bluuebunny/crossref_metadata_2025 huggingface dataset:
Reference serving sizes for the Brazilian population: An analysis of processed food labels
Authors: Kliemann Nathalie , Veiros Marcela Boro , González-Chica David Alejandro , Proença Rossana Pacheco da Costa
Published: September 2014

OBJECTIVE: To compare serving sizes reported on processed food labels with reference serving sizes according to nutrition labeling legislation and the "Food Guide for the Brazilian Population". METHODS: This cross-sectional study analyzed the labels of 2,072 processed foods in a supermarket of Florianópolis, Santa Caratina, Brazil. The foods were classified according to the Brazilian food labeling legislation. Central tendency and variability values were calculated for the serving sizes and energy values reported on the labels, as well as the ratio between the reported and reference energy value. The Spearman correlation test was performed between the reference serving size and the reference energy density, and also between the reference serving size and energy density of each study food. RESULTS: Nutrition labeling and the Food Guide presented reference servings with different sizes and energy values. The serving sizes reported on the labels did not follow either of the references and presented heterogeneous values, with a maximum range of 55-240 g among ready and semi-ready pre-prepared dishes. The reported energy values were between 0.1 times smaller and 2.4 times larger than the reference values. The reference serving sizes presented a highly inverse correlation with the reference energy density (Spearman coefficient= 0.9) and a very low inverse correlation with the energy density of the foods analyzed (Spearman coefficient= 0.2). CONCLUSION: This study showed the need for standardizing reference serving size information for the Brazilian population as well as reviewing nutrition labeling legislation in order to standardize the serving sizes reported on labels and to update the reference energy density used to calculate serving sizes.
Co-ingestion of carbohydrate and pea protein does not enhance muscle recovery after strenuous exercise
Authors: Coutinho Leticia Azen Alves , Cerqueira Lucenildo Silva , Rodrigues André Valentim Siqueira , Porto Cristiana Pedrosa Melo , Pierucci Anna Paola Trindade Rocha
Published: September 2014

OBJECTIVE: To assess the influence of carbohydrate and added pea protein concentrate supplementation on muscle recovery after a military operation called Leader's Reaction Test. METHODS: Twenty-four soldiers from the Brazilian Army were divided into three equal groups (n=8). They received either carbohydrate (0.8.g/kg body weight/h), carbohydrate+carbohydrate (1.0.g/kg body weight/h), or carbohydrate+protein (0.8 g/kg body weight/h of carbohydrate + 0.2 g/kg body weight/h of protein), immediately, 60, and 120 minutes after the Leader’s Reaction Test. Prior, immediately after and 24 hours after the Leader’s Reaction Test, maximal isometric strength and body composition were assessed. Blood samples were also collected for later analysis of concentrations of lactate dehydrogenase and creatine kinase. RESULTS: Twenty-four hours after the Leader's Reaction Test, maximal creatine kinase levels were significantly lower than its levels immediately after (501.00 ± 422.09 versus 275.29 ± 242.08 U/L (carbohydrate); 616.88 ± 291.45 versus 334.57 ± 191.61 U/L (carbohydrate+carbohydrate); and 636.75 ± 340.67 versus 382.88 ± 234.42 U/L (carbohydrate+protein), p=0.004). The maximal isometric strength and lactate dehydrogenase levels were not significantly different during the time trials. CONCLUSION: The present findings suggest that carbohydrate+protein co-ingestion did not improve the recovery of muscle function nor did it attenuate post-exercise muscle damage markers over carbohydrate alone.
Análise do SICK Scapula em jogadores de handebol com e sem dor no ombro durante o arremesso
Authors: Almeida Gabriel Peixoto Leão , Silveira Paula Fiquetti , Rosseto Nathália Polisello , Barbosa Gisele , Ejnisman Benno , Cohen Moisés
Published: September 2014

INTRODUÇÃO: A discinesia escapular é definida como uma alteração da posição escapular, tanto dinâmica quanto estática, resultante de desequilíbrios da musculatura periescapular secundários à fadiga, trauma ou lesão neurológica. O SICK Scapula avalia e caracteriza as alterações escapulares estaticamente, variando de 0 a 20 pontos (0 = melhor possível). No exame, a escápula é avaliada em três aspectos: dor objetiva, dor subjetiva e mau posicionamento escapular.OBJETIVO: Comparar o SICK Scapula entre jogadores de handebol sintomáticos e assintomáticos.MÉTODOS: A amostra foi composta por 57 atletas de handebol divididos em dois grupos, de acordo com a presença de dor no ombro: grupo assintomático (GA) (N = 27) e grupo sintomático (GS) (N = 30). O SICK Scapulafoi avaliado entre os atletas, tanto em relação à sua pontuação final como às subescalas. O GS apresentou maior pontuação no SICK Scapula em relação ao GA (8 ± 2,3 vs 2,7 ± 1,8; p<0,001).RESULTADOS: Nas subescalas, os GA e GS também apresentaram diferenças significantes quanto à dor subjetiva (0 vs. 1,73 ± 0,83; p < 0,001), dor objetiva (0,41 ± 0,64 vs. 2,5 ±0,86; p < 0,001) e mau posicionamento escapular (2,3 ± 1,9 vs. 3,7 ± 1,5; p = 0,002).CONCLUSÃO: Os atletas de handebol com dor relacionada ao arremesso apresentam maior pontuação com relação à dor e às alterações de posicionamento escapular, segundo avaliação pelo SICK Scapula, em comparação com os que não apresentam sintomatologia.
Saúde mental e fatores associados em atletas durante os jogos abertos de Santa Catarina
Authors: Brandt Ricardo , Liz Carla Maria de , Crocetta Tânia Brusque , Arab Claudia , Bevilacqua Guilherme , Dominski Fabio Heck , Vilarino Guilherme Torres , Andrade Alexandro
Published: September 2014

INTRODUÇÃO: A saúde mental de atletas pode predizer seu desempenho esportivo e comportamental, o que a torna um importante objeto de estudo.OBJETIVO: Investigar a saúde mental e fatores associados em atletas que participaram dos Jogos Abertos de Santa Catarina 2011, Brasil.MÉTODOS: A amostra foi composta por 445 atletas participantes da competição (211 homens e 234 mulheres). Para a coleta de dados foi utilizado o questionário de caracterização e a escala de humor de Brunel. Os dados foram coletados individualmente no local da competição entre 30 e 50 minutos antes dos atletas competirem. Os dados foram analisados por estatística descritiva (média, frequência e percentual) e inferencial (Kruskal-Wallis, Mann-Withney e correlação de Spearman com α estabelecido de 0,05).RESULTADOS: Os atletas competiram em 10 diferentes modalidades, coletivas e individuais. A maioria dos atletas cursa ou cursou o ensino médio ou superior, com mais de sete anos de tempo de prática e participação em competições nacionais e estaduais. Grande parte dos atletas teve percepção de qualidade de descanso e sono entre boa e regular durante a competição. De maneira geral, os atletas apresentaram boa saúde mental, com perfil semelhante ao de iceberg (elevado vigor, níveis moderados de tensão e baixa fadiga, depressão, raiva e confusão mental). Os atletas com melhor percepção de sono e saúde que não fazem uso de medicamentos reguladores de humor apresentam melhor saúde mental.CONCLUSÃO: Torna-se evidente a boa qualidade de saúde entre os atletas participantes do estudo, destacando-se um cuidado especial com relação às implicações da qualidade do sono e o uso de medicamentos reguladores de humor na saúde mental dos atletas.
Associação entre o nível de atividade física e a área de gordura visceral em mulheres pós-menopáusicas
Authors: Pitanga Cristiano Penas Seara , Pitanga Francisco José Gondim , Gabriel Ronaldo Eugénio Calçada Dias , Moreira Maria Helena Rodrigues
Published: September 2014

INTRODUÇÃO: O aumento da gordura visceral abdominal está associado à redução dos níveis de atividade física habitual e gera na mulher pós-menopáusica, o surgimento da doença da inatividade física, caracterizada pela manifestação de um conjunto de patologias, entre as quais se incluem diabetes mellitus do tipo 2 e doenças cardiovasculares. Por outro lado, a atividade física regular parece ter impacto significativo na prevenção tanto da gordura intra-abdominal quanto das complicações metabólicas e cardiovasculares.OBJETIVO: Verificar a associação entre a caminhada e a atividade física de moderada intensidade com a área de gordura intra-abdominal em mulheres pós-menopáusicas.MÉTODOS: A amostra foi composta por 239 mulheres com média de idade de 57,4 ± 6,6 anos participantes do programa "Menopausa em Forma". Para análise da atividade física foi utilizado o IPAQ versão longa. Consideraram-se os valores de 1.601 kcal/semana na caminhada e 2.283 kcal/semana na atividade física de moderada intensidade como suficientes para prevenção do excesso de gordura intra-abdominal. Utilizou-se a análise de regressão logística para estimar a odds ratio (OR), com intervalo de confiança de 95%.RESULTADOS: Após análise multivariada observou-se que a caminhada ofereceu proteção contra o excesso de gordura intra-abdominal, principalmente nas mulheres com períodos menstruais regulares, OR = 0,22 (0,08-0,62) e que não fazem reposição hormonal, OR = 0,05 (0,01-0,49). Já o nível de atividade física de intensidade moderada ofereceu proteção contra a gordura intra-abdominal independentemente da reposição hormonal ou dos períodos menstruais regulares, OR = 0,37 (0,14-0,66).CONCLUSÃO: A caminhada e principalmente o nível de atividade física de moderada intensidade podem ser importantes para prevenção do excesso de gordura intra-abdominal e suas complicações metabólicas e cardiovasculares em mulheres pós-menopaúsicas.
Integrando empresas e cooperativas de catadores em fluxos reversos de resíduos sólidos pós-consumo: o caso Vira-Lata
Authors: Demajorovic Jacques , Caires Elisangela Ferreira , Gonçalves Laudicéia Nunes da Silva , Silva Maria Janielly da Costa
Published: September 2014

A Política Nacional de Resíduos Sólidos, aprovada em 2010, reconhece o trabalho dos catadores de materiais recicláveis, organizados como atores fundamentais da cadeia de reciclagem brasileira. Exige também que diversos setores empresariais implementem programas de logística reversa voltados a seus resíduos pós-consumo, privilegiando a integração das cooperativas de catadores nesse processo. No entanto, o pequeno interesse das empresas em gerenciar programas de logística reversa e dificuldades para integrar empresas e cooperativas desafiam a concretização desses objetivos. Esta pesquisa analisa os desafios e as perspectivas para o desenvolvimento dessas iniciativas. A estratégia de pesquisa escolhida foi a realização de um estudo de caso na Cooperativa Vira-Lata, com foco nas ações desenvolvidas pela organização com três empresas. Os resultados mostram que a integração de empresas e cooperativas tem o potencial de viabilizar fluxos reversos e gerar benefícios econômicos e socioambientais, principalmente quando há integração entre empresas, cooperativas e o poder público. Desafios como a melhoria de processos de gestão organizacional e de sistemas de informação das cooperativas, assim como dificuldades para engajar outros fornecedores da cadeia reversa, também foram identificados.
Transparência e legitimação de objetivos institucionais em empresas estatais: um estudo de caso sobre a Petrobras
Authors: Barbalho Fernando Almeida , Medeiros Janann Joslin
Published: September 2014

Este trabalho objetiva determinar até que ponto os objetivos estratégicos duplos das empresas estatais (financeiros e sociais) são legítimos e se refletem nas práticas de governança corporativa, responsabilidade social e transparência dessas empresas. O artigo evidencia que é legítimo as estatais perseguirem simultaneamente um duplo objetivo institucional que atende a várias responsabilidades corporativas. Através de análise das informações disponibilizadas em três portais da Petrobras, procurou-se identificar práticas de transparência e sua associação tanto com os mecanismos isomórficos relacionados ao processo de legitimação, quanto com o alcance dos duplos objetivos institucionais. Achados revelam que informações providas nos portais estão alinhadas a ambos tipos de objetivos institucionais, que as práticas de transparência atendem a pressões isomórficas coercitivas, normativas e miméticas, e que o perfil de pressões isomórficas atendidas se diferencia de acordo com o tipo de responsabilidade social e o público pretendido.O trabalho indica ainda que ameaças às práticas de transparência e à própria legitimidade podem vir de novas exigências de stakeholders, talvez a partir de novas possibilidades do uso de dados abertos disponibilizados nos portais.
Valores relativos à competição organizacional e ação comunicativa: um novo olhar sobre o fazer organizacional
Authors: Domenico Silvia Marcia Russi De , Teixeira Maria Luisa Mendes
Published: September 2014

As organizações agem em seu cotidiano por meio de seus stakeholders, que se relacionam em interações mediadas por linguagem de forma estratégica ou comunicativa. Um dos aspectos que subjazem às ações de entidades sociais são valores. Definimos valores relativos à competição organizacional (VRCOs) como crenças socialmente construídas, com significado para um indivíduo ou grupo, que orientam as ações sociais entre stakeholders. Este estudo visou a compreender como os VRCOs se reproduzem nas interações entre pessoas que agem como stakeholders em organizações atuantes em economia de mercado. O estudo foi desenvolvido segundo a abordagem de comensurabilidade paradigmática parcial entre o interacionismo simbólico e a teoria da ação comunicativa. Configurando-se como um estudo de caso, de natureza exploratório-descritivo-explicativa, foi realizado em uma das maiores empresas coligadas ao projeto Economia de Comunhão na liberdade (EdC), no Brasil. Os dados foram coletados mediante entrevistas, observação participante, conversas espontâneas, por meio de documentos e pela análise e interpretação dos resultados, inspiradas na pragmática e na hermenêutica. Vis-à-vis o recorte teórico, os resultados sugerem os valores relativos à competição organizacional como fruto da busca de equilíbrio dinâmico entre as visões de mundo do fundador - do mundo "como deveria ser" e "como ele é" - e as necessidades da organização, ora privilegiando ações estratégicas, ora baseadas em entendimento. Os VRCOs foram definidos em função de diferentes stakeholders e, ao mesmo tempo em que são produzidos nas interações, reproduzem os aspectos culturais das sociedades das quais os stakeholders fazem parte.
Immunohistochemical evaluation of proliferation, apoptosis and steroidogenic enzymes in the ovary of rats with polycystic ovary
Authors: Lombardi Leonardo Augusto , Simões Ricardo Santos , Maganhin Carla Cristina , Baracat Maria Cândida Pinheiro , Silva-Sasso Gisela Rodrigues , Florencio-Silva Rinaldo , Soares Jr José Maria , Baracat Edmund Chada
Published: September 2014

Objective: to evaluate the immunohistochemical expression of proliferative, apoptotic and steroidogenic enzyme markers in the ovaries of rats with polycystic ovary syndrome (PCOS). Methods: twenty rats were divided into two groups: GCtrl - estrous phase, and PCOS - with polycystic ovaries. The GCtrl animals were subjected to a lighting period from 7 am to 7 pm, while the animals with PCOS group remained with continuous lighting for 60 days. Subsequently, the animals were anesthetized, the ovaries were removed and fixed in 10% formaldehyde, prior to paraffin embedding. Sections were stained using H.E. or subjected to immunohistochemical methods for the detection of Ki-67, cleaved caspase-3, CYP11A1, CYP17A1 and CYP19A1. The results were analyzed using Student's t-test (p < 0,05). Results: morphological results showed evidence of interstitial cells originating from the inner theca cells of degenerating ovarian cysts in PCOS. Immunoexpression of Ki-67 was higher in the granulosa cells in GCtrl, and the theca interna cells in PCOS, while cleaved caspase-3 was higher in granulosa cells of ovarian cysts from PCOS and in the theca interna cells of GCtrl. Immunoreactivity of CYP11A1 in the theca interna, granulosa and interstitial cells was similar between the two groups, while CYP17A1 and CYP19A1 were higher in the granulosa and interstitial cells in the PCOS group. Conclusion: the results indicate that the interstitial cells are derived from the theca interna and that enzymatic changes occur in the theca interna and interstitial cells in ovaries of rats with PCOS, responsible for the high levels of androgens and estradiol.
Helicobacter pylori infection and gastrointestinal symptoms on Chilean pregnant women
Authors: Poveda Gina Ferrer , Carrillo Katia Sáez , Monje Marcela Espinoza , Cruz Carlos Alvarez , Cancino Apolinaria García
Published: September 2014

Objective: the aim of this research was to determine the prevalence of Helicobacter pylori infection on Chilean pregnant women and its relationship with the appearance and severity of hyperemesis and dyspepsia. Methods: quantitative study of prevalence in a transversal cut with variable analysis. The sample was taken from 274 Chilean pregnant women from the Bío Bío province through vein puncture between June and December, 2005. Pregnant women were informed of this study, interviewed and signed an informed consent. The samples were processed using ImmunoComb II Helicobacter pylori IgG kit. Statistical analysis was performed by means of the Statistical Package for Social Sciences (SPSS) Program. Results: out of the total number of pregnant women, 68.6% showed infection by Helicobacter pylori. 79.6% of the total sample had symptoms of dyspepsia, and 72.5% of this group presented Helicobacter pylori infection. 12.4% showed pregnancy hyperemesis; among them, 79.4% were infected with Helicobacter pylori. 73.4% of the pregnant women that showed gastric discomfort during the first three months had Helicobacter pylori infection. 53.7% of them continued with gastric discomfort after the first three months; of those, 95.8% were infected. Helicobacter pylori infection was present only in 1.5% of pregnant women without gastric discomfort. Conclusion: both, gastric discomfort of pregnant women and the continuity of severe symptoms of dyspepsia and hyperemesis after the first three months of gestation are significantly correlated with Helicobacter pylori infection.
Prevalence and factors associated with dyslipidemia after liver transplantation
Authors: Ribeiro Hélem de Sena , Anastácio Lucilene Rezende , Ferreira Lívia Garcia , Lagares Érika Barbosa , Lima Agnaldo Soares , Correia Maria Isabel Toulson Davisson
Published: September 2014

Objective: to determine the prevalence of abnormal total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides in patients undergoing liver transplantation (LTx) and to identify predictors of these disorders. Methods: cross-sectional study to assess the prevalence of dyslipidemia in patients undergoing LTx. Demographic, socioeconomic, clinical, anthropometric and dietetic data were collected to determine the association with dyslipidemia using univariate and multivariate statistical analysis. Results: 136 patients were evaluated, 68.1% of which had at least one type of dyslipidemia. The triglyceride level was high in 32.4% of cases, with low HDL in 49.3% of patients and high LDL levels in only 8.8%. High total cholesterol was observed in 16.2% of the study population and was associated with the recommendation for transplantation due to ethanolic cirrhosis (OR = 2.7) and a greater number of hours slept per night (OR = 1.5). Conclusion: many patients presented dyslipidemia after transplantation, demonstrating the need for interventions in relation to modifiable factors associated with dyslipidemias that can mitigate or prevent these disorders.
Comparison of APACHE II and three abbreviated APACHE II scores for predicting outcome among emergency trauma patients
Authors: Polita Jorge Roberto , Gomez Jussara , Friedman Gilberto , Ribeiro Sérgio Pinto
Published: September 2014

Objective: to compare the ability of the APACHE II score and three different abbreviated APACHE II scores: simplified APACHE II (s-APACHE II), Rapid Acute Physiology score (RAPS) and Rapid Emergency Medicine score to evaluate in-hospital mortality of trauma patients at the emergency department (ED). Methods: retrospective analysis of a prospective cohort study. All patients' victims of trauma admitted to the ED, during a 5 months period. For all entries to the ED, APACHE II score was calculated. APACHE II system was abbreviated by excluding the laboratory data to calculate s-APACHE II score for each patient. Individual data were reanalyzed to calculate RAPS and REMS. APACHE II score and its subcomponents were collected, and in-hospital mortality was assessed. The area under the receiver operating characteristic (AUROC) curve was used to determine the predictive value of each score. Results: 163 patients were analyzed. In-hospital mortality rate was 10.4%. s-APACHE II, RAPS and REMS scores were correlated with APACHE II score (r2= 0.96, r2= 0.82, r2= 0.92; p < 0.0001). Scores had similar accuracy in predicting mortality ([AUROC 0.777 [95% CI 0.705 to 0.838] for APACHE II, AUROC 0.788 [95% CI 0.717 to 0.848] for s-APACHE II, AUROC 0.806 [95% CI 0.737 to 0.864] for RAPS, AUROC 0.761 [95% CI 0.688 to 0.824] for REMS. Conclusion: abbreviated APACHE II scores have similar ability to evaluate in-hospital mortality of emergency trauma patients in comparison to APACHE II score.
Process of speech acquisition and development of autistic children with or without autistic regression
Authors: Tamanaha Ana Carina , Machado Gislaine Mara Guerra , Loebmann Carla , Perissinoto Jacy
Published: September 2014

PURPOSE: To compare the trajectory of acquisition speech and development of autistic children with or without autistic regression.METHODS: The sample consisted of 64 children, aged 3-10 years, of both genders, diagnosed by a multidisciplinary team with autism. In the analysis were investigated during the interview: mention whether or not the episode regression speech reported by parents; number of words produced in a minimum period of three months prior to detection of regression; mention whether or not the episode regression social behaviors concomitant arrest in speech, verbal and production at three years of age. We adopted a significance level of 5% for statistical analysis.RESULTS: Thirty one percent of children had speech regression. These, 100% showed regression of social behaviors. Mean words produced before the detection regression were five. The groups did not show difference on the period of acquisition and development of speech.CONCLUSIONS: It was possible to compare the trajectory speech development of children with or without regression. And we did not find that the children affected by autistic regression period show more positive clinical outcome in relation to the production of speech.
Voice symptoms and vocal deviation self-assessment in different types of dysphonia
Authors: Moreti Felipe , Zambon Fabiana , Behlau Mara
Published: September 2014

PURPOSE: To identify the relationship among the type of dysphonia, vocal deviation self-assessed and the presence of voice symptoms in adults.METHODS: One hundred sixty-four subjects of both genders (58 males and 106 females, mean age 42.89 years) diagnosis of dysphonia, divided into three groups according to the type of dysphonia: 87 individuals with functional dysphonia, 35 individuals with organofunctional dysphonia and 42 individuals with organic dysphonia, answered the Brazilian validated version of Voice Symptom Scale (VoiSS) (Escala de Sintomas Vocais - ESV), that consists of 30 questions with four scores: Impairment, Emotional, Physical and Total, and self-assessed their voices as excellent, very good, good, fair or poor.RESULTS: According to the dysphonia type, there were differences in ESVImpairment, Emotional and Total mean scores, which was not found in the Physical score. The Impairment, Emotional and Total mean scores were higher in organic dysphonia, followed by organofunctional dysphonia and finally functional dysphonia. When the vocal self-assessment is poor, the higher are the deviations in the Impairment, Emotional and Total ESV scores.CONCLUSIONS: Individuals with organic dysphonia reported higher perception of voice symptoms, followed by subjects with organofunctional dysphonia and finally individuals with functional dysphonia. In general, individuals with dysphonia presented physical voice symptoms, regardless of the type of the dysphonia. Finally, there are direct correlations between Impairment, Emotional and Total ESV scores and the vocal self-assessment.
Early lexical and phonological acquisition and its relationships
Authors: Wiethan Fernanda Marafiga , Nóro Letícia Arruda , Mota Helena Bolli
Published: September 2014

PURPOSE: Verifying likely relationships between lexical and phonological development of children aged between 1 year to 1 year, 11 months and 29 days, who were enrolled in public kindergarten schools of Santa Maria (RS).METHODS: The sample consisted of 18 children of both genders, with typical language development and aged between 1 year to 1 year, 11 months and 29 days, separated in three age subgroups. Visual recordings of spontaneous speech of each child were collected and then lexical analysis regarding the types of the said lexical items and phonological assessment were performed. The number of sounds acquired and partially acquired were counted together, and the 19 sounds and two allophones of Brazilian Portuguese were considered. To the statistical analysis, the tests of Kruskal-Wallis and Wilcoxon were used, with significance level of p<0.05.RESULTS: When compared the means relating to the acquired sounds and mean of the acquired and partially acquired sounds percentages, there was difference between the first and the second age subgroup, and between the first and the third subgroup. In the comparison of the said lexical items means among the age subgroups, there was difference between the first and the second subgroup, and between the first and the third subgroup again. In the comparison between the said lexical items and acquired and partially acquired sounds in each age subgroup, there was difference only in the age subgroup of 1 year and 8 months to 1 year, 11 months and 29 days, in which the sounds highlighted.CONCLUSION: The phonological and lexical domains develop as a growing process and influence each other. The Phonology has a little advantage.
Brachial index does not reflect upper extremity functionality following surgery for vascular trauma
Authors: Simsek Erdal , Karapinar Kasim , Ince Ilker , Ulus Ahmet Tulga
Published: September 2014

OBJECTIVES: Vascular injuries to the upper extremities requiring surgical repair are common after accidents. However, neither postoperative functionality nor hemodynamic status of the extremity are routinely described. We evaluated the postoperative functional and hemodynamic status of patients with vascular traumas in the upper extremities. METHODS: 26 patients who suffered penetrating vascular traumas in the upper extremities from November 2008 to December 2011 were retrospectively evaluated. Data on first approach, surgical technique employed and early postoperative outcomes were recorded. Further data on the post-discharge period, including clinical functional status of the arm, Doppler ultrasonography and brachial-brachial index were also evaluated. RESULTS: Average follow up was 33.5±10.8 months. Right (1.05±0.09) and left (1.04±0.08) brachial indexes were measured during follow up,. Doppler ultrasonography showed arterial occlusion in 4 patients (15%). Near-normal brachial-brachial indexes was observed in all four of these patients with occlusion of one of the upper extremity arteries, even though they exhibited limited arm function for daily work. CONCLUSIONS: Evaluation of the postoperative outcomes of this small series of patients with penetrating vascular traumas in the upper extremity revealed that 15% of them suffered occlusion of one artery of the upper extremity. Artery occlusion did not correlate with brachial-brachial Doppler index, probably due to rich collateral circulation, but occlusion was associated with an extremity that was dysfunctional for the purposes of daily work. The result of the brachial-brachial index does not therefore correlate with functionality.
The impact of carotid revascularization on cognitive function
Authors: Oliveira Germano da Paz , Guillaumon Ana Terezinha , Brito Iran Batista de , Lima Joana Mayra Teixeira , Benvindo Sérgio Clementino , Cendes Fernando
Published: September 2014

The concept that carotid disease may compromise cognitive function was initially proposed by Fisher in 1951, based on an autopsy case. However, some topics involving cognitive function remain controversial, such as its correlation with carotid obstructive disease. So, the authors of this review evaluate the impact of carotid revascularization on cognitive function and the repercussions of the revascularization technique (carotid stenting vs. endarterectomy) chosen. It was clear from the literature reviewed that carotid stenosis is related to a decline in cognitive function over time. However, controversy still remains over the impact of carotid revascularization on cognitive function. With elation to the technique employed (carotid stenting vs. endarterectomy), the majority of studies found no difference between the two techniques in terms of overall cognitive outcome.
Pulmonary embolism and stroke associated with mechanical thrombectomy
Authors: Bastianetto Paulo , Pinto Daniel Mendes
Published: September 2014

Mechanical thrombectomy offers the advantage of rapid removal of venous thrombi. It allows venous obstructions to be removed and requires shorter duration of infusion of thrombolytic agents. However, aspiration of thrombi can lead to complications, particularly pulmonary embolism and hemolysis. The validity of using vena cava filters during thrombectomy in order to avoid embolism has not yet been established. The authors report a case of massive pulmonary embolism associated with ischemic stroke in a patient with a hitherto undiagnosed patent foramen ovale. The patient developed respiratory failure and neurological deficit after thrombectomy. This case raise questions about the value of the thrombectomy for the treatment of proximal vein thrombosis due to the risks of this procedure. The authors also discuss the need for vena cava filters and ruling out a patent foramen ovale in patients undergoing thrombectomy.
Avaliação da limpeza de unidade do paciente em hospitais do interior do estado de São Paulo
Authors: Andrade Denise de , Santos Branca Maria de Oliveira , Bispo Adriana Serafim
Published: September 2014

Este estudo objetiva avaliar o procedimento da limpeza de unidade do paciente assim como detectar, apontar e alertar sobre as possíveis falhas nesse processo de limpeza. Os resultados obtidos por entrevistas com os enfermeiros responsáveis pelo Serviço de Enfermagem revelam que o procedimento realizado nos hospitais em estudo não vem atendendo às normas preconizadas pela literatura o que acarreta um produto final com pouca confiabilidade do ponto de vista da desinfecção.
Integração interdisciplinar no ensinar e aprender enfermagem: relato de uma experiência
Authors: Utyama Iwa Keiko Aida , Macedo Gilka Gouveia Carvalho , Janene Sonia Maria Andrade De , Mussi Nair Miyamoto
Published: September 2014

Em 1996, um grupo de docentes das áreas de Imunologia, Histologia, Nutrição, Patologia e Fundamentos de Enfermagem, iniciou o Projeto de Ensino junto ao Programa de Apoio a Projetos Integrados de Ensino e Serviços de Saúde (PAPIENS), no Curso de Enfermagem da Universidade Estadual de Londrina. Este Programa está inserido no Projeto UNI subsidiado pela Fundação Kelloggs, que tem possibilitado inovações no processo ensino-aprendizagem e mudanças curriculares nos cursos da área de Saúde desta Universidade. Este Projeto tem como conteúdo integrador o tema Feridas e como objetivo principal propiciar ao aluno a construção deste conhecimento através da articulação e integração das diferentes áreas envolvidas, partindo da observação da prática dos pacientes portadores de feridas, para a busca do conhecimento. Concluise que o Projeto tem facilitado a aprendizagem dos alunos, além de preparar os professores para o desafio do Currículo Integrado do Curso de Enfermagem a ser implantado no ano 2,000.
"...E a luz está se apagando..." vivências de uma criança com câncer em fase terminal
Authors: Melo Luciana de Lione , Valle Elizabeth Ranier Martins do
Published: September 2014

A criança com possibilidades de vir a morrer defronta-se com a morte de maneira muito particular, pois a esperança que até então se mantinha, modifica-se com o impacto da realidade, reativando sentimentos iniciais de desesperança e dor pela separação das pessoas amadas. O objetivo deste estudo é o acompanhamento de uma criança em fase terminal, utilizando-se como trajetória, o referencial fenomenológico. Foram feitos doze acompanhamentos com uma criança com câncer hospitalizada, em fase terminal, onde a mesma pode expressar situações significativas em seu processo de viver, bem como revelar, com grande intensidade, vários medos, como de morrer, de ficar só, de deixar pessoas queridas, dentre outros. Diante disto, mostra-se para nós, a necessidade de preocupar-nos com questões ligadas às emoções e sentimentos desta criança que caminha inexoravelmente para a morte, atentando para os possíveis modos de ajuda.
Maternidade segura: relato de experiência de uma nova prática em Natal/RN - Brasil
Authors: Davim Rejane Marie Barbosa , Nascimento Maria Lúcia Costa do , Liberalino Francisca Nazaré
Published: September 2014

Trabalho descritivo do tipo relato de experiência, desenvolvido na Maternidade Escola Januário Cicco da Universidade Federal do Rio Grande do Norte (MEJC/UFRN) em Natal/RN desde 1996, onde cinco enfermeiras iniciaram mudanças em suas práticas profissionais a partir da implantação do Projeto de "Curso de Especialização em Enfermagem Obstétrica - Habilidades de Enfermagem Midwifery para uma Maternidade Segura." O Projeto tem como objetivos, diminuir ou eliminar riscos às mulheres que desejam engravidar e/ou ter filhos e garantir uma assistência humanizada durante a gravidez, trabalho de parto, parto, pós-parto e nascimento. Estes objetivos deverão ser alcançados através de profissionais mais conscientes que lidam com o complexo de valores, decisões e ações, envolvendo o processo saúde/doença relacionados à mulher no ciclo grávido puerperal. Foram criados Padrões de Qualidade na Assistência à Admissão, Trabalho de Parto, Parto, Pós-Parto, Recém-Nascido e Visita Domiciliar de até 1 mês de vida. Desde sua implantação, o Projeto já vislumbra algumas mudanças no serviço, na participação ativa do enfermeiro no processo do nascimento, proporcionando, fundamentalmente, satisfação à parturiente e aos profissionais envolvidos nesse Projeto.
Assistência de enfermagem: percepção da pessoa cega - reflexão sobre ética e solidariedade
Authors: Costa Eugênia Maria , Castro Danniely Nascimento , Pagliuca Lorita Marlena Freitag
Published: September 2014

Enfrentar um internamento hospitalar não é tarefa fácil e quando o paciente é uma pessoa cega, torna-se ainda mais complexo, pois a falta de visão retarda sua adaptação. A equipe de enfermagem, como lida constantemente com o paciente, precisa oferecer apoio nesse momento de crise, e o profissional enfermeiro, como chefe da equipe de enfermagem, precisa estar capacitado para intervir. Este trabalho é um estudo de caso onde pretendeu-se refletir sobre a assistência prestada pela equipe de enfermagem e a atuação do enfermeiro junto a uma paciente cega durante um internamento hospitalar. A análise qualitativa dos dados baseou-se no modelo de categorias temáticas. Os achados mostraram que a experiência de hospitalização da deficiente visual contemplou as temáticas comunicação, assistência de enfermagem, ética, direito a saúde e deficiência visual.
Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes
Authors: França Elisabeth , Teixeira Renato , Ishitani Lenice , Duncan Bruce Bartholow , Cortez-Escalante Juan José , Morais Neto Otaliba Libânio de , Szwarcwald Célia Landman
Published: September 2014

OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes.METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes.RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights.CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore, the redistribution of the remaining ill-defined causes based on the investigation allows for more appropriate estimates of the mortality risk due to specific causes.
Gender differences in social support and leisure-time physical activity
Authors: Oliveira Aldair J , Lopes Claudia S , Rostila Mikael , Werneck Guilherme Loureiro , Griep Rosane Härter , Leon Antônio Carlos Monteiro Ponce de , Faerstein Eduardo
Published: September 2014

OBJECTIVE To identify gender differences in social support dimensions’ effect on adults’ leisure-time physical activity maintenance, type, and time.METHODS Longitudinal study of 1,278 non-faculty public employees at a university in Rio de Janeiro, RJ, Southeastern Brazil. Physical activity was evaluated using a dichotomous question with a two-week reference period, and further questions concerning leisure-time physical activity type (individual or group) and time spent on the activity. Social support was measured with the Medical Outcomes Study Social Support Scale. For the analysis, logistic regression models were adjusted separately by gender.RESULTS A multinomial logistic regression showed an association between material support and individual activities among women (OR = 2.76; 95%CI 1.2;6.5). Affective support was associated with time spent on leisure-time physical activity only among men (OR = 1.80; 95%CI 1.1;3.2).CONCLUSIONS All dimensions of social support that were examined influenced either the type of, or the time spent on, leisure-time physical activity. In some social support dimensions, the associations detected varied by gender. Future studies should attempt to elucidate the mechanisms involved in these gender differences.
Federalism and health policy: the intergovernmental committees in Brazil
Authors: Machado Cristiani Vieira , Lima Luciana Dias de , Viana Ana Luiza d'Ávila , Oliveira Roberta Gondim de , Iozzi Fabíola Lana , Albuquerque Mariana Vercesi de , Scatena João Henrique Gurtler , Mello Guilherme Arantes , Pereira Adelyne Maria Mendes , Coelho Ana Paula Santana
Published: September 2014

OBJECTIVE To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states.METHODS The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i) level of institutionality, classified as advanced, intermediate, or incipient; (ii) agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii) political processes, considering the character and scope of intergovernmental relations; and (iv) capacity of operation, assessed as high, moderate, or low.RESULTS Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees’ ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast.CONCLUSIONS The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system) in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes. The creation of federal investments, varied by regions and states, is critical in overcoming the structural inequalities that affect political institutions. The operation of Bipartite Committees is a step forward; however, strengthening their ability to coordinate health care is crucial in the regional organization of the health care system in the Brazilian states.
Factors associated to breastfeeding in the first hour of life: systematic review
Authors: Esteves Tania Maria Brasil , Daumas Regina Paiva , Oliveira Maria Inês Couto de , Andrade Carlos Augusto de Ferreira de , Leite Iuri Costa
Published: September 2014

OBJECTIVE To identify independent risk factors for non-breastfeeding within the first hour of life.METHODS A systematic review of Medline, LILACS, Scopus, and Web of Science electronic databases, till August 30, 2013, was performed without restrictions on language or date of publishing. Studies that used regression models and provided adjusted measures of association were included. Studies in which the regression model was not specified or those based on specific populations regarding age or the presence of morbidities were excluded.RESULTS The search resulted in 155 articles, from which 18 met the inclusion criteria. These were conducted in Asia (9), Africa (5), and South America (4), between 1999 and 2013. The prevalence of breastfeeding within the first hour of life ranged from 11.4%, in a province of Saudi Arabia, to 83.3% in Sri Lanka. Cesarean delivery was the most consistent risk factor for non-breastfeeding within the first hour of life. “Low family income”, “maternal age less than 25 years”, “low maternal education”, “no prenatal visit”, “home delivery”, “no prenatal guidance on breastfeeding” and “preterm birth” were reported as risk factors in at least two studies.CONCLUSIONS Besides the hospital routines, indicators for low socioeconomic status and poor access to health services were also identified as independent risk factors for non-breastfeeding within the first hour of life. Policies to promote breastfeeding, appropriate to each context, should aim to reduce inequalities in health.
Identification and characterization of pathogenic Pestalotiopsis species to pecan tree in Brazil
Authors: Lazarotto Marília , Bovolini Marciéli Pitorini , Muniz Marlove Fátima Brião , Harakawa Ricardo , Reiniger Lia Rejane Silveira , Santos Álvaro Figueredo dos
Published: September 2014

The objective of this work was to characterize and cluster isolates of Pestalotiopsis species and to identify those that are pathogenic to pecan, based on morphological and molecular characters. Pestalotiopsis spp. isolates were identified by sequencing the internal transcribed spacer (ITS) and β?tubulin regions. Identification methods were compared to indicate the key morphological characters for species characterization. Thirteen isolates were used for the pathogenicity tests. Morphological characterization was performed using the following variables: mycelial growth rate, sporulation, colony pigmentation, and conidial length and width. Ten pathogenic isolates were identified, three as -tubulin regions. Identification methods were compared to indicate the key morphological characters for species characterization. Thirteen isolates were used for the pathogenicity tests. Morphological characterization was performed using the following variables: mycelial growth rate, sporulation, colony pigmentation, and conidial length and width. Ten pathogenic isolates were identified, three as Pestalotiopsis clavispora and three as P. cocculi. The other isolates remained as an undefined species. The morphological characters were efficient for an initial separation of the isolates, which were grouped according to differences at species level, mainly colony diameter, which was identified as an important morphological describer. Beta-tubulin gene sequencing was less informative than the ITS region sequencing for species identification.
Bud dormancy in apple trees after thermal fluctuations
Authors: Anzanello Rafael , Fialho Flávio Bello , Santos Henrique Pessoa dos , Bergamaschi Homero , Marodin Gilmar Arduino Bettio
Published: September 2014

The objective of this work was to evaluate the effect of heat waves on the evolution of bud dormancy, in apple trees with contrasting chilling requirements. Twigs of 'Castel Gala' and 'Royal Gala' were collected in orchards in Papanduva, state of Santa Catarina, Brazil, and were exposed to constant (3°C) or alternating (3 and 15°C for 12/12 hours) temperature, combined with zero, one or two days a week at 25°C. Two additional treatments were evaluated: constant temperature (3°C), with a heat wave of seven days at 25°C, in the beginning or in the middle of the experimental period. Periodically, part of the twigs was transferred to 25°C for daily budburst evaluation of apical and lateral buds. Endodormancy (dormancy induced by cold) was overcome with less than 330 chilling hours (CH) of constant cold in 'Castel Gala' and less than 618 CH in 'Royal Gala'. A daily 15°C-temperature cycle did not affect the endodormancy process. Heat waves during endodormancy resulted in an increased CH to achieve bud requirements. The negative effect of high temperature depended on the lasting of this condition. Chilling was partly cancelled during dormancy when the heat wave lasted 36 continuous hours or more. Therefore, budburst prediction models need adjustments, mainly for regions with mild and irregular winters, such as those of Southern Brazil.