Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Avaliação da relação entre qualidade de sono e uma intervenção com jogos para o desempenho de crianças e adolescentes

The sleep is an active brain process that allows the efficient realization of daily tasks. The changes on sleep patterns may influence the different cognitive processes performance. Many recent studies show the possibility of cognitive performance improvement, through the cognitive training with the use of computer games. The question is if these interventions may be influenced by the sleep quality. Thus, we evaluated the sleep quality effect about the efficacy of an intervention with computers games based on the working memory and attention for a cognitive performance training of elementary school students. The sample was constituted by 42 students with average age of 10,43 years old (SD=1,23), with 22 male participants and 20 female participants. We used to evaluate the sleep with the parents a sleep questionnaire, a sleep diary and the Sleep Behavior Questionnaire. In regard to intervention, the subjectives were distributed in an experimental and in a control group, both with 21 participants. In the first group occurred the intervention that consisted in the working memory and attention training with two cognitive tasks (Safari e Brain Workshop) during 30 daily minutes, for a 6 weeks period. In an equal period, the students from the control group should reproduce an artwork using drawing software. To evaluate the cognitive performance we applied before and after the intervention period the Wechsler Intelligence Scale for Children (WISC-III). The results showed that in both the groups the performance of the intelligence, working memory, attention and visuospatial skills was below of the mean. The cognitive processes evaluated after of intervention in the experimental group had a performance significantly higher in the Perceptual Reasoning Index (t = -6,24; p < 0,01) and in the Full Scale IQ (t = -5,09; p < 0,01) and Performance IQ (t = -6,52; p < 0,01), suggesting a improvement on the visuospatial skills, attention, working memory and processing speed. On the control group, the performance was significantly higher in the Coding subtest (t = -5,38; p< 0,01) and in the Perceptual Reasoning Index (t = -3,66; p = 0,01), suggesting a improvement on the visuospatial skills and attention. The mean obtained with the Sleep Behavior Questionnaire was 53,76 (SD=14,96) for an experimental group and 61,19 (SD=12,82) for a control group, indicating tendency for a bad sleep quality in that last one. Not only during the first days, but also in the last fifteen days of the intervention we verified in the two groups an adequate time to sleep, duration and regularity, in the weekdays and on the weekends. We didn t find significant differences between the two groups in none of the sleep variables. We verified statistically meaningful improvement on the performance of the experimental group with the intervention in the two games. We didn t verify significant correlations between the games performance index and in the sleep variables of the experimental group individuals. We verified significant correlations among the performance on the Brain Workshop and the Cubes subtest, the Perceptual Reasoning Index and the Scale Performance IQ, suggesting that the significant improvement of the visuospatial skills and of the attention was correlated with the performance in the Brain Workshop. Although the absence of correlations with the performance in the Safari, possibly it also has relieved in the improvement of the cognitive performance. The findings support the hypothesis that the computer games might be a satisfactory tool for the improvement of the performance in visuospatial skills and attention. This can be resulted of the insertion of visuospatial stimulations in the task, for example, graphical elements with thematic for children that increase the interest. The IQ below mean the individuals might have influenced the improvement absence on the cognitive processes like the working memory with games. Moreover, it wasn t verified a relation between the sleep quality and the intervention efficacy. It might have been influenced by the n of the sample. Future studies must focalize in the improvement of the effect of the interventions with games

Mensuração da qualidade de vida de indivíduos com a doença de Parkinson por meio do questionário PDQ-39

INTRODUÇÃO: A doença de Parkinson (DP) é caracterizada por uma degeneração progressiva seletiva de neurônios localizados na pars compacta da substância negra. Ela compõe-se por um conjunto de quatro sintomas motores: tremor, rigidez, bradicinesia e instabilidade postural. OBJETIVO: O estudo objetivou investigar os fatores relacionados à queda na percepção da qualidade de vida de indivíduos com DP. MATERIAIS E MÉTODOS: Participaram deste estudo 25 indivíduos com diagnóstico de doença de Parkinson, classificados entre os estágios um e cinco da escala de estadiamento de Hoen e Yahr, tendo a sua qualidade de vida avaliada segundo o Parkinson Disease Questionary-39 (PDQ-39). RESULTADOS: Os 25 indivíduos (12 homens e 13 mulheres) apresentaram idade média de 71,2 ± 8,5 anos, variando entre 53 a 85 anos, e tempo de evolução da doença de 6,54 ± 7,71, variando entre 1 e 39 anos de doença. Verificou-se que as piores percepções sobre a qualidade de vida estão relacionadas ao domínio mobilidade, com média de 55% de comprometimento, e ao domínio atividade de vida diária, com 52,78% de comprometimento. Ficou também constatada uma alta correlação entre o escore total do PDQ-39 com os domínios atividade de vida diária, bem-estar emocional e mobilidade. CONCLUSÕES: A partir dos resultados obtidos, é possível constatar que carências de origem motora associadas aos sinais e sintomas e às complicações secundárias da DP interferem negativamente sobre a percepção da qualidade de vida dos indivíduos.

Avaliação de arquitetura de agentes emocionais : uma abordagem baseada em métrica de qualidade e na influência das emoções sobre usuários

There is a need for multi-agent system designers in determining the quality of systems in the earliest phases of the development process. The architectures of the agents are also part of the design of these systems, and therefore also need to have their quality evaluated. Motivated by the important role that emotions play in our daily lives, embodied agents researchers have aimed to create agents capable of producing affective and natural interaction with users that produces a beneficial or desirable result. For this, several studies proposing architectures of agents with emotions arose without the accompaniment of appropriate methods for the assessment of these architectures. The objective of this study is to propose a methodology for evaluating architectures emotional agents, which evaluates the quality attributes of the design of architectures, in addition to evaluation of human-computer interaction, the effects on the subjective experience of users of applications that implement it. The methodology is based on a model of well-defined metrics. In assessing the quality of architectural design, the attributes assessed are: extensibility, modularity and complexity. In assessing the effects on users' subjective experience, which involves the implementation of the architecture in an application and we suggest to be the domain of computer games, the metrics are: enjoyment, felt support, warm, caring, trust, cooperation, intelligence, interestingness, naturalness of emotional reactions, believabiliy, reducing of frustration and likeability, and the average time and average attempts. We experimented with this approach and evaluate five architectures emotional agents: BDIE, DETT, Camurra-Coglio, EBDI, Emotional-BDI. Two of the architectures, BDIE and EBDI, were implemented in a version of the game Minesweeper and evaluated for human-computer interaction. In the results, DETT stood out with the best architectural design. Users who have played the version of the game with emotional agents performed better than those who played without agents. In assessing the subjective experience of users, the differences between the architectures were insignificant

Value of ultrasonographic contrast in duplex scanning of leg arteries - Comparison with conventional duplex scanning and arteriography

Aim. Duplex scanning has been used in the evaluation of the aorta and proximal arteries of the lower extremities, but has limitations in evaluating the arteries of the leg. The utilization of ultrasonographic contrast (USC) may be helpful in improving the quality of the image in these arteries. The objective of the present study was to verify whether the USC increases the diagnostic accuracy of patency of the leg arteries and if it diminishes the time needed to perform duplex scanning.Methods. Twenty patients with critical ischemia (20 lower extremities) were examined by standard duplex scanning, duplex scanning with contrast and digital subtraction arteriography (DSA). The 3 arteries of the leg were divided into 3 segments, for a total of 9 segments per limb. Each segment was evaluated for patency in order to compare the 3 diagnostic methods. Comparison was made between standard duplex scanning and duplex scanning with contrast in terms of quality of the color-coded Doppler signal and of the spectral curve, and also of the time to perform the exams.Results. Duplex scanning with contrast was similar to arteriography in relation to patency diagnosis (p>0.3) and even superior in some of the segments. Standard duplex scanning was inferior to arteriography and to duplex scanning with contrast (p<0.001). There were improvements of 70% in intensity of the color-coded Doppler signal and 76% in the spectral curve after the utilization of contrast. The time necessary to perform the examinations was 23.7 minutes for standard duplex scanning and 16.9 minutes for duplex scanning with contrast (p<0.001).Conclusion. The use of ultrasonographic contrast increased the accuracy of the diagnosis of patency of leg arteries and diminished the time necessary for the execution of duplex scanning.

Adjuvant therapy with GnRH agonists/tamoxifen in breast cancer should be a good council for patients with hormone receptor-positive tumours and wish to preserve fertility

Infertility represents one of the main long-term consequences of the chemotherapy used for the adjuvant treatment of breast cancer. Approximately 60-65% of breast cancers express the nuclear hormone receptor in premenopausal women. Adjuvant endocrine therapy is an integral component of care for patients with hormone receptor-positive (HR+) tumours. The GnRH agonist (GnRHa) alone or in combination with tamoxifen produces results at least similar to those obtained with the different chemotherapy protocols in patients with HR+ breast cancer with respect to recurrence-free survival and overall survival. It is time to indicate adjuvant therapy with GnRHa associated with tamoxifen for patients with breast cancer (HR+ tumours) if they want to preserve their reproductive function. The evaluation of ovarian reserve tests: follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B, antral follicle count (AFC) and ovarian volume 6 months, and 1 year after the end of therapy with GnRHa/tamoxifen must be realised. The recurrence-free survival and overall survival should be analysed. The major implication of this hypothesis will be to avoid adjuvant chemotherapy for patients with breast cancer (HR+ tumours) that request fertility preservation. It is expected that ovarian function should not be altered in almost all cases and subsequent pregnancy a real possibility. (C) 2012 Elsevier Ltd. All rights reserved.

Desempenho zootécnico e tabela de alimentação de girinos de rã-touro (Rana catesbeiana) criados no sistema anfigranja

Objetivou-se com a execução deste trabalho avaliar, em nível de campo, o desempenho zootécnico de girinos de rã-touro (Rana catesbeiana) criados em ranários comerciais que utilizam o sistema anfigranja, e simultaneamente estimar os valores de consumo diário de ração para compor uma tabela de referência para a alimentação dos animais. Os resultados encontrados nas unidades de observações monitoradas (aproximadamente 249 mil animais) atingiram os seguintes índices médios: a mortalidade (em %) variou de: 0,7 a 35,2 (média 5,9%); o ganho de peso (g. p/dia): de 0,03 a 0,22 (média 0,11 g/dia); e a conversão alimentar: de 0,92 a 2,75 : 1; (média 1,50 : 1). Comparados com dados preliminares, tais resultados indicam uma significativa otimização dos índices zootécnicos, demonstrando que houve um relativo ganho de produtividade com o aperfeiçoamento das técnicas de manejo implementadas. A redução do valor médio da conversão alimentar aparente foi provocada principalmente pelo adequado uso da tabela de referência, cujos valores foram ratificados durante o trabalho de monitoramento das unidades. Tal tabela possibilita o cálculo da quantidade de alimento a ser oferecido diariamente, baseado nos peso médio dos girinos e na estimativa do percentual de consumo, para temperatura da água entre 18 a 29 graus centígrados, (girinos de 0,1 a 26 gramas de peso médio).

Desempenho zootécnico e percentual de consumo de alimento de rã-touro (Rana catesbeiana) na fase de recria (pós-metamorfose) do sistema anfigranja

Objetivou-se com este trabalho avaliar (em nível de campo) o desempenho zootécnico da rã-touro, Rana catesbeiana (Shaw, 1882), criada em ranários comerciais que utilizam o Sistema Anfigranja, e , simultaneamente, estimar os valores de consumo diário de alimento para compor uma tabela de referência para o arraçoamento dos animais. As avaliações demonstraram haver valores de produtividade com grandes variações, de acordo com a capacidade do produtor em assimilar a tecnologia e principalmente manejar os animais de forma padronizada, para atingir o ponto de equilíbrio no fluxo de produção de seu plantel. Os resultados encontrados nas unidades de observação monitoradas (aproximadamente 250 mil animais) atingiram os seguintes índices médios: a mortalidade (em %) 0,5 a 39,5 (média geral 12,0); o ganho de peso (g./dia) 0,4 a 2,5 (média geral 1,2); e a conversão alimentar 0,9 a 2,5 : 1,0 (média geral 1,4 : 1,0). É apresentada uma tabela com os percentuais estimados de consumo de alimento, em função do peso médio dos animais, para o cálculo da quantidade de ração a ser oferecida diariamente.

Relação entre aleitamento materno e hábitos de sucção não nutritivos

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

Toxicity of photodynamic therapy with LED associated to Photogem (R): An in vivo study

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

Myocardial dysfunction induced by food restriction is related to morphological damage in normotensive middle-aged rats

Previous works from our laboratory have revealed that food restriction (FR) promotes discrete myocardial dysfunction in young rats. We examined the effects of FR on cardiac function, in vivo and in vitro, and ultrastructural changes in the heart of middle-aged rats. Twelve-month-old Wistar- Kyoto rats were fed a control (C) or restricted diet (daily intake reduced to 50% of the control group) for 90 days. Cardiac performance was studied by echocardiogram and in isolated left ventricular (LV) papillary muscle by isometric contraction in basal condition, after calcium chloride (5.2 mM) and beta- adrenergic stimulation with isoproterenol (10(-6) M). FR did not change left ventricular function, but increased time to peak tension, and decreased maximum rate of papillary muscle tension development. Inotropic maneuvers promoted similar effects in both groups. Ultrastructural alterations were seen in most FR rat muscle fibers and included, absence and/or disorganization of myofilaments and Z line, hyper-contracted myofibrils, polymorphic and swollen mitochondria with disorganized cristae, and a great quantity of collagen fibrils. In conclusion, cardiac muscle sensitivity to isoproterenol and elevation of extracellular calcium concentration is preserved in middle-aged FR rats. The intrinsic muscle performance depression might be related to morphological damage.

Estrous behavior and the estrus-to-ovulation interval in Nelore cattle (Bos indicus) with natural estrus or estrus induced with prostaglandin F2 alpha or norgestomet and estradiol valerate

Estrous behavior and the estrus-to-ovulation interval are essential for estimating the best time to artificially inseminate cattle. Because these parameters are not well characterized in the Nelore breed (Bos indicus), the main purpose of the this study was to determine the estrus-to-ovulation interval in Nelore heifers and cows with natural estrus or with estrus induced by treatments with PGF2 alpha or norgestomet and estradiol valerate (NEV). The cows and heifers were observed continuously (24 h a day) to determine the onset of estrus and to study estrous behavior in the cows. Ten hours after the start of estrus the ovaries were scanned every 2 h by ultrasonography to monitor the dominant follicle until ovulation. Blood samples were collected periodically to determine progesterone levels by RIA. Administration of PGF2 alpha (2 injections, 11 days apart) did not induce estrus in most Nelore females in spite of the presence of functional CL, indicated by progesterone concentrations above 6.0 ng/ml in 25 of 28 animals. Treatment with NEV induced high sexual receptivity in cows (10/11), but only 66% ovulated. Cows with natural or induced estrus exhibited behavioral estrus of 10.9 +/- 1.4 h, and ovulation occurred 26.6 +/- 0.44 h (n = 26) after the onset of estrus. In most of the cows (53.8%) estrus began at night (between 1801 and 600 h), and 34.6% it started and finished during the night. It is concluded that in Nelore females ovulation occurs approximately 26 h after the onset of estrus. Additionally, estrous behavior is shorter than in European breeds, and there is a high incidence of estrus at night, which makes it difficult to detect and, consequently, impairs Al in Nelore cattle. The observation that a high percentage of Nelore females with an active CL did not respond to usual dosages of PGF2 alpha warrants further investigation. (C) 1998 by Elsevier B.V.

Myocardial dysfunction induced by food restriction is related to calcium cycling and beta-adrenergic system changes

Food restriction (FR) has been shown to promote myocardial dysfunction in rats. The aim of this study was to verify the participation of calcium and beta-adrenergic system on myocardial mechanical alteration in rats submitted to FR. Myocardial performance was studied in isolated left ventricular papillar muscle from young Wistar-Kyoto rats (WKY) submitted to FR or to control diet. The groups subjected to FR were fed 50% less food than the control group for 90 days. Mechanical function was studied in isometric contraction at post-rest contraction of 30 seconds (PRC), calcium chloride concentration 5.20 mM, and beta-adrenergic stimulation with isoproterenol 10(-6) M. FR decreased the body weight, and left and right ventricular weight. In basal condition (1.25 MM of calcium) time to peak tension (TPT) and time from peak tension to 50% relaxation (RT50) were greater in the FR group. Muscle function was. The same in both PRC groups. TPT decrease in both high calcium groups, more in FR rats; RT50 dropped only in FR animals. TPT decreased in both Isoproterenol groups, more intensely in the FR group. This result suggests that food restriction impairs myocardial performance and these changes may be attributed to alterations in the intracellular calcium cycling and beta-adrenergic system. (C) 2003 Elsevier B.V. All rights reserved.

Microdilution procedure for antifungal susceptibility testing of Paracoccidioides brasiliensis to amphotericin B and itraconazole

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

Effects of altered epididymal sperm transit time on sperm quality

The epididymal sperm transit time seems to have an important role in the process of sperm maturation, and it seems that alterations to the transit can harm the process. The aim of the present work was to evaluate the influence of altered sperm transit time through the epididymis on sperm parameters and fertility of rats, as well as the role of testosterone in the alterations. Sprague-Dawley adult male rats were randomly assigned to four different groups and were treated for 12 days: (i) 10 mu g/rat/day DES, to accelerate the transit; (ii) 6.25 mg/kg/day guanethidine sulphate, to delay the transit; (iii) same treatment as group 1, plus androgen supplementation; (iv) control animals received the vehicles. Guanethidine treatment delayed the sperm transit time through the epididymal cauda, provoking increased sperm reserves in this region. Animals exposed to DES showed an acceleration of sperm transit time in the epididymis, and consequently decreased sperm density in both epididymal regions, the caput-corpus and cauda, and diminished sperm motility. In both cases sperm production was not altered. Testosterone supplementation was able to restore the transit time to values close to normality, as they were higher than in the control rats. The same occurred in relation to sperm motility. Rats exposed to DES presented lower fertility after in utero artificial insemination using sperm collected from the proximal cauda epididymis. Therefore, it was concluded that the acceleration of rat sperm transit time appeared to harm normal sperm maturation, thus decreasing sperm quality and fertility capacity, in an androgen-dependent way.