Intervention diversity predicts social rehabilitation indicators at discharge in Therapeutic Communities.

INTRODUCTION: The Therapeutic Community Model narrows the gap in substance use disorder's network of assistance in Brazil by offering residential treatment to socially vulnerable populations. Due to a historical lack of evidence-based approaches, the government has established treatment guidelines and has been trying to implement training and monitoring methods. METHOD: This study analysed real-world data from the monitoring system implemented in the largest network of institutions receiving public funds in the State of Sao Paulo. Data came from 8109 records of individuals admitted between 2014 and 2016 in 48 institutions. RESULTS: Results showed that less than half of the sample was exposed to at least one therapeutic activity from each of the recreational, spiritual, educational and selfcare intervention domains, as proposed by the national guidelines. Social rehabilitation outcome (SRO) defined by housing and self-support at discharge was reported by 21 % of the sample, who stayed in residential treatment for 82.6 days in average. More than half completed the therapeutic programme while 27.3 % dropout. Treatment duration and the diversity of the interventions offered were significantly associated with SRO when mutually adjusted. Chances of SRO increased nearly 5 times when residents were offered the full range of intervention domains, even when controlling for treatment duration. Treatment duration increased chances of SRO in a dose-response manner with a threefold increase for stays up to 90 days and over 9 times for stays longer than 90 days. CONCLUSION: Our findings offer evidence to promote treatment guidelines compliance and to pave the way for the implementation of monitoring systems for this modality of treatment in Brazil and abroad.

Mobility and HIV vulnerabilities among female sex workers in Guinea-Bissau: findings from an integrated bio-behavioral survey.

BACKGROUND: Mobility is an important risk determinant for HIV given the potential for intermittent access to HIV services. Mobility may be particularly relevant among female sex workers, (FSW) who have been shown to be at high risk for HIV in settings around the world. Data regarding the role mobility plays in exacerbating HIV risks among FSW across Sub-Saharan Africa remains limited, and data on FSW in Guinea-Bissau is sparse. METHODS: FSW in four regions of Guinea-Bissau were recruited with a respondent-driven sampling (RDS) method and participated in an integrated bio-behavioral survey between September 27, 2017 and January 26, 2018. Associations between reported general mobility, mobility to or residence in Bissau, and social and HIV vulnerabilities among FSW in Guinea-Bissau were assessed using multivariable logistic regression models. Population proportions were weighted for RDS sampling, while logistic regression models were not. RESULTS: Survey respondents included 323 individuals in Bissau, 45 in Bissorã, 140 in Bafatá, and 59 in Gabu. Statistical analyses demonstrated that mobility to more than one destination was significantly associated with recent sex without a condom (ie, sex without a condom within the last three sex acts) with both clients (aOR: 2.47 (95% CI: 1.08, 5.64)) and non-paying partners (aOR: 5.39 (95% CI: 2.61, 11.15)) compared to non-mobility. However, mobility to one or more locations was also associated with higher odds of receiving HIV prevention information, and mobility to more than one location was associated with participating in programming with HIV-related organizations. CONCLUSIONS: These results suggest that while some prevention services including HIV prevention information reach mobile FSW in Guinea-Bissau more than their non-mobile counterparts, the higher rates of condomless sex among mobile FSW suggest that HIV prevention needs may remain unmet for mobile FSW in Guinea-Bissau. Additionally, the results suggest a nuanced relationship between mobility, place of residence, and HIV and social vulnerabilities and prevention indicators.

O impacto das crenças em saúde sobre o controle da hipertensão arterial de idosos / The impact of health beliefs on the control of arterial hypertension in the elderly

Avaliar o impacto das crenças em saúde no controle da pressão arterial de idosos hipertensos em um município com elevado índice de desenvolvimento humano (IDHM), considerando sexo e classe social. Metodologia: O estudo foi realizado nas Unidades Básicas de Saúde do município de São Caetano do Sul. Foram coletadas informações sociodemográficas por meio de questionário. Aferiu-se a PA para a identificação dos pacientes hipertensos controlados e não controlados. Utilizou-se escala de crenças em saúde com sentenças sobre crenças de barreiras e benefícios relacionados a cada um dos treze comportamentos de saúde referentes às medidas de prevenção e controle da hipertensão arterial. Realizou-se análise descritiva e razão de prevalência, considerando significância para p ≤ 0,05. Resultados: Observamos que a maioria dos pacientes aderiu ao tratamento, tendo noção dos benefícios de controlar os fatores de risco de hipertensão. Conclusão: Concluímos que os dados foram semelhantes entre homens e mulheres e a classe social impactou inversamente na adesão ao tratamento medicamentoso

To assess the impact of health beliefs on blood pressure control in hypertensive elderly patients in a municipality with a high human development index (HDI), considering sex and social class. Methodology: The study was carried out at the Basic Health Units of the municipality of São Caetano do Sul. Sociodemographic information was collected through a questionnaire. BP was measured to identify controlled and uncontrolled hypertensive patients. A health belief scale with judgments on the perceived barriers and benefits related to each of the thirteen health behaviors corresponding to hypertension prevention and control measures was used. A descriptive analysis was conducted and a prevalence ratio calculated, considering significance for p ≤0.05. Results: We observed treatment adherence in the majority of patients, who were aware of the benefits of controlling the risk factors for hypertension. Conclusion: We concluded that the data were similar between men and women, and that social class had an inverse impact on compliance with drug treatment

Resveratrol prevents oxidative damage and loss of sperm motility induced by long-term treatment with valproic acid in Wistar rats.

Valproic acid (VPA) is a drug widely use for the treatment of epilepsy in both children and adults. Evidence suggests that long-term use of VPA may lead to an impairment in the male reproductive function. Oxidative stress is considered to play a major role in VPA associated toxicity. In the present work, we demonstrated that the natural antioxidant compound resveratrol (RSV) can be use to prevent VPA oxidative damage. Wistar rats treated with VPA (400mgkg(-1)) by gavage for 28days showed decrease in sperm motility accompanied by increase in oxidative damage to lipids and proteins. Additionally, VPA administration leaded to depletion of reduced glutathione and decrease in total antioxidant potential in testes and epididymides of Wistar rats. The co-administration of RSV (10mgkg(-1)) efficiently prevented VPA pro-oxidant effects. In summary, RSV was shown to protect the reproductive system from the damage induced by VPA. Altogether, our data strongly suggests that RSV administration might be a valuable strategy to minimize reproductive impairment in patients requiring long-term VPA treatment.

Protective effect of vitamin E on sperm motility and oxidative stress in valproic acid treated rats.

Long-term administration of valproic acid (VPA) is known to promote reproductive impairment mediated by increase in testicular oxidative stress. Vitamin E (VitE) is a lipophilic antioxidant known to be essential for mammalian spermatogenesis. However, the capacity of this vitamin to abrogate the VPA-mediated oxidative stress has not yet been assessed. In the current study, we evaluated the protective effect of VitE on functional abnormalities related to VPA-induced oxidative stress in the male reproductive system. VPA (400 mg kg(-1)) was administered by gavage and VitE (50 mg kg(-1)) intraperitoneally to male Wistar rats for 28 days. Analysis of spermatozoa from the cauda epididymides was performed. The testes and epididymides were collected for measurement of oxidative stress biomarkers. Treatment with VPA induced a decrease in sperm motility accompanied by an increase in oxidative damage to lipids and proteins, depletion of reduced glutathione and a decrease in total reactive antioxidant potential on testes and epididymides. Co-administration of VitE restored the antioxidant potential and prevented oxidative damage on testes and epididymides, restoring sperm motility. Thus, VitE protects the reproductive system from the VPA-induced damage, suggesting that it may be a useful compound to minimize the reproductive impairment in patients requiring long-term treatment with VPA.

Perfil socioepidemiológico e autonomia de longevos em Recife-PE, Nordeste do Brasil / Socio-epidemiological profile and autonomy of elderly in the city of Recife, northeastern Brazil

Dos processos articulados de transição demográfica e epidemiológica em curso nas últimas décadas no país, decorre o crescimento da população idosa, particularmente do número de idosos longevos, com idade acima de 80 anos. Este processo de envelhecimento da população impõe uma reorganização do Estado e da sociedade, principalmente em relação aos sistemas de saúde e previdenciário. OBJETIVO: Analisar o perfil socioepidemiológico e o grau de autonomia e independência de idosos longevos na cidade de Recife-PE. MÉTODO: Trata-se de um estudo epidemiológico descritivo, do tipo corte transversal, de amostra aleatória, composto por 227 idosos. Estes responderam ao questionário Brazil Old Age Schedule (BOAS) modificado em entrevistas domiciliares nos seis distritos da cidade. RESULTADOS: Na maioria dos idosos, verificaram-se a feminização, o baixo nível de escolaridade, a viuvez como estado conjugal e a aposentadoria como principal fonte de renda. Os idosos residiam comumente com filhas e netos, e os principais problemas de saúde foram hipertensão, doença de coluna, problemas de visão, incontinência urinária e osteoporose. O grau de autonomia e independência dos idosos longevos foi considerado bom, uma vez que não houve relato de impedimentos em realizar as atividades da vida diária (AVD) pela maioria dos idosos. CONCLUSÕES: Com a tendência de ampliação do número de idosos longevos nos próximos anos, é necessário implementar políticas públicas específicas, adequando programas e ações que contribuam efetivamente para a obtenção da qualidade de vida na velhice avançada. .

Articulated processes of demographic and epidemiological transition in progress in recent decades in the country are followed by the growth of the elderly population, particularly the number of oldest old, aged over 80 years. This population aging requires reorganization of the state and society, especially in relation to health and pension systems. OBJECTIVE: To analyze the socio-epidemiological profile and degree of autonomy and independence of the oldest old in the city of Recife, state of Pernambuco, Brazil. METHOD: This was a descriptive epidemiological study, of cross-sectional type, with random sample composed of 227 seniors. They answered the questionnaire Brazil Old Age Schedule (BOAS) Modified on household interviews in the six districts of the city. RESULTS: In most elderly there are feminization, low level of education, marital status as widowhood and retirement as main source of income. Older people commonly lived with daughters and grandchildren, and major health problems were hypertension, column disease, vision problems, incontinence and osteoporosis. The degree of autonomy and independence of the oldest old was considered good, since there were no reports of impairments in performing activities of daily living (ADLs) for most seniors. CONCLUSIONS: With the trend towards increasing the number of oldest old in the coming years, it is necessary to implement specific policies, adapting programs and actions that contribute effectively to the achievement of quality of life in advanced old age. .

Capacidade funcional de idosos com doenças crônicas residentes em Instituições de Longa Permanência / Functional ability of elderly with chronic diseases living in Long-Stay Institutions / Capacidad funcional de ancianos con enfermedades crónicas residentes en Instituciones de Longa Permanencia

O estudo objetivou descrever o desempenho funcional e a presença de doenças crônicas em 164 idosos residentes em Instituições de Longa Permanência, em Recife-PE, Brasil. Foram aplicados um questionário sociodemográfico, a Medida de Independência Funcional, a escala de Lawton e o Mini-mental. A análise de variância foi utilizada para avaliar as diferenças dos resultados. Os idosos eram predominantemente solteiros, mulheres, com baixa escolaridade. Entre os motivos de admissão destacaram-se: abandono, saúde frágil e vivência em rua. Encontrou-se alto percentual de doenças crônicas; 70% dos idosos eram dependentes para as atividades de vida diária, e todos eram dependentes para as atividades instrumentais. A demência foi o que mais afetou a funcionalidade, seguida das doenças osteoarticulares e do transtorno mental. Entre as atividades comprometidas destacaram-se o uso de escadas e o controle de esfíncteres, sendo a alimentação a de melhor desempenho. Verificou-se que os idosos institucionalizados apresentaram comprometimento funcional e situação de vulnerabilidade social.

The study aimed to describe the functional performance and the presence of chronic diseases in 164 elderly residents in long-stay institutions in Recife-PE, Brazil .A socio-demographic questionnaire, the Functional Independence Measurement, Lawton's scale and the Mini-Mental test were applied. Analysis of variance was used to assess differences in performance. The elders were predominantly single, women, and with low educational level. Among the reasons for admission stood out: abandonment, fragile health and living in the streets. It was found a high percentage of chronic diseases; 70% of elders were dependent for activities of daily living; and all were dependent for instrumental activities. Dementia was the disease that most affected functionality, followed by the osteoarticulares diseases and mental disorder. It was highlighted, among the impaired activities, the use of stairs and the sphincter control, with eating as the best performance. It was found that the institutionalized elderly showed functional impairment and social vulnerability.

El objetivo de este estudio fue describir el desempeño funcional y la presencia de enfermedades crónicas en 164 ancianos de Instituciones de Larga Permanencia, en Recife-PE, Brasil. Fueron aplicados un cuestionario socio-demográfico, la Medida de Independencia Funcional, la escala de Lawton y el Mini-mental. El análisis de varianza fue utilizado para valuar las diferencias de los resultados. Los ancianos eran predominantemente solteros, mujeres y con baja escolaridad. Entre los motivos de admisión se destacaron: abandono, salud frágil y vivencia en la calle. Se encontró alto porcentual de enfermedades crónicas; 70% eran dependientes para las actividades de la vida diaria, y todos dependientes para las actividades instrumentales. La demencia fue la enfermedad que mas afectó la funcionalidad, seguida de las complicaciones osteoarticulares y del trastorno mental. Entre las actividades comprometidas se destaca el uso de escaleras y el control de esfínteres. La alimentación fue la actividad de mejor desempeño. Se verificó que los ancianos institucionalizados presentaron comprometimiento funcional y situación de vulnerabilidad social.

Resveratrol improves sperm motility, prevents lipid peroxidation and enhances antioxidant defences in the testes of hyperthyroid rats.

Hyperthyroidism may lead to a loss of sperm motility and an increase in oxidative stress (OS) in testes and may cause male reproductive disorders. Thus, the use of compounds with antioxidant properties may be a strategy for preventing these disorders. The effect of resveratrol (RSV) on sperm motility and on variables of the antioxidant status in the testes of rats with triiodothyronine-induced hyperthyroidism (100µg/kg) was investigated. Hyperthyroid rats presented lower sperm motility, higher levels of lipid hydroperoxides and thiobarbituric reactive substances, lower catalase and glutathione peroxidase activities and higher glutathione-S-transferase activity in their testes than control animals. RSV treatment (1mg/kg and 10mg/kg) was able to prevent these effects in the hyperthyroid rats and had no effect in the control animals. In conclusion, RSV might be a strategy for therapeutic intervention to preserve sperm motility and to prevent OS in testes, preserving testicular function in those with hyperthyroidism.

[Functional ability of elderly with chronic diseases living in Long-Stay Institutions]. / Capacidade funcional de idosos com doenças crônicas residentes em Instituições de Longa Permanência.

The study aimed to describe the functional performance and the presence of chronic diseases in 164 elderly residents in long-stay institutions in Recife-PE, Brazil .A socio-demographic questionnaire, the Functional Independence Measurement, Lawton's scale and the Mini-Mental test were applied. Analysis of variance was used to assess differences in performance. The elders were predominantly single, women, and with low educational level. Among the reasons for admission stood out: abandonment, fragile health and living in the streets. It was found a high percentage of chronic diseases; 70% of elders were dependent for activities of daily living; and all were dependent for instrumental activities. Dementia was the disease that most affected functionality, followed by the osteoarticulares diseases and mental disorder. It was highlighted, among the impaired activities, the use of stairs and the sphincter control, with eating as the best performance. It was found that the institutionalized elderly showed functional impairment and social vulnerability.

Envelhecimento, mobilidade urbana e saúde: um estudo da população idosa / Ageing, urban mobility and health: study addressing the elderly population

As cidades são objeto de investigação de diversas áreas do conhecimento científico. Urbanização crescente e envelhecimento populacional cursam de modo intenso, acelerado e com forte interface e colocam para os gestores públicos o desafio de pensar o futuro das grandes cidades com seu contingente de idosos que, de tão numerosos, poderão influenciar e até determinar, em algumas delas, suas políticas públicas de atenção social e de saúde. Pensar o futuro das grandes cidades é falar de mobilidade urbana para quem é idoso e para quem envelhece. Este estudo teve como objetivo estudar a relação entre envelhecimento, mobilidade urbana e condições de saúde em uma população idosa. Foram analisados:o perfil sociodemográfico e epidemiológico, a capacidade funcional através da autonomia e independência para o desempenho das Atividades de Vida Diária, a mobilidade dos idosos na cidade (acesso aos lugares e modos de deslocamento utilizados) e o acesso e a utilização dos serviços e ações de saúde pelos idosos no município. É um estudo epidemiológico descritivo de corte transversal, de base populacional, com 1200 moradores idosos (maior ou igual a 65 anos) do Recife/PE. A coleta de dados foi feita com um questionário multidimensional. Encontrou-se uma população essencialmente feminina, pouco escolarizada, com maior percentual de viuvez. Os idosos residem em domicílios multigeracionais e possuem renda (aposentadoria e/ou pensão). Têm uma percepção positiva do seu estado de saúde e boa capacidade funcional, embora refiram sofrer de algumas doenças. Hipertensão arterial foi a mais referida. A maioria é assistida pelo Sistema Único de Saúde. Saem de casa quando desejam, sem precisar de ajuda, deslocando-se a pé ou de ônibus. Consideram a cidade pouco acessível e insegura. Garantir, através de políticas públicas intersetoriais, a mobilidade das pessoas no espaço urbano é promover a capacidade funcional e a saúde e favorecer a participação cidadã dos idosos no cotidiano da cidade.

Resveratrol protects against a model of vacuous chewing movements induced by reserpine in mice.

Reserpine treatment is a putative animal model of orofacial dyskinesia, tremor, and Parkinsonism. Here, we examined the effects of resveratrol, a polyphenol with neuroprotective properties primarily contained in red grapes and red wine, in an animal model of vacuous chewing movements (VCMs) induced by treatment with reserpine. Mice were treated with reserpine (1 mg/kg, subcutaneously on days 1 and 3) and/or resveratrol (5 mg/kg, intraperitoneally 3 consecutive days). VCM, locomotor, and exploratory performance were evaluated. Reserpine treatment produced an increase in VCM intensity, which was significantly reduced by resveratrol co-treatment. Reserpine also decreased locomotor and exploratory activity in the open field test. However, resveratrol co-treatment was not able to protect against these effects. The data suggest that resveratrol could be a promising pharmacological tool for studying VCM in rodents. However, further investigations are needed to understand the exact mechanisms involved in the neuroprotective effects of resveratrol.

Propylthiouracil-induced congenital hypothyroidism upregulates vimentin phosphorylation and depletes antioxidant defenses in immature rat testis.

Congenital hypothyroidism was induced in rats by adding 0.05% 6-propyl-2-thiouracil in the drinking water from day 9 of gestation, and continually up to postnatal day 15. Structural alterations observed by light microscopy of seminiferous tubules and by transmission electron microscopy of Sertoli cells of treated animals were consistent with hypothyroid condition. Hypothyroidism was also associated with high phospho-p38 mitogen-activated protein kinase and decreased phospho-extracellular signal-regulated kinase 1/2 levels. Furthermore, the phosphorylation and the immunoreactivity of cytoskeletal-associated vimentin were increased without altering vimentin expression, suggesting an accumulation of insoluble and phosphorylated vimentin. These alterations in intermediate filament dynamics could result in loss of Sertoli cell cytoskeletal integrity and be somewhat related to the deleterious effects of hypothyroidism in testis. In addition, the mitochondrial alterations observed could also be related to defective cytoskeletal dynamics implying in cell damage. Moreover, we observed decreased oxygen consumption and unaltered lipid peroxidation in hypothyroid testis. However, we demonstrated decreased enzymatic and non-enzymatic antioxidant defenses, supporting an increased mitochondrial reactive oxygen species (ROS) generation, contributing to biochemical changes in hypothyroid testis. In addition, the changes in the testis histoarchitecture could be ascribed to cytoskeletal alterations, decreased antioxidant defenses, and increased ROS generation, leading to oxidative stress in the organ.

Hyperthyroidism in the developing rat testis is associated with oxidative stress and hyperphosphorylated vimentin accumulation.

Hyperthyroidism was induced in rats and somatic indices and metabolic parameters were analyzed in testis. In addition, the morphological analysis evidenced testes maturation and intense protein synthesis and processing, supporting the enhancement in vimentin synthesis in hyperthyroid testis. Furthermore, vimentin phosphorylation was increased, indicating an accumulation of phosphorylated vimentin associated to the cytoskeleton, which could be a consequence of the extracellular-regulated kinase (ERK) activation regulating the cytoskeleton. Biomarkers of oxidative stress demonstrated an increased basal metabolic rate measured by tissue oxygen consumption, as well as, increased TBARS levels. In addition, the enzymatic and non-enzymatic antioxidant defences appeared to respond according to the augmented oxygen consumption. We observed decreased total glutathione levels, with enhancement of reduced glutathione, whereas most of the antioxidant enzyme activities were induced. Otherwise, superoxide dismutase activity was inhibited. These results support the idea that an increase in mitochondrial ROS generation, underlying cellular oxidative damage, is a side effect of hyperthyroid-induced biochemical changes by which rat testis increase their metabolic capacity.

Ionic involvement and kinase activity on the mechanism of nongenomic action of thyroid hormones on 45Ca2+ uptake in cerebral cortex from young rats.

Thyroid hormones (TH) play important roles in brain development. Although most of the nongenomic actions of TH are known to be calcium-dependent, the effects of 3,5,3'-triiodo-L-thyronine (T(3)) or thyroxine (T(4)) on calcium influx in cerebral cortex of rats are not clear. In this study we investigate some mechanisms involved in the effect of T(3) and T(4) on Ca(2+) uptake in slices of cerebral cortex from 10-day-old male rats. Results indicated 10(-6)M T(3) or 10(-7)M T(4) was able to increase (45)Ca(2+) uptake after 30s of hormone exposure. The involvement of L- and T-type voltage-dependent Ca(2+) channels (VDCC) on the effect of TH on (45)Ca(2+) uptake was evidenced by using nifedipine and flunarizine, L- and T-type channel blockers, respectively. Otherwise, chloride currents were not involved in the hormone actions, as demonstrated by using 9-anthracene carboxylic acid, a Cl(-)-channel blocker. In addition, results demonstrated a PKC-dependent mechanism for both T(3) and T(4), as evidenced by stearoylcarnitine chloride, a specific PKC inhibitor. Furthermore, we verified that the T(3) action was also mediated by PKA activity, as demonstrated coincubating T(3) and KT 5720 (PKA inhibitor), and reinforced by using theophylline, a phosphodiesterase inhibitor. In contrast, concerning the effect of T(4), results suggest a partial involvement of PKA activity, and demonstrated that high cAMP levels were not able to support the effect of T(4), suggesting the participation of G inhibitory protein-coupled receptor in the action of this hormone on (45)Ca(2+) uptake. In conclusion, our results evidence a nongenomic action of TH promoting Ca(2+) influx by ionic channels involving mechanisms dependent on kinase activities. It is possible that the modulation of Ca(2+) channels by kinase activities represent an important membrane action of TH signaling mechanism in the central nervous system during development.

Depressão e envelhecimento: estudo nos participantes do Programa Universidade Aberta à Terceira Idade / Depression and aging: study comprising participants of the `Senior Citizens Open University`

OBJETIVOS: identificar a presença de depressão em idosos que freqüentaram o Programa Universidade Aberta à Terceira Idade, da Universidade Federal de Pernambuco, considerando variáveis demográficas e socioeconômicas. MÉTODOS: estudo epidemiológico, descritivo e de corte transversal. Foi realizado um censo com os 358 idosos sendo 312 mulheres e 46 homens (>60 anos), utilizando o questionário "Brasil Old Age Schedule" (BOAS), do qual foi selecionada a seção de saúde mental, quanto à depressão, verificando a freqüência das variáveis solidão, tristeza, pouca disposição, pessimismo em relação ao futuro, irritação, auto-acusação, idéias suicidas, dor de cabeça, insatisfação, distúrbios do sono e do apetite. RESULTADOS: foi encontrado um percentual importante de depressão (24,02 por cento) na população estudada, cuja maioria está classificada em depressão menor, entre a faixa etária de 70-79 anos, do sexo feminino e separados. Foi observada associação significante entre baixa escolaridade e depressão. Os casos de depressão apresentam relevante relação com as variáveis preocupação, dor de cabeça, pouca disposição, irritação, tristeza e insatisfação. CONCLUSÕES: a presença de depressão na população estudada aponta para a importância do planejamento, por parte do Programa, de ações direcionadas à saúde de seus participantes, em particular, os transtornos mentais relativos à depressão.

Acidente vascular cerebral precoce: implicações para adultos em idade produtiva atendidos pelo Sistema Unico de Saúde / Early cerebrovascular accident: implications in working-age adults assisted by the Brazilian Public Health System

OBJETIVOS: conhecer as incapacidades e identificar se há diferenças de gênero, em sobreviventes de primeiro episódio de acidente vascular cerebral (AVC), entre 20 e 59 anos de idade, na cidade do Recife e que tenham sido hospitalizados pelo Sistema Unico de Saúde. MÉTODOS: entrevista domiciliar com uma amostra de sobreviventes, investigando-se as incapacidades referidas na vida funcional e produtiva deles. RESULTADOS: amostra equilibrada entre os sexos, média de idade de 52 anos, com nível elementar de estudos ou analfabeto e trabalhando no setor de serviços, informal ou doméstico. Menos de 20 por cento informam recuperação total após o AVC. Aproximadamente 80 por cento apresentam algum déficit, sendo os problemas de comunicação e os sintomas depressivos mais freqüentes entre as mulheres. Após o AVC aumentou o número de desempregados e aposentados e as incapacidades repercutem negativamente na satisfação de vida de mais de 70 por cento dos entrevistados. CONCLUSÕES: é expressivo o percentual de casos, ainda jovens, com seqüelas pós AVC, sendo este mais precoce e o quadro de incapacidades mais freqüente e/ou grave entre as mulheres. A prevenção e a reabilitação após o AVC são desejáveis, com a implantação de programas, considerando as condições de gênero, para o controle dos riscos e para as seqüelas resultantes do AVC.

Involvement of K+ channels and calcium-dependent pathways in the action of T3 on amino acid accumulation and membrane potential in Sertoli cells of immature rat testis.

The purpose of this study was to investigate the involvement of calcium in K+ currents and its effects on amino acid accumulation and on the membrane potential regulated by tri-iodo-L-thyronine (T3) in Sertoli cells. Immature rat testes were pre-incubated for 30 min in Krebs-Ringer bicarbonate buffer and incubated for 60 min in the presence of [14C]methylaminoisobutyric acid with and without T3 or T4 (dose-response curve). Specific channel blockers or chelating agents were added at different concentrations during pre-incubation and incubation periods to study the basal amino acid accumulation and a selected concentration of each drug was chosen to analyze the influence on the stimulatory hormone action. All amino acid accumulation experiments were carried out in a Dubnoff metabolic incubator at 32 degrees C, pH 7.4 and gassed with O2:CO2 (95:5; v/v). Seminiferous tubules from immature Sertoli cell-enriched testes were used for the electrophysiology experiments. Intracellular recording of the Sertoli cells was carried out in a chamber perfused with KRb with/without T3, T4 or blockers and the membrane potential was monitored. We found that T3 and T4 stimulated alpha-[1-14C] methylaminoisobutyric acid accumulation in immature rat testes and induced a membrane hyperpolarization in Sertoli cells. The action of T3 on amino acid accumulation and on the hyperpolarizing effect was inhibited by the K(+)-ATP channel blocker tolbutamide as well as the voltage-dependent Ca2+ channel blocker verapamil. These results clearly demonstrate for the first time the existence of an ionic mechanism related to Ca2+ and K+ fluxes in the rapid, nongenomic action of T3.

Perfil sócio-epidemiológico demográfico das mulheres idosas da Universidade Aberta à Terceira Idade no estado de Pernambuco / Demographic social-epidemiological profile of elderly women enrolled at the Open University Program for Senior Citizens in the State of Pernambuco

OBJETIVOS: identificar o perfil sócio-epidemiológico demográfico das mulheres idosas que freqüentam o Programa Universidade Aberta à Terceira Idade, da Universidade Federal de Pernambuco (UnATI/UFPE), comparando com determinados estudos sobre universidades da terceira idade. MÉTODOS: estudo epidemiológico descritivo de corte transversal e censitário com 308 idosas, a partir dos 60 anos, do UnATI/UFPE. Foi utilizado um instrumento multidimensional, o Brazil Old Age Schedule composto por um questionário estruturado, através do qual investigou-se a situação pessoal e familiar, a condição econômico-social e os aspectos relativos à autonomia e independência funcional para o desempenho das atividades de vida diária e à ocupação do tempo livre. RESULTADOS: em relação à situação pessoal e familiar, predominam as idosas jovens (60 a 69 anos), com escolaridade de segundo grau completo, cuja maioria é viúva; referem satisfação com a vida; apresentam importantes níveis de autonomia e independência funcional; são capazes de realizar sozinhas as atividades de vida diária e as atividades instrumentais vida diária. A maior parte oferece a seus familiares ajuda financeira e de moradia. CONCLUSÕES: os perfis sócio-epidemiológico e demográfico são bastante semelhantes aos de experiências análogas, aproximando-se da realidade de mulheres idosas que participam de outros programas do tipo Universidades Abertas à Terceira Idade.

Universidade aberta à terceira idade (UnATI/UFPE): um perfil sócio-epidemiológico dos participantes / Open university to the third age (UnATI/UFPE): a profile partner-epidemiologist of the participants

Conhecer o perfil sócio-epidemiológico dos idosos que freqüentam um programa especial, desenvolvido em uma universidade pública federal no estado de Pernambuco a Universidade Aberta à Terceira idade (UnATI/UFPE), experiência pioneira no Estado, é o principal objetivo deste estudo, uma vez que o envelhecimento populacional acelerado pelo qual o Brasil vem passando, e em particular a região Nordeste, exige ações a curto prazo, como uma adequada produção de conhecimento na área do envelhecimento que deve subsidiar o planejamento dessas ações. Realizamos um censo para 358 idosos participantes do Programa no ano de 1998. Para traçar o perfil desejado, realizamos um estudo epidemiológico descritivo de corte transversal, utilizando um instrumento multidimensional, o Brazil Old Age Schedule-BOAS e buscamos respaldo teórico em estudos tanto da área do envelhecimento quanto da saúde coletiva. Identificamos a existência de um grupo de idosos, em geral, com importantes níveis de autonomia, independência funcional e participação, a maioria é capaz de realizar só e sem ajuda as atividades da vida diária - AVD - (cuidados pessoais, alimentação e vestuário, entre outras) e as atividaes instrumentais de vida diária - AIVD - (sair para as compras, administrar medicação, viagens entre, outras). Trata-se de um grupo em que predomina o gênero feminino, na faixa etária entre 60 e 69 anos, casadas e/ou viúvas, com renda de aposentadoria e/ou pensão e com bom nível de escolaridade. Tiveram em média quatro filhos e a maioria refere estar satisfeita com a vida de uma maneira geral. Utilizam serviços médicos e dentários privados (plano/seguro saúde), crêem que a filha é a principal pessoa que pode dispensar-lhes cuidados em caso de doença ou incapacidade. Ocupam adequadamente seu tempo livre e a maioria mantém um adequado nível de integração social. Não dependem financeiramente de suas famílias, pelo contrário, são em várias situações, suas provedoras oferecendo assistência de moradia e financeira, porém consideram importante desfrutar da atenção e da companhia de seus familiares.