For��a muscular respirat��ria e capacidade funcional em idosas hipertensas com sonol��ncia diurna excessiva

The restriction of physical fitness is directly related with hypertension and sleep disorders, while the respiratory muscle strength is associated with hypertension, but the literature is scarce regarding its relationship with sleep disorders and particularly with excessive daytime sleepiness. Objectives: To compare physical fitness and strength of respiratory muscles between people with hypertension with excessive daytime sleepiness (EDS) and non EDS people, those who do not feel excessive daytime sleepiness, in addition to relate aerobics resistance and functional mobility of patients. Methods: An observational, analytical and transversal study, evaluated 32 elderly with hypertension, divided into two groups (EDS and non EDS), in which the following topics were measured; respiratory muscular strength, functional fitness, level of physical activity, level of excessive daytime sleepiness, quality of sleep and intensity of the patients snoring. Results: There was a significant difference in the level of EDS (P=0,00) and quality of sleep (p=0,03), however, the data related to snoring intensity (p=0,18), maximum inspiratory pressure PImax (p=0,39) and maximum expiratory pressure PEmax (p=0,98) did not show any difference. Also, no significant difference was observed concerning physical fitness, presenting p=0,08 for the sitting and getting up test on the chair in 30 ; p=0,54 for the extension and flexing of the elbow test in 30 ; p=0,38 for the walking test 6 ; p=0,38 for the parking gear test 2 , p=0,08 for the sitting and reaching test; p=0,42 for the scratching the back test; p=0,49 for the getting up and walking test; and p=0,62 for the global rate of activity limitation. There was moderate positive correlation between 6MWT and 2MST, r=0,54 (p=0,01) and negative moderate correlation between 6MWT and TUG, r=-0,61 (p=0,000) and between 2MST and TUG, r=-0,60 (p=0,000). Conclusion: The presence of EDS in the hypertension people studied, showed a bad quality of sleep, however this sleepiness did not influence the strength of the respiratory muscles. The physical fitness came out diminished in all hypertension people, regardless of the presence or non presence of sleep disturbance; and there is a close relationship between cardiovascular resistance and physical mobility, since when there is less cardiovascular resistance, there is precarious physical mobility and vice-versa

Avalia����o da fun����o pulmonar em obesos m��rbidos com sonol��ncia diurna excessiva

Background: Obesity impairment to the pulmonary function related to the magnitude of adiposity and is associated with excessive daytime sleepiness (EDS) and snoring, among others symptoms of respiratory disorders related to sleep. It is possible that obese individuals with excessive daytime sleepiness may make changes in lung function on spirometry monitored during the day as a consequence of fragmented sleep or episodes of nocturnal hypoventilation that cause respiratory and changes that can persist throughout the day. The combination of these findings alone sleepiness observed by subjective scales with pulmonary function in obese patients is unknown. Objective: To assess the influence of EDS and snoring on pulmonary function in morbidly obese and distinguish between different anthropometric markers, the snoring and sleepiness which the best predictors of spirometric function and respiratory muscle strength and endurance of these patients. Methods: We evaluated 40 morbidly obese markers on the anthropometric, spirometric respiratory variables, maximal inspiratory and expiratory pressures (MIP and MEP) and maximal voluntary ventilation (MVV) and the measured excessive daytime sleepiness (the Epworth sleepiness scale) and snoring (snoring scale of Stanford). The data were treated when the differences between the groups of obese patients with and without sleepiness, whereas the anthropometric variables, respiratory and snoring. Pearson's correlation was performed, and multiple regression analysis assessed the predictors of pulmonary function. For this we used the software SPSS 15.0 for windows and p <0.05. Results: 39 obese patients were included (28 women), age 36.92+11.97y, body mass index (BMI) 49.3+5.1kg/m��, waist-hip ratio (WHR) 0.96+0.07 and neck circumference (NC) 44.1+4.2 cm. Spirometric values and respiratory pressures were up 80% of predicted values, except for endurance (MVV <80%). Obese with EDS have lower tidal volume. Positive correlation was observed between BMI and EDS, EDS and NC and between snoring and BMI, and negative correlation between EDS and tidal volume (TV), and between snoring and snoring FVC and FEV1. In linear regression the best predictor of pulmonary function was snoring, followed by NC. NC has more obese with higher strength (MEP, p = 0.031) and endurance (MVV p = 0.018) respiratory muscle. Conclusion: Obese with EDS tend to have lower TV. In addition, snoring and NC can better predict pulmonary function in obese when compared with other anthropometric markers or EDS. Obese patients with higher NC tend to have greater capacity for overall strength of respiratory muscles, but may have low muscle endurance

Avalia����o da capacidade de caminhar do portador de obesidade m��rbida utilizando teste de caminhada de 6 minutos

Introduction: The ability to walk is impaired in obese by anthropometric factors (BMI and height), musculoskeletal pain and level of inactivity. Little is known about the influence of body adiposity and the acute response of the cardiovascular system during whole the 6-minute walk test (6mWT). Objective: To evaluate the effect of anthropometric measures (BMI and WHR waist-to-hip ratio), the effort heart and inactivity in ability to walk the morbidly obese. Materials and Methods: a total 36 morbidly obese (36.23 + 11.82 years old, BMI 49.16 kg/m2) were recruited from outpatient department of treatment of obesity and bariatric surgery in University Hospital Onofre Lopes and anthropometric measurements of obesity (BMI and WHR), pulmonary function, pattern habitual physical activity (Baecke Questionnaire) and walking capacity (6mWT). The patient was checking to measure: heart rate (HR), breathing frequency (BF), peripheral oxygen saturation, level of perceived exertion, systemic arterial pressure and duplo-produto (DP), moreover the average speed development and total distance walking. The data were analysed between gender and pattern of body adiposity, measuring the behavior minute by minute of walking. The Pearson and Spearmam correlation coefficients were calculated, and stepwise multiple Regression examined the predictors of walking capacity. All analyses were performed en software Statistic 6.0. Results: 20 obese patients had abdominal adiposity (WHR = 1.01), waist circumference was 135.8 cm in women (25) and 139.8 cm in men (10). Walked to the end of 6mWT 412.43 m, with no differences between gender and adiposity. The total distance walked by obesity alone was explained by BMI (45%), HR in the sixth minute (43%), the Baecke (24%) and fatigue (-23%). 88.6% of obese (31) performed the test above 60% of maximal HR, while the peak HR achieved at 5-minute of 6mWT. Systemic arterial pressure and DP rised after walking, but with no differences between gender and adiposity. Conclusion: The walk of obese didn��t suffers influence of gender or the pattern of body adiposity. The final distance walked is attributed to excess body weight, stress heart, the feeling of effort required by physical activity and level of sedentary to obese. With a minute of walking, the obeses achieved a range of intensity cardiovascular trainning

Efeito do treinamento resistido na press��o arterial e capacidade funcional de idosas hipertensas

The results of studies about the ideal resistance training intensity for reduction of resting blood pressure levels, as well as this type of training to increase the functional capacity of hypertensive older women are still unclear, since the few investigations usually analyze young individuals normotensive, and the literature lacks precise information in elderly hypertensive subjects. Objectives: To determine the effect of two resistance training intensities on resting blood pressure and the effect of resistance training on functional capacity in elderly women with systemic arterial hypertension, analyzing these variables before and after eight weeks of intervention. Methods: Patients underwent eight weeks of resistance training, with a frequency of three times per week on alternate days, in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. Results: It was found that patients who underwent training with moderate resistance, showed a reduction on resting values of diastolic blood pressure (DBP) p<0.03 and of mean arterial pressure (MAP) p<0.03. Patients who underwent mild resistance training showed reduction in resting values of MAP (p<0.03) and a tendency to decrease in DBP (p<0.06). With regard to functional capacity, the results showed significant increase in the strength of arms and legs, agility and aerobic endurance (p<0.001) and maintaining flexibility (p>0.05). Conclusion: The data indicated that both mild and moderate resistance training, even when started in old age, promoted cardiovascular benefits and also improve the functional capacity of hypertensive older women.

Avalia����o das vari��veis cardiovasculares, capacidade de caminhar e n��vel de atividade f��sica de obesos m��rbidos antes e depois da cirurgia bari��trica

Morbidly obese patients present an increase in heart rate, blood pressure and perceived exertion besides lower walking ability compared to normal weight people. However, little is known about how these variables are presented after bariatric surgery. Moreover, despite the distance walked during the six-minute walk (6MWT) improve after surgery is not well established if the level of physical activity influences this improvement. Objective: To evaluate cardiovascular performance, perceived effort, ability of walking and physical activity level of patients with morbid obesity before and after bariatric surgery. Methods: The cardiovascular performance, perception of effort, the ability to walk and level of physical activity were assessed in 22 patients before (BMI = 50.4 kg/m2) and after (BMI = 34.8 kg/m2) bariatric surgery through the 6MWT. The heart rate, blood pressure and perceived exertion were assessed at rest, at the end of the 6MWT and in the second minute post-test (HR recovery). The ability to walk was measured by total distance walked at the end of the test while the level of physical activity was estimated by applying the Baecke questionnaire, analyzing domains occupation, leisure and locomotion and leisure and physical activity. Results: The HR at rest and recovery decreased significantly (91.2 �� 15.8 bpm vs. 71.9 �� 9.8 bpm, 99.5 �� 15.3 bpm vs 82.5 �� 11.1 bpm, respectively), as well as all the arterial pressure and perceived exertion after surgery. The distance achieved by the patients increased by 58.4 m (p = 0.001) postoperatively. Time postoperatively had correlation with the percentage of excess weight lost (r = 0.48, p = 0.02), BMI (r =- 0.68, p = 0.001) and the Baecke (r = 0.52, p = 0.01) which did not happen with the distance walked (r = 0.37, p = 0.09). Despite weight loss, patients showed no difference in the level of physical activity in any of the areas before and after surgery. Conclusion: The cardiovascular performance, the perception of effort and ability to walk seem to improve after bariatric surgery. However, despite improvement in the ability to walk by the distance achieved in the 6MWT after weight loss, this is not reflected in an increase in physical activity level of obese patients after surgery

Compara����o entre erg��metros espec��fico e convencionais na determina����o da capacidade aer��bia de mesatenistas

Funda����o de Amparo �� Pesquisa do Estado de S��o Paulo (FAPESP)

��n��lise da capacidade funcional e da distribui����o regional da ventila����o pulmonar em pacientes com doen��a de chagas

INTRODUCTION: Cardiac and pulmonary manifestations of the Chagas disease (CD) affect between 20-30% of the infected subjects. The chronic Chagas cardiomyopathy (CCC) has some peculiarities such as arrhythmias and, especially heart failure (HF) and is potentially lethal due to left ventricular dysfunction. How respiratory disorders, patients get progressive loss of functional capacity, which contributes to a poor quality of life related to disease. Measurements of lung volume by the movement of the chest wall surface are an alternative evaluation of lung function and kinematics of complex thoracoabdominal for these patients. OBJECTIVE: evaluate the kinematics of the thoracoabdominal complex through the regional pulmonary volumes and to correlate with functional evaluation of the cardiorrespiratory system in patients with Chagas disease at rest. MATERIALS AND METHODS: a cross-section study with 42 subjects had been divided in 3 groups, 15 composed for patients with CCC, 12 patients with HF of different etiologies and 15 healthful presented control group. An optoelectronic plethysmography (POE), Minnesota questionnaire, six minute walk test, spirometer and manovacuometer was used. RESULTS: It was observed in the 6MWT where group CRL presented greater distance 464,93��44,63m versus Group HF with 399,58�� 32,1m (p=0,005) and group CCC 404��68,24m (p=0,015), both the groups presented difference statistics with regard to Group CRL. In the manovacuometer 54,59��19,98; of the group CCC and 42,11��13,52 of group IC found group CRL presented 81,31��15,25 of the predicted versus, presenting in relation to group CRL. In the POE it observed a major contribution in abdominal compartment in patients with IC if compared like CCC and control groups. On the basis of the questionnaire of quality of life of Minessota, verified a low one groups CCC and IC 43,2��15,2 and 44,4��13,1, respectively (p<0,05) when compared with the control group (19,6��17,31). CONCLUSION: it seems that the patients with CCC possess same functional and respiratory characteristics, observed for the POE, 6MWT, manovacuometer and spirometer to the patients of group HF, being able to consider similar interventions for this complementary group as therapeutical of this neglected disease

Associa����o entre diferentes marcadores antropom��tricos com vari��veis espirom��tricas e de for��a muscular respirat��ria em obesos m��rbidos

A obesidade �� uma epidemia global em alarmante ascens��o. Caracterizada pelo excesso de gordura corporal subcut��nea, de car��ter multifatorial, est�� relacionada ao surgimento de diversas co-morbidades, entre elas, v��rias altera����es respirat��rias, estas se tornam mais intensas quanto maior o grau de obesidade. N��o h�� consenso na rela����o entre os marcadores de adiposidade geral ou espec��ficos e suas repercuss��es sobre a fun����o ventilat��ria, especialmente em rela����o �� sobrecarga muscular respirat��ria. Objetivo: Analisar a rela����o entre marcadores antropom��tricos e vari��veis espirom��tricas e de for��a muscular respirat��ria em indiv��duos com obesidade m��rbida. M��todos: Estudo transversal entre setembro de 2007 e outubro de 2012. Participaram da pesquisa 163 obesos m��rbidos (37.1��9.8 anos e IMC=49.0��5.88 Kg/m2) sem altera����es espirom��tricas. Foram observadas as associa����es entre ��ndice de Massa Corporal-IMC, adiposidade localizada (Circunfer��ncias de Pesco��o-CP, Cintura-CC e Quadril-CQ), percentual de gordura corporal atrav��s do ��ndice de Adiposidade Corporal-IAC, volumes e capacidades pulmonares (CVF, VEF1 e VRE) e press��es respirat��ria est��tica (PIM e PEM) e din��mica (VVM). Resultados: O VRE foi o volume mais afetado pela obesidade (apenas 41%predito) e mostrou associa����o negativa nas rela����es com todos os marcadores de adiposidade (IMC: r=-0.52; IAC: r=-0.21; CC: r=-0.44; CP: r=-0.25 e CQ: r=-0.28). H�� rela����o inversa entre o percentual de gordura corporal (IAC) com a CVF (r=-0.59), o VEF1(r=-0.56) e o VVM (r=-0.43). As press��es respirat��rias s��o justificadas principalmente pela adiposidade ao redor do pesco��o e o IAC. Nossos dados de for��a muscular respirat��ria foram melhores associados aos valores de refer��ncias sugeridos pelas equa����es de Harik-Klan et al (1998) para PIM (R��=0.72) e com a equa����o proposta por Neder et al (1999) para PEM (R��=0.52). Em um modelo de regress��o linear, as vari��veis de adiposidade n��o justificam a VVM, j�� o VEF1 explica 62% da vari��ncia da VVM em obesos m��rbidos. Conclus��o: O percentual da adiposidade corporal e a circunfer��ncia do pesco��o est��o associados com a for��a muscular e capacidade de gerar fluxo respirat��rio de obesos m��rbidos. Sugerimos a equa����o elaborada por Harik-Klan et al (1998) para obten����o de valores preditos de PIM e a equa����o proposta por Neder et al (1999) para valores de normalidade da PEM em sujeitos com obesidade m��rbida. Foi poss��vel fornecer uma equa����o de refer��ncia espec��fica para VVM em obesos m��rbidos

Fortalecimento do controle interno governamental: diagn��stico e propostas para a Controladoria Geral do Estado do RN

O objetivo deste trabalho �� fazer uma proposta de interven����o na Controladoria Geral do Estado do Rio Grande do Norte, com o intuito de fortalec��-la, tendo como base a Emenda Constitucional n�� 45/2009, que prop��e a inser����o das macrofun����es do Controle Interno: Auditoria Governamental, Controladoria, Corregedoria, Ouvidoria e Carreiras Espec��ficas para os ��rg��os de Controle Interno. Para dar suporte a proposta, foi feita uma revis��o da literatura sobre controles p��blicos, controle interno governamental, macrofun����es do controle interno e sobre carreiras p��blicas no Brasil. Para propor as mudan��as foram realizados dois diagn��sticos no ��rg��o, por meio de entrevistas, e constatados problemas na ��rea de gest��o organizacional e de pessoal. Diante dos resultados apresentados por meio dos diagn��sticos, foram propostas mudan��as e feitas compara����es entre a estrutura atual e a proposta, procurando evidenciar a vantagem da ��ltima sobre a primeira, em termos de efici��ncia operacional, economia de meio, economia de execu����o, amplitude no atendimento a popula����o, prote����o e combate �� corrup����o, fomento ao controle social, promo����o da cidadania e justi��a social

As Mem��rias de Lacroix: a instru����o p��blica na Fran��a revolucion��ria, em geral, e o ensino de Matem��tica, em particular

O artigo - um exame hermen��utico do livro Essais sur l'enseignement en g��n��ral, et sur celui des math��matiques en particulier, de 1805, de Sylvestre-Fran��ois Lacroix, enfatizando sua segunda parte, na qual o autor discute seu Curso de Matem��tica Elementar, uma s��rie de manuais escolares elaborados para a Escola Central das Quatro Na����es - tem sua fundamenta����o ligada �� Hermen��utica de Profundidade de Thompson conjugada a procedimentos de investiga����o textual sugeridos por Genette quanto aos paratextos editoriais. Defende que o livro de Lacroix �� uma obra auto-referencial, de cunho claramente autobiogr��fico, que responde mais aos ideais iluministas da Fran��a do Setecentos que ��s perspectivas do s��culo XIX, quando a obra circulou, tendo sido reeditada por quatro vezes, sob Napole��o, na primeira metade do Oitocentos. Raramente focalizado em trabalhos de pesquisa, o livro - cujas edi����es est��o dispon��veis eletronicamente - tem uma ��nica tradu����o, ainda in��dita, para o portugu��s.

Estimadores do tipo n��cleo para Vari��vei s I.I.D. com espa��o de estados geral

In this work, the paper of Campos and Dorea [3] was detailed. In that article a Kernel Estimator was applied to a sequence of random variables with general state space, which were independent and identicaly distributed. In chapter 2, the estimator��s properties such as asymptotic unbiasedness, consistency in quadratic mean, strong consistency and asymptotic normality were verified. In chapter 3, using R software, numerical experiments were developed in order to give a visual idea of the estimate process

Qualidade de Vida, Sa��de Geral e Ansiedade em pacientes com diferentes tipos e n��veis de disfun����o temporomandibular

Some studies reported in the literature that emotional factors and quality of life may be involved both in aetiology, as in the progression of Temporomandibular disorders (TMD). Proposition: The purpose of this study is to observe a possible association between different forms of anxiety, quality of life and general health of patients diagnosed as carriers of various types and levels of Temporomandibular Dysfunction. Methodology: The sample consisted of 60 patients diagnosed as carriers of TMJD origin of muscle, joint, or both, with different levels of severity (mild TMD, moderate and severe). The patients were diagnosed with TMD-RDC (Research Diagnostic Criteria) to assess the type of dysfunction (muscle or joint) and by the Protocol of Fonseca to verify the degree of dysfunction (mild, moderate or severe). To evaluate the psychosocial aspects were used three self-applied, with the purpose of obtaining information about the general health (General Health Questionnaire - GHQ), the type of anxiety (Trait Anxiety Inventory-State - STAI) and quality of life (World Health Organization Quality Of Life Short WHOQOL-brief). Results: There was a correlation between all indicators studied in several forms of TMD with varying degrees of commitment. Quality of life appeared linked to the type and the level of TMD: Muscular and Articular TMD (p = 0,037), Disk Displacement With Reduction (p = 0.01) and Mild TMD (p = 0.042). The General Health showed association with the level of TMD, with the exception of the stress factor (p = 0.78). For the analysis of the types and levels to Severe Muscular TMD had a statistically significant indicator of the quality of life (p = 0049). The anxiety only showed association with the level of TMD (p = 0,047 for anxiety-trait). Conclusion: Besides the limitations of the study, it was concluded that anxiety, quality of life and general health are important psychosocial indicators, which are linked to several forms of TMD in different levels of severity

Din��micas centr��petas e centr��fugas na forma����o do Estado mon��rquico no Brasil: o papel do Conselho Geral da Prov��ncia de S��o Paulo

O presente artigo avalia a forma����o e o funcionamento do Conselho Geral da Prov��ncia de S��o Paulo durante o Primeiro Imp��rio. Organismo previsto na Constitui����o de 1824, com fun����es que podem ser consideradas um embri��o do Poder Legislativo provincial, organizou-se efetivamente na prov��ncia de S��o Paulo em 1828, quando o governo de D. Pedro I j�� se desgastava. O significado de sua exist��ncia no contexto das din��micas centr��fugas e centr��petas atuantes na primeira constru����o do Estado no Brasil independente constituem o principal objetivo da presente an��lise.

Escolha de parceiros na adolesc��ncia

Mate choice is a component of sexual selection. Trying to understand the patterns of this process, several studies have emphasized the adaptive value of sexual differences and their influence on the assessment of the market value. The pattern for adults presented on the scientific literature, which is based on the preference for certain characteristics, shows that men search a partner who shows high value of fecundity and fertility, thus looking for partners with the ability of being pregnant and nursing their offspring. On the other hand, women look for partners with high socioeconomic status, which is strongly associated with the ability to protect and provide resources for them and their offspring. Surprisingly, there is few works that investigated the mate choice patterns during the beginning of the period of sexual differentiation on the morphological, physiological and behavioral traits. The aim of this study was to investigate mate choice patterns in adolescence in order to describe their preferences and contribute to the understanding of human reproductive behavior. Took part of this research 1,232 students from educational institutions of Natal, Brazil, and visitors to the Scientific, Technological and Cultural Fair UFRN. In the Experimental Study 1, we applied a questionnaire to evaluate the importance of certain characteristics, assessed the degree of romantic involvement and real and ideal partners age preference. In the Experimental Study 2, we did a survey of characteristics considered relevant and evaluate the importance of these characteristics in mate choice. The Experimental Study 3 brought an investigation of mate choice patterns based on self-assessment of adolescents, evaluating ideal partner for a short-term and long-term relationships and actual partner. We found that adolescents are motivated to live romantic experiences. We also observed a preference for partners of similar age to that described for adults. Finally, we found similarities and differences in the preferences for characteristics in real and ideal partners in relation to the adult pattern. In addition, we observed high similarity on the self-assessment and assessment of real and ideal partners. We suggest that in the mate choice, adolescents are similar to young adults in some aspects but not all. Our results show the relevance of the reproductive behavior investigation in this human developmental period and reinforce that further studies should contribute to the understanding of human behavior in terms of ontogenetic development and their evolutionary history.

Diferen��as funcionais das regi��es hipocampais na forma����o da mem��ria do tipo o qu��", "quando" e "onde" em ratos

Episodic memory refers to the recollection of what, where and when a specific event occurred. Hippocampus is a key structure in this type of memory. Computational models suggest that the dentate gyrus (DG) and the CA3 hippocampal subregions are involved in pattern separation and the rapid acquisition of episodic memories, while CA1 is involved in memory consolidation. However there are few studies with animal models that access simultaneously the aspects &#8215;what-where-when . Recently, an object recognition episodic-like memory task in rodents was proposed. This task consists of two sample trials and a test phase. In sample trial one, the rat is exposed to four copies of an object. In sample trial two, one hour later, the rat is exposed to four copies of a different object. In the test phase, 1 h later, two copies of each of the objects previously used are presented. One copy of the object used in sample trial one is located in a different place, and therefore it is expected to be the most explored object.However, the short retention delay of the task narrows its applications. This study verifies if this task can be evoked after 24h and whether the pharmacological inactivation of the DG/CA3 and CA1 subregions could differentially impair the acquisition of the task described. Validation of the task with a longer interval (24h) was accomplished (animals showed spatiotemporal object discrimination and scopolamine (1 mg/kg, ip) injected pos-training impaired performance). Afterwards, the GABA agonist muscimol, (0,250 &#956;g/&#956;l; volume = 0,5 &#956;l) or saline were injected in the hippocampal subregions fifteen minutes before training. Pre-training inactivation of the DG/CA3 subregions impaired the spatial discrimination of the objects (&#8215;where ), while the temporal discrimination (&#8215;when ) was preserved. Rats treated with muscimol in the CA1 subregion explored all the objects equally well, irrespective of place or presentation time. Our results corroborate the computational models that postulate a role for DG/CA3 in spatial pattern separation, and a role for CA1 in the consolidation process of different mnemonic episodes