Avaliação do retinol em parturientes com diabetes mellitus gestacional no pós parto imediato

Micronutrient deficiencies affect individuals mainly in developing countries, where vitamin A deficiency is a public health problem worldwide more worrying, especially in groups with increased physiological needs such as children and women of reproductive age. Vitamin A is supplied to the body through diet and has an important role in the visual process, cell differentiation, maintenance of epithelial tissue, reproductive and resistance to infection. The literature has demonstrated the relationship between vitamin A and diabetes, including gestational, leading to a risk to both mother and child. Gestational diabetes is any decrease in glucose tolerance of variable magnitude diagnosed each the first time during pregnancy, and may or may not persist after delivery. Insulin resistance during pregnancy is associated with placental hormones, as well as excess fat. Studies have shown that retinol transport protein produced in adipose tissue in high concentrations, this would be associated with resistance by interfering with insulin signaling. Therefore, this study aimed to evaluate the concentration of retinol in serum and colostrum from healthy and diabetic mothers in the immediate postpartum period. One hundred and nine parturient women were recruited, representing seventy-three healthy and thirty-six diabetic. Retinol was extracted and subsequently analyzed by High Performance Liquid Chromatography. Among the results highlights the mothers with gestational diabetes were older than mothers healthy, had more children and a higher prevalence of cases of cesarean section. Fetal macrosomia was present in 1.4% of healthy parturient women and in 22.2% of diabetic mothers. The maternal serum retinol showed an average of 39.7 ± 12.5 mg/dL for healthy parturients 35.12 ± 15 mg/dL for diabetic and showed no statistical difference. It was observed that in the group of diabetic had 17% vitamin A deficiency, whereas in the healthy group, only 4% of the women were deficentes. Colostrum, the concentration of retinol in healthy was 131.3 ± 56.2 mg/dL and 125.3 ± 41.9 mg/dL in diabetic did not differ statistically. This concentration of retinol found in colostrum provides approximately 656.5 mg/day for infants born to healthy mothers and 626.5 mg/day for infants of diabetic mothers, based on a daily consumption of 500 mL of breast milk and need Vitamin A 400 mg/day, thus reaching the requirement of the infant. The diabetic mothers showed significant risk factors and complications related to gestational diabetes. Although no 11 difference was found in serum retinol concentration and colostrum among women with and without gestational diabetes, the individual analysis shows that parturients women with diabetes are 4.9 times more likely to develop vitamin A deficiency than healthy parturients. However, the supply of vitamin A to the newborn was not committed in the presence of gestational diabetes

Distribuição regional da ventilação pulmonar em indivíduos com insuficiência cardíaca crônica após serem submetidos a um programa de treinamento da musculatura inspiratória e sua correlação com dados funcionais

Introduction: Chagas Disease is a serious public health problem, with 5 million infected individuals in Brazil. Of these, approximately 30% develop chronic Chagas cardiomyopathy (CCC), where the main symptoms are fatigue and dyspnea. Objective: To correlate maximal exercise capacity with pulmonary function, inspiratory muscle strength and quality of life in patients with CCC. Methodology: Twelve individuals suffering from CCC were evaluated (7 men), with a mean age of 54.91± 8.60 years and the following inclusion criteria: functional class II and III according to the New York Heart Association (NYHA); left ventricle ejection fraction below 45%; clinical stability (> 3 months); symptom duration > 1 year, body mass index (BMI) < 35Kg/m2 and non-smokers or ex-smokers with a history of smoking <10 packs/day. All subjects were submitted to spirometry, manometer testing, maximal cardiopulmonary exercise testing (CPX) and a quality of life questionnaire (Minnesota). Results: A negative correlation was observed between VO2máx and MLHFQ scores (r=-0.626; p=0.03) and a positive association with MIP (r=0.713; p=0.009). Positive correlations were also recorded between MIP and spirometric variables [FEV1(r=0.825;p=0.001 ), FVC(r=0.66;p=0.01 and FEF25-75%(r=0.639;p=0.02)]. Conclusion: The present study demonstrated that in patients with CCC: VO2MAX is directly related to inspiratory muscle strength and quality of life, while deteriorating lung function is directly associated with respiratory muscle weakness

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

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

Caracterização de processos morfodinâmicos e hidrodinâmicos do cinturão lacustre meridional da Reserva Biológica do Lago Pirituba, Amapá

The Amapá State has an important natural lake system, known as The Amapá Lakes Region . Most of these lakes are on the southern part of Amapá s coastal plain, which has 300 km of extension and it s composed by holocenic sediments deposited at the northern part of Amazon River to the Orange Cape located on the northern part of Amapá state. This region is under influence of the Amazon River discharge which is the largest liquid discharge of about 209.000 m³/s and biggest sediment budget discharged on the ocean in the order 6.108 ton per day. The climate is influenced by the Intertropical Convergence Zone and El Niño Southern Oscillation which act mainly under precipitation, nebulosity, local rivers and tidal hidrology. In this region lake belts are Ocidental, Oriental and Meridional Lake Belts. The last one is formed by the by the lakes Comprido de Cima, Botos, Bacia, Lodão, Ventos, Mutuco and Comprido de Baixo. These lakes are the closest to the Araguari River and are characterized by pelitic sedimentation associated with fluvial and estuarine flood plains under influence of tides. The lakes are interconnected, suffer influence of flood pulses from the Tartarugal, Tartarugalzinho and Araguari rivers and the hydrodynamic and morphodynamic know edge is poor. Volume and area reduction, natural eutrophication, anthophic influence, hidrodynamic alterations, morphological changes and are factors which can contribute to the closing of such lakes on the Meridional Lake Belt. This belt is inside the boundaries of the Biological Reserve of Piratuba Lake, created in 1980 for integral protection. Due to the fragility of the environment together with the poor knowledge of the system and with the study area relevancy it is necessary to know the hydrodynamic and geoenvironmental processes. This work aims the characterization of morphodynamic and hydrodynamic processes in order to understand the geoambiental context of the Meridional Lake Belt, from the Comprido de Baixo Lake to the dos Ventos Lake, including the Tabaco Igarape. Methodology was based on the hydrodynamic data acquisition: liquid discharge (acoustic method), tides, bathymetry and the interpretation of multitemporal remote sensing images, integrated in a Geographic Information System (GIS). By this method charts of the medium liquid discharges of Lake Mutuco and Tabacco Igarape the maximum velocity of flow were estimated in: 1.1 m/s, 1.6 m/s and 1.6 m/s (rainy season) and 0.6 m/s, 0.6 m/s and 0.7 m/s (dry period), the maximum flow in: 289 m³/s, 297 m³/s and 379 m³/s (rainy season) and 41 m³/s , 79 m³/s and 105 m³/s (dry period), respectively. From the interpretation of multitemporal satellite images, maps were developed together with the analysis of the lakes and Tobaco Igarape evolution from 1972 to 2008, and were classified according to the degree of balance in the area: stable areas, eutrophic areas, areas of gain, and eroded areas. Troughout analysis of the balance of areas, it was possible to quantify the volume of lake areas occupied by aquatic macrophytes. The study sought to understand the hydrodynamic and morphodynamic processes occurring in the region, contributing to the elucidation of the processes which cause and/or favor geoenvironmental changes in the region; all such information is fundamental to making the management of the area and further definition of parameters for environmental monitoring and contributing to the development of the management plan of the Biological Reserve of Lake Piratuba. The work activities is a part of the Project "Integration of Geological, geophysical and geochemical data to Paleogeographic rebuilding of Amazon Coast, from the Neogene to the Recent