Avaliação da prevalência de Síndrome Metabólica, Microalbuminúria e Risco Cardiovascular em mulheres com Síndrome dos Ovários Policísticos

Avaliar fatores de risco cardiovascular em mulheres brasileiras com síndrome dos ovários policísticos (SOP), através da utilização de múltiplos parâmetros, incluindo a determinação da prevalência de síndrome metabólica e seus componentes e pesquisa de microalbuminúria como marcador de um possível dano renal precoce nessas pacientes. Métodos: Foram avaliadas 102 mulheres de 20-34 anos de idade, com diagnóstico de SOP pelo Consenso de Rotterdam, tendo sido analisados parâmetros clínicos, antropométricos, bioquímicos e hormonais. Para diagnóstico de síndrome metabólica, foram adotados critérios do National Cholesterol Education Program s Adult Treatment Panel III (NCEP-ATP III). Para avaliação da microalbuminúria foi utilizada a relação albumina/creatinina (A/C), calculada a partir dos níveis de albumina e creatinina em amostra isolada de urina. Foram realizados testes estatísticos para avaliar associações e correlações entre variáveis, bem como comparação de médias ou medianas, adotando-se nível de significância de 5%. Resultados: A prevalência de síndrome metabólica foi de 28,4% (29 em 102 pacientes), estando associada ao aumento do índice de massa corporal (IMC). Quanto à análise da prevalência dos componentes individuais da síndrome metabólica, evidenciou-se: HDL-colesterol < 50 mg/dl em 69,6%, circunferência da cintura ≥ 88 cm em 57,9%, triglicerídeos ≥150 mg/dl em 31,7%, pressão arterial ≥130/85 mmHg em 18,6% e glicemia de jejum ≥110 mg/dl em 2,9%. Quando definida pelos limites convencionais para a relação A/C (3,5 35 mg/mmol), a microalbuminúria esteve presente em apenas três pacientes (3,3%). Entretanto, considerando diferentes limites de corte estabelecidos em recentes estudos que demonstraram aumento do risco cardiovascular associado a níveis muito baixos da relação A/C, a prevalência em mulheres com SOP foi alta, variando de 17,7 a 43,3% (para valores ≥ 0,58 e ≥ 0,37 mg/mmol, respectivamente). Mulheres com intolerância à glucose apresentaram nível significativamente mais elevado da relação A/C, quando comparadas às mulheres com normoglicemia. Os valores de microalbuminúria não apresentaram correlação significativa com IMC, níveis pressóricos, índices de sensibilidade insulínica ou perfil lipídico. Conclusões: Os dados evidenciam uma alta prevalência de síndrome metabólica e seus componentes individuais em mulheres brasileiras com SOP. Além do mais, observou-se elevado percentual de mulheres com níveis de excreção urinária de albumina em faixas significativamente associadas com aumento do risco para eventos cardiovasculares. Em conjunto, esses dados alertam para a necessidade da abordagem interdisciplinar e multidisciplinar das pacientes com SOP, visando à instituição de medidas voltadas para a prevenção primária cardiovascular

Análise da presença de agentes mutagênicos nas águas do Rio Pitimbú/RN

The Pitimbu River is located at the oriental portion of the State of Rio Grande do Norte, including three importants cities named Macaíba, Parnamirim e Natal. Although its high importance as a water source, which supplys great part of the South Zone of the Natal city, this river receives a large quantity of domestic and industrial waste water without treatment. The Pitimbu River headhas its river-head located in the city of Macaiba, goes through Parnamirim, then it flowing into at the Jiqui Lake in Natal. The aim of this study was to evaluate, qualitatively and quantitatively, the environmental quality of the Pitimbu River by genotoxicity bio-assays, which are important tools for genetics toxicological evaluation. In this work, five samples sites, distributed along the river, were used to collect water samples. Another point site, located near Jiqui lake, was used to collect drinkable water, which was treated by CAERN, the water treatment entreprise of Rio Grande do Norte. The following assays where used to evaluate the quality of these samples: Allium cepa assay; Comet assay; Micronuclei (MN) assay; and Ames test. For the Allium cepa assay, sixteen specimes where used for each water sample from the sample sites. In this assay both microscopic, like cytogenetic damage, and macroscopic aspects, as morphological variation were evaluated. Red blood cells from periferical blood of the Crenicichla menezesi native specie were used not only for the MN assay, but also for the Comet assay. These fishes were collected at different points on the Pitimbu River and the negative control was developed using fishes of the same species that were bring to the laboratory and maintained for 100 days in the optimal experimental conditions. For the Ames test, TA100, YG1042, TA98 and YG1041 strains were used in the directed method without metabolic activation. The results found by the Allium cepa assay showed that two water sample sites induced increase of mitotic index (IM). Additionally, compared to the control, all the water samples increased the chromossomal aberrations frequency and/or micronucleus. Among the sample sites, two also showed an abnormal growth rate in its root and two samples induced morphological alteration. With the MN test in red blood cells, a high frequence of MN was observed in tree sample. By comparing all the results obtained on the water sample points and with the negative control, a significant variation on the MN frequency was observed. Positive results were also observed for the same sample to water test by the Comet assay. These results allow concluding that the proposed specie Crenicichla menezesi has a good profile as a bio-indicator for the evaluation of environmental water quality and the MN and comet test can be usuful for in situ evaluation. By the Ames test, it was possible to detect the mutagenic activity on the waters from the Pitimbu River in different levels of mutagenicity. This result suggests that this river has several substances that induced changes directly to the DNA. The mechanisms involved to this phenomenon could be by both processes, by changing of the reading frame and by nucleotide substitution. These data set indicate the presence of mutagenic agents, which can represent in risk to biot and human beens

Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante

Post-menarche patients with clinical signs of vulvovaginitis were analyzed in this study, whose aims were the following: identify the frequency of C. albicans and non C. albicans species and negative results, correlate the vaginal culture for yeast with risk factors and symptomatology; compare positive and negative results for yeast in the vaginal and anal cultures; compare the positive results for C. albicans with other results found in the vaginal and anal cultures; and compare concomitant positivity for C. albicans and non C. albicans in the vaginal and anal cultures. Sample selection occurred between May, 2003 and May, 2005, and included 99 patients from Natal, Brazil. The laboratory methods used consisted of CHROMagar Candida culture medium, thermotolerance test at 42-45°C and hypertonic NaCL, in addition to the classic methods of carbohydrate assimilation and fermentation. We used absolute numbers, percentages, means of central tendency, chi-squared test (χ2) with Yates correction, Fisher s exact test and odds ratio for statistical analysis. The most frequent species was C. albicans in 69% of the cases. The positivity for Candida spp showed an association with the use of tight-fitting intimate clothing and/or synthetics, allergic diseases and the occurrence of itching, leukorrhea and erythema. Anal colonization increased the likelihood of vaginal contamination by 2.8 and 4.9 times, respectively, for Candida spp and C. albicans. When compared to the other species, C. albicans-positive anal colonization increased by 3.7 times the likelihood of vaginal positivity. These data suggest likely vaginal contamination originating in the anus

Análises espaciais na identificação das áreas de risco para a esquistossomose mansônica no município de Lauro de Freitas, Bahia, Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação multidimensional de pessoas idosas atendidas por equipes de saúde da família em Natal-RN: uma análise demográfica e epidemiológica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Novas fronteiras petrolíferas no Brasil : uma análise da necessidade de nova regulamentação da área do pré-sal sob a ótica constitucional

The Oil industry in Brazil has gone through several stages during the economical, political and social historical process. However, the significative changes have happened in the last fifteen years, due to market opening arising from the relaxation of the state monopoly over the Oil deposits and its derivatives. The edition of the Constitutional Amendment #9, changing the first paragraph of the 177th item of the Federal Constitution, marked the end of a stiffness about the monopoly that the Brazilian state kept in relation to the exploration and research of Oil and Gas. The economical order was fundamental to actualize the idea contained in the #9 Amendment, since its contents has the power to set up measures to be adopted by public power in order to organize the economical relations from a social viewpoint. The new brazilian Oil scenery, called pre-salt, presents itself in a way to amaze the economical markets, in addition to creating a new perspective to the social sector. This work will identify, in this new scenario, the need for change in the legal system. Nevertheless, this subject must not be treated in a thoughtless way: being an exhaustible good, we shall not forget that the future generations also must benefit from the exploration of natural resources recently discovered. The settlement of a new regulatory mark, including the change in the concession contract model to production and sharing is one of the suggested solutions as a bill in the National Congress, in an attempt to ensure the sovereignty of the nation. The constitutionality of a new regulatory mark is questioned, starting from an analysis of the state monopoly, grounding the comprehnsions in the brazilian constitutions, the relevance of the creation of Petrobras for self-assertion of the state about the monopoly of Oil and derivatives, and its posture after the Constitutional Amendment nº 9 (1995), when a company stops having control of the state monopoly, beginning to compete in a fairly way with other companies. The market opening and private initiative are emphasized from the viewpoint of the Constitutional Principles of the Economical and Social Order. The relaxation of the monopoly regarding the exploratory activity in the Federal Constitution doesn't deprive from the Union the ownerships of underground goods, enabling to this federal entity to contract, directly or by concession of exploration of goods, to state-owned or private companies. The existing oil in the pre-salt layer transforms the scenario from very high risk to low risk, which gives the Union the possibility of defining another way of exploring this resources in the best interests of the Public Administration

O direito à saúde e a política nacional de atenção oncológica: uma análise a partir da crescente judicialização dos medicamentos antineoplásicos

The 1988 Federal Constitution of Brazil by presenting the catalog of fundamental rights and guarantees (Title II) provides expressly that such rights reach the social, economic and cultural rights (art. 6 of CF/88) as a means not only to ratify the civil and political rights, but also to make them effective and practical in the life of the Brazilian people, particularly in the prediction of immediate application of those rights and guarantees. In this sense, health goes through condition of universal right and duty of the State, which should be guaranteed by social and economic policies aimed at reducing the risk of disease and other hazards, in addition to ensuring universal and equal access to actions and services for its promotion, protection and recovery (Article 196 by CF/88). Achieving the purposes aimed by the constituent to the area of health is the great challenge that requires the Health System and its managers. To this end, several policies have been structured in an attempt to establish actions and services for the promotion, protection and rehabilitation of diseases and disorders to health. In the mid-90s, in order to meet the guidelines and principles established by the SUS, it was established the Política Nacional de Atenção Oncológica PNAO, in an attempt to sketch out a public policy that sought to achieve maximum efficiency and to be able to give answers integral to effective care for patients with cancer, with emphasis on prevention, early detection, diagnosis, treatment, rehabilitation and palliative care. However, many lawsuits have been proposed with applications for anticancer drugs. These actions have become very complex, both in the procedural aspects and in all material ones, especially due to the highcost drugs more requested these demands, as well as need to be buoyed by the scientific evidence of these drugs in relation to proposed treatments. The jurisprudence in this area, although the orientations as outlined by the Parliament of Supreme Court is still in the process of construction, this study is thus placed in the perspective of contributing to the effective and efficient adjudication in these actions, with focus on achieving the fundamental social rights. Given this scenario and using research explanatory literature and documents were examined 108 lawsuits pending in the Federal Court in Rio Grande do Norte, trying to identify the organs of the Judiciary behave in the face of lawsuits that seeking oncology drugs (or antineoplastic), seeking to reconcile the principles and constitutional laws and infra constitutional involving the theme in an attempt to contribute to a rationalization of this judicial practice. Finally, considering the Rational Use of health demands and the idea of belonging to the Brazilian people SUS, it is concluded that the judicial power requires ballast parameters of their decisions on evidence-based medicine, aligning these decisions housing constitutional principles that the right to health and the scientific conclusions of efficacy, effectiveness and efficiency in oncology drugs, when compared to the treatments offered by SUS

A indústria petrolífera nacional e potiguar: uma análise a partir da tecnologia em E&P

O trabalho analisa a Indústria Petrolífera em três ambientes de atuação, mundial, nacional e estadual, a partir da observação de sete variáveis, a saber: caráter do petróleo; risco; economia de escala; integração; barreiras; tecnologia e ambiente. O estudo busca perceber as interações e os transbordamentos das variáveis selecionadas em cada um dos ambientes citados, em razão os aspectos econômicos e institucionais presentes nesta atividade, cujos resultados atingem diversos setores da economia e da sociedade como um todo e balizam o próprio processo de inovação da mesma. O estudo está alicerçado no arcabouço teórico neoschumpeteriano acerca dos aspectos voltados para concorrência e inovação, além da questão institucional, e se apóia em dados da Agência Nacional do Petróleo (A.N.P.), Ministério de Minas e Energia (MME), Movimento de Combate à Corrupção Eleitoral / Tribunal Superior Eleitoral (MCCE/TSE), Organization of the Petroleum Exporting Countries (OPEC), International Energy Agency (IAE), Institut Français Pétrole (IFP), United Nations Development Programme (UNDP). Avalia-se que em termos de caracterização da indústria petrolífera nos três ambientes considerados (mundial, nacional e local), há certa similitude no que se refere ao comportamento destas variáveis, com pequenas modificações suscitadas por fatores como grau de desenvolvimento e complexidade da atividade; resultado do ambiente concorrencial e inovativo; e, pelas influências institucionais acerca de atividades e grau de inserção das mesmas no ambiente socioeconômico onde estão localizadas a atividade produtiva e o seu entorno

Entre o mercado e a construção social: uma análise da experiência da implantação doPRONAF-infraestrutura e PRONAT nos territórios do Mato Grande-RN e sertão do Apodi-RN (1997 - 2010)

Analyzes the development experience in the Territories of Mato Grande and Sertão do Apodi in the state of Rio Grande do Norte, evaluating the actions of the National Program for Strengthening Family Agriculture, specifically the line of infrastructure (PRONAF-INFRA), and the National Program for Sustainable Development of Rural Territories (PRONAT) in these territories. Summarizes the various rural development approaches and takes the theoretical assumptions of territorial development, the concept of constructed territory and market-plan territory, further the cycle model to analyze public policies selected these experiences. Thus, we propose to test the hypothesis that most of the actions implemented would lead to the formation of market-plan territories, in other words, perceived only as a platform for the presentation of projects. The literature and documents, combined with case studies, interviews and direct observation of the meetings of committees, showed that, despite two boards are under the same laws, rules and formal regulations, have clear differences when considering the theory and concepts that were used as reference. The Apodi s territory is closer to a constructed space thus the search for a broader agenda, more autonomous and more appropriate to the reality experienced by local actors. On other hand the Territory of Mato Grande had the characteristics of a market-plan territory more present. As the result, the territory of Sertão do Apodi accesses not only as part of a greater number of policies and funding sources, ensuring a greater and more diverse investment volume than the territory of Mato Grande. Despite these differences, studies have shown that territorial boards surveyed are still far from becoming the main forum for managing the development from conception planning socially constructed. Showed, finally, that territorial development strategy is relevant, but requires a long walk and a deep and continuous learning process to be successfully implemented in rural areas of Northeast Brazil

Reconfigurações industriais das regiões metropolitanas do Nordeste: uma análise a partir do emprego formal

Industrial development experienced by Brazil from the 1950s, changed the concentration of population in the country. The process of development of domestic industry, concentrated in urban areas, crowded growing portion of the population.The Southeast region during the first stage of industrialization driven by the state, with the implementation of Plan goals, captained the major industrial projects implemented in the period and became the main industrial center of the country.In the decade from 1960 to 1980 the state action was marked by numerous regional development projects, softening the industrial concentration and Brazilian investment redirected to the Northeast.The second National Development Plan implemented in the 1970s led to major investments Northeast.This period marked the widespread urban growth and institutionalization of the first metropolitan areas in Brazil.The change of this developmental process is altered with the fiscal and financial crisis of the state in the 1980s and 1990s and spending cuts aimed at national development, reorienting the economy to liberal policies of economic liberalization and reduction of activity in the economy.Industrial policy was relegated to local development plans from the 1990s to the federating units fitting the wide use of tax incentives, the "war tax" to the continued industrialization process.In this context of the national economy work seeks to analyze the industrial setting in the metropolitan areas of Fortaleza, Recife and Salvador between 1995 and 2010.Although the metropolitan areas of Fortaleza, Recife and Salvador are the main urban centers of the Northeast, responsible for the advancement of industrial development, reconfigurations occurred between 1995 and 2010 by changing the level of industrial specialization built by regional division of labor in these regions.The work will be carried out by the method of descriptive analysis of the literature review on regional and urban development.Constitute quantitative method as the secondary data analysis of formal employment from the Annual Social Information (RAIS) Ministry of Labour and Employment (MTE).Using data RAIS / MTE analyzes the industrial specialization index using the Locational Quotient (LQ).Thus, it is assumed as a parameter analysis QL> 1, when the region has become specialized in a particular sector or QL <1, when the region does not have expertise in industrial sector analyzed.The conclusion of study indicates that there was in these metropolitan areas maintained the same bias hub.Fiscal policies, the states, was not successful in diversifying the productive structure and the Northeast region itself.This result is demonstrated by the need and dependence on state investments in the region to promote development.Industrial policies of recent years have been positive to meet the objectives of employment generation, but there must be specific policies for better diversification of production, in addition to integrating the economy of the Northeast sector and regionally

Segurança do paciente no sistema de medicação: análise de enfermeiros de um hospital de ensino

This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care

Fatores de decisão da adoção do gás natural na geração de energia elétrica em pequena escala em postos de combustíveis: um estudo de anális de decusão usando o processo de hierarquia analítica AHP

A modeling of criterias and alternatives is through and applied a questionnaire based on method AHP to proprietors of gas stations. The considered alternatives had been the maintenance of the current state with electric energy of the deliverer and the generation in small scale based on the natural gas. The used criteria had been Cost of the Investment, Final Cost of the Energy, Operational cost, Ambient Benefits, Risk and Variation of Costs. The study it was carried through in the city of Natal, RN in ranks that make use of the natural as for resale, where the generation alternative on the basis of the available gas is present. The main results evidence in a dimension the viability of use of method AHP with questionnaire by means of validation of the judgments with analysis of variance beyond proper the normal mechanisms of analysis of consistency to the method. The main results of the analysis help to show that in this in case that the profile of models of criteria and judgments of the actors is similar, with the final evidence of that it has a dominance of the maintenance of the energy of the deliverer. The main criterion to influence this decision was the risk

Um estudo da aplicação do conceito de risco na conscientização e conhecimento de estudantes de ensino técnico sobre riscos de segurança e saúde ocupacional em laboratório de soldagem

This dissertation presents a discussion on the level of risk awareness of students who have welding practice in the laboratories at CEFET/PI, both in Teresina and Floriano. Its main goal is to investigate risk factors involving students, teachers and employees that work in these laboratories. It s an empirical survey, held among a certain amount of students from the course in Mechanic Technology. For data analysis, the concept of risk was compared to the students direct measure of perception. The main results suggest the students must be better informed, more risk aware and more competent, in order to avoid accidents. They also point to a strong need for a more formal and effective performance to assure full consciousness about the risks involving the welding practice.

Modelo de covariância bayesiana para seleção de protfólios de investimentos

The portfolio theory is a field of study devoted to investigate the decision-making by investors of resources. The purpose of this process is to reduce risk through diversification and thus guarantee a return. Nevertheless, the classical Mean-Variance has been criticized regarding its parameters and it is observed that the use of variance and covariance has sensitivity to the market and parameter estimation. In order to reduce the estimation errors, the Bayesian models have more flexibility in modeling, capable of insert quantitative and qualitative parameters about the behavior of the market as a way of reducing errors. Observing this, the present study aimed to formulate a new matrix model using Bayesian inference as a way to replace the covariance in the MV model, called MCB - Covariance Bayesian model. To evaluate the model, some hypotheses were analyzed using the method ex post facto and sensitivity analysis. The benchmarks used as reference were: (1) the classical Mean Variance, (2) the Bovespa index's market, and (3) in addition 94 investment funds. The returns earned during the period May 2002 to December 2009 demonstrated the superiority of MCB in relation to the classical model MV and the Bovespa Index, but taking a little more diversifiable risk that the MV. The robust analysis of the model, considering the time horizon, found returns near the Bovespa index, taking less risk than the market. Finally, in relation to the index of Mao, the model showed satisfactory, return and risk, especially in longer maturities. Some considerations were made, as well as suggestions for further work

Abordagem da ergonomia para a análise da acessibilidade de uma instituição de longa permanência para idosos da cidade de Natal-RN

This dissertation presents and discusses the results of an applied research on the accessibility of residents in a Long Term Care Institution (LTCIs) in the city of Natal- RN. The main objective of this research is to suggest projectual improvements that maximize the accessibility in a LTCIs of Natal-RN, considering the aspects of mobility, safety, comfort and independence of elderly residents. Moreover, one should consider the specific characteristics of the user population, capabilities and limitations of the biological process of aging, which causes damage to the neurological system, musculoskeletal and cardiovascular and progressively affects on visual acuity, balance and locomotion of elderly people. This research has a qualitative approach and divided into four phases: exploratory, bibliographical and documentary research, mapping of the LTCIs of Natal-RN, case study. The phase of the mapping presented an overview of accessibility on LTCIs of Natal-RN. The institution of the case study was defined based on the overall assessment of accessibility and ergonomics criteria, preceded by an application of an Ergonomic Work Analysis to understand the accessibility of the elderly people. Interactional and observational methods were used to collect field data. To this end, an intense process of social construction was conducted, involving the elderly residents, caregivers, health professionals and general servants and LTCIs´ managers. It was found that the NBR 9050 is not comprehensive to solve the diversity of accessibility problems found in LTCIs. All LTCIs investigated were in disconformity to the NBR 9050. In the case study, it was found that the inappropriate design hinders the daily activities of the elderly people and is a source of risk of accidents. The environment, facilities and lack of assistive technologies hinder the autonomy of the elderly people, and this LTCI requires ergonomic intervention to improve the accessibility, autonomy and security of the elderly people