Risco de doença cardiovascular em mulheres com história de distúrbio hipertensivo da gravidez

OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pré-eclâmpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbuminúria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 (± 4.8) while this ratio in normotensive women was of 23.5 (± 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension

O cuidador familiar de pessoa com doença de Alzheimer: história oral de vida

The aim of the present study was to understand the feelings and the difficulties faced by the family caregiver in the care of the person affected by Alzheimer`s Disease (AD). It is a descriptive, exploratory study with a qualitative approach, using the oral life history proposed by Bom Meihy as the method. Data collection was conducted in the Basic Health Unit of Candelaria, located in Natal -RN, with five collaborators that carry out the role of family caregivers for people affected by Alzheimer`s disease (AD) and are members of the Group "Caring for those who Care". Caregi vers who resided with the affected family member for at least one year were selected for the study, and as a collection tool, it was opted to use semi-structured interviews via a script of open questions, recorded by permission of the collaborators, then t ranscribed and subsequently returned to respondents for checking the contents described. To analyze the results, the collaborators narrative technique was used in conjuction with the specific literature on the subject.The discussions were organized around five themes inherent to the guiding questions, and defined as follows: the incorporation of the role of the family caregiver; life before and after assuming the role of caregiver, the caregiver`s feelings and attitudes after assuming the care, difficulti es in caring, participation of the group as a foundation for caregivers. The stories showed many difficulties in the daily routine of the caregivers, and also that their participation in the group "Caring for those who Care" helps them in maintaining the q uality of their lives. The results open possibilities for the construction of new forms of approach and care for the people who fulfill the role of family caregiver contributing to strengthening of subsidies that help them better face the daily difficulti es.This study helped shed light on the fact that being a family caregiver of a person affected by AD is a suffered, exhausting and stressful condition involving much self-denial in one´s life. The situation experienced by these collaborators is considered a public health issue, and thus highlights the urgency for governmental political -social actions, besides the programs of care and health promotion for this target group.

Estado nutricional antropométrico, perfil lipídico e consumo alimentar como fatores de risco para doença cardiovascular em adolescentes

The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents

Gritos de silêncio: na voz dos familiares cuidadores de portadores da doença de Alzheimer

This work is an investigation related to issues of those who take home care of people who suffer from Alzheimer disease (AD). Thus, it is justified by the need to acknowledge how these relatives perform this task and in which ways they do this. The study has is analytical and qualitative methodology with the use of a thematic oral history approach. The subjects of the research were nine relatives of those who suffer from AD that participate in the home care group in the Candelária neighborhood in the city of Natal in Rio Grande do Norte-Brazil. The data was collected using a semi-structured questionnaire and interview that was booked in advance and had full support from the care takers. After information collection, three thematic axles were defined. After this procedure, three analisys subcategories were also defined. The first thematic axle emphasizes the so called movement of rite of passage, when the relative becomes a care taker of a person with AD. The second category deals with the care takers strategies, either related to their own behalf or on their relative. It is possible to infer that amongst other forms of help, the care taker needs to rely on a support network, such as health services, groups composed by multiprofessionals that enable better articulation between family and collaborators. The dimension related to faith and spirituality was also observed and pointed out as an important aspect in the emotional support process for these relatives. In the third axle the perspectives of struggle, conquests of the right to health and life quality of those who suffer from AD as well as their relatives was observed. These also deal with dreams and hope

História oral de vida de pacientes transplantados renais: novos caminhos a trilhar

The therapeutic possibilities for chronic renal failure closely are related to the biological and social condition, and in this perspective the renal transplant is considered the best option, for providing quality of life better. This study it objectified to apprehend, by means of the rescue of the verbal history of life of the kidney transplant patients, the experiences lived since the diagnosis of the renal to the current with the current therapeutic modality. One is about a study of qualitative boarding, exploratory and descriptive, having the verbal history of life as a technique and method. The colony was formed with the ten first kidney transplant patients of the Rio Grande of the North, taken care of in the clinic of the Nephrology in the University Hospital Onofre Lopes-UFRN, located in the city of Christmas-RN. The net was composed for collaborators of both the sex, in the age band between 21 and 56 years of age, submitted it more than has one year to the renal transplant and that, in some cases, together of its familiar ones, they had voluntarily accepted to participate of the study. The first collaborator interviewed for this was excluded not to desire to participate the study more than. After approval for the Committee of Ethics in Search of the UFRN, we carry through the collection of data, by means of a halfstructuralized interview, recorded individually, in environment chosen for the collaborators. We carry through the transcription of the interviews and later we return to the interviewed ones so that the same ones made the conference, what it made possible in them to carry through the transcriation, after consecutive readings. We analyze the stories by means of the analysis of content of Bardin. Guiding the analysis of the stories of the collaborators, we find three axles thematic: Impact in the social relations, Impact in the social condition and Behavior front the illness and treatment. We conclude in this study that the loss of the renal function reed-echo drastically in the life of the collaborators, but that the acceptance of the pathological condition emerged, mainly for the support of the family and in the belief in God. The renal transplant was seen as the chance for a new life, however, so that they reach an improvement in the quality of life, other questions must be optimized, as the guarantee of constitutional laws, the rescue of the citizenship and offer of bigger support of the professionals of the health, family and society for the confrontation of the problems generated for the chronic renal illness and its treatments

Trajetos no labirinto: história de vida dos portadores de doenças oncológicas em uso de transfusões sanguíneas na cidade de Natal/RN

The studies paths in the maze: life story of individuals with oncological diseases into use of blood transfusion in Natal has the hemotherapy as a primordial procedure to review the relationship between users of oncological health and the due ramifications. The hemotherapy looks for supply the organic needs through blood transfusion, which acquires vital function to the ones that have cancer, because it might reestablish the functionality of the organism throughout the raising of blood components. The impact over the transfusion affects emotionally and physically the users life. Aiming to reflect on these impacts, this study tried, through narratives of lives, rescue their experience since their knowledge of the disease until the time of blood transfusion using. It s about an exploratory-descriptive study, where the qualitative approach uses the theoretical-methodological reference of the oral life history to analyze a colony consisting of five users of health diagnosed with cancer, with achievement of at least three blood transfusions, the clinic Núcleo de Hematologia e Hemoterapia - UFRN, in Natal-RN. The network, in turn, was composed by employees of both sexes, regardless of age, who voluntarily agreed to participate in the study. The data collection, with approval of the Ethics Committee in Research, Liga Norte Riograndense Contra o Cancer, on the number 001/001/2012, occurred through semi-structured interviews, recorded individually in the home context that was previously chosen by employees. The methodological procedure occurred with the transcription of the interviews and their transcreations, and analysis of reports by thematic content analysis. At the reading orientation and interpretation of the employees stories, were discussed three categories of analysis: the impact on psychological REVIEW; impact on socialization and group membership, the environment and the impact of blood transfusion on treatment. Based on the narrative of the life histories of employees, we conclude that the experiences and feelings, hope and sorrow, pain and faith, even when facing a disease like cancer, bring lots of teaching and learning to health professional that deposits humanization health and reinstate hemotherapy forms of clinical critical

Vivências compartilhadas de filhos separados pela hanseníase no RN a luz da história oral de vida

Several epidemics marked the lives of individuals and communities in all historical periods, and a prime example is leprosy, infectious disease marked by stigma, prejudice and social exclusion. In the past, the compulsory isolation of patients with leprosy caused serious social and psychological problems, resulting in the separation and the partial or total disruption of the family relationship. Children deprived of this living, removed often inhumanely, were kept and bred in preventoriums / educational establishments. This study aimed to: rescue the oral history of life of the children of leprosy patients that were built in preventorium Osvaldo Cruz, Natal, Rio Grande do Norte; develop a contextual analysis about these children; know the life trajectory of children of leprosy patients institutionalized in preventoriums / educational establishments; produce a documentary on the history of life of children of parents separated by leprosy; forming MORHAN of Rio Grande do Norte state; and implement the I Meeting of MORHAN of Rio Grande do Norte state. This is an exploratory and descriptive study, with a qualitative approach, approved by the ERC No. 024/024/2012 Liga Norteriograndense Contra o Câncer. We used the contributions of the method and technique of oral history of life as methodological reference. We interviewed 10 individuals egress from preventorium Osvaldo Cruz in Natal/RN, sons of former patients proven to be residents in the city, of both sexes, older than 18, with cognitive, intellectual and emotional conditions preserved. The analysis of the histories obtained from collaborators was performed in the light of Thematic Content Analysis. The results and discussions are presented through two articles which meet the proposed objectives. The first, called Contextual Analysis on the children of leprosy patients in preventoriums aimed to record the phenomenon of children of leprosy patients in preventorium through four contextual levels, which identified the need to broaden the debate on public policy in the field of leprosy as a way to enable more effective measures to propagate in the search for harm reduction and direct consequences resulting from stigma and marginalization around patients and their healthy children, egress from preventoriums. The second, Leprosy and the denial of history: the story of separated children , aimed to know the life trajectory of children of leprosy patients who were institutionalized in preventoriums / educational establishments. In this article, we discuss the research question through the establishment of three main themes: 1. Losses and damages: disintegration and reintegration into the family and denied childhood; 2. Unforgettable: remarkable things you do not forget; and 3. Expectancy in living new situations: in search of other paths and destinations. These thematic axis highlighted the negative implications for the lives of the subjects, arising from the separation of their parents, leprosy patients at the time of compulsory isolation; however, has also been shown that this separation was not decisive in their life histories, once they have succeeded in providing a new sense of these experiences and lead their lives with dignity and fortitude. It was concluded that these children demonstrated resilience as form of defense and fighting stigma and prejudice, being able to reinvent themselves and build new paths and destinations

Trajetória de vida de mulheres mastectomizadas integrantes de um grupo de auto ajuda a luz da História Oral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Organização espacial e processo saúde-doença no bairro Guarapes, Natal/RN

La santé et la maladie sont des objets de préoccupation dans la société. Tout au long de l'histoire de l'humanité, ils ont été traités sous différents yeux. La géographie est une façon de comprendre les processus liés à des questions de santé et de maladie, de façon privilégiée dans le but d'être une science concernées par la zone géographique où cela implique non seulement une structure de la matière, mais les personnes et les flux découlant de la relation est établie Entre la société et la nature. Un lien est établi entre l'organisation spatiale de la santé-maladie est au c ur de ce travail, avec la coupe Guarapes espace du quartier, situé dans l'ouest de la Région administrative de Natal (plus bolsão pauvreté de la ville) pour la période correspondante de la 1990 par 2004 (jalon important pour le bien et la dynamique des populations de la zone d'étude) et de réduire le temps de la recherche. Au cours de l'analyse procède à l'étude des formes de production et d'organisation de l'espace vécu. Depuis comprendre le quotidien des personnes souffrant d'un réseau de relations, motivés par les besoins et la solidarité qui génèrent des formes et des contenus qui façonnent l'aire géographique. Sur la base de revue de la littérature, la recherche empirique à travers la réalisation des feuilles de route des entretiens avec le représentant des gens du quartier (résidents, des dirigeants communautaires, des coordonnateurs pédagogiques, des infirmières et des agents de santé de la PSF). Outre les visites effectuées à l'Agence de régulation des services d'assainissement de la municipalité de Noël - ARSBAN, le Secrétariat spécial pour l'Environnement et Urbanisme - SEMURB, secrétaire du Travail et de la protection sociale SEMTAS, Secrétariat municipal de la santé - SMS. Sur la base de l'espace vécu voir que les éléments du quotidien local exercer une forte influence sur la santé et La maladie de la population étudiée, avec un accent sur les problèmes découlant de chômage, sous-emploi, l'insécurité et un manque d'assiduité de certains responsables de l'USF - Guarapes. La production et l'organisation de la région convergent à l'apparition de maisons, les rues et les petits commerces non équipés de l'infrastructure de base dédiée à la prise en charge des personnes favorables à l'occupation désordonnée et non planifiée pour plusieurs zones du district, ainsi que l'apparition De vecteurs transmetteurs de maladies

Consanguinidade e efeito fundador da mutação G377S da doença de Gaucher em população de Tabuleiro do Norte – Ceará – Brasil

Gaucher’s disease (GD) is caused by a β-glucocerebrosidase deficiency, leading to the accumulation of glucocerebroside in the reticuloendothelial system. The prevalence of GD in Tabuleiro do Norte (TN) (1:4000) is the highest in Brazil. The purpose of this study was to present evidence of consanguinity and founder effect for the G377S mutation (c.1246G>A) among GD patients in TN based on enzyme, molecular and genealogical studies. Between March 2009 and December 2010, 131 subjects at risk for GD (GC in dried blood ≤2.19 nmol/h/ml) and 5 confirmed GD patients from the same community were submitted for molecular analysis to characterize the genetic profile of the population. Based on the enzymatic and molecular analysis, the subjects were classified into three categories: affected (n=5), carrier (n=20) and non-carrier (n=111). All carriers were (G377S/wt). Affected subjects were homozygous (G377S/G377S). The identification of a single mutation in carriers and homozygotes from different generations, the history of the community and the genealogy study suggest that the high prevalence of GD in this population may be due to a combination of consanguinity and founder effect for the G377S mutation

Trajetória de pessoas com AIDS em situação de vulnerabilidade social: à luz da história oral de vida

The epidemic caused by HIV presents a global, dynamic and unstable phenomenon, which depends on the individual and collective human behavior. Efforts to deconstruct the stigmatized image caused by infection of AIDS are still often associated with adoption of socially unacceptable behavior to be a circumscribed the susceptibilities of vulnerable individuals and communities to infection, illness and death by HIV. This study aimed to: narrate the trajectory of life of people with AIDS more vulnerable enrolled in the Municipal Social Assistance Parnamirim / RN. It is a study of qualitative, exploratory and descriptive approach, taking oral history of life as technical and methodological framework. The colony consisted of 186 people with AIDS. The network was comprised of 13 employees of both sexes, aged between 19 and 62 years old with positive diagnosis and agreed to voluntarily participate. After approval by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), in the opinion No. 719,926 CAAE: 30408114.5.0000.5537 on 6 June 2014 data were collected from August to September 2014. The employees signed the Informed Consent and Informed and letter of assignment. Held transcribing the interviews and later returned to respondents to retest, ie so that they confer what allowed us to carry out transcreation after consecutive readings. The reports were analyzed through Bardin content analysis. Guiding the analysis of the accounts of employees, we find three themes: Prejudice and discrimination in living with AIDS; Reacting to the diagnosis and the accession process to antiretroviral treatment; and religious coping in people with AIDS. It can be concluded in this study, that employees have shown great emotional impact after positive diagnosis for HIV / AIDS, especially with regard to social life, the family ties, work and above all to the prejudice of society. Treatment with antiretroviral drugs was seen as a motivation to regain dreams and plans for a future once uncertain, and even if it is not a cure therapy, provided the employees improved quality of life.

Trajetória de pessoas com AIDS em situação de vulnerabilidade social: à luz da história oral de vida

The epidemic caused by HIV presents a global, dynamic and unstable phenomenon, which depends on the individual and collective human behavior. Efforts to deconstruct the stigmatized image caused by infection of AIDS are still often associated with adoption of socially unacceptable behavior to be a circumscribed the susceptibilities of vulnerable individuals and communities to infection, illness and death by HIV. This study aimed to: narrate the trajectory of life of people with AIDS more vulnerable enrolled in the Municipal Social Assistance Parnamirim / RN. It is a study of qualitative, exploratory and descriptive approach, taking oral history of life as technical and methodological framework. The colony consisted of 186 people with AIDS. The network was comprised of 13 employees of both sexes, aged between 19 and 62 years old with positive diagnosis and agreed to voluntarily participate. After approval by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), in the opinion No. 719,926 CAAE: 30408114.5.0000.5537 on 6 June 2014 data were collected from August to September 2014. The employees signed the Informed Consent and Informed and letter of assignment. Held transcribing the interviews and later returned to respondents to retest, ie so that they confer what allowed us to carry out transcreation after consecutive readings. The reports were analyzed through Bardin content analysis. Guiding the analysis of the accounts of employees, we find three themes: Prejudice and discrimination in living with AIDS; Reacting to the diagnosis and the accession process to antiretroviral treatment; and religious coping in people with AIDS. It can be concluded in this study, that employees have shown great emotional impact after positive diagnosis for HIV / AIDS, especially with regard to social life, the family ties, work and above all to the prejudice of society. Treatment with antiretroviral drugs was seen as a motivation to regain dreams and plans for a future once uncertain, and even if it is not a cure therapy, provided the employees improved quality of life.