Short-Term Cigarette Smoking in Rats Impairs Physical Capacity and Induces Cardiac Remodeling.

Despite the strong evidence on the cardiac and renal damages after chronic exposure to cigarette smoke, there is a paucity of data on its short-term effects. The study evaluated the short-term effects of cigarette smoking on left ventricular (LV) remodeling, in vitro myocardial and renal function. Female Wistar rats were randomized to control (C) and cigarette smoking rats for eight weeks. Physical capacity was assessed using an adapted model of exhaustive swim; left ventricle (LV) morphology and function were also evaluated. Renal function was assessed by creatinine clearance and urine protein. The in vitro myocardial performance was analyzed in isolated papillary muscles. Rats exhibited reduced physical capacity after short-term cigarette smoking. Although there was no change on LV function, reduced chamber diameter was found in the smoking group associated with an increased LV wall thickness. There was augmented cardiac mass compared to C that was confirmed by increased cardiomyocyte nucleus volume, but in vitro myocardial performance and renal function were unchanged. A short-term cigarette smoking induces cardiac remodeling without abnormalities in function. The smoking group still preserved renal function and in vitro myocardial performance. However, the reduced physical capacity may suggest an impairment of the cardiac reserve.

High-Fat Diet-Induced Obesity Model Does Not Promote Endothelial Dysfunction via Increasing Leptin/Akt/eNOS Signaling.

Experimental studies show that the unsaturated high-fat diet-induced obesity promotes vascular alterations characterized by improving the endothelial L-arginine/Nitric Oxide (NO) pathway. Leptin seems to be involved in this process, promoting vasodilation via increasing NO bioavailability. The aim of this study was to test the hypothesis that unsaturated high-fat diet-induced obesity does not generate endothelial dysfunction via increasing the vascular leptin/Akt/eNOS signaling. Thirty-day-old male Wistar rats were randomized into two groups: control (C) and obese (Ob). Group C was fed a standard diet, while group Ob was fed an unsaturated high-fat diet for 27 weeks. Adiposity, hormonal and biochemical parameters, and systolic blood pressure were observed. Concentration response curves were performed for leptin or acetylcholine in the presence or absence of Akt and NOS inhibitor. Our results showed that an unsaturated high-fat diet promoted a greater feed efficiency (FE), elevation of body weight and body fat (BF), and an adiposity index, characterizing a model of obesity. However, comorbidities frequently associated with experimental obesity were not visualized, such as glucose intolerance, dyslipidemia and hypertension. The evaluation of the endothelium-dependent relaxation with acetylcholine showed no differences between the C and Ob rats. After NOS inhibition, the response was completely abolished in the Ob group, but not in the C group. Furthermore, Akt inhibition completely blunted vascular relaxation in the C group, but not in the Ob group, which was more sensitive to leptin-induced vascular relaxation. L-NAME incubation abolished the relaxation in both groups at the same level. Although Akt inhibitor pre-incubation reduced the leptin response, group C was more sensitive to its effect. In conclusion, the high-unsaturated fat diet-induced obesity improved the vascular reactivity to leptin and does not generate endothelial dysfunction, possibly by the increase in the vascular sensitivity to leptin and increasing NO bioavailability. Moreover, our results suggest that the increase in NO production occurs through the increase in NOS activation by leptin and is partially mediated by the Akt pathway.

Lipectomy associated to obesity produces greater fat accumulation in the visceral white adipose tissue of female compared to male rats.

BACKGROUND: Mobility of fat deposited in adipocytes among different fatty territories can play a crucial role in the pathogenesis of obesity-related diseases. Our goal was to investigate which of the remaining fat pads assume the role of accumulating lipids after surgical removal of parietal WAT (lipectomy; LIPEC) in rats of both sexes displaying MSG-induced obesity. METHODS: The animals entered the study straight after birth, being separated according to gender and randomly divided into CON (control, saline-treated) and MSG (monosodium glutamate-treated) groups. Next, the animals underwent LIPEC or sham-operated surgery (SHAM). Obesity was induced by the injection of MSG (4 mg/g/day) during neonatal stage (2nd to 11th day from birth). LIPEC was performed on the 12th week, consisting in the withdrawal of parietal WAT. On the 16th week, the following WATs were isolated and collected: peri-epididymal-WAT (EP-WAT); parametrial-WAT (PM-WAT); omental-WAT (OM-WAT); perirenal-WAT (PR-WAT) and retroperitoneal-WAT (RP-WAT). RESULTS: The adiposity index was significantly increased in both male (3.2 ± 0.2** vs 1.8 ± 0.1) and female (4.9 ± 0.7* vs 2.6 ± 0.3) obese rats compared to their respective control groups. LIPEC in obese animals produced fat accumulation in visceral fat sites in a more accentuated manner in female (3.6 ± 0.3** vs 2.8 ± 0.3 g/100 g) rather than in male (1.8 ± 0.2* vs 1.5 ± 0.1 g/100 g) rats compared to obese non-lipectomized animals. Among the visceral WATs, the greater differences were observed between gonadal WATs of obese lipectomized rats, with higher accumulation having been observed in PM-WAT (2.8 ± 0.3* vs 2.1 ± 0.2 g/100 g) rather than in EP-WAT (1.0 ± 0.1 ± 0.9 ± 0.1 g/100 g) when compared to obese non-lipectomized animals. CONCLUSIONS: The results of the present study led us to conclude that obesity induced by MSG treatment occurs differently in male and female rats. When associated with parietal LIPEC, there was a significant increase in the deposition of visceral fat, which was significantly higher in obese female rats than in males, indicating that fat mobility among WATs in lipectomized-obese rats can occur more expressively in particular sites of remaining WATs.

Identification of post-cesarean surgical site infection: nursing consultation.

OBJECTIVE: To describe the profile of women in relation to their living conditions, health status and socio-demographic profile, correlating it with the presence of signs and symptoms suggestive of post-cesarean surgical site infection, identifying information to be considered in the puerperium consultation performed by nurses and proposing a roadmap for the systematization of care. METHOD: Quantitative, exploratory, descriptive, cross-sectional and retrospective review of medical records of women who had cesarean deliveries in 2014, in the city of São Paulo. RESULTS: 89 medical records were analyzed, 62 of them with incomplete information. In 11, there was at least one of the signs and symptoms suggestive of infection. CONCLUSION: Given the results of the study, the systematization of puerperal consultation is essential. The roadmap is an instrument that can potentially improve the quality of service and the recording of information.

Identification of post-cesarean surgical site infection: nursing consultation / Identificación de la infección de sitio quirúrgico después de la cesárea: consulta de enfermería / Identificação da infecção de sítio cirúrgico pós-cesariana: consulta de enfermagem

ABSTRACT Objective: To describe the profile of women in relation to their living conditions, health status and socio-demographic profile, correlating it with the presence of signs and symptoms suggestive of post-cesarean surgical site infection, identifying information to be considered in the puerperium consultation performed by nurses and proposing a roadmap for the systematization of care. Method: Quantitative, exploratory, descriptive, cross-sectional and retrospective review of medical records of women who had cesarean deliveries in 2014, in the city of São Paulo. Results: 89 medical records were analyzed, 62 of them with incomplete information. In 11, there was at least one of the signs and symptoms suggestive of infection. Conclusion: Given the results of the study, the systematization of puerperal consultation is essential. The roadmap is an instrument that can potentially improve the quality of service and the recording of information.

RESUMEN Objetivo: Describir el perfil de las mujeres en relación con sus condiciones de vida, de salud, así como el perfil sociodemográfico, que correlacionan con la presencia de signos y síntomas sugestivos de infección del sitio quirúrgico post-cesárea; identificar informaciones a ser consideradas en la consulta de puerperio realizada por el enfermero y proponer un itinerario para la sistematización de la asistencia. Método: Investigación cuantitativa, exploratoria, descriptiva, transversal y retrospectiva de revisión de prontuarios de mujeres que tuvieron parto cesárea en 2014, en el municipio de São Paulo. Resultados: Se analizaron 89 prontuarios, 62 de ellos con informaciones incompletas. En 11 de ellos, hubo la presencia de al menos uno de los signos y síntomas sugestivos de infección. Conclusión: Ante los resultados del estudio, la sistematización de la consulta puerperal es indispensable. El itinerario es un instrumento que puede potencialmente mejorar la calidad de la atención y el registro de las informaciones.

RESUMO Objetivo: Descrever o perfil das mulheres em relação às suas condições de vida, de saúde e perfil sociodemográfico, correlacionando com a presença de sinais e sintomas sugestivos de infecção do sítio cirúrgico pós-cesariana, identificar informações a serem consideradas na consulta de puerpério realizada pelo enfermeiro e propor um roteiro para a sistematização da assistência. Método: Pesquisa quantitativa, exploratória, descritiva, transversal e retrospectiva de revisão de prontuários de mulheres que tiveram parto cesariano em 2014, no município de São Paulo. Resultados: 89 prontuários foram analisados, 62 deles com informações incompletas. Em 11, houve a presença de, pelo menos, um dos sinais e sintomas sugestivos de infecção. Conclusão: Diante dos resultados do estudo, a sistematização da consulta puerperal é imprescindível. O roteiro é um instrumento que pode potencialmente melhorar a qualidade do atendimento e o registro das informações.

Prevalência de Sobrepeso e Obesidade em Idosas do Centro de Convivência para a Terceira Idade de Vitória/ES / Prevalence of Overweight and Obesity among Aged Women from the Community Center for the Elderly in Vitória, ES, Brazil

Introdução: A senescência provoca alterações nas características morfofuncionais do indivíduo, bem como uma série de desordens nutricionais como sobrepeso e obesidade. Objetivo: O estudo avaliou a prevalência de sobrepeso e obesidade em idosas dos Centros de Convivência para a Terceira Idade de Vitória/ES. Material e Métodos: Foi realizado estudo de campo transversal e a amostra de conveniência foi composta por 135 idosas entre 60 e 79 anos. Foram mensuradas a massa corporal, estatura e dobras cutâneas para verificação do índice de massa corpórea (IMC) e percentual de gordura corporal (%GC), respectivamente. Para a comparação das características antropométricas entre os grupos etários de idosas foi utilizado o teste "t" de Student para amostras independentes. As prevalên-cias de sobrepeso e obesidade foram analisadas por meio do teste do qui-quadrado. O nível de significância adotado foi 5%. Resultados: Os resultados, com base no IMC, demonstram alta prevalência de obesidade (28% e 22% nos grupos etários de 60 a 69 e 70 a 79 anos, respectivamente) e sobrepeso (19% e 17% nos grupos etários de 60 a 69 e 70 a 79 anos, respectivamente), representando conjuntamente 42,96% de prevalência de excesso de peso na população estudada. Os resultados do %GC mostram alta prevalência de idosas agrupadas na classificação "ruim" e "muito ruim", representando 33% em ambos os grupos etários. Conclusão: O estudo mostra alta prevalência de sobrepeso e obesidade nas idosas, reforçando a necessidade de implementação de programas de reeducação alimentar e atividade física destinados à redução de gordura corporal. (AU)

Introduction: Senescence alters the morpho-functional characteristics of the individual as well as do a number of nutritional disorders, such as overweight and obesity. Objective: This study assessed the prevalence of overweight and obesity among aged women from the Community Center for the Elderly in Vitória, ES, Brazil. Materials and Method: A cross-sectional study was performed and a convenience sample was composed of 135 women aged between 60 and 79 years. Body weight, height and skinfold were recorded in order to check body mass index (BMI) and percentage of body fat (%BF), respectively. T test for independent samples was used to compare the anthropometric characteristics among age groups. The prevalence of overweight and obesity was analyzed using the chi-square test. The level of significance was 5%. Results: BMI values showed a high prevalence of obesity (28% and 22% in the age groups 60-69 and 70-79 years, respectively) and overweight (19% and 17% in the age groups 60-69 and 70 to 79 years, respectively), which consist together of an overweight prevalence of 42.96% in the studied population. The %BF results showed a high prevalence of elderly classified into the "poor" and "very poor" categories, representing 33% of the sample in both age groups. Conclusion: This study shows a high prevalence of overweight and obesity among aged women from the Community Center for the Elderly in Vitória, ES, which reinforces the need for implementation of nutritional and physical activity programs for body fat reduction. (AU)

HIPERTENSÃO EM ESTUDANTES DA REDE PÚBLICA DE VITÓRIA/ES: INFLUÊNCIA DO SOBREPESO E OBESIDADE / HYPERTENSION IN PUBLIC SCHOOL STUDENTS FROM VITÓRIA/ES: INFLUENCE OF OVERWEIGHT AND OBESITY / HIPERTENSIÓN EN ESTUDIANTES DE LA RED PÚBLICA DE VITÓRIA/ES: INFLUENCIA DEL SOBREPESO Y LA OBESIDAD

RESUMO Introdução: Pesquisas demonstram que a obesidade pode ter início na infância. Além disso, o excesso de peso presente em 50% na infância é fator preditor da obesidade na vida adulta. As consequências são preocupantes pela associação com diversas comorbidades, entre elas, a hipertensão arterial. Estudos mostram que crianças obesas apresentam risco superior de hipertensão arterial em relação às não obesas. Objetivo: Identificar a prevalência de hipertensão arterial e sua relação com o sobrepeso e obesidade em crianças e adolescentes estudantes da rede pública do município de Vitória, ES, Brasil. Foram estudados 477 alunos, com idade entre 7 e 17 anos, sendo 42,56% e 57,44% dos gêneros masculino e feminino, respectivamente, selecionados por meio de amostragem estratificada por conglomerados . Métodos: Na análise do perfil antropométrico foram utilizados: percentual de gordura por meio de medida de dobras cutâneas e índice de massa corporal (IMC). Além disso, foi realizada aferição da pressão arterial para classificação da hipertensão arterial. Resultados: Os resultados mostram nos estudantes de Vitória, ES, com sobrepeso, valores pressóricos elevados (limítrofes e hipertensos 1 e 2), representando nos gêneros masculino e feminino 21,1% (PAS: 112 ± 10,4 mmHg e PAD: 65,6 ± 8,91 mmHg) e 19,2% (PAS: 108 ± 12,1 mmHg e PAD: 65,6 ± 8,90 mmHg), respectivamente. No entanto, nos estudantes obesos, a prevalência foi maior, abrangendo 26,3% (PAS: 113 ± 11,3 mmHg e PAD: 67,8 ± 10,1 mmHg) no gêneros masculino e 25% (PAS: 108 ± 14,4 mmHg e PAD: 68,3 ± 10,2 mmHg) no feminino. Conclusão: Os achados relatados neste estudo mostram altos índices de crianças e adolescentes acometidos tanto por excesso de peso quanto pela hipertensão arterial. Estes resultados sugerem a implementação de medidas preventivas e de tratamento dos fatores de risco cardiovascular em crianças e adolescentes do município de Vitória, ES.

ABSTRACT Introduction: Researches show that obesity can start in childhood. Furthermore, the excess of body weight, present at 50% in childhood, is a predictor of obesity in adulthood. Consequences are alarming due to the association with several comorbidities, among them, hypertension. Studies show that obese children are at higher risk for hypertension compared to non-obese population. Objective: To identify the prevalence of hypertension and its relation to overweight and obesity in children and adolescents from public schools of the municipality of Vitória, ES, Brazil. We studied 477 students, aged between 7 and 17 years, 42.56% male and 57.44% female, who were randomly selected by stratified cluster sample. Methods: In the analysis of anthropometric profile the following were used: percentage of body fat by measuring skinfold thickness and body mass index (BMI). Moreover, measurement of blood pressure was performed to classify the arterial hypertension. Results: The results show in overweight students of Vitória, ES, high blood pressure values (pre-hypertension and stages 1 and 2 hypertension), representing 21.1% in males (SBP: 112 ± 10.4 mmHg and DBP: 65.6. ± 8.91 mmHg) and 19.2% in females (SBP: 108 ± 12.1 mmHg and DBP: 65.6 ± 8.90 mmHg), respectively. However, in obese students, the prevalence was higher, comprising 26.3% in males (SBP: 113 ± 11.3 mmHg and DBP: 67.8 ± 10.1 mmHg) and 25% in females (SBP: 108 ± 14.4 mmHg and DBP: 68.3 ± 10.2 mmHg). Conclusion: The findings reported in this study show high rates of children and adolescents affected by both overweight and hypertension. These results suggest the implementation of preventive measures and treatment of cardiovascular risk factors in children and adolescents from the municipality of Vitória, ES.

RESUMEN Introducción: La investigación ha demostrado que la obesidad puede comenzar en la infancia. Además, el peso excesivo presente en 50% de los niños en edad escolar es un factor predictivo de la obesidad en la vida adulta. Las consecuencias son preocupantes por la asociación con varias comorbilidades, entre ellas, la hipertensión arterial. Los estudios demuestran que los niños obesos tienen un mayor riesgo de hipertensión en comparación con los no obesos. Objetivo: Identificar la prevalencia de la hipertensión y su relación con el sobrepeso y la obesidad en niños y adolescentes de la red pública municipal de Vitória, ES, Brazil. Se estudiaron 477 estudiantes, con edades comprendidas entre los 7 y 17 años, 42,56% y 57,44%, hombres y mujeres, respectivamente, seleccionados mediante muestreo por conglomerado estratificado. Métodos: Fueron usados en el análisis del perfil antropométrico: porcentaje de grasa mediante la medición de pliegues cutáneos y el índice de masa corporal (IMC). Además, se realizó la medición de la presión arterial para la clasificación de la hipertensión arterial. Resultados: Los resultados muestran en los estudiantes de Vitória, ES, con sobrepeso, valores de presión sanguínea elevados (borderline e hipertensos 1 y 2), en representación de los hombres y mujeres 21,1% (PAS: 112 ± 10,4 mmHg y PAD: 65,6 ± 8,91 mmHg) y 19,2% (PAS: 108 ± 12,1 mmHg y la PAD: 65,6 ± 8,90 mm Hg), respectivamente. Sin embargo, en los estudiantes obesos, la prevalencia fue mayor, comprendiendo 26,3% (PAS: 113 ± 11,3 mmHg y PAD: 67,8 ± 10,1 mmHg) en el sexo masculino y 25% (PAS: 108 ± 14,4 mmHg y la PAD: 68,3 ± 10,2 mmHg) en el sexo femenino. Conclusión: Los resultados reportados en este estudio muestran altos índices de niños y adolescentes afectados por tanto el sobrepeso como por la presión arterial alta. Estos resultados sugieren la aplicación de medidas preventivas y de tratamiento de los factores de riesgo cardiovascular en niños y adolescentes en el municipio de Vitória, ES.

Obesity Resistance Promotes Mild Contractile Dysfunction Associated with Intracellular Ca2+ Handling / Resistência à Obesidade Promove Disfunção Contrátil Leve Associada com Trânsito Ca2+ Intracelular

Abstract Background: Diet-induced obesity is frequently used to demonstrate cardiac dysfunction. However, some rats, like humans, are susceptible to developing an obesity phenotype, whereas others are resistant to that. Objective: To evaluate the association between obesity resistance and cardiac function, and the impact of obesity resistance on calcium handling. Methods: Thirty-day-old male Wistar rats were distributed into two groups, each with 54 animals: control (C; standard diet) and obese (four palatable high-fat diets) for 15 weeks. After the experimental protocol, rats consuming the high-fat diets were classified according to the adiposity index and subdivided into obesity-prone (OP) and obesity-resistant (OR). Nutritional profile, comorbidities, and cardiac remodeling were evaluated. Cardiac function was assessed by papillary muscle evaluation at baseline and after inotropic maneuvers. Results: The high-fat diets promoted increase in body fat and adiposity index in OP rats compared with C and OR rats. Glucose, lipid, and blood pressure profiles remained unchanged in OR rats. In addition, the total heart weight and the weight of the left and right ventricles in OR rats were lower than those in OP rats, but similar to those in C rats. Baseline cardiac muscle data were similar in all rats, but myocardial responsiveness to a post-rest contraction stimulus was compromised in OP and OR rats compared with C rats. Conclusion: Obesity resistance promoted specific changes in the contraction phase without changes in the relaxation phase. This mild abnormality may be related to intracellular Ca2+ handling.

Resumo Fundamento: A obesidade induzida por dieta é frequentemente utilizada para demonstração de disfunção cardíaca. No entanto, alguns ratos, como humanos, são suscetíveis ao desenvolvimento de um fenótipo de obesidade, enquanto outros são resistentes. Objetivo: Avaliar a relação entre resistência à obesidade e função cardíaca e o impacto da resistência à obesidade no trânsito de cálcio. Métodos: Ratos Wistar machos com trinta dias de idade foram distribuídos em dois grupos com 54 animais cada: controle (C; dieta padrão) e obesos (quatro dietas palatáveis hiperlipídicas) por 15 semanas. Após o protocolo experimental, os ratos alimentados por dietas hiperlipídicas foram classificados de acordo com o índice de adiposidade e subdivididos em propensos à obesidade (PO) e resistentes à obesidade (RO). Foram avaliados o perfil nutricional, comorbidades e remodelação cardíaca. A função cardíaca foi avaliada pelo estudo do músculo papilar isolado em condições basais e após manobras inotrópicas. Resultados: As dietas hiperlipídicas promoveram aumento na gordura corporal e no índice de adiposidade em ratos PO comparados com ratos C e RO. Os perfis de glicose, lipídios e pressão arterial permaneceram inalterados em ratos RO. Além disso, os ratos RO apresentaram peso total do coração e dos ventrículos direito e esquerdo mais baixos do que ratos PO, mas semelhantes aos ratos C. Os músculos cardíacos de todos os ratos apresentaram dados semelhantes na condição basal, mas a resposta miocárdica a um estímulo de contração pós-pausa estava comprometida em ratos PO e RO em comparação aos ratos C. Conclusão: A resistência à obesidade promoveu alterações específicas na fase de contração, sem alterar a fase de relaxamento. Esta anormalidade leve pode estar relacionada com o trânsito intracelular de Ca+2.

Obesity Resistance Promotes Mild Contractile Dysfunction Associated with Intracellular Ca2+ Handling.

BACKGROUND: Diet-induced obesity is frequently used to demonstrate cardiac dysfunction. However, some rats, like humans, are susceptible to developing an obesity phenotype, whereas others are resistant to that. OBJECTIVE: To evaluate the association between obesity resistance and cardiac function, and the impact of obesity resistance on calcium handling. METHODS: Thirty-day-old male Wistar rats were distributed into two groups, each with 54 animals: control (C; standard diet) and obese (four palatable high-fat diets) for 15 weeks. After the experimental protocol, rats consuming the high-fat diets were classified according to the adiposity index and subdivided into obesity-prone (OP) and obesity-resistant (OR). Nutritional profile, comorbidities, and cardiac remodeling were evaluated. Cardiac function was assessed by papillary muscle evaluation at baseline and after inotropic maneuvers. RESULTS: The high-fat diets promoted increase in body fat and adiposity index in OP rats compared with C and OR rats. Glucose, lipid, and blood pressure profiles remained unchanged in OR rats. In addition, the total heart weight and the weight of the left and right ventricles in OR rats were lower than those in OP rats, but similar to those in C rats. Baseline cardiac muscle data were similar in all rats, but myocardial responsiveness to a post-rest contraction stimulus was compromised in OP and OR rats compared with C rats. CONCLUSION: Obesity resistance promoted specific changes in the contraction phase without changes in the relaxation phase. This mild abnormality may be related to intracellular Ca2+ handling.

Vulnerabilidades das mulheres à infecção de sítio cirúrgico pós-parto cesárea: proposta de um roteiro para auxílio à consulta de enfermeiro na atenção básica / Womens vulnerability to surgical infection after cesarean section; an exploratory study and guide proposal to support nurses consultation at basic attention

A infecção de sítio cirúrgico pós-cesárea corresponde a 8% de todas as infecções pós-parto. Sua magnitude está relacionada ao alto percentual de partos cesáreos, no mundo todo. O puerpério é um período em que há maior atenção ao recém-nascido, podendo passar despercebidas condições que indicam infecção. Objetivos: Descrever o perfil das mulheres submetidas ao parto cesáreo (condições de vida, saúde reprodutiva e perfil sociodemográfico), correlacionando-o à presença de infecção e propor um roteiro que auxilie o enfermeiro da atenção básica a identificar indícios de infecção de sítio cirúrgico pós-cesárea no puerpério. Método: estudo exploratório, descritivo, transversal, retrospectivo, realizado por meio de revisão de prontuários (prontuários geral e Mãe Paulistana e Ficha A do SIAB) de 89 mulheres que tiveram parto cesáreo, de 01/01 a 31/12/2014. Tomaram-se informações de diagnóstico médico de infecção de sítio cirúrgico e situações em que havia, pelo menos, uma condição sugestiva de sinais e sintomas. A análise foi realizada segundo estatística descritiva (teste de Fischer). Resultados: A ocorrência de sinais e sintomas de infecção de sítio cirúrgico pós- cesárea foi verificada em 11 prontuários. Em 16 prontuários, não foram encontrados sinais e sintomas, e 62 prontuários não continham informações ou elas estavam incompletas. Raça/cor e dor em baixo ventre podem indicar infecção, mulheres pardas e negras foram as mais frequentes do grupo que apresentaram sinais sugestivos de infecção, apresentando diferença estatística significativa (p. =0,038). O roteiro para consulta de enfermagem no puerpério pós-parto cesáreo complementa dados que auxilia a identificação da ocorrência de sinais e sintomas sugestivos de infecção de sítio cirúrgico e auxilia a identificação de diagnósticos de Enfermagem. Conclusão: O roteiro pode auxiliar o profissional enfermeiro a reconhecer situações de risco e vulnerabilidade para o desenvolvimento de infecção de sítio cirúrgico pós-parto cesáreo ou outro sinal de complicação pós-parto, contribuindo com a melhoria da qualidade da assistência e segurança do paciente.

The surgical infection after cesarean section applies to 8% of all infections post childbirth. The magnitude of this event is related to cesarean sections high percent in the whole world. The puerperium is the period where there is more attention to the new born and the conditions that points to the infection can be unnoticed. Goals: To describe the profile of women who are submitted to cesarean section (life conditions, reproductive health and socio-demographic profile) correlating it to the presence of the infection and to propose a guide that will help the Basic Attention nurse to identify the surgical infection after cesarean section evidences at the puerperium. Method: exploratory, descriptive, transversal and retrospective study, achieved by medical record review (general records, Mãe Paulistana and Ficha A from SIAB) of eighty-nine women who had cesarean section, from January 01st to December 31st, 2014. Were analyzed medical records that had information about medical diagnosis of infection after cesarean section and conditions that contained at least one high trace of infection after cesarean sections signs and symptoms. The analysis was held through descriptive statistics (Fischers test). Results: The occurrence of signs and symptoms of surgical infection after cesarean section was observed in eleven medical records. In sixteen records wasnt found any reference to these signs and symptoms and sixty-two records didnt had the information or they were incomplete. Race/color, lower womb pain can indicate infection, black and dark women were more frequent among the group that presented high signs of infection, performing a significant statistical difference (p. =0,038). The guide to nurse consulting at puerperium after cesarean section complements the data that helps to identify the signs and symptoms of infection after cesarean section and supports the identification of nursing diagnosis. Conclusion: The guide can help the nurse to recognize situations of risk and vulnerability for the development of infection after cesarean section or any other sign of complication post childbirth complication, contributing to a better quality of patients assistance and safety.

Vulnerabilidades das mulheres à infecção de sítio cirúrgico pós-parto cesárea: proposta de um roteiro para auxílio à consulta de enfermeiro na atenção básica / Womens vulnerability to surgical infection after cesarean section: an exploratory study and guide proposal to support nurses consultation at Basic Attention

A infecção de sítio cirúrgico pós-cesárea corresponde a 8% de todas as infecções pós-parto. Sua magnitude está relacionada ao alto percentual de partos cesáreos, no mundo todo. O puerpério é um período em que há maior atenção ao recém-nascido, podendo passar despercebidas condições que indicam infecção. Objetivos: Descrever o perfil das mulheres submetidas ao parto cesáreo (condições de vida, saúde reprodutiva e perfil sociodemográfico), correlacionando-o à presença de infecção e propor um roteiro que auxilie o enfermeiro da atenção básica a identificar indícios de infecção de sítio cirúrgico pós-cesárea no puerpério. Método: estudo exploratório, descritivo, transversal, retrospectivo, realizado por meio de revisão de prontuários (prontuários geral e Mãe Paulistana e Ficha A do SIAB) de 89 mulheres que tiveram parto cesáreo, de 01/01 a 31/12/2014. Tomaram-se informações de diagnóstico médico de infecção de sítio cirúrgico e situações em que havia, pelo menos, uma condição sugestiva de sinais e sintomas. A análise foi realizada segundo estatística descritiva (teste de Fischer). Resultados: A ocorrência de sinais e sintomas de infecção de sítio cirúrgico pós- cesárea foi verificada em 11 prontuários. Em 16 prontuários, não foram encontrados sinais e sintomas, e 62 prontuários não continham informações ou elas estavam incompletas. Raça/cor e dor em baixo ventre podem indicar infecção, mulheres pardas e negras foram as mais frequentes do grupo que apresentaram sinais sugestivos de infecção, apresentando diferença estatística significativa (p. =0,038). O roteiro para consulta de enfermagem no puerpério pós-parto cesáreo complementa dados que auxilia a identificação da ocorrência de sinais e sintomas sugestivos de infecção de sítio cirúrgico e auxilia a identificação de diagnósticos de Enfermagem. Conclusão: O roteiro pode auxiliar o profissional enfermeiro a reconhecer situações de risco e vulnerabilidade para o desenvolvimento de infecção de sítio cirúrgico pós-parto cesáreo ou outro sinal de complicação pós-parto, contribuindo com a melhoria da qualidade da assistência e segurança do paciente.

The surgical infection after cesarean section applies to 8% of all infections post childbirth. The magnitude of this event is related to cesarean sections high percent in the whole world. The puerperium is the period where there is more attention to the new born and the conditions that points to the infection can be unnoticed. Goals: To describe the profile of women who are submitted to cesarean section (life conditions, reproductive health and socio-demographic profile) correlating it to the presence of the infection and to propose a guide that will help the Basic Attention nurse to identify the surgical infection after cesarean section evidences at the puerperium. Method: exploratory, descriptive, transversal and retrospective study, achieved by medical record review (general records, Mãe Paulistana and Ficha A from SIAB) of eighty-nine women who had cesarean section, from January 01st to December 31st, 2014. Were analyzed medical records that had information about medical diagnosis of infection after cesarean section and conditions that contained at least one high trace of infection after cesarean sections signs and symptoms. The analysis was held through descriptive statistics (Fischers test).Results: The occurrence of signs and symptoms of surgical infection after cesarean section was observed in eleven medical records. In sixteen records wasnt found any reference to these signs and symptoms and sixty-two records didnt had the information or they were incomplete. Race/color, lower womb pain can indicate infection, black and dark women were more frequent among the group that presented high signs of infection, performing a significant statistical difference (p. =0,038). The guide to nurse consulting at puerperium after cesarean section complements the data that helps to identify the signs and symptoms of infection after cesarean section and supports the identification of nursing diagnosis. Conclusion: The guide can help the nurse to recognize situations of risk and vulnerability for the development of infection after cesarean section or any other sign of complication post childbirth complication, contributing to a better quality of patients assistance and safety.

Training and cardiovascular responses from cigarette smoke exposure.

The aim of this study was to evaluate the early effect of the endurance training (ET) on systolic blood pressure (SBP), heart rate (HR) and rate pressure-product (RPP) after acute cigarette smoke exposure. Twenty male Wistar rats were randomly allocated into two groups: trained (TEx; n = 10) and control (CEx; n = 10), exposed to smoke. TEx rats undertook ET during 2 weeks (swimming, 5 days/week; 1 h/session) and CEx group was kept in sedentary lifestyle. After ET protocol both groups were exposed to cigarette smoke only once (total 1 h; 2 × 30 min with interval of 10 min between exposures; rate of 10 cigarettes/30 min). SBP, HR and RPP were measured after 2 weeks and just after (5 min) acute cigarette smoke (tail plethysmograph). All parameters did not differ (P > 0.05) between TEx (RPP = 45018 ± 1970 mmHg/bpm) and CEx (43695 ± 2579 mmHg/bpm) after ET protocol. However, all cardiovascular parameters increased (P < 0.05) only for CEx just after the cigarette smoke exposure. We concluded that ET can attenuate the aggression from acute smoking to cardiovascular system, with a few days of training and even with no chronic effect on these parameters at basal condition.

Atenção farmacêutica e a humanização da assistência: lições aprendidas na promoção da adesão de usuários aos cuidados terapêuticos nas condições crônicas / Pharmaceutical Care and humanization of care: lessons from the promotion of adhesion to therapeutic care of users in chronic conditions

O alto consumo de medicamentos tem despertado, para os profissionais de saúde, cada vez mais a preocupação com aadesão ao tratamento dos usuários. O presente artigo tem o objetivo de relatar experiências na assistência farmacêuticarealizada por uma Unidade Básica de Saúde (UBS) do Município de São Paulo. A farmacêutica da Unidade, para além datradução das receitas e confecção de caixas com pictogramas para orientar o uso racional das medicações, desenvolveu,em articulação com a gerente e os profissionais que participam das reuniões técnicas do serviço, a estratégia assistencialde acompanhamento do uso das medicações em domicílio para os usuários com mais dificuldades na adesão ao tratamento.As principais lições aprendidas tratam sobre a importância da colaboração do farmacêutico na Estratégia Saúde daFamília para a promoção do uso racional dos medicamentos, e que as ações empreendidas para potencializar a adesãodos usuários aos medicamentos devem estar contidas nas ações gerais de promoção da autonomia do sujeito, ou seja, asdecisões e o controle sobre sua saúde. Como caminho a percorrer, promover atitude emancipadora na assistência farmacêuticasignifica promover práticas que sejam mediadoras entre o saber dos profissionais de saúde e usuários, objetivandoo cuidado mais qualificado das famílias.(AU)

The high consumption of drugs is increasingly making health professionals be concerned about adherence to treatment bypatients. This article aims to share experiences in pharmaceutical care performed by a Basic Health Unit (BHU) in São Paulo.The BHU pharmacy, in addition to translating prescription notes and making boxes with pictograms to guide the rational useof drugs, together with the manager and the professionals who attend the meetings of the technical service, developed anassistance strategy for medication monitoring use at home for users having more difficulties with adherence to treatment. Themain lessons learned are about dealing with the importance of cooperation of the pharmacist in the Family Health Strategy topromote the rational use of drugs, and that the actions taken to enhance the adhesion of drug users should be part of the generalactions for promoting subjects autonomy, that is, decisions and control over their own health. The route to be followedinvolves promoting an emancipatory attitude in pharmaceutical care is equal to promoting practices mediating between theknowledge of health professionals and the patients, aiming at a more qualified family health care.(AU)

Atenção farmacêutica e a humanização da assistência: lições aprendidas na promoção da adesão de usuários aos cuidados terapêuticos nas condições crônicas / Pharmaceutical Care and humanization of care: lessons fromthe promotion of adhesion to therapeutic care of users inchronic conditions

O alto consumo de medicamentos tem despertado, para os profissionais de saúde, cada vez mais a preocupação com a adesão ao tratamento dos usuários. O presente artigo tem o objetivo de relatar experiências na assistência farmacêutica realizada por uma Unidade Básica de Saúde (UBS) do Município de São Paulo. A farmacêutica da Unidade, para além da tradução das receitas e confecção de caixas com pictogramas para orientar o uso racional das medicações, desenvolveu,em articulação com a gerente e os profissionais que participam das reuniões técnicas do serviço, a estratégia assistencial de acompanhamento do uso das medicações em domicílio para os usuários com mais dificuldades na adesão ao tratamento.As principais lições aprendidas tratam sobre a importância da colaboração do farmacêutico na Estratégia Saúde da Família para a promoção do uso racional dos medicamentos, e que as ações empreendidas para potencializar a adesão dos usuários aos medicamentos devem estar contidas nas ações gerais de promoção da autonomia do sujeito, ou seja, as decisões e o controle sobre sua saúde. Como caminho a percorrer, promover atitude emancipadora na assistência farmacêutica significa promover práticas que sejam mediadoras entre o saber dos profissionais de saúde e usuários, objetivando o cuidado mais qualificado das famílias.

The high consumption of drugs is increasingly making health professionals be concerned about adherence to treatment by patients. This article aims to share experiences in pharmaceutical care performed by a Basic Health Unit (BHU) in São Paulo.The BHU pharmacy, in addition to translating prescription notes and making boxes with pictograms to guide the rational useof drugs, together with the manager and the professionals who attend the meetings of the technical service, developed an assistance strategy for medication monitoring use at home for users having more difficulties with adherence to treatment. Themain lessons learned are about dealing with the importance of cooperation of the pharmacist in the Family Health Strategy topromote the rational use of drugs, and that the actions taken to enhance the adhesion of drug users should be part of the general actions for promoting subjects autonomy, that is, decisions and control over their own health. The route to be followed involves promoting an emancipatory attitude in pharmaceutical care is equal to promoting practices mediating between theknowledge of health professionals and the patients, aiming at a more qualified family health care.

Estudo in vitro da influência do uso de base resiliente associada a dois sistemas adesivos na infiltração marginal / In vitro study of the influence of a resilient base associated with two adhesive systems

O objetivo deste estudo foi avaliar a influência da interposição da resina de baixa viscosidade e dos sistemas adesivos convencional e autocondicionante na inflitração marginal em cavidades restauradas com resina composta. Cavidades circulares, em dentes bovinos, foram confeccionadas de modo que a margem cervical se localizasse em cemento/dentina e a incisal em esmalte. As amostras foram divididas, aleatoriamente, em quatro grupos de 10 dentes, de acordo com o sistema adesivos e uso da resina composta de baixa viscosidade: Grupo 1 - Single Bond (3M/ESPE), Grupo 2- Single Bond (3M/ESPE)+ flow, Grupo 3 -Clearfil SE Bond (Kuraray), Grupo 4 - Clearfil SE Bond (Kuraray)+flow. Todas as cavidades foram restauradas com resina composta Filtek Z250 (3M/ESPE). Após a termociclagem, as amostras foram armazenadas numa solução de azul de metileno a 2,0 por cento por 2 horas. A infiltração foi analisada em lupa estereoscópica com aumento de 40X. A análise estatística evidenciou que a infiltração entre os grupos não apresentou diferença estatisticamente significativa tanto em esmalte (p=0,681), como em cemento/dentina (p=0,079). Conclui-se que o uso de base resilente não influenciou a infiltração marginal, independentemente do sistema adesivo utilizado e a infiltração marginal não foi evitada totalmente neste modelo de estudo.

In vitro wear evaluation of dental materials in primary teeth.

PURPOSE: To evaluate the effect of dental materials on primary enamel wear. METHODS: Four composites (Filtek Z250, Heliomolar, Point 4, SureFil), two compomers (Dyract AP, F2000) and a resin-modified glass-ionomer (Vitremer) were placed into box-shaped preparations in buccal surfaces of primary molars and stored for 24 hours in water at 37 degrees C. The specimens (n = 6) were subjected to abrasive three-body wear against a primary enamel cusp. Material wear, enamel wear (adjacent to the material), and wear on enamel cusps were estimated by profilometry and video-analysis software. Results were compared with ANOVA and Tukey's tests (P < 0.05). RESULTS: Vitremer showed the highest wear (P < 0.05), followed by Dyract AP and F2000, which were not statistically different (P > 0.05). There was no significant difference between Filtek Z250 and Dyract AP (P > 0.05). Filtek Z250, Heliomolar, Point 4 and SureFil, showed the lowest wear values and there was no difference among them (P > 0.05). The highest wear values on the enamel adjacent to the material were found with Dyract AP (P < 0.05) and the lowest next to Point 4 and SureFil (P < 0.05). There was no difference in the wear of the enamel next to Vitremer, F2000, Heliomolar and Filtek Z250 (P > 0.05). Vitremer and F2000 caused the highest wear on enamel cusps (P < 0.05), and there was no statistically significant difference (P > 0.05) between them; SureFil caused the lowest wear (P < 0.05) on the opposing enamel. There was a correlation (r = 0.85) between wear of materials and wear on the enamel cusps, but not (r = 0.53) for the wear on enamel besides the restoration and wear on enamel cusps. SEM micrographs showed different surface characteristics of the materials after the wear test.