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

Projeto em Áreas Consolidadas de Patrimônio Cultural: Propostas para a Construção de uma Metodologia de Ensino

Le thème du patrimoine culturel architectural et urbain continue d avoir une place importante dans le milieu technique et scientifique. Le concept s est élargi et aujourd hui comprend différentes procédures de projets d intervention. L importance accordée au thème amène à l inclusion de la matière de techniques rétrospectives et aux contenus qui en sont liés: conservation, restauration, restructuration et reconstruction d édifices et ensembles urbains, dans les parcours des cours d architecture et d urbanisme au Brésil établies par le Ministère de l Education Nationale (MEC) dans les années quatre-vingt-dix, postérieurement incorporés dans les directrices disciplinaires nationales. Nous partons des discussions théoriques et conceptuelles du Domaine du Patrimoine Culturel, ainsi que des principales théories pédagogiques d enseignements et d apprentissage articulées au projet. Dans ce contexte les objectifs principaux de cette thèse consistent à systématiser et à analyser les principales procédures méthodologiques contribuant pour la construction de méthodes d enseignement tournée vers des activités pratiques dans ce domaine. Pour cela, la recherche a été systématisée dans une approche à deux niveaux. En ce qui concerne le premier, basé sur des données secondaires, neuf cours d architecture et urbanisme ont étés identifiés entre institutions publiques d enseignement supérieur dont huit brésiliennes et une française, considérées représentatives en ce qui concerne les pratiques d enseignement de projet et de patrimoine culturel. Trente disciplines dédiées à la matière ont été également reconnues initialement, et postérieurement, cinq disciplines qui possèdent un emploi du temps dédié à la pratique de projet ont aussi été reconnues. Dans le deuxième cas, basée sur des données primaires, ont étés analysées les méthodologies et les stratégies d enseignement de projet basées sur les définitions des matières et des autres éléments des plans de travail avec des observations, des entrevues et des questionnaires en trois ateliers. Par rapport aux résultats nous avons constaté que toutes les écoles possèdent les contenus de la matière, mais peu d entre elles privilégient la relation du projet appliqué au patrimoine culturel. Nous avons constaté que les questions des projets dans ce contexte, même s elles sont considérées complexes, ont privilégié le listage et l analyse du site. L atelier qui intègre les fondements des théories de préservation, l histoire de l architecture et urbanisme et techniques anciennes et actuelles, est mis en valeur comme un modèle cohérent avec les propositions d intégration des connaissances théoriques et pratiques du projet appliqué à la discipline. Basé sur ces constatations il est possible de démontrer quatre étapes du projet appliqué au patrimoine culturel: 1ª) les fondements généraux qui concernent les bases théoriques sur la préservation, histoire et technique rétrospective, par exemple, l appropriation de lois et normes et la sensibilisation de l élève sur les questions de patrimoine culturel; 2ª) le contacte avec la réalité qui inclut l appropriation du problème à partir de ces acteurs, de ces échelles, de cette lecture de site et l analyse de l objet d étude; 3ª) le développement de la proposition qui inclut programmes (fonctions existantes et propositions), définitions du partit (types d intervention), conception (hypothèse et discussion) et définition de proposition; 4ª) la finalisation du projet qui consiste à développer la proposition avec sa représentation graphique et sa présentation finale. Nous concluons que le projet en Domaine du Patrimoine Culturel demande une attention spéciale et doit être présent dans les cursus considérant les principes généraux nécessaires à la formation de l élève. Le binôme projet / patrimoine signifie avoir dans le cursus universitaire les contenus et questions nécessaires les connaissances, les variables et possibilités existantes dans le projet appliqué au patrimoine culturel de façon à ce que ces connaissances soient incorporées dans l exercice de projet et n apparaissent pas comme un simple contenu théorique sans articulation avec la pratique. Naturellement ces conclusions n épuisent pas la réflexion sur la question. Nous espérons que les analyses faites contribuent à définir des méthodologies d enseignements capables d êtres vérifiées et testées dans la pratique en salle de cours, et puisse collaborer avec les nouvelles recherches surtout celles qui ont pour but des nouvelles théories pédagogiques d enseignement apprentissage du projet en Domaine du Patrimoine Culturel

Caracterização do acidente de trânsito e gravidade do trauma: um estudo em vítimas de um hospital de emergência de Natal

Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

Fatores influenciadores da participação pública na tomada de decisão ambiental :o caso do programa de combate ao caramujo gigante (Achatina fulica) em Parnamirim/RN

The aim of this work is to investigate the factors which influence people s participation in the enviromental decision, in Parnamirim, Rio Grande do Norte, from the vision of the residents of that area, approaching the Plan of Control/Eradication of the African s Huge Snail (Achatina Fulica),with the jointly work of IBAMA and Municipal Town Hall of Parnamirim .The applied methodology consists of a research (Survey kind) including 395 interviews by people who live in that county, with minimum age of 18, within an universe of 124.690 residents. The choice of the county was due to a detection (made by IBAMA technicians and reported in a Technical Report) -which showed that the dangerous Snail is already spreading in 14 of 17 districts of the county-, as well as the support given by Parnamirim s Town Hall, with the implementation of the Plan Control/Eradication of the African s Huge Snail, widely known as Day C . The research tools used in that research consists of questionnaires with all sorts of questions. The results show us that most of the residents were feeling threatened by the presence of the animal as well as having had a little participation in the fight against the animal. It also shows us that residents believe that organizations (Town Hall, IBAMA and Local Community) involved are able to solve the problem and believe that the amounts which organization are supposed to take 89,4 %, 87,6% and 80,8%, in that order. As we check the results, we notice in 95%, the variety of threaten and frequency reunion and participation level

A melancolia nas crônicas de Maria Judite de Carvalho

Maria Judite de Carvalho began his literature in 1949 in journals of Lusitanian capital. Until his death, which occurred in 1998, published more a thousand texts, most of them have never been extracted from their support original, the newspaper, making them unknown to the public today. In order to rescue of this precious material chosen as the literary corpus of Search the chronicles published in the Diário de Lisboa, periodic where the writer published the largest number of texts in the section Rectângulos da Vida, 395 (three hundred and ninety-five) chronic for five consecutive years (1968-1972). Looking at these texts I realized that she inserted into her narrative the changes occurred in the twentieth century, in Portugal, capturing the moment of breaking with traditional models and introducing new paradigms imposed by modernity. What happens in this period is an extremely fast and deep change of values and customs with which the Portuguese society faces and experiences with a certain uneasiness. Given this unstable scenario, Maria Judite expresses, through her ironic and critical narrative, the portrait of the Portuguese people and their behavior full of anguish and sorrows that are revealed through the gloom. After a thorough reading of his texts I found that this was the guiding element of juditiana writing. It is presented in the chronicles in many respects they were privileged during the five years of publications they are loneliness, abandonment, death, isolation of individuals who feel increasingly powerless in the face of changes experienced as a consequence of this state and present is melancholy all the time. This is a photograph of Maria Judite de Carvalho on Portuguese society told in her chronicles as I saw this survey.

Efeitos agudos de diferentes intensidades de pressão expiratória positiva sobre os volumes pulmonares em pacientes com acidente vascular encefálico

observar os efeitos agudos de diferentes intensidades de Pressão Expiratória Positiva (PEP) sobre a cinemática do complexo toracoabdominal de pacientes acometidos por Acidente Vascular Encefálico (AVE). Métodos: Foram selecionados 21 indivíduos com AVE e 16 indivíduos saudáveis pareados por idade sexo e IMC para grupo controle. Avaliamos função pulmonar, pressões dos músculos respiratórios e os volumes pulmonares por meio da Pletismografia Optoeletrônica durante três diferentes intensidades de PEP 10, 15 e 20 cmH2O. Resultados: o efeito da PEP no volume corrente (VC) do grupo AVE em relação ao grupo controle foi diferente. Enquanto o grupo controle aumentou o VC em relação a respiração tranquila em 343%, 395,2% e 431,8% nas PEP10, PEP15 e PEP20 cmH2O o grupo AVE aumento 186%, 218.8% e 209.5% (p < 0.0001). A PEP também influenciou de forma diferente em relação ao Tempo inspiratório com intensidades diferentes no grupo controle e AVE (p < 0.0001). No ciclo de trabalho foi observado um aumento no grupo controle nas PEP10 (p < 0.001) e PEP15 (p < 0.05) e no grupo AVE foi observada uma redução PEP20 (p < 0.01) quando comparada com a respiração tranquila. Os volumes operacionais do grupo AVE foi observado aumento do volume inspiratório final da parede torácica (Vifpt) e do Volume expiratório final da parede torácica (Vefpt) diferente do grupo controle que gerou aumento do Vifpt acompanhado de diminuição do Vefpt durante as três intensidades de PEP. Conclusão: A hiperinsuflação observada no grupo AVE demonstra que essa terapêutica deve ser utilizada com cautela especialmente nas intensidades maiores que 10 cmH2O para essa população

As estruturas sociais e econômicas do Império Romano do Ocidente e o estabelecimento do reino dos visigodos nas Galliae Aquitania e Narbonensis

In the year 376 of the Common Era, a tribe of Germanic warriors known as Tervingi , of Gothic extraction, crossed the Hister (Danube) river due south, entering the Roman Empire. They fled the Huns, a nomadic group that came plundering their way from the East. It did not take long for a conflict between the Roman imperial authorities and the refugees to begin. Peace was reached in 382 and, henceforth, the Tervingi would be officially foederati (allies) of the Romans, gaining the right to remain an autonomous tribe inside the borders of the Empire. For the next thirteen years the Tervingi warriors fought beside the Roman imperial armies in every major conflict. Nevertheless, after the death of the emperor Theodosius I in 395, their relations deteriorated severely. In theory, the Tervingi remained Roman allies; in practice, they begun to extort monies and other assets from the emperors Honorius and Arcadius. The sack of Rome by the Tervingi king Alaric in 410 was both the culmination and the point of inflection of this state of affairs. During the 410s the Tervingi warriors would fought again beside the Roman Imperial armies and be rewarded with a piece of land in the southwestern portion of the Gallic diocese. Dubbed Visigoths , they would remain trusted Roman allies throughout the next decades, consolidating their own kingdom in the process. This dissertation deals not only with the institution of the Visigothic kingdom in the southwestern portion of the Galliae but also with the social and economic conditions that hindered the Roman ability to defend their territory by themselves, hence opening opportunities for foederati like the Tervingi to carve out a piece of it for themselves.

Projeto político de formação do enfermeiro: contextos, textos, (re)construções

This research analyses politic Project for nursing education, in its articulation with economical, political and social context of 1970s and 1980s in national level and, in special, nurse formation process in FAEN/UERN space, situating it on the context of Brazilian sanitary reformation movement and participation movement. The thesis is firmed on the sense of explaining whether that movement circa the nurse formation process has been able to build necessary instruments for the transformation of biomedical formation model historically consolidated, in the perspective of conceiving another model anchored on social determination of health/illness process, with the purpose of assuring ethical and political commitment with the SUS praised by sanitary reformation. The study visualized the object considering its specificity, its concrete historical determinations and institutional as well as organizational relationships that permeate possibilities of valorizing it, analyzing it, interpreting it and rebuilding it. Its operationalization occurred in three movements, it means, bibliographical review; documents study; interviews and focal groups realized with professors of the institution. We can apprehend as main results that the nurse formation process has incorporated widely spread conceptions by the sanitary reformation movement and participation movement, assuming the commitment with transformation of health services and social reality. Nevertheless it prevails, still, amongst some professors in the same institutional space, the commitment to a predominantly technicist formation, focused on instrumental knowledge. Opinion divergence explicit diversity of conceptions circa education and, as consequence, distinct political commitments, also contradictory to formation. Thus, there is a lacuna between what is foreseen on political pedagogical project and what is rendered in FAEN/UERN, evidencing the clash related to conceptual bases of formation project. Interpretations, divergent political attitudes and resistances to the process allowed several formation ways. However, formation under new conceptual bases, find limits on the context of social politics implemented in Brazil during the 1990s, neoliberal-based, expressed on expansion and consolidation of health private system, managed by market rules, strengthening biomedical formation model. Notwithstanding, there is a favorable to its implementation, starting from the first years of 21st century, moment when Brazilian sanitary reformation reappear on health speech, as well as facing the policy of permanent education in health. This reality explicit a process of dialectical tension between instituted and institutor, anticipating the moment of scission or adaptation and return to what is already known. Despite of clashed, knowledge, accumulated experience, contribution to services, the construction of partnerships out of university space and articulation with national movement of (re)orientation of nurse formation, have been constituted as vital instruments to offer support to formation in FAEN/UERN. Still, we consider necessary the (re)visitation to FAEN/UERN politic pedagogical Project considering the existing and implemented construction, without, yet, depreciate the norther axis of the project at the reaching of its intentionality

Caracterização geomorfológica e modelagem de dados espaciais na plataforma continental rasa do RN nos limites da folha Touros

This work focuses the geomorphological characterization and spatial data modeling in the shallow continental shelf within the Folha Touros limits (SB-25-CV-II), based on bathymetric data analysis and remote sensing products interpretation. The Rio Grande do Norte state is located in northeastern Brazil and the work area is located at the transition region between the eastern and northern portions of their coast. The bathymetric surveys were conduced between march and may 2009, using a 10 meters long vessel and 0.70 meters draught, equipped with global positioning system and echo sounder (dual beam, 200KHz , 14°). The fieldwork resulted in 44 bathymetric profiles espaced 1.5 km and 30 km average length. The bathymetric data amount were 111,200 points and were navigated 1395.7 km within na area about 1,850 km2. The bathymetric data were corrected for the tide level, vessel draught and were subsequently entered into a geographic information system for further processing. Analysis of remote sensing products was carried out using Landsat 7/ETM + band 1, from november 1999. The image was used for visualization and mapping submerged features. The results showed the presence of geomorphological features within the study area. Were observed, from the analysis of local bathymetry and satellite image, seven types of geomorphological features. The channels, with two longitudinals channels (e. g. San Roque and Cioba channels) and other perpendicular to the coast (e. g. Touros, Pititinga and Barretas). Coastal reef formations (Maracajaú, Rio do Fogo and Cioba). Longitudinal waves, described in the literature as longitudinal dunes. The occurrence of a transverse dune field. Another feature observed was the oceanic reefs, an rock alignment parallel to the coast. Were identified four riscas , from north to south: risca do Liso, Gameleira, Zumbi, Pititinga (the latter being described for the first time). Finally, an oceanic terrace was observed in the deepest area of study. Image interpretation corroborated with the in situ results, enabling visualization and description for all features in the region. The results were analysed in an integrating method (using the diferent methodologies applied in this work) and it was essential to describe all features in the area. This method allowed us to evaluate which methods generated better results to describe certain features. From these results was possible to prove the existence of submerged features in the eastern shallow continental shelf of Rio Grande do Norte. In this way, the conclusions was (1) this study contributed to the provision of new information about the area in question, particularly with regard to data collection in situ depths, (2) the method of data collection and interpretation proves to be effective because, through this, it was possible to visualize and interpret the features present in the study area and (3) the interpretation and discussion of results in an integrated method, using different methodologies, can provide better results