Abstract Background Nothing is known about ischemic heart disease (IHD) in the Germans who emigrated to Brazil during the last century. Objective We sought to compare age at diagnosis and IHD manifestations between German immigrants and their first-generation descendants in the region of Blumenau, Brazil. Methods We reviewed medical records of hospitals in Blumenau. Comparison of the groups in the evaluation times was made by analysis of variance (ANOVA) with repeated measures, and comparison of two factors was made by two-way ANOVA. The level of significance was set at p <0.05. Results Study population comprised 68 patients who were born in Germany (group G) and 99 descendants (group D). Twenty-nine patients of group D had two German parents and 70 had one. Mean age at diagnosis was 66.8 ± 10.6 years, with a significant difference between the groups, four years higher in Group G than group D (69.0 ± 8.8 vs 65.4 ± 11.5 years old) (p = 0.025). There was no significant difference in risk factors or coronary angiography data between the groups. HDL cholesterol levels were significantly higher in group G than in group D (48.4 ± 11.1 mg/dL vs 43.3 ± 11.2 mg/dL, p = 0.005). Conclusion At the time of first IHD diagnosis, mean age of the group G was significantly higher than group D, with no differences between groups in sex, risk factors, LDL levels, or clinical and angiographic manifestations. An earlier manifestation of the disease could be part of lifestyle changes in descendants, in this population that mantained eating habits characterized by high saturated fat consumption.

RESUMO: O objetivo deste trabalho foi avaliar o crescimento, as trocas gasosas foliares e a colonização por fungos micorrízicos arbusculares em três espécies de plantas medicinais, sob diferentes intensidades de irradiância. Fridericia chica (Bonpl.) L.G. Ohmmann, Mikania laevigata Sch.Bip. ex Baker e Varronia curassavica Jacq. foram propagadas por estaquia e cultivadas por 120 dias em ambientes artificialmente sombreados, utilizando telas do tipo sombrite, em quatro níveis de irradiância, 100%, 70%, 50% e 30%. O delineamento experimental foi inteiramente casualizado, em esquema fatorial 3 x 4 (três espécies de plantas e quatro níveis de irradiação) com sete repetições. As três espécies medicinais avaliadas apresentaram maiores taxas de assimilação líquida, crescimento em massa e colonização radicular por fungos micorrízicos arbusculares quando expostas a ambientes com 70% de disponibilidade de luz. Em relação às respostas fisiológicas, V. curassavica apresentou maior taxa fotossintética, condutância estomática e transpiração quando submetidas a 70% de irradiância, podendo ser cultivada em ambientes mais abertos e com maiores níveis de radiação. Por outro lado, F. chica e M. laevigata apresentaram características de plantas tolerantes à sombra. Os resultados obtidos na fase inicial de crescimento podem ser utilizados como um indicador para recomendar o ambiente de plantio dessas três espécies medicinais em sistemas agroflorestais.

ABSTRACT: This study o evaluated growth, leaf gas exchange and arbuscular mycorrhizal fungi root colonization in three medicinal plant species under different irradiance intensities. Fridericia chica (Bonpl.) L.G.Lohmann, Mikania laevigata Sch.Bip. ex Baker and Varronia curassavica Jacq. were propagated by cutting and cultivated for 120 days in artificially shaded environments using black shade-type screens, obtaining four irradiance levels: 100%, 70%, 50% and 30%. The experimental design was completely randomized in a 3 x 4 factorial scheme (three plant species and four irradiation levels) with seven replicates. The three medicinal species showed higher liquid assimilation, mass growth and arbuscular mycorrhizal fungi root colonization rates when exposed to environments with 70% light availability. In relation to physiological responses, V. curassavica presented higher photosynthetic rate, stomatal conductance and transpiration when submitted to 70% irradiance, being able to be cultivated in more open environments with higher irradiation levels. Conversely F. chica and M. laevigata presented shade tolerance characteristics. At the initial growth phase, the results obtained can be used as indicators to recommend the ideal cultivation environment for these species in agroforestry systems.

Resumo Fundamento A redução da mortalidade e das sequelas de uma vítima de parada cardíaca depende de um atendimento eficaz, rápido e iniciado o mais precocemente possível. O suporte básico de vida (SBV) compreende uma série de etapas que podem ser iniciadas fora do ambiente hospitalar, e ensinadas para qualquer pessoa em cursos específicos. Porém, é importante que o socorrista retenha o conhecimento e as habilidades, pois nunca se sabe quando será necessário realizar uma ressuscitação cardiopulmonar (RCP). Entretanto, estudos mostram que existe uma perda das habilidades em executar uma RCP já com 30 dias após o treinamento, com variações segundo algumas características das pessoas e da atividade profissional. Objetivo Avaliar se os estudantes de medicina são capazes de reter as habilidades por mais de seis meses. Métodos Estudo prospectivo, caso controle, observacional. Estudantes de medicina realizaram um curso sobre morte súbita e parada cardíaca de 40 horas. A avaliação das habilidades foi realizada imediatamente após o curso e seis meses depois. Foram comparadas as notas individuais entre dois momentos, foi avaliada a porcentagem de acerto em cada etapa e uma análise global do atendimento foi classificado como ótimo, bom e ruim. Os avaliadores e critérios foram os mesmos nos dois momentos. Os dados foram analisados pelos teste-t pareado e teste de McNemar, onde para um nível de confiança de 95% o critério para significância foi p < 0,05. Resultados Cinquenta estudantes (27 do sexo feminino) do primeiro ano, com idade entre 18 e 24 anos (média 21), realizaram o curso. O número de etapas cumpridas de forma correta após seis meses foi significativamente menor que logo após o curso (10,8 vs 12,5 p < 0,001). O sexo e idade não interferiram nos resultados. A qualidade global foi considerada ótima em 78% dos atendimentos realizados logo após o curso, significativamente, maior que os 40% após seis meses (p < 0,01). Após seis meses, maior número de erros foi observado nas etapas relacionadas às habilidades mais práticas (como posicionamento das mãos). Conclusão Seis meses após o curso observamos uma perda significativa das habilidades, entre estudantes de medicina, prejudicando a eficácia global do atendimento.

Abstract Background Reduction of mortality and sequelae of cardiac arrest depends on an effective and fast intervention, started as soon as possible. Basic life support involves a series of steps that may be initiated out of the hospital setting and taught to any person in specific courses. However, it is important that the rescuers retain the knowledge and skills to perform cardiopulmonary resuscitation (CPR), as one never knows when they will be required. Studies have shown that a loss of skills occurs as early as 30 days after the training course, with variations according to personal and professional characteristics. Objectives to assess whether medical students are able to retain skills acquired in a BLS course for more than six months. Methods Prospective, case-control, observational study. Medical students attended a 40-hour course on sudden death and cardiac arrest. Skills acquired during the course were evaluated immediately after and six months after the course. Students’ individual scores were compared between these time points, the percentage of correct answers was evaluated, and overall performance was rated as excellent, good, and poor. Observers and evaluation criteria were the same immediately after the course and six months later. Data were analyzed using the paired t-test and the McNemar test. The 95% confidence interval was established, and a p < 0.05 was set as statistically significant. Results Fifty students (27 female) in the first year of medical school aged from 18 to 24 years (mean of 21 years) attended the course. The number of steps successfully completed by the students at six months was significantly lower than immediately after the course (10.8 vs 12.5 p < 0.001). Neither sex nor age affected the results. Overall performance of 78% of the students was considered excellent immediately after the course, and this percentage was significantly higher than six months later (p < 0.01). After six months, the steps that the students failed to complete at six months were those related to practical skills (such as a correct hand positioning). Conclusion A significant loss of skills was detected six months after the BLS course among medical students, compromising their overall performance.

Resumo O estudo objetivou analisar o papel dos atores da cadeia de logística reversa de embalagens de agrotóxicos utilizadas no Cerrado piauiense. Para tanto, foram realizadas entrevistas com representantes dos agentes da cadeia em quatro municípios que mais produzem soja no Piauí. Participaram da pesquisa representantes da Central, da Agência de Defesa Agropecuária do Piauí, da agricultura empresarial e da agricultura familiar. Constatou-se que, apesar de iniciativas positivas como a atuação de centrais de recebimento de embalagens, de produtores e do poder público, há muito a ser feito para que haja minimização dos impactos negativos à natureza e os consequentes danos à saúde das pessoas, visto que existem falhas nos mecanismos de fiscalização do poder público junto às unidades de produção agrícola que fazem uso diariamente dos agrotóxicos. Assim, é necessária a ação conjunta dos agentes da cadeia de logística reversa, iniciada pelo poder público e disseminada para os demais elos da cadeia.

Abstract The study aimed to analyze the role of actors in the reverse logistics chain of used pesticide packaging in the Cerrado of Piauí. To that end, interviews were conducted with representatives of chain agents in the four municipalities that most produce soy in Piauí. Representatives of the Receiving Centers of the Agricultural Defense Agency of Piauí, business agriculture and family farming participated in the research. It was found that, despite positive initiatives of packaging receiving center operators, agricultural producers and the government, there is much to be done to minimize the negative impacts on nature and the consequent damage to people’s health, as there are flaws in the official mechanisms for inspecting agricultural production units that make daily use of pesticides. Thus, joint action in the reverse logistics chain is necessary, initiated by the public authorities and disseminated to the rest of the chain participants.

Resumen El estudio tuvo como objetivo analizar el papel de los actores en la cadena logística inversa de los envases de pesticidas utilizados en el Cerrado de Piauí. Con este fin, se realizaron entrevistas con representantes de agentes de la cadena en cuatro municipios que más producen soja en Piauí. Se descubrió que, a pesar de iniciativas positivas como el desempeño de los centros de recepción de envases, los productores y el gobierno, hay mucho por hacer para minimizar los impactos negativos en la naturaleza y el consiguiente daño a la salud de las personas, ya que que existen fallas en los mecanismos de inspección por parte de las autoridades públicas junto con las unidades de producción agrícola que hacen uso diario de pesticidas. Por tanto, es necesaria la actuación conjunta de los agentes de la cadena de logística inversa, iniciada por los poderes públicos y difundida al resto de la cadena.

Resumo O objetivo do presente estudo foi investigar relevantes parâmetros físico-químicos e sensoriais de três diferentes porções musculares da espécie Arapaima gigas. Porções cranial, medial e caudal foram analisadas em relação a composição centesimal, parâmetros instrumentais de cor e textura e atributos sensoriais. As porções medial e caudal apresentaram o maior conteúdo de lipídeos e valor energético (P < 0,05); no entanto, os menores teores de umidade e carboidrato ( P < 0,05). O conteúdo de proteína foi similar ( P > 0,05) entre as diferentes porções musculares. Antes do cozimento, as porções medial e caudal demonstraram os maiores valores de L* , a*, dureza e mastigabilidade (P < 0,05). Após o cozimento, não se observou diferença (P > 0,05) nos parâmetros instrumentais de cor entre as diferentes porções musculares. A porção medial apresentou menor dureza e mastigabilidade ( P < 0,05), quando comparada à porção caudal. A porção cranial apresentou o menor escore de sabor e impressão global (P < 0,05). Portanto, as porções musculares medial e caudal de Arapaima gigas demonstraram potencial superior para satisfazer as exigências dos consumidores.

Abstract The objective of the present study was to investigate the relevant physicochemical and sensory parameters of three different Arapaima gigas muscle portions. Cranial, medial and caudal portions were analysed regarding their proximate compositions, instrumental colour and texture parameters, and sensory evaluations. The medial and caudal portions exhibited the greatest (P < 0.05) lipid contents and energy values and the lowest (P < 0.05) moisture and carbohydrate levels. The protein contents were similar (P > 0.05) for the different muscle portions. Before cooking, the medial and caudal portions displayed the greatest (P < 0.05) values for lightness, redness, hardness and chewiness. After cooking, no differences ( P > 0.05) were observed between the different muscle portions for the instrumental colour parameters, while the medial portion exhibited lower (P < 0.05) values for hardness and chewiness as compared to the caudal portion. The cranial portion received the lowest (P < 0.05) scores for flavour and overall liking. Thus the Arapaima gigas medial and caudal muscle portions presented the greatest potentials to satisfy the consumer requirements.

Introduction Crackles are discontinuous, non-stationary respiratory sounds and can be characterized by their duration and frequency. In the literature, many techniques of filtering, feature extraction, and classification were presented. Although the discrete wavelet transform (DWT) is a well-known tool in this area, issues like signal border extension, mother-wavelet selection, and its subbands were not properly discussed. Methods In this work, 30 different mother-wavelets 8 subbands were assessed, and 9 border extension modes were evaluated. The evaluations were done based on the energy representation of the crackle considering the mother-wavelet and the border extension, allowing a reduction of not representative subbands. Results Tests revealed that the border extension mode considered during the DWT affects crackle characterization, whereas SP1 (Smooth-Padding of order 1) and ASYMW (Antisymmetric-Padding (whole-point)) modes shall not be used. After DWT, only 3 subbands (D3, D4, and D5) were needed to characterize crackles. Finally, from the group of mother-wavelets tested, Daubechies 7 and Symlet 7 were found to be the most adequate for crackle characterization. Discussion DWT can be used to characterize crackles when proper border extension mode, mother-wavelet, and subbands are taken into account.

OBJECTIVE: To determine whether Tai Chi Chuan or ballroom dancing promotes better performance with respect to postural balance, gait, and postural transfer among elderly people. METHODS: We evaluated 76 elderly individuals who were divided into two groups: the Tai Chi Chuan Group and the Dance Group. The subjects were tested using the NeuroCom Balance Master¯ force platform system with the following protocols: static balance tests (the Modified Clinical Tests of Sensory Interaction on Balance and Unilateral Stance) and dynamic balance tests (the Walk Across Test and Sit-to-stand Transfer Test). RESULTS: In the Modified Clinical Test of Sensory Interaction on Balance, the Tai Chi Chuan Group presented a lower sway velocity on a firm surface with open and closed eyes, as well as on a foam surface with closed eyes. In the Modified Clinical Test of Sensory Interaction on Unilateral Stance, the Tai Chi Chuan Group presented a lower sway velocity with open eyes, whereas the Dance Group presented a lower sway velocity with closed eyes. In the Walk Across Test, the Tai Chi Chuan Group presented faster walking speeds than those of the Dance Group. In the Sit-to-stand Transfer Test, the Tai Chi Chuan Group presented shorter transfer times from the sitting to the standing position, with less sway in the final standing position. CONCLUSION: The elderly individuals who practiced Tai Chi Chuan had better bilateral balance with eyes open on both types of surfaces compared with the Dance Group. The Dance Group had better unilateral postural balance with eyes closed. The Tai Chi Chuan Group had faster walking speeds, shorter transfer times, and better postural balance in the final standing position during the Sit-to-stand Test.

Discursos colonialistas sobre a infância - ao inscreverem o corpo da criança no interior de um território definido, que deve ser protegido contra a ameaça do Outro estranho e estrangeiro - constituem-no com base na mesma "gramática" dual da organização das relações humanas segundo um tipo único e fixo de vínculo político-cultural: o estado-nação. Desse modo, discursos colonialistas conformam o corpo infantil segundo a mesma lógica bélica e imperialista da exploração capitalista. Contrapondo-se a essa visão, o propósito deste artigo é caracterizar discursos pós-colonialistas que, com base na noção de hibridismo cultural, reivindicam a necessidade de se descolonizar o conceito de infância visto, ele próprio, como uma invenção colonizadora.

Colonialist discourses about childhood - inscribing the child's body within a defined territory to be protected against the threat of the "Other" strange and foreign - are constituted on the basis of the same dual "grammar" of the organization of human relations, according to a unique and fixed type of cultural-political tie: the nation-state. Thus, colonialist discourses shape the child's body according to the same imperialist and war logic of capitalist exploitation. Opposing this view, the purpose of this article is to characterize postcolonial discourses that, based on the notion of cultural hybridity, claim the need to decolonize the very concept of childhood, which is considered a colonialist invention.

Les discours colonialistes sur l'enfance - en plaçant le corps de l'enfant au sein d'un territoire défini qui doit être protégé contre la menace d'un " Autre " étrange et étranger - constituent ce corps sous la même double "grammaire" de l'organisation des relations humaines selon un type unique et fixe de lien politico-culturelle: l'État-nation. Ainsi, les discours colonialistes façonnent le corps de l'enfant selon la même logique de guerre et impérialiste de l'exploitation capitaliste. En opposition à ce point de vue, le but de cet article est de caractériser les discours postcoloniaux qui reposent sur la notion d'hybridité culturelle, affirmant la nécessité de décoloniser le concept de l'enfance, lui même considéré comme une invention coloniale.

Este artigo tem por objetivo compreender o entrelaçamento da cultura com reações psicológicas de indivíduos expostos ao processo de migração e estabelecer relações entre o fenômeno da migração e adoecimento psicossomático. O enfoque metodológico é essencialmente qualitativo, baseado em representações sociais de pacientes migrantes e da equipe de funcionários e profissionais de um centro de saúde do município próximo de Campinas. A análise demonstrou que a migração era percebida negativamente, como uma causadora de doenças quando havia perda do emprego/renda e fragmentação de laços familiares e comunitários. Se tais elementos estavam estabilizados, fatores estressantes do cotidiano permaneciam mascarados (mantidos fora da consciência) e a piora da saúde não era atribuída à migração ou à qualidade de vida. O problema da migração e doença, pela perspectiva do centro de saúde, incluía abordagem terapêutica exclusivamente biológica sem outra perspectiva que contribuísse para os sujeitos assimilarem as novas condições de vida num novo ambiente sócio-cultural.

This paper aims to debate relations between culture and psychological reactions of individuals exposed to the process of migration and to establish relations between migration and psychosomatic sickening. The methodological approach is essentially qualitative and based on social representations of migrant patients, staff and professionals of a public health unit near Campinas. The analysis demonstrated that migration was negatively experienced as producing ailments when loss of job/income, break of family/community ties was involved. When these elements were stabilized, stressful factors of daily life remained covered (out of conscience) and worsening in health condition was attributed neither to migration nor to life quality. The problem of migration and ailments, from the health center perspective, involved merely biological procedures and did not include additional perspectives to help patients to assimilate their new life conditions in a new social environment.

OBJETIVO: Analisar os intervalos de tempo entre o início da Fibrilação Ventricular/Taquicardia Ventricular (FV/TV) e os principais procedimentos realizados. MÉTODOS: Foram realizadas e filmadas 20 simulações de FV/TV em ambiente hospitalar, utilizando-se manequim estático, ocorridas em dia e hora aleatórios. Todas as equipes tinham o mesmo nível de habilidades. Foram analisados os tempos (em s) relativos ao suporte básico de vida (SBV) - chegada da equipe (TC) confirmação da parada (TCP) início da RCP (TI) e os tempos relativos ao suporte avançado de vida (SAV) - 1º desfibrilação (TD) 1º dose de adrenalina (TA) e intubação orotraqueal (TIOT). As variáveis foram analisadas e comparadas em dois grupos: unidade de cuidados intensivos (UCI) e enfermarias com telemetria (ETL). RESULTADOS: ETL x UCI respectivamente - TC (70,2+38,7 x 38,6+49,2); TCP (89,4+57,1 x 71+63,9); TI (166,8+81,1 x 142+66,2); TD (282,5+142,8 x 108,4+52,5); TA (401,4+161,7 x 263,3+122,8) e TIOT (470,3+150,6 x 278,8+98,8). Apresenta a comparação das médias de tempos entre os dois grupos. CONCLUSÃO: As diferenças observadas em relação a TD, TA e TIOT favoráveis à UCI estão associadas às facilidades de realização das manobras de SAV nesse ambiente. Os tempos relacionados ao SBV foram semelhantes nos dois grupos, reforçando a necessidade do uso de desfibriladores semi-automáticos mesmo em ambiente hospitalar.

OBJECTIVE: To analyze the time intervals between the beginning of the Ventricular Fibrilation/Ventricular Taquicardia (VF/VT) and the main procedures made. METHODS: Twenty VF/VT simulations were performed and filmed in a hospital environment, using a static mannequin, on random days at random times. All teams had the same level of skills. The times (in sec.) related to basic life support (BLS) - arrival of the team (AT), confirmation of the arrest (CAT), beginning of the CPR (IT) and the times related to the advanced life support (ALS) - 1st defibrillation (DT), 1st dose of adrenalin (AT) and orotracheal intubation (OTIT). The variables were analyzed and compared in two groups: intensive care unit (ICU) and wards with telemetry (TLW). RESULTS:The results in both groups was in that order (GW x ICU ) - AT (70.2+38.7 x 38.6+49.2); CCA (89.4+57.1 x 71+63.9); SC (166.8+81.1 x 142+66.2); FD (282.5+142.8 x 108.4+52.5); FE (401.4+161.7 x 263.3+122.8) e OI (470.3+150.6x278.8+98.8). Shows the comparison of the average times between the two groups. CONCLUSION: The differences noted in relation to DT, AT and OTIT favorable to ICU are associated to the facility of performance of the ALS maneuvers in such environment. The BLS-related times were similar in both groups, which reinforce the need for the use of semi-automatic defibrillators, even in a hospital environment.

Este trabalho analisa 172 pacientes consecutivos operados de cirurgia valvar e coronária simultânea, no período compreendido entre julho de 1980 e junho de 1989.0 número de pacientes submetidos a revascularização do miocárdio e tratamento cirúrgico da valva aórtica (RAo) foi de 95, sendo que 75 foram submetidos a tratamento cirúrgico da valva mitral e revascularização do miocárdio (RMi). As lesões valvares mais freqüentes foram a estenose aórtica, 44 casos de insuficiência mitral em 40 casos. O número de anastomoses por paciente foi de 1,87 em média para os pacientes RMi e de 1,56 nos pacientes RAo. A mortalidade hospitalar foi de 9,8% sendo que a mortalidade para os pacientes RAo foi de 7,3% e para os pacientes RMi foi de 12%. Não houve diferença significativa (x²=04423) entre a mortalidade dos pacientes portadores de insuficiência mitral isquémica, operados eletivamente ou em caráter de emergência, sendo a mortalidade de 20% nos eletivos e de 37,5% nos de emergência. Não houve relação entre mortalidade e número de anastomoses por paciente. Houve tendência de melhores resultados com relação à mortalidade nos pacientes RMi com cirurgia conservadora (x²=1,6382). A curva actuarial de sobrevida mostra 82,6% em 19 semestres para os pacientes RMi, 90,4% para os pacientes RAo e 86,3% para o estudo global de pacientes. Com uma evolução de 5172 meses/pacientes, 75% apresentam-se em classe funcional I (NYHA).

In the period between July 1980 and June 1989,172 consecutive patients were submitted to combined coronary and valvular surgery. There were patients with predominantly valvular indications and others with predominant coronary indications. In 95 cases, myocardial revascularization and surgical treatment of the aortic valve (RAo) were simultaneously performed. Seventy five patients were submitted to myocardial revascularization and surgical treatment of the mitral valve (RMi). The more frequent valvular lesions were aortic stenosis (44 cases) and mitral insufficiency (40 cases). The mean number of anastomoses per patient was 1,87 for RMi cases and 1,56 for RAo patients. Overall hospital mortality was 9,8%; RAo mortality was 7,3% and RMi mortality was 12%. Mortality of patients with ischemic mitral insufficiency operated on electively (20%) or in an emergency basis (37,5%) was not statistically significant (x²=04423). There was not a relationship between mortality and the number of anastomoses per patient. A tendency for better results regarding mortality was observed in RMi patients in which the valve was preserved (x²=1,6382). The survival actuarial curves in 19 semesters demonstrates a valve of 82,6% for RMi patients, 90,4% for RAo patients and 86,3% for the whole series. After evolution of 5172 months/patients, 75% were in functional class I (NYHA).