Prevalência de doença arterial obstrutiva periférica (DAOP) e alterações sensoriais em pacientes diabéticos tipo 2: impacto da DAOP sobre a qualidade de vida, nível de atividade física e composição corporal

Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rhô= -0,26), diabetes duration (p=0,02; rhô= -0,28) and blood pressure (p= 0,0007; rhô= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population

Controle circadiano e homeostático do sono-virgília em pacientes com acidente vascular encefálico e correlações com a qualidade de vida e o nível de atividade física

The cerebral vascular accident is a neurological dysfunction of vascular origin that leds to development of motor sensibility, cognitive, perceptive and language deficits. Despite the fact that the main sleep disorders in stroke patients are well known, it is still necessary to analyze which mechanisms of regulation of sleep and wakefulness are affected. The objective of this study was to evaluate the changes in the circadian and homeostatic control of sleep-wakefulness in stroke patients and the correlations with quality of life and level of physical activity. The study analyzed 22 stroke patients (55± 12 years old) and 24 healthy subjects (57 ±11 years old). The instruments used in this study were questionnaires on sleep quality, daytime sleepiness, quality of life, physical activity level and the actigraphy. The data were analyzed using the Student `t test, Mann-Whitney test, ANOVA and Spearman's correlation tests. The results showed stability in the sleep-wake circadian expression with changes in the amplitude of the rhythm. However, significant changes were found related to the homeostatic component characterized by increased sleep duration, increased latency, fragmented sleep and lower sleep efficiency. Additional data showed decreased quality of sleep and increased daytime sleepiness, as well as decreased quality of life and level of physical activity. The results indicate that the interaction of circadian and homeostatic control of sleep-wake is compromised and the main reason might be because of the homeostatic component and the lower activity level resulting from the brain damage. Thus, further studies may be developed to evaluate whether behavioral interventions such as increased daytime activity and restriction of sleep during the day can influence the homeostatic process and its relation to circadian component, resulting in improved quality of nocturnal sleep in stroke patients

Efeitos do ultrassom terapêutico sobre parâmetros morfométricos e clínicos e método de extração de metaloproteinases em sujeitos com úlceras venosas

Venous wounds cause physical, psychological and financial problems that impact the quality of life of patients. Treatment alternatives are investigated in order to reduce healthcare costs and improve quality of life of people affected by this problem. Physical resources, such as therapeutic ultrasound (US), are being considered in the treatment of ulcers as a potential healing agent. This study aimed to investigate the application of US as a treatment for venous ulcers. Subjects were divided into two groups: US group, where treatment consisted of 5 sessions of pulsed US (3 MHz, 1W/cm²) associated with compression and kinesiotherapy; and sham group, where individuals went through the same procedures, but with sham US therapy. Subjects were evaluated for wound size by planimetry and digital photography, visual analogue scale for pain, quality of life by the questionnaires SF- 36 and VEINES-QoL/Sym and enzymatic activity of metalloproteinases 2 and 9 by zymography. It was observed mean reduction in wound area of 41.58±53.8% for the US group and 63.47±37.2% for the placebo group, maintenance of quality of life scores in the US group and significant improvement (p<0.05) in the placebo group by VEINES questionnaire. It was observed decreased perception of pain in the placebo group. Sample feasibility for analysis of the protein activity of metalloproteinases 2 and 9 by zymography collected by swab method was also confirmed. Our data did not give us evidence to support the theory that the US accelerates healing of venous ulcers in a short-term analysis. However, we observed that standard care associated with compression therapy and kinesiotherapy were able to significantly shorten the progression of chronic venous ulcers

Relacionamento conjugal, problemas de comportamento e habilidades sociais de pré-escolares

Variáveis do relacionamento conjugal e relacionamento pais-filhos podem afetar o comportamento das crianças. O objetivo deste trabalho é comparar relatos de pais e mães de pré-escolares com e sem problemas de comportamento, quanto ao relacionamento conjugal. Participaram 48 casais, distribuídos em dois grupos: pais biológicos de crianças com problemas de comportamento e pais biológicos de crianças socialmente habilidosas, segundo avaliação de professores. Os pais foram entrevistados, individualmente, sobre expressão de carinho, comunicação conjugal, características positivas e negativas do cônjuge e qualidade do relacionamento conjugal. Foram encontrados alguns resultados na direção esperada. Os casais com criança socialmente habilidosa foram mais positivos quanto à comunicação e características do cônjuge. Não foram encontradas diferenças na expressão de carinho.

Avaliacão da satisfação do usuário e da qualidade dos tratamentos endodônticos em Centros de Especialidades Odontológicas da Grande Natal-RN

Objective: To evaluate the degree of users satisfaction and technical quality of endodontic treatment in specialized dental clinics (CEO) of Grande Natal / RN between 2006 and 2008. Methodology: evaluated 282 endodontically treated teeth in CEOs through clinical and radiographic examinations. A questionnaire about the clinical condition of the tooth, evaluation of care and satisfaction with treatment was applied. Data on pre-and trans-operative were noted by the patient's clinical record. Endodontically treated teeth were examined by a specialist in endodontics, which compared with previous radiographs and current ones. The collected datas were presented descriptively by absolute numbers, percentages, averages. To determine the association between the independent and dependent variables was carried out through the bivariate association test Chi-square and Fisher exact test. Results: 79.8% presented with radiographic normal and 84.4% without pain symptoms. 8.2% of the teeth were fractured and 3.2% extracted. The persistence of the periapical lesion was associated with initial periapical status (p <0.05). 91.5% of patients are satisfied with the outcome of treatment. Such satisfaction is associated with absence of pain and an adequate esthetic tooth position (p <0.05). Conclusion: endodontic treatment in specialized dental clinics have an adequate technical quality, resulting in the success of endodontic therapy performed in these centers and that users are satisfied with the treatment

Qualidade de vida, eficiência mastigatória e presença de disfunção temporomandibular em usuários de prótese parcial removível com arco dental curto inferior

Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. In addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of different lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory efficiency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OHIP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quality of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinical analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability. The statistical tests used were chi-squared and analysis of variance as well as Tukey s post test, when applicable, all with a 95% confidence level. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn t, but this result wasn t statistically significant. The mean of the results of masticatory efficiency, WHOQOL and OHIP didn t show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that studied patients with low posterior support using lower PRP didn t have better masticatory efficiency, general quality of life, less impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn t use the prosthesis

Impacto sócio-dentário das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes

Nas últimas décadas, com a significativa redução da cárie dentária em crianças e adolescentes, uma maior atenção tem sido dada a outros problemas bucais como as oclusopatias. Em termos epidemiológicos no Brasil, esta tem ocupado o terceiro lugar dentre os problemas de saúde oral na população e, portanto, a inclusão destas como um problema de saúde pública se deve não apenas à sua alta prevalência, mas também ao impacto social, que interfere diretamente na qualidade de vida das pessoas. Diante do exposto é que este estudo objetiva buscar o impacto da presença e severidade das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes escolares de um município. Sendo assim, foram examinados 356 escolares na faixa etária de 15 -19 anos e determinadas a prevalência, severidade e necessidade de tratamento de oclusopatias através dos índices DAI, IOTN e ICON. O impacto sócio dentário das oclusopatias na qualidade de vida dos adolescentes foi analisado através do índice CS-OIDP. A fim de se verificar possíveis influências de variáveis estudadas na determinaçao do impacto na qualidade de vida das oclusopatias, estas serão coletadas através do estatus sócio-econômico, gênero, idade e tipo escola. Nos resultados parciais, relacionado a 50% da amostra, se observou uma maior prevalência do escolares de escola pública(68,1%), idade entre 15-16 anos(74,7%), gênero feminino(52,7%) e maior prevalência do SES baixo(77,5%). A análise estatística usando o teste qui-quadrado mostrou uma associação significativa do impacto da oclusopatia na qualidade de vida apenas quando avaliada com o índice ICON e o A-IOTN do examinado, comprovando uma associação da necessidade de tratamento com a presença do impacto na qualidade de vida. Com isso, busca-se comprovar e enfatizar a necessidade de se estabelecer políticas públicas que trabalhem na prevenção e interceptação dessas oclusopatias na população, melhorando, portanto, a qualidade de vida e saúde oral dos adolescentes.

Impacto sócio-dentário das ocusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes

Nas últimas décadas, com a significativa redução da cárie dentária em crianças e adolescentes, uma maior atenção tem sido dada a outros problemas bucais como as oclusopatias. Em termos epidemiológicos no Brasil, esta tem ocupado o terceiro lugar dentre os problemas de saúde oral na população e, portanto, a inclusão destas como um problema de saúde pública se deve não apenas à sua alta prevalência, mas também ao impacto social, que interfere diretamente na qualidade de vida das pessoas. Diante do exposto é que este estudo objetiva buscar o impacto da presença e severidade das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes escolares de um município. Sendo assim, foram examinados 356 escolares na faixa etária de 15 -19 anos e determinadas a prevalência, severidade e necessidade de tratamento de oclusopatias através dos índices DAI, IOTN e ICON. O impacto sócio dentário das oclusopatias na qualidade de vida dos adolescentes foi analisado através do índice CS-OIDP. A fim de se verificar possíveis influências de variáveis estudadas na determinaçao do impacto na qualidade de vida das oclusopatias, estas serão coletadas através do estatus sócio-econômico, gênero, idade e tipo escola. Nos resultados parciais, relacionado a 50% da amostra, se observou uma maior prevalência do escolares de escola pública(68,1%), idade entre 15-16 anos(74,7%), gênero feminino(52,7%) e maior prevalência do SES baixo(77,5%). A análise estatística usando o teste qui-quadrado mostrou uma associação significativa do impacto da oclusopatia na qualidade de vida apenas quando avaliada com o índice ICON e o A-IOTN do examinado, comprovando uma associação da necessidade de tratamento com a presença do impacto na qualidade de vida. Com isso, busca-se comprovar e enfatizar a necessidade de se estabelecer políticas públicas que trabalhem na prevenção e interceptação dessas oclusopatias na população, melhorando, portanto, a qualidade de vida e saúde oral dos adolescentes.

Sistemas certificáveis de gestão ambiental e da qualidade: práticas para integração em empresas do setor moveleiro

O principal objetivo deste artigo é propor, a partir do referencial teórico e de um estudo de caso em uma empresa moveleira, práticas para integração de sistemas certificáveis de gestão ambiental e da qualidade. A coleta de dados do estudo de caso se deu por meio de entrevistas semiestruturadas com o responsável direto pelos dois sistemas e com alguns colaboradores-chave do nível operacional, além de análise documental e de visitas in loco. Ao final deste artigo, são propostas práticas para integração desses sistemas, relacionadas aos seguintes elementos: alta administração; apoio administrativo, financeiro e pessoal; serviço de consultoria; coordenação do programa de integração; interface entre os sistemas; capacitação técnico-gerencial; sistema de liderança, prospecção, avaliação e desenvolvimento de fornecedores; sistema de informação; indicadores; comunicação com o cliente, e integração contínua.

Qualidade de sono e qualidade de vida em trabalhadores submetidos a diferentes esquemas de trabalho de uma empresa petroquímica

One of the largest problems of the present time resulting from the economic globalization and the modern technology, of the point of view of the biological rhytms of our organism, it is offering services and production of goods available in 24 o'clock, that it demands organized workers in several work schedules besides the hours of the day. Those schedules cause a series of biopsychosocial consequences in the worker's health, in function of circadian, homeostatic and psychosocial alterations. Accordingly, the aim of this study was to accomplish an evaluation of the effects of several works schedules in the pattern of the sleep wake cycle, anxiety, stress and in the health. We counted with a sample of 274 workers subdivided in 49 daytime worker groups and 225 workers in different shift work schedules with different speeds (rotating shift group, slower day shift group, faster day shift group). From the results analysis it is verified irregularities of the daily activities, stress and alterations in the workers' health in all schedules. It was also verified thata the workers thata presented irregularities in the daily activities were the mroe stressed. On the other hand, the shift works were considered more ansious and associated with bad sleep quality. It was verified that the workers with bad sleep quality were those presented larger levels of dispocional anxiety. There was no statistically significant correlation between bad sleep quality and irregular daily lifestyle. However, it can be affirmed thata shift work schendules doesn't are the main determinant for the circadian alterations, but the answers of the individuals to the shifts work; and that the inadequate behavioural strategies to work with the effects of the shift schedules. In conclusion, individual strategies related to the coping of the work in shift (adaptation and tolerance) should be extolled as indispensable tool in the ergonomic evaluation of the work

Qualidade subjetiva do sono e queixa de insônia em pacientes com Acidente Vascular Cerebral

Brain injury can be associated with changes in the sleep-wake cycle. However, studies about sleep disturbances and their relationship with quality of sleep are scarce. Besides, it remains to be known how stroke affects the mechanisms of sleep. The aim of this study was to investigate quality of sleep, complaints of sleep disturbances and associated factors in stroke patients from the Physical Therapy services in Natal -RN. This was a cross-sectional descriptive study involving 70 individuals (aged 45-65 years), 40 patients (57 ± 7 years), 11 ± 9 months after injury, and 30 healthy individua ls (52 ± 6 years), evaluated with the Pittsburgh Sleep Quality Index (PSQI) and Sleep Habits Questionnaire. The data were analyzed by Chi-square test, t Student test and logistic regression. Poor quality sleep was found in 57,5% of the patients (6,3 ± 3,5) and was significantly higher than in the control population (3,9 ± 2,2) (t Student test, p=0,002). The patients showed significantly higher value of PSQI than controls: sleep latency (p=0,019), length of sleep (p=0,039) and dysfunction during the day (p=0,001). Regarding complaints of sleep disturbances (dyssomnias and parasomnias) analyzed by Chi-square test, the complaint of insomnia was the most prevalent (patients: 37,5%; healthy subjects: 6,7%; p=0,007). Regression analysis showed that sl eep latency (p=0,036) and complaint of insomnia (p=0,036) were associated with quality sleep. In addition, female gender (p=0,036) and complaint of broken sleep (p=0,003) were considered risk factors for the presence of insomnia. Our results show that stroke affects the homeostatic process of sleep. Shorter sleep latency and the absence of insomnia are considered protective factors for good sleep quality and this should be taken into consideration in the diagnostic and therapeutic strategies

Avaliação da estratégia saúde da família na capital potiguar

This research aimed to evaluate the Family Health Strategy (FHS) in Natal, Rio Grande do Norte, through its managers, professionals and users, having as its support the Theory of Belief and the Cognitive-Behavioral Theory. This is a multimethod research and is divided into three sub-studies. In the first study, nine managers answered to a semi-structured interview, to verify the knowledge and beliefs on SUS; the quantitative data were analyzed with descriptive statistics with the aid of SPSS software and the qualitative data were submitted to lexical analysis with support of ALCESTE software. In the second study, we have a descriptive correlational research in which the antecedent variables are related to working conditions in the family health units (FHUs) and to the professionals‟ profile; the corresponding variables refer to the evaluations of the FHS; a stratified probabilistic sample with 475 professionals, who answered to two scales, both consisting of three factors: Physical infrastructure, Material resources, and Treatment effectiveness, and data were analyzed using descriptive, bivariate and multivariate statistics, with the aid of SPSS. The third study is a descriptive correlational research in which the antecedent variables refer to the treatment in the FHUs and to the users‟ profile, and the corresponding variables refer to the evaluations of the FHS, with a stratified non-probabilistic sample with 390 users, who contributed to the construction of a new scale with a factor, effectiveness in treatment, analyzed through descriptive, bivariate and multivariate statistics, with the aid of SPSS. The results showed problems which start from management, under the shape of admission due to political indication and lack of knowledge on SUS and the FHS; they pass through the low tenure of professionals and insufficient professional; and they end up spreading all over the analyzed items: infrastructure of FHUs, material resources, professionals‟ training, accessibility and referral system. One concludes that, despite following an ideal model, the FHS is in need of changes with regard to the barriers to its operational reality

Medida da preditividade de instrumentos psicológicos nas avaliações psicológicas de condutores

The object of this study was to identify the possibility of predicting the involvement in traffic infractions from the results of the psychological tests carried out by psychologists specialized in the process of driver licensing in the state of Rio Grande do Norte (RN). The proposal consisted in identifying the penalty points recorded in national driving licenses (CNH) and identifying the corresponding tests and scores obtained, verifying if the average scores in the tests of drivers with and without an infraction record were significantly different and if there is any relation between the test scores and the frequency of the infractions. The results of the psychological instruments were collected in two moments the first being in the act of acquisition of the CNH and the second being during license renewal at the only certified clinic and at the DETRAN-RN. A population of 839 drivers of 14 municipalities were identified. 127 protocols of psychological tests were identified in the records of the DETRAN-RN (2002) and 76 at the clinic (2007), pointing out failures in the process of safekeeping of the psychological material, as well as in its retrieval from the record files. The sample was thus reduced to 68 drivers, all male, with age range between 18 and 41 years old, mean of 21,72 years old (DP = 5,24). 54 drivers were identified without a record of infraction, and 14 with a record. The latter committed 29 infractions. The penalty points recorded in their CNH ranged from 0 to 35 and the typical value of points (median) was zero. In the group with a record of infractions the number of points ranged between 3 and 35, mean of 10,79 (DP = 7,73). Differences were observed in the composition of the battery of tests in the two moments with the same subjects. The use of different tests to assess the same construct of the subject, first and second moment of assessment, did not allow for some analyzes with more efficient statistical proof. It was pointed out that five tests were not carried out and 118 were not corrected/analyzed. Significant differences between the groups were not identified with the psychological instruments used. In another attempt to establish differences between the means, the application of the independent t-Test evidenced a significant difference in the scores of the instruments of concentrated attention in 2002 (t = 2,21, gl = 25, p = 0.037) and of diffuse attention in 2002 (t = 2,37, gl = 24, p = 0.026). The results also did not evidence significant correlation between the scores of the tests and the penalty points of the infractions. Based on this study, it cannot be concluded with precision that the high or low scores are good criteria to determine that a driver will commit more or less traffic infractions, nor that the drivers with higher scores in the tests commit less infractions and vice-versa. Furthermore, the problems to find the instruments and the most basic data require a stronger monitoring on the part of the certified clinic and of the DETRAN-RN.

A eliminação do mosquito do dengue em ambientes residenciais: uma questão de cuidado ambiental?

Dengue is currently considered one of the most relevant public health problems worldwide. Studies indicate the surroundings of the houses as the preferred sites for the proliferation of Aedes aegypti. The residential areas are privileged environments for human development and contribute to the formation of the individual s identity and for the establishment of affective, social and cultural bonds. The purpose of this study was to investigate possible links between psychological indicators of pro-environmentalism and conservation status of residential backyards. Data collection was performed in 147 homes and methodological strategy involved the use of interview, the Scale of Ecocentric and Anthropocentric Environmentalism, Scale of Consideration of Future Consequences and a tool for environmental evaluation. It was found that the participants expressed as environmental practices the garbage recycling, besides they had the knowledge of how the transmission of dengue occurs. These residents showed ecofriendly motivated commitment: pro-environmentalist ecocentric and anthropocentric. In evaluating the backyard it was verified that the conservation conditions, in almost half of the homes, appeared as carelessness on the part of residents and those conditions are conducive to the proliferation of Aedes aegypti. The pro-environmentalists and guidance for the future identified by the scales were not associated with the conservation status of the backyards. However, it was found that the trends of reduction and stability of infestation levels are associated with self-reported environmental care. These results can contribute to the discussion and design of new mosquito control actions and practices of education and health information among the population

A experiência da criança com a droga :características do uso e circunstâncias familiares

The study is a reflexion of the use of drugs among children, pointing that as one of the most serious social problem nowadays. Customize the abuse of drugs reflecting on the childhood and the family s influence of the problem of the children that use drugs, is the main objective of this thesis. Choosing the qualitative method of research, the investigation starts with the reports of the children and mothers assisted at Centro de Referência e Apoio à Criança e ao Adolescente Usuários de Drogas, program of specialized assistance of 1ª Vara da Infância e da Juventude de Natal/RN. The research was done through semi-structured interviews, in a total of six subjects: three children and their respective mothers. Through the reports of the subjects, it is brought theorical reflexions that illustrates their perceptions and conceptions about topics like the usage of drugs, the circumstances the usage of drugs was started, the family s structure and dynamic, the situation on the streets, and other factors that affect the development of a child in her/his environment. It is proved that the usage of drugs in Brazil, problem that has been increasing the number of children affected by, is a multi faceted and complex phenomenon but some factors of social and family risks deserve to be pointed out like the manner of support future actions in the prevention area