Influ��ncia de fatores ambientais na Leishmaniose visceral no Rio Grande do Norte

The Visceral Leishmaniose (LV) disease is endemic in some places in Brazil. It is caused by the protozoa Leishmania chagasi, being transmitted for vector, the phlebotomies, Lutzomyia longipalpis. In virtue of the expansion of the illness in Rio Grande do Norte, it is necessary to evaluate the determinative ambient factors in the proliferation of the vector for better control of the illness. The variable rainfall and the social variables had been analyzed using space regression with two models and the ambient variable of ZANE and the variables analyzed in 205 houses in the cities of Natal, Extremoz, N��sia Floresta, S��o Gon��alo do Amarante, S��o Jose do Mipibu, Parnamirim and Maca��ba the Person and ML Chi-square were used . The analyses had shown that high rainfall, plain relief, the forest, the humid tropical climate the activities of production culture of sugar cane and fruit culture and the presence of bovines increase the risk of the LV. The work showed that it has space aggregation and that ambient factors influence in the LV in the State

An��lise da contribui����o de fatores gen��ticos e ambientais na manuten����o da hanseniase nos estados do Rio Grande do Norte e Par��

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior

Influ��ncia de fatores biopsicossociais sobre a mortalidade de idosos no munic��pio de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Marcadores de risco cardiovasculares bioqu��micos e antropom��tricos em idosos hipertensos e aparentemente saudaveis

Idosos apresentam preval��ncia aumentada de Hipertens��o Arterial Sist��mica - HAS al��m de multiplicidade de fatores de risco cardiovasculares adicionais relacionados a maus h��bitos de vida. Este �� um estudo transversal que teve como objetivos comparar e correlacionar marcadores bioqu��micos e antropom��tricos e h��bitos de vida indicadores de risco cardiovascular em idosos hipertensos e predominantemente saud��veis, sedent��rios e praticantes de atividade f��sica. A amostra foi composta por 322 idosos, e distribu��da em 2 grupos: G1: hipertensos e G2: predominatemente saud��veis. A coleta de dados constou de anamnese e avalia����es bioqu��mica (perfil lip��dico e Prote��na C-Reativa - PCR) e antropom��trica (��ndice de Massa Corp��rea - IMC, Circunfer��ncia da Cintura - CC, Circunfer��ncia abdominal - CA e Rela����o Cintura- Quadril - RCQ). Na an��lise dos dados utilizou-se estat��stica descritiva, Teste t de Student, an��lise de vari��ncia (ANOVA One-Way) e correla����o de Pearson. Os resultados mostram que no G1: 100% eram hipertensos, sendo que 31,55% eram diab��ticos e hipertensos e 0% era exclusivamente diab��tico, no G2: 28,86% eram hipertensos, sendo que 13,40% eram diab��ticos e hipertensos, 5,15% eram exclusivamente diab��ticos e 65,99% n��o apresentam qualquer processo patol��gico ativo. Com rela����o aos h��bitos e estilo de vida, no G1: 58,22% eram sedent��rios; 2,6% fumantes e 1,7% etilistas. No G2: 5,15% eram sedent��rios; 7,21% fumantes e 8,24% etilistas. Com rela����o ao estado nutricional, verificou-se que no G1: 10,52% dos homens apresentaram Sobrepeso - SP e 14,03% Obesidade - OB, j�� entre as mulheres, 25,59% apresentaram SP e 20,23% OB. No G2: 6,06% dos homens apresentaram SP e 9,09% OB, e entre as mulheres, 15,87% apresentaram SP e 22,22% OB. Na an��lise da RCQ, apresentaram valores acima dos recomendados: 24,56% dos homens e 82,14% das mulheres do G1 e 12,12% dos homens e 74,60% das mulheres do G2. Com rela����o a CC e CA, apresentaram valores indicativos de risco, respectivamente: no G1 (52,63% e 29,82% dos homens e 91,66% e 87,5% das mulheres) e no G2 (9,09% e 9,09% dos homens, e 80,95% e 55,55% das mulheres). Com rela����o �� idade, as freq����ncias de SP e OB no G1(n=225) foram: SP (A1=11,11%, A2=8%, A3=1,77%), OB (A1=8,44%, A2=8,88%, A3=1,33%), e no G2(n=97) foram: SP (A1= 5,15%, A2= 5,15%, A3= 2,06%) e OB (A1=9,27%, A2=7,21%, A3=0%). Na compara����o entre G1 e G2 observou-se diferen��a estat��sticamente significativa entre as seguintes m��dias: IMC: [G1=27,23 e G2=23,26 x (p=0,0344)]; CA: [G1=99,09 e G2=89,51 (p<0,0001)]; CC: [G1=93,64 e G2=86,37 (p<0,0001)] e RCQ: [G1=93,64 e G2=86,37 (p<0,0001)]. Na correla����o, verificou-se associa����o considerada como fraca positiva (p<0,05) entre PCR e as vari��veis antropom��tricas e o perfil lip��dico. Os resultados apontam para maior freq����ncia e intensidade de fatores de risco cardiovasculares adicionais a hipertens��o em mulheres em rela����o aos homens, nas faixas et��rias relativamente mais jovens, A1 e A2, em rela����o a mais velha, A3, e no grupo de idosos hipertensos, G1, em rela����o ao de idosos predominantemente saud��veis, G2. Observou-se correla����o, considerada fraca positiva (r>0,30), entre PCR, perf��l lip��dico e vari��veis antropom��trica (p<0,05). Esta tese apresenta uma rela����o de interface multidisciplinar, tendo o seu conte��do uma aplica����o nos campos da Fisioterapia, Educa����o F��sica, Medicina, Nutri����o e da Bioqu��mica

Fatores preditivos da dor em pacientes submetidos �� cirurgia card��aca

A identifica����o de fatores que interferem na dor p��s-operat��ria �� ��til para minimizar o sofrimento desnecess��rio e favorecer a uma interven����o analg��sica adequada, evitando generaliza����es nas condutas terap��uticas. O prop��sito dessa investiga����o foi identificar os fatores preditivos da dor em pacientes submetidos �� cirurgia card��aca e a rela����o existente entre dor, analgesia e personalidade. Trata-se de um estudo prospectivo e anal��tico, aprovado pelo comit�� de ��tica da UFRN (175/06), o qual proporcionou uma abordagem multidisciplinar ao envolver ��reas distintas como: fisioterapia, psicologia, m��dica e enfermagem (interdisciplinaridade) na elucida����o do objeto de estudo relacionado a fatores preditivos da dor. Para caracteriza����o geral dos pacientes foi utilizada uma ficha de avalia����o fisioterap��utica; a dor p��s-operat��ria foi avaliada pela escala num��rica de dor e question��rio para dor McGill e o Invent��rio Millon de Estilos de Personalidade (MIPS) foi utilizado para identificar e avaliar as manifesta����es das caracter��sticas comportamentais e de personalidade. Foram acompanhados, do 1�� ao 5�� dia de p��s-operat��rio (DPO), 160 pacientes submetidos �� cirurgia card��aca, 57,5% do sexo masculino, com idade m��dia de 56,8��14,4 anos, sendo inclu��dos no estudo aqueles que se queixaram de dor no p��s-operat��rio em pelo menos um dos dias de avalia����o e assinaram termo de concentimento livre e esclarecido (TCLE). Os dados foram submetidos ao teste Qui-quadrado, regress��o log��stica multivariada, teste de correla����o de Spearman, teste t e ANOVA. Ao serem submetidos �� an��lise de regress��o foram encontrados seis fatores preditivos da dor: tempo cir��rgico > 3 horas, dreno mediastinal e lateral, tosse, v��mitos, tempo de dreno > 24 horas e sexo feminino. Estes fatores apresentaram uma correla����o positiva e significava com a intensidade dolorosa referida pelos pacientes na escala num��rica de dor e os pacientes que apresentaram mais fatores preditivos da dor referiram mais dor. 23 J�� em rela����o ao McGill n��o se obteve diferen��a significativa entre os pacientes com mais e menos fatores preditivos. Observou-se que foram administrados diferentes tipos de analg��sicos, isolados ou associados, sendo estes: paracetamol, paracetamol associado �� code��na, dipirona, tramadol, toradol e tilatil. A percep����o dolorosa apresentou magnitudes variando de leve a moderada do 1�� ao 5�� DPO e ao ser relacionada com as caracter��sticas de personalidade, nos pacientes com menos dor, observou-se os fatores: preserva����o, individualismo, introvers��o e os com mais dor foram: prote����o, extrovers��o, retraimento, discrep��ncia, afetividade, acomoda����o, comunicabilidade e firmeza. Evidenciou-se que o comportamento doloroso p��s-cirurgia card��aca �� multifatorial e que a determina����o da exist��ncia de fatores preditivos da dor permite ao profissional da ��rea de sa��de fazer o uso adequado dos analg��sicos, haja vista que o al��vio da dor �� responsabilidade de todos os profissionais da sa��de. Os aspectos psicol��gicos enquanto caracter��sticas de personalidade podem influenciar padr��es de comportamento como os observados.

Fatores litog��nicos em pacientes com lit��ase urin��ria de Fortaleza, Cear��

Lithiasis is considered a public health issue due to its high prevalence and rates of recurrence. Objective: To identify risk factors for lithiasis in kidney stone patients from Fortaleza, Brazil. In the first stage of the study, the medical records of 197 patients with urinary lithiasis covering the period 1996 2006 were analyzed with regard to clinical and metabolic data. In the second stage, 340 kidney stones were submitted to morphological examination under 10x magnification. According to the external morphology and the cut surface, the stones were classified as pure or mixed, and major and minor components were identified. In addition, the stone fragments of 25 patients treated with lithotripsy were submitted to morphological analysis. In the third stage, a subsample of 50 stones was used in a double-blind comparison of morphological and chemical findings. Results were expressed as concordant, partly concordant (discordant for minor components) or discordant (discordant for major components). The average age of first symptoms was 35.8��13.3 years, with no significant difference between the genders. The male/female ratio was 1:1.7. Recurrence was reported in 53.3% of cases. The main metabolic changes observed were hypernatriuria (80.7%), hypercalciuria (48.7%), low urine volume (43.7%), hyperoxaluria (30.5%) and hyperuricosuria (17.3%). Pure stones represented 34.7% of the total sample of 340 stones. The most common route of elimination was spontaneous for pure stones (49.1%) and surgical for mixed stones (50.5%). Pure stones consisted most frequently of calcium oxalate (OxCa) (59.3%) and uric acid (UA) (23.7%), the former prevalent in women, the latter prevalent in men. The most frequently observed component in mixed stones was OxCa (67.1%), followed by carbapatite (11.2%) and struvite (7.9%). The main components were OxCa and UA for men, and carbapatite and struvite for women. Nearly half (48%) the 25 analyzed fragments were pure, consisting of calcium oxalate dihydrate (COD) (56%), calcium oxalate monohydrate (COM) (48%), phosphate (32%) and UA (20%). Four patients (16%) had infectious stones. In the chemical analysis of the subsample of 50 stones, the most 64 frequently observed major components were calcium (70%), oxalate (66%), ammonium (56%), urate (28%) and carbonate (24%). In the morphological analysis, the main components were calcium and magnesium phosphate (32%), COM (24%), UA (20%), COD (18%) and cystine (6%). Morphological and chemical findings were totally concordant for 38% of the stones, partly concordant in 52% and discordant in 10%. Conclusion: The risk factors for lithiasis in kidney stone patients from Fortaleza (Brazil) were hyperoxaluria, hypercalciuria with or without hypernatriuria, hyperuricosuria and low urine volume

Risco de doen��a cardiovascular em mulheres com hist��ria de dist��rbio hipertensivo da gravidez

OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pr��-ecl��mpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbumin��ria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 (�� 4.8) while this ratio in normotensive women was of 23.5 (�� 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension

S��ndrome metab��lica e fatores associados: estudo comparativo com mulheres que apresentaram pr��-ecl��mpsia e gravidez normal, acompanhadas cinco anos ap��s o parto

Preeclampsia is defined as an extremely serious complication of the pregnancy-puerperium cycle with delayed emergence of cardiovascular risk factors, including metabolic syndrome. The research aimed estimate the prevalences of metabolic syndrome and associated factors in women with preeclampsia and normal pregnancy followed five years after childbirth. This is a cross-sectional observational study using a quantitative approach, conducted at a maternity school in the city of Natal in Rio Grande do Norte state. The sample was composed of 70 women with previous preeclampsia and 75 normal selected by simple random probability sampling. Subjects were analyzed for sociodemographic, obstetric, clinical, anthropometric and biochemical parameters. International Diabetes Federation criteria were adopted to diagnose metabol ic syndrome. The Kolmogorov-Smirnov, Mann-Whitney, Student s t, Pearson s chi-squared, and Fisher s exact tests, in addition to simple logistic regression, were used for data analysis, at a 5% significance level (p &#8804; 0.05). Statistical tests demonstrated elevated body mass index (p = 0.001), predominance of family history of diabetes mellitus (p = 0.022) and significantly higher prevalence of metabolic syndrome in the preeclampsia group (37.1%) when compared to normal (22.7%) (p = 0.042). Intergroup comparison showed a high number of metabolic syndrome components in women with previous preeclampsia. Altered systolic and diastolic blood pressure (p < 0.001) was the most prevalent, followed by low concentrations of high-density lipoproteins (p = 0.049), and hyperglycemia (p=0.030). There was a predominance of the metabolic syndrome in women with schooling 0-9 years (42.4%) (p = 0.005), body mass index above 30Kg.m 2 (52.3%) (p < 0.001), uric acid high (62.5%) (p = 0.050 and family history of hypertension (38.5%) (p< 0.001). Multivariate analysis of the data showed that the body mass index above 30 kg.m2, education level less than 10 years of study (p < 0.001) and family history of hypertension (p = 0.002) remained associated with the metabolic syndrome after multivariate analysis of the data. It is considered Women with previous preeclampsia exhibited high prevalence of metabolic syndrome and their individual components in relation to normal, especially, altered systolic and diastolic blood pressure, low concentrations of high-density lipoproteins and hyperglycemia. The factors associated to this ou tcome were obesity, less than 10 years of schooling, and family history of hypertension. Overall, this study identified young women with a history of PE exposed to a higher cardiovascular risk than normal

Avalia����o da preval��ncia de S��ndrome Metab��lica, Microalbumin��ria e Risco Cardiovascular em mulheres com S��ndrome dos Ov��rios Polic��sticos

Avaliar fatores de risco cardiovascular em mulheres brasileiras com s��ndrome dos ov��rios polic��sticos (SOP), atrav��s da utiliza����o de m��ltiplos par��metros, incluindo a determina����o da preval��ncia de s��ndrome metab��lica e seus componentes e pesquisa de microalbumin��ria como marcador de um poss��vel dano renal precoce nessas pacientes. M��todos: Foram avaliadas 102 mulheres de 20-34 anos de idade, com diagn��stico de SOP pelo Consenso de Rotterdam, tendo sido analisados par��metros cl��nicos, antropom��tricos, bioqu��micos e hormonais. Para diagn��stico de s��ndrome metab��lica, foram adotados crit��rios do National Cholesterol Education Program s Adult Treatment Panel III (NCEP-ATP III). Para avalia����o da microalbumin��ria foi utilizada a rela����o albumina/creatinina (A/C), calculada a partir dos n��veis de albumina e creatinina em amostra isolada de urina. Foram realizados testes estat��sticos para avaliar associa����es e correla����es entre vari��veis, bem como compara����o de m��dias ou medianas, adotando-se n��vel de signific��ncia de 5%. Resultados: A preval��ncia de s��ndrome metab��lica foi de 28,4% (29 em 102 pacientes), estando associada ao aumento do ��ndice de massa corporal (IMC). Quanto �� an��lise da preval��ncia dos componentes individuais da s��ndrome metab��lica, evidenciou-se: HDL-colesterol < 50 mg/dl em 69,6%, circunfer��ncia da cintura &#8805; 88 cm em 57,9%, triglicer��deos &#8805;150 mg/dl em 31,7%, press��o arterial &#8805;130/85 mmHg em 18,6% e glicemia de jejum &#8805;110 mg/dl em 2,9%. Quando definida pelos limites convencionais para a rela����o A/C (3,5 35 mg/mmol), a microalbumin��ria esteve presente em apenas tr��s pacientes (3,3%). Entretanto, considerando diferentes limites de corte estabelecidos em recentes estudos que demonstraram aumento do risco cardiovascular associado a n��veis muito baixos da rela����o A/C, a preval��ncia em mulheres com SOP foi alta, variando de 17,7 a 43,3% (para valores &#8805; 0,58 e &#8805; 0,37 mg/mmol, respectivamente). Mulheres com intoler��ncia �� glucose apresentaram n��vel significativamente mais elevado da rela����o A/C, quando comparadas ��s mulheres com normoglicemia. Os valores de microalbumin��ria n��o apresentaram correla����o significativa com IMC, n��veis press��ricos, ��ndices de sensibilidade insul��nica ou perfil lip��dico. Conclus��es: Os dados evidenciam uma alta preval��ncia de s��ndrome metab��lica e seus componentes individuais em mulheres brasileiras com SOP. Al��m do mais, observou-se elevado percentual de mulheres com n��veis de excre����o urin��ria 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 �� institui����o de medidas voltadas para a preven����o prim��ria cardiovascular

Preval��ncia e fatores associados �� dor em professores de educa����o f��sica em academias de gin��stica da cidade do Salvador-BA

Physical Education professionals are usually exposed to excessive physical workloads that evolve into painful symptomatology and muscle and bone disorders that originate from the work-related exercises. Purposo: The goal of this study was to investigate the prevalence and factors associated with pain painful symptomatology in teachers in gymnastics academies. An analytical transversal cut study was performed involving 163 gymnastics teachers working in the main gyms in the city of Salvador-BA. For evaluation of pain, validated versions in Portuguese of the McGill Protocol and the Wisconsin Pain Inventory were used. For obtain results of descriptive statistical analysis of the collected data was performed, followed by TStudent, and Pearson and Spearman correlation tests to verify possible correlations between the presence of pain and other variables which were considered independent. Finally, for the identification of potential risk factors associated with pain, a binary logistic regression analysis was performed. For all statistical analysis, we cnsidered p< 0.05. Results: The painful symptoms was reported by 88.3% of the subjects surveyed. High pain levels were observed in 63.8% of the interviewed professionals, where the intensity varied from moderate to severe. Pain in the lumbar region was present in 55.2% of subjects. Positive correlations were found between the level of pain intensity and the variables related with the workload activity and daily life of the teachers in almost all body joints analyzed. Some factors had been verified associates to the painful sintomatologia as the age of the professionals, the daily hours load of labor work, and the lack of interval of rest between the lessons. Conclusions: We found a high prevalence in gym teachers working in the city of Salvador-BA, which interfered in various daily activities of their home and professional lives. The most affected region was the lumbar region, followed by the knees, neck, shoulders, ankles, hands, hips, feet, elbows and forearms. The factors associated with development of painful symptomatology were the age of the professionals, daily hours of work and the lack of rest intervals between lessons. The high prevalence of pain in Physical Education teachers can be regarded as a serious occupational health problem, which would demand the urgent deployment of preventive intervention programs to minimize the impact of pain among these professionals

Estudo dos fatores associados �� infec����o chag��sica em ��rea end��mica do Rio Grande do Norte

The Chagas disease is a infectious and parasite disease that has as the causative agent a Trypanosoma cruzi, a protozoan parasite that can be transmitted to humans by the faeces of triatomines ( barbeiros ) in the blood-sucking. To understand the relationship between factors associated with chagasic infection and the risk of transmission of Trypanosoma cruzi, this work aimed to make a correlation between the results of serology, obtained by different immunological techniques, used for diagnosis of Chagas disease and risk factors to which the population of the city of Apodi-RN is exposed, to be considered a endemic area. The case-control study was conducted with 199 individuals, which initially was applied a questionary about socio-economic questions and some risk factors which they were exposed and also favor the spread of disease. Then was given the diagnosis by immunological techniques of serology by indirect hemagglutination, ELISA and indirect immunofluorescence. From the diagnosis, the subjects were divided into case group (presence of infection) and control group (no infection). Regarding the descriptive characteristics of the sample, were found a higher frequency of female individuals (59.3%), between 36 and 50 years of age (36.7%), with low education level (91%) and income monthly up to 1 minimum wage (67.8%). The serology, performed by three techniques of different principles, had a reactivity of 38.9% by Indirect Hemagglutination, 39.7% by ELISA and 38.7% by Indirect Immunofluorescence. As the result of the serology, 71 of samples showed reactivity in 2 or more techniques. On some risk variables, was found a significant relationship between individuals who had been bitten by the triatomines and had positive serology for Chagas disease (93.3%). Other variables of risk revealed individuals who had positive serology and had domestic animal (80.3%), lived in poorly maintained homes (97.2%) and near the forest (84.5%). A better understanding of the dynamics of transmission of T. cruzi and the risk factors that contribute to its occurrence in a region are needed to develop effective strategies for control of Chagas disease in these ��reas

Aspectos da fun����o pulmonar ap��s revasculariza����o do mioc��rdio relacionados com risco pr��-operat��rio

OBJETIVOS: Comparar os valores das complac��ncias din��mica e est��tica, da resist��ncia de vias a��reas (Cdin, Cest e Raw) e do ��ndice de troca gasosa (PaO2/FiO2), no p��s-operat��rio de cirurgia de revasculariza����o mioc��rdica (RM) com os par��metros de normalidade e comparar os valores destas vari��veis entre grupos com e sem fatores de risco no pr��-operat��rio. M��TODO: Questionamento aos doentes a respeito de antecedentes pulmonares, sintomas respirat��rios, tabagismo e comorbidades. Ap��s cirurgia de RM, foram feitas as medidas de Cdin, Cest, Raw e do PaO2/FiO2. As vari��veis foram comparadas com a normalidade e relacionadas ��s vari��veis pr�� e p��s-operat��rias pelo Teste n��o-param��trico de Mann-Whitney e pelo Teste para uma propor����o (p<0,05). RESULTADO: Foram avaliados 70 doentes (61% homens), com idade entre 26 e 77 anos. em rela����o �� normalidade, apresentaram diminui����o da Cdin e da Cest, 64 e 66 pacientes, respectivamente, e 24 apresentaram aumento da Raw. Aproximadamente 50% apresentaram redu����o do PaO2/FiO2. N��o houve diferen��a significante das vari��veis p��s-operat��rias com respeito aos antecedentes pulmonares, sintomas respirat��rios e tabagismo. Nos pacientes com comorbidades, o PaO2/FiO2 foi significativamente menor e, nos homens, a Cdin e a Cest foram maiores que nas mulheres. CONCLUS��O: As complac��ncias pulmonares est��o diminu��das na maioria dos pacientes, e a resist��ncia das vias a��reas est�� aumentada em um ter��o deles. O ��ndice de troca gasosa encontra-se diminu��do em metade deles. A presen��a de antecedentes pulmonares, sintomas respirat��rios e tabagismo n��o influencia as vari��veis mec��nicas, mas o ��ndice de troca gasosa �� influenciado pela presen��a de comorbidades.

Lupus eritematoso sist��mico: novo fator de risco para aterosclerose?

OBJETIVO: Avaliar a preval��ncia de eventos cardiovasculares (ECV) secund��rios �� aterosclerose em pacientes com lupus eritematoso sist��mico (LES) e correlacion��-los aos tradicionais fatores de risco, tempo de doen��a e drogas utilizadas na terapia. M��TODOS: Estudo retrospectivo atrav��s da coleta e an��lise dos dados contidos nos prontu��rios de pacientes com diagn��stico confirmado h�� no m��nimo dois anos e seguidos desde 1992. Foram considerados ECV: angina do peito (AP), IAM e acidente vascular cerebral (AVC) de causa n��o relacionada �� atividade do LES. Foram computados os fatores de risco para aterosclerose e dados sobre tratamento. RESULTADOS: Foram analisados 71 prontu��rios. A m��dia de idade dos pacientes foi de 34,2��12,7 anos; 68 mulheres e tr��s homens; 58 caucas��ides (81,6%). Dez (14,08%) apresentaram ECV. Os pacientes nos quais os eventos cardiovasculares foram observados apresentavam idade mais elevada (42,7 vs 32,8 anos p=0,0021) e maior tempo de doen��a (10,8 vs 7,2 anos p=0,011). Os tradicionais fatores de risco, as doses di��rias e cumulativas de ester��ides, imunossupressores e antimal��ricos n��o apresentaram diferen��a estat��stica significante entre pacientes que apresentaram ou n��o ECV. CONCLUS��O: A preval��ncia de secund��rios �� aterosclerose no LES foi semelhante ao da literatura, 14,08%. Os tradicionais fatores de risco n��o mostraram associa����o com a ocorr��ncia ou n��o de ECV no LES. Os pacientes nos quais os eventos cardiovasculares foram observados apresentavam idade mais elevada e maior tempo de doen��a. �� precoce estabelecer-se que o LES possa ser um fator independente no desenvolvimento da aterosclerose.

Fatores de riscos cardiovasculares em adolescentes da cidade do Natal-RN

Estudos t��m demonstrado elevada preval��ncia de fatores de risco cardiovascular em adolescentes a redor do mundo, entretanto, �� poss��vel que esses fatores de risco se comportem de modo diferente em diferentes localidades. Objetivos: Examinar a preval��ncia do sobrepeso/obesidade e sua associa����o com outros fatores de risco cardiovasculares, em adolescentes, da cidade do Natal-Brasil. M��todos: Estudo observacional de delineamento transversal, realizado em 626 adolescentes (10 a 19 anos) de ambos os sexos. Foram estudadas as vari��veis: peso, idade, g��nero, cor, escolaridade, renda familiar, h��bitos de vida, hist��ria familiar, peso, estatura, ��ndice de massa corporal, rela����o cintura/quadril, press��o arterial, perfil lip��dico, Glicose e Insulina de jejum e p��s Dextrosol. Resultados: Foram avaliados 273 (43,6%) adolescentes do sexo masculino e 353 (56,4%) feminino. 26,4% dos adolescentes apresentaram sobrepeso/obesidade. A presen��a de obesidade familiar foi relatada por mais de 30 % da nossa amostra. Na an��lise de regress��o log��stica m��ltipla; Idade, renda familiar, percentil de press��o sist��lica, hist��ria familiar de hipertens��o e obesidade, triglicer��deos, HDL colesterol, e HOMA RI mostraram-se associados com sobrepeso/obesidade. A rela����o cintura quadril apresentou-se mais elevada nas mulheres, e encontramos 10,9 % dos adolescentes com percentil de press��o sist��lica (PAS) 95, e 7,4 % com percentil de press��o diast��lica (PAD) 95. As dosagens de triglicer��deos, colesterol HDL e HOMA-RI alterados foram mais prevalentes nos que apresentavam IMC aumentado. As altera����es do xi colesterol total, triglicer��dios, glicemia p��s dextrosol e HOMA teste, tiveram maior preval��ncia no g��nero feminino. Na regress��o log��stica bin��ria, foram observadas associa����es do sobrepeso / obesidade com idade; OR 0,85, IC de 95% (0,78-0,92); p<0,001, press��o arterial sist��lica; OR 2,65, IC de 95% (1,18- 5,94); p< 0,020, renda familiar; OR 2,34, IC de 95% (1,53-3,58); p< 0,001, hist��ria familiar de hipertens��o arterial; OR 1,76, IC de 95% (1,15-2,71); p< 0,009, hist��ria familiar de obesidade; OR 1,50, IC de 95% (1,09-2,27); p< 0,04, aumento dos trigliceridios; OR 2,74, IC de 95% (1,69-4,43); p< 0,001, redu����o do colesterol; HDL OR 0,58, IC de 95% (0,38-0,87); p< 0,009 e o aumento do HOMA OR 3,16, IC de 95% (1,64 - 6,02); p<0,001. Conclus��o: A preval��ncia de fatores de risco cardiovascular em Natal ��� Brasil se constitui em grave problema de sa��de p��blica, atingindo n��veis que se igualam ou at�� superam os de outras cidades tanto no Brasil, como em outros pa��ses

Perfil dos benefici��rios do Programa de Suplementa����o Alimentar de uma unidade b��sica de sa��de de Botucatu, S��o Paulo

OBJETIVO: Este estudo objetivou apreender algumas caracter��sticas s��cio-sanit��rias do grupo de benefici��rios do Programa de Suplementa����o Alimentar de unidade b��sica de sa��de de um munic��pio de m��dio porte do interior paulista. Especificamente, buscou-se delinear o perfil deste grupo quanto aos fatores de risco para a desnutrição infantil a que estava exposto e dimensionar a utiliza����o dos crit��rios de inclus��o neste programa. M��TODOS: A pesquisa �� de cunho descritivo e se baseou em documentos oficiais vigentes para a defini����o dos fatores de risco a serem analisados. Foram avaliadas 290 crian��as cujas m��es ou respons��veis foram entrevistados, segundo um protocolo previamente estabelecido. RESULTADOS: O grupo de benefici��rios caracterizou-se por ser heterog��neo quanto �� freq����ncia e ao grau da exposi����o a fatores de risco para a desnutrição, denotando que h�� diferen��as nos problemas socioecon��micos e sanit��rios apresentados, como tamb��m na combina����o entre eles, em cada fam��lia. CONCLUS��O: Para a otimiza����o do programa, ainda vigente no munic��pio, sugere-se a padroniza����o loco-regional de crit��rios de inclus��o, conforme a proposta oficial central, com o registro claro dos mesmos e, tamb��m, a aplica����o de m��todos avaliativos peri��dicos, adequada capacita����o da equipe de sa��de e maior envolvimento da popula����o usu��ria.