Efeito de um programa misto de intervenção nutricional e exercício físico sobre a composição corporal e os hábitos alimentares de mulheres obesas em climatério

OBJETIVO: Foi avaliar o efeito de programa misto de intervenção nutricional e exercício físico sobre a composição corporal e hábitos alimentares de mulheres obesas em climatério. MÉTODOS: Trabalhou-se com 2 grupos de 15 pessoas por 40 semanas: Grupo Dieta (intervenção nutricional) e Grupo Exercício (intervenção nutricional e exercício). RESULTADO: As reduções do peso (-2,3kg para Grupo Dieta e -5,3kg para o Grupo Exercício) e da circunferência da cintura (-4,8cm para Grupo Dieta e -7,6cm para Grupo Exercício), foram maiores para o Grupo Exercício. Foi verificada evolução positiva na classificação do Índice de Massa Corporal para ambos os grupos, sendo que o Grupo Exercício respondeu melhor ao tratamento. O padrão alimentar foi considerado monótono e com baixo consumo de alimentos regionais. CONCLUSÃO: O programa foi efetivo para perda de peso, em maior intensidade na presença de exercício. A educação alimentar proposta foi capaz de acarretar mudanças nos hábitos alimentares.

Intervenção fonoaudiológica na síndrome de kabuki: relato de caso

TEMA: este trabalho teve como objetivo descrever o processo de intervenção fonoaudiológica em um caso de síndrome de Kabuki, com ênfase na terapia de linguagem. PROCEDIMENTOS: trata-se de relato de caso de uma criança de seis anos e seis meses de idade, gênero feminino, com diagnóstico de síndrome de Kabuki, que realizou terapia fonoaudiológica durante três anos em uma clínica-escola. Foi realizada análise documental dos dados do prontuário relativos à anamnese, avaliação e relatórios terapêuticos fonoaudiológicos, exames e avaliações multidisciplinares. Aos três anos e cinco meses, a criança passou por avaliação fonoaudiológica e apresentou, como histórico, características típicas da síndrome de Kabuki: alteração cardíaca, episódios de pneumonia, otite média secretora recorrente, alterações ortopédicas e crises convulsivas. Na avaliação fonoaudiológica, apresentou tempo de atenção auditiva e visual reduzido, dificuldade de compreensão oral, comunicação por meio de poucos gestos e vocalizações e problemas de comportamento. RESULTADOS: o processo terapêutico teve como objetivo principal promover o desenvolvimento da linguagem com ênfase na interação social por meio de atividades lúdicas, orientação familiar e escolar. Foi observada melhora na compreensão e emissão oral, no contato social e manutenção da atenção. CONCLUSÃO: este estudo permitiu divulgar o percurso de atuação fonoaudiológica na síndrome de Kabuki, do processo diagnóstico à terapia de linguagem. Verificou-se que a terapia foi eficaz no que se refere às habilidades comunicativas e de interação social. Esses dados podem contribuir para elucidar lacunas existentes na literatura acerca da terapia fonoaudiológica na síndrome em questão e subsidiar intervenções clínicas nesses casos.

Modelos lineares generalizados mistos na avaliação genética da prenhez precoce na raça Nelore

This study aimed to use the generalized linear models with probit and logit link function to evaluate early pregnancy, and to observe the effects on genetic variability and on sire selection when different ages are adopted in the definition of this trait. Early pregnancy was studied at 15 (EP15), and 21 (EP21) months. The analysis was done in R software. Pearson correlations (PC), between genetic predicted values and percentage of bulls in common considering only 10% of bulls with higher genetic values (TOP 10), between classification by logit and probit models and in each model among EP15 and EP21, were calculated. The heritability for EP15 and EP21 were close between models, except for EP15 using probit link function. PC and TOP10 among models were high. The Akaike and Bayesian criteria reported was similar between models. TOP10, considering the same model, among EP15-EP21 were moderated between EP15-EP21.

Utilização do metabolismo protéico ( 15N-glicina) na detecção precoce de agravamento da atividade da doença em pacientes portadores de retocolite ulcerativa inespecífica

Disease activity was assessed in 10 (five males and five females) ulcerative colitis patients through the following parameters: clinical, laboratory, sigmoidoscopic and histological. Protein metabolism was also assessed with 15N-glycine and urinary ammonia as end product. Only one patient had exacerbation of the disease two months after the study started. This patient presented in the beginning of the study protein synthesis and breakdown of 4.51 and 3.47 g protein/kg/day, respectively, values higher than all other patients, showing an hypermetabolic state, suggesting an increase of the disease activity. However, this increase was not detected by others indicators and indexes utilised. These data allow to suggest the hypothesis that protein metabolism predicts precociously the exacerbation of disease activity in ulcerative colitis patients.

A administração precoce de hormônio de crescimento resulta em efeitos deletérios na remodelação ventricular após o infarto agudo do miocárdio

Objective: To assess the effect of growth hormone (GH) on myocardial remodeling in infarcted rats. Methods: This study comprised 24 Wistar rats divided into 3 groups as follows: 1) AMI-GH group - comprising 8 rats that underwent infarction and were treated with GH; 2) AMI group - comprising 8 rats that underwent infarction and received only the diluent of the GH solution; and 3) control group (C group) - comprising 8 rats that underwent simulated infarction. After 30 days, the animals underwent functional study through echocardiography, and the changes in myocardial contractility of the isolated left ventricular (LV) papillary muscle were studied. Results: The echocardiography identified an increase in the diastolic (C=7.32±0.49; AMI=8.50±0.73; AMI-GH=9.34±0.73; P<0.05) and systolic (C=3.38±0.47, AMI=5.16±1.24; AMI-GH=5.96±1.54; P<0.05) diameters (mm) in the LV of the infarcted animals. The AMI-GH group animals had a lower ejection fraction (%) (C=0.9±0.03; AMI=0.76±0.12; AMI-GH=0.72± 0.14; P<0.05 for C vs AMI-GH) compared with those in controls. The study of the isolated left ventricular papillary muscle showed that the AMI-GH group had changes (C=1.50±0.59; AMI= 1.28±0.38; AMI-GH=1.98±0.41; P<0.05 for C vs AMI-GH) only in the tension at rest (TR - g/mm2) and in the time delta for a 50% decrease in the tension developed (TR50, ms) after stimulation with calcium (C=23.75±9.16; AMI=-16.56±14.82; AMI-GH=-4.69±8.39; P<0.05 for C vs AMI-GH) and in the delta of tension developed (TD, g/mm2) after stimulation with isoproterenol (C=0.99±0.17; AMI=0.54±0.62; AMI-GH=0.08±0.75; P<0.05 for C vs AMI-GH) compared with those in control animals. Conclusion: The early administration of GH in the experimental infarction model in rats may result in adverse effects on the process of ventricular remodeling.

Determinação precoce do sexo fetal pela análise do DNA no plasma materno

Purpose: to verify the viability of early diagnosis of fetal gender in maternal plasma by the real-time polymerase chain reaction (real-time PCR) starting at the 5th week of pregnancy. Methods: peripheral blood was collected from pregnant women with single fetus starting at the 5th week of gestation. After centrifugation, 0.4 mL plasma was separated for fetal DNA extraction. The DNA was analyzed in duplicate by real-time PCR for two genomic regions, one of the Y chromosome and the other common to both sexes, through the TaqMan® method, which uses a pair of primers and a fluorescent probe. Patients who aborted were excluded. Results: a total of 79 determinations of fetal DNA in maternal plasma were performed in 52 pregnant women. The results of the determinations were compared to fetal gender after delivery. Accuracy according to gestational age was 92.6% (25 of 27 cases) at 5 weeks with 87% sensitivity, and 95.6% (22 of 23 cases) at 6 weeks with 92% sensitivity. Starting at the 7th week of pregnancy, accuracy was 100% (29 of 29 cases). Specificity was 100% regardless of gestational age. Conclusion: real-time PCR for the detection of fetal gender in maternal plasma starting at the 5th week of gestation has good sensitivity and excellent specificity. There was agreement of the results in 100% of the cases in which male gender was diagnosed, regardless of gestational age, and from the 7th week of gestation for female gender diagnosis.

Desenvolvimento motor de criança com paralisia cerebral: Avaliação e intervenção

The objective of this study was to analyze the motor development of a ten year old child with ataxic cerebral palsy and the effects of a motor activities program in the swimming pool. Motor development was measured according to the motor assessment and the intervention program of motor activities in the swimming pool conducted at Sesi/Londrina, twice a week, during 45 minute sessions over a 2 month period, with an attendance rate of 87%. Data was analyzed descriptively comparing the results with before and after tests. Generally, the motor quotient regarding all items was classified as very low, characterizing motor deficit, with exception of temporal organization, presented as normal low. After intervention, the only area that showed positive change was balance; this result showed that the child gained 12 months in motor age, without corresponding alterations in the other areas.

Caracterização de programas de intervenção com crianças e/ou adolescentes

The objective was to present a descriptive analysis of interventions to prevent and/or reduce children's and/or adolescents' problem behaviors. The study reviewed 192 abstracts from journal articles published between the 1986 and June 2006, available on the following databases: Index-Psi/Periódicos, Lilacs, PsycInfo, Scielo and Medline. Categories of analysis focused on bibliography, method, and studies' results. Data-analysis showed that most of the studies focused on groups and families, and samples with more than 30 participants. Study designs were experimental and quasi-experimental, combining observation and self report or just self report for data collection. Result analysis suggests that the intervention programs contributed specially for reducing behavior problems, and improving parental practices. Discussion evaluates contributions of the study and gaps in knowledge.

Avaliação de grupo de intervenção para as mães/cuidadores de crianças pré-escolares com problemas de comportamento externalizantes

Negative parental practices may influence the onset and maintenance of externalizing behavior problems, and positive parenting seem to improve children's social skills and reduce behavior problems. The objective of the present study was to describe the effects of an intervention designed to foster parents' social skills related to upbringing practices in order to reduce externalizing problems in children aged 4 to 6 years. Thirteen mothers and two care taker grandmothers took part in the study with an average of four participants per group. To assess intervention effects, we used a repeated measure design with control, pre, and post intervention assessments. Instruments used were: (a) An interview schedule that evaluates the social interactions between parents and children functionally, considering each pair of child's and parent's behaviors as context for one another; (b) A Social Skills Inventory; (c) Child Behavior Checklist - CBCL. Intervention was effective in improving parent general social skills, decreasing negative parental practices and decreasing child behavior problems.

Educação inclusiva: Análise e intervenção em uma sala de recursos

This paper is based on the Support Paradigm, which establishes the principles to the inclusive education, which indicates educational adjustments participating in the regular school to all students. This study aimed to analyze a special classroom working arrangements and to describe an intervention implemented having a special classroom teacher as participant. Data collection comprised the following phases: (a) special classroom description; (b) analysis of the teacher's teaching plan; (c) application of survey and discussion comprising theory and practice on inclusive education; (d) curricular adaptation fulfilling. Data analysis comprised: special classroom characterization, survey analysis, comparative analysis of curricular adaptation. As results, the study shows divergences between public educational policies and school reality. The intervention provided the teacher with a reflection about her on-work performance based on new teaching procedures.

Fondaparinux em intervenção coronária percutânea no tratamento da síndrome coronária aguda

Background: Fondaparinux is considered an agent with a well-established safety and efficacy profile in the treatment of non-ST segment elevation acute coronary syndromes, but when used alone, is associated to a higher incidence of thrombotic complications during invasive coronary procedures, requiring the supplementation of an anti-IIa agent. This study aimed to evaluate the efficacy and safety of percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndromes previously treated with fondaparinux. Methods: Prospective, controlled registry enrolling 127 consecutive patients submitted to an early invasive stratification during treatment with fondaparinux, with supplementation of intravenous unfractionated heparin at a dose of 85 U/kg at the time of PCI. Results: The rate of the composite primary endpoint including death, acute myocardial infarction, stroke, stent thrombosis or emergency myocardial revascularization was 3.2%. The cumulative incidence of major bleeding and vascular complications was 3.2%. There were no cases of guidecatheter thrombosis or abrupt vessel closure. Conclusions: PCI in patients with acute coronary syndromes receiving fondaparinux is associated with a low rate of major adverse cardiovascular ischemic events and severe hemorrhagic complications. Supplementation of unfractionated heparin during the invasive procedures eliminates the risk of catheter-related thrombosis.

Aplicação do Processo Analítico Hierarquico (AHP) Para Priorização de Obras de Intervenção em Áreas e Setores de Risco Geológico nos Municípios de Itapecerica da Serra e Suzano (SP)

Municipal Plans of Risk Reducing (PMRR's) were produced in settlements in the municipalities of Itapecerica da Serra (SP) and Suzano (SP), covering areas at risk of landslides and washouts of banks of streams. The development of PMRR's provided the delimitation of areas of risk, the indication of intervention works in order to eliminate and / or reduce risks, and consequently an indication of the areas and priority sectors for implementation of intervention works. The prioritization of areas and sectors that should receive the works of reducing or eliminating risk was performed by an expert involved in risk mapping. Despite the specialist's judgment exercise caution, the decision regarding the priority sites for implementation of alternative interventions is subjective. Since there is no way to eliminate this subjectivity, the use of decision-making techniques is important to evaluate whether the expert's reasoning is consistent. One of the first techniques developed for multiple criteria is the AHP (Analytic Hierarchy Process). This paper describes the results of a research carried out in order to assess whether the use of Analytic Hierarchy Process contributes to the results of the indication of the areas and priority sectors for implementation of interventions can be considered more consistent than in situations where the priority occurs without the use of decision making techniques. Results were compared between the prioritization of interventions for implementation contained in PMRR's of Itapecerica da Serra and Suzano and those obtained from the use of Analytic Hierarchy Process (AHP). It was concluded that such techniques permits an evaluation of the expert's judgment is logically coherent, thus contributing to produce results more technically based.

Desmame precoce: Falta de conhecimento ou de acompanhamento?

Objective: To assess the knowledge of women and the instructions received on breastfeeding during pregnancy and after childbirth, and their influence on breastfeeding practice. Method: This study was a longitudinal investigation following 84 pairs of mothers and babies from pregnancy through the sixth month of baby's life. In the first phase of the research, interviews were made with the pregnant women at home and at Basic Health Units to collect information about their intentions and knowledge of breastfeeding. In the second phase of the research, mothers and babies were followed up from the first to sixth month of baby's life to record the difficulties of breastfeeding and reasons for weaning. Results: In the first month, 94.3% (82) of the babies were breastfed, but only 49.4% (43) were breastfed exclusively. At the end of the sixth month of life, 43.7% (38) of the babies had already been weaned. No mother breastfed exclusively her baby within the sixth month. During pregnancy, 60.7% (51) of the mothers had no instructions about breastfeeding and 83.4% (70) of the mothers received instructions on breastfeeding after childbirth. Most mothers (76.2%) knew about the ideal breastfeeding period. Seventy-three (86.9%) mothers believed that breastfeeding was beneficial for the baby, but only 41 (48.8%) of them really breastfed. Only 11 (13.1%) mothers were followed up by the public health system team during lactation. Conclusion: Although most women had been instructed during pregnancy or after childbirth and had knowledge of breastfeeding, early weaning occurred. Advising is important, but the support and follow up of the mothers are of utmost importance for a successful breastfeeding practice.

Identificação precoce do risco para transtornos da atenção e da leitura em sala de aula

In this his study the accuracy was investigated of collective pedagogical activities, based on phonological judgments by matching figures and figures to spoken words, to identify students at risk for reading and/or attention disorders. Forty-five second graders (mean age of 7 years, 29 males) were divided into two groups, a control group, without reading difficulties (n=32), and an at-risk group, with reading difficulties (n=13). The low-achievement on these collective activities, defined by scores more than 1.65 SD below the mean of the control group, presented good sensitivity (true positives) and specificity (true negatives) in the early identification of at risk students.