Fatores genéticos e não genéticos em formas avançadas de Retinopatia Diabética em pacientes com Diabete Melito tipo 2

Introdução: A retinopatia diabética (RD) é a principal causa de novos casos de cegueira entre norte-americanos em idade produtiva. Existe uma associação entre RD e as outras complicações microvasculares do diabete melito. A associação da RD com a fase inicial da nefropatia, a microalbuminúria, não está esclarecida em pacientes com diabete melito (DM) tipo 2. Polimorfismos de genes (ENNP1; FABP2) relacionados à resistência insulínica, entre outros, poderiam estar associados à RD. Objetivo: O objetivo deste estudo foi avaliar fatores genéticos e não genéticos associados à RD avançada em pacientes com DM tipo 2. Métodos: Neste estudo caso-controle foram incluídos pacientes DM tipo 2 submetidos à avaliação clínica, laboratorial e oftalmológica. Foi realizada oftalmoscopia binocular indireta sob midríase e obtidas retinografias coloridas em 7 campos padronizados. Foram classificados como casos os pacientes portadores de RD avançada (formas graves de RD não proliferativa e RD proliferativa) e como controles os pacientes sem RD avançada (fundoscopia normal, e outras formas de RD). Foram estudados os polimorfismos K121Q do gene ENNP1 e A54T do gene FABP2. Na análise estatística foram utilizados testes paramétricos e não paramétricos conforme indicado. Foi realizada análise de regressão logística múltipla para avaliar fatores associados à RD avançada. O nível de significância adotado foi de 0,05%. Resultados: Foram avaliados 240 pacientes com DM tipo 2 com 60,6 ± 8,4 anos de idade e duração conhecida de DM de 14,4 ± 8,4 anos. Destes, 67 pacientes (27,9%) apresentavam RD avançada. Os pacientes com RD avançada apresentaram maior duração conhecida de DM (18,1 ± 8,1 vs. 12,9 ± 8,2 anos; P< 0,001), menor índice de massa corporal (IMC) (27,5 ± 4,2 vs. 29,0 ± 9,6 kg/m2; P= 0,019), além de uso de insulina mais freqüente (70,8% vs 35,3%; P< 0,001) e presença de nefropatia diabética (81,1% vs 34,8%; P< 0,001) quando comparados com os pacientes sem RD avançada. Na avaliação laboratorial os pacientes com RD avançada apresentaram valores mais elevados de creatinina sérica [1,4 (0,6 -13,6) vs 0,8 (0,5-17,9) mg/dl; P<0,001] e de albuminúria [135,0 (3,6-1816,0) vs 11,3 (1,5-5105,0) μg/min; P<0,001] quando comparados com pacientes sem RD avançada. A distribuição dos genótipos dos polimorfismos do ENNP1 e FABP2 não foi diferente entre os grupos. A análise de regressão logística múltipla demonstrou que a presença de nefropatia (OR=6,59; IC95%: 3,01-14,41; P<0,001) e o uso de insulina (OR=3,47; IC95%: 1,60- 7,50; P=0,002) foram os fatores associados à RD avançada, ajustados para a duração de DM, presença de hipertensão arterial, glicohemoglobina e IMC. Quando na análise foram incluídos apenas pacientes normoalbuminúricos e microalbuminúricos, a microalbuminúria (OR=3,8; IC95%: 1,38-10,47; P=0,010), o uso de insulina (OR=5,04; IC95%: 1,67-15,21; P=0,004), a duração do DM (OR=1,06 IC95%: 1,00-1,13; P=0,048) e a glicohemoglobina (OR=1,35; IC95%: 1,02-1,79; P=0,034) foram os fatores associados à RD avançada, ajustados para a presença de hipertensão arterial e IMC. Conclusão: Pacientes com DM tipo 2 portadores de formas avançadas de RD apresentam mais freqüentemente envolvimento renal pelo DM, incluindo o estágio de microalbuminúria. Uma avaliação renal com medida de albuminúria dever ser incorporada como avaliação de rotina nestes pacientes.

Análise empírica do value-at-risk por simulação histórica com atualização de volatilidade para fundos de ações no Brasil

Há mais de uma década, o Value-at-Risk (VaR) é utilizado por instituições financeiras e corporações não financeiras para controlar o risco de mercado de carteiras de investimentos. O fato dos métodos paramétricos assumirem a hipótese de normalidade da distribuição de retornos dos fatores de risco de mercado, leva alguns gestores de risco a utilizar métodos por simulação histórica para calcular o VaR das carteiras. A principal crítica à simulação histórica tradicional é, no entanto, dar o mesmo peso na distribuição à todos os retornos encontrados no período. Este trabalho testa o modelo de simulação histórica com atualização de volatilidade proposto por Hull e White (1998) com dados do mercado brasileiro de ações e compara seu desempenho com o modelo tradicional. Os resultados mostraram um desempenho superior do modelo de Hull e White na previsão de perdas para as carteiras e na sua velocidade de adaptação à períodos de ruptura da volatilidade do mercado.

Os efeitos das reclamações online na lealdade dos consumidores: um estudo experimental

In an environment of constant change, technological developments, market competition and more informed consumers, the search for a lasting relationship through the conquest of loyalty has become the objective of companies. However, several authors suggest that this loyalty can be affected by negative comments available on the internet. Therefore, this dissertation has as objective to examine if the complaints are available on the internet impact the loyalty to a brand of mobile phone. The research used as the basis the Expanded NCSB model suggest by Johnson et al. (2001), studying five prominent drives of loyalty: image/brand reputation, affective commitment, calculative commitment, perceived value and trust, beyond the satisfaction construct as moderator variable. The research method adopted was the experimental design which included 285 undergraduate students, with the trial which included 285 undergraduate students, with the field study of the mobile industry, specifically, the brands of cell phones. The research approach was quantitative and methods were descriptive statistics, factor analysis, cluster analysis, linear regression and non-parametric test of Wilcoxon for data analysis. Of the 16 hypothesis stemmed from the research model proposed, 12 were confirmed. The results showed that the complaint available on the internet, here represented by the available on the site Reclame Aqui, may impact consumer perceptions about brand loyalty, as well as its antecedents, being that these complaints can affect all the consumers, regardless of historical satisfaction with the brand. It also noted the positive relationship between the independent variables trust, image/brand reputation, perceived value, affective commitment and calculative commitment and the dependent variable - loyalty, even when considering the data obtained after exposure to the complaint. However, no unanimous conclusion that the relationship between these variables was strongest in the group with satisfactory experience. At the first moment of the research, the trust was the most important variable for the formation of loyalty. However, after exposure to treatment, the image/brand reputation, was more relevant. Contributions of the study, limitations and recommendations for future researches are approached in the present investigation

Tornar-se, ser e viver do professorado: entre regularidades e variações identitárias

The main aim of this research has been to analyze the identity patterns of the teacher s staff of fundamental education public schools in the Metropolitan Area of Natal-RN. It sets out from the hypothesis that being a teacher within this context grows out of the regularities of a specific habitus, which, according to Bourdieu, develops into mental schemes of thought and action within a specific social group. This habitus forms the basis on which is built the social representation of being a teacher prevailing in the group, as well as the symbolic differences that typify its identity variations. Three data sources have been fundamental in building up this thesis: (a) formative essays of students graduating from a Higher Teacher s Formation Course, as well as observing some of the public defense of these essays during field work; (b) a questionnaire aimed at classifying economically, socially, and culturally a sample of public teachers of the Natal-RN county; and (c) submitting a sub-sample of this group to the process of Multiple Classification Procedures (MCP). The analysis of data was done according to the multidimensional, non-parametric statistical procedures of both the Category Content Analysis and Enunciation Analysis methods. The results of the analysis took into account an ample set of variables, its associations and implications, the cultural and social profile of the population under scrutiny, their life styles, as well as the strategies they developed in the process of becoming a teacher, and the social representation of being a teacher . We came to the conclusion that the social identity of the teachers corps, or as we prefer to say it being a teacher , is a result of a set of regularities produced by the habitus that gives social shape and meaning to the existence of the group proper. We note the existence of identity variations caused by the variables (a) educational level; and (b) mode of action in fundamental education (if these are the first or last grades where the subjects operate). However, these variations will not break the power of the regularities that give shape, meaning, and social visibility to the group. The social representation of being a teacher points to the tensions, ambiguities, and trends inherent to common sense, as well as to a strong tendency to reassign a new meaning to being a teacher. Our thesis, therefore, is that the identity configuration of the teachers corps under scrutiny is characterized by an integrative synthesis, by-product of a habitus that is superimposed, and at the same time co-exists with different identity variations

Representação social do ensinar: a dimensão pedagógica do habitus professoral

Teaching is an activity inherent to the human condition. Historically, from the institutionalization of education, the key role to pursue that activity has been attributed to the teacher, who is required to adapt to the demands of each historical conjuncture. Currently, according to the new paradigmatic requirements, the teacher must possess various skills in order to handle the complex and challenging act of teaching. Assuming the existence of a gap between what the State and the scientific discourse recommend the teacher act upon in the classroom, a decision was made to identify the configuration and structure of social representation in the act of teaching, put forth by elementary school teachers in the public schools of Natal, RN, Brazil. Therefore, the research relied on the theoretical model developed by Domingos Sobrinho (1998, 2000, 2003), which articulates the praxeology of Pierre Bourdieu with the theory of social representations of Serge Moscovici (1978). It was intended to demonstrate how teachers habitus, in its due historical context, directs the construction of social representations in the act of teaching which guides the actions of the teacher, particularly in the classroom context. At the methodological level, the following methods and techniques were used: bibliographic and documentary review in order to identify the scientific discourse on the subject matter and the official parameters of educational regulation and the act of teaching; the Procedure of Multiple Classifications PMC in order to capture the configuration and structure of the representational content in focus, the direct observation of the classroom to identify in actual terms the social representation as "guide to action" as the theory preaches. From the standpoint of the analysis, quantitative data were analysed through Multidimensional Scaling MDS, covering in this study the Multidimensional Scale Analysis MSA and Smallest Space Analysis SSA; and non-parametric statiscal techniques. Additional data of qualitative value had to undergo categorical content analysis. It was then concluded that the teachers investigated guided themselves by social representation, the product of collectively constructed and shared assumptions about the act of teaching, forming a synthesis of different sources of information and knowledge acquirement, involving elements of common sense, religious habitus, pedagogic models considered outdated, the agencies responsible for teacher training and the hegemonic discourse about education today

Haematological and biochemical reference intervals for farmed channel catfish

The reference intervals for biochemical variables and red blood cell indices of healthy intensively bred channel catfish Ictalurus punctatus were determined. The blood variables were determined using standardized clinical methods. The reference intervals (25th and 75th percentiles) were established using a non-parametric method. Reference intervals for plasma glucose, serum total protein, sodium, potassium, calcium, magnesium, chloride concentration, primary and secondary red blood cell indices were established. The haematological and biochemical reference intervals established may allow important clinical decisions about channel catfish. (c) 2007 the Authors Journal compilation (C) 2007 the Fisheries Society of the British Isles.

Efeitos dos esteroides anabólicos androgênicos sobre o útero e parâmetros reprodutivos de ratas adultas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of respiratory biofeedback associated to re-expansive ventilation patterns in individuals with functional mouth breathing

Objectives: Assess the effect of re-expansive respiratory patterns associated to respiratory biofeedback (RBF) on pulmonary function, respiratory muscle strength and habits in individuals with functional mouth breathing (FMB).Methods: Sixty children with FMB were divided into experimental and control groups. The experimental group was submitted to 15 sessions of re-expansive respiratory patterns associated to RBF (biofeedback pletsmovent; MICROHARD (R) V1.0), which provided biofeedback of the thoracic and abdominal movements. The control group was submitted to 15 sessions using biofeedback alone. Spirometry, maximum static respiratory pressure measurements and questions regarding habits (answered by parents/guardians) were carried out before and after therapy. The Student's t-test for paired data and non-parametric tests were employed for statistical analysis at a 5% Level of significance.Results: Significant changes were found in forced vital. capacity, Tiffeneau index scores, maximum expiratory pressure, maximum inspiratory pressure and habits assessed in FMB with the use of RBF associated to the re-expansive patterns. No significant differences were found comparing the experimental and control groups.Conclusions: The results allow the conclusion that RBF associated to re-expansive patterns improves forced vital capacity, Tiffeneau index scores, respiratory muscle strength and habits in FMB and can therefore be used as a form of therapy for such individuals. (C) 2008 Elsevier B.V. All rights reserved.

Estimativa populacional e uso do hábitat do boto-cinza (Sotalia guianensis) no litoral sul do Rio Grande do Norte

Four areas are known as of frequent usage by Guiana dolphins (Sotalia guianensis) in the south coast of Rio Grande do Norte state, northeast Brazil: Tabatinga, Pipa, Lagoa de Guaraíras and Baia Formosa. This extension of 40 km of shoreline is under increasing anthropogenic impacts due to continuous development of the coastal areas and vessel traffic. The objective of this study was to investigate aspects of population biology and habitat use of the population of Sotalia guianensis in the south coast of Rio Grande do Norte. It was applied the photo-identification technique and posterior methods of capture-recapture for population estimation (POPAN extension in MARK). The distribution, movement and site fidelity of the dolphins were analyzed trough the geographic information system (GIS) and group characteristics and behavior trough non-parametric statistics. Field work was conducted on board a 10m motor vessel from March 2008 to March 2009. Photo-identification effort was 329h with 113h of direct observation of the dolphins. The population estimatives for each area: Tabatinga: 75 (63-92); Pipa 105 (88-129); Lagoa de Guaraíras: 27 (18-54) e Baia Formosa: 112 (89-129) individuals. Total population estimative was: 223 (192 a 297). High site fidelity was detected for only part of the population (<15%) as low site fidelity and transients individuals were also detected (>20%). It was observed frequent movements between Tabatinga, Lagoa de Guaraíras and Pipa, but not Baía Formosa. This suggests a division in two communities along this shore extension: one in Pipa and other in Baía Formosa. Group size was small, most groups with up to 10 dolphins. The areas were use intensively, only in Lagoa de Guaraíras dolphins were not seen in all field trips. Lagoa de Guaraíras is an area used by small groups exclusively for foraging. In Tabatinga and Pipa dolphins concentrated close to the shore, in the inner sector of the area and the main activity is also foraging. Significant larger groups were seen in socializing behavior but there was no difference in group size between the inner and external sectors of the area. The presence of calves and juveniles were significant greater in the inner areas of Tabatinga and Pipa, confirming the hypothesis that these beaches are also used for parental care. In Baia Formosa dolphins concentrated in the outer sector and foraging was also predominant. Significant larger groups were seen in the outer sector, mainly engaged in mixed behaviors of travel/foraging, possibly in some kind of group foraging. Calves and juveniles were significant more present in the outer sector where group size was also larger. In general there was no difference in area usage and period of the day. Sotalia guianensis has characteristics that make the species vulnerable to human activities such as small population concentrated in patches of suitable habitats restrict to coastal areas. We hope that this study bring new information for the species and help for the adequate management of the area in order to assure the presence of the dolphins as well as its behavior pattern and gene flow betweencommunities.

Efeitos de um programa de orientação para adultos com lombalgia

OBJETIVO: Implantar um programa de Escola da Postura para pacientes com lombalgia crônica. MÉTODOS: Foram avaliados 41 sujeitos (46,81 ± 13,35 anos), de ambos os gêneros, com idade entre 25-65 anos que possuíam dor lombar há mais de 6 meses. Inicialmente, foi realizado a avaliação da qualidade de vida (Medical Outcomes Study 36- Item Short-Form Health Survey- SF-36) e capacidade funcional (Oswestry Low Back Pain Disability Questionnaire - ODQ). em seguida, todos os sujeitos participaram de cinco encontros semanais de 60 minutos, nos quais foram desenvolvidos as capacitações teórico-práticas. Após uma semana, os sujeitos foram reavaliados. Os dados obtidos nas avaliações foram analisados utilizando o teste estatístico não-paramétrico de Wilcoxon, com nível de significância de 5% (p<0,05). RESULTADOS: Foi observada melhora significativa na capacidade funcional (ODQ, p<0,0001). em relação à qualidade de vida observou-se melhora significativa nos domínios capacidade funcional (p=0,0016), dor (p=0,0035), estado geral de saúde (p<0,0001), vitalidade (p<0,0001), aspectos sociais (p<0,0001) e saúde mental (p=0,0007). Nos itens aspectos físicos e aspectos emocionais não foi observada diferença significativa. CONCLUSÃO: O programa Escola da Postura elaborado foi capaz de melhorar a qualidade de vida e capacidade funcional dos participantes.

Extrinsic compression of popliteal artery in asymptomatic athlete and non-athlete individuals - A comparative study using duplex scan (color duplex sonography)

Aim. Extrinsic compression of the popliteal artery and absence of surrounding anatomical abnormalities characterize the functional popliteal artery entrapment syndrome (PAES). The diagnosis is confirmed to individuals who have typical symptoms of popliteal entrapment and occlusion or important stenosis of the popliteal artery with color duplex sonography (CDS), magnetic resonance imaging (MRI) or arteriography during active plantar flexion-extension maneuvers. However, variable result findings in normal asymptomatic subjects have raised doubts as to the validity of these tests. The purpose of this study was to compare the frequency of popliteal artery compression in 2 groups of asymptomatic subjects, athletes and non-athletes.Methods. Forty-two individuals were studied. Twenty-one subjects were indoor soccer players, and 21 were sedentary individuals. Physical activity was evaluated through questionnaires, anthropometric measurements, and cardiopulmonary exercise test. Evaluation of popliteal artery compression was performed in lower limbs with CDS, ankle-brachial index (ABI) measurements and continuous wave Doppler of the posterior tibial artery.Results. The athletes studied fulfilled the criteria of high level of physical activity whereas sedentary subjects met the criteria of low level of activity. Popliteal artery compression was observed with CDS in 6 (14.2%) studied subjects; 2 of whom (4.7%) were athletes and 4 (9.5%) were non-athletes. This difference was not statistically significant (p=0.21). Doppler of the tibial arteries and ABI measurements gave good specificity and sensibility in the identification of popliteal artery compression.Conclusion. The frequency of popliteal artery compression during maneuvers in normal subjects was 14.2% irrespective of whether or not they performed regular physical activities. Both Doppler and ABI showed good agreement with CDS and should be considered in screening popliteal arteries in individuals suspected of PAES.

Efeitos da isoflavona sobre os sintomas climatéricos e o perfil lipídico na mulher em menopausa

OBJETIVO: avaliar os efeitos da isoflavona, do gérmen da soja, sobre os sintomas climatéricos e o perfil lipídico na mulher em menopausa. MÉTODOS: foi conduzido estudo prospectivo, com 50 mulheres em menopausa, divididas em: G1, usuárias de isoflavona (60 mg/dia) (n=25), e G2, placebo (n=25). Os critérios de inclusão foram FSH >40 mUI/mL e presença de fogachos. Foram excluídas as vegetarianas, fumantes, asiáticas, portadoras de doenças gastrointestinais e usuárias de terapia de reposição hormonal. No seguimento, de seis meses, foram obtidos o índice menopausal de Kupperman (IMK), o perfil hormonal e o lipídico. Na análise estatística, empregaram-se ANOVA, o teste t pareado e as provas não paramétricas de Wilcoxon e Mann-Whitney. RESULTADOS: os valores medianos do IMK, inicialmente iguais entre os grupos (IMK = 20), reduziram-se nas usuárias de isoflavona aos 2 e 4 meses (IMK = 14 e 9, respectivamente) e no grupo controle, apenas aos 2 meses (IMK = 15) (p<0,01). Ao final do estudo, a isoflavona foi superior ao placebo na redução dos fogachos (44% versus 12%, respectivamente). Aos seis meses, verificou-se que os valores médios de estradiol foram superiores no G1 quando comparados ao G2 (18,0 ± 6,7 versus 12,3 ± 3,8 ng/dL) (p<0,05), sem alterações no FSH e LH. Entre as usuárias de isoflavona, houve redução de 11,8% no LDL (de 151,5 ± 39,2 para 133,6 ± 26,4 mg/dL) e elevação de 27,3% no HDL (de 44,0 ± 11,3 para 56,0 ± 11,9 mg/dL) (p<0,05). CONCLUSÕES: a isoflavona, do gérmen da soja, induziu efeitos favoráveis sobre os sintomas climatéricos e o perfil lipídico, revelando-se opção interessante como terapêutica alternativa para mulheres em menopausa.

An acqueous extract of Bidens pilosa L. protects liver from cholestatic disease: experimental study in young rats

OBJETIVO: Testar o efeito hepatoprotetor do extrato aquoso de Bidens pilosa L. (EBP) na doença hepática induzida pela ligadura e ressecção do ducto biliar comum (LRDBC) em ratos jovens. MÉTODOS: Estudamos ratos Wistar com 21º. dia de vida (P21) divididos em quatro grupos de 10 animais, Grupo SA: operação simulada e água; Grupo SD: operação simulada e EBP (160mg de folhas frescas/100g de peso corporal/dia); Grupo LA: LRDBC e água e Grupo LD: LRDBC e EBP diariamente. O tempo de sono por pentobarbital (TSP), aspartato (AST) e alanina (ALT) aminotransferase foram determinadas após o sacrifício (P70). O Score de Ruwart (SR) para fibrose hepática foi atribuído para cada animal. Foi realizada análise de variância com dois fatores e pelo teste de Tukey para comparações múltiplas ou por teste não paramétrico. RESULTADOS: Houve diferença estatisticamente significativa entre LA e LD nas variáveis: TSP (médias LA=390; LD=173), AST (médias LA=8, LD=5), ALT (medianas LA=2; LD=1) e SR (medianas LA=2; LD=1). CONCLUSÃO: EBP poderá ser empregado na fitoterapia da doença hepática induzida pela colestase obstrutiva crônica, pois protege a função hepática, diminui a velocidade de necrose e a intensidade da fibrose hepática na obstrução biliar extra-hepática.

Avaliação do Índice de Remanescente Adesivo utilizando braquetes com e sem tratamento na base e a interação com três sistemas de colagem

OBJETIVO: avaliar o Índice de Remanescente Adesivo (IRA) em dentes bovinos após a descolagem de braquetes com e sem tratamento na base. METODOLOGIA: foram utilizados três sistemas de colagem ortodôntica para os dois padrões de base. Os dentes bovinos foram divididos em seis grupos de 40, de acordo com a base do braquete e o sistema de colagem. Vinte e quatro horas após a colagem foram realizados os testes de compressão em uma máquina de ensaios. A avaliação do IRA foi realizada em um estereomicroscópio por três examinadores calibrados. Foi utilizado o teste não paramétrico de Kruskal-Wallis, seguido do método de Dunn, para fazer as comparações múltiplas entre todos os grupos. RESULTADOS E CONCLUSÕES: observou-se que o tratamento das bases dos braquetes com óxido de alumínio não foi determinante para o aumento da adesividade entre o braquete e o adesivo. O grupo em que se utilizou braquetes com tratamento na base e adesivo TXT (3M-Unitek) + Transbond Plus SEP (3M-Unitek) apresentou a maior parte das fraturas na interface dente-adesivo (escore 4).

Direct and transdentinal antibacterial activity of chlorhexidine

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)