Alterações de equilíbrio postural e qualidade de vida em mulheres no ciclo gravídico puerperal

INTRODUCTION: The pregnancy and childbirth cause many changes in a woman's life, whether physical, hormonal, emotional or social. Such changes may affect the postural balance and the quality of life of women in pregnancy and may persist after delivery. To analyze changes in postural balance and quality of life in women in pregnancy and postpartum. METHODS: This study consisted of 47 women participants of the Course for Pregnant Women of the Department of Physical Therapy at UFRN, evaluated during pregnancy (2° or 3° trimester) and in the period 1-8 months postpartum. In all participants was evaluated the postural balance, the Balance Master® in five specific tests: (1) Modified Clinical Test of Sensory Interaction on Balance-MCTSIB; (2) Rhythmic Weight Shift Test - RWS (3) unilateral stance - US, (4) Sit to Stand - STS, and (5) Walk Across - WA. The quality of life (QoL) was assessed by applying the Quality Score of life Ferrans & Powers (IQVFP), both during pregnancy and in the postpartum period. For statistical analysis we used the Statistical Package for Social Sciences software for Personal Computer- SPSS (version 20.0), applying the tests: Shapiro-Wilk to assess the normality of the data; Chi-square to analyze the frequency of postural balance changes in the two groups of pregnancy and postpartum in both groups; McNemar test to analyze balance disorders frequency of related samples in the two time points; to compare the behavior of postural balance during pregnancy and postpartum, and to compare the QoL between the periods, we used the Wilcoxon test; and yet, the MannWhitney test to compare the QoL scores in the two groups of pregnancy and postpartum in both groups. We adopted p-value <0.05. RESULTS: Comparing the postural balance during pregnancy and postpartum in MSTSIB test has statistical difference in unstable surface with closed eyes (p=0.001) and in the US test, the speed of oscillation with right leg with eyes closed (p=0,03). Quality of life, there was statistical difference between the scores only among postpartum groups, the family domain (p=0.03); and to comparing pregnancy and postpartum in domain health and operation (p=0.02) and the Socioeconomic domain (p=0.01). CONCLUSIONS: It was observed that the balance changes present during pregnancy persist postpartum, and the quality of life is considered good by women, both during pregnancy and postpartum.

Influência de fatores biopsicossociais sobre a mortalidade de idosos no município de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Efeitos da inclinação da esteira na marcha de indivíduos hemiparéticos crônicos

Objective: To examine the effects of treadmill inclinations on the walking of hemiparetic chronic subjects. Design: Observational descriptive study. Location: Laboratory of human movement analysis. Participants: Eighteen subjects, 10 men and 8 women were evaluated, with a mean age of 55.3 ± 9.3 years and the time since the injury of about 36 ± 22.8 months. Intervention: Not applicable. Main Outcome Measures: All subjects were evaluated for functional independence (Functional Independence Measure - FIM) and balance (Berg Balance Scale). Angular variations of the hips, knees and ankles in the sagittal plane were observed, as well as the speed of the movement (m/s), cadence (steps/min), stride length (m), cycle time (s), step time on the paretic leg and on the non-paretic leg (s), support phase time and balance phase time on the paretic leg (s) and the ratio of symmetry inter-limb as subjects walked on a treadmill at three conditions of inclination (0%, 5% and 10% ). Results: There were angular increases in the initial contact of the hip, knee and ankle, amplitude increase in the hip between 0% and 10% (37.83 ± 5.23 versus 41.12 ± 5.63, p < 0,001) and 5% and 10% (38.80 ± 5.96 versus 41.12 ± 5.63, p = 0,002), amplitude increases in the knee between 0% and 10% (47.51 ± 15.07 versus 50, 30 ± 12.82, p = 0,040), extension decreases in the hip, dorsiflexion increases in the balance phase and in the time of support phase from 0% to 5% (0.83 ± 0.21 versus 0.87 ± 0, 20, p = 0,011) and 0% and 10% (0.83 ± 0.21 versus 0.88 ± 0.23, p = 0,021). Conclusion: The treadmill inclination promoted angle changes as such as the increase of the angle of the hip, knee and ankle during the initial contact and the balance phase and the increase of the range of motion of the hip and knee; furthermore, it also promoted the increase of the support time of the paretic lower limb

Eficácia do cimento de ionômero de vidro como selante oclusal sobre a paralisação de lesões cariosas em dentina

Dental caries consists in a multifactorial and dynamic process. The knowledge of the ionic interactions among dental tissues and dental biofilm make possible its understanding as a process that can be stopped. Recently, the use of sealants have lost its function as preventive agent and passed to be argued as a possible therapeutical agent. This happens by hindering the substratum flow to the lesion inner and, therefore, controls the advance of the process. This study aimed to evaluate glass ionomer cement as a not invasive technique of treatment in occlusal caries without clinical cavitation, but with dentinal involvement. The research was accomplished using a controlled clinical trial with two groups (experimental and control) in 38 subjects (8-18 years) with 51 molars. The teeth of the experimental group were sealed with glass ionomer cement (Vidrion-R, S.S.White, Juiz de Fora, Brazil) and the molars control did not suffer intervention. The experimental group was followed by a year and the control by 8 months due the progression of the carious injury. Both groups were reevaluated to each 4 months with the use of clinical, radiographic and laser fluorescence (DIAGNOdent®) examination. The analysis of the clinical evaluation did not observe a significant difference between experimental and control groups. However, analysis with radiographic and laser fluorescence (DIAGNOdent®) examination observed a significant difference (p> 0,05) between groups, demonstrating a wors condition to the group without intervention. The results suggest that glass ionomer cement as sealant can be efficient to paralyze dentinal caries without clinical cavitation

As competições sociais em grupos de Callithrix jacchus (Callitrichidae, Primates) são influenciadas pelo parentesco e pela convivência?

The Callitrichidae family is characterized by flexibility in its mating system, being possible to find monogamous, polyandrid and polygynic groups. Its social organization and mating system can be defined by the interaction between ecological and demographic factors plus the degree of relatedness among the individuals in the population. The objective of this work was to demonstrate the influence of relatedness and coexistence on the establishment and maintenance of social relations between Callithrix jacchus adult males. Four pairs of related adult males (CP), 4 pairs with coexistence between the animals in the pair (CC) and 4 pairs with no relatedness (SP) were studied. The pairs in the group CC had been kept in the same cage for at least 8 months before the experiment and the pairs in the group SP were put together at the beginning of the study. Each animal was observed 3 times/week for 2 months, in 15 min. sessions, through focal time sampling with instantaneous record each minute. In the first month, only the pair of males was kept in the cage (Phase I) and in the second month, a female was introduced into the cage (Phase II). The affiliative, agonistic and sexual interactions were registered. Affiliative interactions showed similar frequencies for all groups in phases. There was also no significant difference in the agonistic interactions of the CP, CC and SP males in Pase I, even considering that group SP exhibited higher levels of agonism. In Phase II, there was a statistically significant increase comparing to the others. The results demonstrate that relatedness and coexistence are of great importance for maintaining reprodutive and social stability inside the group. Nonetheless, in this study, only one of the males in the pair had sexual interations with the females, except for 2 pairs. This was assured through mate guarding and agonism directed to the potencial competitor. The most probable mating system would be functional monogamy, where the males would present low levels of competition, if there is relatedness and coexistence among them; on the other hand, a strong competition if there is no relatedness between the individuals. Even so, a polyandric system would also have to be considered

Ecologia alimentar e reprodutiva da piaba-do-rabo-amarelo, Astyanax cf. lacustris (Reinhardt, 1874) (Osteichthyes: Characidae) na Lagoa do Piató, Assu, Rio Grande do Norte, Brasil

The feeding habits and biological aspects of the reproductive cycle of two-spot astyanax, Astyanax cf. lacustris (Reinhardt, 1874) were investigated. Fish samples were captured on a monthly basis, using gillnets of 4 cm mesh size, from the Piató Lake, Assu, Rio Grande do Norte, during the period of September, 2006 to August, 2007. Physico-chemical parameters, such as, temperature, electrical conductivity and dissolved oxygen of the lake were registered. The monthly values of rainfall also were obtained. The 360 individuals captured, were measured, weighed, dissected, and stomach weight and the stage of gonadal maturity were registered. The stomach contents analyses were carried out based on volumetric method, points, frequency of occurrence and applying the Index of Relative Importance. The degrees of repletion of the stomachs were determined besides the Index of Repletion relating to feeding activity variations and frequency of ingestion with limnological parameters and rainfall. The food items identified were separated into distinct groups according to their origin. Sex ratio and Gonadosomatic Relation of females were verified to determine the spawning period and fecundity. The physico-chemical parameters presented the following annual mean values: temperature = 28.8ºC, electrical conductivity = 992.5 µS.cm-1; dissolved oxygen = 4.9 mg.L-1 during the study period. The annual mean of the rainfall was 63.5 mm. The results indicate that this species present an omnivorous feeding habit with a tendency towards insectivory, with an increase in feeding activity during the dry season. The aquatic oxygen to interfere very importance in the feeding activity than the others factors physico-chemicals of water and rainfall. There was a predominance of females, with a sex proportion of 1M:7F. The macroscopic characteristics of the ovaries and testicles revealed four stages of gonadal development: immature, maturing, mature and spent. A temporal variation was observed for the gonadal development of males and females. There was reproductive activity through out the year, with peaks in the months of February, April and June to correspond with the rain of precipitation of the region. The mean fecundity was 7.681 mature oocytes, varying from 4.476 to 12.036, with mean of 7.681. There was positive relation between fecundity and body mass. Condition Factor is not an efficient indicator of the reproductive period of this species. The species A. cf. lacustris is an opportunist and is well adapted to the conditions of the semi-arid Caatinga Biome

Abundância e distribuição sazonal de espécies autóctones de camarões peneídeos no canal de abastecimento do sistema primar de aquicultura orgânica (Laguna de Guaraíras, Tibau do Sul, Rio Grande do Norte, Brasil)

Guaraíras lagoon, located in Tibau do Sul in the eastern littoral of Rio Grande do Norte (Brazil), presents a permanent connection to the sea, which guarantees the occurrence of a rich biodiversity, which includes the autochthonous shrimp species Litopenaeus schmitti, Farfantepenaeus subtilis and Farfantepenaeus brasiliensis. In spite of being subject to a strong human intervention in the last decade, mainly related to the installation of shrimp (Litopenaeus vannamei) farms, the lagoon is still scarcely studied. The present study aims at characterizing the populations of the three autochthonous penaeid shrimp species inhabiting Guaraíras, taking into consideration their abundance and seasonal distribution in the inflow channel of Primar System of Organic Aquaculture (Tibau do Sul, Rio Grande do Norte, Brazil). Twelve monthly samples were carried out from May 2005 to April 2006 with the aid of a circular cast net in the inflow channel, which is daily supplied with water from Guaraíras. Sampling months were grouped in trimesters according to the total pluviosity, thus comprising four trimesters. Water salinity was monitored twice a week and temperature values registered on a daily basis at noon, during the study period. The daily pluviosity data from the municipality of Tibau do Sul were supplied by Empresa de Pesquisa Agropecuária do Rio Grande do Norte (EMPARN). Collected shrimp were identified, weighted, measured and sexed. L. schmitti specimens (0.2 g to 17.8 g) were distributed in 1.3 g weight classes intervals. From the eighth sampling month (December 2005) onwards, males were classified into three categories, in accordance with the development of their petasm: (a) rudimentary petasm, (b) partially formed petasm, and (c) completely formed petasm. Among the ecological variables, rainfall showed the greatest dispersion (s.d.=187.74Rainfall and abundance of L. schmitti were negatively correlated (r = -0.85) whereas its abundance and water salinity were positively correlated (r = 0.63). Among 1,144 collected individuals, 1,127 were L. schmitti, 13 were F. subtilis and 4 were F. brasiliensis, which corresponded to 98.51%, 1.14% and 0.35% of the total of collected individuals. L. schmitti occurred in 100 % of all samples. Differently, the presence of F. subtilis and F. brasiliensis was restricted to 33% and 17% of the collected samples, respectively. The present study confirmed the occurrence of L. schmitti, F. brasiliensis and F. subtilis in Guaraíras. However, this lagoon seems to be primarily inhabited by juvenile Litopenaeus schmitti. The population of L. schmitti analysed showed a seasonal pattern of distribution. In general, in the months of high salinity and absence of rain, the number of individuals was higher than in the wet months. Further studies on the reproductive biology and ecology of L. schmitti, F. brasiliensis and F. subtilis may elucidate questions referring to the abundance, period, and phase of occurrence of these shrimp genera in Guaraíras. Finally, the risks associated to the establishment of L. vannamei in the lagoon provide a novel outlet for studies in this biotope

Aspectos da biologia reprodutiva de Eretmochelys imbricata (testudines, cheloniidae) no litoral sul do Rio Grande do Norte, Brasil

Female hawksbill turtles (Eretmochelys imbricata) nesting along the southeastcoastline of Rio Grande do Norte State, Brazil (6º13'40"S, 35º03'05"W) were captured and weighed during the four months from January to April 2007, in the course of the annual egglaying season, which extended from 06 rd November 2006 to 30 rd May 2007. In all, 99 weight measurements were performed. On first contact the females exhibited an average post-oviposition weight of 79.1 kg (range 56.2-98.9 kg, SD = 10.9 kg, n = 44 females). Those individuals which were subsequently recaptured showed a mean weight loss of 1.7 kg (range 0.7-4.5 kg, SD = 1.0 kg, n = 39 sets of measurements on 20 females) in the interval between two consecutive post-ovipositions, separated by a maximum time interval of 17 days. In the cases where the female aborted the nesting process, the pre-oviposition weight was measured. The clutch weight, that is to say, the weight loss between consecutive pre-oviposition and post-oviposition measurements (separated by a maximum time interval of 3 days), was found to be 5.2 kg (range 4.3-6.0 kg, SD = 0.9 kg, n = 6 sets of measurements). This value is significantly higher (t-test, p<0.001) than the loss between two consecutive post-oviposition measurements with the same female. The mean recovery in body weight, that is to say, the average gain in weight between successive post-oviposition and pre-oviposition captures of the same individual (separated by a time interval of 12 to 17 days), was found to be 3.0 kg (range 1.9-4.3 kg, SD = 1.0 kg, n = 4 sets of measurements) Although the small sample size makes it unwise to generalise, the recovery in body weight was found to be always significantly lower (t-test, p<0.005) than the clutch weight. This fact is in agreement with the observed weight loss tendency throughout the breeding season for this species. Considering the clutch weight and the internidal recovery in body weight we found that the total weight loss of the adult hawksbill females after three to five nesting events varied from 10.4% (range 8.7-11.9%, SD = 1.6%, n = 3) to 14.1% (range 11.8-15.4%, SD = 1.3%, n = 6) in relation to their initial pre-oviposition weight. If there were no body weight recovery during the internesting interval we estimate that a female that nests three to five times in the course of the season would lose from 19% to 31% of its initial weight. We emphasise that our clutch weight estimate was performed by weighing the females and not by multiplying the number of eggs in the nest by their average unit weight. In this way, our measurements take into account the loss of liquid during the oviposition. Despite the unequivocal evidence of body weight recovery during the internidal interval, it is not clear if the cause of this process is rehydration or feeding

Redução da morbi-mortalidade na síndrome de hellp completa com o uso de altas doses de dexametasona

Objective: To determine the clinical maternal and neonatal outcomes in HELLP syndrome patients treated with dexamethasone who either developed renal injury or renal insufficiency and to identify predictive values of urea and creatinine for the identification of subjects with HELLP syndrome at risk of developing renal insufficiency. Methods: Non-radomized intervention study of dexamethasone use in HELLP syndrome. A total of 62 patients were enrolled at Maternidade Escola Januário Cicco (MEJC). Patients received a total of 30 mg of dexamethasone IV, in three doses of 10 mg every 12 hours. A clinical and laboratory follow up were performed at 24, 48 and 72 hours. Patients were followed up to 6 months after delivery. Patients were grouped in accordance to renal function, i.e, normal and some type of renal lesion. Renal lesion was considered when creatinine was equal or greater than 1.3 mg/dl and diuresis less than 100 ml in 4 hours period and renal insufficiency was defined when dialysis was needed. Results: A total of 1230 patients with preeclampsia were admitted at MEJC. Of those 62 (5%) developed HELLP syndrome. There was no statistical difference in the groups with renal involvement or normal renal function with respect to the demographics, type of anesthesia used and delivery, and weight of the newborn. An improvement in the AST, ALT, LDH, haptoglobine, antithrombine, fibrinogenen and platelets was observed within 72 hours after dexamethosone use. There was a significant increase in the diuresis within the interval of 6 hours before the delivery and 24 hours after it. Of the 62 patients, 46 (74. 2%) had normal renal function and 16 (25.8%) evolved with renal lesion, with 5 (8.1%) needing dialysis. These 5 patients who received dialysis recovered the xi renal function. The delay in administering dexamethasone increased in 4.6% the risk of development of renal insufficiency. Patients with renal insufficiency had received significantly more blood products than subjects without renal lesion (p=0.03). Diuresis, leukocytes, uric acid, urea, creatinine were significantly different between the groups with normal renal function, renal lesion and renal insufficiency. The levels of creatinine 1.2mg/dl and uric acid 51mg/dl, at admission are predictive of subjects who will evolve with renal lesion (p<0.001). Maternal mortality was 3.2%. None of the subjects with renal insufficiency evolved with chronic renal disease. Conclusions: Dexamethasone in patients with HELLP syndrome seems to reduce significantly the hepatic microthrombosis and normalize hemostasis as seen by improvement of liver function. Renal injury can be considered, in HELLP syndrome, when creatinine levels are greater than 1.3 mg/dl and diuresis less than 100 ml/h in interval of 4 hours. The level of creatinine greater than 1.2 mg/dl and urea greater than 51mg/dl are predictive of subjects with HELLP syndrome who will develop renal injury. Patients who receive more red cell packs develop renal insufficiency. Finally, the delay in administering dexamethasone increases the risk of developing renal insufficiency

HIV/AIDS e estilo de vida: parâmetros imunológicos, virológicos, síndrome lipodistrófica e sua relação com a prática de exercícios

This descriptive study aimed to investigate the relationship between expression of immunological (TCD4 +) and virological (viral load) parameters, lipodystrophy syndrome and lifestyle variables of people living with HIV who underwent a program of physicalexercise. Initially, the sample was composed by 17 persons, recorded at the Department of Giselda Trigueiro Hospital Care (GTH), Natal-RN . With the passing of the stages of intervention (physical training program- PTP) the number of participants has changed (17, 9, 8 and 7) as the training phases (I, II, III and IV). Data collected were on total cholesterol, High Density Lipoprotein (HDL) and triglycerides. The % fat (% F), body mass index (BMI), waist-hip ratio (WHR), lean mass (LM), central fat (BF), total (TF) and peripheral (PF), weight and height were used to measure the morphological parameters. For control of variables (TCD4 +, viral load, Triglycerides, Cholesterol, HDL), the information contained in the blood tests every four months were investigated. After Phase I and II, it was used a structured interview. Then sampling was carried out considering the pre-and post-tests 1, 2, 3 and 4 (after 16, 32, 48 and 64 weeks of training, respectively). Daily, the intensity of the work was checked by the scale of perceived exertion for exercises adapted to resistance34. Procedures used were descriptive statistics (dispersion, absolute and relative frequencies, means, standard deviations and minimum and maximum values) as well as Spearman linear correlation adopting a significance level of p &#8804; 0.05. Positive changes were observed for TCD4 + and viral load in all phases of the PTP. For the morphological components, the loss of central subcutaneous fat (CSF) and total subcutaneous fat (TSF) for both sexes and the decrease in % BF among women were the most dramatic results after the training phase I. For men, results were more significant to % F and LM in Phases I and II and peripheral subcutaneous fat (PSF) declined in all phases of the exercise. As for women, results were more expressive for % F and TM in the phases I and II and the PSF decreased in all phases of the exercise. Whereas for women, the waist/hip ratio (WCQ) and 0% F decreased and showed a positive association with triglycerides (WHR r * 0.82, p 0.042, r 0.88 TSF *, p 0.019 and r 1.00 ** CSF, p <0.001) and among men with limb subcutaneous fat (LSF)* r 0.65, p 0.029). The PTP provided improvement in the health, self-esteem and quality of life, proving to be a possible strategy to positively influence the expression of immunological parameters (TCD4 +) and virological (viral load) and morphological components of people living with HIV causing no deleterious effects in these parameters

Efeitos do treino em esteira com suporte parcial de peso e do método de facilitação neuromuscular proprioceptiva na marcha hemiparética: estudo comparativo

Objective: To compare the effects of the treadmill training with partial body-weight support (TPBWS) and Proprioceptive Neuromuscular Facilitation (PNF) method on gait of subjects with chronic stroke. Design: Quasi-experimental study. Setting: Laboratorial research. Participants: Twenty-three subjects (13 men and 10 women), with a mean age of 56,7 ± 8,0 years and a mean time since the onset of the stroke of 27,7 ± 20,3 months, and able to walk with personal assistance or assistive devices. Interventions: Two experimental groups underwent gait training based on PNF method (PNF group, n=11) or using the TPBWS - Gait Trainer System 2, Biodex, USA (TPBWS group, n=12), for three weekly sessions, during four weeks. Measures: Evaluation of motor function - using the Stroke Rehabilitation Assessment of Movement (STREAM) and the motor subscale of the Functional Independence Measure (motor FIM) -, and kinematic gait analyze with the Qualisys System (Qualisys Medical AB, Gothenburg, Sweden) were carried out before and after the interventions. Results: Increases in the STREAM scores (F=49.189, P<0.001) and in motor FIM scores (F=7.093, P=0.016), as well as improvement in symmetry ratio (F=7.729, P=0.012) were observed for both groups. Speed, stride length and double-support time showed no change after training. Differences between groups were observed only for the maximum ankle dorsiflexion over the swing phase (F=6.046, P=0.024), which showed an increase for the PNF group. Other angular parameters remain unchanged. Conclusion: Improvement in motor function and in gait symmetry was observed for both groups, suggesting similarity of interventions. The cost-effectiveness of each treatment should be considered for your choice