989 resultados para 4-26
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Article
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Introducción: El programa de Tutores Pares-TP es una iniciativa creada en la EMCS de la Universidad del Rosario que brinda acompañamiento académico a través de estudiantes-tutores a pares menos avanzados. Éste entrega a sus Tutores sistemáticamente, herramientas para desempeñarse armónicamente en el ejercicio de guía y provee habilidades para el manejo del saber. Este estudio busca explorar posibles ´impactos´ generados tras la participación de estudiantes de medicina como TPs dentro de un programa estructurado. Materiales y métodos: Estudio cualitativo que involucró la construcción y aplicación de encuestas a grupos focales –TPs, Docentes y Familiares- creadas a partir de seis ejes/categorías que enmarcan al médico ideal. Las respuestas obtenidas de preguntas cerradas –en escala valorativa- y de naturaleza abierta fueron sometidas a análisis descriptivo –modas- y triangulación. Resultados: 41 tutores, agrupados en 4 grupos de análisis, evidenciaron un impacto general positivo con predominio en habilidades interpersonales (60%,65%,66%,45%, respectivamente), funciones/actividades basadas en la práctica y mejoramiento (57%,67%,60%,45%) y la forma como se emplean los conocimientos (47%,70%,67%,48%). Ocho docentes encuestados consideraron relevante el impacto del programa en habilidades interpersonales-(49%), conocimientos-(42%) y la interacción con colegas-(38%). En los padres de familia hay consenso en el cambio en habilidades interpersonales, funciones basadas en la práctica y mejoramiento y en actitudes-valores ético/morales. Dichos resultados están en paralelo con las observaciones plasmadas en las preguntas abiertas. Conclusiones: Se evidenció un impacto general positivo en la formación y desempeño profesional tras la participación como TPs dentro del programa; hallazgo que soporta aquellos publicados de experiencias académicas similares.
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La planificación urbana en la consolidación de las ciudades ha venido adquiriendo una gran importancia para el desarrollo urbano, a través de instrumentos de gestión urbana. Dentro de esta investigación se analiza las operaciones estratégicas como un instrumento de gestión que ha tenido cambios en su objetivo, alcance e implementación para poder transformar y mejorar a través de intervenciones urbanas los temas físicos, económicos, sociales y culturales dentro de los territorios. A partir de lo anterior, se identificaron cinco elementos que han limitado la implementación de las operaciones estratégicas que son, una visión a largo plazo, la falta de una gerencia especifica, voluntad política, continuidad y la coordinación y comunicación interinstitucional.
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Resumen basado en el de la publicaci??n
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Objective: We investigated whether lifestyle-induced changes in dietary fat quality are related to Improvements on glucose metabolism disturbances in Japanese Brazilians at high risk of type 2 diabetes Methods: One hundred forty-eight first- and second-generation subjects with impaired glucose tolerance or impaired fasting glycemia who attended a lifestyle intervention program for 12 mo were studied in the city of Bauru. State of Sao Paulo, Brazil Dietary fatty acid intakes at baseline and after 12 mo were estimated using three 24-h recalls. The effect of dietary fat intake on glucose metabolism was investigated by multiple logistic regression models Results: At baseline, mean standard deviation age and body mass index were 60 II y and 25 5 4.2 kg/m2, respectively After 12 mo. 92 subjects had normal plasma glucose levels and 56 remained in prediabetic conditions. Using logistic regression models adjusted for age, gender, generation, basal intake of explanatory nutrient, energy intake, physical activity, and waist circumference, the odds ratios (95% confidence intervals) for reversion to normoglycemia were 3 14 (1 22-8 10) in the second wrote of total w-3 fatty acid, 4 26 (1.34-13 57) in the second tunic of eicosapentaenoic acid, and 280 (1 10-7.10) in the second tertile of linolenic acid. Similarly. subjects in the highest wrote of w-3.w-6 fatty acid ratio showed a higher chance of improving glucose disturbances (2 51, 1.01-6.37) Conclusions: Our findings support the evidence of an independent protective effect of omega-3 fatty acid and of a higher omega-3:omega-6 fatty acid ratio on the glucose metabolism of high-risk individuals (C) 2010 Elsevier Inc All rights reserved.
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Detectar os principais achados fundoscópicos em crianças portadoras de hemoglobinopatias falciformes. Métodos: Foram estudados 26 pacientes com hemoglobinopatias falciformes, no Serviço de Oftalmologia do Hospital Universitário Onofre Lopes, Natal, RN, que foram submetidos a protocolo de pesquisa pré-estabelecido. Os resultados foram avaliados estatisticamente pelo teste qui-quadrado. Resultados: A idade média foi de 10,6 anos, com acuidade visual igual ou melhor que 20/25 na maioria, excetuando-se 3 olhos, que apresentavam outras doenças associadas. O tipo mais freqüente foi o SS com 57,7% (15/26) dos casos, seguido pelos SC e SA com 15,4% (4/26) cada, e pelo S-Thal com 11,5% (3/26). A freqüência da retinopatia por células falciformes foi maior após os 10 anos de idade, sendo mais freqüente, em valores relativos, no tipo S-Thal (100% dos casos) e, em valores absolutos, no tipo SS (9 casos). Os dois achados mais comuns foram tortuosidade venosa (12/26) e “black sunburst” (7/26). Conclusões: Observamos que a incidência de retinopatia por células falciformes aumentou após os 10 anos de idade e não evidenciamos achados da doença proliferativa. Portanto, enfatizamos a necessidade do exame oftalmológico precoce nos portadores de anemia falciforme, como forma de prevenir futuras complicações oculares
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Preeclampsia is a spectral disease, with different clinical forms which can evolve with severe multisystemic complications. This present study aimed to determine the risk factors associated with preeclampsia (PE); to validate the existence of aggregation of hypertensive disease in families of women with preeclampsia and verify the existence of association between polymorphisms in the VEGF gene and level of VEGF and its soluble receptor (sFlt1). A case-control study was performed (n = 851). Genotyping of VEGF was performed and serum levels of VEGF and sFlt1 were measured by ELISA. It was observed that 38% of mothers (173, 455) of a case of preeclampsia and 30.8% (78 of 361) of controls had history of hypertension (p <0.0001). Similarly, when examining the history of maternal preeclampsia, we observed that 14.6% (48 of 328) of mothers of women with preeclampsia and 9.6% (12 of 294) of mothers of controls had a history of preeclampsia (p = 0.0001). As for maternal history of preeclampsia, we found that 5.1% (15 of 295) of cases and 3.6% (7 of 314) of controls had a history of preeclampsia (p = 0.0568). Sisters of women with preeclampsia also had a history of hypertensive disease in 9% (41 of 455) versus 6.6% (13 of 361), p = 0.002. Similarly when examining the history of preeclampsia in sisters, it was observed that 22.7% (57 of 251) of a sister of case versus 11.4% (26 of 228) of controls had a history of preeclampsia (P = 0.0011). We observed a decrease in free VEGF in the serum of patients (P <0.05) and increased soluble VEGF receptor. There was no association between polymorphisms in the VEGF gene and preeclampsia. The data obtained in this work validate that hypertensive disease in mothers and sisters with preeclampsia are risk factors for preeclampsia. The risk of illness in the family is higher according to disease severity. High incidence of preeclampsia can be assumed by the high incidence of this disease among the controls. Significant differences between the frequency of preeclampsia in mothers of cases and controls indicate familial factors. Work is being conducted with the to eventually perform genome wide association studies to identify susceptibility loci
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Avaliou-se a preferência alimentar de adultos de Diabrotica speciosa (Germar), pelos genótipos de batata Achat, Baronesa, Monalisa, N 140-201 e NYL 235-4. Foram realizados ensaios com e sem chance de escolha, em laboratórios e em casa de vegetação, na FCAV/UNESP, Jaboticabal, SP. em dois testes utilizaram-se discos de folíolos provenientes de plantios em vaso (plantas com 40 dias); em outros seis semelhantes (exceção ao genótipo N 140-201) foram utilizados discos de folíolos provenientes de plantio de campo (plantas com 30, 50 e 70 dias). Nas placas de Petri (repetições) foram liberados dois adultos/disco. Dois outros ensaios foram efetuados em gaiolas (sem chance de escolha), no interior de casa de vegetação, com plantas com 15 e 45 dias de idade, liberando-se três e 10 adultos/planta respectivamente, avaliando-se o consumo de área foliar quatro e cinco dias após. Nos testes em laboratório com material de vaso, o genótipo NYL 235-4 (com e sem chance) foi o menos consumido (1,08 a 1,12 mg de peso seco). Com material de campo (com e sem chance), o peso de matéria fresca consumida pela praga foi menor em NYL 235-4 (médias de 26,2 e 66,1 mg) e Baronesa (30,2 e 57,9 mg). Nos ensaios em gaiolas (sem chance) também verificou-se menor consumo em NYL 235-4 (3,35 cm² e 16,70 cm²/planta). Esses resultados revelam que o genótipo NYL 235-4 apresenta resistência do tipo não-preferência para alimentação em relação a D. speciosa.
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Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form ( = 4.26), consultation ( = 4.02) and basic basket ( = 4.24); regular condition to pot ( = 3.56) and unsatisfactory conditions for transportation tickets ( = 1.50) and sputum smear microscopy ( = 2.42) and X-rays ( = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory ( = 3.16 - = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Introduction: Hypoestrogenism is the main characteristic of female aging. It promotes significant changes in body composition, both in fat mass as in lean body mass, leading to a decrease in muscle strength and physical performance. Objective: The aim of this study was to test whether menopausal status and hormone levels are associated with muscular strength and physical performance in middle-aged women. Methods: In a cross-sectional study it was collected sociodemographic data, gynecological history, anthropometric and biochemical measures in women aged 40 to 65 years in Parnamirim-RN. The menopause status (pre, peri and post menopause) was determined by menstrual history. All women underwent three dimensions of physical performance assessment: handgrip dynamometry, gait speed and chair stands test - Short Physical Performance Battery (SPPB). Categorical data were presented as absolute and relative frequencies. Quantitative data were showed as mean and standard deviation and the normality of distribution was verified with Kolmogorov-Smirnov (KS) test. Biochemical measures of estradiol and follicle-stimulating hormone (FSH) were transformed to log10. ANOVA with Tukey post-test for comparison of variables between the groups pre, peri and post-menopausal was performed and then multiple linear regression analyzes. Results: Two hundred and seventy eight women aged 50.2 (±5.58) years composed this study, being 50 women in premenopausal status (18%), 122 in perimenopausal (43.9%), and 106 postmenopausal stage (38.1%). The groups were different in age (p=0.001), marital relationship duration (p <0.001), number of pregnancies (p=0.001) and parity (p=0.001). Differences in biochemical measures were observed among the groups: estradiol (p<0.001), FSH (p<0.001), total cholesterol (p=0.001). There were no differences in gait velocity between menopausal status. Values in mean of grip strength decreased by postmenopausal women to perimenopausal and premenopausal ones (24.5 ± 5.1, 25.6 ± 5.4, 26.9 ± 4.9 for post-stage, pre and peri menopausas, respectively, p = 0.02) and the performance of chair stands test was better in premenopausal women compared with that in peri and postmenopausal status (p = 0.02). In multiple linear regression for muscle strength, the variables that remained were: age, estradiol and somatic symptoms measured by Menopause Rating Scale-MRS (R2=0.15). While for the xiv chair-stands test the predictors were number of births and FSH values (R2=0.04). Conclusion: There is a relationship between the stages of menopause and muscle performance in measures of grip strength and sit-up test and these are influenced by the fall of estrogens levels. Data suggest that the decrease in muscle strength and physical performance already appear in the transition to menopause stage, pointing to the need for more research in this area and appropriate preventive interventions
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Study Design. Case-control study.Objective. To evaluate respiratory muscle force in children with myelomeningocele. Summary of Background Data. Myelomeningocele is a common spinal cord malformation with limitations linked to central nervous system lesions and abnormalities in respiratory movements. Despite this, little attention has been given to evaluating respiratory muscle force in these patients.Methods. Children with myelomeningocele aged between 4 and 14 years ( myelomeningocele group; MG, n = 20) were studied and compared with healthy children ( control group; CG, n = 20) matched for age and gender. Respiratory muscular force was evaluated by maximum inspiratory ( Pimax) and expiratory ( Pemax) pressures.Results. Groups were similar for age [ CG = 8 ( 6 - 13) = MG = 8 ( 4 - 14), P > 0.05]; gender, and body mass index [ CG = 17.4 ( 14.1 - 24.7) x MG = 19.2 ( 12.6 - 31.9), P > 0.05]. The lumbosacral region was predominantly affected ( 45%). Maximum respiratory pressures were significantly higher in CG than MG ( Pimax = CG: similar to 83 +/- 21.75 > MG: -54.1 +/- 23.66; P < 0.001 and Pemax = CG: + 87.4 +/- 26.28 > MG: + 64.6 +/- 26.97; P = 0.01). Patients with upper spinal lesion ( UL) had lower maximum respiratory pressure values than those with lower spinal lesion ( LL), [Pimax ( UL = - 38.33 +/- 11.20 cm H2O x LL = - 60.85 +/- 24.62 cm H2O), P < 0.041 and Pemax ( UL = + 48 +/- 20.82 cm H2O x LL + 71.71 +/- 26.73 cm H2O), P = 0.067]).Conclusion. Children with myelomeningocele at the ages studied presented reduced respiratory muscle force with more compromise in upper spinal lesion.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Seventy beef males of three breeding systems (BS), straightbreds Charolais (Ch) and Nellore (Ne), G1 crossbreds: 1/2 Ch + 1/2 Ne (1/2 Ch) and 1/2 Ne + 1/2 Ch (1/2 Ne) and G2 crossbreds: 3/4 Ch + 1/4 Ne (3/4 Ch) and 3/4 Ne + 1/4 Ch (3/4 Ne) were used. The number of animals by genetic group was, respectively, 15, 12,8, 12,14 and 9. Thirty-five males were castrated (C) at seven months and 35 were kept intact (1). The animals were feedlot finished from 20 to 24 months. The longissimus dorsi muscle was used for the meat evaluation. No significant interaction was observed between genetic composition and sexual condition, for the variables studied. The I males displayed meat with darker color (3.05 vs. 3.78 points) with less amount of marbling (4.26 vs. 5.75 points) and less amount of ether extract (1.73 vs. 2.88%). However they presented larger (66.03 vs. 60.50 cm(2)) longissimus dorsi area and meat with better palatability, juiciness and tenderness. Ch animals had larger longissimus dorsi than the Ne. In the G I group, the 1/2 Ch meat showed larger amount of marbling and ether extract and less cooking losses than the 1/2 Ne meat. Between G2 animals, the 3/4 Ne showed meat with larger thawing losses and larger amount of ether extract. In G1 animals meat, the heterosis level reached 18.54% for longissimus dorsiarea, 28.10% for ether extract and 64.01% for amount of marbling. In G2, the heterosis was -17.30% for lean texture and 10.40% for longissimus dorsi area.
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The size distributed composition of ambient aerosols is used to explore seasonal differences in particle chemistry and to show that dry deposition fluxes of soluble species, including important plant nutrients, increase during periods of biomass (sugar cane trash) burning in São Paulo State, Brazil. Measurements were made at a single site centrally located in the State's sugar cane growing region but away from the immediate vicinity of burns, so that the air sampled was representative of the regional background. Calculation of ion equivalent balances showed that during burning periods smaller particles (Aitken and accumulation modes) were more acidic, containing higher concentrations of SO(4)(2-), oxalate, NO(3)(-), HCOO(-), CH(3)COO(-), and Cl(-), but insufficient NH(4)(+) and K(+) to achieve neutrality. Larger particles showed an anion deficit due to the presence of unmeasured ions and comprised resuspended dusts modified by accumulation of nitrate, chloride, and organic anions. Increases of resuspended particles during the burning season were attributed to release of earlier deposits from the surfaces of burning vegetation as well as increased vehicle movement on unsurfaced roads. During winter months the relative contribution of combined emissions from road transport and industry diminished due to increased emissions from biomass combustion and other activities specifically associated with the harvest period. Positive increments in annual particulate dry deposition fluxes due to higher fluxes during the sugar cane harvest were 44.3% (NH(4)(+)), 42.1 % (K(+)), 31.8% (Mg(2+)), 30.4% (HCOO(-)), 12.8% (Cl(-)), 6.6% (CH(3)COO(-)), 5.2% (Ca(2+)), 3.8% (SO(4)(2-)), and 2.3% (NO(3)(-)). Na(+) and oxalate fluxes were seasonally invariant. Annual aerosol dry deposition fluxes (kg ha(-1)) were 0.5 (Na(+)), 0.25 (NH(4)(+)), 0.39 (K(+)), 0.51 (Mg(2+)), 3.19 (Ca(2+)), 1.34 (Cl(-)), 4.47 (NO(3)(-)), 3.59 (SO(4)(2-)), 0.58 (oxalate), 0.71 (HCOO(-)), and 1.38 (CH(3)COO(-)). Contributions of this mechanism to combined aerosol dry deposition and precipitation scavenging (inorganic species, excluding gaseous dry deposition) were 31% (Na(+)), 8% (NH(4)(+)), 26% (K(+)), 63% (Mg(2+)), 66% (Ca(2+)), 32% (Cl(-)), 33% (NO(3)(-)), and 36% (SO(4)(2-)).