Plano de ação para redução da alta incidência de pacientes com hipertensão arterial sistêmica e diabetes mellitus na área da ESF São Pedro

A Hipertensão Arterial e a Diabetes Mellitus (DM) vem aumentando muito nos últimos anos na área de abrangência da Equipe de Saúde da Família. O modelo econômico e social leva a um ambiente cultural e socioeconômico específico em cada região, e em nossa população existem hábitos de vida não saudáveis que podem ser tanto por condições financeiras quanto por aspectos culturais. Os principais determinantes nesse aumento: alimentação inadequada, falta de atividade física, stress, sobrepeso e a obesidade. No município de Itinga a principal causa de óbito são as doenças do aparelho cardiovascular tanto em homens como em mulheres, sendo a maioria dos casos associadas à Hipertensão Arterial Sistêmica (HAS). Assim, este estudo objetivou elaborar um projeto de intervenção para diminuir a incidência de Hipertensão Arterial e Diabetes Mellitus em o ESF São Pedro de Itinga. Este plano se baseou no Planejamento Estratégico Situacional e na pesquisa de artigos na Biblioteca Virtual em Saúde, com os descritores: Hipertensão, Diabetes Mellitus e fatores de risco. Espera-se evitar complicações e sequelas provenientes dessas doenças e aumentar a qualidade de vida desses pacientes

PRAXIS DOCENTE EN LOS PROGRAMAS NACIONALES DE FORMACIÓN/TEACHING PRAXIS IN NATIONAL TRAINNIG PROGRAMS

Los Programas Nacionales de Formación (PNF) constituyen una forma dinamizante e innovadora de gestionar los currículos universitarios venezolanos en consonancia con el momento histórico y de transformación social del país, cuyo fin es el Socialismo del Siglo XXI, como forma de organización política, histórica, económica, cultural y territorial. El artículo realiza un acercamiento desde lo documental de cómo se ha venido materializando la praxis del docente a partir  de  estos programas en los Institutos Universitarios de Tecnologías. Se fundamenta teóricamente en los aportes de autores como García (2010), Barrera (2008), Becerra y Moya (2010), la documentación presentada por la Misión Sucre (2011) y Misión Alma Mater (2009).  El  objetivo propuesto fue analizar la praxis docente en los PNF, abordando algunas categorías que inciden en ella. Se aplicó el enfoque de corte analítico, enmarcado en el paradigma post positivista. Como resultado del análisis se identificaron en la praxis docente, persistencias de prácticas conductistas o constructivistas contrapuestas a los modelos conceptuales aplicados

Nonalcoholic Fatty Liver Disease, Diabetes Mellitus and Cardiovascular Disease: Newer Data

Nonalcoholic fatty liver disease (NAFLD) is the most common, chronic liver disease worldwide. Within this spectrum, steatosis alone is apparently benign, while nonalcoholic steatohepatitis may progress to cirrhosis and hepatocellular carcinoma. NAFLD is strongly associated with obesity, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease. The pathogenesis of hepatic steatosis is not clearly known, but its main characteristics are considered insulin resistance, mitochondrial dysfunction, increased free fatty acids reflux from adipose tissue to the liver, hepatocyte lipotoxicity, stimulation of chronic necroinflammation, and fibrogenic response. With recent advances in technology, advanced imaging techniques provide important information for diagnosis. There is a significant research effort in developing noninvasive monitoring of disease progression to fibrosis and response to therapy with potential novel biomarkers, in order to facilitate diagnosis for the detection of advanced cirrhosis and to minimize the need of liver biopsy. The identification of NAFLD should be sought as part of the routine assessment of type 2 diabetics, as sought the microvascular complications and cardiovascular disease, because it is essential for the early diagnosis and proper intervention. Diet, exercise training, and weight loss provide significant clinical benefits and must be considered of first line for treating NAFLD

Dietary fat intake as a risk factor for the development of diabetes. Multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (MGDS)

In the context of the Multinational MGSD Nutrition Study, three groups of subjects were studied: 204 subjects with recently diagnosed diabetes(RDM),42subjectswithundiagnoseddiabetes(UDM)(AmericanDiabetesAssociation criteria—fasting plasma glucose [FPG] 126 mg/dl), and 55 subjects with impaired fasting glucose(IFG)(FPG 110and126mg/dl).Eachgroupwascomparedwithacontrolgroupof nondiabetic subjects, matched one by one for center, sex, age, and BMI. Nutritional habits were evaluated by a dietary history method, validated against the 3-day diet diary. In RDM, the questionnaire referred to the nutritional habits before the diagnosis of diabetes. Demographic data were collected, and anthropometrical and biochemical measurements were taken. RESULTS— Compared with control subjects, RDM more frequently had a family history of diabetes(49.0vs.14.2%;P0.001),exercisedless(exerciseindex53.5vs.64.4;P0.01),and more frequently had sedentary professions (47.5 vs. 27.4%; P 0.001). Carbohydrates contributed less to their energy intake (53.5 vs. 55.1%; P 0.05), whereas total fat (30.2 0.5 vs. 27.8 0.5%; P 0.001) and animal fat (12.2 0.3 vs. 10.8 0.3%; P 0.01) contributed moreandtheplant-to-animalfatratiowaslower(1.50.1vs.1.80.1;P0.01).UDMmore frequentlyhadafamilyhistoryofdiabetes(38.1vs.19.0%;P0.05)andsedentaryprofessions (58.5vs.34.1%;P0.05),carbohydratescontributedlesstotheirenergyintake(47.61.7vs. 52.81.4%;P0.05),totalfat(34.71.5vs.30.41.2%;P0.05)andanimalfat(14.2 0.9 vs. 10.6 0.7%; P 0.05) contributed more, and the plant-to-animal fat ratio was lower (1.6 0.2 vs. 2.3 0.4; P 0.05). IFG differed only in the prevalence of family history of diabetes (32.7 vs. 16.4%; P 0.05). CONCLUSIONS— Our data support the view that increased animal fat intake is associated with the presence of diabetes

Pancreas volumes in humans from birth to age one hundred taking into account sex, obesity, and presence of type-2 diabetes

Our aims were (1) by computed tomography (CT) to establish a population database for pancreas volume (parenchyma and fat) from birth to age 100 years, (2) in adults, to establish the impact of gender, obesity, and the presence or absence of type-2 diabetes on pancreatic volume (parenchyma and fat), and (3) to confirm the latter histologically from pancreatic tissue obtained at autopsy with a particular emphasis on whether pancreatic fat is increased in type-2 diabetes. We measured pancreas volume in 135 children and 1,886 adults (1,721 nondiabetic and 165 with type-2 diabetes) with no history of pancreas disease who had undergone abdominal CT scan between 2003 and 2006. Pancreas volume was computed from the contour of the pancreas on each CT image. In addition to total pancreas volume, parenchymal volume, fat volume, and fat/parenchyma ratio (F/P ratio) were determined by CT density. We also quantified pancreatic fat in autopsy tissue of 47 adults (24 nondiabetic and 23 with type-2 diabetes). During childhood and adolescence, the volumes of total pancreas, pancreatic parenchyma, and fat increase linearly with age. From age 20–60 years, pancreas volume reaches a plateau (72.4 ± 25.8 cm3 total; 44.5 ± 16.5 cm3 parenchyma) and then declines thereafter. In adults, total (∼32%), parenchymal (∼13%), and fat (∼68%) volumes increase with obesity. Pancreatic fat content also increases with aging but is not further increased in type-2 diabetes. We provide lifelong population data for total pancreatic, parenchymal, and fat volumes in humans. Although pancreatic fat increases with aging and obesity, it is not increased in type-2 diabetes. Clin. Anat. 20:933–942, 2007. © 2007 Wiley-Liss, Inc

El acto de donación de órganos vitales en el audiovisual. Estudio de caso en Manzanillo (Original)

The power of audiovisuals to build up an interpretation in favor of the vital organ donation act exceeds the limits of the trivial use of advertising campaigns. The scrutinizing of audiovisual media related to the treatment of this generous gesture corroborates that though a magnificent commercial may contribute to such social sensitization, television reports, documentaries and movies as genres have greater  media power for the need of this type of messages  to be understood.  The general aim of this presentation is to back up the media and communicational influence of audiovisuals in understanding the vital organ donation act.  The specific aims are to analyze and compare the influence of television genres among the Manzanillo people involved in a donation and transplantation process since 2010 up to 2016. In order to verify the value of these genres, there are used data making up the record gathered up through a case study being carried out in Manzanillo entitled “Meanings of the vital organ donation act”. The study is developed from the precepts of Sociology and combines the macrosocial and the microsocial. There are used ethnographic observation techniques, focal groups, life stories and thorough interviews.  The most significant outcome: it was verified the capacity of audiovisuals and their genres to cause among spectators: subject/performing actor – now in the role of vital organ donor- a mimetic attitude, effect from the television and movie diegesis.  El poder del audiovisual para construir una interpretación a favor del acto de donación de órganos vitales desborda los límites del trivial uso de campañas publicitarias. El escudriñamiento a los medios audiovisuales en torno al tratamiento de este gesto generoso  corrobora que, si bien un magnífico spot publicitario puede contribuir a tal sensibilización social, los reportajes televisivos, los documentales  y los filmes como géneros tienen mayor fuerza mediática para que se  comprenda  la necesidad de este tipo de mensajes. El objetivo general de esta ponencia es argumentar la influencia mediática y comunicacional del audiovisual en la comprensión del acto de donación de órganos vitales. Los objetivos específicos son analizar y comparar la influencia de los géneros televisivos entre los manzanilleros que se involucraron en un proceso de donación y trasplante del 2010-2016. Para constatar el valor de estos géneros se utilizan datos que forman parte del registro obtenido en un estudio de casos que se realiza en Manzanillo con el título “Significados del acto de donación de órganos vitales”. El estudio se realiza desde el  asidero de la Sociología y combina lo macrosocial y lo microsocial. Se usan las técnicas de observación etnográfica, grupos focales, historias de vida y  entrevistas en profundidad. El resultado más significativo: se constató la capacidad del audiovisual y sus géneros  para  provocar en el espectador: sujeto/actor  interpretante – ahora en el rol de donante de órganos vitales- la actitud mimética, efecto de la diégesis televisiva y cinematográfica

Spinal versus General Anaesthesia in Postoperative Pain Management during Transurethral Procedures

We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (P = 0.027). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy (P = 0.017 and P = 0.007, resp.). A higher VAS score was observed in pT2 patients. Patients with resected tumour volume >10 cm3 exhibited a VAS score >3 at 8 h and 24 h (P = 0.050, P = 0.036, resp.). Multifocality of bladder tumours induced more pain overall. It seems that spinal anaesthesia is more effective during the first 2 postoperative hours, while general prevails at later stages and at larger traumatic surfaces. Finally, we incidentally found that tumour stage plays a significant role in postoperative pain, a point that requires further verification