Ações educativas com portadores de diabetes Mellitus através da educação popular em saúde

Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care

O significado da educação popular na formação dos trabalhadores de saúde: estudo com base em experiências de extensão universitária

A Saúde do Trabalhador (ST) refere-se a um campo do saber que compreende as relações entre o trabalho e o processo saúde/doença de modo articulado a um corpo de práticas teóricas interdisciplinares. No contexto das possibilidades para se efetivar a ST na amplitude que exige este conceito, diferentes iniciativas de Educação Popular em Saúde se articulam com demandas do Controle Social em Saúde, permitindo novas abordagens para configurar a formação crítica e ativa de trabalhadores de saúde e movimentos sociais no mosaico das políticas de ST. Nessa direção, os projetos de extensão universitária orientados pela Educação Popular têm desvelado caminhos metodológicos e novas possibilidades teóricas de pensar a Atenção à Saúde do Trabalhador, de forma articulada com a necessidade de re-significar o processo de formação dos profissionais da saúde, com ênfase no cuidado integral na atenção à saúde. O estudo promovido por ocasião do Doutoramento em Ciências da Saúde propiciou a avaliação do impacto e da potência das ações destes projetos na reorientação do cuidado guiado pela educação popular no campo da saúde do trabalhador. A sistematização foi utilizada como principal estratégia metodológica para a produção dos dados analisados, além de estratégias de pesquisa qualitativa como constituintes da fase exploratória do estudo, tendo como técnica central, nesse sentido, o grupo focal. Os resultados mostraram mudanças significativas no processo do cuidar em saúde guiado pela educação popular, A reorientação de práticas e saberes, coadunadas aos princípios fundamentais do Sistema Único de Saúde, foi observada nos sujeitos que participaram da experiência. A sistematização da experiência permitiu ainda concluir que estratégias de diálogo, organização político-social e troca de experiências de vida se apresentam como cenário significativo no compartilhamento de cultura e saúde do trabalhador, oportunizando crescimento coletivo e melhor qualidade de vida.

A educação popular para todos de uma cidade educadora (Natal, Rio Grande do Norte, 1957-1964)

This work has as a research subject of popular education policies of the city of Natal, Rio Grande do Norte, in the years 1957 to 1964. It aims to identify and analyze popular education policies developed and implemented by the Municipality of Natal in these years. To get the historical data, we establish as a guiding reserch question the following: Which elaborated educational policies were implemented by the Municipality of Natal in the years 1957-1964? and took over as the method Evidential Paradigm as proposition in Pinheiro (2009). This is anchored in documentary sources of Educational Legislation at National, State and Municipal levels as well as in the newspapers Folha de Tarde and Jornal de Natal; in existing documents from the archives of the Historical and Geographical Institute of Rio Grande do Norte (IHGRN), the Municipal Public Archives of Natal; iconographic sources; interviews and academic publications. In addition to these sources, we were inspired by the works of Aristotles (2011), Hobbes (2009), Freire (2011), Góes (1980), Germano (1989), Cortez (2005) and Galvão (2004). This research allowed us to understand that policies of popular education of Natal (RN) were based on a democratic educational practice, supported on three pillars, namely: participation and involvement of Natal population; construction and reconstruction of teaching practices in prioritizing their action programs to mass literacy and the training of lay teachers; and the democratization of culture. This historical process made Natal on educating city.

Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

Movimento de educação e cultura popular no Brasil dos anos 1960: resistência desfeita

In this work we defend the thesis that the movements of culture and popular education in the 1960s in Brazil, manifested itself into resistance to hegemonic thought, coming from the North, which reduced the popular individuals and their knowledge to the ignorant condition. The focus of our study lies on the resistance produced by these movements in the history of the Country. We used as theoretical reflective foundation the thinking of Boaventura de Sousa Santos and his thesis about the construction of rationalities focused in the fight against indolent reason and the deconstruction of the inferiority in the colonized plan. But the analysis also favors approaches of other authors in the proportion that deals with the action of social actors of culture and popular education movements that have marked their presence in the public space, whose views and interests were invented and reinvented constantly in the relacional game. From the point of empirical view, the research makes use of bibliographies and written documentary sources such as newspaper articles, speeches, statements, manifests and documents like these. The research intends to seek in the past the understanding of those Movements in an effort to enable the viewing of certain remnants of the past that have relevance as social and academic wealth of experience. From the popular and the local, movements of culture and popular education in the 1960s, they overcame the barriers of invisibility and raised Itself to the plan of the global history, when they began to become protagonists of their own history, until their dreams were buried by the 1964 tragedy.

Movimento de educação e cultura popular no Brasil dos anos 1960: resistência desfeita

In this work we defend the thesis that the movements of culture and popular education in the 1960s in Brazil, manifested itself into resistance to hegemonic thought, coming from the North, which reduced the popular individuals and their knowledge to the ignorant condition. The focus of our study lies on the resistance produced by these movements in the history of the Country. We used as theoretical reflective foundation the thinking of Boaventura de Sousa Santos and his thesis about the construction of rationalities focused in the fight against indolent reason and the deconstruction of the inferiority in the colonized plan. But the analysis also favors approaches of other authors in the proportion that deals with the action of social actors of culture and popular education movements that have marked their presence in the public space, whose views and interests were invented and reinvented constantly in the relacional game. From the point of empirical view, the research makes use of bibliographies and written documentary sources such as newspaper articles, speeches, statements, manifests and documents like these. The research intends to seek in the past the understanding of those Movements in an effort to enable the viewing of certain remnants of the past that have relevance as social and academic wealth of experience. From the popular and the local, movements of culture and popular education in the 1960s, they overcame the barriers of invisibility and raised Itself to the plan of the global history, when they began to become protagonists of their own history, until their dreams were buried by the 1964 tragedy.

A política nacional de educação ambiental: limites e desafios para a sua efetivação na Universidade Federal do Rio Grande do Norte

The Environmental Education is a plural and diversified knowledge field, composed by a group of social agents of specific State, government and civil society sectors, with different world views and theoretical matrices that exercised and influenced its genealogy and constitutive dynamic. The Environmental Education – while specific knowledge field – has been produced, systematized and diffused in Brazil in the last decades by official State organisms, through public policies, as well as by social movements of popular education, and constitutes a large and historical movement about the environmental question, that was worldwide projected in the 1960 decade (the environmentalist movement). Concerning the creation of public policies and specific programs to the Environmental Education, in the scope of the governmental initiative, the approval of the National Policy of Environmental Education, by means of the Law n. 9.795/99 – together with its regulatory decree, the Decree nº 4.281 – represents the consolidation of a inclusion process of the environmental dimension in the educational field. These normative acts, beyond charging the public power with the incumbency to define public policies that incorporate the environmental dimension and to promote the Environmental Education in all education levels, also charge the educational institution with the duty of promoting this component in an integrated and articulated way with the educational programs that such institutions develop. In this context, it is aimed to identify and analyze under the light of the dialectical and historical materialism, the practices and concepts developed under the Federal University of Rio Grande do Norte (UFRN), with regard to its institutional policy on Environmental Education, relating it to establishing the Pnea. The analysis by means specific legislation on the subject and institutional documents UFRN. The research showed that, in general, the National Environmental Education Policy has limits to its effectiveness given the absence of specific funding for this purpose and the little government involvement in that the Brazilian State assumes, by through effective policies, the material conditions of financing actions with respect to this field of education. The fragmented and disjointed way the analyzed actions are developed constitutes a limit to the challenge for the UFRN implement, consistently and objectively, an Environmental Education policy, which can be monitored and evaluated as an effective public policy, both landmarks major goal of own Pnea as the demands of development whose agenda a critical environmental perspective.

Avaliação do efeito do liraglutida nos tecidos muscular e adiposo e nos parâmetros bioquímicos em camundongos Swiss submetidos à dieta de cafeteria e a atividade física

Obesity is a chronic metabolic disease characterized by adipose tissue formation excess leading to an increase in body fat mass, of multifactorial origin, produced mainly by poor eating habits combined with a sedentary lifestyle. Data consider obesity as a serious disease that affects the world's population, ranking fifth in death rates. Faced with this situation, individuals seek, increasingly, means to lose weight with less physical effort and food. In 2009 and 2010 the drug liraglutide was lauched in order to reduce weight in individuals with diabetes mellitus type 2, thus avoiding the emergence of other diseases. The aggravating factor is that obese nondiabetic individuals are making use of this substance, even if its use is not authorized by ANVISA (Brazilian Health Surveillance Agency). Thus the objective of this research is to evaluate the effect of liraglutide for muscle or fat tissues and biochemical parameters in Swiss mice submitted to cafeteria diet and physical activity. The study was approved by the Ethics Committee on Animal Use - CEUA (nº003 Protocol / 2014). For this study 74 animals (Swiss mice) were used, divided as follows: in the initial phase of this study, we carried out a pilot study (n = 10) divided into a control group (PCON) (n = 5) and cafeteria group (PCAF) (n = 5), in order to evaluate a cafeteria diet which was both attractive to the animals and that could provide an increase in adipose tissue. After the induction of the diet, animals were euthanized and as a result, the animals in the PCAF group showed an intra-abdominal adiposity 0.74 ± 0.05 g, taken as the parameter for increasing fat in animals. Subsequently the study base was conducted for this research where animals were used (n = 64) divided into 2 groups: the Cafeteria Study Base Group (EBCAF) divided as follows: cafeteria + exercise + liraglutide (CEL) (n = 8), cafeteria + exercise + saline (CES) (n = 8), cafeteria + liraglutide (CL) (n = 8) and cafeteria + saline (CS) (n = 8). The Chow Study Base group (EBR) was divided into: exercise + liraglutide (EL) (n = 8), exercise + saline + (ES) (n = 8), liraglutide (L) (n = 8) and saline solution (SS) (n = 8). All animals went through the submission process to the cafeteria diet, followed by exercise protocol through swimming and treatment with the test substance intraperitoneally (200 mg / mL / kg). After the treatments, the animals were euthanized and had the following parameters evaluated: the muscle tissue mass, adipose tissue mass and biochemical parameters. It was observed that the processing done with the exercise-associated liraglutide reduced adipose tissue mass significantly (0.32 ± 0.05 g) compared to the saline group (0.53 ± 0.07 g). There were no changes in the muscle tissue of the group which was treated and exercised (1.39 ± 0.03 g) compared to the saline group (1.33 ± 0.03 g). Regarding biochemical parameters it was evident that there were changes in these parameters. Interesting to note that, although blood glucose values have been changed, the animals did not become diabetic. Thus, it appears that physical activity together with liraglutide is eficcient to the loss of intraabdominal adipose tissue and the maintenance of lean body mass thereby generating a satisfactory result in the pursuit of quality of life and disease prevention.

Avaliação do efeito do liraglutida nos tecidos muscular e adiposo e nos parâmetros bioquímicos em camundongos Swiss submetidos à dieta de cafeteria e a atividade física

Obesity is a chronic metabolic disease characterized by adipose tissue formation excess leading to an increase in body fat mass, of multifactorial origin, produced mainly by poor eating habits combined with a sedentary lifestyle. Data consider obesity as a serious disease that affects the world's population, ranking fifth in death rates. Faced with this situation, individuals seek, increasingly, means to lose weight with less physical effort and food. In 2009 and 2010 the drug liraglutide was lauched in order to reduce weight in individuals with diabetes mellitus type 2, thus avoiding the emergence of other diseases. The aggravating factor is that obese nondiabetic individuals are making use of this substance, even if its use is not authorized by ANVISA (Brazilian Health Surveillance Agency). Thus the objective of this research is to evaluate the effect of liraglutide for muscle or fat tissues and biochemical parameters in Swiss mice submitted to cafeteria diet and physical activity. The study was approved by the Ethics Committee on Animal Use - CEUA (nº003 Protocol / 2014). For this study 74 animals (Swiss mice) were used, divided as follows: in the initial phase of this study, we carried out a pilot study (n = 10) divided into a control group (PCON) (n = 5) and cafeteria group (PCAF) (n = 5), in order to evaluate a cafeteria diet which was both attractive to the animals and that could provide an increase in adipose tissue. After the induction of the diet, animals were euthanized and as a result, the animals in the PCAF group showed an intra-abdominal adiposity 0.74 ± 0.05 g, taken as the parameter for increasing fat in animals. Subsequently the study base was conducted for this research where animals were used (n = 64) divided into 2 groups: the Cafeteria Study Base Group (EBCAF) divided as follows: cafeteria + exercise + liraglutide (CEL) (n = 8), cafeteria + exercise + saline (CES) (n = 8), cafeteria + liraglutide (CL) (n = 8) and cafeteria + saline (CS) (n = 8). The Chow Study Base group (EBR) was divided into: exercise + liraglutide (EL) (n = 8), exercise + saline + (ES) (n = 8), liraglutide (L) (n = 8) and saline solution (SS) (n = 8). All animals went through the submission process to the cafeteria diet, followed by exercise protocol through swimming and treatment with the test substance intraperitoneally (200 mg / mL / kg). After the treatments, the animals were euthanized and had the following parameters evaluated: the muscle tissue mass, adipose tissue mass and biochemical parameters. It was observed that the processing done with the exercise-associated liraglutide reduced adipose tissue mass significantly (0.32 ± 0.05 g) compared to the saline group (0.53 ± 0.07 g). There were no changes in the muscle tissue of the group which was treated and exercised (1.39 ± 0.03 g) compared to the saline group (1.33 ± 0.03 g). Regarding biochemical parameters it was evident that there were changes in these parameters. Interesting to note that, although blood glucose values have been changed, the animals did not become diabetic. Thus, it appears that physical activity together with liraglutide is eficcient to the loss of intraabdominal adipose tissue and the maintenance of lean body mass thereby generating a satisfactory result in the pursuit of quality of life and disease prevention.

Círculos ao invés de linhas: em busca de valores e princípios estruturantes da gestão social. Projeto juventude, participação e autonomia (Instituto Universidade Popular - UNIPOP)

The organizations are characterized as dynamic spaces, they are being revisited and redefined, because they constitute structural human spaces and new vain outlines won expression. As it begins, of the non consensus in its conception, it is explicit the complexity degree that is identified in the plurality and diversity, brought by the people that compose them, characterizing it as accomplishment space, of happiness and also of conflict, of relationships of power and organizational limits and from birth and burial of faiths, values, norms, symbols, knowledge and rituals, therefore, deeply human. In that way, to know the administration of the organization is preponderant condition for the format of the human relationships to be delineated in its living. Like this the work makes an option in knowing the social administration, this work tries to know and analyze the values and beginnings of the social administration; revealling characteristics and specificities of the organizational performance of UNIPOP that contribute to the formation of the conception of Social Administration, it tends as source of the information the managers of the institution; to identify the formative values of UNIPOP that contribute to the youths' partner-political action in the community, tends for reference the current students of the organization and last to evaluate values structurates and supporting that interconnection between the organizational Administration, formation youth's program, participation and autonomy and attendance, starting from the existences gained by the exits, of that program. This way, the research will be qualitative, looking for understanding starting from their documents, the existence of those values

Círculos ao invés de linhas: em busca de valores e princípios estruturantes da gestão social: projeto juventude, participação e autonomia (Instituto Universidade Popular - UNIPOP)

The organizations are characterized as dynamic spaces, they are being revisited and redefined, because they constitute structural human spaces and new vain outlines won expression. As it begins, of the non consensus in its conception, it is explicit the complexity degree that is identified in the plurality and diversity, brought by the people that compose them, characterizing it as accomplishment space, of happiness and also of conflict, of relationships of power and organizational limits and from birth and burial of faiths, values, norms, symbols, knowledge and rituals, therefore, deeply human. In that way, to know the administration of the organization is preponderant condition for the format of the human relationships to be delineated in its living. Like this the work makes an option in knowing the social administration, this work tries to know and analyze the values and beginnings of the social administration; revealling characteristics and specificities of the organizational performance of UNIPOP that contribute to the formation of the conception of Social Administration, it tends as source of the information the managers of the institution; to identify the formative values of UNIPOP that contribute to the youths' partner-political action in the community, tends for reference the current students of the organization and last to evaluate values structurates and supporting that interconnection between the organizational Administration, formation youth's program, participation and autonomy and attendance, starting from the existences gained by the exits, of that program. This way, the research will be qualitative, looking for understanding starting from their documents, the existence of those values

Trajetos cênicos do grupo parafolclórico da UFRN:que dança é essa?

This paper aims at studying UFRN Parafolclórico Group, whose aesthetic formation is subjected to our analysis, specially at its two last performances, that is, Flor do Lírio (Lily Flower), 2004, and Debaixo do Barro do Chão (Under the Mud of the Ground), 2008. Three targets are envisaged here: to analyze the aesthetic ideas backing Parafolclórico Group exhibitions; to evaluate how their many folk elements interact with different artist languages in order to compose a certain choreography; and finally, to identify the aesthetic conformation placed behind the two different choreographs of the last performances, their trends and innermost features that differentiate them. In accordance with the Analysis of Contents (BARDIN, 2006), interviews have been made with the choreographers and the staff of the spectacles, resulting in elucidating answers to the understanding of their thematic axis. On the first chapter we called attention to motivating subjects as recollection, personal experiences, bibliography research, research in loco regarded as propelling forces of the creative works. Herein, folk culture is depicted as a dynamic process opening a frank dialogue with contemporary events and reinforcing their continuity. On the second chapter, we approached the aesthetic conformation and the scenic elements (costumes, light, scenario, make-up), integrating the studied spectacles and disseminating folk songs in various ways. As what concerns the subjects discourse, we have obtained support in authors like Robatto (1994); Lobo; Navas (2008); Burke (1989); Canclini (2006); Dufrenne (2005); Medeiros (2005); Pavis (2005); Silva (2005), among others. Those authors have provided us with an indispensable theoretic support which, added to the interviews, convinced us that the Parafolclórico Group s aesthetic conception tends to identify itself with the artist languages and other techniques of that Group. It also made sure that the Group s course aims at an aesthetic conception which is not limited to popular culture manifestations, like dance, but admits to play with other media in order to communicate its art. In view of this situation, we arrived to two conclusions: first: the group s interchanges emphasize the dynamic character of popular culture which, by establishing contacts with different realities, receives influences capable of extending its own continuity; second: the contemporary state of arts also improves multiple interchanges opening way, so, for many accomplishments in their field. Therefore, UFRN Parafolclórico Group inserts itself in the contemporary scenery by performing new evaluations of the popular dances as long as it puts them in contact with different technical, aesthetic, artist and culture combinations

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

Avaliação bioquímica e hostológica de fígado de ratas wistar diabéticas e tratadas com tamoxifeno

Tamoxifen (TX), a drug used in the treatment of breast cancer, may cause hepatic changes in some patients. The consequences of its use on the liver tissues of rats with or without diabetes mellitus (DM) have not been fully explored. The purpose of this multidisciplinary study was to evaluate the correlation between plasma hepatic enzyme levels and the presence of iron overload in the hepatic tissue of female Wistar rats with or without streptozotocin-induced DM and using TX. Female rats were studied in control groups: C-0 (non-drug users), C-V (sorbitol vehicle only) and C-TX (using TX). DM (diabetic non-drug users) and DM-TX (diabetics using TX) were the test groups. Sixty days after induced DM, blood samples were collected for glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST) alkaline phosphatase (ALP) and bilirubin measures. Hepatic fragments were processed and stained with hematoxylin and eosin (H&E), Masson s trichrome, Perls. The hepatic iron content was quantified by atomic absorption spectrometry. AST, ALT and ALP levels were significantly elevated in the DM and DM-TX groups, with unchanged bilirubin levels. Liver iron overload using Perls stain and atomic absorption spectrometry were observed exclusively in groups C-TX and DM-TX. There was positive correlation between AST, ALT and ALP levels and microscopic hepatic siderosis intensity in group DM-TX. In conclusion, TX administration is associated with liver siderosis in diabetic and non-diabetic rats. In addition, TX induced liver iron overload with unaltered hepatic function in 2 non-diabetic rats and may be a useful tool for investigating the biological control of iron metabolism

Anormalidades cardiovasculares e metabólicas em pacientes com a síndrome de Berardinelli - SEIP

A Síndrome de Berardinelli-Seip (SBS) ou Lipodistrofia Generalizada Congênita acomete freqüentemente o aparelho cardiovascular e também promove anormalidades metabólicas envolvendo os metabolismos glicídico e lipídico. O objetivo do nosso trabalho foi avaliar a prevalência das anormalidades cardiovasculares e metabólicas em portadores da SBS. Vinte e dois pacientes do estado do Rio Grande do Norte (Brasil), com diagnóstico da SBS, foram submetidos à avaliação clinica, eletrocardiograma de repouso, ecodopplercardiograma, radiografia de tórax, eletrocardiografia dinâmica de 24 horas, teste ergométrico e análise laboratorial. Os pacientes eram predominantemente adultos jovens (n=22) , sendo 14 do sexo feminino. O mais novo tinha 8 e o mais velho 44 anos(22,4±9,7 anos). A totalidade da amostra apresentou resistência à insulina, acanthosis nigricans e HDL-colesterol diminuído. A presença de esplenomegalia, hepatomegalia, diabetes mellitus tipo II e triglicérides elevados eram constantes. A síndrome metabólica foi caracterizada em 81,8% dos pacientes com predominância para sexo feminino e com um alto grau de consangüinidade paterna (86,4%). A hipertensão arterial sistêmica e pré-hipertensão foram encontradas em mais da metade dos pacientes (77.3%). O eletrocardiograma e a radiografia de tórax não foram úteis para identificar a presença de anormalidades cardíacas na SBS, em particular a presença de hipertrofia ventricular esquerda. Para identificar o acometimento cardiovascular foi indispensável o estudo ecodopplercardiografico. Este exame mostrou a presença de hipertrofia concêntrica do ventrículo esquerdo (50%), hipertrofia excêntrica do ventrículo esquerdo (4,5%) e geometria normal do ventrículo esquerdo (45,5%). Disfunção sistólica do ventrículo esquerdo foi encontrada em apenas um paciente (4,5%) e disfunção diastólica em nenhum. Elevada taxa de arritmia foi evidenciada no Holter, tais como, extra-sístoles ventriculares, extra-sístoles supraventriculares e taquicardia supraventricular sustentada. Incompetência cronotrópica (54,5%) foi observada no teste ergométrico. Anormalidades cardiovasculares e metabólicas foram encontradas em elevada prevalência em indivíduos jovens e assintomáticos com SBS. Esses achados xii apontam para a necessidade de acompanhamento cardiológico sistemático e de medidas preventivas nesse grupo de risco