Perfil epidemiológico dos distúrbios hipertensivos na gravidez

The preeclampsia is a disease that evolves to high death rate for the mother and for the fetus. The incidence of this disease in the world is variable and there are no data of this disturb in the Brazilian population. This paper had the objective to determine the incidence and risk factors for development of hypertensive disorders of pregnancy in a neighborhood in Natal, RN, Brazil, taking place a prospective study, cohort type, with the objective of evaluating the entire pregnancy of 242 women that got pregnant between 2004-2007. The incidence of hypertensive disorders was of 17%, while the incidence of preeclampsia was of 13.8%. The age average of women that developed the hypertensive disorders was of 27.4 years (SD±.9), whilst those that developed preeclampsia was of 26.6 (SD ±7.8) years and the normotensive was of 23.9 (SD±5.8) (p=0.002). It is noted a significant increase of the hypertensive disorder with age (p=0.0265). The gestational age for those who developed preeclampsia was lower than the women that developed normotensive pregnancy (p=0.0002). The body mass index (BMI) of the group of women that developed the hypertensive disorder was of 25.8 (SD±3.9), significantly higher than the group of normotensive women with 23.5 (SD±3.7) (p=0.02). The levels of triglycerides and cholesterol tended to be higher on women with preeclampsia than on normotensive, p=0.0502 and p=0.0566, respectively. Six (6) women presented with severe preeclampsia and one (1) developed HELLP Syndrome. The resolution of the pregnancy was performed by cesarean section in 70% of women that developed hypertensive disorders, whilst the normotensive was of 23.6% (p<0.0001). A subgroup of the studied subjects was reassessed one year after labor, revealing that 50% of the patients were still hypertensive. There were no larger complications nor mother death during labor. The incidence of hypertensive disorders are above the levels noted in other studies and 30% of the women were within the poles of greater risk for the hypertensive disorders; the elevated BMI in the beginning of the pregnancy is a risk factor for hypertensive disorder. The risk of severe complication in preeclampsia is high, with imminence of eclampsia occurring in 20.1% of women who developed hypertensive disorder of pregnancy. The adequate prenatal care and the opportune labor assistance may minimize the complications of the pregnancy hypertension and avoid mother death, although the risk of women remaining hypertensive is elevated

Prwncwyj: drama social e resolução de conflito entre os Apãniekra Jê-Timbira.

This work considers a ethnography boarding on the Apãniekra Jê-Timbira group of Central Brazil - leaving of a proposal of agreement of the group in perspectives of historical situations, analyzing its social organization from situational approaches. Taking the ethnography as main tool of production of data, the focus of the research takes dimension, when in the course of the ethnography situation, they come out, from certain events, social dramas that if ramify in crises, conflicts, faccionalismo. I analyze the mechanisms elaborated for the group to neutralize these dramas , such as the constitution of a tribal court , composites for native mediators and external mediators, dynamics ritual processes and politicians.

Significados e percepções de puérperas sobre as síndromes hipertensivas da gravidez e parto prematuro

Hypertensive syndromes in pregnancy (HSP) are configured as one of the major complications in the pregnancy and postpartum period and can lead premature newborn and subsequent hospitalization of the newborn to the Neonatal Intensive Care Unit (NICU). This study aimed to analyze the perceptions, meanings and feelings of mothers on the hypertensive syndromes in pregnancy and premature obstetric labor. The research was qualitative and has a theoretical methodological the Social Representations Theory(SRT) in the approach to the Central Nucleus Theory. The study included 70 women, mean age 29 years, predominantly school to high school, most of them married or in consensual union, primiparous and prevalence of cesarean delivery occurred between 32 and 37 weeks of pregnancy.The data were collected from may to december 2008 in the Maternity School Januário Cicco in Natal , and obtained through the following instruments for data collection: questionnaire including questions about socio-demographic status; the Free Words Association Test (FWAT) and and verbalized mental image construction used three stimuli: such as pregnancy with high blood pressure, preterm birth and NICU, and interview with the following guiding question: what it meant for you to have a pregnancy with high blood pressure and consequently the birth of a premature baby? Data analysis was performed using multi-method obtained from the data processing by EVOC (Ensemble Programmes Permettant L 'Analyze des Évocations) and ALCESTE (Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte) and thematic analysis in categories. The results will be presented in four thematic units under the following representative universes: HSP, prematurity as a result of HSP, NICU and the social representations of mothers on the hypertensive disorder of pregnancy sequenced premature birth and hospitalization of the child in the NICU. The results obtained by multimethod analyses showed similar constructions and point to death as the central nucleus and negative aspects, coping strategies, need of care, knowledge about the disease, fragility and meanings of the NICU as peripheral elements. It is considered that the perceptions, meanings and feelings of puerperal women in relation to HSPs and to premature delivery are a negative social representation, with representational elements that may have influenced the adverse effects on the disease and its consequences. We suggest action on the peripheral elements of this representation, with adequate orientation, early diagnosis, effective conduct, receptive attitude on the part of the team, health promotion measures and effective public policies, in order to improve the care provided to puerperal women, making them feel welcome and minimizing their suffering

Significados e percepções do homem diante da gravidez de sua companheira com síndromes hipertensivas

The general aim of the research was to comprehend the Social Representations constructed by the man in the face of his companion s risk pregnancy caused by hypertensive syndromes. The study is of exploratory and descriptive character in a qualitative approach developed at two public maternity hospitals, both located in Natal-RN, with 65 men whose wives had undergone high-risk pregnancy. The project was submitted to the Ethics on Research Committee of the Federal University of Rio Grande do Norte, Brazil (CEP-UFRN), with favorable report no. 81/07. For data collection, the following multimethods were employed: a word free association test; a projective test for registering mental images; and a semistructured interview schedule. The speech contents were analyzed in accordance with the Theory of Social Representations and complemented by the Central Nucleus Theory. The discussion of the results was grounded on literary findings of the companion s participation in pregnancy as well as in risk pregnancy associated with hypertensive syndromes. The data showed fear as representation s central nucleus, while recollections of that feeling referred to death of both companion and child in addition to fear of the unknown. The categories preoccupation and carefulness, other feelings, and clinical picture of the disease represented components of the peripheral nucleus. The results concerning mental images followed the same category criteria of the word free association test fear, other feelings, preoccupation, carefulness, and clinical picture of the disease. After being processed in accordance with the principles of content analysis, the statements originated three thematic unities: fear and insecurity in the presence of the companion s risk pregnancy; attitudes of carefulness to the risk pregnancy of the partner; and humanized assistance during the companion s risk pregnancy. Considering the results, the conclusion is that the partner s risk pregnancy caused by hypertensive syndromes represents, for the man, feelings of fear, preoccupation, insecurity, lack of acceptance and information, as well as attitudes of carefulness. The results reveal necessity of reorganizing the obstetric assistance with an eye to including the man as participant in the reproductive process. That demands extension of humanized carefulness to the companion with a view to make him an active coadjutor in the assistance of high-risk pregnant

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

Síndrome metabólica e fatores associados: estudo comparativo com mulheres que apresentaram pré-eclâmpsia e gravidez normal, acompanhadas cinco anos após o parto

Preeclampsia is defined as an extremely serious complication of the pregnancy-puerperium cycle with delayed emergence of cardiovascular risk factors, including metabolic syndrome. The research aimed estimate the prevalences of metabolic syndrome and associated factors in women with preeclampsia and normal pregnancy followed five years after childbirth. This is a cross-sectional observational study using a quantitative approach, conducted at a maternity school in the city of Natal in Rio Grande do Norte state. The sample was composed of 70 women with previous preeclampsia and 75 normal selected by simple random probability sampling. Subjects were analyzed for sociodemographic, obstetric, clinical, anthropometric and biochemical parameters. International Diabetes Federation criteria were adopted to diagnose metabol ic syndrome. The Kolmogorov-Smirnov, Mann-Whitney, Student s t, Pearson s chi-squared, and Fisher s exact tests, in addition to simple logistic regression, were used for data analysis, at a 5% significance level (p ≤ 0.05). Statistical tests demonstrated elevated body mass index (p = 0.001), predominance of family history of diabetes mellitus (p = 0.022) and significantly higher prevalence of metabolic syndrome in the preeclampsia group (37.1%) when compared to normal (22.7%) (p = 0.042). Intergroup comparison showed a high number of metabolic syndrome components in women with previous preeclampsia. Altered systolic and diastolic blood pressure (p < 0.001) was the most prevalent, followed by low concentrations of high-density lipoproteins (p = 0.049), and hyperglycemia (p=0.030). There was a predominance of the metabolic syndrome in women with schooling 0-9 years (42.4%) (p = 0.005), body mass index above 30Kg.m 2 (52.3%) (p < 0.001), uric acid high (62.5%) (p = 0.050 and family history of hypertension (38.5%) (p< 0.001). Multivariate analysis of the data showed that the body mass index above 30 kg.m2, education level less than 10 years of study (p < 0.001) and family history of hypertension (p = 0.002) remained associated with the metabolic syndrome after multivariate analysis of the data. It is considered Women with previous preeclampsia exhibited high prevalence of metabolic syndrome and their individual components in relation to normal, especially, altered systolic and diastolic blood pressure, low concentrations of high-density lipoproteins and hyperglycemia. The factors associated to this ou tcome were obesity, less than 10 years of schooling, and family history of hypertension. Overall, this study identified young women with a history of PE exposed to a higher cardiovascular risk than normal

Análise dos remanescentes de mata atlântica do Estado do Rio Grande do Norte : uma perspectiva em alta resolução

The habitat loss and fragmentation are considered the main threats to the biodiversity. These threats operate at the landscape level, which drives the need to manage entire landscapes, not just its components. Although systematic monitoring of the Atlantic Forest biome has been ongoing since the late eighties, current data on forest fragmentation for the sub-region of Pernambuco are practically nonexistent. This study aimed to map out, with high spatial resolution, the remnants of Atlantic forest in Rio Grande do Norte, and conduct a landscape level analysis. The results show that the landscape is highly fragmented, where about 13.6% to 17% of biome remains. Most of the fragments is less than 10 ha, while a few fragments have area larger than 100 ha. Although the high degree of fragmentation, the average distance between fragments found was small (128 m), this estimate is lower than has been observed for the biome (1440m). There is evidence that abrupt changes in the quantification of landscape structure can occur when one observes the fragmentation at high spatial resolution. The results presented here can be used in management actions, in order to make the scenario more conducive to maintaining biodiversity.

Concepções de homens quanto a influência de uma gravidez sobre outra

O processo de reprodução humana é caracterizado por experiências singulares que afetam o homem e a mulher de forma diferenciada. O homem que vivencia o processo gestatório de sua companheira, mesmo não sofrendo as modificações gravídicas, enfrenta transformações relacionadas ao papel que desempenha junto à mulher gestante. Tal vivência é entremeada por significados diversos que dependem tanto da forma como ele concebe a gestação de sua companheira, como da experiência com gestações anteriores. Sendo assim, torna-se imprescindível reconhecer as concepções masculinas acerca das repercussões que uma gravidez conduz nas experiências seguintes, a fim de promover uma atenção em saúde direcionada para as necessidades apresentadas pelo homem, favorecer seu envolvimento e responsabilização no processo gestatório de sua companheira. Com base no exposto, objetivou-se compreender a concepção de homens, que vivenciam a gestação de sua companheira, acerca da influência de uma gravidez anterior sobre as demais. Para tal foi realizado uma pesquisa qualitativa por meio de entrevista semi-estruturada com homens que vivenciaram duas ou mais gestações de sua companheira com intervalo de no máximo cinco anos entre tais experiências. Cumpre ressaltar que as entrevistas ocorreram após parecer favorável de no 045/2011, emitido pelo Comitê de Ética e Pesquisa da Universidade Federal do Rio Grande do Norte. Os dados foram coletados por amostragem teórica e analisados, seguindo as etapas da Teoria Fundamentada nos Dados, sob a ótica proposta pelo Interacionismo Simbólico. Seguindo o percurso dos referenciais adotados, foram elaboradas três categorias: Sentimentos vivenciados pelo homem diante da gestação da companheira, Expectativas do homem diante da gestação da companheira e Repercussões da vivência de uma gravidez anterior sobre a seguinte. A análise das propriedades e dimensões de tais categorias suscitou à construção da teoria Influências de uma gravidez sobre a outra. Assim evidenciou-se que a gravidez anterior influencia nos sentimentos do homem diante de uma nova gestação, nas suas expectativas, principalmente quanto ao sexo do segundo filho, bem como em suas atitudes e comportamentos diante da companheira, do primogênito e do recém-nascido. Revelou-se que em todos esses aspectos ocorreram processos interativos do homem consigo mesmo, com sua companheira e com o contexto social no qual estava inserido. Assim sendo, conclui-se que a interação que o homem estabelece com a experiência anterior conduz a determinação de seus sentimentos e ações frente ao advento de uma nova gravidez. Diante disso, compreende-se que o entendimento sobre tal assunto é imprescindível para fundamentar ações do enfermeiro voltadas à inserção do homem no processo de gravidez, por meio da compreensão das repercussões de vivências anteriores na sua experiência com as demais gestações. Essa compreensão possibilitará uma dinâmica familiar favorável à adaptações requeridas em processos gestatórios seguintes, centrada na satisfação e valorização de seus membros.

Multi-resolução com fóvea móvel para redução e abstração de dados em tempo real

We propose a new approach to reduction and abstraction of visual information for robotics vision applications. Basically, we propose to use a multi-resolution representation in combination with a moving fovea for reducing the amount of information from an image. We introduce the mathematical formalization of the moving fovea approach and mapping functions that help to use this model. Two indexes (resolution and cost) are proposed that can be useful to choose the proposed model variables. With this new theoretical approach, it is possible to apply several filters, to calculate disparity and to obtain motion analysis in real time (less than 33ms to process an image pair at a notebook AMD Turion Dual Core 2GHz). As the main result, most of time, the moving fovea allows the robot not to perform physical motion of its robotics devices to keep a possible region of interest visible in both images. We validate the proposed model with experimental results

A estratégia didática de resolução de problemas na formação de professores de química

In this work it is presented a research developed in the initial training of teachers of the chemistry graduation course at the Universidade Federal do Rio Grande do Norte (UFRN). The intervention was realized in two classes in the context of a discipline in the curricular structure with nineteen undergraduate students of chemistry. The study utilizes characteristics of the qualitative approach and uses observation, questionnaires, interviews and examination papers. The experiment involved a sequence of activities fundamented on the Problem Solving (PS) teaching strategy to approach chemical concepts. The proposal was planned and organized according to the theoretical presupposition of the work developed by the authors of the Science Education in PS, of teaching experience and from the initial hypotheses of the research. The goal was that the future teachers could experience the strategy and advance to the new meanings. The themes addressed in the activities were the difference between exercises and problems, exercises turning into problems, the steps of problem solving and some implications of the teaching strategy for the work of the teacher. The results showed evidence that through a process of collective reflection, and from the difficulties experienced in the strategy practice, the undergraduates are introduced to new perspectives of reflection and action of teaching practice, and understanding some benefits of innovative proposals for the teaching of chemistry. It also showed that, although this theme is approached, in some moments of the graduation, the future teachers don‟t know when or how to realize activities in this perspective. From the aspects that rose in research we highlighted the difficulties in the problem solving steps, the use of the strategy in school and the knowledge and skills of the teacher for planning activities in Problem Solving

Uma sequencia didática para o ensino da resolução da equação do 2. grau : adequação para o uso com professores

The present study aims to check whether the use of activities mediated by the History of Mathematics can contribute to improve the understanding of resolution the 2nd degree equation for teachers and undergraduates that reproduce methods of solving such equations, uncritically, without domain of the justifications for their actions. For this, we adapted a didactic sequence with activities that aims to cause a rediscovery of resolutive formula of 2nd degree equation through the method known as cut and paste. Finally, we presented the activity module containing the didactic sequence used during the study, as suggestion for use in the classroom, by the math teacher

Morfologia em alta resolução espacial de estrelas de tipo Mira e R Corenae Borealis

Mira and R Coronae Borealis (R CrB) variable stars are evolved objects surrounded by circumstellar envelopes (CSE) composed of the ejected stellar material. We present a detailed high-spatial resolution morfological study of the CSE of three stars: IRC+10216, the closest and more studied Carbon-Rich Mira; o Ceti, the prototype of the Mira class; and RY Sagitarii (RY Sgr), the brightest R CrB variable of the south hemisphere. JHKL near-infrared adaptive optics images of IRC+10216 with high dynamic range and Vband images with high angular resolution and high depth, collected with the VLT/NACO and VLT/FORS1 instruments, were analyzed. NACO images of o Ceti were also analyzed. Interferometric observations of RY Sgr collected with the VLTI/MIDI instrument allowed us to explore its CSE innermost regions (»20 40 mas). The CSE of IRC+10216 exhibit, in near-infrared, clumps with more complex relative displacements than proposed in previous studies. In V-band, the majority of the non-concentric shells, located in the outer CSE layers, seem to be composed of thinner elongated shells. In a global view, the morphological connection between the shells and the bipolar core of the nebulae, located in the outer layers, together with the clumps, located in the innermost regions, has a difficult interpretation. In the CSE of o Ceti, preliminar results would be indicating the presence of possible clumps. In the innermost regions (.110 UA) of the CSE of RY Sgr, two clouds were detected in different epochs, embedded in a variable gaussian envelope. Based on a rigorous verification, the first cloud was located at »100 R¤ (or »30 AU) from the centre, toward the east-north-east direction (modulo 180o) and the second one was almost at a perpendicular direction, having aproximately 2£ the distance of the first cloud. This study introduces new constraints to the mass-loss history of these kind of variables and to the morphology of their innermost CSE regions

Métodos numéricos para resolução de equações diferenciais ordinárias lineares baseados em interpolação por spline

In this work we have elaborated a spline-based method of solution of inicial value problems involving ordinary differential equations, with emphasis on linear equations. The method can be seen as an alternative for the traditional solvers such as Runge-Kutta, and avoids root calculations in the linear time invariant case. The method is then applied on a central problem of control theory, namely, the step response problem for linear EDOs with possibly varying coefficients, where root calculations do not apply. We have implemented an efficient algorithm which uses exclusively matrix-vector operations. The working interval (till the settling time) was determined through a calculation of the least stable mode using a modified power method. Several variants of the method have been compared by simulation. For general linear problems with fine grid, the proposed method compares favorably with the Euler method. In the time invariant case, where the alternative is root calculation, we have indications that the proposed method is competitive for equations of sifficiently high order.

Gravidez tardia: bem-estar subjetivo e percepção da gestação

The subjective well- being (SWB) is formed by global judgments of satisfaction with life, or with peculiar domains the positive and the negative emotional experiences. The perception in turn, is the process of interpretive process of sensory data with cognitive or informative sense, absorbed in function of a context. From this perspective, the research aimed to evaluate SWB and the perception of advanced age pregnant women. Participated in the survey 80 pregnant with 35 years old or older (Group A or older) and 80 pregnant aged between 20 and 34 years old (Group B or young adults). The instruments used were: the scale of subjective well-being and a questionnaire, that included sociodemographic informations, items about pregnancy and a statement based on the Free Association of Words Technique (FAWT) to approach the perception of pregnancy. The data from the questionnaire and scale, in order to compare the data between groups suffered descriptive and inferential statistical analyzes. The analyzes performed with chi-square test among groups, which had values that were statistically significant, with the sociodemographic variables the type of contraceptive and health problems. The indicators of the SWB had further more by means in groups. The results of the Wilcoxon's test that there were no differences between the groups referred above. In the relation indicators of well being with variables age, education and income, some associations were significant. In addition, the words derived from the (FAWT) were analyzed using the software Programmer s Permenttant l´Analyse des Evocation (EVOC2000) and categorized according to content analysis of Bardin in three thematic categories (positive and negative affects, perception of gestation and implications of pregnancy) discussed as a group, since most of words were common. The study highlights shown how similar were the presented data by pregnant women surveyed. It is supposed about this fact the similarity is related to the social context. The relevance of this study for the health care network is to help with proposals aimed at specific improvements to the public and the sector, beside demonstrate that advanced age pregnant women and young adulst in the researched context showed no differences in the most of the studied characteristics

Usando a história da resolução de alguns problemas para introduzir conceitos: sistemas lineares, determinantes e matrizes.

In this work we studied the method to solving linear equations system, presented in the book titled "The nine chapters on the mathematical art", which was written in the first century of this era. This work has the intent of showing how the mathematics history can be used to motivate the introduction of some topics in high school. Through observations of patterns which repeats itself in the presented method, we were able to introduce, in a very natural way, the concept of linear equations, linear equations system, solution of linear equations, determinants and matrices, besides the Laplacian development for determinants calculations of square matrices of order bigger than 3, then considering some of their general applications