POPULAÇÕES DE RISCO E PROTEÇÃO SOCIAL

Populações de risco e proteção social são temáticas importantes e atuais, pouco discutidasem seminários e congressos de saúde, pois ainda o inconsciente coletivo está impregnado doparadigma biológico. Já a Política Nacional de Promoção da Saúde, revisada em 2006, inserida nocontexto do SUS, trouxe como proposta a reorientação do modelo de atenção, significando ummarco para a definição de metas e a alocação de recursos específicos para a área no âmbito dastrês esferas governamentais e tem um desafio contínuo, aprofundar a compreensão sobre osdeterminantes sociais, que afetam as condições de saúde da população

A Proposal for Computer use in Mathematics Classes: Algebra Teaching in College

O presente trabalho é baseado no ensino de matemática, especialmente no ensino de álgebra nos cursos de matemática da faculdade. O tema mencionado é o Grupo de Estrutura da Fábrica, existem pesquisadores no Brasil que se destacam como dificuldades dos alunos em entender o tópico. Com isso, os alunos acham difícil associar o ensino de álgebra ao software Dynamic Geometry, em particular o "GeoGebra". Propõe-se a um planejamento didático da sessão, nenhum professor qualificado realiza o "GeoGebra" para o ensino da Estrutura Algébrica do Grupo. Para realizar essa proposta de ensino, é criada a Sequência Fedathi. O uso de "GeoGebra" nas aulas de Álgebra é sugerido

Radiocontrast - induced nephropathy in patients undergoing coronary angiography – analysis of protective methods

Radiocontrast-induced nephropathy (RIN) is considered an important cause of renal failure in patients undergoing coronary angiography. This data becomes more relevant when it presents a positive correlation with higher morbidity and mortality rates. The objectiveof the study is to identify and compare the main described therapies for RIN found in the international medical database in the last twenty years. Among the different methods it was possible to highlight the effects of the use of renal protective drugs like N-acetylcysteine and fenoldopam in diabetic patients and in patients with some degree of renal insufficiency.A insuficiência renal aguda induzida por contraste (IRAIC) é considerada, atualmente, uma importante causa de disfunção renal em pacientes hospitalizados submetidos à cinecoronarioangiografia (CAG). Este achado adquire maior importância quando se verifica que a IRAIC é responsável por um aumento significativo dos índices de morbidade e mortalidade hospitalar. Com o objetivo de evidenciar as principais formas de prevenção e tratamento da IRAIC, realizou-se uma revisão bibliográfica ampla, utilizando as principais bases de dados internacionais. A adoção de medidas de prevenção da instalação da IRAIC como, autilização de N-acetil-cisteína ou do fenoldopam antes da injeção do contraste, foi o método que melhor repercutiu na sobrevida dos pacientes estudados, principalmente naqueles que são diabéticos ou que apresentam algum prejuízo da função renal

Prevalence, Awareness, and Treatment of Hypertension in Patients with Type 1 Diabetes: A Nationwide Multicenter Study in Brazil

Objective. This study evaluated the prevalence, awareness, and type of treatment for hypertension in Brazil in patients with type 1 diabetes (T1D). Methods. This was a cross-sectional, multicenter study that was conducted from December 2008 to December 2010 in 28 public clinics located in 20 Brazilian cities. Results. A total of 3,591 patients were studied, 56% female, average age 21.2±11.7 years, with a median duration of diabetes 9.6±8.1 years. Blood pressure levels were available for a total of 3,323 patients and 689 (19.2%) patients were hypertensive. Hypertensive patients were older, exhibited longer duration of diabetes, and had higher body mass index (BMI), total cholesterol, triglycerides, and LDL-C values (P<0.001, for all comparisons), but only 370 (53.7%) received treatment. Patient awareness of hypertension was documented in 453 (65.5%) patients. However, only 76 (22.9%) of the treated patients attained the target systolic (sBP) and diastolic blood pressures (dBP). Conclusions. Our results demonstrate that a large number of T1D patients with hypertension do not receive appropriate treatment; few of the treated T1D patients achieved the target sBP and dBP values. Greater attention should be paid to blood pressure evaluation, hypertension diagnosis, and treatment of T1D patients in Brazil

PERFIL FARMACOTERAPÊUTICO DE PORTADORES DE HIPERTENSÃO ARTERIAL SISTÊMICA

O trabalho teve como objetivo traçar o perfil farmacoterapêutico de portadores de HAS. Foi um estudo documental e analítico com abordagem quantitativa e descritiva e aconteceu de agosto a outubro de 2012, no Serviço Municipal de Saúde, em Campina Grande-PB. Dos 97 hipertensos (79%) pertenceram ao gênero feminino com idade média de 65 anos enquanto que o gênero masculino foi de 75 anos. A média da Pressão Arterial Sistólica e da Pressão Arterial Diastólica demonstrou um controle dos níveis pressóricos resultando na classificação da pressão em Ótima, Normal e Limítrofe. A maioria realizava terapia mista e utilizava Diuréticos, Inibidores da Angina Conversora da Angiotensina, Inibidores Adrenérgicos e Bloqueadores de Canais de Cálcio. Registrou-se Resultados Negativos a Medicamentos RNM’s sendo a Insegurança não quantitativa o principal tipo. Verificou-se que os hipertensos em sua maioria conseguiram obter um controle da Pressão Arterial, no entanto, torna-se necessário por parte dos profissionais de saúde um olhar mais atencioso a esses pacientes, que são cada vez mais numerosos e requerem cuidados específicos

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Influência da resposta crônica sobre as variáveis hematológicas de indivíduos diabéticos tipo 2 submetidos a um treinamento misto de bola suíça

The main function of the immune system is the defense against infection, being composed by the leukocytes that modulate the immune response, which can be innate or adaptive. The physical exercise can causes positive or negative alterations in the total or relative number of leukocytes. When the exercise has a low or moderate intensity it`s considered beneficial for improving the function of the cells responsible for the defense and to reduce the risk of infectious illnesses. The type 2 diabetes is related to an incapacity of the body in rightly respond to insulin, associated to an resistance to its actions. The purpose of this research was to make a study of the immune system characteristics, as well as the type 2 diabetes and the relation among both and the physical exercise. So, it was analyzed a group of type 2 diabetics coming from Diabetics House of Franca -SP, treated through a program of mix physical training. Two collections of blood were pre and post training program for the pair comparable of the participants. It was found positive alterations of the subpopulations of leukocytes that show a probable improvement of the immunological state what allows us to suggest about a possible improvement of the immunological activity, what would be measured by the activation of these cells forward to an inflammatory/infectious condition. So, we suggest that future studies involving diabetes, immune system and physical exercise be encouraged.O sistema imune tem como função principal a defesa contra a infecção, sendo composto pelos leucócitos que modulam resposta imune, a qual pode ser inata ou adaptativa. O exercício físico pode provocar alterações positivas ou negativas sob o número total ou relativo de leucócitos. A diabetes tipo 2 está relacionada a uma incapacidade do corpo em responder de forma adequada à insulina, associada a uma resistência às ações desta, mesmo quando suas concentrações plasmáticas são normais ou altas. Esta pesquisa teve como objetivo realizar um estudo das características do sistema imune, assim como do diabetes tipo 2 e da relação entre os dois e o exercício físico. Foram analisados 6 pacientes diabéticos tipo 2 de uma Instituição de apoio e tratamento ao Diabético de Franca-SP, tratados através de um programa de condicionamento físico misto. As coletas de sangue ocorreram antes e após treinamento para comparação de dados pareados. Foram encontradas alterações positivas das sub-populações de leucócitos que indicam provável melhora do estado imunológico entre as fases pré e pós treinamento o que nos permite sugerir uma possível melhora da atividade imunológica geral. Assim, sugerimos que estudos futuros envolvendo diabetes, sistema imune e exercício físico sejam encorajados