Políticas públicas para a terceira idade: uma avaliação do Programa Idoso Cidadão da Prefeitura Municipal de Mossoró/RN

Nos últimos anos, o tema velhice tem despertado mais a atenção de diversos setores da sociedade. O resultado disso é o aumento de reportagens, artigos, monografias, dissertações e teses sobre ele.O Brasil está caminhando para se tornar a sexta população de idosos no mundo, fruto do grande avanço tecnológico, intensificado na segunda metade do século XX, facilitando as conquistas da medicina, da saúde e da genética. Vale salientar que essa problemática está inserida em um contexto social, político e econômico específico, que é o da resignificação do poder local. É nessa conjuntura que situamos o presente trabalho, que é um estudo sobre a avaliação de políticas públicas. Nesse sentido, procuramos analisar a efetividade do Programa Idoso Cidadão, da Prefeitura Municipal de Mossoró. O quadro de referência teórico-metodológico situa-se na revisão da literatura sobre terceira idade, poder local e avaliação de políticas públicas, observação assistemática; e entrevista semi-estruturada com os gestores, os profissionais envolvidos e particularmente com os usuários do Programa, tendo como meta averiguar como esses agentes percebem a implementação e os resultados do Programa. Com este tratamento conceitual foi possível apreender as condições em que se deu o estudo sobre a efetividade do referido programa para o processo de inclusão dos idosos na sociedade. O Programa Idoso Cidadão é, sem dúvida, um avanço no trabalho com os idosos e na inclusão destes na sociedade. É um espaço para a construção da cidadania, embora apresente muitas limitações, principalmente na área física e no quadro profissional. Constatou-se que, de modo geral, o Programa atende às necessidades básicas de sua clientela. Portanto podemos dizer que a avaliação da efetividade dessa política de atendimento ao idoso se mostrou eficaz, uma vez que podemos perceber o quanto o programa é importante para a vida de seus usuários, promovendo a elevação de sua auto-estima e de sua aceitação como categoria social

Medidas da dinâmica respiratória em idosos participantes de grupos de terceira idade

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

Correlação entre a qualidade de vida, classe funcional e idade em portadores de marca-passo cardíaco

OBJETIVO: Avaliar se existe correlação entre qualidade de vida e classe funcional em pacientes no pós-implante de marca-passo cardíaco, e sua relação com idade. MÉTODOS: Investigados 107 pacientes de ambos os sexos (49,5% do sexo feminino e 50,5% do sexo masculino), tempo médio de implante 6,36º ±2,99 meses e média de idade 69,3º ±12,6 anos. Para avaliação da classe funcional, foi utilizada escala proposta por Goldman e para qualidade de vida, questionário AQUAREL associado ao SF-36. Realizada análise estatística pela correlação de Spearman, com significância de 5%. RESULTADOS: Foram observadas correlações negativas entre qualidade de vida e classe funcional: AQUAREL nos três domínios, desconforto no peito (r=-0,197, P=0,042), dispneia (r=-0,508, P =0,000), arritmia (r=-0,271, P=0,005) e, no SF-36 nos oito domínios. em relação à idade, correlação negativa com Capacidade Funcional do SF-36 (r=-0,338, P=0,000) e não se observou correlação com AQUAREL. Entre idade e classe funcional observou-se correlação positiva (r=0,237, P=0,014). CONCLUSÃO: Neste estudo, encontrou-se correlação negativa entre qualidade de vida e classe funcional, evidenciando nesta amostra que os pacientes pertencentes a melhor classe funcional apresentaram melhor qualidade de vida. Conforme maior idade, pior a qualidade de vida em Capacidade Funcional e em classe funcional. Sugere-se, que idade e classe funcional influenciam qualidade de vida e as escalas de classificação funcional podem constituir um dos instrumentos que integram a avaliação e refletem a qualidade de vida em portadores de marca-passo.

Cirurgia aórtica totalmente laparoscópica para tratamento de isquemia crítica de membros: relato do primeiro caso no Brasil

A cirurgia videolaparoscópica (CVL) vem evoluindo como alternativa cirúrgica menos invasiva para o tratamento da doença aterosclerótica oclusiva aortoilíaca. O objetivo deste relato de caso foi demonstrar os resultados da primeira cirurgia aórtica totalmente laparoscópica relatada no Brasil para o tratamento da doença oclusiva aortoilíaca em paciente com isquemia crítica. Os tempos cirúrgicos totais de dissecção e exposição da aorta antes do clampeamento, exposição retroperitoneal da aorta, clampeamento total e da anastomose proximal com técnica totalmente laparoscópica foram de 220 minutos, 15 e 27 minutos, 42 minutos, 110 minutos e 78 minutos, respectivamente. A técnica videolaparoscópica é mais uma ferramenta minimamente invasiva, viável, segura e eficaz para o tratamento da doença oclusiva aortoilíaca extensa. Ela, que nada mais é do que a cirurgia convencional realizada sob visão laparoscópica, tem bons resultados a longo prazo, que se associam à elegância técnica.

Effect of respiratory muscle training on pulmonary function in preoperative preparation of tobacco smokers

OBJETIVO: Avaliar o efeito da utilização de um programa de treinamento específico dos músculos respiratórios sobre a função pulmonar em indivíduos tabagistas. MÉTODOS: Foram estudados 50 indivíduos tabagistas assintomáticos com idade superior a 30 anos, nos seguintes momentos: A0 - avaliação inicial seguida do protocolo de exercícios respiratórios; A1 - reavaliação após 10 minutos da aplicação do protocolo; e A2 -reavaliação final após duas semanas de treinamento utilizando o mesmo protocolo três vezes por semana. A avaliação foi realizada através das medidas de pressões respiratórias máximas (PImax. e PEmax.), picos de fluxo respiratórios (PFI e PFE), ventilação voluntária máxima (VVM), capacidade vital Forçada (CVF) e Volume expiratório forçado no primeiro segundo (VEF1). RESULTADOS: Não houve melhora na CVF e VEF1 da avaliação inicial para a final. Houve aumento significativo das variáveis PFI, PFE, VVM e PImax nas avaliações A1 e A2. A variável PEmax. aumentou somente na avaliação A2. CONCLUSÃO: A aplicação de protocolo de exercícios respiratórios com e sem carga adicional em indivíduos tabagistas produziu melhora imediata na performance dos músculos respiratórios, mas esta melhora foi mais acentuada após duas semanas de exercício.

Study on functional cardiorespiratory changes after laparoscopic Nissen fundoplication

PURPOSE: To analyze the behavior of cardiopulmonary function in postoperative of laparoscopic Nissen fundoplication.METHODS: Thirty-two patients, 13 males (41%) and 19 females (59%), were evaluated. Their age ranged from 25 to 67 years, with a mean of 44.4 +/- 10.9. Pulmonary volumes, respiratory pressures and exercise tests were performed in the preoperative period (PRE) and in the first (PO1), second (PO2), fifth (PO5) and thirtieth (PO30) postoperative periods.RESULTS: Thirty-two patients were evaluated, of whom 59% were females. Mean age was 44.4 +/- 10.9 years. Lung volumes had significant decrease at PO1 and PO2 and were similar to PRE values at PO5. Respiratory pressures were altered only at PO1. The distance covered in the 6-minute walk test had significant reduction until PO2, and climbing time in the stair-climbing test significantly increased at PO2.CONCLUSION: Patients submitted to LNF surgery have decreased cardiorespiratory function in the early postoperative period; however, they soon return to preoperative conditions.

A história do intemperismo na Província Borborema Oriental, Nordeste do Brasil: implicações paleoclimáticas e tectônicas

Until some years ago, weathering geochronology was primarily based on the K-Ar and 40Ar/39Ar dating of supergene minerals. Recent advances in the analysis of supergene goethite by the (U-Th)/He method expanded the number of suitable minerals for such purpose, as well as the time of application for weathering geochronology. This study represents the first systematic approach in Brazil, combining both the 40Ar/39Ar e (U-Th)/He methodologies to improve the knowledge on the weathering and the age of nonfossiliferous sediments. Supported by geologic and geomorphologic correlations, we identified different types of weathering profiles occurring in the interior and coastal areas of northeastern Brazil. These profiles were correlated to main regional geomorphological domains: the Borborema Plateau , the Sertaneja Depression , and the Coastal Cuestas and Plains, and respective planation surfaces, which study is fundamental to understand the landscape evolution of the northern portion of the eastern Borborema Province. The depth and stratigraphic organization of the weathering profiles in each of the geomorphological domains permitted to establish that: (i) the profiles on the highlands that cap the Borborema Surface are deeper (up to 100 m) and can be considered as typical lateritic profiles; (ii) on the lowlands that form the Sertaneja Surface , the weathering profiles are shallow and poorly developed (2-5 m deep); (iii) the profiles along the coastal area are moderately developed (up to 25 m deep), and are characterized by thick saprolites and mottle zones. Aiming to establish the timing of the evolution of northeastern Brazil, we studied 29 weathering profiles representing distinct topographic levels of the Borborema Province, from the highlands to the coast, through the analysis of 248 grains of supergene manganese oxides using laser step-heating 40Ar/39Ar geochronology. Additionally, we applied the (U-Th)/He method in 20 weathering profiles, by dating 171 grains of supergene iron oxides and hydroxides. Geochronological results for 248 grains of manganese oxides analyzed by the 40Ar/39Ar method indicate that the weathering profiles in the study area record the history of weathering from the Oligocene to the Pleistocene, with ages in the order of 31.4 ± 1.0 Ma to 0.8 ± 0.4 Ma. Dating of 171 grains of goethite by the (U-Th)/He method yielded ages ranging from 43.2 ± 4.3 Ma to 0.8 ± 0.1 Ma, suggesting the weathering processes last from the Eocene to the Pleistocene. The precipitation of supergene goethite in this interval confirms the age of the weathering processes identified from the manganese oxides record. 105 goethite grains from 8 different occurrences of the Barreiras Formation were dated by the (U-Th)/He method. Five grains collected from the cement in the Barreiras Formation sandstones, in the Lagoa Salgada and Rio do Fogo coastal cuestas, yielded ages of 17.6 ± 1.8 Ma, 17.3 ± 1.7 Ma, 16.3 ± 1.6 Ma, 16.2 ± 1.6 Ma and 13.6 ± 1.4 Ma. Results of 69 goethite grains from authigenic pisoliths collected in 7 different localities also yielded concordant ages, varying from 17.8 ± 1.8 to 7.5 ± 0.8 Ma. Results obtained from 31 detrital grains are concordant in 3 distinct localities (Lagoa Salgada, Praia da Garças e Ponta Grossa); they vary in the range of 43.2 ± 4.3 to 21.6 ± 2.2 Ma, and indicate that the maximum age for the Barreiras Formation deposition is around 22 Ma. 40Ar/39Ar results for 15 manganese oxides grains associated with the Barreiras Formation weathering profiles, in 3 different localities, vary from 13.1 ± 0.9 to 7.7 ± 0.4 Ma, in the same range of ages obtained by the (U-Th)/He method. The systematic application of the 40Ar/39Ar and (U-Th)/He methods, respectively for manganese oxides and goethites, show that the Barreiras Formation sediments were already deposited since ca. 17 Ma, and that the weathering processes were active until ca. 7 Ma ago. The ages obtained from manganese oxides collected in the Cenozoic basalts (Macau Formation) also reveal a weathering history between 19 and 7 Ma, pointing to hot and humid conditions during most of the Miocene. 40Ar/39Ar ages yielded by manganese oxides associated with the Serra do Martins Formation vary from 14.1 ± 0.4 to 10.5 ± 0.3 Ma. On the other hand, (U-Th)/He ages from iron oxides/hydroxides collected in the Serra do Martins Formation mesas vary from 20.0 ± 2.0 to 5.5 ± 0.6 Ma, indicating that those sediments are older than 20 Ma. 40Ar/39Ar and (U-Th)/He results produced in this study are in agreement with paleoclimatic interpretations based on stable isotopes and clay index values measured in the Atlantic Ocean sediments, validating the use of weathering geochronology to investigate paleoclimatic variations. The direct dating of the Barreiras Formation permitted, for the first time, confident inferences on the age of the brittle deformation recorded by this sedimentary unit in the Rio Grande do Norte and Ceará states. The first event, syn-deposition, occurred during the early Miocene; an younger event, related to the post-depositional deformation of the Barreiras Formation, is associated with tectonic activity from the very early Miocene to the Holocene. In agreement with data from other areas, results obtained in this study reveal that the depth and complexity of the weathering profiles reflect the time of exposition of such areas to the weathering agents close to the surface. However, there is no clear relationship between ages vs. altitude. The depth and the stratigraphic organization of weathering profiles in northeastern Brazil, contrary to the southeastern Brazil pattern, do not vary toward the coast. In our study area, field observations reveal the presence of ancient, thick and complex lateritic profiles preserved in the sedimentary mesas on the Borborema Plateau, as younger, narrow and incipient ones occur in the dissected areas. Geochronological results obtained for these profiles yielded older ages on the high altitudes, and younger ages in the lowlands, suggesting the scarp retreatment is the most reliable model to explain the regional landscape evolution. However, in the coastal lowlands, the relatively older ages obtained indicate that more complexes processes were involved in the modeling of the local relief

Evolução geodinâmica e condicionamento estrutural dos terrenos Piancó-Alto Brígida e Alto Pajeú, domínio da zona transversal, NE do Brasil

This thesis aims to advance in the geological knowledge of the region comprising the Piancó-Alto Brígida (TPAB) and Alto pajeú (TAP) terranes, in the Transversal Zone Domain (Borborema Province, NE Brazil), with the main objective of understanding the geodynamic evolution and the structural framework of these units. To reach this objective, and besides field work and interpretation of traditional aerial photographs, other tools were employed like of remote sensing products (Landsat 7 ETM+, aeroradiometrics, aeromagnetics and topographical images), lithogeochemical (whole rock) analyses and geochronological dating (U-Pb in zircon), besides integration with literature data. In the area, several precambrian geological units outcrop, represented in the TAP by the paleoproterozoic Serra Talhada and Afogados da Ingazeira complexes, Riacho Gravatá Complex (metavolcano-sedimentary sequence of Stenian-Tonian age) and Cariris Velhos orthogneisses (of Tonian age). The TPAB comprises the Santana do Garrote (lower unit) and Serra do Olho d'Água (upper unit) formations of the Cachoeirinha Group (Neoproterozoic III), besides the Piancó orthogneisses and Bom Jesus paragneisses; the latter correspond to an older (basement ?) block and a possible high grade equivalent of the Cachoeirinha Group (or Seridó Group ?), respectively. Several Brasiliano-age plutons occur in both terranes.The aeromagnetic data show the continuity, at depth, of the main shear zones mapped in the region. The Patos, Pernambuco, Boqueirão dos Cochos, Serra do Caboclo, Afogados da Ingazeira/Jabitacá and Congo-Cruzeiro do Nordeste shear zones reach depths greater than to 6-16 km. The aeromagnetic signature of other shear zones, like the Juru one, suggests that these structures correspond to shallower crustal features. The satellite images (Landsat 7 ETM+) and aerogamaspectrometric images discriminate different geological units, contributing to the mapping of the structural framework of the region. The Serra do Caboclo Shear Zone was characterized as the boundary/suture between the TPAB and TAP. This structure is an outstanding, pervasive feature that separates contrasting geological units, such as the Neoproterozoic III Cachoeirinha Group in the TPAB and the Riacho Gravatá Complex and the Cariris Velhos metaplutonics, of Stenian-Tonian age, in the TAP. Occupying different blocks, these units are not found in authoctonous relations, like unconformities and intrusive contacts. Concerning the Cariris Velhos (ca. 1,0 Ga old) event is recorded by radiometric ages of the Riacho Gravatá Complex metavolcanics and intrusive augen and orthogneisses, all of them displaying geochemical affinities of arc or collisional settings. A structural signature of this event was not recorded in the region, possibly due to its low grade/low strain style, obliterated by the overprinting of younger, higher grade/high strain Brasiliano-age fabrics.The first tectonic event (D1) observed in the Cariris Velhos lithotypes presents contractional kinematics with transport to the NW. Neoproterozoic III geochronologic dates, obtained in late-D1 granitoids, imply a Brasiliano age (ca. 610-600 Ma) for this deformation event. The second tectonic event (D2) characterized in the region corresponds to the Brasiliano transcurrent kinematics of the outstanding shear zones and associated granitoid plutons. The geochronological (U-Pb in zircon) data obtained during this thesis also confirms the occurrence of the Cariris Velhos magmatic suite in the TAP, as well as the Neoproterozoic III age to the Cachoeirinha Group in the TPAB. The TAP (Riacho Gravatá Complex, augen and orthogneisses) is interpreted as a continental arc possibly accreted to a microcontinent during the Cariris Velhos (Stenian-Tonian) event. Later on, this terrane collided with the TPAB at the beginning of the Brasiliano orogeny (D1 contractional deformation), and both domins were reworked by the transcurrent shear deformation of the D2 event

Litoestratigrafia e deformação cenzóica na região de Icapuí, Ceará, e implicações para a estruturação de campos de petróleo na borda ocidental da bacia Potiguar(NE do Brasil)

This thesis deals with the sedimentological/stratigraphic and structural evolution of the sedimentary rocks that occur in the NW continental border of the Potiguar Basin. These rocks are well exposed along coastal cliffs between the localities of Lagoa do Mato and Icapuí, Ceará State (NE Brazil). The sedimentological/stratigraphic study involved, at the outcrop scale, detailed facies descriptions, profile mapping of the vertical succession of different beds, and columnar sections displaying inferred lateral relationships. The approach was complemented by granulometric and petrographic analyses, including the characterization of heavy mineral assemblages. The data set allowed to recognize two kinds of lithological units, a carbonate one of very restricted occurrence at the base of the cliffs, and three younger, distinct siliciclastic units, that predominate along the cliffs, in vertical and lateral extent. The carbonate rocks were correlated to the late Cretaceous Jandaíra Formation, which is covered by the siliciclastic Barreiras Formation. The Barreiras Formation occurs in two distinct structural settings, the usual one with nondeformed, subhorizontal strata, or as tilted beds, affected by strong deformation. Two lithofacies were recognized, vertically arranged or in fault contacts. The lower facies is characterized by silty-argillaceous sandstones with low-angle cross bedding; the upper facies comprises medium to coarse grained sandstones, with conglomeratic layers. The Tibau Formation (medium to coarse-grained sandstones with argillite intercalations) occurs at the NW side of the studied area, laterally interlayered with the Barreiras Formation. Eolic sediments correlated to the Potengi Formation overly the former units, either displaying an angular unconformity, or simply an erosional contact (stratigraphic unconformity). Outstanding structural features, identified in the Barreiras Formation, led to characterize a neocenozoic stress field, which generated faults and folds and/or reactivated older structures in the subjacent late cretaceous (to paleogene, in the offshore basin) section. The structures recognized in the Barreiras Formation comprise two distinct assemblages, namely a main extensional deformation between the localities of Ponta Grossa and Redonda, and a contractional style (succeeded by oblique extensional structures) at Vila Nova. In the first case, the structural assemblage is dominated by N-S (N±20°Az) steep to gently-dipping extensional faults, displaying a domino-style or listric geometry with associated roll-over structures. This deformation pattern is explained by an E-W/WNW extension, contemporaneous with deposition of the upper facies of the Barreiras Formation, during the time interval Miocene to Pleistocene. Strong rotation of blocks and faults generated low-angle distensional faults and, locally, subvertical bedding, allowing to estimate very high strain states, with extension estimates varying between 40% up to 200%. Numerous detachment zones, parallel to bedding, help to acommodate this intense deformation. The detachment surfaces and a large number of faults display mesoscopic features analoguous to the ones of ductile shear zones, with development of S-C fabrics, shear bands, sigmoidal clasts and others, pointing to a hydroplastic deformation regime in these cases. Local occurrences of the Jandaíra limestone are controled by extensional faults that exhume the pre-Barreiras section, including an earlier event with N-S extension. Finally, WNWtrending extensional shear zones and faults are compatible with the Holocene stress field along the present continental margin. In the Vila Nova region, close to Icapuí, gentle normal folds with fold hinges shallowly pluging to SSW affect the lower facies of the Barreiras Formation, displaying an incipient dissolution cleavage associated with an extension lineation at high rake (a S>L fabric). Deposition of the upper facies siliciclastics is controlled by pull-apart graben structures, bordered by N-NE-trending sinistral-normal shear zones and faults, characterizing an structural inversion. Microstructures are compatible with tectonic deformation of the sedimentary pile, burried at shallow depths. The observed features point to high pore fluid pressures during deformation of the sediments, producing hydroplastic structures through mechanisms of granular flow. Such structures are overprinted by microfractures and microfaults (an essentially brittle regime), tracking the change to microfracturing and frictional shear mechanisms accompanying progressive dewatering and sediment lithification. Correlation of the structures observed at the surface with those present at depth was tested through geophysical data (Ground Penetrating Radar, seismics and a magnetic map). EW and NE-trending lineaments are observed in the magnetic map. The seismic sections display several examples of positive flower structures which affect the base of the cretaceous sediments; at higher stratigraphic levels, normal components/slips are compatible with the negative structural inversion characterized at the surface. Such correlations assisted in proposing a structural model compatible with the regional tectonic framework. The strong neogenepleistocene deformation is necessarily propagated in the subsurface, affecting the late cretaceous section (Açu and Jandaíra formations), wich host the hydrocarbon reservoirs in this portion of the Potiguar Basin. The proposed structural model is related to the dextral transcurrent/transform deformation along the Equatorial Margin, associated with transpressive terminations of E-W fault zones, or at their intersections with NE-trending lineaments, such as the Ponta Grossa-Fazenda Belém one (the LPGFB, itself controlled by a Brasiliano-age strike-slip shear zone). In a first step (and possibly during the late Cretaceous to Paleogene), this lineament was activated under a sinistral transpressional regime (antithetic to the main dextral deformation in the E-W zones), giving way to the folds in the lower facies of the Barreiras Formation, as well as the positive flower structures mapped through the seismic sections, at depth. This stage was succeeded (or was penecontemporaneous) by the extensional structures related to a (also sinistral) transtensional movement stage, associated to volcanism (Macau, Messejana) and thermal doming processes during the Neogene-Pleistocene time interval. This structural model has direct implications to hydrocarbon exploration and exploitation activities at this sector of the Potiguar Basin and its offshore continuation. The structure of the reservoirs at depth (Açu Formation sandstones of the post-rift section) may be controlled (or at least, strongly influenced) by the deformation geometry and kinematics characterized at the surface. In addition, the deformation event recognized in the Barreiras Formation has an age close to the one postulated for the oil maturation and migration in the basin, between the Oligocene to the Miocene. In this way, the described structural cenario represents a valid model to understand the conditions of hydrocarbon transport and acummulation through space openings, trap formation and destruction. This model is potentially applicable to the NW region of the Potiguar Basin and other sectors with a similar structural setting, along the brazilian Equatorial Atlantic Margin

Monitoramento de parâmetros laboratoriais em gatos sem raça definida durante o período neonatal

O objetivo do presente estudo foi à monitoração dos parâmetros laboratoriais como hemograma, enzimas hepáticas alanina aminotransferase (ALT) e gama-glutamiltransferase (GGT), glicemia e proteinograma sérico, e avaliar o efeito da idade em gatos sem raça definida durante a fase neonatal. Vinte gatos machos e fêmeas foram utilizados a partir do terceiro dia de vida até o 38º dia de idade. As amostras de sangue foram colhidas semanalmente e as análises laboratoriais (hemograma, enzimas hepáticas, glicemia e proteinograma sérico) realizadas no 3º, 10º, 17º, 24º, 31º e 38º dia de idade. Os resultados exibiram efeito significativo da idade sobre a contagem total de eritrócitos, concentração de hemoglobina, volume globular, volume corpuscular médio, concentração de hemoglobina corpuscular média, leucócitos totais, neutrófilos, eosinófilos e basófilos. Nenhum efeito foi observado em células como linfócitos, monócitos ou na concentração sérica de glicose. A análise das modificações ocorridas nos parâmetros laboratoriais durante a fase neonatal reflete o desenvolvimento fisiológico do filhote e contribui para o conhecimento do processo adaptativo em gatos neonatos durante o primeiro mês de vida, sendo útil para a avaliação clínica, diagnóstico e tratamento das doenças neonatais.

Origem anômala de artéria coronária esquerda do tronco pulmonar: síndrome de Bland-White-Garland

A origem anômala da artéria coronária esquerda a partir do tronco pulmonar, conhecida como síndrome de Bland-White-Garland (BWG), é uma doença rara, que, habitualmente, leva à morte antes do primeiro ano de vida. Os autores relatam o caso de uma criança branca, com 2 anos e 6 meses de idade, portadora da síndrome de BWG, e revisam a apresentação clínica, a fisiopatologia, o diagnóstico e o tratamento desses pacientes.

Estudo epidemiológico da Toxoplasmose em gestantes atendidas na Maternidade Escola Januário Cicco, Natal, Rio Grande do Norte

Congenital Toxoplasmosis results in severe systemic disease. If mother is infected for the first time during gestation, she can infect the fetus causing substantial damage. However, relatively little is known about the seroprevalence and epidemiological and economic factors of Toxoplasmosis infection in pregnancy in the most state in northeastern Brazil and knowledge about this can be essential in determining effective and acceptable prevention strategies. Our aim was to determine the prevalence of Toxoplasmosis in pregnant woman consulted by reference Maternity Escola Januário Cicco in Natal, a city in Northeastern Brazil, which belongs to the public health system, correlating to the risk factors involved in the infection and to accomplish active Search in the Hospital of Pediatrics Profº Heriberto Bezerra of the damages caused by the Toxoplasmic infection in children up to 12 years of age. The study was conducted from March to December 2007 and sera obtained from 190 pregnant women were tested for IgM and IgG antibodies avidity to Toxoplasma by Microparticle enzyme immunoassay (Abbott AxSYM system - Abbott Laboratories, Chicago, IL, USA). Data were examined with univariate analysis. Chi-squared (x2) and Odds ratio was calculated (IC 95% p 0,05). Of these women, 126 (66,3%) had only IgG antibodies high-avidity against T. gondii; 01 (0,52%) had a IgM and IgG high-avidity antibodies against T. gondii and 63 (33,1%) have neither IgM nor IgG against T. gondii. Our studies shown that the direct contact with cats or dogs was highly associated with the Toxoplasma gondii infection (OR, 2.72, p<0.001, 95% CI 1.46 5.02). The years school (p<0,001), socioeconomic status and knowledge about the disease (both p value 0.05) also were associated with Toxoplasmosis. The pattern of risk factors for infection presents regional variations, however our data corroborate others studies in Brazil. In children up to 12 years, one case of Congenital Toxoplasmosis was just registered in seven years (2000 - 2006). There were several suggestive cases, with signs and characteristic symptoms, but that the infection was not confirmed due to lack in the researches through laboratorial and images exams that addressed that it zoonosis

Determinação de haplótipos do gene βs em portadores de anemia falcifome

Haplotypes linked to the βS gene represent patterns of DNA polymorphisms along chromosome 11 of individuals bearing the βS gene. Analysis of haplotypes, in addition to serving as an important source for anthropological studies about the ethnic origin of a population, contributes to a better understanding of the variations in clinical severity of sickle cell anemia. The aim of the present study was to determine βS gene haplotypes in a group of patients with sickle cell anemia treated at the Dalton Barbosa Cunha Hematology Center (Hemonorte) in Natal, Brazil and the Oncology and Hematology Center in Mossoró, Brazil. Blood samples were obtained from 53 non-related patients (27 males and 26 females), aged between 3 months and 61 years (mean age: 16.9 ± 12.1 years). Laboratory analyses consisted of the following: erythrogram, reticulocyte count, hemoglobin electrophoresis at alkaline pH, measurement of hemoglobin A2 and Fetal hemoglobin, solubility test and molecular analysis to determine βS gene haplotypes. DNA samples were extracted by illustra blood genomicPrep Mini Spin kit and βS gene haplotypes were determined by PCR-RFLP, using Xmn I, Hind III, Hinc II and Hinf I restriction enzymes for analysis of six polymorphic restriction sites in the beta cluster. Of 106 βS chromosomes studied, 75.5% were Central African Republic (CAR) haplotype, 11.3% Benin (BEN) and 6.6% Cameroon (CAM). The atypical haplotypes had a frequency of 6.6%. More than half the patients (58.5%) were identified as CAR/CAR genotype carriers, 16.9% heterozygous CAR/BEN, 13.2% CAR/CAM and 1.9% BEN/BEN. Patients with atypical haplotype in one or two chromosomes accounted for 9.5% (CAR/Atp, BEN/Atp and Atp/Atp). The genotype groups showed no statistically significant difference (p < 0.05) in their laboratory parameters. This is the first study related to βS haplotypes conducted in state of Rio Grande do Norte and the higher frequency of Cameroon halotype found, compared to other Brazilian states, suggests the existence of a peculiarity of African origin