Resumen Los profesionales de la salud de las Unidades de Cuidados Intensivos (UCI) enfrentan situaciones de sufrimiento humano, competitividad y demanda, que podrían perjudicar su calidad de vida y su salud mental. El objetivo del estudio fue describir los trastornos mentales comunes y la calidad de vida relacionada con la salud en profesionales de la salud de la UCI en Salvador, Brasil. Este estudio transversal con 195 profesionales utilizó un cuestionario sociodemográfico y laboral, el Self-Reporting Questionnaire (SRQ-20) de trastornos mentales comunes y el 36-Item Short Form Health Survey (SF-36v2) de calidad de vida relacionada con la salud. El 29.7 % de los profesionales presentaron trastornos mentales comunes, especialmente entre profesionales de enfermería (RP = 2.28; IC 1.19-4.39; p = .007). La calidad de vida relacionada con la salud para todos los profesionales estuvo disminuida, principalmente en función social (44.25 ± 10.15) y rol emocional (45.86 ± 10.58). El SRQ-20 correlacionó fuertemente con los dominios dolor corporal (r = -.502), salud general (r = -.526), vitalidad (r = -.656), función social (r = -.608), salud mental (r = -.631) y el componente de salud mental (r = -.638) del SF-36v2 (p < .01). Los profesionales con trastornos mentales comunes mostraron una calidad de vida relacionada con la salud más deteriorada, esencialmente en dominios del componente de salud mental, y refirieron también dolor corporal. Es necesario discutir e implementar estrategias de evaluación, prevención y promoción de la salud mental entre los profesionales de las UCI para que sean consideradas dentro de las políticas de salud laboral.

ABSTRACT Introduction: Few studies are available about common mental disorders and mental health-related quality of life among dental healthcare providers. Objective: Describe the common mental disorders and the mental health-related quality of life of members of oral health teams from the primary health care section of the Unified Health System in the Metropolitan Region of Salvador de Bahia, Brazil. Methods: A descriptive cross-sectional study was conducted based on the Symptom reporting questionnaire for the evaluation of common mental disorders, the Health questionnaire about health-related quality of life, and a sociodemographic characterization questionnaire. Results: The study sample was composed of 161 professionals, of whom 59.6% were dentists and 40.4% were dental auxiliaries. Dentists obtained a higher average score in the Symptom reporting questionnaire (p = 0.032), whereas their scores in the mental health domains of the Health questionnaire were lower and significant. Three factors in the Symptom reporting questionnaire exhibited a high negative correlation with the mental health domains of the Health questionnaire. Conclusions: Dentists presented greater symptoms of common mental disorders and mental health-related quality of life deterioration than dental auxiliaries. It is therefore necessary to implement mental health promotion strategies aimed at members of oral health teams.

RESUMEN Introducción: Existen pocos estudios sobre los trastornos mentales comunes y calidad de vida relacionada con la salud mental en trabajadores de salud bucal. Objetivo: Describir los trastornos mentales comunes y la calidad de vida relacionada con la salud mental en trabajadores de equipos de salud bucal en atención primaria de salud del Sistema Único de Salud de la Región Metropolitana de Salvador de Bahía, Brasil. Métodos: Estudio transversal y descriptivo, que utilizó el Cuestionario de declaración de síntomas para evaluar trastornos mentales comunes, el Cuestionario de salud para calidad de vida relacionada con la salud y un cuestionario de caracterización sociodemográfica. Resultados: Conformaron la muestra 161 profesionales (59,6 % odontólogos y 40,4 % auxiliares de salud bucal). El promedio de la puntuación para Cuestionario de declaración de síntomas fue mayor para los odontólogos (p = 0,032). Los dominios de salud mental del Cuestionario de salud fueron menores y significativos en odontólogos. Tres factores del Cuestionario de declaración de síntomas presentaron alta correlación negativa con los dominios de salud mental del Cuestionario de salud. Conclusiones: Los odontólogos presentaron mayores síntomas de trastornos mentales comunes y deterioro de la calidad de vida relacionada con la salud mental que los auxiliares de salud bucal, siendo necesarias estrategias de promoción de la salud mental para trabajadores de los equipos de salud bucal.

Resumo: Introdução: As alterações no ciclo sono/vigília (CSV) dos jovens universitários podem acarretar consequências na saúde física, psíquica e social. Além disso, alguns comportamentos adotados nessa fase podem estar associados a comprometimento do CSV. Objetivo: Portanto, este estudo tem por objetivo identificar quais fatores dos determinantes sociais da saúde (DSS) estão associados à má qualidade do sono e à sonolência diurna excessiva (SDE) de universitários. Método: Trata-se de um estudo transversal que incluiu 298 universitários, com idade entre 18 e 35 anos, 73,2% dos estudantes do sexo feminino do interior do Rio Grande do Norte, Brasil. Os dados foram coletados a partir dos seguintes questionários: A Saúde e o Sono, Questionário de Cronotipo de Munique, Índice de Qualidade do Sono de Pittsburgh e Escala de Sonolência de Epworth. Para avaliar a associação dos DSS com a má qualidade de sono e a SDE, realizou-se a regressão de Poisson com variância robusta. Resultado: A prevalência da má qualidade do sono e de SDE nos universitários foi de 79,2% e 51,3%, respectivamente. Entre os determinantes intermediários da saúde, observou-se maior razão de prevalência de má qualidade de sono nos estudantes que apresentaram problema de saúde no último mês (18,4%), fumavam (23,5%) e faziam uso de bebidas estimulantes próximo ao horário de dormir (25,8%), e naqueles que usavam eletrônicos antes do horário de dormir durante a semana (18,4%), quando comparados aos que não adotam esses comportamentos. Com relação à SDE, os estudantes que justificaram o horário de dormir na semana e de acordar no fim de semana por causa da demanda acadêmica apresentaram 27% e 34%, respectivamente, de menor prevalência de SDE do que o grupo que não adota esses comportamentos. Conclusão: As altas prevalências de má qualidade do sono e de SDE observadas nos universitários foram decorrentes de fatores biológicos e, em sua maioria, de fatores comportamentais.

Abstract: Introduction: Changes in the Sleep/Wake Cycle (SWC) of university students can have consequences on physical, mental and social health. In addition, some behaviors adopted at this stage may be associated with SWC impairment. Objective: Therefore, this study aims to identify which factors of social determinants of health (SDH) are associated with poor sleep quality and excessive daytime sleepiness (EDS) in university students. Method: This is a cross-sectional study that included 298 university students, aged between 18 and 35 years; 73.2% of the students were females and from the countryside of the state of Rio Grande do Norte, Brazil. Data were collected from the following questionnaires: Health and Sleep, Munich Chronotype Questionnaire, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. To assess the association of SDH with poor sleep quality and excessive daytime sleepiness, Poisson Regression with robust variance was performed. Result: The prevalence of poor sleep quality and excessive daytime sleepiness among the university students was 79.2% and 51.3%, respectively. Between the intermediate determinants of health, a higher prevalence rate of poor sleep quality was observed in students who reported health problems in the previous month (18.4%), smoked (23.5%), drank stimulating beverages close to bedtime (25.8%) and those who used electronic devices before bedtime during the week (18.4%) when compared to those who did not have these behaviors. Regarding excessive daytime sleepiness, students who justified bedtime during the week and wake-up time at the weekend because of the academic demand showed, respectively, 27% and 34% lower prevalence of EDS than the group that did not have these behaviors. Conclusions: The high prevalence of poor sleep quality and EDS observed among university students was associated to biological factors and most of them, behavioral factors.

Resumo A influência de um programa de educação sobre o sono (PES) nos conhecimentos, hábitos e qualidade do sono, e sonolência diurna foi avaliada em 40 professores brasileiros do ensino básico [Grupos: Experimental (GE=26)/Controle (GC=14)]. A Saúde e Sono, o Índice de Qualidade de Sono de Pittsburgh e o diário de sono foram aplicados nos grupos antes e três semanas após um PES aplicado no GE. O programa baseado na teoria da Aprendizagem Significativa consistiu de quatro encontros de 4h/cada. Após o programa, o GE aumentou os conhecimentos sobre sono e reduziu o relato de consumo de café próximo a dormir, com melhora na qualidade de sono em 17% dos professores. Embora não tenha havido diferenças nos horários de sono e sonolência, os resultados positivos reforçam a necessidade do desenvolvimento de programas educacionais sobre sono com professores para difusão do assunto nas escolas e melhora da qualidade do sono nestes profissionais.

Abstract The influence of a sleep education program (SEP) on the knowledge, habits, quality of sleep, and daytime sleepiness was evaluated in 40 Brazilian elementary and high school teachers [Groups: Experimental (EG=26)/Control (CG=14)]. The Health and Sleep questionnaire, Pittsburgh Sleep Quality Index and sleep logs were applied to both groups, at baseline and in reassessment three weeks after a SEP with the EG. The methodology of the SEP was based on the Meaningful Learning theory proposed by Ausubel, consisting of four fortnightly meetings, lasting 4h each. After the program, the EG showed an increase in sleep knowledge and a reduction in coffee consumption near bedtime. Besides, 17% of teachers improved sleep quality in this group. However, no changes occurred in sleep schedules and sleepiness. Nevertheless, the positive results reinforce the need for sleep education programs with teachers to spread sleep knowledge in schools and improve the sleep quality in these professionals.

Resumen La influencia de un programa de educación sobre el sueño (PES) en los conocimientos, hábitos, calidad de sueño y somnolencia diurna fue evaluado en 40 maestros brasileños de educación básica [Grupos: Experimental (GE=26)/Control (GC=14)]. Los cuestionarios Salud y Sueño, Índice de calidad de sueño de Pittsburgh y diario del sueño se aplicaron en los grupos, antes y tres semanas después de un PES en el GE. El programa basado en la teoría del aprendizaje significativo consistió en cuatro sesiones de 4 horas/cada uno. Después del programa, el GE aumentó su conocimiento sobre el sueño y hubo una reducción en el consumo de café cerca de la hora de acostarse, con una mejora en la calidad del sueño en 17% de los maestros. Aunque no hubo diferencias en los horarios de sueño y la somnolencia, los resultados positivos refuerzan la necesidad de desarrollar programas educativos sobre el sueño con los maestros para difundir el tema en las escuelas y mejorar la calidad del sueño en estos profesionales.

RESUMO: A articulação temporomandibular é uma das mais complexas do corpo humano sendo o processo condilar responsável pela expressão do crescimento mandibular. A hipoplasia condilar é caracterizada por uma formação defeituosa do processo condilar. A otite média aguda é um processo inflamatório, desencadeada a partir de infecções das fossas nasais, cavidades paranasais e rinofaringe, propagadas por meio da tuba auditiva. No caso apresentado, a paciente apresentava assimetria facial desde o primeiro ano de vida, além de recorrentes casos de otite justamente nos estágios iniciais do fechamento da sutura temporotimpânica e do forame de Huschke o que facilitaria a disseminação dessa infecção otológica o que comprometeria o desenvolvimento do côndilo resultando na hipoplasia identificada, somente do lado direito. Assim, os profissionais que atuam na região da articulação temporomandibular e ouvido devem ter o conhecimento da existência e das implicações clínicas do forame de Huschke para um diagnóstico precoce e evitar o desenvolvimento das assimetrias faciais nos casos em que esta apresenta associação com sinais clínicos de infecção das áreas afetadas, restabelecendo função, estética e o estado psicológico do paciente.

ABSTRACT: The temporomandibular joint is one of the most complex of the human body and the condylar process is responsible for the expression of mandibular growth. The condylar hypoplasia is characterized by a defective formation of the condylar process. The acute otitis media is an inflammatory process, triggered from infections of the nasal cavity, paranasal sinuses and, nasopharynx, propagated through the Eustachian tube. In the presented case, the patient had facial asymmetry since the first year of life, and recurring cases of otitis just in the early stages of closing the temporal tympanic suture and in the foramen of Huschke, which would facilitate the dissemination of this ear infection which would undermine the development of condyle resulting in hypoplasia identified, only in the right side. Thus, professionals who work in temporomandibular joint and ear regions must have knowledge of the existence and clinical implications of the foramen of Huschke for early diagnosis and prevent the development of facial asymmetry where this association presents with clinical signs of infection of the affected areas, restoring function, aesthetic and, psychological state of the patient.

A influência do horário de trabalho nos hábitos e qualidade de sono, e sonolência diurna de acordo com preferências individuais nos horários de sono foi avaliada por questionários em 131 professores do ensino básico. Professores que iniciam as aulas ± 7:00 h acordam mais cedo e apresentam frequentemente sonolência diurna excessiva comparados aos que iniciam à tarde. Dentre estes, àqueles com preferência por horários intermediários ou tardios de sono são mais irregulares nos horários de acordar e aumentam a duração do sono no fim de semana comparados aos professores com preferência por acordar mais cedo. Em contrapartida, trabalhar somente à tarde parece proporcionar melhores condições de sono/vigília, devido não acarretar privação de sono e proporcionar menor frequência de sonolência diurna. Portanto, a discussão do horário de início das escolas originalmente levantada para adolescentes, precisa ser ampliada para professores contribuindo para melhora nos hábitos de sono e qualidade de vida no ambiente escolar.

The influence of work schedule on sleep habits and quality, and daytime sleepiness according to individual preferences in sleep schedules was assessed in 131 elementary and high school teachers through questionnaires. Teachers who initiate classes around 7:00 hr wake up earlier and show more frequency of poor sleep quality than those who start classes in the afternoon. Between them, those who have a preference for intermediate or later hours for sleep are more irregular in their wake up schedules and increase their sleep duration on the weekend compared to those with earlier sleep preferences. On the other hand, working only in the afternoon seems to provide better sleep/awake conditions for teachers, because they keep the same sleep duration during the week and on the weekend, and they are diagnosed with less daytime sleepiness. Therefore, the discussion of school start times, originally proposed for adolescents, needs to be magnified to teachers, contributing to improvement of sleep habits and life quality in school environments.

La influencia del horario de trabajo en los hábitos y la calidad del sueño (dormir) y la somnolencia diurna según cronotipo se evaluó por cuestionarios en 131 maestros. Los maestros que empiezan las clases a las ±7:00 h despiertan más temprano y tienen con frecuencia somnolencia diurna en comparación con los maestros que inician las clases por la tarde. Entre ellos, los intermedios y trasnochadores son más irregulares en los horarios de despertar en comparación con los madrugadores. Además, aumentan la duración del sueño el fin de semana. Por otra parte, trabajar solamente por la tarde parece ofrecer mejores condiciones para el sueño y vigilia del maestro, debido no causar privación del sueño y proporcionar menor frecuencia de somnolencia diurna. Por lo tanto, la discusión del horario de inicio de las escuelas originalmente planteadas para los adolescentes, debe ampliarse a los maestros contribuyendo para mejorar los hábitos del sueño y la calidad de vida en la escuela.

As doenças que acometem a órbita de forma aguda e não traumática por vezes não são conhecidas por médicos em centros de emergência. Essas condições são decorrentes de diversos fatores, como desordens imunológicas, congênitas, infecciosas, vasculares, entre outras. As causas infecciosas correspondem a mais de 50% de todos os casos e requer rápido diagnóstico e conduta para minimização de sequelas. A tomografia computadorizada (TC) é o exame de imagem de primeira linha nesses casos, sendo geralmente disponível nos centros de emergência e capaz de fornecer auxílio diagnóstico de forma rápida, precisa e eficaz. Esse artigo de revisão visa descrever os principais aspectos tomográficos da órbita aguda infecciosa, correlacionando-os com os dados da literatura.

The acute and nontraumatic diseases that involve the orbit are often little known by most physicians. These conditions are due to several factors, such as immune disorders, congenital, infections, vascular, among others disorders. The infectious causes correspond to more than 50% of all cases and require rapid diagnosis and management in order to minimize sequels. Computed tomography (CT) is the first line imaging method on these cases, generally being available in emergency centers and capable to provide an accurate, quick and effective diagnostic information. This review article aims to describe the main tomographic findings in acute orbit infections, correlating them with the literature data.

Animals have neural structures that allow them to anticipate environmental changes and then regulate physiological and behavioral functions in response to these alterations. The suprachiasmatic nucleus of the hypothalamus (SCN) is the main circadian pacemaker in many mammalian species. This structure synchronizes the biological rhythm based on photic information that is transmitted to the SCN through the retinohypothalamic tract. The aging process changes the structural complexity of the nervous system, from individual nerve cells to global changes, including the atrophy of total gray matter. Aged animals show internal time disruptions caused by morphological and neurochemical changes in SCN components. The effects of aging on circadian rhythm range from effects on simple physiological functions to effects on complex cognitive performance, including many psychiatric disorders that influence the well-being of the elderly. In this review, we summarize the effects of aging on morphological, neurochemical, and circadian rhythmic functions coordinated by the main circadian pacemaker, the SCN.

INTRODUCTION: Breast cancer has the second highest world's incidence rate, according to the Brazilian National Cancer Institute (INCa). Clinical examination and mammography are the best methods for early diagnosis. Computer-aided detection (CADe) and computer-aided diagnosis (CADx) systems are developed to improve mammographic diagnosis. Basically, CADx systems have three components: (i) segmentation, (ii) parameters extraction and selection, (iii) lesion classification. The first step for a CADx system is segmentation. METHODS: A microcalcification segmentation method is proposed, based on morphological operators, Otsu's Method and radiologists' knowledge. Pre-processing with top-hat operators improves contrast and reduces background noise. The Otsu's method automatically selects the best grey-level threshold to segment microcalcifications, obtaining binary images. Following, inferior reconstruction and morphological dilatation operators are applied to reconstruct lost structure details and fill small flaws in the segmented microcalcifications. Finally, the Canny edge detection is applied to identify microcalcifications contour candidates for each region-of-interest (ROI). Two experienced radiologists intervene in this semi-automatic method, firstly, selecting the ROI and, then, analyzing the segmentation result. The method was assessed in 1000 ROIs from 158 digital images (300 dpi, 8 bits). RESULTS: Considering the radiologists opinion, the rates of ROIs adequately segmented to establish a diagnosis hypothesis were 97.8% for one radiologist and 97.3% for the other. Using the Area Overlap Measure (AOM) and the 2136 microcalcifications delineated by an experienced radiologist as gold standards, the method achieved an average AOM of 0.64±0.14, being 0.56±0.09 for small microcalcifications and 0.66±0.13 for the large ones. Moreover, AOM was 0.64±0.13 for the benign and 0.64±0.14 for the malignant lesions with no statistical differences between them. CONCLUSION: Based on these findings, the proposed method could be used to develop a CADx system that could help early breast cancer detection.

O respirador bucal utiliza a cavidade oral como principal via durante a respiração. Dentre as principais causas, destacam-se: as hipertrofias adenoamigdalianas e as doenças inflamatórias como a rinite alérgica. OBJETIVO: Verificar a presença de atopia, os principais alérgenos envolvidos e verificar a coexistência de atopia com o grau de hipertrofia das tonsilas faríngeas e palatinas, em pacientes respiradores bucais. MÉTODO: Estudo de coorte histórico com corte transversal com revisão de 308 prontuários de pacientes acompanhados em um centro do respirador bucal de um hospital terciário, no período de 2008 a 2010. Foram coletados dados sobre a história clínica de respirador bucal e realizados exames clínico otorrinolaringológico, nasofibroscópico e teste cutâneo de leitura imediata aos aeroalérgenos. RESULTADOS: Dos 308 pacientes, 36% apresentaram positividade no teste alérgico, sendo que dos atópicos 95% foram positivos para ácaros. Do total de pacientes, 46% apresentaram hipertrofia adenoideana. Destes, 37% são atópicos e 47% apresentaram hipertrofia amigdaliana e, destes, 33% são atópicos. CONCLUSÃO: Nenhuma correlação direta entre atopia e o grau de aumento das tonsilas palatinas e faríngeas foi observada nos pacientes respiradores bucais avaliados.

Mouth breathers use the oral cavity as their principal breathing route. The main causes include: adenotonsillar hypertrophy and inflammatory diseases such as allergic rhinitis. OBJECTIVE: To look for atopy, the main allergens involved and to check for atopy as a comorbidity with the degree of hypertrophy of the tonsils and adenoids in mouth breathers. METHOD: A historical cohort study with cross-sectional review of 308 medical charts of patients treated at a mouth breather care center of a tertiary hospital in the period of 2008-2010. We collected data on the mouth breather's clinical history and we ran otolaryngological exams, flexible nasal endoscopy and skin prick test to aeroallergens. RESULTS: Of 308 patients, 36% were positive on allergy testing, with 95 % of atopic patients being positive for mites. Among all patients, 46% had adenoid hypertrophy; of these, 37% were atopic and 47% had tonsillar hypertrophy, and among these, 33% were atopic. CONCLUSION: We found no direct correlation between atopy and the degree of tonsils and adenoid hypertrophy observed among the mouth-breathing patients assessed. si.

The aim of this study was to characterize the sleep-wake cycle, daytime sleepiness and sleep quality of high school teachers. Ninety-eight high school teachers participated in this study. They were asked to complete the Health and Sleep, Horne & Ostberg, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index questionnaires and to keep a 14-day sleep diary. This study showed that high-school teachers wake up on average 1 h 12 min earlier (ANOVA; p < 0.05) and go to bed on average 34 min earlier (ANOVA; p < 0.05) during the week than on the weekend. This results in an average of 42 min less time in bed (ANOVA; p < 0.05) on weekdays and characterizes partial sleep deprivation. Moreover, 46% and 51% of teachers were diagnosed with excessive daytime sleepiness and poor sleep quality (χ2; p > 0.05), respectively. Therefore, high-school teachers show characteristics of partial sleep deprivation that may contribute to excessive daytime sleepiness and poor sleep quality. This situation may compromise health and quality of life, in addition to teaching performance that can affect the education of their students.

OBJECTIVES: A number of complications exist with invasive mechanical ventilation and with the use of and withdrawal from prolonged ventilator support. The use of protocols that enable the systematic identification of patients eligible for an interruption in mechanical ventilation can significantly reduce the number of complications. This study describes the application of a weaning protocol and its results. METHODS: Patients who required invasive mechanical ventilation for more than 24 hours were included and assessed daily to identify individuals who were ready to begin the weaning process. RESULTS: We studied 252 patients with a median mechanical ventilation time of 3.7 days (interquartile range of 1 to 23 days), a rapid shallow breathing index value of 48 (median), a maximum inspiratory pressure of 40 cmH(2)0, and a maximum expiratory pressure of 40 cm H(2)0 (median). Of these 252 patients, 32 (12.7%) had to be reintubated, which represented weaning failure. Noninvasive ventilation was used postextubation in 170 (73%) patients, and 15% of these patients were reintubated, which also represented weaning failure. The mortality rate of the 252 patients studied was 8.73% (22), and there was no significant difference in the age, gender, mechanical ventilation time, and maximum inspiratory pressure between the survivors and nonsurvivors. CONCLUSIONS: The use of a specific weaning protocol resulted in a lower mechanical ventilation time and an acceptable reintubation rate. This protocol can be used as a comparative index in hospitals to improve the weaning system, its monitoring and the informative reporting of patient outcomes and may represent a future tool and source of quality markers for patient care.

A delay in bedtime occurs in adolescence compared with childhood. However, the early waking that morning school hours impose leads to partial sleep deprivation. Although exposure to light is the most important regulator of circadian rhythm in mammals, physical exercise influences circadian synchronization. To assess the effect of morning physical exercise in sunlight on the sleep-wake cycle (SWC) in adolescents, 160 first- and second-year high-school students were exposed to classes in their usual classroom (Group C) or in a swimming pool exposed to sunlight (Group E) while physically exercising (EE; i.e., swimming) or resting (EL). At baseline, we applied Health and Sleep and Horne & Ostberg chronotype assessment questionnaires. One week later and during the intervention, we applied the Sleep Diary and Karolinska Sleepiness Scale. During the intervention we observed no changes in bedtime, time in bed and in indices of irregularity of bedtime and wake-up time. The changes observed in wake-up time (i.e., a delay in the EE group on Saturday), sleep quality (i.e., an improvement), and sleepiness (i.e., an increase) were also observed in the control group, discarding an intervention effect. We suggest that morning physical exercise in sunlight had no effect on SWC parameters, sleep quality, or daytime sleepiness, possibly because of the large irregularity in the SWC between weekdays and weekends in adolescent students as well as the low frequency and duration of exercise during the intervention. Therefore, studies that evaluate a higher frequency or duration of exercise are needed to assess its effect on the SWC in adolescents.

The coral reefs of Pirangi beach have suffered the impact of anthropic actions, mainly those related to tourism. To evaluate these effects, algal samples were collected at nine stations, distributed along the reef fringe. The macrobenthic community (algae/coral) was identified through photographic methods. A total of thirty species of algae, five species of coral, and one species of mollusk were identified. In areas of intense tourist activity, small algae were predominant, while in areas without human interference, foliose algae were predominant. Cluster analysis of the organisms revealed a pattern in spatial distribution into five zones: (1) a submerged zone with very diverse flora, (2) a zone with a predominance of Caulerpa racemosa, (3) a zone with high coverage of Sargassum vulgare, (4) a trampled zone with bare spaces, small algae and Zoanthus sociatus, and (5) a zone with predominance of Palythoa caribaeroum. The results show that human disturbances of the natural order can result in a different distribution model for benthic organisms in reefs. Moreover, these results allow us to infer that the area studied has undergone changes resulting from human activities and that the differences in biological composition can be used as an important indicator of the health of the Pirangi reef.

OBJECTIVE: To verify whether the capacity of high-density lipoprotein (HDL) to simultaneously receive nonesterified cholesterol, triglycerides, cholesteryl esters, and phospholipids changes with aging and the presence of coronary artery disease. DESIGN: Cross-sectional study with biochemical analyses. SUBJECTS: Eleven elderly patients with coronary artery disease (74±5 years) were compared with the following groups of non-coronary artery disease subjects (referred to as "healthy"): 25 young (25±5 years), 25 middle-aged (42± years), and 25 elderly subjects (75±8 years). METHODS: Plasma samples were incubated with a nanoemulsion labeled with radioactive lipids; the transfer of the lipids from the nanoemulsion to the HDL was measured in chemically precipitated HDL. HDL size and paraoxonase-1 activity were also determined. RESULTS: The transfer of cholesteryl esters and phospholipids to high-density lipoprotein was significantly greater (p<0.001) in healthy elderly subjects than in the middle-aged and younger subjects. Non-esterified cholesterol and triglyceride transfer was not different among these three groups. The HDL size was significantly greater (p<0.001) in healthy elderly subjects than in the middle-aged and younger subjects. The paraoxonase-1 activity was similar among the groups. Compared with healthy elderly subjects, coronary artery disease elderly subjects had significantly less (p<0.05) transfer of non-esterified cholesterol, triglycerides, and cholesteryl esters to the HDL and a significantly smaller (p<0.05) HDL size. CONCLUSION: Because lipid transfer is enhanced in healthy elderly subjects but not in those with coronary artery disease, increasing lipid transfer to HDL may be a protective mechanism against the disease.