated from bivariate and multivariate logistic regression (p<0.05). A prevalence of 9.8% was found (n = 94 cases): 11% males and 8.3% females. Hierarchized multivariate analysis showed a significant association between regular physical activities (OR= 1.94; CI 95%, 1.22-3.10) and shortening of the rectus femoris muscle (OR= 7.15; CI 95%, 2.86-17.86). The results may serve as a basis for therapeutic and prophylactic measures, in addition to increasing our knowledge of this syndrome in Brazilian adolescents. This investigation used a multidisciplinary approach, involving elements of anatomy, nutrition, physical education and physical therapy to elucidate the object under study related to Osgood-Schlatter syndrome

Análise das emissões atmosféricas por veículos automotores em Natal-RN

The fast urban occupation of Brazil, mainly from the last decade of 50, a sensible degradation of the quality of the air generated mainly for the activities was verified human beings associates to industrialization. From the past years, the situation has gotten worst in function of the increment of the fleet of vehicles in circulation in the great cities. Being these, in the city of Natal-RN, the ones that offer the biggest contributions to the atmospheric pollution. For atmospheric air to be a finite natural resources, indispensable and essential to the maintenance of the life in the land, is necessary to the implementation of action to improve its quality and to protect the health of the population. With the objective to study relative aspects to the characteristics of vehicles in use, the present study it searchs to analyze the levels of emissions of gases generated for vehicles converted bi-fuels into the modalities: natural gas (GNV), gasoline and alcohol, inspected for ends of register and together licensing to the State Department of Transit. One used the data gotten from inspections carried through for the company System Specialized in Inspection To propagate, in the city of the Natal-RN, capital of the State of Rio Grande do Norte, between 14 of November of 2003 and 30 of December of 2004. The analyzed parameters are established in the resolution nº 07/93 CONAMA. Of a total of 1.517 inspected vehicles, a average of 15,2% of failed was gotten, or either, that they emit levels of pollution above of the limits established for the legislation, below of the national average that is of 20,0%. The analysis of the data discloses that 7.3% of the fleet are converted the GNV; the growth of vehicles converted the GNV into the city is gradual, with a average of increment in last the 4 years of 23,3%; it has a vehicle predominance that has as combustible original to the gasoline (88,2%); the inspected fleet has average age of 8 years of use, considered young for the Brazilian standards, except for the moved one to the alcohol (average of use of 15 years). Moreover, the type of fuel is not the main parameter to define the indices of emissions; the age of the fleet is the parameter most important when emission is analyzed to propagate; the gas that more generates failed in the inspections is the corrected carbon monoxide; the vehicles generate higher indices of emissions in idling for all the fuels; the presence of the catalyser was not reflected, as it expected, in the reduction of emissions of gases toxic, however when analyzed according to year of manufacture, it was observed that for the vehicles manufactured between 1997 and 2004, reduction of 46,0% in the failed of the vehicles equipped with catalyser was gotten. In conclusion, the fleet of the studied sample, in average terms, takes care of to the requirements of Resolution CONAMA nº 07/93. The results gotten for the present study can subsidize action of public administrations that aim at to the improvement and the maintenance of the quality of air in the city of Natal-RN, as, for example, to implant a net of monitoramento of the quality of air

Se inicia oração com pronome clítico? Atitudes linguísticas, na escola, em relação aos padrões brasileiros de colocação pronominal

Focusing on the empirical assessment issue, proposed by Language change theory (cf. cf. WEINREICH; LABOV; HERZOG, 2006; LABOV, [1972] 2008), this research assists to clarifying Portuguese teacher s attitudes in Natal- RN, regarding (a) to proclisis in three specific contexts: in the beginning of a simple/compound sentence (V1), after the subjects (SV), and proclisis after the secondary verb in complex verbal structures (V1V2); (b) to students who use such patterns in usage. Specific contexts were gathered thanks to their representing of the standard variety, as many studies have proven (Martins, 2012; Schei, 2003; Biazzoli, 2010, 2012). The research aims at: (i) verifying by means of a classroom assessment test, whether Portuguese teachers correct proclisis on referred contexts; (ii) identifying, via attitudinal tests what actions teachers take regarding to the usage of standards above mentioned, as well as students as users of those. Twenty Portuguese teachers, picked at random out of different of public schools in Natal-RN, responded to a classroom assessment test in addition to other two attitudinal ones. Results achieved point to a recurring high proclisis correction index of 50% in simple/compound sentences, even though such variety has been implemented to pronominal usage standards in Brazilian Portuguese. This setting of usage was generally assessed negatively, having no commonality between this assessment and the neutral one used by students. Unlike previous setting, the proclisis after subject did not receive any correction of the twenty teachers, what proves coherence with the positive evaluation both the varieties and the students attained. As for the second verb of complex verbal structures, proclisis correction went negative on presenting single results, despite their proximity, with correction indexes of 20% (infinite structures), 10% (present progressive structures) and 25% (participle structures). The assessment on these contexts of proclisis ranged between positive and neutral, also valid for the one students utilized. It means that proclisis in the beginning of simple/compound sentences are yet seemingly spotted in writing school scenario, much likely due to the negative evaluation, opposite to students . Later to subjects and earlier to secondary verbs in structures, proclisis appears to be acknowledged in writing school scenarios, which reflects on teachers assessment as compared to students who use proclisis in these contexts; being in general either positive or neutral

A institucionalização do programa nacional de Educação Fiscal nos estados brasileiros e Distrito Federal

The research seeks to comprehend the development of the promoting and structuring Fiscal Education actions in the states and in the federal district, attending to the guideline and the administrative requirements established by the Escola de Administração Fazendária (ESAF) to implement the Programa Nacional de Educação Fiscal (PNEF). The study has an exploratory content with a qualitative approach. The informations were collect with a questionnaire applied through the Google-docs by the managers of the program in any federated unit. Were founded several results, as the fragility of the program in the budgeting and financial area, the low frequency of the Grupo de Educação Estadual (GEFE) in regular meetings, the absence to monitor undertaken actions and the absence of interlocution between the GEFE and the forums of national discussions, especially the Conselho Nacional de Política Fazendária (CONFAZ). Despite the fragilities, the work shows the occurrence of some actions to disseminate Fiscal Education in schools and universities, the establishment of partnerships and the participation of the GEFE‟s in the national meetings. With the study, it was possible to conclude that in spite of the weaknesses found in its structure, the PNEF s institutionalized in the states and in the federal district, observing the differences between the federal units in relation to the ripening of the program. Despite the difficulties evidenced, it appears that they are capable of resolution, as far as it recognizes the importance of the Program for the promotion of a culture of active citizenship in the society and it will gives better conditions of implementation

A relação entre os determinantes sociais em saúde e os investimentos setoriais e a mortalidade infantil em municípios brasileiros com mais de 80 mil habitantes

Investments in health have controversial influence on results of the health of populations, besides being subject rarely explored in literature. Moreover, from the 1970s, the social determinants of health have been consolidated in the disease process as multifactorial factors (social, economic, cultural, etc.) that directly or indirectly influence the occurrence of health problems of populations, as well as mortality rates. This study aimed to evaluate the influence of these investments and the social determinants of health on infant mortality and its neonatal and post-neonatal mortality. This is an ecological study, in which the sample was composed of Brazilians cities with over 80,000 inhabitants, avoiding fluctuations in mortality rates for common small populations, and ensure greater coverage of information systems on mortality and births Brazilians and, therefore, increase data consistency. To isolate the effect of investments in health, we used multiple linear regression. The socioeconomic indicators (p <0.001, p = 0.004, p <0.001), the inequality index (p <0.001, p = 0.001, p = 0.006) and coverage of prenatal visits (p <0.001, p <0.001; p = 0.005) were associated with infant mortality rate total, neonatal and post-neonatal, and the Gross Domestic Product per capita only influenced the overall infant mortality rate and neonatal (p=0.022; 0.045). Investments in health, in this model, lost statistical significance, showing no correlation with mortality rates among children under one year. We conclude that the social determinants of health has an influence on the variation in mortality rates of Brazilian cities, however the same was not observed for indicators of health investment

Índices de obesidade central e fatores de risco cardiovascular na síndrome dos ovários policísticos

Fundamento: A obesidade abdominal apresenta elevada prevalência em mulheres com síndrome dos ovários policísticos (SOP) e está associada a um aumento do risco cardiovascular. Objetivo: Verificar a acurácia da circunferência da cintura (CC), da relação cintura-quadril (RCQ), da relação cinturaestatura (RCEST) e do índice de conicidade (índice C), no que se refere à detecção de fatores de risco cardiovascular (FRCV) em mulheres com SOP. Métodos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 ± 5 anos) com diagnóstico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicerídeos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia após teste oral de tolerância à glicose (TOTG) e a pressão arterial (PA) foram avaliados em todas as pacientes, além das variáveis antropométricas. Resultados: A relação cintura-estatura foi o marcador que apresentou correlações positivas significativas com o maior número de FRCV (PA, TG e glicemia após TOTG), destacando-se ainda a correlação negativa com HDL-C. Todos os marcadores antropométricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correlação positiva também com TG. No tocante à acurácia para detecção de FRCV, os indicadores antropométricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Conclusão: A RCEST demonstrou ser o indicador antropométrico com a melhor acurácia para a predição de FRCV. Nesse sentido, propõe-se a inclusão desse parâmetro de fácil mensuração na avaliação clínica para o rastreamento de mulheres com SOP e FRCV----------------------ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. Objective: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. Methods: The present transversal study allocated 102 women (26.5 ± 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. Results: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. Conclusion: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF

Inclusão de alunos com deficiência no ensino superior: ações no contexto da Universidade Federal do Rio Grande do Norte

Aborda a educação inclusiva no âmbito da Universidade Federal do Rio Grande do Norte (UFRN), com vistas às ações estruturantes para alunos com deficiência, no período de 2001 a 2007. O seu objetivo principal é situar as ações que foram desenvolvidas por essa universidade e, ainda, as que estão em andamento e que privilegiam o acesso e a qualidade do ensino, particularmente, a esses alunos. Este estudo caracteriza-se também por uma abordagem qualitativa e exploratória, por meio do qual empregou-se a análise documental. Os primeiros resultados apontam para ações de diversas naturezas, tais como: criação de uma comissão para elaborar diretrizes gerais e propor ações acadêmicas para a educação especial; realização de Seminários de Educação Inclusiva; criação do ‘espaço inclusivo” na biblioteca central; adequação e construção de ambientes acessíveis; aprovação de projeto no Programa Incluir, dentre outras. Portanto, a partir dessas ações a UFRN demonstra ser fiel aos princípios que norteiam a construção de um sistema educacional democrático e inclusivo, ao buscar garantir a qualidade da oferta e do acesso aos seus cursos, respeitando a diversidade de todos os que nela ingressam

A mãe nas ações de acompanhamento do crescimento e desenvolvimento infantil

ARAÚJO, Marluce Oliveira de; ENDERS, Bertha Cruz. A mãe nas ações de acompanhamento do crescimento e desenvolvimento infantil. Revista Baiana de enfermagem, Salvador, v.19,n.1/2/3,p.93-103, jan./dez. 2004, jann./dez.2005.

Análise comparativa e teste empírico da validade dos modelos CAPM tradicional e condicional: o caso das ações da Petrobrás

ALVES, Janaína da Silva. Análise comparativa e teste empírico da validade dos modelos CAPM tradicional e condicional: o caso das ações da Petrobrás. Revista Ciências Administrativas, Fotaleza, v. 13, n. 1, p.147-157, ago. 2007.

Diagnóstico, estadiamento e tratamento cirúrgico do adenocarcinoma de pâncreas

O adenocarcinoma pancreático é um dos tumores sólidos de pior prognóstico, sendo o tratamento cirúrgico o único potencialmente curativo. Na grande maioria dos pacientes o tumor é diagnosticado em fase avançada, comumente na presença de doença metastática. A introdução de modernos métodos diagnósticos associados ao aperfeiçoamento dos já existentes tem gerado controvérsia quanto à melhor maneira de se estabelecer o diagnóstico e estadiamento do tumor. Da mesma forma, o papel da cirurgia na paliação e aspectos técnicos da ressecção de lesões localizadas estão longe de alcançarem consenso na prática. Método - Revisão da literatura sobre os aspectos controversos relacionados ao tema e um algoritmo para a abordagem dos pacientes com suspeita de tumor de pâncreas são apresentados. Foram utilizados os descritores: “adenocarcinoma” e “pâncreas” para pesquisa no PubMed (www.pubmed.com) e na Bireme (www.bireme.br) e a seguir selecionadas as publicações pertinentes a cada tópico escolhido com atenção especial para metanálises, estudos clínicos controlados, revisões sitemáticas e ainda publicações de grandes centros especializados em doenças pancreáticas. Conclusões - Na suspeita de adenocarcinoma de pâncreas é possível realizar estadiamento muito próximo do real sem a necessidade da exploração cirúrgica sistemática em virtude da disponibilidade na prática de exames modernos e eficientes. Isso permite que paliação menos invasiva seja praticada na maioria dos pacientes com lesões avançadas e incuráveis. Nos em que a cura é possível, a operação deve ser realizada objetivando-se, essencialmente, a remoção da lesão com margens livres e com aceitáveis índices de morbi-mortalidade

Fatores de longevidade do programa Central do Cidadão no Rio Grande do Norte

The public management reform in Brazil, since 1995, provoked new experiences in public administration. Among the new models of public service the one-stop shopping has distinguished and was adopted at Rio Grande do Norte with the Citizens Center Program. The one-stop shopping assembles in the same place many public services with appropriate structure, enabled human resources and citizens focus processes. The goal of this research was understand how citizens focus processes help to explain Citizens Center Program s longevity. It was made a case study and the research tools were applied with Citizen Center Programs workers and citizen-users at South Unit of Citizen Center Program placed at Via Direta Mall, Natal. The major contributions for Citizen Center Program s longevity were imputed to Basic Operation Processes. The most spoken features in Citizen Center Program mentioned were quality, efficiency, celerity e personal appearance, what demonstrate concern and care with citizen-users. Worker s personal appearance, accommodation, celerity, politeness and attending capacity planning were high evaluated by citizen-users revealing the wisely choice of use a large quality concept and citizenship concept in public administration. Citizen-users also pointed the necessity of refine and enlarge the communication ways that form an essential mechanism to public citizen focus administration. Not ignoring the policy aspect citizen focus processes were noticed like especial management actions that make easier citizen s activities and public service access, what generate satisfaction to citizen-users. It s possible to conclude that the high level approving evaluation of Citizen Center Program consolidates it an especial public policy that serves citizen s necessities e create appropriate legitimacy conditions of the public policy making harder the choice of ending the policy even in more fragile moments strongly contributing for its longevity

Política de promoção da exportação : um olhar sobre a evolução da cultura de melão do Rio Grande do Norte

Some sectors in Brazil are earning notoriety in the international market, configuring itself in dynamic areas for the Country. The most typical case is the agribusiness. Rio Grande do Norte state has important role, because 90% of the output of the melon exported by Brazil is produced at Assu/Mossoró. The present work planned to verify the evolution of the culture of the melon produced at Assu/Mossoró area, from 1990 to 2003. Through descriptive research, utilizing the case study and documentary analysis of secondary data this work showed the evolution of the area reaped of melon in the pole Assu/Mossoró, the quantity produced of melon and of the value of the output of the melon between 1990 and 2003. The research verified that all of the factors studied show growth during the analyzed period, showing up the importance of the agribusiness for the region. However the analysis shows the vulnerability of the sector concerning external macroeconomics factors, such as the exchange rates. Showing the importance and/or dependence of the producers for public actions to development of the culture, that might be on areas like infrastructure, economics or taxes

O idoso e as ações sociais em prol desse grupo etário: um estudo sobre a qualidade de vida na Terceira Idade e o Projeto Saúde e Cidadania na Melhor Idade

The present study regards an applied qualitative social research (descriptive) which approaches the matter between old age and Brazilian social actions performed in social projects, aiming a qualified life and citizenship for this group of age. The objective of the study is to evaluate the contribution of Project Health and Citizenship in Old Age regarding social actions from the government directed to old age individual treatment for life quality improvement. The theoretical fundamentals of this work is, in a first moment, about old age and certain existing theories about aging process, as well as the differences and perspectives that come up throughout this process. In a second moment, some reflections are developed about the relation between life quality and leisure regarding old age, with the conception and historical rescue about these questions, as well as the evidence of leisure as an instrument of well-being feasibility and a better life quality in old age. Then the study contextualizes Brazilian government treatment to old age individuals, cutting off the Constitution of Republic from 1988 and some social attitudes taken by the government in a try to reach this specific group. Finally, the study presents the Project Health and Citizenship in Old Age , as a social program which belongs to extension activities from Federal Center of Technological Education of Rio Grande do Norte (CEFET-RN), which aims old age treatment and their citizenship and life quality. After the application of a semi-structured interview using the technique of Analysis of content for the Analysis and Discussion of Results, it is possible to conclude that the Project Health and Citizenship in Old Age fulfils its objective regarding contribution, through offered leisure activities, for old age well-being and life quality improvement. Hence, on this regard, it is possible to observe the importance and value of government actions, social projects and programs assisting old age individuals, for they are able to provide this group the opportunity to live out activities that allow their citizenship and socialization, regarding well-being and life quality improvement.

A ouvidoria pública como instrumento de controle das ações da Secretaria de Saúde do Pará

The State and Public Administration have gone through several reforms in search of a quick operation and the provision of services with quality. With the democratization of the country and the issue of the Constitution in 1988, further reform of the State and Public Administration, joined the government agenda in 1995 and included among its objectives, the principles of participation and social control. In view of this, it raises the Public Ombudsman in order to be a channel for the participation of users in the management of public affairs, social control, transparency of administrative actions, improving the quality of service and meeting the needs of the community. The aim of this study is to assess whether the Ombudsman of the State Department of Public Health to contribute to the period 2006-2008, for the improvement of specialized consulting services. The research is characterized as descriptive, qualitative approach. The collection technique used was the interview, conducted with 37 service users and two servants of the Ombudsman. The analysis was developed based on the perception of users and servers in the opinion of the Ombudsman. The most relevant results of the research showed that 41% of users search the Ombudsman because they believed that solve the problem presented. However, even with this level of public acceptance, the Ombudsman reached average index of resolvability of 53% in the period. In his role has not developed mechanisms for quality control of services, which is mentioned by 67% of users. It turned out the same fact in relation to popular participation, which is confirmed by 84% of users. For 24% of users, the problems raised were resolved, and of these, 56% believe that the Ombudsman has contributed to the positive outcome. As a result of the search results, it appears that the Ombudsman's SESPA / PA, is not fulfilling its role to ensuring the democratization of articipation in management, social control and has limited contribution to solving the problems of users and to improve the quality of services