bluuebunny/crossref_metadata_2025 huggingface dataset:
A concepção de vazio em Roland Barthes
Authors: Fontanari Rodrigo
Published: February 2019

Resumo Este ensaio busca reler O Império dos signos, em que Barthes elabora, à sua maneira, uma espécie de etnografia da cultura oriental, especialmente a arte de vida japonesa, que será para ele como a revelação de uma estética muito pessoal, que ele parece ter intuído desde O Grau zero da escritura: a estética do vazio. Essa estética encontra, por hipótese, conclusão sob o nome de Neutro, essa utopia da linguagem que suspende toda a significação. A meio caminho entre O Grau zero da escritura e O Neutro, O Império dos signos será o pivô desta pesquisa.
Para além da morte: L’instant De Ma Mort, de Maurice Blanchot
Authors: Pimentel Davi Andrade
Published: February 2019

Resumo A partir do tema da morte, base de toda a narrativa de L’instant de ma mort, do escritor francês Maurice Blanchot, este artigo busca refletir sobre algumas questões derivadas desse tema, como, por exemplo: a relação entre o eu e o outro em um relato, a estreita relação que o texto blanchotiano mantém com os textos de Franz Kafka, os modalizadores que tornam o relato do narrador hesitante, a especificidade da palavra literária e, por fim, a ideia da impossibilidade da morte proposta pelo escritor ao longo de seu texto ficcional.
Use of a species-rich and highly eutrophic tropical estuary in the South Atlantic by Pleuronectiformes (Teleostei: Acanthopterygii)
Authors: Silva-Junior Luiz Constantino , Santos Sérgio Ricardo , Macedo Márcio Chagas , Nunan Gustavo Wilson , Vianna Marcelo
Published: February 2019

Abstract: A total of 1,471 specimens of 16 species of flatfishes (Pleuronectiformes) were caught during 48 sampling campaigns between July 2005 and June 2007 at ten stations in Guanabara Bay, Rio de Janeiro, Brazil. Paralichthyidae was the dominant family, with Etropus crossotus as the dominant species. The outer stations, especially those on the western side of the lower estuary, were distinguished as a result of their higher abundance of flatfishes and number of species. The spatial distribution of E. crossotus and its population structure indicate that this species is an estuarine resident despite the apparent reduction in its area of occupation within the estuarine complex. Among the other species, nine were classified as marine stragglers (Achirus declivis, Bothus ocellatus, Cyclopsetta chittendeni, Etropus longimanus, Paralichthys orbignyanus, P. patagonicus, Syacium micrurum, Symphurus diomedeanus and Trinectes paulistanus) and three as estuarine opportunists (Bothus robinsi, Citharichthys macrops and Syacium papillosum); another three could not be classified due to the small number of captures or lack of previous data (S. tessellatus, A. lineatus and C. spilopterus).
Treehopper (Membracidae, Auchenorrhyncha) assemblages in four semi-arid areas of caatinga of Northeast Brazil
Authors: Rotheá Rembrandt Romano Andrade Dantas , Lourenço Aline , Vasconcellos Alexandre , Creão-Duarte Antonio José
Published: February 2019

Abstract Treehopper assemblages were sampled in four semi-arid areas of caatinga in Northeast Brazil during the rainy seasons of 2016 and 2017, using three different capture methods. The areas are located in two Ecoregions of the Caatinga: “Depressão Sertaneja Setentrional” (Northern Sertaneja Depression) and “Planalto da Borborema” (Borborema Plateau). A total of 2,394 individuals of 43 species were sampled, corresponding to approximately 87% of the mean estimated species richness for all four areas. The species richness varied among the areas from 14 to 21, while the abundance of individuals ranged from 129 to 1860. Eighteen species were shared among areas, of which only Enchenopa eunicea, Sundarion sp. 1, Ceresa vitulus and Erosne parvula occurred in all four due to the general behavior of the first three and the wide distribution of host plant of Erosne parvula - Mimosa tenuiflora. Twenty-five species occurred only in one area, of which 23 were categorized as rare with a maximum of eight individuals sampled, and seven with only one individual collected (singletons). Considering that the Caatinga Domain possesses at least nine Ecoregions with different climates, geomorphology and vegetation, along with marked endemism of plants, it is expected that the species richness of treehoppers will increase substantially on a regional scale.
Plasticity in the timing of activity in the Red-rumped Agouti, Dasyprocta leporina (Mammalia: Rodentia), in the Atlantic Forest of southeastern Brazil
Authors: Magalhães Laura Martins , Srbek-Araujo Ana Carolina
Published: February 2019

Abstract Timing of activity is a consequence of adaptations to daily and seasonal changes in the environment and examining these patterns is important to better understand the temporal niches of the species. Here we examine temporal activity in the Red-rumped Agouti (Dasyprocta leporina) in two fragments of Atlantic Forest and those factors that influence the circadian rhythm in the study areas. Camera traps were used to gather data in two protected areas (one montane and other coastal) in the state of Espírito Santo, southeastern Brazil. A total of 49 photos were taken in the mountains and 152 in the coastal area. Activity patterns were diurnal and bimodal, and animals were active for 14-15 hours each day. Activity peaked in the morning soon after sunrise and then before and during dusk. Activity patterns were different in the two study areas (W = 6.77, p = 0.034). There was a longer peak in the morning in the coastal area, and a higher peak in the evening in the mountains, where activity starts later and becomes less intense earlier. The difference between activity patterns in the two locations suggests plasticity in agouti behavior. Because the two study areas are at about the same latitude, we suggest that the behavioral plasticity is due to different temperature regimes associated with a local effect of altitude and topography of the terrain on the incidence of solar rays inside the forest. The influence of other factors is also discussed. In addition to a better understanding of the temporal niche of the Red-rumped Agouti, the behavior patterns we describe here can be useful to optimize strategies for D. leporina conservation in southeastern Brazil once the species is more susceptible to poaching at times when animals are most active.
Fístula arteriovenosa pós-cateterismo radial com repercussões cardiopulmonares
Authors: Oliveira Alexandre Faraco de , Ribeiro Alexandre David , Ávila Marcio Costa Silveira
Published: February 2019

Resumo O presente artigo relata o caso de um paciente coronariopata de 86 anos submetido a cateterismo cardíaco via acesso radial à esquerda. Cerca de 16 meses após o procedimento, manifestou dispneia sem relação com esforço, associada a hipóxia noturna. Apresentava frêmito à palpação do punho esquerdo e foi diagnosticado com fístula arteriovenosa radiocefálica no punho esquerdo. Ao duplex scan apresentava alteração de padrão de onda e aumento da velocidade diastólica compatível com fístula arteriovenosa. Foi submetido a correção cirúrgica da fístula, apresentando melhora clínica e laboratorial após o procedimento. O acesso radial para cateterismo cardíaco tem sido cada vez mais utilizado, principalmente por causar complicações menos frequentes e menos deletérias em comparação ao acesso femoral. Entretanto, complicações como fístula arteriovenosa ocorrem e podem ser especialmente prejudiciais em pacientes octogenários.
CHIVA to treat saphenous vein insufficiency in chronic venous disease: characteristics and results
Authors: Faccini Felipe Puricelli , Ermini Stefano , Franceschi Claude
Published: February 2019

Abstract There is considerable debate in the literature with relation to the best method to treat patients with chronic venous disease (CVD). CHIVA is an office-based treatment for varicose veins performed under local anesthesia. The aim of the technique is to lower transmural pressure in the superficial venous system and avoid destruction of veins. Recurrence of varicosities, nerve damage, bruising and suboptimal aesthetic results are common to all treatments for the disease. This paper evaluates and discusses the characteristics and results of the CHIVA technique. We conclude that CHIVA is a viable alternative to common procedures that is associated with less bruising, nerve damage, and recurrence than stripping saphenectomy. The main advantages are preservation of the saphenous vein, local anesthesia, low recurrence rates, low cost, low pain, and no nerve damage. The major disadvantages are the learning curve and the need to train the team in venous hemodynamics.
Tratamento da doença arterial obstrutiva periférica em território femoropoplíteo com stent primário: análise em até 24 meses
Authors: Geiger Martin Andreas , Guillaumon Ana Terezinha
Published: February 2019

Resumo Contexto O stent primário é uma opção de tratamento bem estabelecida para a doença arterial periférica em território femoropoplíteo. Estudos nacionais são escassos. Objetivos Avaliar desfechos clínicos e radiológicos em curto e médio prazo em pacientes classificados como Rutherford 3-6, tratados com o uso de stent em lesões femoropoplíteas. Métodos A análise foi realizada com base em um banco de dados prospectivamente mantido de doentes tratados entre julho de 2012 e julho de 2015. O objetivo primário foi a perviedade. Os objetivos secundários foram melhora na classificação de Rutherford, índice tornozelo/braço, revascularização do vaso-alvo, taxa de salvamento do membro e óbito em até 24 meses. Resultados Foram incluídos 64 pacientes, sendo 61 com lesões TASC II A/B (95%). A taxa de perviedade primária em 6, 12 e 24 meses foi de 95,2%, 79,1% e 57,9%, respectivamente. A análise de regressão de Cox revelou uma menor perviedade em pacientes com doença oclusiva (RR, 6,64, IC 95%, 1,52-28,99, p = 0,02), bem como uma perda de perviedade cerca de seis vezes maior em doentes TASC B do que TASC A (RR, 5,95, IC 95%, 1,67-21,3, p = 0,0061). Em 12 meses, 90,38% dos doentes permaneceram assintomáticos. A taxa de salvamento do membro em 24 meses foi de 94,3% (IC 95%, 87,9-100%). A ausência de revascularização do vaso-alvo em 24 meses foi de 90,5% (IC 95%, 82,8-98,9%). Conclusões Os resultados foram compatíveis com estudos internacionais, apesar do estágio mais avançado da doença vascular observada em nosso grupo. Piores desfechos foram associados a doença oclusiva e lesões complexas.
Prevalence of vitamin D deficiency and its relationship with factors associated with recurrent wheezing
Authors: Peçanha Mirna Brito , Freitas Rodrigo de Barros , Moreira Tiago Ricardo , Silva Luiz Sérgio , Oliveira Leandro Licursi de , Cardoso Silvia Almeida
Published: February 2019

ABSTRACT Objective: To determine the prevalence of vitamin D deficiency/insufficiency in children 0-18 years of age with recurrent wheezing and/or asthma residing in the microregion of Viçosa, Minas Gerais, Brazil, and treated at a referral center, and to determine its association with major risk factors for wheezing. Methods: A cross-sectional study was performed using a semi-structured questionnaire, which was administered by trained interviewers to the legal guardians of the study participants. Data were obtained regarding general characteristics of recurrent wheezing; general sociodemographic, environmental, and biologic factors; and atopy-related factors. The magnitude of the statistical association was assessed by calculating ORs and their corresponding 95% CIs by using multiple logistic regression. Results: We included 124 children in the study. The prevalence of vitamin D deficiency/insufficiency in the sample was 57.3%. Vitamin D deficiency/insufficiency was found to be associated with wheezing in the first year of life, personal history of atopic dermatitis, environmental pollution, and vitamin D supplementation until 2 years of age. Conclusions: The prevalence of vitamin D deficiency/insufficiency was high in our sample. Vitamin D concentrations were directly associated with vitamin D supplementation until 2 years of age and were inversely associated with wheezing events in the first year of life, personal history of atopic dermatitis, and environmental pollution.
LIGHT QUALITY IN THE IN VITRO INTRODUCTION OF Corymbia HYBRID CLONES
Authors: Souza Denys Matheus Santana Costa , Xavier Aloisio , Otoni Wagner Campos , Miranda Natane Amaral , Maggioni Joane Helena
Published: February 2019

ABSTRACT Micropropagation via axillary bud proliferation is recommended for rejuvenation or reinvigoration of selected clones, as well as for improving clonal seedlings rooting. The success of a micropropagation protocol depends on the in vitro introduction, since following phases, multiplication, elongation, and rooting can only take place once the aseptic crop with vegetative vigor has been established. This study aims to assess the effect of light on the in vitro introduction of hybrid clones of Corymbia torelliana x C. citriodora e Corymbia citriodora x C. torelliana by the micropropagation technique through proliferation by axillary buds. The mini-stumps, suppliers of explants for in vitro introduction, were conducted in semi-hydroclonal mini-clonal hedge. Nodal segments from three Corymbia torelliana x C. citriodora (TC01, TC02 e TC03) clones and one Corymbia citriodora x C. torelliana (CT01) clone were collected, disinfested and inoculated in JADS culture medium, in order to compare the effects of light quality from a dark/fluorescent lamp, a fluorescent lamp, and white and red/blue LEDs. At 30 days after inoculation, the following characteristics were evaluated: average contamination percentage, oxidation, non-reactive explants, shoot length and average number of shoots per explant greater than 0.5 cm. Gathered data showed that the use of red/blue LED light source obtained the best results in all assessed characteristics in the in vitro introduction.
COMPETITIVENESS AND EFFICIENCY FOR THE RUBBER TREE PRODUCTION SYSTEM IN SOUTHERN BAHIA (BRAZIL) THROUGH BY THE POLICY ANALYSIS MATRIX (PAM)
Authors: Santana Adrielli Santos de , Soares Naisy Silva , Schröder Cristian Arnecke
Published: February 2019

ABSTRACT The objective of this survey was to analyze the competitiveness and economic efficiency of the rubber tree (Hevea brasiliensis) production system in the southern of Bahia, through by the Policy Analysis Matrix (PAM). The analysis was divided into four categories: profitability analysis; efficiency analysis; protection analysis; and net transfer of policies. The results it possible to affirm that rubber tree production system is a profitable and competitive activity, in the long term, from a private and social point of view. However, the results point out that producers are penalized for the presence of political measures, which focus on product price and productive inputs. In the sensitivity analysis, it was observed that the indicators are sensitive to the fluctuations in the exchange rate and the social income, thus the changes in the price of natural rubber have a strong impact on determining the competitiveness of this productive system.
EVALUATING THE COMPETITIVE ENVIRONMENT FOR WILD PISTACHIO (Pistacia atlantica Desf.) SEEDLINGS IN THE CENTRAL FORESTS OF IRAN
Authors: Kiani Bahman , Amiri Asma
Published: February 2019

ABSTRACT Wild pistachio (Pistacia atlantica Desf.) is an important tree species from dry forests of Eurasia. Seedlings must usually compete with other tree and shrub species in the dry harsh environment of mountain forests. In this study, we identified the main competitor species and evaluated some widely used competition indices, including distance-dependent and distance-independent ones, to quantify the relationship between the reference seedlings and their neighbors. The results indicated that the main competitors are mountain almond (Amygdalus scoparia Spach.), thorny almond (Amygdalus lycioides Spach.), montpellier maple (Acer monspessulanum subsp. cinerascens Boiss.) and other wild pistachio seedlings. We found that competition increases the height growth but reduces the diameter, basal area growth and crown development of wild pistachio seedlings. Some competition indices had a noticeable correlation with seedling growth, indicating that competition does exist. A combination of log-transformed indices could explain 85% of the diameter growth variations, 46% of height growth, 76% of basal area growth and 72% of crown area development with a good precision.
Prevalence, treatment, and control of dyslipidemia in diabetic participants of two brazilian cohorts: a place far from heaven
Authors: Martins Nestor S. , Mello Daniel S.S. , Barreto Joaquim , Soares Alexandre A.S. , Breder Ikaro , Cunha Jessica , Nadruz Wilson , Coelho Filho Otavio R. , Matos-Souza José Roberto , Coelho Otavio R. , Munhoz Daniel B. , Silva José Carlos Quinaglia e , Sposito Andrei C. , Carvalho Luiz Sergio F
Published: February 2019

SUMMARY OBJECTIVE Diabetes is one of the leading causes of cardiovascular mortality. Over the last years, mortality has decreased significantly, more in individuals with diabetes than in healthy ones. That is mostly due to the control of other cardiovascular risk factors. The objective of our study was to analyze the dyslipidemia control in two diabetes cohorts. METHODS Patients from two distinct cohorts were studied, 173 patients from the BHS (Brasília Heart Study) and 222 patients from the BDS (Brazilian Diabetes Study). The data on dyslipidemia control were studied in both different populations. All patients had diabetes. RESULTS There are significant differences concerning comorbidities between the LDL-C and BDS groups. The average glycated hemoglobin is of 8.2 in the LDL-C > 100 group in comparison with 7.7 and 7.5 in the 70-100 and < 70 groups, respectively (p = 0.024). There is a higher percentage of hypertensive patients with LDL between 70-100 (63.9%), when comparing the < 70 and > 100 groups (54.3% and 54.9%, respectively; p = 0.005). Diastolic pressure is higher in the group with LDL > 100, with an average of 87 mmHg, in comparison with 82.6 mmHg and 81.9 mmHg in the 70-100 and < 70 groups, respectively (p = 0.019). The group with LDL > 100 has the greatest percentage of smokers (8.7%) in comparison with the groups with LDL between 70-100 and < 70 (5.6% and 4.3%, respectively; p = 0.015). There is also a difference in the previous incidence of coronaropathy. In the group with LDL < 70, 28.3% of patients had already experienced a previous infarction, compared with 11.1% and 10.6% in the 70-100 and > 100 groups, respectively (p < 0.001). CONCLUSIONS The data in our study have shown that the dyslipidemia control in diabetic patients is inadequate and there is a tendency of direct association between lack of blood glucose control and lack of dyslipidemia control, in addition to the association with other cardiovascular risk factors, such as diastolic hypertension and smoking. This worsened control might be related to the plateau in the descending curve of mortality, and investments in this regard can improve the cardiovascular health in diabetic patients.
Diabetes control could through platelet-to-lymphocyte ratio in hemograms
Authors: Atak Burcin , Aktas Gulali , Duman Tuba T. , Erkus Edip , Kocak M. Zahid , Savli Haluk
Published: February 2019

SUMMARY OBJECTIVE Association between type 2 diabetes mellitus and inflammation is well-established. We aimed to study platelet-to-lymphocyte ratio (PLR), a novel inflammatory index derived from hemogram, in diabetic patients in comparison to those in healthy volunteers. METHODS Medical data of type 2 diabetics that showed up in general outpatient medical clinics of our institution between February 2017 and August 2017 were recorded and analyzed. RESULTS Median PLR of type 2 diabetic patients was significantly higher than the PLR of healthy controls (p=0.001). Moreover, PLR was significantly and positively correlated with HbA1c (p<0.001, r=0.58), fasting plasma glucose (p<0.001, r=0.49), and c-reactive protein (p=0.003, r=0.30) levels. Type 2 diabetic subjects with proteinuria had significantly higher PLR levels than that of diabetic subjects without proteinuria. CONCLUSION As an inexpensive and easy to use index, PLR may be useful in predicting the development and control levels of type 2 diabetes mellitus. However, its correlation with HbA1c needs to be validated by larger prospective studies.
Consumption of animal-based and processed food associated with cardiovascular risk factors and subclinical atherosclerosis biomarkers in men
Authors: Acosta-Navarro Júlio César , Oki Adriana Midori , Antoniazzi Luiza , Bonfim Maria Aparecida Carlos , Hong Valeria , Gaspar Maria Cristina de Almeida , Sandrim Valeria Cristina , Nogueira Adriana
Published: February 2019

SUMMARY OBJECTIVE To evaluate the frequency of food consumption in apparently healthy men and their association with cardiovascular risk factors and biomarkers of subclinical atherosclerosis. METHODS In this observational study, 88 men had their food standard obtained through the food frequency questionnaire (FFQ). Associations of dietary patterns with cardiovascular risk factors, such as anthropometric data, laboratory and clinical evaluations, carotid-femoral arterial stiffness (IMT) and pulse wave velocity were evaluated. RESULTS The highest values were observed, for most of the risk factors evaluated, with the highest frequency of weekly consumption of dairy products, meats, sweets, fats, cold meats, sodas, milk and white chocolate; and lower frequency of weekly consumption of fruits, cereals, vegetables, legumes, oilseeds, and soy. There was no significant difference for coffee and dark chocolate CONCLUSIONS A diet with high consumption of animal products has a higher correlation with cardiovascular risk factors; the opposite is true for the consumption of plant-based food, associated with the profile of more favorable biomarkers for cardiovascular health and better biochemical and structural parameters.
Diabetic regulation of subjects with type 2 diabetes mellitus is associated with serum vitamin D levels
Authors: Erkus Edip , Aktas Gulali , Kocak M. Zahid , Duman Tuba T. , Atak Burcin M. , Savli Haluk
Published: February 2019

SUMMARY OBJECTIVE Vitamin D deficiency is not only associated with bone metabolism but also with diabetes mellitus. We aimed to study the possible association between serum vitamin D concentration and HbA1c level in patients with type 2 diabetes mellitus (T2DM) in this retrospective report. METHODS Patients with T2DM were enrolled to the study either in regulated or non-regulated T2DM groups, according to HbA1c levels. An HbA1c level of <8% was considered as relatively controlled and others were considered as poorly controlled T2DM. RESULTS Serum vitamin D levels in poorly controlled T2DM subjects (9.4 (4.9-34) ng/ml) were significantly lower than that of the relatively well regulated T2DM patients (13.5 (3.4-36) ng/ml) (p=0.03). Vitamin D was strongly and inversely correlated with HbA1c levels (r= -0.295, p=0.005). CONCLUSION Whatever the cause or result of the diabetes mellitus, it is clear that lower vitamin D is strongly associated with worse diabetic regulation in T2DM subjects. Randomized controlled larger studies, which research the relation between diabetic regulation and vitamin D status, are needed to claim whether it could be a therapeutic target in future in diabetic subjects.
Cardiovascular autonomic neuropathy in type 2 diabetic patients
Authors: Breder Ikaro Soares Santos , Sposito Andrei C.
Published: February 2019

SUMMARY Diabetes is one of the most common chronic pathologies around the world, involving treatment with general clinicians, endocrinologists, cardiologists, ophthalmologists, nephrologists and a multidisciplinary team. Patients with type 2 Diabetes Mellitus (T2DM) can be affected by cardiac autonomic neuropathy, leading to increased mortality and morbidity. In this review, we will present current concepts, clinical features, diagnosis, prognosis, and possible treatment. New drugs recently developed to reduce glycemic level presented a pleiotropic effect of reducing sudden death, suggesting a potential use in patients at risk.
Diabetic cardiomyopathy: factual or factoid?
Authors: Quinaglia Thiago , Oliveira Daniela C. , Matos-Souza José Roberto , Sposito Andrei C.
Published: February 2019

SUMMARY Although long ago described, there is no established consensus regarding the real existence of Diabetic Cardiomyopathy (CMPDM). Due to its complex pathophysiology, it has been difficult for clinical and experimental research to establish clear connections between diabetes mellitus (DM) and heart failure (HF), as well as to solve the mechanisms of the underlying myocardial disease. However, the epidemiological evidence of the relationship of these conditions is undisputed. The interest in understanding this disease has intensified due to the recent results of clinical trials evaluating new glucose-lowering drugs, such as sodium-glucose transporter inhibitors 2, which demonstrated favorable responses considering the prevention and treatment of HF in patients with DM. In this review we cover aspects of the epidemiology of CMPDM and its possible pathogenic mechanisms, as well as, present the main cardiac phenotypes of CMPDM (HF with preserved and reduced ejection fraction) and implications of the therapeutic management of this disease.
Central role of obesity in endothelial cell dysfunction and cardiovascular risk
Authors: Lima Júnior José Carlos de , Moura-Assis Alexandre , Cintra Riobaldo M. , Quinaglia Thiago , Velloso Lício A. , Sposito Andrei C.
Published: February 2019

SUMMARY Atherosclerosis is the leading cause of mortality in the contemporary world. The critical role of the endothelial cells (EC) in vascular homeostasis, the metabolic changes that take place when the cell is activated, and the elements involved in these processes have been widely explored over the past years. Obesity and its impact, promoting a rise in blood levels of free fatty acids (FAs) are often associated with atherosclerosis and cardiovascular mortality. However, the mechanisms that promote cardiovascular structural changes and adaptive changes in the ECs, particularly in the context of obesity, are little known. Here, we reviewed studies that assessed the metabolic adaptations of healthy and dysfunctional ECs during exposure to FAs, as well as the epidemiological perspectives of cardiovascular structural changes in obesity. Finally, we explored the role of new agents – sphingolipids, dietary unsaturated fatty acids and sodium-glucose cotransporter-2 inhibitors (iSGLT2) – in atherosclerosis and their relationship with obesity.
Serum uric acid to HDL-cholesterol ratio is a strong predictor of metabolic syndrome in type 2 diabetes mellitus
Authors: Kocak M. Zahid , Aktas Gulali , Erkus Edip , Sincer Isa , Atak Burcin , Duman Tuba
Published: February 2019

SUMMARY OBJECTIVE Metabolic syndrome (MS) is a clinical entity that associated with increased risk of type 2 Diabetes Mellitus (DM) and cardiovascular diseases. Serum uric acid levels are correlated MS criteria. We hypothesized whether a uric acid to HDL-cholesterol ratio (UHR) could predict diabetic regulation and presence of MS in type 2 diabetic subjects. METHODS Admissions of the subjects with type 2 DM to outpatient clinics of our institution were retrospectively analyzed. Study population grouped into well-controlled and poorly controlled diabetics according to the HbA1c level (cut off 7%) and further grouped into type 2 DM with and without MS according to the presence of MS. UHR of study groups compared. RESULTS A hundred diabetic subjects enrolled. Mean UHR was significantly lower in well-controlled diabetics (9.7 ± 3.7%) compared to poorly controlled subjects (14 ± 5.4%) (p<0.001). Median UHR of diabetics with MS (13 (6-29) %) was greater than that of the diabetics without MS (9 (3-16) %) (p<0.001). UHR greater than 11% has 77% sensitivity and 60% specifity in predicting worse diabetic control (AUC: 0.752, p<0.001) and a UHR greater than 10.6% has 83% sensitivity and 71% specifity in predicting MS (AUC: 0.839, p<0.001). Sensitivity and specifity of UHR in predicting MS were better than most of the sensitivities and specifities of the five criteria of MS. CONCLUSION We suggest utilization of UHR in diagnosis of MS as a novel criteria. Nevertheless, prospective studies with larger population may make a better scientific evidence in that issue.
ATENDIMENTO INTEGRAL E COMUNITÁRIO EM SAÚDE MENTAL: AVANÇOS E DESAFIOS DA REFORMA PSIQUIÁTRICA
Authors: Clementino Francisco de Sales , Miranda Francisco Arnoldo Nunes de , Pessoa Júnior João Mário , Marcolino Emanuella de Castro , Silva Júnior José Antônio da , Brandão Gisetti Corina Gomes
Published: February 2019

Resumo Objetivou-se caracterizar e analisar a organização dos processos de trabalho em serviços de saúde mental no município de Campina Grande, Paraíba, Brasil. Trata-se de um estudo quantitativo, retrospectivo e documental, realizado entre julho e agosto de 2014. Coletaram-se os dados a partir de formulário baseado em instrumento validado para o estudo, considerando uma amostra de 402 prontuários. Para o processamento das análises estatísticas, utilizou-se o SPSS, versão 17.0. Observou-se um perfil de usuários predominantemente composto por mulheres na faixa etária adulta, com diagnóstico clínico de esquizofrenia, associado a outros diagnósticos clínicos. Quanto às internações em hospitais psiquiátricos antes e após o ingresso no serviço, notou-se redução estatisticamente significante. Como importante avanço, evidenciaram-se os elevados registros de oficinas realizadas. Como principal limitação do estudo, apontam-se falhas nos registros dos prontuários, mas que não os tornam menores ou irrelevantes. Reforça-se que o atendimento integral e de base comunitária ao usuário com transtorno mental e sua família, condizente com os preceitos reformistas, requer, entre outros, maiores investimentos na infraestrutura dos serviços, equipamentos e tecnologias, apoio institucional, capacitação e comprometimento da gestão nos processos de educação permanente.
O PET-SAÚDE COMO NORTEADOR DA FORMAÇÃO EM ENFERMAGEM PARA O SISTEMA ÚNICO DE SAÚDE
Authors: Noro Luiz Roberto Augusto , Moya José Luis Medina
Published: February 2019

Resumo A saúde de qualidade e de acesso universal é um direito que deve ser garantido por políticas públicas, financiamento compatível e pela adequada formação dos profissionais de saúde. Uma das estratégias identificadas para alcançar esse desafio é o Programa de Educação para o Trabalho em Saúde, que visa promover a interação ativa de alunos e professores com os serviços de saúde. O objetivo deste estudo foi comparar, por meio dos resultados do Exame Nacional de Desempenho dos Estudantes dos cursos de Enfermagem de 2013, o desempenho dos que participaram com o daqueles que não fizeram parte do referido Programa. Trata-se de estudo observacional, de corte transversal analítico, que analisou o desempenho pelas médias ponderadas em formação geral, formação profissional e em Saúde Coletiva. A pesquisa analisou o desempenho pelas médias ponderadas em formação geral, formação profissional e saúde coletiva. A amostra do estudo consistiu de 30.289 estudantes, dos quais 876 vinculados ao Programa de Educação para o Trabalho em Saúde. Os alunos envolvidos com o Programa tiveram um desempenho superior em todos os segmentos, com diferença estatisticamente significativa (p <0,001) em comparação com aqueles que não participaram. Os resultados indicam que o Programa em questão tem potência para compreender a necessidade da formação no Sistema Único de Saúde, ao envolver conhecimentos de Saúde Coletiva e da área profissional, e deve ser elemento norteador da construção dos currículos dos cursos de Enfermagem.
A LITERATURA SOBRE METODOLOGIAS ATIVAS EM EDUCAÇÃO MÉDICA NO BRASIL: NOTAS PARA UMA REFLEXÃO CRÍTICA
Authors: França Junior Raimundo Rodrigues de , Maknamara Marlécio
Published: February 2019

Resumo Este trabalho parte da emergência de escolas médicas que fundamentam seus currículos nas metodologias ativas. Teve como objetivo realizar um mapeamento na Revista Brasileira de Educação Médica com base na produção científica sobre conexões entre formação médica e metodologias ativas. O levantamento bibliográfico incluiu 53 artigos, agrupados em quatro categorias de análise: análise comparativa entre modelos curriculares fundamentados no método tradicional e nas metodologias ativas; avaliação da mudança curricular baseada no uso das metodologias ativas; avaliação do desempenho discente com uso das metodologias ativas; e capacitação docente no contexto das metodologias ativas. Esses resultados apontam as metodologias ativas como propostas que podem dar respostas aos anseios de mudança curricular dos cursos de medicina no Brasil, ainda que não exista um consenso em relação à efe-tividade do seu uso nessa área. Todavia, um olhar mais detalhado sobre esses resultados nos permitiu concluir que esse processo, quando baseado apenas na mudança do método de ensino, pode apresenta lacunas e mostra não ser suficiente para mudança do perfil do egresso em medicina. Desse modo, recomendamos serem realizadas mais pesquisas nesse campo para melhor compreender os usos das metodologias ativas nas dinâmicas curriculares que fundamentam a educação médica no Brasil.
EVOLUÇÃO, DISTRIBUIÇÃO E EXPANSÃO DOS CURSOS DE MEDICINA NO BRASIL (1808-2018)
Authors: Oliveira Bruno Luciano Carneiro Alves de , Lima Sara Fiterman , Pereira Marina Uchoa Lopes , Pereira Júnior Gerson Alves
Published: February 2019

Resumo O estudo identificou o padrão de evolução, distribuição e expansão dos cursos de medicina no Brasil e descreveu os processos governamentais relacionados à ampliação da oferta de vagas. Trata-se de estudo descritivo, baseado em dados disponíveis no sistema do Ministério da Educação sobre escolas médicas. Com as informações sobre os cursos, desde os primeiros implantados, estabelecem-se seis períodos de governo para análise: de 1808 a 1963 (monarquia e governos republicanos iniciais), de 1964 a 1988 (governos militares - José Sarney), de 1989 a 1994 (Fernando Collor - Itamar Franco), de 1995 a 2002 (Fernando Henrique Cardoso), de 2003 a 2010 (Lula) e 2011 a 2018 (Dilma Rousseff - Michel Temer). Observou-se relevante expansão de escolas a partir dos governos militares, com pico em 2014 (Dilma Rousseff), frente à implementação do Programa Mais Médicos. Ao longo dos períodos analisados, o ensino médico tornou-se progressivamente privatizado e parcialmente deslocado para as Regiões Norte, Nordeste e Centro-Oeste e para cidades de médio e pequeno portes populacionais no interior dos estados. Os resultados apontam que a combinação de gestão governamental das políticas de saúde e educação e de desenvolvimento socioeconômico influenciaram a expansão dos cursos de medicina e as marcadas diferenças intra e interregionais.
PROGRAMA MAIS MÉDICOS E DIRETRIZES CURRICULARES NACIONAIS: AVANÇOS E FORTALECIMENTO DO SISTEMA DE SAÚDE
Authors: Oliveira Felipe Proenço de , Santos Leonor Maria Pacheco , Shimizu Helena Eri
Published: February 2019

Resumo Há iniciativas, em diversos países, de adequar a formação médica às necessidades dos sistemas de saúde. No Brasil, o Programa Mais Médicos introduziu as modificações mais recentes estabelecendo um novo marco regulatório na formação médica exposto nas novas Diretrizes Curriculares Nacionais, enfatizando o desenvolvimento de capacidades profissionais na atenção básica. Neste estudo, buscou-se analisar as representações sociais de estudantes de medicina sobre o trabalho na atenção básica no contexto de implantação das referidas diretrizes. Para tanto, 149 estudantes de medicina de cursos públicos ‘tradicionais’ e ‘novos’ da Região Nordeste responderam a um questionário sociodemográfico e a um roteiro de evocação livre no segundo semestre de 2017. Os resultados demonstram um perfil de estudantes correspondente à ‘primeira geração universitária’ nas escolas ‘novas’. Nestas escolas, as representações sociais dos estudantes de medicina são mais condizentes com as novas diretrizes, com destaque para a evocação de termos como ‘vínculo’, ‘responsabilidade’ e ‘comunidade’. Nas escolas ‘tradicionais’, os termos mais destacados foram ‘desvalorizado’ e ‘precariedade’, sugerindo uma vivência insuficiente destes estudantes na atenção básica. Espera-se que as experiências inovadoras analisadas possam ser multiplicadas e aprofundadas na radicalidade necessária para o fortalecimento do Sistema Único de Saúde em uma formação de acordo com as necessidades sociais.
O CUIDADO PARA PESSOAS COM HIV/AIDS SOB A ÓTICA DE AGENTES COMUNITÁRIOS DE SAÚDE
Authors: Garbin Cléa Adas Saliba , Sandre Amanda Santos de , Rovida Tânia Adas Saliba , Pacheco Karina Tonini dos Santos , Pacheco Filho Antonio Carlos , Garbin Artênio José Ísper
Published: February 2019

Resumo Este estudo buscou investigar a experiência de atuação dos agentes comunitários de saúde em relação aos indivíduos que vivem com HIV/Aids em áreas de risco social. Trata-se de uma pesquisa de natureza qualitativa, realizada no ano de 2015 com agentes comunitários atuantes em município de médio porte do estado de São Paulo, Brasil. A produção das narrativas foi realizada pelo método do grupo focal, interpretadas e analisadas por meio da análise temática de conteúdo. O preconceito apresentou-se como a principal causa das dificuldades de atuação dos agentes; porém, a criação do vínculo com os usuários, aliada à conquista da confiança, foi a principal potencialidade nas ações desses profissionais. Torna-se essencial o rompimento da barreira gerada pelo preconceito para uma efetiva atuação dos agentes comunitários de saúde nos territórios, para que possam colaborar com o acolhimento desses usuários e com a redução dos efeitos da vulnerabilidade existente.
PROJOVEM URBANO: A PRECARIZAÇÃO MASCARADA SOB O SIGNO DA FORMAÇÃO INICIAL PARA O TRABALHO SIMPLES
Authors: Gaspar Leandro
Published: February 2019

Resumo A primeira década do século XXI é particularmente importante para a educação brasileira por registrar o crescimento das políticas de governo direcionadas aos jovens e adultos trabalhadores. Especificamente, após a criação do Programa Nacional de Inclusão de Jovens (2005), a relação entre as políticas de governo e a educação profissional tornam-se parte da promessa integradora da educação hegemônica para a redução das desigualdades sociais. Nessa direção, o Projovem Urbano passa a instituir, em suas práticas pedagógicas, a formação inicial em um arco de ocupações para que os trabalhadores consigam responder às demandas da reestruturação produtiva, reduzindo, assim, a crise do desemprego. O objetivo deste estudo foi apreender a realidade concreta sobre a formação inicial para o trabalho, com base em um quadro categorial, composto por algumas experiências do Projovem Urbano. O resultado da pesquisa aponta na direção de que o signo da formação inicial tem servido para mascarar a precarização da qualificação profissional para o trabalho simples.
Unilateral hearing loss and the use of hearing aid: speech recognition, benefit, self-perception of functional performance and satisfaction
Authors: Costa Lidiéli Dalla , Santos Sinéia Neujahr dos , Costa Maristela Julio
Published: February 2019

ABSTRACT Purpose: to investigate speech recognition in silence and in noise in subjects with unilateral hearing loss with and without hearing aids, and to analyze the benefit, self-perception of functional performance, satisfaction and the use of hearing aids in these subjects. Methods: eleven adults with unilateral, mixed and sensorineural, mild to severe hearing loss participated in this study. Speech recognition was evaluated by the Brazilian Portuguese sentences lists test; functional performance of the hearing was assessed by using the Speech Spatial and Qualities of Hearing Scale questionnaire; satisfaction was assessed by the Satisfaction with Amplification in Daily Life questionnaire, both in Brazilian Portuguese; and to assess the use of hearing aids, the patient's report was analyzed. Results: the adaptation of hearing aids provided benefits in speech recognition in all positions evaluated, both in silence and in noise. The subjects did not report major limitations in communication activities with the use of hearing aids. They were satisfied with the use of sound amplification. Most of the subjects did not use hearing aids, effectively. The discontinuity of hearing aids use can be justified by the difficulty on perceiving participation’s restriction caused by hearing loss, as well as the benefit of the hearing aid, besides the concern with batteries’ costs and aesthetic aspects. Conclusion: although showing benefits in speech recognition, in silence and in noise, and satisfaction with sound amplification, most subjects with unilateral hearing loss do not effectively use hearing aids.
Orofacial myofunctional evaluation in cleft lip and palate: an integrative literature review
Authors: Graziani Andréia Fernandes , Berretin-Felix Giédre , Genaro Katia Flores
Published: February 2019

ABSTRACT Purpose: to identify the focus of scientific publications in the field of orofacial motricity in individuals with cleft lip and palate, as well as validated protocols used in speech and language evaluation. Methods: a study conducted using the following databases: Medline, SciELO, Lilacs and Google Scholar, through keywords including: cleft palate + cleft lip + evaluation + speech therapy + stomatognathic system + speech + phonation + chewing + swallowing + breathing + validation studies, in Portuguese and English. Results: a total of 572 articles that addressed the evaluation of the stomatognathic system was selected. The articles were published between 2012 and 2017, and examined for year of publication, subject area, focus, instrument used for evaluation, and type of study. Of these, 90 articles met the inclusion criteria, but only 5 used validated protocols. The greatest number of articles was published in 2014. The studies covered broad age groups, using subjective and objective methods, and instruments were often non-standardized. Conclusion: speech was the prevalent theme, while other orofacial functions were poorly investigated, demonstrating that studies with other approaches were lacking.
Relationship between dizziness and learning difficulties in schoolchildren: an integrative review
Authors: Silva Eliza Mikaele Tavares da , Barbosa Alexandre Lucas de Araújo , Mantello Erika Barioni , Azoni Cíntia Alves Salgado , Gazzola Juliana Maria
Published: February 2019

ABSTRACT Purpose: this study aims to verify the level of scientific evidence on the relationship between dizziness and academic achievement in childhood. Methods: the study was performed using the following search terms: dizziness, vertigo, child, learning, spelling, learning skills, academic skills, reading, and their correspondents in Portuguese in the following databases: PubMed, Scielo, LILACS and PsycINFO. Observational studies that examined the relationship between dizziness and academic achievement in childhood, published between 2007 and 2017, were included. Articles that did not allow access to the full text, and studies based on samples with motor, hearing, and cognitive disorders were excluded. Results: we initially found 315 articles and three met the established inclusion and exclusion criteria. These were scored according to the Newcastle-Ottawa Modified Scale with scores between 2 and 3 and as IIb according to the American Speech-Language Hearing Association levels of evidence and quality indicators. Conclusion: the results of this integrative review showed a low level of scientific evidence on the relationship between dizziness and academic achievement in childhood. It is important to emphasize the importance of improving study design to better understand their relationship, to allow provision of the best preventive, assessment, and intervention methods.
Prostitución y feminismo(s). Disputas por el reconocimiento en los Encuentros Nacionales de Mujeres (Argentina, 1986-2017)
Authors: Martynowskyj Estefanía
Published: February 2019

Resumen La “prostitución” es una de las grandes preocupaciones del feminismo, y la postura en relación a la misma ha polarizado a las feministas como casi ninguna otra cuestión. En Argentina, este debate tuvo como uno de sus primeros escenarios al Encuentro Nacional de Mujeres (ENM), que se realiza todos los años desde 1986, nucleando a miles de mujeres, algunas de las cuales se identifican en distintos grados con el feminismo -esto varía de año a año- y que por tres días discuten las problemáticas que consideran relevantes para el movimiento de mujeres. En este trabajo, estudio los cambios y las continuidades en los debates sobre “prostitución” en el ENM, prestando atención a cómo los mismos se relacionan, tanto con la mutación en las preocupaciones públicas nacionales, como con la variación de las reivindicaciones de los feminismos. Reflexiono sobre qué perspectivas sobre el sexo comercial han tenido (o no) lugar y qué feminidades se han construido como legítimas para reclamar derechos. El corpus de fuentes está compuesto por las nóminas de talleres y los libros de conclusiones de los 32º ENM, así como por los debates que han circulado en las redes sociales a raíz del pedido de la Asociación de Mujeres Meretrices de la Argentina por reincorporar el taller “Mujer y trabajo sexual” en el 31° ENM (2016); y por registros etnográficos de cuatro talleres sobre “prostitución” en los cuales he participado.
Una etnografía del aborto clandestino en contextos de interrupción legal del embarazo. Estudio de caso entre estudiantes de la Ciudad de México
Authors: Hernández-Rosete Daniel , Hipólito Rocío Estrada
Published: February 2019

Resumen En este artículo se analizan las creencias sobre embarazo juvenil y su relación con la decisión de interrumpir un embarazo no deseado de manera clandestina, a pesar de la existencia de la Interrupción Legal del Embarazo (ILE). Se trata de un estudio con enfoque fenomenológico, que explora los universos de sentido y significado, sustentado en observación etnográfica y en 32 entrevistas a estudiantes y a 3 profesores de un bachillerato en la Ciudad de México. Se encontró que la sexualidad es vivida en una dimensión culposa que afecta la dignidad y dificulta la toma de conciencia en materia de derechos sexuales y reproductivos. La laicidad sólo funciona como un ideal constitucional, ya que las creencias y prejuicios juegan un papel imprescindible en la creación de puntos de vista entre los estudiantes. Sin embargo, el aborto sigue siendo visto como un pecado pero, paradójicamente, supone prácticas de clandestinaje que ponen en riesgo la salud sexual y reproductiva de las jóvenes menores de edad, debido a inconsistencias legales.
A metamorfose de Adelina Gomes: gênero e sexualidade na psicologia analítica de Nise da Silveira
Authors: Magaldi Felipe
Published: February 2019

Resumo Este artigo trata do caso de Adelina Gomes (1916-1984), interna no antigo Centro Psiquiátrico Nacional do Engenho de Dentro, no Rio de Janeiro, entre 1937 e 1984, ano de seu falecimento. Adelina tornou-se conhecida pela produção de mais de 17.500 obras, entre pinturas e esculturas. Tal material pôde existir graças à atuação da psiquiatra alagoana Nise da Silveira (1905-1999), responsável pelo pioneirismo na implementação terapêutica de oficinas expressivas no hospital em questão. O caso clínico da paciente, tal como analisado por sua terapeuta, é utilizado para explorar o modo pelo qual os problemas de gênero e de sexualidade se imprimiam nas instituições psiquiátricas e nos saberes médico-psicológicos durante o século XX, com especial referência à psicologia analítica de C.G. Jung e sua apropriação por Nise da Silveira. A partir de análise de documentos bibliográficos, sustenta-se que esse saber, embora diferenciando-se da psicanálise freudiana e da medicina somática, opera a partir de uma naturalização em relação ao estatuto do feminino.