Ankle-Brachial Index: Nurses Strategy To Cardiovascular Disease Risk Factors Identification

Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease, with assessment through the ankle-brachial index (ABI). This study aimed to demonstrate that the ABI and the Edinburgh Claudication Questionnaire are tools to be used by nurses in prevention and/or treatment of CVD (cardiovascular disease). A cross-sectional study was carried out with patients from a cardiovascular clinic. The Edinburgh Claudication Questionnaire was applied and the ABI was measured with the formula (ABI= Blood Pressure Ankle/Blood Pressure Brachial). A total of 115 patients were included, most were females (57.4%), aged 60.6 ± 12.5 years. The most prevalent risk factors were hypertension (64.3%), physical inactivity (48.7%) and family history (58.3%). The study showed that abnormal ABI was frequently found and 42.6% of the patients with abnormal ABI showed intermittent claudication. The method to evaluate the ABI associated to the Edinburg Claudication Questionnaire, can be easily used by nurses in the clinical evaluation of asymptomatic and symptomatic CVD patients.

Versão em português da Family Environment Scale: aplicação e validação

OBJETIVO: Traduzir a Escala do Ambiente Familiar (Family Environment Scale) para a língua portuguesa e aplicar o instrumento para sua validação. MÉTODOS: A tradução foi aplicada a membros de famílias brasileiras, visando avaliação da consistência interna e a concordância entre membros da mesma família. Foram selecionados 154 voluntários não sujeitos a qualquer intervenção para lidar com problemas familiares, residentes na cidade de São Paulo, em 2003. As pontuações médias nas dez subescalas do instrumento foram comparadas entre homens e mulheres e entre membros da mesma família. Avaliou-se a consistência interna pelo alfa de Cronbach. RESULTADOS: A pontuação máxima possível era nove em cada subescala (bom funcionamento familiar), exceto em relação a conflito e controle. Na maioria das subescalas, a pontuação média da amostra estudada esteve entre 5,1 e 7,6 (homens) e entre 5,4 e 7,7 (mulheres). Nas subescalas conflito e controle as médias variaram entre 1,8 e 4,6 (homens) e entre 1,6 e 4,6 (mulheres), sendo semelhantes às relatadas em estudos internacionais, exceto maior pontuação nas subescalas coesão e organização, e menor na subescala conflito. Não houve diferença estatisticamente significativa entre as pontuações atingidas por homens e mulheres. A confiabilidade da escala avaliada pelo alfa de Cronbach variou entre 0,61 e 0,78 para as dez subescalas. CONCLUSÕES: Fatores culturais podem ter influenciado os resultados obtidos em algumas subescalas. A versão em português da Escala do Ambiente Familiar apresentou razoável consistência interna que permite sua utilização para avaliar alterações no ambiente ou funcionamento familiar, e após intervenções terapêuticas.

Prevalence and factors associated to the epidemic neuropathy in a population assisted by a family doctor in Cuba

With the outbreak of an epidemic neuropathy (EN) of unknown ethiology, a study of the prevalence and factors associated to the disease was carried out in the Zamora community, municipality of Marianao, Havana City. There were 11 patients identified with EN for a prevalence rate of 1.7/100. The major risk group was the one between 45 and 64 years of age, female sex, black skin. In the univaried analysis, a high prevalence ratio (PR) was found linked to beverage intake (PR=5.32 95%; confidence intervals (CI) = 1.2-24.4), frequent drugs intake (PR=6.59; CI=1.8-24.6), consumption of edible of non certified fats (PR=4.48; CI=1.2-16.7) and the smoking habit (PR=3.6; CI=1.1-12.2). More than73/100 (CI= 68.7-78.3) of the people under serologic study were infected with Coxsakie virus A-9 (strain 47) isolated from a patient still under research. It seems there are many factors like linder intake, antecedents of hemorrhagic conjuntivitis, nutritional aspects and others that, with the virus isolated were associated with this epidemiologic situation.

Laboratory evaluation of methanolic extract of Atlantia monophylla (Family: Rutaceae) against immature stages of mosquitoes and non-target organisms

Methanolic extracts of the leaves of Atlantia monophylla (Rutaceae) were evaluated for mosquitocidal activity against immature stages of three mosquito species, Culex quinquefasciatus, Anopheles stephensi, and Aedes aegypti in the laboratory.Larvae of Cx. quinquefasciatus and pupae of An. stephensi were found more susceptible, with LC50 values of 0.14 mg/l and 0.05 mg/l, respectively. Insect growth regulating activity of this extract was more pronounced against Ae. aegypti, with EI50 value 0.002 mg/l. The extract was found safe to aquatic mosquito predators Gambusia affinis, Poecilia reticulata, and Diplonychus indicus, with the respective LC50 values of 23.4, 21.3, and 5.7 mg/l. The results indicate that the mosquitocidal effects of the extract of this plant were comparable to neem extract and certain synthetic chemical larvicides like fenthion, methoprene, etc.

A multicriteria model to assess tractors used in family agriculture

In recent years, public policy has been offering subsidized credit for machine purchase to family farmers. However, there is no methodological procedure to select a suitable tractor for these farmers' situation. In this way, we aimed to develop a selection model for smallholder farmers from Pelotas city region in the state of Rio Grande do Sul. Building a multicriteria model to aid decisions is divided into three main stages: structuring stage (identifying stakeholders, decisional context and model creation), evaluation stage (stakeholder preference quantification) and recommendation stage (choice selection). The Multicriteria method is able to identify and value the criteria used in tractor selection by regional family farmers. Six main evaluation areas were identified: operational cost (weight 0.20), purchase cost (weight 0.22), maintainability (weight 0.10), tractor capacity (weight 0.26), ergonomics (weight 0.14) and safety (weight 0.08). The best-rated tractor model (14.7 kW rated power) also was the one purchased by 53.3% of local families.

Energetic sustainability of three arabica coffee growing systems used by family farming units in Espírito Santo state

Three growing systems of Arabica coffee were evaluated under the energy perspective, in the state of Espírito Santo in Brazil. The systems are conventional cultivation (CC), cultivation with good agricultural practices (CGP) and organic farming (OF). It was made a comparison of the energy flows within these three systems to show sustainable levels of each one based on production average data of several family-farming units. Therefore, we analyzed crop yield, total energy efficiency reverse (TEER), energy efficiency of ripe coffee (EERC) and non-renewable energy efficiency (NREE). OF system had values for TEER, EERC and NREE of 3.3 4.7 and 7.9 respectively. Yet CC showed values of 1.8, 1.9 and 1.6 for TEER, EERC and NREE respectively. Furthermore, CGP presented values for TEER, EERC and NREE of 0.7, 1.3 and 1.4 respectively. The highest yield was observed in CGP, reaching an amount of 1794 kg ha-1(17,455 MJ); however, this system expends more energy than it converts. Thus, over those points, OF is the most sustainable system.

Identification and antimicrobial resistance of members from the Enterobacteriaceae family isolated from canaries (Serinus canaria)

Abstract: The Enterobacteriaceae family contains potentially zoonotic bacteria, and their presence in canaries is often reported, though the current status of these in bird flocks is unknown. Therefore, this study aimed to identify the most common genera of enterobacteria from canaries (Serinus canaria) and their antimicrobial resistance profiles. From February to June of 2013, a total of 387 cloacal swab samples from eight domiciliary breeding locations of Fortaleza city, Brazil, were collected and 58 necropsies were performed in canaries, which belonged to the Laboratory of Ornithological Studies. The samples were submitted to microbiological procedure using buffered peptone water and MacConkey agar. Colonies were selected according to their morphological characteristics on selective agar and submitted for biochemical identification and antimicrobial susceptibility. A total of 61 isolates were obtained, of which 42 were from cloacal swabs and 19 from necropsies. The most isolated bacteria was Escherichia coli with twenty five strains, followed by fourteen Klebsiellaspp., twelve Enterobacterspp., seven Pantoea agglomerans, two Serratiaspp. and one Proteus mirabilis. The antimicrobial to which the strains presented most resistance was sulfonamides with 55.7%, followed by ampicillin with 54.1% and tetracycline with 39.3%. The total of multidrug-resistant bacteria (MDR) was 34 (55.7%). In conclusion, canaries harbor members of the Enterobacteriaceae family and common strains present a high antimicrobial resistance rate, with a high frequency of MDR bacteria.

Investigation of single-strand conformational polymorphism of the TP53 gene in women with a family history of breast cancer

Breast cancer in families with germ line mutations in the TP53 gene has been described in the medical literature. Mutation screening for susceptibility genes should allow effective prophylactic and preventive measures. Using single-strand conformational polymorphism, we screened for mutations in exons 5, 6, 7 and 8 of gene TP53 in the peripheral blood of 8 young non-affected members (17 to 36 years old) of families with a history of breast cancer. Studies of this type on young patients (mean age, 25 years) are very rare in the literature. The identification of these mutations would contribute to genetic counseling of members of families with predisposition to breast cancer. The results obtained did not show any polymorphism indicating mutation. In our sample, the familial tumorigenesis is probably related to other gene etiologies.

Association between EcoRI fragment-length polymorphism of the immunoglobulin lambda variable 8 (IGLV8) gene family with rheumatoid arthritis and systemic lupus erythematosus

The human immunoglobulin lambda variable 8 (IGLV8) subgroup is a gene family containing three members, one of them included in a monomorphic 3.7-kb EcoRI genomic fragment located at the major lambda variable locus on chromosome 22q11.1 (gene IGLV8a, EMBL accession No. Z73650) at 100% frequency in the normal urban population. The second is a polymorphic RFLP allele included in a 6.0-kb EcoRI fragment at 10% frequency, and the third is located in a monomorphic 8.0-kb EcoRI fragment at 100% frequency, the last being translocated to chromosome 8q11.2 and considered to be an orphan gene. Our Southern blot-EcoRI-RFLP studies in normal individuals and in patients with rheumatoid arthritis (RA) or with systemic lupus erythematosus (SLE), using a specific probe for the IGLV8 gene family (probe pVL8, EMBL accession No. X75424), have revealed the two monomorphic genomic fragments containing the IGLV8 genes, i.e., the 3.7-kb fragment from chromosome 22q11.1 and the 8.0-kb fragment from 8q11.2, both occurring at 100% frequency (103 normal individuals, 48 RA and 28 SLE patients analyzed), but absence of the 6.0-kb IGLV8 polymorphic RFLP allele in all RA or SLE patients. As expected, the frequency of the 6.0-kb allele among the normal individuals was 10%. These findings suggest an association between the absence of the 6.0-kb EcoRI fragment and rheumatoid arthritis and systemic lupus erythematosus.

Transcriptional up-regulation of PHLDA1 by 17β-estradiol in MCF-7 breast cancer cells

Most breast cancer risk factors are associated with prolonged exposure of the mammary gland to high levels of estrogens. The actions of estrogens are predominantly mediated by two receptors, ERα and ERβ, which act as transcription factors binding with high affinity to estrogen response elements in the promoter region of target genes. However, most target genes do not contain the consensus estrogen response elements, but rather degenerated palindromic sequences showing one or more mutations and other ER-binding sites such as AP-1 and SP-1. Using the differential display reverse transcription-polymerase chain reaction technique, our group identified several genes differentially expressed in normal tissue and in ER-positive and ER-negative primary breast tumors. One of the genes shown to be down-regulated in breast tumors compared to normal breast tissue was the PHLDA1 (Pleckstrin homology-like domain, family A, member 1). In the present study, we investigated the potential of PHLDA1 to be regulated by estrogen via ER in MCF-7 breast cancer cells. The promoter region of PHLDA1 shows an imperfect palindrome, an AP-1- and three SP-1-binding sites potentially regulated by estrogens. We also assessed the effects of 17β-estradiol on PHLDA1 mRNA expression in MCF-7 breast cancer cells. MCF-7 cells exposed to 10 nM 17β-estradiol showed more than 2-fold increased expression of the PHLDA1 transcripts compared to control cells (P = 0.05). The anti-estrogen ICI 182,780 (1 µM) inhibited PHLDA1 mRNA expression and completely abolished the effect of 10 nM 17β-estradiol on PHLDA1 expression (P < 0.05), suggesting that PHLDA1 is regulated by estrogen via ER.

Emissões otoacústicas por produtos de distorção em crianças de 2 a 7 anos

Com a descoberta das Emissões Otoacústicas (EOA), tornou-se possível analisar e investigar as funções auditivas das células ciliadas externas do órgão da audição. Podem ser espontâneas, evocadas transientes ou por produto de distorção. O teste das EOAEs-DP caracteriza-se por ser um exame objetivo, rápido, indolor, não-invasivo e de fácil aplicação tanto para clínica como para programas de triagem auditiva. FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Foram avaliadas 105 crianças entre 2 e 7 anos de idade da creche "Lar da Criança", de Marília, SP. A avaliação constou de exame otorrinolaringológico completo e EOAEs-DP. Todas estas crianças, após prévia autorização dos responsáveis, foram submetidas a exame otorrinolaringológico completo e EOAEs-DP. RESULTADOS: Os resultados demonstraram que das 105 crianças avaliadas, 44,76% apresentavam cerume. 12 crianças permaneceram com cerume mesmo após uso de ceruminolítico e lavagem auricular ou não apresentaram consentimento informado de seus responsáveis. Portanto, estas foram excluídas do trabalho sendo o restante, 93 crianças, submetidas a avaliação das EOAEs-DP Após a realização das EOAEs-DP, verificou-se que 5,37% das crianças apresentaram exames alterados, sendo que 60% destas eram do sexo masculino e 60% com acometimento bilateral. DISCUSSÃO: Os resultados encontrados foram inferiores aos citados na literatura, assim como o predomínio do sexo masculino. Além disso, notou-se alta prevalência de cerume nos pacientes testados. CONCLUSÃO: É essencial uma avaliação otorrinolaringológica completa prévia. O exame de EOAEs-DP pode ser realizado em crianças para detecção precoce e prevenção de falhas no desenvolvimento cognitivo e psicoemocional.

STRATEGIC DECISIONS OF FAMILY FIRMS ON CASH ACCUMULATION

ABSTRACTGiven the particular strengths, weaknesses, and peculiarities of family firms as well as the importance of liquidity in today’s marketplace, we analyze the distinct characteristics and strategies of family businesses related to the amount of cash a firm holds. We look beyond the traditional factors that influence decisions related to cash management to examine factors that are particularly important for family firms. Specifically, we outline the relevance of strategic decisions guided by family firms’ conservatism, flexibility, long-term view, and the active control that they have over family members. To our knowledge, no prior studies exist regarding family firms and their strategic adjustment of cash holding. Therefore, we investigate whether the ownership structure of the firm (through the presence of a controlling family) moderates decisions on cash holding. We found that family firms tend to accumulate cash for strategic reasons and as a result of their own idiosyncrasies. Thus, family firms can achieve optimal cash accumulation more efficiently than non-family firms.

Prevalência de cárie dentária em escolares de 7 a 12 anos de idade, na cidade de Araraquara, SP (Brasil), 1979

São apresentados os resultados de levantamento epidemiológico de cárie dentária em escolares de 7 a 12 anos de idade da cidade de Araraquara, SP, Brasil, cuja água de abastecimento público é fluoretada. O objetivo do estudo é verificar a prevalência de caria dentária e o nível de assistência odontológica oferecido a esta população. A população de estudo compõe-se de escolares nascidos e sempre residentes na cidade e escolares não nascidos e/ou nem sempre residentes na cidade; são comparados os índices CPO-D obtidos para os dois grupos.

Aspectos ecológicos da Leishmaniose tegumentar americana: 7-Capacidade vetorial flebotomínea em ambiente florestal primário do Sistema da Serra do Mar, região do Vale do Ribeira, Estado de São Paulo, Brasil

Um total de 5.038 indivíduos foram coletados, na região do Vale do Ribeira, Estado de São Paulo (Brasil), durante três anos consecutivos de captura de flebotomíneo, distribuído em dezenove espécies. As armadilhas CDC instaladas na floresta contribuíram com 92,2% e a isca humana com apenas 7,0%, enquanto que no peridomicílio a CDC rendeu 0,7%. De um modo geral, as densidades obtidas com o cálculo da média geométrica de Williams foram reduzidas e a espécie mais comum na área foi P.ayrozai. O resultado de seu grau de antropofilia impede atribuir-lhe papel vetorial importante. Sendo também reduzida a presença de L.intermedia, L. migonei e L. fischeri, até na isca humana, admite-se que essas populações não estariam preenchendo condições de transmissão da doença para o homem, no ambiente florestal, ao lado de outras com hábito fundamentalmente zoófilo. O quadro mostrado poderia indicar que a função vetorial flebotomínea na região estaria sendo desenvolvida por população sobrevivente à devastação, sugerindo que um novo padrão epidemiológico da doença no Brasil parece existir e em associação com focos de L.b. braziliensis.

Health and poverty: health management by the woman

The goal this follow-up study was to relate the mother's marital satisfaction to family health status in a low SES. The random sample was made up of 30 families with children under 7 years old: 15 considered as sick (Group A) and 15 as healthy (Group B). Both group had similar demographic characteristics (age of father and mother, persons per family group and age of children) and SES. Results showed that mothers were those mainly in charge of their family groups. Mothers of Group A were significantly less understanding and more dissatisfied than those of Group B ( p < .05 and p < .01). Mothers of Group A had significantly more arguments with their partners than those of Group B (p < .006). Health care was learned less from the child's own mother in group A than in B (p < .05). Health was considered by mothers of Group A as something that "must be taken care of" more than by those of Group B (p < .01). The behaviours of mothers in choosing one of the health systems was similar in both groups. Dissatisfied mothers were associated more with sick family members during the 6 month follow-up. It is suggested that the satisfaction of the mother is a factor that needs further investigation because health is managed by mothers is the large majority of families.