Cardiovascular Risk Assessment in Women With Rheumatoid Arthritis Through Carotid and Femoral Artery Doppler Ultrasound.

OBJECTIVE: The aims of this study were to assess cardiovascular risk in patients with rheumatoid arthritis (RA) classified as low-risk by the Framingham score, before and after the multiplication by 1.5 recommended by the European League Against Rheumatism (EULAR), and to stratify them using carotid and femoral Doppler ultrasound (DUS) in order to optimize the assessment of the asymptomatic cardiovascular disease incidence. METHODS: Thirty-five female patients with RA and 35 healthy women (control group), both with low cardiovascular risk by Framingham score, were enrolled in the study (randomized). All of them underwent carotid and femoral DUS studies. RESULTS: The mean age at diagnosis was 44.57 years, the mean disease duration was 12.11 years and the mean disease activity score according to the Disease Activity Score 28 was 1.91, whereas according to the Clinical Disease Activity Index, it was 6.176. The sample was homogeneous. Within the RA group, 46% showed changes in the carotid and/or femoral DUS, compared with 14% in the control group (p = 0.004). Of the DUS with abnormalities, in the RA group, 31% of the carotid DUS and 81% of the femoral DUS (p = 0.005) showed intima-media thickness and/or atherosclerotic plaques. After EULAR 1.5 multiplication factor, 66% remained low cardiovascular risk. Of these, 35% of the patients showed changes in the carotid and/or femoral DUS, compared with 14% of the control group (p = 0.07). CONCLUSIONS: The EULAR criteria are effective at identifying patients with high cardiovascular risk. Carotid DUS and, especially, femoral DUS are tools that can be used in clinical practice as ways to detect CVD even in its asymptomatic form.

Mapeamento dos casos de violência contra a mulher na região metropolitana de Belém narrados pela mídia impressa do estado do Pará. / Mapping cases of violence against in the metropolitan area of Belém narrated by printed media in state of Pará.

Objetivo: mapear casos de violência contra a mulher na região metropolitana de Belém narrados por jornal paraense.Método: estudo descritivo, quantitativo, com coleta de dados realizada na Biblioteca da Fundação Cultural do ParáTancredo Neves (CENTUR) nos exemplares do jornal O Liberal. Foram consultados 2.178 exemplares, destes 571notas mencionavam a violência contra a mulher na região metropolitana de Belém, no período de 2005 a 2010. Aanálise dos dados foi por meio da estatística descritiva apresentada em gráficos e tabelas. Resultados: a análise dasnotas revelou mulheres vítimas de violência na faixa etária referente às três primeiras décadas de vida, violentadasem suas residências por pessoas conhecidas; sofrendo violências física e sexual, sendo a genitália o local do corpomais afetado e tendo como principal desfecho a denúncia. As cidades consideradas mais violentas respectivamenteforam: Santa Bárbara (122,5 casos/100mil habitantes), seguida de Marituba, Ananindeua, Belém, Benevides eSanta Isabel. Os bairros com maior número de casos foram: o Guamá (6,30%), seguido por Icuí Guajará (5,60%),Coqueiro (4,02%), Marambaia (3,85%) e Paar (3,85%). Os bairros considerados mais violentos são conhecidospela ocupação desordenada e alto contingente populacional, considerados bairros de níveis social e econômicoreduzidos. Conclusão: é fundamental compreender que é necessário desconcentrar os focos de estabelecimentosde enfrentamento à violência contra a mulher da capital Belém para toda a região metropolitana, especialmente asperiferias que apresentam maior índice de violência contra a mulher por habitantes. Compreende-se que dessa formasupera-se o deslocamento como justificativa para as dificuldades de ajuda e tratamento.

Objective: map cases of violence against women, in Belém?s metropolitan area, documented in the newspapers inState of Pará. Methods: this paper was made in a descriptive way, in a quantitative nature. The data was collectedat the Fundação Cultural Tancredo Neves (CENTUR) and from copies of newspaper O Liberal. 2,190 copies wereconsulted, from which 571 newspaper notes mentioned violence against women in Belém?s metropolitan areabetween years from 2005 to 2010. The data analysis was made by descriptive statistics and represented by chartsand tables. Results: the newspaper notes analysis revealed women violence victims aged referring to the first threedecades of life, violated at their own houses mostly by people already known, violated physically and sexually,as site of the body mostly affected being the genitals, and as the main outcome, the complaint. The most violentcities, respectively, are: Santa Bárbara (122.5 cases/100,000 inhabitants), followed by Marituba, Ananindeua, Belém,Benevides and Santa Isabel. The neighborhoods with highest case numbers are: Guamá (6.30%), followed by IcuíGuajará (5.60%), Coqueiro (4.02%), Marambaia (3.85%) and Paar (3.85%). The most violent neighborhoods areknown by their disorientated occupation and high density, being considered neighborhoods with low social andeconomic levels. Conclusion: there is a need of decentralizing the focus of establishments against women violenceof Belém to the rest of the metropolitan area, specially to suburbs that present higher rates of violence againstwomen per inhabitants. It is understood that this decentralization can overcome the misplacement as a reason for thedifficulties of help and treatment.