Diabetes mellitus: plano de ação para diminuir a prevalência e melhorar a adesão dos diabéticos ao tratamento no PSF Santa Marta no município de Bom Despacho/MG

O Programa Saúde da Família (PSF) surge no Brasil como uma estratégia de reorientação do modelo assistencial a partir da atenção básica. Apresentando-se como uma nova maneira de trabalhar em saúde, tendo a família como centro de atenção e não somente o indivíduo doente. Com o objetivo maior de potencializar a reorientação do processo de trabalho e das ações que constituem o modelo de atenção proposto pelo Sistema Único de Saúde (SUS), a estratégia Saúde da Família é nosso pilar fundamental de trabalho. O PSF Santa Marta pertence à cidade de Bom Despacho e atende uma população de aproximadamente 2.234 habitantes. Ao realizar o diagnóstico situacional da área de abrangência do PSF Santa Marta, foram identificados diversos problemas como: alta prevalência de Hipertensão Arterial e alto índice de Tabagismo. Entretanto, o problema de maior relevância está relacionado com Alta prevalência de Diabetes Mellitus e dificuldades na adesão dos diabéticos ao tratamento. O Diabetes Mellitus (DM) é um problema grave de saúde pública no Brasil e no mundo. É uma doença crônica degenerativa, não transmissível, que nos últimos anos tem incrementado sua prevalência no mundo e estima-se que seguirá aumentando nos próximos anos. O desenvolvimento de ações e estratégias para a aplicação de medidas preventivas e de promoção à saúde, controle do Diabetes Mellitus e suas complicações são diretrizes previstas na Estratégia de Saúde da Família que objetivam uma melhor qualidade de vida da população. Nesta perspectiva, foi elaborada uma proposta de intervenção com o objetivo de diminuir a prevalência do Diabetes Mellitus e melhorar a adesão dos diabéticos ao tratamento no PSF Santa Marta do município de Bom Despacho/MG. Este estudo trata de um projeto de intervenção, que será realizado no ano de 2016 pela equipe de saúde do PSF Santa Marta de Bom Despacho/MG, após a realização do diagnóstico situacional, seguindo o método de Planejamento Estratégico Situacional (PES). O público-alvo será a população adstrita ao PSF. Para a construção desse projeto foram pesquisadas bases de dados como: SCIELO, NESCON, Biblioteca Virtual da Universidade Federal de Minas Gerais, Biblioteca Virtual em Saúde, Literatura Latino-Americana e do Caribe em Ciências de Saúde (Lilacs), etc. Esperando-se com o desenvolvimento deste trabalho diminuir a prevalência desta doença e melhorar a adesão dos diabéticos ao tratamento

Anthropometric assessment of nutritional status in hypertensive patients

Introducción: la antropometría ofrece herramientas costo efectivas para la detección de la obesidad, con la identificación de riesgos para el desarrollo de la hipertensión arterial.Objetivo: evaluar antropométricamente el estado nutricional de los pacientes hipertensos pertenecientes al CMF # 17, policlínico Raúl Sánchez, municipio Pinar del Río, durante el período de noviembre de 2018 a julio de 2021.Métodos: se realizó un estudio descriptivo y transversal con un universo de 209 pacientes hipertensos, se estudiaron las variables edad, sexo, peso, estatura, índice de masa corporal (IMC), circunferencia de la cintura, circunferencia de la cadera, índice cintura cadera, índice cintura talla, pliegues cutáneos, por ciento de grasa corporal, hábitos alimentarios y sedentarismo, se confeccionó una base de datos y se realizó el procesamiento estadístico de todas las variables.Resultados: de los 143 pacientes hipertensos estudiados, 35 eran obesos (24,47 %) según el IMC. Predominó el sexo femenino (71,43 %), el grupo etario entre 50 – 65 (51,43 % grupo I vs. 38,89 grupo II), los hábitos alimentarios inadecuados (82,86 %) y el sedentarismo (100 %), lo que mostró relación directa con la obesidad. El por ciento de grasa corporal permitió que se clasificaran como obesos siete nuevos pacientes cuyo IMC era inferior a 30.Conclusiones: el estudio mostró una elevada incidencia del sobrepeso y la obesidad entre los pacientes con Hipertensión Arterial, se demostró una relación directa entre determinados factores de riesgo y el desarrollo de la enfermedad.Introduction: anthropometry offers cost-effective tools for the detection of obesity, identifying risks for the development of hypertension.Objective: to assess anthropometrically the nutritional status of hypertensive patients belonging to Doctor’s Office No-17, Raul Sanchez polyclinic, Pinar del Rio municipality, during the period from November 2018 to July 2021.Methods: a descriptive and cross-sectional study was carried out with a target group of 209 hypertensive patients, the variables were: age, sex, weight, height, body mass index (BMI), waist circumference, hip circumference, waist hip index, waist height index, skin folds, body fat percentage, eating habits and sedentary lifestyle were studied, a database was made and the statistical processing of all variables was performed.Results: of the 143 hypertensive patients studied, 35 were obese (24,47 %) according to BMI. Female sex predominated (71,43 %), age group between 50 - 65 (51,43 % group I vs. 38,89 group II), inadequate eating habits (82,86 %) and sedentary lifestyle (100 %), showing a direct relationship with obesity. The body fat percentage allowed 7 new patients whose BMI was below 30 to be classified as obese.Conclusions: the study showed a high incidence of overweight and obesity among patients suffering from hypertension, demonstrating a direct relationship between certain risk factors and the development of the disease

Choque cardiogénico por síndrome coronario agudo en el servicio de cardiología de Las Tunas

Introduction: cardiogenic shock is the most severe form of acute heart failure and the main cause of death in patients with acute myocardial infarction.Objective: to characterize patients with cardiogenic shock due to acute coronary syndrome in the cardiology service of Las Tunas in the period October 2017 to June 2021.Methods: a descriptive and cross-sectional study was carried out with a universe of 325 patients and a sample intentionally formed by 296 patients with the diagnosis of acute heart failure due to acute coronary syndrome. The variables studied were age, sex, personal pathological history, obesity, smoking, associated valvulopathies, heart rate, systolic blood pressure, previous drug use, adverse events, echocardiographic and electrocardiographic variables.Results: 16,5 % of the patients studied developed cardiogenic shock; age > 60 years (67,3 % group I vs. 80,3 % group II), male sex and history of HT (87,8 %) prevailed. Previous use of ACEI or ARA II showed an inversely proportional association with the presence of cardiogenic shock (61,5 %). Echocardiographically, reduced LVEF (61,2 %), altered E/e' ratio (32,6 %), S-wave velocity 60 años (67,3 % grupo I vs. 80,3 % grupo II), el sexo masculino y los antecedentes de HTA (87,8 %). El uso previo de IECA o ARA II mostró una asociación inversamente proporcional a la presencia de choque cardiogénico (61,5 %).  Ecocardiográficamente predominó la FEVI reducida (61,2 %), relación E/e´ alterada (32,6 %), velocidad de la onda S <5,4 cm/seg (42,9 %) y VFS elevados (46,9 %). Prevaleció el IMACEST (81,6 %) y la topografía anterior (51,1 %).Conclusiones: los pacientes con síndrome coronario agudo que con mayor frecuencia evolucionan al choque cardiogénico son los de edad avanzada, sin tratamiento farmacológico previo, con infartos de topografía anterior y fracción de eyección del ventrículo izquierdo reducida.

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Forward-central two-particle correlations in p-Pb collisions at root s(NN)=5.02 TeV

Two-particle angular correlations between trigger particles in the forward pseudorapidity range (2.5 2GeV/c. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B. V.Peer reviewe

Event-shape engineering for inclusive spectra and elliptic flow in Pb-Pb collisions at root(NN)-N-S=2.76 TeV

Peer reviewe

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia