Síndrome metabólica e risco cardiovascular na pós- menopausa: avaliação por diferentes critérios diagnósticos e influência de fatores sócio-econômicos

The metabolic syndrome (MetS) involves a group of risk factors and is associated with a significantly higher risk of developing cardiovascular diseases (CVD) and type 2 diabetes. Recent studies have shown the importance of preventing CVD through early diagnosis and treatment of patients with MetS. The objective of our study was to determine the prevalence of MetS by different diagnostic criteria in postmenopausal women and analyze the influence of socioeconomic factors on cardiovascular risk in this sample of the population. A cross-sectional study involving 127 postmenopausal women (45 to 64 years) from Natal and Mossoró, Brazil. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. The experimental protocol consisted of applying structured interview, clinical examination and implementation of dosages blood. The diagnosis of MetS was based on NCEP-ATP III (National Cholesterol Education Program-Adult Treatment Panel III) and IDF (International Diabetes Federation) criteria. The research was accomplished with the participation of an interdisciplinary team in their several phases. The result of the sample studied had mean age of 53.9 ± 4.6 years and per capita income of 54.5 dollars. The prevalence of MetS, according to NCEP-ATP III and IDF criteria, was 52.8% and 61.4$, respectively. The agreement rate between NCEP-ATP III and IDF criteria was 81.9%, with a kappa value of 0.63 (CI 95%, 0.49-0.76), indicating good agreement between the two definitions. The most prevalent cardiovascular risk factor was HDL < 50 mg/dl, observed in 96.1% of the women analyzed, followed by increased waist circumference (≥ 80 cm) in 78.0%, elevated blood pressure in 51.2%, triglycerides ≥ 150 mg/dl in 40.9% and glycemia ≥ 100 mg/dl in 37.0% of the women. The occurrence of MetS was significantly associated with schooling and body mass index (BMI). High blood pressure was significantly associated with low family income, low schooling and weight gain. There was no significant association between the intensity of climacteric symptomatology and the occurrence of MetS. The conclusions of the research were that MetS and its individual components show a high prevalence in postmenopausal Brazilian women, and significant associations with weight gain and low socioeconomic indicators. The data point to the need for an interdisciplinary approach at the basic health care level, directed toward the early identification of risk factors and the promotion of cardiovascular health of climacteric women.

Impactos sócio-econômicos e ambientais da introdução da Tilápia do Nilo, Oreochromis niloticus, em açudes públicos do semi-árido nordestino, Brasi

The stocking of exotic fish, especially the tilapia, has become a common practice in the public reservoirs of the Brazilian semi-arid region. The stocking of tilapias has had as its main aim the improvement of the fisheries in the reservoirs and consequently the improvement of the socio-economic conditions of the families that have fishing as the main source of income. However, the environmental risks associated with this practice are high and can lead to a loss in aquatic biodiversity and to changes in the quality of the water. The object of this work was to quantify the socio-economic and environmental effects of the introduction of the Nile tilapia in the public reservoirs of the semi-arid northeastern Brazil. The analysis of the fish yield of 100 public reservoirs from 1970 to 2000 demonstrated that the introduction of the Nile tilapia apparently contributed to an increase in the total fish yield from the late 1970 s until the mid-1980 s. Nevertheless, from that time onwards the fish yield in these reservoirs has fallen into decline to levels inferior to those observed prior to the introduction of the tilápia. The analysis of the fishing activity statistics of the Gargalheiras reservoir located in the city of Acari, Rio Grande do Norte, demonstrated that the introduction of the Nile tilapia in the reservoir has not significantly increased the fish yield, the gross overall income, the gross per capita income nor the number of fishermen actively fishing in the reservoir. On the other hand, the analysis of the fishing activity statistics of the Gargalheiras reservoir has revealed a significant reduction in the captures of other commercially important fish species after the introduction of the tilapia. This result suggests that the Nile tilapia could have negatively affected other species of fish in the reservoir, contributing to the decline in their stocks. In order to assess the perception of the fishermen concerning the effects of the Nile tilapia over other species of fish and the quality of the water, questionnaires containing open and multiple choice questions were applied with 30 fishermen from the colony of the Gargalheiras reservoir. The great majority of the local fishermen stated that the tilapia is currently the most important species of fish to those who depend on fishing as a source of income and that they have not caused damage to other species of fish nor to the quality of the water in the reservoir. However, the results of the present work indicate that the alleged socio-economic benefits, employed to justify the introduction of the Nile tilapia in the reservoirs, are overestimated while the environmental impacts of the introduction of this exotic species are underestimated

Intervenção dietoterápica em portadores de lipodistrofia generalizada congênita do Rio Grande do Norte

Congenital generalized lipodystrophy is a rare genetic disease with autosomal recessive inheritance characterized by the generalized absence of subcutaneous adipose tissue and insulin resistance. The aim of our study was to determine the profile of patients with congenital generalized lipodystrophy (Berardinelli-Seip syndrome) through their clinical history, eating habits, and socioeconomic and cultural aspects; assess food consumption and nutritional status of the study group; propose and evaluate a diet therapy model associated to oral supplementation with zinc to help in the control and prevention of metabolic complications associated to the pathology. Initial assessment of food consumption indicated a voracious appetite in all the patients studied. The introduction of zinc reduced appetite, contributing to patient adherence to the food plan proposed. It was also observed that the proposed diet contributed mainly to glycidic control, specifically with respect to HbA1c. The nutritional status of the patients investigated was adequate in terms of body mass index (BMI), arm muscle circumference (AMC), arm muscle area AMA, but triceps skinfold (TSF) indicated serious malnutrition. Our study is unique in the literature and provides important information to the field of nutrition and to individuals with this pathology. Furthermore, it contemplates the interdisciplinary and multidisciplinary requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte (UFRN), Natal, Brazil

FERRITINA: intervalos de referência para adultos no Estado do Rio Grande do Norte

Ferritin is a protein composed of heavy and light chains, non-covalently linked and which accommodates, in its core, thousands of atoms of iron. Furthermore, this protein represents the stock of iron in the body and it is characterized as an acute marker and predictor of diseases, such as iron deficiency anemia, hereditary hemochromatosis and others. Considering the variability of reference values and the analytical methods currently available, the aim of this work was to propose 95% confidence intervals for adults in the State of Rio Grande do Norte, Brazil, after determining the average concentration of serum ferritin for both sexes, beyond its correlation with the age. We analyzed 385 blood samples, collected by venipuncture from individuals residing in the State, after 12-14 hours of fast. The populational sample had 169 men and 216 women between 18-59 years old, which filled a questionnaire on socioeconomic, food habits and accounts about previous and current diseases. The sample collections were itinerant and the results of erythrogram, fasting glucose, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, urea, creatinine, leukocyte count and platelets, beyond C-reactive protein, were issued to each participant, so that, after selection of the apparently healthy individuals, the dosage of serum ferritin was carried out. Statistical analysis was performed using the softwares SPSS 11.0 Windows version, Epi Info 3.3.2 and Graf instant pad (version 3.02), and the random population sample was single (finite population), for which the test of linear correlation and diagram of dispersion were also made. After selection of individuals and determination of serum ferritin, the most discrepant outliers were disregarded (N = 358, Men = 154/Women = 207) and the average value determined for the masculine sex individuals was 167,18 ng / dL; for the feminine sex individuals, the average value obtained was 81,55 ng / dL. Moreover, we found that 25% of men had values < 90,30 ng / dL; 50% ≤ 156,25 ng / dL and 75% ≤ 229,00 ng / dL. In the group of women, 25% had values < 38,80 ng / dL; 50% ≤ 65,00 ng / dL and 75% ≤ 119,00 ng / dL. Through the correlation coefficient (r = 0,23 with p = 0,003), it is possible to suggest the existence of positive linear correlation between age and serum ferritin for men. The correlation coefficient for women (r = 0,16 with p = 0,025) also confirms the existence of positive linear correlation between serum ferritin and age. Considering the analysis carried out and specific methods corroborating with the proposed benchmarks, we concluded that the average value found for men is higher than that found for women. Furthermore, this scenario rises with age for both sexes, and the 95% confidence intervals obtained were 74 ng/dL ≤ μ ≤ 89 ng/dL and 152ng/dL ≤ μ ≤183ng/dL for the feminine and masculine sex individuals respectively

Territorialidade e pesca: atualidades e tradições no uso dos recursos pesqueiros na comunidade litorânea da praia da Pipa Rio Grande do Norte

The need for sustainability in the exploitation of natural resources in coastal areas has been out in recent years, as well as the social and cultural sustainability of traditional communities in these regions. Coastal and estuarine wild areas are influenced directly or indirectly by a set of human activities such as artisanal fishing. Therefore, there is a demand for an integrated design of these areas and according to the landing values, a pattern of unsustainable development of national marine fishing activity. The study was conducted in the coastal community of Praia da Pipa, Tibau do Sul municipality, RN, between june 2009 and june 2010 and aimed to characterize the fishery performed, its socio-economic strategies and fishing areas, as well as to identify ichthyofauna, to assess the sustainability of the major resources and to identify cultural traits related to artisanal fisheries, their problems and prospects; linking tradition and the present fishing activity carried out in the community. For this study, a total of 67 structured interviews were collected, including qualitative and quantitative data. A total of 133 fish landings and direct observations were performed. Informants were identified according to one of the following categories: fishermen, vessel masters and members of the local population with offspring. Applications SPSS 10.0, Paint.Ink and Microsoft Office Excel 2007 were used for tabulation and analysis of results. Local fishermen are, on average, 25 years fishing, have 40 years old and the average monthly income is up to 03 minimum wages. The local fleet consists of 20 vessels, that uses different line sizes and types of networks, operating in 21 fishing grounds and showing a reduction in the vessel numbers by 66% in the last decade. We recorded 76 species of fish, captured by the local fleet and the top 5 were quantitatively analyzed serra spanish mackarel (Scomberomorus brasiliensis), little tunny (Euthynnus alleteratus), yellowtail snapper (Ocyurus chrysurus), red snapper (Lutjanus analis) and common snook (Centropomus undecimalis), accounting for 46,5% of production in the period. The capture of these species was composed mostly of adults. Data analysis showed a significant decrease of the local fishing activity over the last decade due to the weakness displayed by the political-social category, the devaluation of local knowledge and the emergence of new sources of income through increased tourism. The characteristics of the fishing community suggest it to pass through significant changes as the appreciation of their cultural and traditional aspects. We identified a tendency to sustainability of main species caught, suggesting that public policies to be adopted locally comply with the current characteristics of fishing undertaken in the community and knowledge of fishermen related to the environment, allowing environmental, as well as social and cultural sustainability of the community involved.

Parâmetros urbanísticos para habitação de interesse social: uma análise crítica para as Rocas em Natal/RN

Through the comparative critical analysis of the demanded urbanistic parameters in the legislation and of the urbanistic index found in the Rocas neighbourhood, having as study object the already consolidated constructions of residential use, intended to demonstrate that the neighbourhood needes specific norms and that the limits established for recognition of Special Areas of Social Interest for the urbanistic legislation of the City of Natal would have to be reviewed and to be brought up to date, once they show occupations like the ones of the reffered neighbourhood. At a first moment, bibliographical revision and elaboration of the theoretical referencial had been made, , to analyze afterwards the urbanistic legislation for the neibourhood of Rocas, that determines relative parameters for the sizes of land lots, coefficients of exploitation, minimum taxes of occupation and retreat. Through a field research in the area, a study on the occupation description was done at first, characterization of the neibourhood through the study of the social-economic aspects, of the existing infrastructure in the place, environmental aspects, morphologic and tipolgic analysis of the neibourhood as a whole. From the grouping of the found characteristics, sub-zones had been delimited, where the real object of study was detached to be analyzed. From the Sub-zoning, a statistic sampling was carried through with the intention to examine which of the urbanistic index is found in the dwellings of that already materialized place. This sampling, of one hundred and eighteen residences, was carried through by measurement of the lots and existing constructions in these places. Through this survey, for each habitacional unit, area of the lot, constructed area, retreats and coefficient of exploitation had been calculated. The comparison between the legislation parameters and the index found in the place reveal an expressive index of urbanistic irregularity and the necessity of special regulation for the Rocas neibourhood due to its specific social-space characteristic

Análise da resiliência sócio-ecológica em unidades de conservação de uso sustentável: subsídios para o manejo da pesca artesanal no Brasil

O uso da biodiversidade pelo homem leva a alterações no funcionamento dos ecossistemas, podendo ainda levar a perda de resiliência. Pode-se definir resiliência como a capacidade de um sistema absorver um distúrbio e reorganizar-se, enquanto submetido a mudanças, mantendo a mesma estrutura e funcionamento. Em um sistema social, entende-se como a capacidade dos usuários de recursos naturais de enfrentar e adaptar-se as mudanças nas regras que regem o uso e acesso a estes. Alterações na resiliência, tanto ecológica quanto social, podem ser resultantes das ações de exploração e manejo destes recursos. Assim, torna-se essencial compreender como funcionam as estratégias de manejo e sua interação com a resiliência sócio-ecológica, permitindo a auto-avaliação das ações e possíveis modificações das mesmas. Neste projeto, propõe-se comparar a resiliência sócio-ecológica de três Unidades de Conservação (UCs) de uso sustentável: Reserva de Desenvolvimento Sustentável (RDS) Ponta do Tubarão, localizada no estado do Rio Grande do Norte; e as Reservas Extrativistas do Batoque e Prainha do Canto Verde, ambas localizadas no estado do Ceará. Em cada área de estudo serão escolhidas comunidades pesqueiras, permitindo a comparação entre elas. A partir destas comunidades, alguns aspectos relacionados ao uso dos recursos serão analisados, como atividade pesqueira, dieta e modo de vida. Os dados serão coletados através de questionários semi-estruturados, contendo questões baseadas em aspectos sociais, econômicos e ecológicos. Os resultados obtidos servirão de indicadores para a resiliência ecológica (informações obtidas com base na atividade pesqueira) e social (informações obtidas com base no acompanhamento da dieta e análise do modo de vida). Apesar da similaridade ecológica entre as áreas de estudo, algumas estratégias de manejo distintas em função da categoria da UC podem apresentar diferentes resultados sobre a resiliência sócio-ecológica. Desta forma, compreender como a resiliência sócio-ecológica se comporta, dentro dos sistemas de manejo estudados, permitirá avaliar a influência destes dois tipos de UCs (RDS e RESEX) na promoção da sustentabilidade ecológica e/ou social

Mortalidade por câncer de boca e condição sócio-econômica no Brasil

BORGES,D. M. L.et al. Mortalidade por câncer de boca e condição sócio-econômica no Brasil.Cad. Saúde Pública, Rio de Janeiro, v.25,n.2, p.321-327, fev, 2009

Caracterização socio-econômico-cultural de raizeiros e procedimentos pós-colheita de plantas medicinais comercializadas em Maceió, AL

ARAUJO, Afranio Cesar de et al. Caracterização socio-econômico-cultural de raizeiros e procedimentos pós-colheita de plantas medicinais comercializadas em Maceió, AL. Rev. Bras. Pl. Med, Botucatu, v. 11, n. 01, p.81-91, 2009. Disponível em: . Acesso em: 04 out. 2010.

Fatores sócio-demográficos e diagnósticos de enfermagem em pacientes transplantados renais

Analisar a associação estatística entre diagnósticos de enfermagem identifi cados nos pacientes transplantados renais e seus fatores sócio-econômicos. Estudo transversal realizado em um hospital universitário em Fortaleza-CE, no período compreendido entre dezembro de 2004 a abril de 2005. Foram identifi cados 38 diagnósticos de enfermagem. Dez diagnósticos apresentaram freqüências acima do percentil 75: Risco de infecção; percepção sensorial perturbada: visual; Padrão de sono perturbado; Nutrição desequilibrada: mais do que as necessidades corporais; Fadiga; Disfunção sexual; Percepção sensorial perturbada: audição; Dor aguda; Padrões de sexualidade inefi cazes; Risco de nutrição desequilibrada: mais do que as necessidades. O estudo sobre diagnósticos de enfermagem ajudou a expandir o conhecimento da realidade dos pacientes, o que é necessário para o estabelecimento de cuidados de enfermagem ao transplante renal, bem como para abordar os resultados que vierem a ser desenvolvidas com o objetivo de melhorar a qualidade de vida

Mortalidade por câncer de boca e condição sócio-econômica no Brasil

Chronic non-communicable diseases represent a major public health problem, requiring more effective investigation and control by government agencies. The aim of this study was to correlate the mortality rate for oral cancer in Brazilian State capitals from 1998 to 2002 with socioeconomic factors collected in the 2000 census, using an ecological study design. Data were obtained from the Mortality Information System from 1998 to 2002. Social factors were taken from the Brazilian Human Development Atlases. After data collection, statistical analysis was performed using Pearson's correlation index. The findings included positive and significant correlations among the socioeconomic indicators (Municipal Human Development Index - MHDI, MHDI-income, MHDI-education, MHDI-life expectancy, and per capita income), and negative and significant correlations with the socioeconomic indicators Gini Index and infant mortality. Despite the study’s limitations and probable underreporting in less developed State capitals, the study found significant statistic correlations between the selected socioeconomic indicators and the oral cancer mortality rate___________________________RESUMO As doenças crônico-degenerativas representam um grande problema de saúde pública, necessitando de levantamento e controle mais efetivos destas enfermidades por parte dos órgãos públicos. O objetivo deste estudo foi correlacionar os índices de mortalidade por câncer oral nas capitais do Brasil no período de 1998 a 2002 com indicadores sócio-econômicos do Censo Demográfico de 2000 , por meio de um estudo do tipo ecológico. Os dados foram extraídos do Sistema de Informação de Mortalidade (Ministério da Saúde/DATASUS), para os anos de 1998-2002. Os indicadores sócio-econômicos foram obtidos a partir do Atlas do Desenvolvimento Humano no Brasil. Após coleta dos dados, a análise estatística foi realizada usando-se o índice de correlação de Pearson. Observaram-se corre- lações positivas e significativas entre os indicadores sócio-econômicos (Índice de Desenvolvimento HumanoMunicipal – IDH-M, IDH-M renda, IDH-M educação, IDH-M longevidade e renda per capita), e correlação negativa e significante para os indicadores sócio-econômicos índice de Gini e mortalidade infantil. Apesar das limitações do estudo e da provável problemática de sub-registros nas capitais menos desenvolvidas, o presente trabalho encontrou correlações estatisticamente significantes entre os indicadores sócio-econômicos selecionados e o índice de mortalidade por câncer oral

Caracterização socio-econômico-cultural de raizeiros e procedimentos pós-colheita de plantas medicinais comercializadas em Maceió, AL

ARAUJO, Afranio Cesar de et al. Caracterização socio-econômico-cultural de raizeiros e procedimentos pós-colheita de plantas medicinais comercializadas em Maceió, AL. Rev. Bras. Pl. Med, Botucatu, v. 11, n. 01, p.81-91, 2009. Disponível em: . Acesso em: 04 out. 2010.

Fatores sócio-demográficos e diagnósticos de enfermagem em pacientes transplantados renais

Analisar a associação estatística entre diagnósticos de enfermagem identifi cados nos pacientes transplantados renais e seus fatores sócio-econômicos. Estudo transversal realizado em um hospital universitário em Fortaleza-CE, no período compreendido entre dezembro de 2004 a abril de 2005. Foram identifi cados 38 diagnósticos de enfermagem. Dez diagnósticos apresentaram freqüências acima do percentil 75: Risco de infecção; percepção sensorial perturbada: visual; Padrão de sono perturbado; Nutrição desequilibrada: mais do que as necessidades corporais; Fadiga; Disfunção sexual; Percepção sensorial perturbada: audição; Dor aguda; Padrões de sexualidade inefi cazes; Risco de nutrição desequilibrada: mais do que as necessidades. O estudo sobre diagnósticos de enfermagem ajudou a expandir o conhecimento da realidade dos pacientes, o que é necessário para o estabelecimento de cuidados de enfermagem ao transplante renal, bem como para abordar os resultados que vierem a ser desenvolvidas com o objetivo de melhorar a qualidade de vida

Impacto da Estratégia Saúde da Família com equipe de saúde bucal sobre a utilização de serviços odontológicos

PEREIRA, C. R. S. et al. Impacto da estratégia saúde da família com equipe de saúde bucal sobre a utilização de serviços odontológicos. Cad. Saúde Pública, v. 25, n. 5, p.985-996. Maio, 2009. ISSN 0102-311X.

Impacto da Estratégia Saúde da Família com equipe de saúde bucal sobre a utilização de serviços odontológicos

PEREIRA, Carmen Regina dos Santos et al. Impacto da Estratégia Saúde da Família com equipe de saúde bucal sobre a utilização de serviços odontológicos. Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 5, p. 985-996, maio 2009.