Prevenção da síndrome metabólica em crianças obesas: uma proposta de intervenção

OBJETIVO: Analisar o efeito de 12 semanas de intervenção envolvendo prática de atividade física, orientações alimentar e psicológica sobre fatores de risco para o desenvolvimento da síndrome metabólica em crianças e adolescentes obesos. MÉTODOS: Estudo longitudinal com 23 crianças e adolescentes obesos, com idade entre seis e 16 anos (12,0±3,2 anos). Foram mensurados: gordura corporal total e de tronco, glicemia, colesterol total e triglicérides, pressão arterial sistólica e diastólica. Os jovens foram submetidos a três sessões semanais de 60 minutos de exercício físico (atividades esportivas recreativas, ginástica, circuitos e caminhadas), durante 12 semanas. O teste do qui-quadrado foi usado para comparar dados categóricos daqueles que apresentaram valores acima das recomendações para cada fator de risco. O teste t para dados pareados foi aplicado para comparar os dois momentos do estudo. RESULTADOS: em indivíduos com alterações metabólicas no início do estudo, observou-se, após a intervenção, a diminuição de 11,6% na glicemia (105 para 93mg/dL; p=0,046) e de 24,9% no triglicérides (217 para 163mg/dL; p=0,013); porém, não houve diferenças na pressão arterial e no colesterol total. CONCLUSÕES: O programa de exercício físico aplicado nas crianças e adolescentes foi eficiente para melhorar os valores de glicemia e triglicérides.

Variáveis relacionadas ao processo de adesão a um programa de prevenção de quedas em idosos cadastrados na Estratégia de Saúde da Família

Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult

Fatores de influência na produção de leite bovino sobre os níveis da contagem bacteriana total

The objective of this study was to evaluate the influence of milking procedures on the levels of total bacterial count (TBC) in bovine milk. In the first study the influences of procedures for hygienic milking, cleaning of milking equipment and milk cooling tanks on the TBC levels were evaluated. Four bulk samples of milk were collected from each tank in eight properties for TBC analysis, employing the flow cytometry method. A questionnaire was applied in each property to assess the current situation of milking procedures on each production system that took part on this research, followed by training of employees in good agricultural practices in the production of milk and monitoring of the TBC measurements. The methodology for analysis of longitudinal data was considered, focusing on random effects models. The results showed that the handling procedures for milking and the cleanliness of the cooling tank contributed to a further reduction in the levels of TBC raw milk cooling tanks. The second study aimed to describe the percentage of the properties that comply with the Normative Instruction Nº 51 (Brazil s IN 51) with regard to total bacterial count (TBC) in bovine milk. The study was conducted from January 2010 to July 2011. Milk samples were collected from the eight properties selected for TBC analysis by the flow cytometry method. Again, on each property a questionnaire was applied to assess the current situation of milking procedures on each production system that took part on this research, followed by training of employees in good agricultural practices in the production of milk and monitoring of the TBC measurements. The methodology of marginal models based on Generalized Estimate Equations (GEEs) was followed in the statistical analysis. The results showed that the handling procedures of the milking and the cleanliness of the cooling tanks contributed to a considerable percentage of the properties that reached the limits of TBC established by IN 51

Caracterização dos sistemas de produção de leite bovino na microrregião Seridó do estado do Rio Grande do Norte

The objective was to contribute to a reading of the characteristics and diversity of production systems from bovine milk in the microregion Seridó of Rio Grande do Norte, discuss the social, economic, environmental and husbandry-related primary activity of milk production. We randomly selected 28 agricultural establishments that performed the activity of dairy bovine culture with subsequent applicat ion of a structured questionnaire during September and October 2011. Data were analyzed with application of measures of descriptive analysis and determination of the index rural development (IRD). The results showed that 53.57% of the interviewees were owners of the land, the median area of the properties amounted to 135 hectares, the median number of animals in the herd was 51 head, with minimum 11 and maximum of 350 heads establishments in the sample, 85.72% of establishments had maximum 23 cows in lactation, 100% performed manual milking with suckling calves, average productivity of 3.91 liters / cow / day, 92.86% of the interviewees did not produce silage and / or hay, 64.29% had no access to technical assistance, the average age of interviewees was 51 ± 10.85 years, 78.57% had only elementary education. The average of the IRD computed in the test sample amounted to 0.43 ± 0.11 on a scale 0-1. The sites were grouped into 04 classes, based on your IRD. The average IRD in each dimension was 0.43, 0.55 and 0.34, respectively for economic / husbandry, social and environmental. The determination of the rate of rural development - IDR found for the sample could add establishments hierarchically. It is necessary that the inclusion of best practices in herd management, bookkeeping zootechnical, technical assistance and reorganization practices in land and environmental preservation

Levantamento exploratório da composição e frações proteicas do leite bovino em propriedades leiteras

The direct relationship with the processing, industrial yield and price of milk, the importance of the centesimal composition of milk and their protein fractions has increased for both the dairy industry and for the producers, so it is important to identify the possible causes on variation of these components. The aim of this study was to evaluate the effect of the seasons, order of calving and lactation phase on milk composition and protein fractions in dairy farms in the Agreste and Leste meso-regions, of Rio Grande do Norte State (RN). Milk samples were taken in seven milk farms directly from the bulk tanks except for one farm where samples were taken from higher milking cows producers and heifers. The experiment was done in seven properties with milk samples taken directly from the bulk tanks and in one property were collected from higher production cows and heifers. Composition analyses were carried out for both experiments and sensorial trial was performed for the second experiment only. The data results were submitted to analysis of variance (ANOVA) and Tukey test performed for 5% significance level. In the first experiment was observed response of the seasons, dry and rainy season; while in the second, the effect of the order of calving and lactation phase had influence on milk composition and protein fractions. There was significant response (p < 0.05) for season effects but due to farms. The rainy season had higher averages in the protein, lactose, total solids and nonfat dry extract. Multiparous cows had higher CCS, NUL and PCAS milk contents; while, first calving heifers showed higher average for the sensory attribute, color of milk. The final third of lactation was responsible for the elevation of the levels of almost all milk components and their protein fractions

Efeito do tratamento com as drogas antipsicóticas haloperidol e clozapina sobre a infecção de toxoplasma gondii em cultura de células retinianas embrionárias

T. gondii is an obligate intracellular protozoan and the main cause of retinochoroiditis in humans. The aim of this study was to evaluate the effect of the antipsychotic drugs haloperidol and clozapine on the course of infection by T. gondii of cultured embryonic retinal cells. Embryo retinas of Gallus gallus domesticus (E12) were used for the preparation of mixed monolayer cultures of retinal cells. Cultures were maintained on plates of 96 and 24 wells by 37°C in DMEM medium supplemented with 5% fetal bovine serum for 2 days. After this period, cultures were simultaneously infected with tachyzoites of T. gondii and treated with the antipsychotics haloperidol and clozapine for 48 hours. Treatment effects were determined by both assessing cell viability with the MTT method and evaluating infection outcomes in slides stained with Giemsa. The treatment with haloperidol and clozapine cells infected with T. gondii resulted in higher viability of these cells, suggesting a possible prevention of neuronal degeneration induced by T. gondii. Additionally, intracellular replication of this protozoan in cells treated with haloperidol and clozapine were significantly reduced, possibly by modulation of the parasite s intracellular calcium concentration

Avaliação da prevenção de falhas em processos utilizando métodos de tomada de decisão

Este trabalho apresenta uma investigação sobre o emprego de FMEA (Failure Mode and Effect Analysis) de Processo com a exposição de irregularidades na sua utilização. O método AHP (Analytic Hierarchy Process) e os Conjuntos Fuzzy são aplicados no estudo das práticas atuais de utilização de FMEA. O AHP é aplicado para a priorização das irregularidades quanto à gravidade de sua ocorrência. Os Conjuntos Fuzzy são aplicados para avaliação do desempenho da utilização de FMEA em algumas empresas do ramo automotivo. Como resultado, tem-se a aceitação de oito e a não aceitação de três dos onze formulários de FMEA averiguados.

Avaliação da estabilidade térmica e oxidativa dos biodieseis de algodão, girassol, dendê e sebo bovino

The search for new sources of environmentally friendly energy is growing every day. Among these alternative energies, biodiesel is a biofuel that has had prominence in world production. In Brazil, law 11.097, determine that all diesel sold in the country must be made by mixing diesel/biodiesel. The latter called BX, , where X represents the percent volume of biodiesel in the diesel oil, as specified by the ANP. In order to guarantee the quality of biodiesel and its mixtures, the main properties which should be controlled are the thermal and oxidative stability. These properties depend mainly of the chemical composition on the raw materials used to prepare the biodiesel. This dissertation aims to study the overall thermal and oxidative stability of biodiesel derived from cotton seed oil, sunflower oil, palm oil and beef tallow, as well as analyze the properties of the blends made from mineral oil and biodiesel in proportion B10. The main physical-chemical properties of oils and animal fat, their respective B100 and blends were determined. The samples were characterized by infrared and gas chromatography (GC). The study of thermal and oxidative stability were performed by thermogravimetry (TG), pressure differential scanning calorimeter (PDSC) and Rancimat. The obtained biodiesel samples are within the specifications established by ANP Resolution number 7/2008. In addition, all the blends and mineral diesel analyzed presented in conformed withthe ANP Regularion specifications number 15/2006. The obtained results from TG curves data indicated that the cotton biodiesel is the more stable combustible. In the kinetic study, we obtained the following order of apparent activation energy for the samples: biodiesel from palm oil > sunflower biodiesel > tallow biodiesel > cotton biodiesel. In terms of the oxidative stability, the two methods studied showed that biodiesel from palm oil is more stable then the tallow. Within the B100 samples studied only the latter were tound to be within the standard required by ANP resolution N° 7. Testing was carried out according to the EN14112. This higher stability its chemical composition

Caracterização de resíduo sólido formado em biodiesel de sebo bovino

Biodiesel production has increased over the last decade because of the benefits associated with this fuel, including renewability, domestic feedstock, lower toxicity, and biodegradability. From 2008, the use of beef tallow as a feedstock for biodiesel production in Brazil has increased in significance, representing the second largest source of biodiesel, after soybeans. However, the performance of biodiesel in cold weather conditions is worse than diesel because of deposition of insoluble at low temperatures, accelerating the plugging of fuel filters and injectors of the vehicle engine. Studies have been conducted on beef tallow biodiesel, mostly related to the properties of thermal and oxidative stability. However, few studies have described the nature of the precipitate formed and its influence on product quality. Research suggests that the cause of deposition is related to the nature of saturated esters and monoacylglycerols as inducing agents. This study monitored the levels of mono-, diand triacylglycerols, the oxidation stability and the cold filter plugging point (CFPP) in beef tallow biodiesel samples from two commercial producers in Brazil for a period of twelve months. Filtered precipitates were analyzed by comparative techniques of GCFID, HPLC-UV/VIS, HPLC-MS-IT-TOF and TG to verify the nature, using monopalmitin and monostearin as reference standards. The formation of precipitate reduced the levels of monoacylglycerols in the beef tallow biodiesel. GC-FID and LCMS- IT-TOF results confirmed the nature of the deposit as saturated monoacylglycerols, predominantly monostearin and monopalmitin as the second major component. Moreover the TG analysis of the residue indicated similar thermal decomposition of the reference standards. The precipitate did not affect the oxidation stability of beef tallow biodiesel and the CFPP characteristic of blends up B60. However, the presence of iron reduced significantly the oxidation stability of biodiesel

Caracterização de resíduo sólido formado em biodiesel de sebo bovino

Biodiesel production has increased over the last decade because of the benefits associated with this fuel, including renewability, domestic feedstock, lower toxicity, and biodegradability. From 2008, the use of beef tallow as a feedstock for biodiesel production in Brazil has increased in significance, representing the second largest source of biodiesel, after soybeans. However, the performance of biodiesel in cold weather conditions is worse than diesel because of deposition of insoluble at low temperatures, accelerating the plugging of fuel filters and injectors of the vehicle engine. Studies have been conducted on beef tallow biodiesel, mostly related to the properties of thermal and oxidative stability. However, few studies have described the nature of the precipitate formed and its influence on product quality. Research suggests that the cause of deposition is related to the nature of saturated esters and monoacylglycerols as inducing agents. This study monitored the levels of mono-, diand triacylglycerols, the oxidation stability and the cold filter plugging point (CFPP) in beef tallow biodiesel samples from two commercial producers in Brazil for a period of twelve months. Filtered precipitates were analyzed by comparative techniques of GCFID, HPLC-UV/VIS, HPLC-MS-IT-TOF and TG to verify the nature, using monopalmitin and monostearin as reference standards. The formation of precipitate reduced the levels of monoacylglycerols in the beef tallow biodiesel. GC-FID and LCMS- IT-TOF results confirmed the nature of the deposit as saturated monoacylglycerols, predominantly monostearin and monopalmitin as the second major component. Moreover the TG analysis of the residue indicated similar thermal decomposition of the reference standards. The precipitate did not affect the oxidation stability of beef tallow biodiesel and the CFPP characteristic of blends up B60. However, the presence of iron reduced significantly the oxidation stability of biodiesel

Cartografia de uma intervenção comunitária para prevenção de DST/HIV/AIDS

Community-based interventions have been presented as a proposal of operationalization of the concept of vulnerability to STD/Aids prevention. This study aimed to analyze the Community intervention developed through the project Strengthening of Community action networks for STD/Aids prevention: know and intervenein, at Mãe Luiza neighborhood, in the city of Natal, State of Rio Grande do Norte, Brazil. The study was conducted in the same location where intervention occurs and took as time reference the first 30 months of construction and deployment process, from April 2010 until December 2012. This is research with qualitative approach, participatory character, developed from the immersion of the researcher in the field, being this community intervention itself. In this perspective, the study approximates to the Cartographic method in which the researcher-researched is engendered in the acts and effects research. The data-generating sources were the memories of the researcher from the field notes, written narratives of subjects involved in the intervention and documents pertaining to the project. In the methodological path of cartography, the image of the rhizome by Deleuze and Guattari (1995) has accompanied the immersion in the field given the nature of research-intervention which approach to the concept of object-Rhizome. The presentation of results was composed for the attempted rhizomatic and a hypertext representation, based on the descriptive narrative taken from the documentary analysis and the multi-faceted narratives with the voices, the looks and the affections narrated by the subject involved, respectively. On the path taken, three lanes were drawn as synthesis of learning produced by experience-that can contribute to understanding the process under study, in his singular character, and reflections on other experiences of community intervention: track 1- Community intervention as active-reflective space and a cause; track 2 Inclusion as power and challenge of community involvement; track 3 Sustainability as A challenge of Community intervention. The study indicates that community intervention is presented as a potential producer of health as also produces practical and creative skills, subjects and inventive in the daily life of the community with a view to reinventing knowledge and practices for the prevention of STD/HIV/Aids

Eficácia do ondansetron e da alizaprida na prevenção de náusea e vômito em laparoscopia ginecológica

JUSTIFICATIVA E OBJETIVOS: A laparoscopia ginecológica é procedimento que determina alta incidência de náusea e vômito no pós-operatório. Este estudo teve por finalidade comparar a eficácia do ondansetron e da alizaprida na prevenção de náusea e vômito em pacientes submetidas à laparoscopia ginecológica. MÉTODO: Participaram do estudo 52 pacientes, estado físico ASA I ou II, com idades entre 21 e 50 anos, sem queixas gástricas prévias, submetidas à laparoscopia para diagnóstico ou cirurgia. As pacientes foram divididas em 2 grupos: o grupo 1 recebeu ondansetron (4 mg) e o grupo 2, alizaprida (50 mg), por via venosa, antes da indução da anestesia. Todas as pacientes receberam midazolam (7,5 mg) por via oral como medicação pré-anestésica, sufentanil (0,5 µg.kg-1) e propofol (2 mg.kg-1) para indução, propofol (115 µg.kg-1) e N2O/O2 em fração inspirada de O2 a 40% para manutenção e atracúrio (0,5 mg.kg-1) como bloqueador neuromuscular. A analgesia pós-operatória foi realizada com cetoprofeno (100 mg) e buscopam composto®. RESULTADOS: Ambos os grupos foram idênticos quanto aos dados antropométricos e à duração da cirurgia e da anestesia. No grupo 1 (n=27) uma paciente apresentou náusea, No grupo 2, uma paciente apresentou náusea e três vomitaram, resultados estatisticamente não significativos. CONCLUSÕES: O ondansetron e a alizaprida foram similares na prevenção de náusea e vômito em pacientes submetidas à laparoscopia ginecológica.

Comparação entre pericárdio bovino preservado em glicerina e malha de poliéster no reparo de falhas da parede abdominal em ratos

OBJETIVO: Comparar uma malha comercial de poliéster com o pericárdio bovino preservado em glicerina na reconstituição de defeitos da parede abdominal. MÉTODOS: Foram utilizados 30 ratos, divididos em dois grupos eqüitativos. Efetuou-se uma excisão retangular de 2,5 x 2 cm, incluindo toda a musculatura abdominal e peritônio. No grupo I a parede abdominal foi reparada com malha de poliéster e no grupo II com pericárdio bovino conservado em glicerina. Os animais foram sacrificados aos 15, 60 e 90 dias de pós-operatório, sendo o local cirúrgico avaliado macroscópica e histologicamente. RESULTADOS: Os animais do grupo I apresentaram aderências mais severas e em maior número quando comparados aos do grupo II; porém, sem comprometimento funcional. A análise histológica revelou incorporação dos tecidos aos implantes, com maior resposta fibroblástica nos animais do grupo I. CONCLUSÃO: A malha de poliéster oferece maior resistência estrutural e resposta fibroblástica mais intensa; contudo, promove grande quantidade de aderências às vísceras abdominais, quando comparada ao pericárdio bovino.

Tuberculose ativa em pacientes cirúrgicos com baciloscopia negativa no pré-operatório

OBJETIVO: Verificar a proporção de pacientes com baciloscopia negativa no pré-operatório e que apresentaram TB ativa na peça cirúrgica. MÉTODOS: Estudo retrospectivo de pacientes com diagnóstico histopatológico de TB ativa ou sequelar e operados entre os anos de 2003 e 2006 em um hospital universitário. Foram pesquisados antecedentes e aspectos clínicos relativos à doença, pesquisa de bacilos álcool-ácido resistentes (BAAR), tipo de cirurgia realizada e exame histopatológico da peça cirúrgica. RESULTADOS: Foram incluídos 43 pacientes, com média de idade de 44 ± 19 anos, sendo 27 do sexo masculino. Apresentavam história prévia de TB com tratamento adequado 28 pacientes, e 15 não referiam antecedentes para TB. O principal motivo da procura pelo serviço foi infecção de repetição, seguida por achados em exames de imagem. Dos 43 pacientes, foi pesquisado BAAR no pré-operatório em 35: 32 apresentaram resultados negativos e 3, resultados positivos. Dos 35 pacientes pesquisados, 26 apresentavam diagnóstico histopatológico de TB ativa e 9 de TB sequelar na peça cirúrgica; os outros 8 também foram diagnosticados com TB sequelar. A proporção de TB ativa em doentes com baciloscopia negativa foi de 72% (23/32), e o de baciloscopia negativa em TB ativa foi de 88% (23/26), sendo a pesquisa de BAAR positiva somente em 11,5% (3/26). CONCLUSÕES: A baciloscopia direta tem rendimento muito baixo, e muitos pacientes mesmo já tratados podem permanecer com TB em atividade com baciloscopia negativa. A TB ativa pode ser confundida com infecções secundárias ou com câncer.

Prevenção de conflitos médico-legais no exercício da medicina

Os conflitos médico-legais que ocorrem no exercício da Cirurgia e da Medicina são motivos de preocupação não só no meio médico, mas também na sociedade como um todo, pois se de um lado geram um maior desgaste emocional ao médico, por outro, os pacientes estão sendo rejeitados. As causas desses conflitos são muitas, envolvendo fatores não assistenciais, como o sistema de saúde distorcido e desorganizado, a falta de participação da sociedade e do médico na melhoria desse sistema, o aparelho formador que lança no mercado grande número de jovens médicos despreparados para o exercício dessa nobre profissão, além da falta do ensino continuado. A solução para esses conflitos não poderá ser por meio de simples criação de leis, e nem pela negativa da existência do erro médico, que ocorre numa freqüência até maior do que os próprios conflitos. Todavia, pode-se afirmar que é muito importante melhorar a relação médico-paciente. É necessário, ainda, que o médico conheça a fundo seus deveres de conduta e que, principalmente, se abstenha de praticar abusos do poder. A sociedade deve também entender que a saúde não é uma questão exclusiva dos médicos e que deve lutar pela melhoria das condições dos níveis de vida.