Repositório RCAAP

Allergies are caused by immunological reactions to allergens, which are substances capable of triggering specific IgE responses in genetically predisposed subjects. In tropical and subtropical regions, allergens derived from B. tropicalis are important causes of IgE-mediated sensitization among patients with asthma and allergic rhinitis. The aim of this study was to produce the recombinant Blo t 5 allergen and to evaluate its reactivity to IgE in sera from atopic patients compared to its native counterpart and B. tropicalis crude extract using immunoenzymatic assays. A full-length cDNA encoding was Blo t 5 was cloned from a mRNA Bt using a transcriptase reverse and PCR. The cDNA was PCR-amplifed, sequenced and subcloned into E.coli expression vector and recombinant protein rBlo t 5 was purified. Immunoglobulin E (IgE) reactivity of the nBlo t 5 and rBlo t 5 allergens was determined by enzyme-linked immunosorbent assay (ELISA). rBlo t 5 was capable of binding to IgE revealing the preservation of additional unique IgE epitopes in rBlo t 5 BT+ group (36%) and BT- (31,2%). This comparative study confirmed production and purification the recombinant Blo t 5. The recombinant protein showed great, when patients sera was used, presenting moderate correlation of human IgE reactivity between rBlo t and crude Bt extract, rBlo t 5 and nBlo t 5 in these sera in patients in Brazil.

The present study has the objective of evaluating the HRQL of mothers of children and adolescents affected by DS in comparison with mothers of healthy children and adolescents and verify the association with clinical and demographical variables and with the HRQL of the affected, as perceived by their mothers. Participated in this study mothers of subjects affected with DS and mothers of healthy subjects with maximum age of 21 years, paired by gender and age of the affected subjects in reason of 2:1. After signing the free and clear term, the mothers answered a questionnaire with their demographical information (age, conjugal situation, scholarity, paid activities, family income) and their children information (age, gender, number of brothers, scholarity); and also clinical data about the mother (presence of chronical disease), about the children with DS (use of medication, presence of other chronical diseases or comorbities) and about the family (other people affected by chronical disease in the same residence). The HRQL of the mothers was evaluated through the Medical Outcomes Survey Short Form36 (SF-36) and the intensity of the depressive symptons was verified through the Beck s Depression Inventory (BDI). The mothers of subjects affected with DS with age 5 of greater also answered the Child Health Questionnaire Parental Form 50 (CHQ-PF50), to evaluate the QVRS of the affected, and to the Child Assestment Questionnaire (CHAQ), to evaluate the functional capacity. The Alfa Cronbach coefficient was calculated to determine the reliability of the instruments. The SF-36 scores were compared between the control group and the group of mothers of children affected with DS (Mann-Whitney test). The demographical and clinical variables were compared (Mann-Whitney test, Kruskal-Wallis or Qui-Square) and correlated (Spearman s correlation coefficient) with the scores of the SF-36. The medium age of the mothers in the DS group was 39.0 years and in the control group it was 35.0 years. In relation with the subjects with DS, most of them were males (61.0%), their medium age was 8.0 years, with predominance of adolescents (41,7%). The Alpha-Cronbach coefficient varied from 0.75 to 0.94 to the SF-36. The mothers of subjects affected by DS obtained significantly lower scores than the mothers of the control group in the following domains: physical function, general health, vitality, social function and mental component summary in the SF-36 (p<0,05). The CHQ-PF50 scales that were mostly correlated with the scores of the SF-36 were: behavior, mental health and health perception. Concluding, mothers of subjects affected with DS presented negative impact in the mental dimension, in comparison with the mothers of healthy children and adolescents. The greater the intensity of the depressive symptoms, the greater was the physical and mental injury in the HRQL of the mothers. Few associations were found between the other demographical and clinical variables that were analyzed.

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Process management requires the need to establish indicators for the quality and development measurement of the processes implemented. The current work picked out the level of disability on diagnosis (GID) and on patient´s discharge (GIA), as well as the number of assessments performed by the physiotherapy sector (a process experienced by the patient in a health unit of national reference in terms of Hansen s disease in Brazil) aiming to assess the impact in the prevention of disabilities in patients under treatment, in two periods, before (2003-2005) and after (2006-2008) the application of the processes. A study carried out with 351 predominantly male patients in both periods: 58.8% on P1 and 58.6% on P2 in the age-group from 31 to 60 years of age. In terms of occupation, domestic work prevailed for women and retirement and general services predominated amongst men. The MB patients (66.0% on P1 and 61.8% on P2) and the borderline-tuberculoid clinical form (41.2% on P1 and 40.8% on P2) were the most widespread in both periods. On P2 there were more patients diagnosed with GID=0 and GID=2, but on the patient´s discharge period there was a reduction of 1.9% in the cases with GIA=2 in relation to the P1, in which there was an increase of 1.6% in patients with GIA=2. From P1 to P2, between the diagnosis and the discharge period, there was an increase of 16% in the assessment average per patient (p=0.009). This is the first epidemiological study assessing the impact of the process management in the prevention of disabilities in patients treated in a Hansen´s Disease National Reference Center in Brazil, which resulted in a reduction of the GIA-2 and a significant increase in the number of assessments on P2, showing that the patients had a greater adherence to the full treatment. It also evidences that a health service aiming to be a technical reference in any disease cannot put aside the application of management by process for its organization. Also, this model must be a prerequisite for the Health Ministry of Brazil and other countries for the certification of the services aiming to work as Hansen´s Disease National Reference Center.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Despite recent advances in neonatal intensive care, prematures born at less than 25 weeks gestation have high rates of morbidity and mortality. Parents and doctors face difficult decisions concerning instituting and/or continuing resuscitation and intensive care of these babies. This is, therefore, a complex ethical/moral problem with a strong impact on the lives of the surviving prematures and their families, as well as for the heath care system and society. There is increasing interest in regulating and standardizing the care of very premature babies. However, there are significant differences between the protocols used in different countries concerning the decision to resuscitate premature babies that are at the threshold of viability. In Brazil, there is no protocol on this matter. The purpose of this study is to describe the biological, bioethical, economic and legal aspects present in the decisions of resuscitation or not at the threshold of viability and to propose recommendations appropriate to Brazilian conditions. The authors suggest that comfort care measures should be offered to babies of less than 25 weeks and intensive care to those beyond this gestational age. If parents, after detailed discussions and clear information about the medical recommendation for comfort care measures to those between 23 and 25 weeks decide in favor of intensive care measures, it should be provided and rediscussed continually.

Leprosy is an important health problem in Brazil, with a high detection rate despite the application of the multidrug therapy. The nasal mucosa is considered the preferential site of entry and exit of the Mycobacterium leprae, although some lesions have been found in the buccal mucosa. However, the buccal mucosa involvement in bacilli transmission has never been investigated. We have shown the presence of the M. leprae DNA in buccal swabs of leprosy patients (334) and household contacts (1288) through conventional polymerase chain reaction (PCR), and results were correlated with clinical and other laboratorial evaluations. The overall positivity for patients was 18.26%, divided into 12.03% and 21.23% for paucibacillary and multibacillary forms, respectively. Among contacts, the positivity reached 6.83%, which were considered either as healthy carriers or sub-clinically infected, when the ELISA test presented a positive anti-PGL-1 result. This study showed important evidences that the buccal mucosa may be a secondary site of M. leprae transmission and infection. Furthermore, contacts with positive PCR may be actively involved in the transmission. Our findings have great epidemiological relevance, especially for the leprosy control programs and for the dentistry clinics, and must be considered in the new strategies of control and prevention.

Objetivo - Conhecer a epidemiologia dos disparos de arma de fogo em Uberlândia, MG, e os aspectos clínico-cirúrgicos das vítimas. Métodos - Foram obtidos dados sobre disparos de armas de fogo de: Boletins de Ocorrência da Polícia Militar; prontuários do Hospital de Clínicas de Uberlândia - 2001 e 2002; laudos de lesão corporal e necropsias do Posto Médico Legal - 2000 a 2003. Resultados - As ocorrências foram principalmente em bairros periféricos; 171 (53,61%) em vias públicas, 72 (22,57%) em residências, mais de 1/3 em finais de semana; dos disparos para os quais os dados foram obtidos, em 110 (75,34%) a arma utilizada foi o revólver e foram motivados principalmente por discussão (46; 29,68%) e acerto de contas/vingança (40; 25,81%); de 94 (26,40%) casos cujo dado foi obtido, em 60 (63,83%) o agressor foi classificado como cidadão comum; em 130 (67,01%) casos os agressores fugiram. As percentagens aproximadas de vítimas do sexo masculino, de 10 a 39 anos e solteiras foram de, respectivamente, 90%, 80% e 70%. Nos casos fatais, os locais mais atingidos foram o tronco (257; 93,12%) e o crânio (150; 54,35%) lesionando sobretudo o cérebro (128; 46,38%) e os pulmões (125; 45,29%). Conclusões - são freqüentes os disparos em bairros periféricos, vias públicas ou residências, em finais de semana, por revólver, motivados por dificuldades de relacionamento interpessoal, realizados por cidadãos comuns que, geralmente fogem da cena do crime; as vítimas são, sobretudo, homens jovens e solteiros; nos casos fatais são mais comuns lesões em tronco e crânio, acometendo cérebro e pulmão.

Parkinson is a disabling neurodegenerative disease. It is also invariably progressive. The more severe the disease, the worse patients perceive their quality of life (QL). In order to quantify the impact of the disease in the QL of these patients, QL measurement instruments have been developed. However, they need to be translated, culturally adapted and validated in order to be used in our environment. The objective of this study was to translate, culturally adapt and validate the Parkinson disease Quality of Life (PDQL) - the PDQL- BR, an assessment instrument of Health-related Quality of Life (HRQL) specific for the Parkinson Disease (PD). Method: 52 patients answered the PDQL-BR, the Beck Depression Inventory (BDI) and a questionnaire with sociodemographic data. Twenty-one patients answered the PDQL-BR again after 14 days. The Unified Parkinson s Disease Rating Scales (UPDRS) and the modified Hoehn and Yahr scale were also applied. The psychometric properties of the PDQL-BR were assessed by examining data quality, reliability and instrument validity. Data quality was assessed by the occurrence of floor and ceiling effects and the percentage of missing data. Reliability was assessed by internal consistency of the item, internal consistency reliability (homogeneity of the data) and reproducibility of the instrument. Validity was assessed by the convergent and discriminant validity. Results: There were no floor and ceiling effects. For the assessment of the internal consistency, the items 20, 30 and 37 presented correlation coefficient of 0.34; 0.26 and 0.37, respectively. Correlation coefficients for the other items were above 0.4. The &#945;-Cronbach s coefficient was above 0.65 for all domains and 0.93 for the instrument as a whole. Scores of the PDQL-BR between the two applications were statistically similar. For the assessment of the discriminant validity, scores of the instrument and of domains of parkinsonian and systemic symptoms were different for each stage of the disease, being worse for the more advanced ones. For the assessment of the convergent validity, the emotional function domain showed a strong association with the UPDRS and BDI scales (correlation coefficients of 0.59 and 0.56, respectively). The domain Parkinsonian symptoms showed a strong correlation with the UPDRS (coefficient correlation of 0.78). Conclusion: The translated version of PDQL did not show significant change in the process of translation and cultural adaptation. Its psychometric properties were similar to those of the original instrument. Careful interpretation must be given to the evaluation of responses of items 20, 30 and 37.

Currently, good aesthetic results combined with functional recovery of the limbs in radical saphenectomy postoperative are eagerly sought not only by patients but also by vascular surgeons. The objective of this study was to determine whether ultrasound (U.S.) and manual lymphatic drainage (MLD) influence the absorption of the hemorrhagic suffusions after radical saphenectomy, and if there is superiority of one in relation to the other. The study included 36 white female patients living with chronic venous insufficiency that have undergone radical saphenectomy; 63 limbs (analysis units) were randomized in three groups of 21 each: DLM (Leduc method), U.S. (continuous mode, 3 Mhz and 1 W/cm²) and Control. The proceedings were started on the 5th postoperative day and completed on the 30th postoperative day, three times a week on alternate days. The limbs were photographed at 5th, 20th and 30th days after surgery, and then three vascular surgeons, assessed the photos blindly, through score given from 0 (best condition) to 10 (worst condition) for three variables: colors intensity and areas of the hemorrhagic suffusions and aesthetics of the limbs. To assess the degree of improvement in each group were obtained variations (differences) in notes between 5th and 20th and between 5th and 30th postoperative days, by subtracting the notes given on the 5th postoperative day from those obtained on the 20th and on the 30th days after surgery, respectively. We used Tukey´s Test to verific significant differences in average scores between groups DLM, U.S. and Control (p <0.05). On the 5th postoperative day, DLM, U.S. and Control groups had similar grade point average but only for colors intensity (p> 0.05); on the 20th and 30 th postoperative days, there was no significant difference between U.S. and MLD groups; grade point averages were lower for DLM and U.S. groups in relation to Control group, for all variables (p <0.05). Variations in notes between 5th and 20th and between 5th and 30th postoperative days of MLD and U.S. groups, showed to be higher than in the Control group (p <0.05), and on the MLD group greater than in the U.S. group (p <0.05), indicating so that although both, DLM and U.S. are effective therapy resources to absorb the hemorragics suffusions after radical saphenectomy, the DLM is more effective than US.

The aim of this study was to evaluate the profile of serotypes and antimicrobial resistance of pneumococcal strains obtained from clinical specimens of patients admitted with a diagnosis of meningitis at the Hospital Clinics, Federal University of Uberlandia (HC-UFU). Invasive pneumococcal strains isolated in the Clinical Laboratory of HC-UFU samples from inpatients were identified and sent to Instituto Adolfo Lutz (IAL) in Sao Paulo, SP, to confirm the identification, serotyping and determination of antimicrobial susceptibility. From April 1999 to April 2009, among 338 strains recovered, 72 obtained from patients with meningitis were evaluated. Forty six (63.9%) patients were male and the age ranged from one month to 82.2 years old, mean of 18.4 ± 22.9 years, median of 5.2 years. Strains were isolated from cerebrospinal fluid [66 occasions (91.7%)] and blood [6 occasions (8.3%)]. There were 24 different serotypes of pneumococcus and the most commonly identified were 14, 19F, 3, 7F, 6A, 6B, 10A, 18C, 23F, 5 and 34 giving a figure of coverage by the 7-valent conjugate vaccine of 79.8% and the 10-valent of 91.3 among children aged up to five years. Amongst 20 [27.8%] oxacillin-resistant strains, 17 [23.6%] confirmed resistant to penicillin and nine [12,5%] resistant to ceftriaxone, both being more common in children until 24 months and during the period of 2005 to 2009.

Heart failure (HF) is a chronic disease that incapacitates and provokes emotional repercussions that may actually worsen the disease itself. Possible results include disinterest by the patient in pursuing treatment, increased hospitalization and reduced quality of life. The present study seeks to verify the presence of symptoms of anxiety and depression in patients with HF and compare them with a group of patients without HF for analysis in terms of principal socio demographic characteristics of the two groups. A total of 100 patients were evaluated. Fifty of these (the study group) had HF and 50 (the control group) without the disease. The presence of anxiety and depression were verified using three psychological instruments: Beck's Anxiety Inventory, Beck's Depression Inventory and the Hospital Scale of Anxiety and Depression. Patients were also submitted to a medical examination and responded to a socio demographic questionnaire. There was no significant difference between the two groups in terms of occupation, sex or number of children. The patients with HF demonstrated more anxiety and depression than the control group, as measured by all of the instruments. Further analysis revealed that the study group was older, had less leisure time and less education than the control group. The study thus revealed the importance of psychological instruments for the identification of symptoms of anxiety and depression among patients with HF. The need for psychological assistance, principally for upper working class patients was evident.

The morbidity and mortality from external causes is a significant point in the epidemiological transition in the country, due to the large number of victims, particularly young workers who develop disabilities requiring care and treatment services, which creates a personal reflection, family and social negative. Since most studies focus on the question of mortality, little is known about the evolution of non-fatal victims. Due to the scarcity of research regarding this aspect, we carried out this descriptive study. Data were collected prospectively from 285 patients victims of external causes who received primary care at the Rehabilitation Centre Municipal de Uberlândia (CEREM), MG in the period from January to July 2005. This study aimed to characterize the external causes that motivated the search for CEREM, the physiotherapy treatment and the evolution of the patients. It was used as a tool for obtaining the data used a semistructured questionnaire on two occasions: on admission to the service and upon his discharge. Addressed to aspects related to the patient, the lesion causing the event, to care, to physiotherapy treatment, the functional outcome. In cases where treatment was discontinued, close to the protocol, we attempted to telephone contact with the patient, personal contact with the professional responsible for care, and information in the records of medical records. It was found that almost all patients (280, 98.2%) were from Uberlândia, mostly male (161, 56.5%) aged between 20 and 59 years (217, 76, 2%), and unstable marital relationship (144, 50.5%). Regarding the to schooling, most people (194, 68.1%) had not completed high school, exercised occupations that required little qualification (38 general services, 13.3%, construction workers, 31, 10, 9%), presenting, therefore, of less than three minimum wages (133, 46.6%). During treatment, 185 patients (65%) had a formal job and of these, 129 (69.7%) were away from work for an average of 66 days, most had no health plan (220, 77.2 %). The accidents were responsible for most injuries (274, 96.1%) among them, falls (124, 43.5%) and traffic accidents (83, 29.1%) stood out, resulting mainly fractures (191, 62.2%) with predominant involvement of upper limbs (156, 51.6%). Nearly half the events occurred on public roads (135, 47.3%). The public network originated 98.6% of referrals (281). The median time from injury to the request for physiotherapy was 56 days, and waiting for the start of treatment after 48 days of your request. Of the 285 patients admitted students, 198 (69.5%) completed the treatment, performing an average of 17 sessions; kinesiotherapy (228, 82.3%), electrotherapy (211, 76.1%) and thermotherapy for the addition ( 200, 72.2%) were the most used therapeutic resources. In 27.7% of cases (79), treatment was interrupted for several reasons. Initially, when joining the service, the majority of respondents complained of pain (240, 84.2%) and decreased range of motion of the joint or segment involved in the lesion (244, 85.6%). However, despite this fact, most (177, 62.1%) reported independence in relation to performing their daily activities. Of those who completed treatment (198, 69.5%), the majority reported complete relief of pain (116, 58.5%), total recovery of movements (122, 61.6%) and independence in carrying out its activities daily life (191, 96.4%) after intervention. It follows that people affected by external causes that need to be rehabilitated in specialized centers are predominantly male, aged between 20 and 59 years, which have low education and income, have occupations requiring little qualification, besides not have a health insurance plan. Formal employment relationship is common among respondents and almost half of them away from work temporarily in light of the injuries, which are mainly caused by accidents occurring on public roads, resulting mostly in fractures with involvement of upper limbs. Referrals for physiotherapy comes almost exclusively from public service, and the elapsed time of occurrence of the injury to the request for physiotherapy an average of 56 days, and this the beginning of treatment 48 days. Almost 70% of treatments started are completed with an average of 17 sessions, with exercise, electrotherapy and thermotherapy by adding the resources most commonly used treatment. Overall, patients treated by physiotherapy independent completing treatment or do not show good response with respect to the control of pain, the gain range of motion and level of independence in their daily activities.

Background: The use of diuretics has been proven effective in patients with chronic renal failure by increasing the volume and urinary sodium excretion, but most studies have been performed using high doses of this drug, acutely. The objective of the present study was to verify whether chronic renal patients on HD with residual diuresis who were using small doses of furosemide present different levels of urinary volume and sodium excretion compared to patients with residual diuresis who do not use this drug. Methods: We studied 19 chronic renal patients on HD who presented any level of residual diuresis. Urine was collected during the 24-hour interdialytic period, and physical examinations and blood drawing for testing took place immediately before the start of HD. Patients were divided into two groups: DG (n=10), in which patients had been using 40 of Furosemide for at least 3 months, and NDG (n=9), in which patients used no diuretics. Results: Although both groups presented the same average glomerular filtration rate (GFR) (p > 0.05) and time in dialysis (p > 0.05,) the DG presented an average of twice the urinary volume in 24 h (1142 ± 184 vs 453 ± 135 ml/24 h, respectively; p= 0.008) and double the total excreted sodium mass (UVNa) compared to patients in the NDG (112 ± 22.4 vs 45.2 ± 16.0 mEq/24 h, respectively; p= 0.02). Conclusion: The results of this study have shown that chronic use of small doses of furosemide in chronic renal patients with residual diuresis could increase urinary volume and sodium excretion compared to patients who did not use this drug.

In Brazil, the few studies conducted have used viral etiology, in general, traditional methods (imunofluorescense techniques and and viral cultures) in hospitalized children. The purpose of the present study was to investigate the presence of respiratory viruses using indirect immunofluorescence techniques and the reverse transcription followed by polymerase chain reaction in nasopharyngeal aspirates of children with acute respiratory disease attendet in public institutions of primary and secondary care in the city of Uberlândia. Between february, 2008 to may, 2010 were obtained a convenience sample, nasopharyngeal aspirates from children under five years old with symptoms of acute respiratory disease, attended at Unidade Básica de Saúde da Família - Granada 1, Unidade de Atendimento Integrado-Pampulha and in Clinica Infantil Don Bosco in Uberlândia. Acute respiratory disease was defined by the presence of coryza, coughing, breathing difficulties and/or sibilance, with or without fever. The indirect immunofluorescence techniques and the reverse transcription followed by polymerase chain reaction were used to test for the presence of respiratory viruses. A total of 43 children (53,5% male and 46,5% female) between two and 60 months of age (average: 18,3 months; median 15 months; DP±16). The clinical diagnosis for admission was common cold for 23 children (53,4%), tracheobronchitis in four (9,3%); pneumonia in 12 (28%) and bronchiolitis in four (9,3%). At least one respiratory virus was detected in 22 (51,1%) of the samples. A total of 26 viruses were identified. Ten (38,4%) samples were positive for the respiratory syncytial virus; ten (38,4%) for rhinovirus, three (11,5%) for parainfluenzavirus; two (7,7%) for adenovirus and one (3,8%) for influenzavirus. Co-infection occurred in three of the samples. The indirect immunofluorescence techniques identified nine (21,0%) and the reverse transcription followed by polymerase chain reaction 19 (44,1%) of the respiratory viruses. The rhinovirus and respiratory syncytial virus were the respiratory virus most prevalent in children with acute respiratory disease in public institutions of primary and secondary care. The use of molecular method permitted a two fold increase in the capacity for detection of the viral agent collected from the nasopharyngeal aspirates.

The surgical site infection is one of the main healthcare-associated infections (HAIs), the main surgical complication and the use of antimicrobials is part of a set measures used in order to reduce this infection. There are well-conducted studies with general recommendations and specific standards for each type of surgery on surgical prophylaxis with antimicrobial. However, the inappropriate use of antimicrobials remains one of the major errors in medication administration in hospitals and prescription for far too long persists as one of the major flaws in the prophylaxis of surgical site infection (SSI). The purpose of this study is to know the effectiveness of interventions aimed at changing the conduct of surgeons regarding the correct indication and adequate time for maintenance of antimicrobial prophylaxis of SSI. It is a prospective study, before and after kind, conducted at Hospital das Clínicas de Uberlândia, an institution with a little more than 500-bed, linked to Universidade Federal de Uberlândia. There were two interventions: a prophylaxis with antimicrobial in surgery guide available, build up with the surgeon participation and Cefazolin liberation restriction, one of the more utilized antimicrobial with SSI prophylaxis purpose. Surgeries of the specialties trauma-orthopedic and general surgery and, the adaptation of antibiotic prophylaxis making reference to indication, antimicrobial prescribed and time of use. The study has been divided in three collection periods: baseline (period I), after the first intervention, elaboration and guide availableness (period II) and a third during the second intervention, Cefazolin restriction (period III). The indication of the use of prescribed antibiotic prophylaxis of SSI was considered adequate in the three collection periods. The antimicrobial choice has been convenient in the three periods of trauma-orthopedic however, in general surgery, the percents were 20%, 63,9% and 61,5% of the cases (p=0,011), respectively, in the three collection periods. The maintenance timing of the antimicrobial prophylaxis was considered adequate in 23,00% at the period I, in 46,15% at period II and 82,46% at period III (p<0,0001). The conclusion of this study is that educational interventions and mainly the administrative ones can increase of the use of antimicrobial prophylaxis in surgery.

Lactogenesis is constituted by two phases, called as lactogenesis I and lactogenesis II. The transition between those phases is characterized by increase in the lactose concentration. This study aimed to evaluate the interference of diabetes mellitus in the lactose concentration associated to transition between phases I and II of lactogenesis. It was studied 11 puerperal women with pre-gestational diabetes mellitus and 19 without diabetes. During the five first days after delivery, at each 24 hours, it was collected colostrums samples to evaluate its lactose concentration by reaction with picric acid. In both groups there were progressive increases in the lactose levels with time. The lactose concentrations in both groups exhibited statistically significant sigmoidal dependences with the time after delivery, with neat two-state transition between the phases I and II of lactogenesis. The analysis of those transitions revealed an 18 hours time delay in the beginning of lactogenesis II of diabetes carriers women with inadequate metabolic control in relation to puerperal females without diabetes.

Conselho Nacional de Desenvolvimento Científico e Tecnológico

The present study evaluated the frequency of major risk factors for atherothrombosis in patients with Chronic Obstructive Pulmonary Disease (COPD) in oxygen in both gender. The sample consisted of 62 individuals, 28 men and 34 women, mean age 71.8 ± 8.7 years, all members of the Home Care Program, Hospital de Clinicas, Universidade Federal de Uberlândia. COPD was diagnosed when there were clinical signs and symptoms with changes in spirometry [(Forced Expiratory Volume in one second by forced vital capacity (FEV1/FVC) &#8804; 0.7 boncodilatador post (BD)]. All subjects received regular treatment with inhaled corticosteroids, Tiotropium and ß-2 agonist with long duration. We evaluated the following risk factors for atherothrombosis: body composition [(body weight, body mass index (BMI) and waist to hip index (WHI)], fasting plasma glucose, plasma lipid profile [(Total Cholesterol (TC), HDL-cholesterol (HDL-C) and triglycerides (TG)], smoking and tobacco intake, sedentary lifestyle, blood pressure at rest, C-reactive protein highly sensitive (hsCRP), forced expiratory volume in first second (FEV1), heart rate (HR), hypoxemia and calculation of Framingham risk score (FRS). The statistical analysis used SPSS 13.0 for Windows and BioEstat 5.0. Mean comparisons were made using T test and U test of Mann-Whitney, adopting, as significant, p values <0.05. At final evaluation, it was observed that all subjects were sedentary, the rate of type 2 diabetes mellitus (T2DM) was 11.3%, the rate of hypertension (HBP) was 41.9% and 19.4% of the subjects smoked actively. The mean HR was 82.8 ± 13.9 bpm; partial pressure of oxygen in the blood (PO2) found the average was 48.4 ± 8.8 mmHg, the mean FEV1 was 35 ± 15%, median hsCRP was found to be 6.5 ± 13.6 mg / l. The average weight (kg) was 59, 3 ± 15.3, BMI 24.4 ± 5.5 and ICQ 1.0 ± 0.1. The ERF was below average in this population, probably by correcting hypoxemia and oxygen provided by the appropriate treatment of COPD . The elevated serum levels of TG, TC, LDL-C and fasting glucose, and presence of high levels of blood pressure and smoking were equally distributed in both gender. Serum HDL-C were significantly lower in men. Variables such as hsCRP, FC, and PO2 were also equally distributed between men and women, except for the FEV1, lower in men. Men had higher ERF (higher risk for MI or death in 10 years) and low HDL-C in men contributed decisively to this finding. FEV1 reduced CRP levels and hypoxemia characteristics were found across the sample, and these items are included in the risk factors for atherothrombosis.

Kidney dysfunction is a prevalent phenomenon in old age. In adults, kidney dysfunction is associated with an elevated risk of cardiac dysfunction and cardiovascular mortality. Left ventricular function in the elderly may be affected by the general decline in kidney disfunction with age. Evaluation of the blood creatinine level does not accurately reflect renal function in the elderly. Hypertension and metabolic disorders, which are frequently present in the elderly, may alter cardiac and kidney function. Most studies have suggested a link between chronic kidney disease and cardiac dysfunction in patients with a renal filtration rate under 45 ml/min/1.73 m2. Cardiac dysfunction may be present in elderly patients with a renal filtration rate between 45 and 90 ml/min/m2. Twenty-six men and twenty-two women aged sixty years or more were studied. Kidney function was evaluated by measuring the creatinine clearance rate, evaluating cardiac function by echocardiogram and establishing the metabolic profile by evaluating blood samples and a 24 hours collected urine.We evaluated each subject s history of coronary disease, hypertension, smoking status and cardiovascular drug profile. For statistical analysis, we used the Student s t Test and Linear Regression with significance set at p<0.05. Patients were separated into two groups: Group I included patients with normal kidney function (Creatinine Clearance &#8805; 90 ml/min/1.73 m2) and Group II included those with early-stage kidney dysfunction (45 < Creatinine Clearance < 90 ml/min/1.73 m2). We found a significant difference in the ejection fraction between groups I and II (0.71±0,01 vs. 0.67±0,01 ; p<0.01), serum triglycerides (105.7±10 mg/dl vs. 143,3±16 mg/dl ; p=0.02), phosphate in 24 h urine (810.2±56 vs. 573,6±46 mg/dl ; p=0.002),calcium in 24 h urine (177,5± 33 vs. 107 ± 12 mg/dl ; p=0,03). Linear Regression analysis of Creatinine Clearance and the ejection fraction shows a statistically significant positive relationship (r=0.41; p=0.0036). No difference were observed between the two groups in terms of age, sex, hypertension, pulse pressure, cardiovascular drug use, smoking status, coronary disease, blood hemoglobin, glycemia, sodium, potassium, calcium, phosphate, uric acid, C-reactive Protein, homocysteine, total or fractioned cholesterol , serum creatinine, 24-h urine protein, creatinine, calcium , uric acid, left ventricular mass, relative posterior left ventricular thickness, cardiac output, left ventricular end-systolic volume or left ventricular end-diastolic volume. Our results suggest that mild kidney dysfunction in the elderly coexists with reductions in the ejection fraction when Creatinine Clearance is between 45 and 90 ml/min/1.73 m2. This relationship is not related to the presence of hypertension, metabolic or inflammatory disease, anemia, smoking status, coronary disease or use of cardiovascular drugs. Cardiorenal Syndrome can be detected early in asymptomatic elderly patients with Creatinine Clearance above 45 ml/min/1.73 m2. Based upon our results, we were not able to differentiate between Type 2 and 4 Cardiorenal Syndrome. These results may facilitate early care of the patients following cardiac changes and may therefore reduce cardiac mortality in this population.