Crises hipertensivas em portadores de hipertensão arterial em tratamento ambulatorial Crisis hipertensivas en portadores de hipertensión arterial en tratamiento ambulatorio Hypertensive crises in bearers of arterial hypertension in ambulatorial treatment

O presente estudo avaliou as características sociodemográficas e de adesão terapêutica de 27 portadores de hipertensão arterial em tratamento ambulatorial que apresentaram crises de urgências ou emergências hipertensivas e haviam sido atendidos em uma unidade de leito-dia e em uma unidade de emergência da cidade de Fortaleza-Ceará, no período de outubro de 2002 a maio de 2003. A maioria era mulher, com idade de 50 a 60 anos, pouca escolaridade, tempo de tratamento inferior a cinco anos e tempo de diagnóstico entre cinco e dez anos. O uso dos remédios foi o tratamento mais referido, seguido pela redução do consumo de sal e comparecimento às consultas. No entanto, o fato de comparecerem às consultas e receberem orientação parece não modificar o comportamento, uma vez que a maioria dos entrevistados não praticava exercícios físicos e demonstrava deficiência no conhecimento sobre a doença, atribuindo a elevação da pressão arterial a fatores emocionais.<br>El presente estudio evaluó las características sociodemográficas y de adhesión terapéutica de 27 portadores de hipertensión arterial en tratamiento ambulatorio que presentaron crisis de urgencias o emergencias hipertensivas y habían sido atendidos en una unidad de internamiento diurno y en una unidad de emergencia de la ciudad de Fortaleza - Ceará, en el período de octubre del 2002 a mayo del 2003. La mayoría fue del sexo femenino, con edad de 50 a 60 años, poca escolaridad, tiempo de tratamiento inferior a cinco años y tiempo de diagnóstico entre cinco y diez años. El uso de los remedios fue el tratamiento más referido, seguido por la reducción del consumo de sal y asistencia a las consultas. Entre tanto, el hecho de asistir a las consultas y recibir orientación parece no modificar su comportamiento, pues la mayoría de los entrevistados no praticaba ejercicios físicos y demostraba falta de conocimiento sobre la enfermedad, atribuyendo la elevación de la presión arterial a factores emocionales.<br>This study assessed the socio-demographic characteristics and the characteristics of therapeutic adhesion of 27 bearers of arterial hypertension undergoing ambulatorial treatment who had hypertensive urgencies crises or emergencies in the city of Fortaleza in the period between October of 2002 and May of 2003. The majority were women, between 50 and 60-years old, with little formal education, treatment time shorter than 5 years and time of diagnosis varying from 5 to 10 years. The use of medicine was the treatment that was most mentioned, followed by the reduction of the consumption of salt and attendance to medical appointments. However, attending the appointments and receiving orientation did not seem to change their behavior, since most of the patients that were interviewed practiced no physical exercises and demonstrated little knowledge of the illness, for they attributed the rise of the arterial pressure to emotional factors

Potential impacts of climate change on biogeochemical functioning of Cerrado ecosystems

The Cerrado Domain comprises one of the most diverse savannas in the world and is undergoing a rapid loss of habitats due to changes in fire regimes and intense conversion of native areas to agriculture. We reviewed data on the biogeochemical functioning of Cerrado ecosystems and evaluated the potential impacts of regional climate changes. Variation in temperature extremes and in total amount of rainfall and altitude throughout the Cerrado determines marked differences in the composition of species. Cerrado ecosystems are controlled by interactions between water and nutrient availability. In general, nutrient cycles (N, P and base cations) are very conservative, while litter, microbial and plant biomass are important stocks. In terms of C cycling, root systems and especially the soil organic matter are the most important stocks. Typical cerrado ecosystems function as C sinks on an annual basis, although they work as source of C to the atmosphere close to the end of the dry season. Fire is an important factor altering stocks and fluxes of C and nutrients. Predicted changes in temperature, amount and distribution of precipitation vary according to Cerrado sub-regions with more marked changes in the northeastern part of the domain. Higher temperatures, decreases in rainfall with increase in length of the dry season could shift net ecosystem exchanges from C sink to source of C and might intensify burning, reducing nutrient stocks. Interactions between the heterogeneity in the composition and abundance of biological communities throughout the Cerrado Domain and current and future changes in land use make it difficult to project the impacts of future climate scenarios at different temporal and spatial scales and new modeling approaches are needed