The current conjuncture of collective public transport in the insular space in the Metropolitan region of Greater São Luís-Ma

No Brasil, a expansão urbana dispersa originou problemas na mobilidade de passageiros, no transporte de mercadorias e em muitos outros setores. O artigo objetivou-se analisar a mobilidade do usuário de transporte público nos municípios da Ilha do Maranhão e a sua relação entre as instituições (públicas e privadas) e equipamentos urbanos do referido setor. A pesquisa foi realizada em 2015 nos municípios assentados na Ilha do Maranhão que, juntamente com outros municípios, compõem a Região Metropolitana da Grande São Luís. Aplicou-se 203 questionários e realização de 10 entrevistas com usuários do transporte público. Ao longo da pesquisa, foi possível observar que os equipamentos urbanos dos municípios investigados são inadequados para garantir mobilidade aos usuários, a qual está concentrada nas áreas nobres. O transporte público perdeu produtividade ao longo dos anos, o que pode ser comprovado pela estagnação do IPK e pela migração de muitos usuários para o transporte alternativo.In Brazil, the dispersed urban sprawl has led to problems in mobility of passengers in the transport of goods and in many other sectors. The article aimed to analyze the mobility of public transport users in the municipalities of Ilha do Maranhão and its relationship between institutions (public and private) and urban equipment in this sector. The research was conducted in 2015 in the municipalities settled on the Island of Maranhão, which, together with other municipalities, make up the Metropolitan Region of Greater São Luís. 203 questionnaires were applied and 10 interviews were conducted with users of public transport. Throughout the research, it was possible to observe that the urban equipment of the investigated municipalities is inadequate to ensure mobility to users, which is concentrated in the noble areas. The public transportation lost productivity, which can be evidenced by the stagnation of the IPK and the migration of many users for alternate transportation

A abordagem lúdica no hospital: impacto positivo na condição emocional dos pais e crianças internadas no Hospital Universitário HU-UFJF

The act of playing is part of the children's daily routine, but when they are hospitalized and inserted in an environment totally different from the usual, their routine changes and their behavior changes, resulting from the psycho-emotional changes that take place. In this context, the objective of the present study was to analyze how a playful approach in the hospital environment impacts the emotional and psychological condition of children and their parents / guardians. A cross-sectional study was carried out with a convenience sample of 33 parents / guardians and 29 children, of both genders and ages ranging from 2 to 15 years, admitted to the pediatric ward of Hospital Universitário-UFJF. The study was conducted from March to December 2019, when recreational activities were carried out with the children, through games and games, developed by the dental team of the extension project Integrando o Saber. The results showed that when asked about the play activity developed, 93.93% of parents / guardians considered it to be excellent and 6.06%, good. As for the children's perception of play, 96.55% reported liking it. Regarding the self-reported feeling of the children, after the recreational activities 39% said they were happier, 24% happy, 15% less afraid of the hospital and 15% the same before. Thus, it is possible to observe that the development of playful activities, with hospitalized children, generated a positive impact on their emotional and psychological state, due to the break in the hospital routine. Regarding the impact of activities on parents, what was noticed was that when they saw their children playing and happier, parents felt less tense, anxious and sad, which proves the benefit of playfulness in both groups.O ato de brincar faz parte da rotina de vida das crianças, mas quando elas estão hospitalizadas e inseridas em um meio totalmente diferente do habitual, sua rotina se modifica e seu comportamento sofre alterações, decorrentes das mudanças psicoemocionais que se processam. Nesse contexto, o objetivo do presente estudo foi analisar como uma abordagem lúdica no ambiente hospitalar impacta na condição emocional e psicológica das crianças e de seus pais/responsáveis. Foi realizado um estudo transversal com uma amostra de conveniência de 33 pais/responsáveis e 29 crianças, de ambos os gêneros e idade variando de 2 a 15 anos, internadas na ala pediátrica do Hospital Universitário-UFJF. O estudo foi conduzido de março a dezembro de 2019, quando foram realizadas atividades lúdicas com as crianças, por meio de jogos e brincadeiras desenvolvidas pela equipe de odontologia do projeto de extensão Integrando o Saber. Os resultados mostraram que quando inqueridos a respeito da atividade lúdica desenvolvida, 93,93% dos pais/responsáveis a consideraram ótima e 6,06%, boa. Quanto à percepção das crianças em relação as brincadeiras, 96,55% relataram gostar. Em relação às emoções manifestadas pelas crianças, após as atividades lúdicas 39% disseram-se mais felizes, 24% alegres, 15% com menos medo do hospital e 15% igual antes. Assim, é possível observar que o desenvolvimento das atividades lúdicas, com as crianças internadas, gerou um impacto positivo em seu estado emocional e psicológico, devido à quebra na rotina hospitalar. Em relação ao impacto das atividades nos pais, o que se percebeu foi que ao verem seus filhos brincando e mais felizes, os pais sentiram-se menos tensos, ansiosos e tristes, o que comprova o benefício do lúdico, em ambos os grupos

Pathophysiological aspects of nephropathy caused by non-steroidal anti-inflammatory drugs

Abstract Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used medications associated with nephrotoxicity, especially when used chronically. Factors such as advanced age and comorbidities, which in themselves already lead to a decrease in glomerular filtration rate, increase the risk of NSAID-related nephrotoxicity. The main mechanism of NSAID action is cyclooxygenase (COX) enzyme inhibition, interfering on arachidonic acid conversion into E2 prostaglandins E2, prostacyclins and thromboxanes. Within the kidneys, prostaglandins act as vasodilators, increasing renal perfusion. This vasodilatation is a counter regulation of mechanisms, such as the renin-angiotensin-aldosterone system works and that of the sympathetic nervous system, culminating with compensation to ensure adequate flow to the organ. NSAIDs inhibit this mechanism and can lead to acute kidney injury (AKI). High doses of NSAIDs have been implicated as causes of AKI, especially in the elderly. The main form of AKI by NSAIDs is hemodynamically mediated. The second form of NSAID-induced AKI is acute interstitial nephritis, which may manifest as nephrotic proteinuria. Long-term NSAID use can lead to chronic kidney disease (CKD). In patients without renal diseases, young and without comorbidities, NSAIDs are not greatly harmful. However, because of its dose-dependent effect, caution should be exercised in chronic use, since it increases the risk of developing nephrotoxicity

Obesity in Heart Failure with Preserved Ejection Fraction:Insights from the REDUCE LAP-HF II Trial

BACKGROUND AND AIMS: Obesity is causally related to the development of HFpEF but complicates the diagnosis and treatment of this disorder. We aimed to determine the relationship between severity of obesity and clinical, echocardiographic and hemodynamic parameters in a large cohort of patients with documented HFpEF. METHODS: The REDUCE LAP-HF II trial randomized 626 patients with EF =40% and exercise pulmonary capillary wedge pressure (PCWP) =25?mmHg to atrial shunt or sham procedure. We tested for associations between body mass index (BMI), clinical characteristics, cardiac structural and functional abnormalities, physical limitations, quality of life and outcomes with atrial shunt therapy. RESULTS: 60.9% of patients had BMI =30?kg/m . As the severity of obesity increased, symptoms (KCCQ score) and 6-min walk distance worsened. More severe obesity was associated with lower natriuretic peptide levels despite more cardiac remodeling, higher cardiac filling pressures, and higher cardiac output. Lower cut points for E/e' were needed to identify elevated PCWP in more obese patients. Strain measurements in all 4 chambers were maintained as BMI increased. Pulmonary vascular resistance at rest and exercise decreased with higher BMI. Obesity was associated with more first and recurrent HF events. However, there was no significant interaction between obesity and treatment effects of the atrial shunt. CONCLUSIONS: Increasing severity of obesity was associated with greater cardiac remodeling, higher right and left ventricular filling pressures, higher cardiac output and increased subsequent HF events. Despite significant obesity, many HFpEF patients have preserved right heart and pulmonary vascular function and thus, may be appropriate candidates for atrial shunt therapy. This article is protected by copyright. All rights reserved

Satellyptus: analysis and database of microsatellites from ESTs of Eucalyptus

The main goal of our research was to search for SSRs in the Eucalyptus EST FORESTs database (using a software for mining SSR-motifs). With this objective, we created a database for cataloging Eucalyptus EST-derived SSRs, and developed a bioinformatics tool, named Satellyptus, for finding and analyzing microsatellites in the Eucalyptus EST database. The search for microsatellites in the FORESTs database containing 71,115 Eucalyptus EST sequences (52.09 Mb) revealed 20,530 SSRs in 15,621 ESTs. The SSR abundance detected on the Eucalyptus ESTs database (29% or one microsatellite every four sequences) is considered very high for plants. Amongst the categories of SSR motifs, the climeric (37%) and trimeric ones (33%) predominated. The AG/CT motif was the most frequent (35.15%) followed by the trimeric CCG/CGG (12.81%). From a random sample of 1,217 sequences, 343 microsatellites in 265 SSR-containing sequences were identified. Approximately 48% of these ESTs containing microsatellites were homologous to proteins with known biological function. Most of the microsatellites detected in Eucalyptus ESTs were positioned at either the 5′ or 3′ end. Our next priority involves the design of flanking primers for codominant SSR loci, which could lead to the development of a set of microsatellite-based markers suitable for marker-assisted Eucalyptus breeding programs