Test of effort in obese boys and adolescents: proposal for classification by maturity

With increasing of obesity in children and adolescents the specialized care services, for the most serious cases, become imperative. Child and Adolescent Obesity Clinic, in the Clinics Hospital/Unicamp give assistance to patients between 03 and 19 years, with BMI≥percentile 95 of the CDC curve. This assistance involves physicians, nutritionists, psychologists and physical educators. For orientation of physical activities and its follow-up an effort test is used, the go-and-come test (Course-Navette), wich was proposed by Leger and Lembert (1982-1988). Children maturity was classified according to criteria of pubescence of Tanner (1962). Subjects: 33 boys, aged between 7 and 18 years old. The values of VO2max (ml/kg/min-1) were distributed in average and Standard Deviation, by age and maturity. There is a greater result oscillation in the breakdown by age, and a further drop in the classification values by maturity in VO2max (ml/kg/min-1). These values tend to fall from the young ones to the older ones, unlike the expected. In the population studied, there is an inversion of the trend of VO2max, probably due to children’s obesity habits; the classification by maturity seems to give more reliable results; the test proved to be suitable for use in outpatient service

Cytotoxicity analysis of three Bacillus thuringiensis Subsp. israelensis d-Endotoxins towards insect and mammalian cells

Three members of the d-endotoxin group of toxins expressed by Bacillus thuringiensis subsp. israelensis, Cyt2Ba, Cry4Aa and Cry11A, were individually expressed in recombinant acrystalliferous B. thuringiensis strains for in vitro evaluation of their toxic activities against insect and mammalian cell lines. Both Cry4Aa and Cry11A toxins, activated with either trypsin or Spodoptera frugiperda gastric juice (GJ), resulted in different cleavage patterns for the activated toxins as seen by SDS-PAGE. The GJ-processed proteins were not cytotoxic to insect cell cultures. On the other hand, the combination of the trypsinactivated Cry4Aa and Cry11A toxins yielded the highest levels of cytotoxicity to all insect cells tested. The combination of activated Cyt2Ba and Cry11A also showed higher toxic activity than that of toxins activated individually. When activated Cry4Aa, Cry11A and Cyt2Ba were used simultaneously in the same assay a decrease in toxic activity was observed in all insect cells tested. No toxic effect was observed for the trypsin-activated Cry toxins in mammalian cells, but activated Cyt2Ba was toxic to human breast cancer cells (MCF-7) when tested at 20 mg/mL

[pediatric Care In Brazil's Unified Health System: Reflections On The Role Of Pediatricians In Family Healthcare Strategy].

This essay seeks to contribute to the elucidation of the potential activities of pediatricians in the Family Healthcare Strategy. The origins, types of care and inherent implications to the process of change in the Healthcare Model that are being implemented in the Brazilian Unified Health System (SUS) since the Basic Operational Norms were instituted in 1996 are duly presented.164221-

Cross-cultural adaptation of the neurobehavior inventory (NBI) for Brazil

OBJETIVO: Realizar a adaptação transcultural de instrumento para avaliação das alterações comportamentais tipicamente descritas em portadores de epilepsia do lobo temporal (ELT), o Inventário Neuro-Comportamental (NBI) para a população brasileira. MÉTODOS: Inicialmente, foi feita a tradução do instrumento original para o português. Esta versão foi revisada e retrotraduzida para o inglês. A seguir, a versão retrotraduzida foi comparada à versão original em inglês, sendo corrigidas as divergências no texto em português. Em um segundo momento, 15 pacientes do Ambulatório de Epilepsia do Hospital das Clínicas da UFMG portadores de ELT responderam ao inventário. À aplicação do questionário, eventuais dificuldades e os itens mal compreendidos foram analisados pelos autores. RESULTADOS: Na versão final para o português, os itens 11, 14, 17, 61 e 75 foram modificados. Sete pacientes (46,7%) eram do sexo feminino, com idade entre 26 e 65 anos. A maioria dos pacientes (93,3%) apresentou uma pontuação total elevada. Os domínios mais comumente alterados foram hiperreligiosidade, detalhismo e crença na predestinação pessoal (73,3% dos pacientes em cada um deles). CONCLUSÃO: A versão em português do NBI pode ser um instrumento útil para avaliar alterações comportamentais na ELT aplicada ao contexto clínico dos pacientes brasileiros.PURPOSE: To perform the cross-cultural adaptation of an instrument designed to measure behavioral changes typically described in temporal lobe epilepsy (TLE), the Neurobehavior Inventory (NBI), for Brazilian population. METHODS: At first the original instrument was translated to Portuguese-Brazilian language. This version was revised and translated back into English. Later, both English versions were compared and the divergences were corrected in the Portuguese text. The second step consisted of the application of the inventory to 15 TLE patients from the Epilepsy Program, Federal University of Minas Gerais. The authors analyzed eventual difficulties and misunderstandings in the application of the questionnaire. RESULTS: In the final Portuguese version, the questions 11, 14, 17, 61 and 75 were considered difficult to understand and were modified. Seven (46.7%) subjects were women, with 26 to 65 years. Most of the patients (93.3%) had a high total score level. Religious convictions, interest in details and sense of personal destiny were the most common altered domains (73.3% of the patients in each one of them). CONCLUSION: The Portuguese-Brazilian version of the NBI may be a useful instrument to evaluate TLE behavioral alterations in the Brazilian clinical context

Neurological Disorders Depression Inventory for Epilepsy (NDDI-E): brazilian version of a screening instrument

INTRODUCTION: Depression is the most common psychiatric comorbidity in epilepsy, being its identification frequently neglected in most epilepsy centers. OBJECTIVE: To evaluate the performance of the Brazilian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) in a group of patients from a specialized center. METHODS: The recently validated Brazilian version of the NDDI-E was applied to a group of 142 outpatients with epilepsy. We used the MINI-Plus as a gold standard to diagnosis major depressive episode. Results: Forty patients (28.2%) were depressed at the time of evaluation. The ROC curve analysis indicated that the cutoff at 15 (>15) represented the greatest dichotomy between depressed and nondepressed (sensitivity 70.0%, specificity of 87.3%, positive predictive value of 68.3% and negative predictive value of 88.1%). The use of lower cutoff points may eventually be adopted to provide greater sensitivity to the instrument. CONCLUSION: The Brazilian version of NDDI-E is a sensitive and practical tool that can help in tracking depression in epilepsy in order to reduce its underdiagnosis.INTRODUÇÃO: Depressão é a comorbidade psiquiátrica mais frequente na epilepsia, sendo sua identificação frequentemente negligenciada nos centros especializados. OBJETIVO: Avaliar o desempenho da versão brasileira do Inventário de Depressão em Transtornos Neurológicos para a Epilepsia (IDTN-E) em um grupo de pacientes atendidos em um serviço especializado. MÉTODOS: A versão brasileira do ITDN-E foi aplicada em um grupo de 142 pacientes com epilepsia. Foi utilizado o MINI-Plus como padrão ouro para o diagnóstico de episódio depressivo maior. Resultados: Quarenta pacientes (28,2%) apresentavam o diagnóstico de depressão no momento da avaliação. A análise da curva ROC indicou que o ponto de corte em 15 (>15) para o IDTN-E representa dicotomização ótima entre deprimidos e não deprimidos (sensibilidade de 70,0%, especificidade de 87,3%, valor preditivo positivo de 68,3% e valor preditivo negativo de 88,1%). A utilização de pontos de corte inferiores pode eventualmente ser adotada para proporcionar uma maior sensibilidade ao instrumento. CONCLUSÃO: A versão brasileira do IDTN-E é um instrumento sensível e prático que pode auxiliar o rastreamento da depressão na epilepsia, diminuindo o seu subdiagnóstico.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Hospital Felício Rocho Centro Universitário de Belo HorizonteUniversidade Federal de São Paulo (UNIFESP) Departamento de Neurologia e NeurocirurgiaUniversidade Federal de São Paulo (UNIFESP) Departamento de PsiquiatriaUniversidade Federal de Minas Gerais Faculdade de MedicinaUniversidade Federal de Minas Gerais Instituto de Ciências BiológicasUniversidade Federal de Minas Gerais Hospital das Clínicas Serviço de NeurologiaHospital Felício Rocho Núcleo Avançado de Tratamento das EpilepsiasUniversidade Federal de Minas Gerais Hospital das ClínicasUNIFESP, Depto. de Neurologia e NeurocirurgiaUNIFESP, Depto. de PsiquiatriaSciEL

An exploratory study of short-term camping in Antarctica: Hormonal and mood states changes

Long-term Antarctic expedition’s studies indicated harmful or positive behavioral and psychophysiological adaptive changes that arise from adversities in isolated, confined, and extreme environments. Whereas most of the published studies focused on overwintering situations, most Brazilian Antarctic Program summer expeditions consist of short-term stays. We evaluated the influence of a permanence in Antarctic short-term (13-day) summer camp on the hormonal responses and mood states in eight volunteers. Data collection was carried out at the beginning (initial measure, days 3 to 5) and the end (final measurement, days 10 to 12) of the camping. Morning and evening samples of saliva were obtained to measure the testosterone and cortisol concentrations. Morning blood drops were used to determine thyroid-stimulating hormone (TSH) and thyroxine (T4) concentration. The volunteers also answered a mood states questionnaire. During the short-term camp, T4 (3.92 ± 0.75 vs 2.21 ± 0.71 μg.dL-1) and T4/TSH (3.16 ± 0.97 vs 1.79 ± 0.74 AU) reduced, without concomitant changes in TSH (1.28 ± 0.17 vs 1.30 ± 0.09 μU.mL-1), and salivary cortisol increased (2,392 ± 1,153 vs 4,440 ± 1,941 pg.mL-1) resulting in greater cortisol amplitude (calculated from the difference between morning and evening measurement, 1,400 ± 1,442 vs 3,230 ± 2,046). In men, testosterone increased as well (26.2 ± 12.5 vs 67.8 ± 45.8, all differences with P<0.05). There was a moderate effect in mood states evidenced by increased anger and fatigue, and reduced vigor. At the end of the camp, the change in cortisol correlated with anger, and the final cortisol values with anger and tension. We concluded that staying in a short-term summer camp in Antarctica induced endocrine and mood state changes, indicators of stress reaction

Dimerização e trimerização de eteno catalisadas por Ni(acac)2NaX ou NaY/AlEt3

29

Core competencies as a determinant in highly competitive environments: the mobile telephone sector in Minas Gerais

In competitive environments it is essential that companies continuously innovate resources, capabilities and skills to quickly face demands from external sources. Some authors such as Hitt, Ireland and Hoskinsson, 200 and Hamel e Prahalad, 1995, state that core competencies promote competitive advantages and above average returns that persist until competition imitates or surpasses them. Others, Barney and Muhanna, 2004 and Peng, 2008, understand them as a set of capabilities that are valuable, rare, difficult to imitate and ones that the organization succeeds in implementing. In highly competitive environments there is evidence that effective strategic leadership by means of core competencies makes companies more agile and capable of superior performance (BARNEY; MUHANNA, 2004; PENG, 2008). This article describes the results of a survey of companies of the mobile telephone sector in Minas Gerais that investigated processes for formulation and management of core competencies as determinants in sector competition and achievement of leadership. A multi-case study was made with semi-structured interviews of the managers. Core competencies were found to be the subject of great attention and concern for organization leaders, although there are no recognized methods to promote these capabilities.En ambientes competitivos es imprescindible que las empresas innoven continuamente en recursos, capacidades y competencias para atender rápidamente las constantes demandas del ambiente externo. Según algunos autores (HAMEL; PRAHALAD, 1995; HITT; IRELAND; HOSKINSSON, 2001), las competencias esenciales (CE) promueven ventajas competitivas y retornos superiores al promedio que se sostienen mientras los adversarios no las imitan o superan. Las CE son entendidas (BARNEY; MUHANNA, 2004; PENG, 2008) como un conjunto de capacidades VRIO (Valiosas, Raras, difíciles de Imitar y que la Organización consigue implementar). En contextos hipercompetitivos, existen evidencias de que un liderazgo efectivo estratégico por medio de las CE vuelve las empresas más dinámicas y capaces de obtener un desempeño más elevado (BARNEY; MUHANNA, 2004; PENG, 2008). El artículo describe los resultados de una investigación en empresas del sector de telefonía móvil del estado de Minas Gerais, realizando un estudio de los procesos de formulación y gestión de Competencias Esenciales como elementos determinantes de la competencia y de la obtención del liderazgo en ese sector. Se ha adoptado el método de análisis de casos múltiplos y han sido realizadas encuestas semiestructuradas con los gerentes de las empresas. Ha sido posible constatar que las CE son blancos de grande atención y preocupación del cuadro directivo de las organizaciones, aunque no existan metodologías formales que promuevan su desarrollo.Em ambientes competitivos é imprescindível que as empresas inovem continuamente em recursos, capacidades e competências, para atender rapidamente às constantes demandas do ambiente externo. Segundo alguns autores (HAMEL; PRAHLAD, 1995; HITT; IRELAND; HOSKINSSON, 2001), enquanto a concorrência não as imita ou as supera, as competências essenciais (CE) promovem vantagens competitivas e retornos acima da média que se sustentam. As CE são entendidas (BARNEY; MUHANNA, 2004; PENG, 2008) como um conjunto de capacidades VRIO (Valiosas, Raras, difíceis de Imitar e que a Organização consegue implementar). Em contextos hipercompetitivos, há evidências de que uma efetiva liderança estratégica por meio de CE torna as empresas mais ágeis e aptas a um desempenho superior (BARNEY; MUHANNA, 2004; PENG, 2008). Este artigo descreve os resultados de uma pesquisa em empresas do setor de telefonia celular de Minas Gerais, investigando os processos de formulação e gestão de Competências Essenciais como fatores determinantes da competição e da obtenção da liderança nesse setor. Adotou-se o método de estudo multicasos e foram realizadas entrevistas semiestruturadas com os gerentes das empresas. Verificou-se que as CE são alvo de grande atenção e preocupação dos dirigentes das organizações, embora não existam metodologias formais que promovam o seu fomento