Academic literature on the topic 'Acoma women'

Abstract OBJECTIVE Blood blister-like aneurysms are small hemispherical bulges from the dorsomedial wall of the internal carotid artery that resemble berry aneurysms but differ in their clinical and surgical features. On the basis of our literature review, blister-like aneurysms have been reported to occur only at nonbranching sites of the dorsomedial internal carotid artery. In this report on our series of five patients, we describe blister-like aneurysms of the anterior communicating artery (AComA) and discuss important diagnostic and therapeutic aspects unique to them. METHODS In our retrospective review of 719 patients with nontraumatic subarachnoid hemorrhage admitted to our service from 1998 to 2003, 181 (25.17%) patients harbored AComA aneurysms. Five (2.76%) patients (four women, one man) had blister-like aneurysms that were recognized at the time of surgery. RESULTS Initial digital subtraction angiography was diagnostic in only one patient. A second digital subtraction angiogram was diagnostic in one patient but failed to reveal an aneurysm in the remaining three patients; these were eventually diagnosed by computed tomographic angiography. All aneurysms were clipped. At the time of surgery, the aneurysms arose from the horizontal portion of the AComA without any involvement of the branches of the anterior cerebral artery. All presented as blister-like aneurysms that were thin-walled and lacking a surgical neck. On dissection, two of the lesions ruptured. All lesions were treated with straight fenestrated clips through the A1–AComA junction, thus remodeling the AComA. No delayed rupture was noted at the time of the last follow-up evaluation. At the time of discharge, outcomes were good in two patients, fair in two, and poor in the remaining patient. CONCLUSION Blister-like aneurysms constitute technically challenging lesions that may occur at the AComA. Computed tomographic angiography is valuable in diagnosis. Blister-like aneurysms should be suspected when digital subtraction angiography findings are negative for subarachnoid hemorrhage.

This study evaluated anatomical variants in the carotid siphon and of the circle of Willis in patients with aneurysms. We performed a retrospective analysis of cerebral angiographies. The Control Group was composed of patients without aneurysms. Posterior communicating artery (PcomA) aneurysms were more common in women (p<0.05), and the anterior communicating artery (AcomA) aneurysms in men (p<0.1). The incidence of fetal-type PcomA was higher in cases with co-occurring PcomA aneurysm (24 versus 8%, p<0.05). Patients with AcomA aneurysm had higher incidence of A1 hypoplasia (p<0.0001, OR=32.13, 95%CI 12.95-79.71) and lower frequency of fetal-type PcomA compared to their control counterparts (p=0.0125). The angle of carotid siphon was narrower in patients with PcomA aneurysm (27.3±19.1 versus 34.8±22.6, p=0.028). In conclusion, a narrower carotid siphon or the presence of fetal-type PcomA or A1 hypoplasia may cause hemodynamic stress, thereby promoting the formation of aneurysms in susceptible individuals.

Objective – to establish the features of clinical presentation and to optimize surgical treatment of arterial aneurysms (AA) of the anterior cerebral artery–anterior connecting artery (ACA–AComA) complex.Materials and methods. The results of surgical treatment of 267 (100 %) patients with AA of the ACA–AComA complex during the period from 01.01.2011 till 31.12.2017 were analyzed. There were 143 (53.6 %) women and 124 (46.4 %) men. Microsurgical clipping was performed in 165 (61.8 %) cases, endovascular coiling in 122 (38.2 %) cases. The organization of the medical care, clinical and instrumental examinations, medical and surgical treatment was done according to the current protocols (the Decree of the Ministry of Health of Ukraine dated April 17, 2014, N 275, EBM Guidelines, 28.8.2017, Juha E. Jääskeläinen).Results. The AA rupture was diagnosed in 238 (89.2 %) patients. 181 (67.9 %) patients were hospitalized till the 28th day since AA rapture. The severity of the patients state according to the level of conscious during hospitalization: in conscious – 92 (34.4 %), obtunded – in 127 (47.6 %), stuporous – in 28 (10.5 %), comatose – 20 (7.5 %). The severity of subarachnoid hemorrhage (SAH) according to WFNS (World Federation of Neurological Surgeons) Grading Scale: grade I – in 63 (23.6 %) patients, grade II – in 43 (16.1 %) patients, grade III – in 78 (29.2 %) patients, grade IV – in 36 (13.5 %) patients, grade V – in 18 (6.8 %) patients. Altered mental status was found in 87 (32.6 %) patients, among them in 29 (10.8 %) patients with non-hemorrhagic presentation. Motor deficiency was diagnosed in 116 (43.4 %) patients, cranial nerve palsy – in 42 (15.7 %) patients, particular visual disturbances – in 28 (10.5 %) cases, oculomotor palsy – in 5 (1, 9 %) cases, visual and oculomotor disturbances – in 9 (3.3 %) cases.Subarachnoid hemorrhage with intracerebral hematoma was detected in 184 (77.3 %) patients. Localization of hematomas: frontal lobes – 161 (87.5 %) cases, corpus callosum – 15 (8.1 %) and/or septum pellucidum – 8 (4.4 %). The intraventricular hemorrhage was diagnosed in 81 (34 %) patients: 1–4 points according to Graeb score – in 32 (39.5 %) patients, 5–8 points – in 27 (33.3 %) patients, 9–12 points – in 22 (27.2 %) patients. Lateral or axial dislocation was found in 28 (11.8 %) cases. Cerebral vasospasm in acute period was observed in 59.7 % of patients, and in 19.3 % of patients in «cold» period.The localization of the AA of ACA–AComA complex (according to M.G. Yasargil): anterior – in 50 (18.7 %) cases, posterior – in 42 (15.7 %), superior – in 98 (36.7 %), inferior – in 35 (13.2 %), mixed projection – 42 (15.7 %) cases. Saccular aneurysms were found in 192 (71.9 %) patients, «complex» AA – in 75 (28.1 %). The size of AA in the most observations (252 (94.3 %)) was less than 15 mm. Hypoplasia or aplasia of one A1 segments of ACA we revealed in 45 (18.9 %) cases.Comorbid conditions: hypertension (HTN) – in 175 (65.5 %) patients, the combination of HTN with ischemic heart disease (IHD) – in 117 (43.8 %), hypertension, HTN in combination with systemic atherosclerosis – in 87 (32.6 %), diabetes mellitus (DM) – in 61 (22.8 %), combination of HTN, IHD, DM and systemic atherosclerosis – in 47 (17.6 %) cases.According to the timing of procedure, there were 54 (20.2 %) emergency procedure, 127 (47.6 %) urgent, and 86 (32.2 %) semi-elective. In 37 (68.5 %) cases, emergency surgical interventions were microsurgical clipping, in 32 (59.3 %) – combined. Class I of occlusion of the treated AA according to Raymond scale was achieved in 93.9 % after microsurgical clipping, and 77.5 % after endovascular coiling. Favorable outcome according to Extended Glasgow Outcome Scale (GOSE) after surgical treatment were achieved in 75.3 % with a total mortality of 7.1 %, and significant differences in outcome in groups with different timing of surgery.Conclusions. It was found that hemorrhagic presentation with the formation of intracerebral hematoma in the frontal lobes, with dislocation syndrome, intraventricular expansion, cerebral vasospasm with clinical manifestations of the I–III grade of SAH of WFNS scale, motor deficiency (43.4 % of cases), cranial nerve palsy (15.7 %) and altered mental status (32.6 %) was typical for AA of ACA–AComA complex. It was found the dependence of outcome after surgical treatment of AA of ACA–AComA complex from the timing and method of surgical procedure. The criteria for the selection of optimal surgical tactic are the type of clinical presentation of the disease, the timing after aneurysms rapture, the severity of the preoperative condition, the presence of cerebral vasospasm, anatomical and topographical characteristics of the aneurysm.

Background Acetylsalicylic acid (ASA) and statins have been identified as potentially reducing the risk of intracranial aneurysms (IA) rupture. We aim to determine the effect of this drugs on the risk of rupture of IA. Patients and methods We performed a retrospective cohort study from a prospective database of patients with IA treated in our institution between January 2013 and December 2018. Demographics, previous oral treatments, presence of multiple aneurysms, size of aneurysm, lobulation, location and morphology of the aneurysms were recorded. Patients were dichotomized as ruptured and unruptured IA. Results A total of 408 IA were treated, of which 283 (68.6%) were in women. The median age was 53, 194 (47.5%) were ruptured IA. 38 patients (9.3%) were receiving ASA and 84 (20.6%) were receiving statins at the moment of the IA diagnosis. In the multivariable regression analysis, ASA plus statin use and multiple aneurysms were independently associated with unruptured IA (OR 5.01, 95% CI, 1.37–18.33, P = 0.015 and OR 2.72, 95% CI 1.68–4.27, P<0.001, respectively). Whereas, lobulated wall aneurysm and PComA/AComA location were inversely and independently associated with unruptured IA condition (OR 0.34, 95% CI 0.21–0.55, P<0.001 and OR 0.37, 95% CI 0.23–0.60, P<0.001, respectively). However, ASA and statins in monotherapy were not independently associated with unruptured IA condition. Conclusions In our study population ASA plus statins treatment is independently associated with unruptured IA. Larger and prospective studies are required to explore this potential protective effect against IA rupture.

Anterior communicating artery (AComA) aneurysm accompanied by visual symptoms is rarely reported. The first case is an asymptomatic 65-year-old woman who presented with an AComA aneurysm, and the pre-procedure high-resolution magnetic resonance imaging (MRI) revealed an AComA aneurysm compressed the left optic nerve and the chiasma with a size of 8.3 × 9.2 mm. She suffered a sudden onset of left eye visual loss and the temporal hemianopia of the right eye after endovascular embolization. She had a light sensation of the left eye and minor enlargement of the visual field in the right eye at the six-month follow-up. The second case is a symptomatic 55-year-old woman suffering a visual loss in the left eye and inferior nasal quadrantanopsia in her right eye. Pre-operative high-resolution MRI found an AComA aneurysm compressing the left part of the chiasma with a size of 7.1 × 8.3 mm. Her visual symptoms improved after surgical clipping. High-resolution MRI could depict the anatomic relationship between the AComA aneurysm and the surrounding optic pathways. Endovascular treatment of an AComA aneurysm may result in visual deterioration due to the mass effect or ischemia after the procedure. Surgical clipping of the AComA aneurysm could relieve the compression symptoms.

Introduction: Anterior communicating artery complex (ACoA) is the most frequent intracranial aneurysms (30%) and the most complex of the anterior circulation, due to variation of architecture, flow and many branches involved. This paper aims toestablish anatomical study and clinical manifestations, analyzing a series of cases of AcoA aneurysms. Methods: Articles in PubMed, Scientific Direct were reviewed using as key words, anatomy variations. In addition, AcoA features were analyzedbased on our series cases. Results: Most common anatomical variations found in the literature were: plexiform (30%), curling (33%), fenestration (21%), duplication (18%). Clinical features: Fasciobraquial hemiparesis, headache, personality changes,intellectual deficit, anxiety, fear, emotional disturbances, dizziness, agitation, hypokinesia, decreased level of consciousness. Total of 5-year series of 234 cerebral aneurysms (32 deaths -13.6 %). Analyzing the series, 41 ACoA (18%), with 32 ruptured (78%); 19 deaths (46%); 16 prior hypertension arterial (39%); and a ratio between women and men of 2.25 were found. Conclusion: In our series, we concluded that the ACoA aneurysms are more common in women, the diagnosis is often after rupture and highincidence of death. Probably the anatomical variations, location between bifurcation arteries, A1 characteristics and different direction of the domus, contribute for different outcomes and uncertain clinics. Therefore, to predict the topography of theaneurysm by analyzing only the clinic is difficult.

Because infundibular widening most commonly appears at the origins of the posterior communicating artery and anterior choroidal artery from the internal carotid artery, its occurrence in association with the anterior communicating artery (ACoA) or the A1-A2 junction can be misinterpreted as an ACoA aneurysm on angiograms. The authors report on 2 such cases; one in a 73-year-old woman with infundibular widening of the recurrent artery of Heubner, and the other in a 44-year-old woman with infundibular widening of a perforating vessel from the ACoA. The correct diagnosis was established based on surgical exploration. In addition, grayscale modification of 3D reconstruction images of preoperative digital subtraction angiography revealed the cases of the recurrent artery of Heubner and perforating artery of the ACoA arising from the apex of the infundibular widening.

Aim: to verify hypotheses about differences in the level of satisfaction with life and its aspects, as well as aggression in the ACoA and the control group, and the relationship between satisfaction and aggression in these groups. Method: The sample consisted of 100 people living in Warsaw. Among the respondents were 58 men and 42 women. Everyone involved in the study was over 18 years of age, the oldest tested was 25 years old. The average age was 23.3. The study used The Life Satisfaction Questionnaire (KZZ), to examine the level of aggression Inventory of Psychological Aggression Syndrome (IPSA) and to explore the emergence of the group of ACoA - Questionnaire for Research Place in the Family. Results: ACoA show lower life satisfaction and higher levels of aggression than the control group.

Objective: to establish the characteristics of location for cerebral aneurysms according to ethnicity in the population of Yakutia.Patients and methods. A total of 433 patients with aneurysmal hemorrhagic stroke (AHS) who had been admitted consecutively to the regional vascular center (Yakutsk) were examined. Group 1 included representatives of the indigenous ethnic groups of the Asian race in Yakutia (n=331; 33.8% of men); Group 2 comprised patients of the Caucasian race (n=102; 45.1% of men). The diagnosis was made by digital subtraction cerebral angiography (77.6%) and multislice computed tomography angiography (22.4%).Results. A total of 433 ruptured saccular aneurysms, including the latter in the anterior cerebral and anterior communicating arteries (ACAAcoA) (33.8%), middle cerebral artery (MCA) (38.7%), internal carotid artery (ICA) (21.6%), and vertebrobasilar arteries (5.8%), were diagnosed. In Group 1, the most common location for aneurysms was MCA (41.1 and 39.7% in men and women, respectively); in Group 2, that was ACA-AcoA (52.2%) in men and ICA (42.8%) in women. The ethnic groups showed significant differences in the incidence of MCA aneurysms (40.2 and 26.4% in Groups 1 and 2; respectively (p=0.014)); (odds ratio (OR = 1.866; 95% confidence interval (CI), 1.111–3.146). In Group 1, the incidence of MCA aneurysms was higher in women than in those in Group 2 (p=0.012) (OR=2.417; 95% CI, 1.155–5.141).Conclusion. The location for cerebral aneurysms differs according to ethnicity. In Yakutia among AHS patients, the most frequent location for aneurysms is MCA among indigenous Asians, while that is ACA-AcoA in Caucasian men and ICA is in Caucasian women. The incidence of MCA aneurysms is significantly higher in indigenous Asian women than in Caucasian ones.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
For centuries, discourses about beauty have involved the female body in delicate power relations, in addition to transforming it into the object of consumption and desire in different societies. In the last decades, the body has gained even more importance with the possibility of aesthetic and surgical interventions for beauty and physical performance. For all this, the figure of the fat, the potbellied and the sedentary became an indication of failure before so many possibilities of beauty, health and success released by advertising and the media and general. However, since the early 2000s something has been changing in this discourse. Blogs, social networks and other alternative media have been releasing a more optimistic message about obesity. Without apologies to fat, Internet encourages self-love and the end of suffering caused by useless diets and treatments to lose weight. These channels are lead by young women who are supposed to have learned to like themselves and to overcome issues such as prejudice, lack of accessibility and representativeness. Some bloggers already add up to hundreds of thousands of followers and have achieved good advertising contracts thanks to their power of influence on social networks. A good part of this positive discourse is fashion, which already sees in people considered to be overweight an important lode for business. The so-called fashion plus size, as the segment was named, today moves the fashion industry more than any other, and already has events, parades, stylists and own models, all increasingly sought after. Even in the face of this new scenario in relation to obesity, is it possible to imagine that the changes have come to stay? This paper discusses a bit of the history of the fat body and the building of beauty standards, as well as the paradigms that social networks and mass culture are helping to break down by proposing the notion that it is possible to have extra kilos and be beautiful and, above all, happy
Há séculos, os discursos sobre beleza envolvem o corpo feminino em delicadas relações de poder, além de transformá-lo em objeto de consumo e desejo em diferentes sociedades. Nas últimas décadas, o corpo ganhou ainda mais importância com a possibilidade de intervenções estéticas e cirúrgicas em prol da beleza e do rendimento físico. Por tudo isso, a figura do gordo, do barrigudo e do sedentário virou um indicativo de fracasso diante de tantas possibilidades de beleza, saúde e sucesso divulgadas pela publicidade e pela mídia e geral. No entanto, desde o início dos anos 2000 algo vem mudando nesse discurso. Blogs, redes sociais e outras mídias alternativas vêm divulgando uma mensagem mais otimista em relação à obesidade. Sem apologias à gordura, o que se vê na Internet são incentivos ao amor próprio e o fim do sofrimento causado por dietas inúteis e tratamentos para emagrecer. O que se vê nesses canais são jovens que supostamente aprenderam a gostar de si mesmas e a superar questões como preconceito, falta de acessibilidade e representatividade. Algumas blogueiras já somam centenas de milhares de seguidores e conseguiram bons contratos publicitários graças ao seu poder de influência nas redes sociais. Boa parte desse discurso positivo passa pela moda, que já enxerga nas pessoas consideradas acima do peso um filão importante para os negócios. A chamada moda plus size (tamanhos grandes, em inglês), como foi batizado o segmento, hoje movimenta a indústria da moda mais do que qualquer outro, e já conta com eventos, desfiles, estilistas e modelos próprios, todos cada vez mais requisitados. Mesmo diante desse novo cenário em relação à obesidade, é possível imaginar que as mudanças vieram para ficar? Este trabalho discute um pouco do histórico em relação ao corpo gordo e à construção de padrões de beleza, bem como os paradigmas que as redes sociais e a cultura de massas estão ajudando a quebrar ao propor a noção de que é possível ter quilos a mais e ser bonita e, sobretudo, feliz

Alguns estudos vêm apontando o hipotireoidismo como um fator de risco para depressão; entretanto, esta associação é ainda controversa. Como objetivo o presente estudo estimou a prevalência de sintomas depressivos numa amostra probabilística de mulheres e investigou se existe uma associação entre níveis de TSH e a presença de sintomas depressivos. Conduzimos um estudo transversal de base populacional onde avaliou-se uma amostra de mulheres com 35 anos ou mais anos de idade, residentes no município do Rio de Janeiro (RJ), que foram entrevistadas e tiveram amostras de sangue coletadas. O desenho de amostra proposto para a pesquisa seguiu um modelo de amostragem probabilística por conglomerado, em três estágios de seleção, tendo por base os setores censitários do município. A função tireoidiana foi medida pelo TSH sérico, a partir das amostras coletadas no domicílio. Para avaliação da presença/ausência de sintomas depressivos utilizou-se um instrumento padronizado e validado (PRIME-MD). Foram também coletados dados sócio demográficos e outras informações de saúde da participante. A prevalência de sintomas depressivos, frequências e associações foram calculadas levando-se em conta o desenho de amostra complexo, utilizando procedimentos específicos do pacote SAS (versão 9.1). Da amostra de 1500 mulheres, 1298 foram entrevistadas, sendo o percentual de não-resposta igual a 13,5%. A amostra final foi composta por 1249 participantes, onde foi encontrada uma prevalência de sintomas depressivos igual a 45,9%. Em relação aos níveis de TSH, 4,8% da amostra apresentaram-se acima do ponto de corte adotado (≥6,0 mUl/ml). Destas, 61,9% apresentaram sintomas depressivos, contra 44,9% entre as mulheres com TSH<6,0 (p=0,04). A análise ajustada mostrou que mulheres com nível de TSH≥6,0 tiveram uma chance duas vezes maior de apresentarem sintomas depressivos do que aquelas com TSH normal (OR=2,04). Ao excluir da análise as participantes que auto-referiram diagnóstico prévio de doença tireoidiana, a associação entre níveis de TSH e sintomas depressivos perdeu a significância. Concluindo, foi observada alta prevalência de sintomas depressivos na amostra, especialmente entre o grupo com níveis elevados de TSH. Os resultados chamam atenção para a importância de se investigar em pacientes deprimidos a comorbidade tireoidiana.
Some studies have been indicating that hypothyroidism is a risk factor for depression; however, this association is still controversial. The present study estimated the prevalence of depressive symptoms in a probabilistic sample of women and investigated whether there was any association between thyroid-stimulating hormone (TSH) levels and the presence of depressive symptoms. A cross-sectional population-based study was carried out and sample of women aged 35 years and over living in the municipality of Rio de Janeiro (RJ) was evaluated. They were interviewed and blood samples were taken. The sample design proposed for this study followed a model of probabilistic sampling by clusters, with three selection stages based on the census tracts of municipality. Thyroid functions was measured from serum TSH levels, using samples collected in the subjects homes. To assess the presence/absence of depressive symptoms, a standardized validated instrument (PRIME-MD) was used. Sociodemographic data and other information on participants health were also gathered. The prevalence of depressive symptoms, frequencies and associations were calculated while taking into account the design of this complex sample, using specific procedures from the SAS statistical package (version 9.1). Out of a sample of 1500 women, 1298 were interviewed. The no-response rate was 13.5%. The final sample was composed of 1249 participants, among whom a prevalence of depressive symptoms of 45.9% was found. Regarding TSH levels, 4.8% of the sample was above the cutoff point adopted (≥6.0 mUl/ml). Of these, 61.9% presented depressive symptoms, versus 44.9% among the women with TSH <6.0 (p=0.04). The adjusted analysis showed that the women with TSH levels ≥ 6.0 had twice as much chance of presenting depressive symptoms as did those with normal TSH levels (OR= 2.04). when the participants who self-reported a previous diagnosis of thyroid disease were excluded from the analysis, the association between TSH levels and depressive symptoms lost its significance. High prevalence of depressive symptoms was observed in the sample, specially among the group with high TSH levels. The results draw attention towards the importance of investigating thyroid comorbidity in depressed patients.

Orientadores: Lúcia Helena Simões da Costa Paiva, Luiz Francisco Cintra Baccaro
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: O envelhecimento populacional no Brasil está atualmente entre os mais acelerados do mundo. Com o aumento da expectativa de vida e do número de idosos, a qualidade de vida desses anos vividos a mais consiste em uma importante preocupação, e está relacionada com a incapacidade funcional e a presença de multimorbidades que acometem essa população em envelhecimento. O objetivo deste estudo foi avaliar a prevalência de incapacidade funcional e sua associação com multimorbidades em mulheres brasileiras com 50 anos ou mais. Sujeitos e Métodos: Realizou-se uma análise secundária de estudo de corte transversal de base populacional com 622 mulheres com idade igual ou superior a 50 anos, conduzido de 10 de maio a 31 de outubro de 2011, no município de Campinas, São Paulo, Brasil. A amostragem foi realizada através do sorteio de sessenta e seis setores censitários de Campinas, de acordo com uma lista fornecida pelo Instituto Brasileiro de Geografia e Estatística (IBGE), por amostragem aleatória simples ou probabilidade igual de seleção. Um questionário contendo sete itens para avaliar capacidade funcional foi aplicado pessoalmente ou por telefone por entrevistadoras treinadas. A incapacidade funcional foi definida pela incapacidade de realizar pelo menos um dos sete ítens. Também foram avaliados auto-percepção da saúde, fatores sócio-demográficos, multimorbidades e condições de saúde. A variável dependente foi definida como não ser capaz de realizar qualquer um dos sete itens. As variáveis independentes foram auto-percepção de saúde, dados sócio-demográficos, hábitos e problemas relacionados à saúde. A análise estatística foi realizada pelo teste do qui-quadrado e regressão de Poisson. Resultados: A media de idade foi de 64.1 anos e a prevalência de incapacidade funcional foi de 43.4%. Idade (PR 1.02; 95% CI 1.01¿1.03; p=0.017), medo de cair (PR 1.59; 95% CI 1.17¿2.16; p=0.003), IMC elevado (PR 1.03; 95% CI 1.01¿1.05; p=0.003), antecedente de infarto (PR 1.36; 95% CI 1.06¿1.76; p=0.017), fumar mais de 15 cigarros/dia (PR 1.34; 95% CI 1.04¿1.72; p=0.023), internação hospitalar nos últimos 12 meses (PR 1.29; 95% CI 1.03¿1.62; p=0.027), multimorbidade (PR 1.43; 95% CI 1.02¿2.02; p=0.039) e uso de medicação prescrita pelo médico (PR 1.57; 95% CI 1.02¿2.41; p=0.042) estiveram associados à maior prevalência incapacidade funcional. Auto-perceção de saúde boa/muito boa (PR 0.67; 95% CI 0.52¿0.86; p=0.002); uso de tratamentos alternativos (PR 0.54; 95% CI 0.33¿0.90; p=0.018) e maior escolaridade (PR 0.65; 95% CI 0.45¿0.93; p=0.020) estiveram associados à uma menor prevalência de incapacidade funcional. Conclusões: A prevalência de incapacidade funcional foi alta e esteve associada à idade avançada, às multimorbidades e suas consequências. Palavras chaves: capacidade funcional, mulheres, multimorbidades, fatores de risco, menopausa, fatores de risco
Abstract: The aging of the Brazilian population is currently one of the fastest growing in the world. With the increase of life expectancy and the number of elderly, the quality of life of these extra years consists in an important concern, and is related with disabilities and the presence of multimorbidities that affect this population during the aging process. The goal of this study was to evaluate the prevalance of limitations in functional capacity and it¿s assosiation with multimorbidities in brazilian women over 50 years of age. This is secondary analysis of a cross-sectional population with 622 women over 50 years of age, conducted from the 10th of May to the 31st of October of 2011, in Campinas, São Paulo, Brazil. Based on a list supplied by the Brazilian Institute of Geography and Statistics (IBGE), and classified according to the identification number of each sector, a total of 66 census sectors in Campinas were used to select the population with random sampling or equal probabilities of section. A questionnaire containing seven items was implemented in person or by telephone by trained interviewers. The dependant variable, disability, was defined by the incapacity to realize at least one of the seven items. Self-perception of health, sociodemographic data, health-related habits and problems were also evaluated as independente variables. The statistical analysis was carried out by chi-square test and Poisson regression using the backward selection criteria. The average age was 64.1 years old and the prevalence of limited functional capacity was 43.4%. Age (PR 1.02; 95% CI 1.01¿1.03; p=0.017), fear of falling (PR 1.59; 95% CI 1.17¿2.16; p=0.003), having a higher BMI (PR 1.03; 95% CI 1.01¿1.05; p=0.003), personal history of heart attack (PR 1.36; 95% CI 1.06¿1.76; p=0.017), smoking more than fifteen cigarettes a day (PR 1.34; 95% CI 1.04¿1.72; p=0.023), having been admitted to a hospital in the last 12 months (PR 1.29; 95% CI 1.03¿1.62; p=0.027), multimorbidity (PR 1.43; 95% CI 1.02¿2.02; p=0.039) and use of any medication prescribed by a doctor (PR 1.57; 95% CI 1.02¿2.41; p=0.042) were associated with a higher prevalence of disability. Self-perception of health as good/very good (PR 0.67; 95% CI 0.52¿0.86; p=0.002); use of alternative medications (PR 0.54; 95% CI 0.33¿0.90; p=0.018) and having more years of schooling (PR 0.65; 95% CI 0.45¿0.93; p=0.020) were associated with a lower prevalence of disability. The prevalence of functional limitation was high and associated with aging as well as multimorbidity and it¿s consequences. Key words: disability evaluation, women, multimorbidity, menopause, risk factors, life style
Mestrado
Fisiopatologia Ginecológica
Mestra em Ciências da Saúde

Orientador: Vera Aparecida Madruga Forti
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física
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Resumo: A presente dissertação foi desenvolvida na cidade do Rio de Janeiro-RJ, no Complexo de Favelas da Maré, região da Leopoldina, visando à implantação de um programa de saúde, não assistencialista, para idosos em alto risco social. Avaliou-se os indicadores de saúde relacionados a aptidão física em mulheres com idade igual ou superior a 50 anos ingressantes no projeto ¿Bom Dia Maré Caminhada¿, realizado na Vila Olímpica da Maré. Foram avaliadas 144 voluntárias em um estudo do tipo transversal observacional descritivo. As variáveis de saúde investigadas foram: pressão arterial circunstancial, peso, estatura, índice de massa corporal, independência funcional e flexibilidade. Apesar da dimensão do Complexo da Maré, apenas sete comunidades participaram do estudo, pois muitas pessoas deste local receiam o trânsito em determinadas áreas. Como critério de inclusão da amostra utilizou-se o PAR-Q, onde os participantes do estudo foram os que apresentaram mais de uma resposta afirmativa. Foi identificada alta prevalência de obesidade (46,7%), adiposidade abdominal (91,2%) e hipertensão arterial circunstancial (63,4%) indicando o elevado risco cardíaco presente no grupo. Na avaliação da independência funcional constatou-se que quanto mais avançada a idade maior o desequilíbrio corporal; e que se torna mais difícil levantar do que sentar durante a execução do teste. Este gesto motor tem grande relevância na independencia funcional o que influencia as atividades da vida diária. Em relação a flexibilidade, os índices obtidos foram baixos, demonstrando pouco condicionamento desta valência. Conclui-se que há mulheres residentes na Maré com quadro de obesidade, e que este agravo de saúde não possui um delineador social, ou seja, ele atinge a todas as camadas. A hipertensão arterial circustancial encontrada pode ter relação com o quadro de saúde, mas fundamentalmente tem influência das condições ambientais conflituosas em áreas de risco social. Recomenda-se que programas desta ordem sejam implantados em comuninadades com as mesmas caracteristicas, e que, as populações desta natureza tenham a oportunidade de iniciar atividades físicas voltadas à saúde, com o intuito de diminuir o nível de sedentarismo em mulheres de meia idade no Brasil
Abstract: This essay was developed in the city of Rio de Janeiro-RJ at the Maré Shanty Community, Leopoldina region, aiming to implement a health program, not as welfare work, for elderly people running high social risk. The indicators were evaluated in respect to physical fitness in women 50 or more years old participating in the project ¿Mare Good Morning Walk¿, carried out at the Mare Vila Olimpica. One hundred and forty four volunteers were evaluated in a descriptive observational transversal study. The health variables investigated were: circumstantial arterial pressure, weight, height, corporal mass index, functional independence and flexibility. Regardless of the Mare Community¿s size, only seven communities participated in the study, as many people there are afraid to pass through certain areas. As criterion to be included in the sample, PAR-Q was used, where participants in the study were the ones who had submitted more than one affirmative answer. High prevalence of obesity (46.7%), abdominal adiposity (91.2%) and circumstantial arterial hypertension (63.4%) was identified demonstrating the high cardiac risk found in the group. When evaluating functional independence it was verified that the older they were the higher their corporal imbalance was; and that it becomes more difficult to get up than to sit down during the execution of the test. This motion gesture has great relevancy in functional independence as it affects daily life activities. In terms of flexibility, the indexes obtained were low, evidencing little conditioning in this value. It was concluded that there are women at Mare with obesity problems and that this health deficiency does not have a social connotation that is, it reaches all social levels. Circumstantial arterial hypertension found may be related to the health aspect, but it is fundamentally affected by conflicting environmental conditions in areas of social risk. It is recommended that programs such as this be implemented in communities with the same characteristics, and that people with these issues have the opportunity to start physical activities oriented to health, with the objective to reduce the level of sedentariness of middle-age women in Brazil
Mestrado
Mestre em Educação Física

O presente trabalho tem como objeto a Academia Literária Feminina do Rio Grande do Sul (ALFRS), fundada em Porto Alegre no ano de 1943, e que segue em atividade na cidade até os dias de hoje (2016). Esta dissertação teve como questionamento central quais os pensamentos e práticas permeadas por gênero constituíram esta instituição de letras feminina, bem como suas transformações, ao longo das décadas de 1940 a 1970 em Porto Alegre. O recorte temporal abarcou o período da criação da ALFRS e seus trinta anos iniciais, englobando nas fontes utilizadas as Atas da instituição, de 1943 a 1973, seus estatutos, e a revista Atenéia, que circulou de 1949 a 1972. Através da categoria gênero, teve como horizonte rastrear quais discursos a transpassaram, seja internamente, através de suas Atas, seja externamente, por meio dos editoriais de sua revista. Primeiro, analisou-se os porquês da sua criação, para compreender como se estruturou esta academia de letras exclusivamente de mulheres e quais foram suas características iniciais, além das informações gerais do periódico, que foi o órgão de intercâmbio cultural e de defesa dos interesses da ALFRS. Posteriormente, três perspectivas orientaram a estrutura da narrativa: a “Academia para dentro” (estabelecimento, organização e transformações de práticas e posicionamentos da ALFRS internamente ao longo de suas três décadas iniciais – 1943-1973); “de fora para dentro da Academia” (temas e finalidades da ALFRS levados ao público externo nos editoriais de Atenéia) e, por fim, “de fora para dentro da Academia e vice-versa” (sentidos políticos de uma escrita aparentemente descomprometida nos editoriais de Atenéia).
This study has as an object the Academia Literária Feminina do Rio Grande do Sul (ALFRS), founded in Porto Alegre by the year of 1943, being still in activity in the city until the present day (2016). This dissertation has as a main question to understand what were the thoughts and practices permead by gender constituted this feminine literary institution, as well as, its transformation from the 1940s to 1970s in Porto Alegre. The time frame clipping has embraced the ALFRS creation period and its first thirty initial years, encompassing the Institution meeting minutes in the sources used in this study from 1943 to 1973, its bylaws, and the Atenéia magazine, that had been published from 1949 to 1972. Through the category of gender, this study has had as an outlook to track back which speeches permeated the Academy, either internally, through its meetings minutes, or externally, by means of its magazine editorials. Initially, the reasons of its creation were examined, to understand how this women uniquely literary academy was structured and what were its first initial characteristics, further the journal general informations, which was the cultural cooperation executive body and acted in the ALFRS interests defence. Afterward, three perspectives guided the narrative structure: the “inward academy” (establishment, organization and ALFRS internally practices transformations and placements over the course of its first three decades – 1943-1973); “the outside in academy” (ALFRS themes and purposes taken to the external public by the editorials of Atenéia) and, finally, “from the outside in Academy to inward Academy and vice versa” (political senses from an apparently non-committal writing in the editorials of Atenéia).