Hearing aid effectiveness on patients with chronic tinnitus and associated hearing loss

Abstract Objective: Our study aimed to measure the effectiveness of using HA in reducing the disturbance caused by tinnitus. Methods: Study was designed as a within-subjects clinical trial. Nineteen patients with chronic tinnitus and untreated sensorineural hearing loss were under counseling, HA fitting and 6 months follow-up. Tinnitus assessment was performed with Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), pitch and loudness matching, and Minimum Masking Level measurements (MML). Results: following 6 months of HA use, a reduction in reported tinnitus and hearing handicap scales scores was observed both statistically and clinically. The pitch and loudness matching, as well as MML at the baseline and final evaluation were compared. MML's thresholds reduced significantly after 6 months of HA use. Conclusion: Our study has provided evidence that HA fitting is a valuable treatment strategy for chronic tinnitus relief and associated hearing loss subtype of patient. Level of evidence: 3.

Effectiveness of Dry Needling in Bothersome Chronic Tinnitus in Patients with Myofascial Trigger Points

Abstract Introduction Therapeutic dry needling (DN) is effective in reducing the discomfort of chronic somatosensory tinnitus in patients with myofascial trigger points (MTP)s. Objective To evaluate the efficacy of DN in chronic somatosensory tinnitus discomfort in patients with MTP. Methods Placebo-controlled paired trial that included 16 patients with a diagnosis of somatosensory chronic tinnitus and with the presence of at least one active or latent MTP. Treatment was performed in two phases: (1) four sessions (one session per week for four consecutive weeks) of placebo DN and (2) four sessions of therapeutic DN with a gap (washout) of 15 days between these phases. Results The Tinnitus Handicap Inventory (THI) variable and its emotional domain had a statistically significant reduction in therapeutic DN when compared with placebo DN (p= 0.024 and p = 0.011, respectively). The tinnitus visual analogic scale (VAS) signaled a reduction in tinnitus discomfort when compared with moments before and after therapeutic DN (p< 0.05). Conclusion The therapeutic DN technique for MTP in patients with chronic tinnitus of somatosensory origin proved effective in reducing symptom discomfort, as measured by the THI (total score) and its emotional domain when compared with placebo DN.

Diagnosis of catecholaminergic polymorphic ventricular tachycardia during late adulthood due to a rare genetic variant in RYR2: a case report

Background@#Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe hereditary channelopathy characterized by the presence of ventricular arrhythmias triggered by adrenergic stimuli, usually diagnosed in the first two decades of life. Genetic variants in the cardiac ryanodine receptor gene are the most frequently occurring that cause an increase in intracellular calcium concentration and thus induce ventricular arrhythmias due to a delayed after depolarisation-induced triggered activity.Case presentationWe present the case of a 74-year-old male, a regular athlete with no relevant family history who suffered from sinus dysfunction and frequent premature ventricular complexes with no symptoms. A treadmill test revealed severe polymorphic ventricular arrhythmias which led to the suspicion of CPVT. A genetic study was undertaken, and it identified a rare genetic variant in the RYR2 gene which was possibly associated with its development in heterozygosity: c.14465G > A, p.Arg4822His. While evaluating the co-segregation, we observed that most of his relatives exhibit polymorphic ventricular arrhythmias with exertion without symptoms and carried the same variant. @*Conclusions@#We described, for the first time, the clinical characteristics and co-segregation of a family diagnosed with CPVT secondary to a little-known genetic variant of the RYR2 gene. It is a variant that, in our case study, suggests an association with a very good prognosis.

Diagnosis of catecholaminergic polymorphic ventricular tachycardia during late adulthood due to a rare genetic variant in RYR2: a case report

Background@#Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe hereditary channelopathy characterized by the presence of ventricular arrhythmias triggered by adrenergic stimuli, usually diagnosed in the first two decades of life. Genetic variants in the cardiac ryanodine receptor gene are the most frequently occurring that cause an increase in intracellular calcium concentration and thus induce ventricular arrhythmias due to a delayed after depolarisation-induced triggered activity.Case presentationWe present the case of a 74-year-old male, a regular athlete with no relevant family history who suffered from sinus dysfunction and frequent premature ventricular complexes with no symptoms. A treadmill test revealed severe polymorphic ventricular arrhythmias which led to the suspicion of CPVT. A genetic study was undertaken, and it identified a rare genetic variant in the RYR2 gene which was possibly associated with its development in heterozygosity: c.14465G > A, p.Arg4822His. While evaluating the co-segregation, we observed that most of his relatives exhibit polymorphic ventricular arrhythmias with exertion without symptoms and carried the same variant. @*Conclusions@#We described, for the first time, the clinical characteristics and co-segregation of a family diagnosed with CPVT secondary to a little-known genetic variant of the RYR2 gene. It is a variant that, in our case study, suggests an association with a very good prognosis.

Qualidade do consumo alimentar e fatores associados em crianças de um ano de vida na Atenção Primária à Saúde / Dietary intake quality and associated factors in one year-old children seen by primary healthcare services

Resumo O objetivo foi analisar a qualidade do consumo alimentar de crianças com um ano de idade acompanhadas por um serviço de Atenção Primária à Saúde (APS). Trata-se de estudo transversal aninhado a uma coorte de saúde bucal infantil em que foram coletados dados de crianças nascidas em 2013 e acompanhadas por 2 anos, em Porto Alegre. Foi aplicado um questionário sobre variáveis maternas e frequência de consultas de puericultura, medidas antropométricas e consumo alimentar da criança. Para tal, foi gerado um escore a partir da pontuação criada conforme o SISVAN (Sistema de Vigilância Alimentar e Nutricional). Foi calculado um modelo multivariado, por meio da Regressão de Poisson com variância robusta. A amostra consistiu de 249 crianças. Encontrou-se 30,5% (76) de qualidade ruim/regular da alimentação, que no modelo multivariado esteve associada com nível educacional do responsável, sendo até ensino médio incompleto (RP = 2,14, IC95% = 1,03-4,44) e ensino médio completo (RP = 1,70, IC95% = 0,81-3,54), assim como não ter consultado com dentista (RP = 2,54, IC95% = 1,33-4,84) ou ter consultado até o quarto mês de idade (RP = 1,94, IC95% = 1,01-3,72). Conclui-se que não consultar com dentista no primeiro ano de vida e menor escolaridade materna repercutem negativamente na qualidade alimentar infantil.

Abstract The purpose of this paper was to analyze the food intake quality in one year-old children seen by a primary healthcare (PHC) service. This is a cross-sectional studied nested within a child oral health cohort study which collected data regarding children born in 2013 and monitored in Porto Alegre for two years. We applied a questionnaire on maternal variables and frequency of pediatric appointments, weight and height measurements, and children's food intake. To that end, a score was generated based on the points assigned according to SISVAN (meaning 'food and nutrition monitoring system,' run by the Brazilian Ministry of Health). A multivariate model was calculated using Poisson regression with robust variance. The sample comprised 249 children. We found 30.5% (76) of poor/regular dietary quality, which in the multivariate model was associated to the guardian's educational background, considering up to incomplete high school (PR = 2.14, CI95% = 1.03-4.44) and complete high school (PR = 1.70, CI95% = 0.81-3.54), as well as their failure to see a dentist (PR = 2.54, CI95% = 1.33-4.84) or having seen one before the age of four months (PR = 1.94, CI95% = 1.01-3.72). It is our conclusion that failing to see a dentist within the first year of life and lower maternal schooling negatively impact on children's dietary quality.

Comparison of ART outcomes in men with altered mRNA protamine 1/protamine 2 ratio undergoing intracytoplasmic sperm injection with ejaculated and testicular spermatozoa / 亚洲男科学杂志(英文版)

Assisted reproductive technologies involving the use of spermatozoa and eggs for in vitro fertilization (IVF) have come as the solution for many infertile couples to become parents. However, in some cases, the use of ejaculated spermatozoa delivers poor IVF performance. Some studies have suggested the use of testicular spermatozoa in severe male infertility cases, but no guidelines regarding their utilization are currently available. In the present study, we found the mRNA protamine 1/protamine 2 (P1/P2) ratio to be a valuable biomarker of poor sperm function that could be used as a diagnostic key for the identification of cases that would benefit from the use of testicular spermatozoa. A total of 23 couples undergoing egg donation cycles with at least one previous cycle failure were studied. All couples underwent two consecutive intracytoplasmic sperm injection (ICSI) cycles with either ejaculated or testicular spermatozoa (TESA). The sperm mRNA P1/P2 ratio, fertilization rate, blastocyst rate, and pregnancy and live birth rate were compared. Results showed improved ICSI and clinical outcomes in cycles with testicular spermatozoa in men with altered mRNA P1/P2 ratios. TESA cycles presented significantly higher rates of fertilization (mean ± standard deviation: 76.1% ± 15.1% vs 65.5% ± 18.8%), blastocyst formation (55.0% ± 20.3% vs 30.8% ± 23.8%), and good morphological quality blastocyst (28.9% ± 22.9% vs 13.5% ± 17.9%) and also improvements on pregnancy (60.9% vs 0%) and healthy birth rates (56.5% vs 0%) than EJACULATE cycles. The results described here suggest that in patients with previous IVF/ICSI failures and aberrant mRNA protamine ratios, the use of testicular spermatozoa may be a good alternative to improve clinical outcomes.

Recording of tinnitus psychoacoustic measurements: an integrative literature review / Registro de medidas psicoacústicas do zumbido: revisão integrativa

ABSTRACT Purpose: to review both the national and international literature as well as to describe the methods used to collect psychoacoustic measurements in tinnitus patients. Methods: the current integrative review was conducted on articles in specialized national and international journals, in both the Portuguese and English languages, available in the PubMed/Medline, BVS - LILACS and SCIELO databases. The following keywords and descriptors were used: hearing, tinnitus, psychoacoustic measurements, acuphenometry, and assessment, in both the Portuguese and English languages. The retrieved articles were read and selected for the review according to the eligibility criteria, which included the use of psychoacoustic measurements in tinnitus patients and the presence of a detailed methodological description of the protocol employed, in individuals with normal hearing and those with hearing loss. Results: a total of 12 articles, in which psychoacoustic measures were used for the characterization and the measurement of tinnitus in individuals with normal hearing and in those with hearing loss, were reviewed. The main findings were associated with the sample characterization and the way in which the psychoacoustic measures were performed. Conclusion:given the grouping of several protocols for tinnitus evaluation, which were determined following an integrative literature review, a great heterogeneity in the methods used to perform psychoacoustic measurements for tinnitus assessment for both clinical and scientific purposes was noted.

RESUMO Objetivo: revisar a literatura nacional e internacional e descrever os métodos usados para a coleta das medidas psicoacústicas do zumbido. Métodos: essa revisão integrativa foi realizada por meio da busca de artigos em periódicos especializados, nacionais e internacionais, nos idiomas português e inglês, disponíveis nas bases de dados: PubMed/Medline, BVS - LILACS e SCIELO. As palavras-chaves e descritores utilizados foram: audição, zumbido, medidas psicoacústicas, acufenometria e avaliação e, seus correspondentes em inglês. Os artigos levantados foram lidos e selecionados para a revisão seguindo os critérios de elegibilidade: aqueles que empregaram medidas psicoacústicas do zumbido e com descrição metodológica detalhada do protocolo empregado, em indivíduos normo-ouvintes e com perda auditiva. Resultados: foram revisados 12 artigos nos quais as medidas psicoacústicas foram empregadas para a caracterização e mensuração do zumbido, em indivíduos normo-ouvintes e com perda auditiva. Os principais achados referem-se à caracterização da amostra e modo de realização das medidas psicoacústicas. Conclusão: o agrupamento de diversos protocolos para avaliação do zumbido, realizado a partir da revisão integrativa de literatura, evidenciou grande heterogenidade dos métodos de realização das medidas psicoacústicas para a mensuração do zumbido para fins clínicos e científicos.

Associação entre a autopercepção do envelhecimento e a autopercepção da saúde / Association between the self-perception of aging and the self-perception of health

A autopercepção da saúde é um determinante multidimensional e subjetivo do indivíduo para análise de sua própria saúde, considerado um fator para evidências de declínio funcional e de mortalidade. O objetivo deste estudo foi verificar a associação da autopercepção do envelhecimento e autopercepção da saúde. Trata-se de um estudo com delineamento transversal, descritivo e de associação. A amostra foi constituída de 224 indivíduos com idade igual ou superior a 60 anos, de ambos os sexos, sendo 64,4% indivíduos femininos e 35,5% masculinos, todos residentes no Distrito Federal. A coleta de dados foi realizada por meio de questionário sociodemográfico e pelo Questionário de Autopercepção do Envelhecimento (QAPE), versão brasileira. Foram realizadas análises descritivas, comparativas de grupo e correlações. Verificou-se que não ocorreu diferença estatística significativa entre a autopercepção do envelhecimento e a autopercepção da saúde, contudo, os dados demonstram que quanto melhor a autopercepção da saúde, melhor a autopercepção do envelhecimento. (AU)

The self-perception of health is a multidimensional and subjective, determinant factor for an individual to analyze their own health, considered part of evidence of functional decline and mortality. The objective of this study was to investigate the association between self-perception of aging and self-perception of health. It is a cross-sectional, descriptive and associative study. The sample consisted of 224 individuals over 60 years of age, of both sexes, with 64.4% female and 35.5% male individuals, resident in the Federal District. Data collection was performed using a demographic questionnaire and the Aging Self- -Perception Questionnaire (QAPE), Brazilian version. Descriptive, comparative analysis group and correlations were performed. It was verified that there was no significant statistical difference between the self-perception of aging and the self-perception of health, however, the data shows that the better the self-perception of health, the better the self-perception of aging. (AU)

Effect of Fractal Tones on the Improvement of Tinnitus Handicap Inventory Functional Scores among Chronic Tinnitus Patients: An Open-label Pilot Study

Abstract Introduction Music-based sound therapies become recently a trend in the treatment of tinnitus. Few publications have studied the therapeutic use of fractal tones to treat chronic tinnitus. Objective The aim of this study was to determine the benefits of using fractal tones as a unique sound therapy for chronic tinnitus sufferers. Methods Twelve participants were recruited; however, six could not be assigned. At baseline and at 1, 3 and 6 months, the participants were provided with the Tinnitus Handicap Inventory (THI) and Hearing Handicap Inventory for Adults (HHIA) questionnaires, and their visual analog scale score was recorded. Tinnitus pitch and loudness matching was performed before fitting and after 6 months of use. Results The visual analog scale (VAS) score, pitch and loudness matching and minimal masking levels did not result in significant improvement at the end of the treatment. The mean THI measured at baseline was 45, and the final one was 25. A paired sample t-test showed that this 20-point difference was statistically significant. Conclusions We measured the benefits of using fractal tone therapy for the treatment of chronic tinnitus and found that most of the benefits were in the THI functional domain, which includes concentration, reading, attention, consciousness, sleep, social activities, and household tasks. For all patients with bothersome chronic tinnitus and high scores on the THI functional scale, fractal tones should be considered a promising initial sound therapy strategy. The findings from this open-label pilot study are preliminary, and further trials are needed before these results can be generalized to a larger tinnitus population.

Barreiras e facilitadores para a atividade física em pessoas com déficit intelectual / Barriers and facilitators to physical activity people with intellectual disability

O objetivo deste estudo foi descrever as barreiras e os facilitadores da prática de atividade física (AF) no tempo livre e sua associação com essa prática em pessoas maiores de seis anos de ambos os sexos com déficit intelectual (DI) inseridas nas Associações de Pais e Amigos dos Excepcionais (APAES). A amostra foi composta por 1.191 pessoas com DI representadas pelos seus responsáveis. As barreiras e facilitadores para a prática de AF foram identificadas com questões fechadas em que o responsável respondia se o fator influenciava sempre (1), influenciava às vezes (2) ou não influenciava (3) na prática de AF. As questões foram separadas em três dimensões que correspondiam a onze fatores de ordem pessoal, sete de ordem ambiental e dez de ordem social. Verificou-se no aspecto pessoal sete facilitadores e duas barreiras, nos quais destaca-se o fato de sentir-se capaz como facilitador associado com a prática de AF e não possuir dinheiro como barreira; no aspecto ambiental seis facilitadores e uma barreira, sendo a companhia de pessoas próximas o principal facilitador pela associação com a prática de AF e a ausência de projetos sociais como barreira; e no aspecto social cinco facilitadores e uma barreira, no qual encontram-se a existência de locais próximos de casa e os profissionais estarem preparados para trabalhar com pessoas com DI os principais facilitadores e a falta de companhia como barreira. Conclui-se que as barreiras e facilitadores de AF para as pessoas com DI podem estar ligados ao estímulo que recebem, pois a companhia de outra pessoa foi o principal facilitador associado com a prática, isto pode ocorrer devido às limitações que a maioria possui no aspecto social. Oferta de locais com qualidade para prática de AF também facilitam a prática de AF, o que pode ser amenizado com o investimento em políticas públicas e projetos sociais de qualidade.

The objective of this study was to describe the barriers and facilitators of free time physical activity (PA), their influence both in this practice of people with intellectual deficit (ID) inserted in APAES / RS. The sample consisted of 1191 ID individuals represented by their legal representatives. The barriers and facilitators for the practice of PA were identified with closed questions in which the respondent answered whether the factor always influences (1), so-metimes influences (2) or does not influence (3) the practice of PA. The issues were separated into three dimensions: personal, environmental and social. As a result, seven facilitators and two barriers were observed in the personal aspect, in which the fact that they feel capable as a facilitator associated with the practice of PA and lack of money as a barrier; In the environmental aspect, six facilitators and a barrier, the company of close people being the main facilitator by the association with the practice of PA and non-existence of social projects as a barrier; And in the social aspect five facilitators and a barrier in which the existence of places close to their homes and professionals prepared to work with people with ID appear as the main facilitators and lack of companion as a barrier. It is concluded that some barriers and facilitators are linked to the stimulus that the people receive, since they can arouse the taste for PA if there is company, providing conditions for the practice due to the limitations that the majority has in the social aspect. Offering quality PA sites also facilitate, which can be provided by the investment in public policies and social projects.

Práticas Comunitárias Participativas e Rearranjos de Trabalho:: Acolhimento Coletivo do Idoso / Participatory Community Pratices and Work Rearrangements:: Collective Reception of the Elderly

O presente relato de experiência aborda um processo de mudança de fluxo para marcação de consultas do idoso numa Unidade Básica de Saúde do município de Porto Alegre (RS), dispositivando-o como mecanismo de participação comunitária, fortalecimento e apropriação coletiva do processo saúde-adoecimento, bem como da política do Sistema Único de Saúde (SUS). A partir do relato desta experimentação, erigida em discussões na equipe e no Conselho Local de Saúde, buscamos visibilizar e discutir potências e entraves na proposição de espaços coletivos de emancipação na atenção básica, a partir de necessidades em saúde.

The present experience report addresses a process of change of workflow for marking consultations of the elderly in a Basic Health Unit of the city of Porto Alegre (RS), arranging it as a mechanism for community participation, strengthening and collective appropriation of the health-disease process, as well as the policy of the Unified Health System (SUS). Based on the report of this experimentation, built on team discussions and at the Local Health Council, we seek to make visible and discuss potentials and obstacles in the proposal of collective spaces for emancipation in basic care, based on health needs.

Giant Anteater (Myrmecophaga tridactyla Linnaeus, 1758) of the Brazilian cerrado: hematology and storage effect / Tamanduás-bandeiras (Myrmecophaga tridactyla Linnaeus, 1758) do cerrado brasileiro: hematologia e efeito de estocagem

Giant Anteater (Myrmecophaga tridactyla) is a vulnerable species because of progressive habitat destruction, mostly affected by wildfires and car accidents. The increasing number of animals that are attended by wildlife rescue centres reinforces the need of knowledge about haematological parameters, especially for those that inhabit Brazilian cerrado biome. For this purpose and in order to establish reference values for this species and also to compare them with previous studies, haematological analysis of captive giant anteaters from Brazilian cerrado were performed. Moreover, the alterations of blood samples after 24 and 48 hours of storage at refrigeration temperatures (4oC) and preserved with two different EDTA concentrations (5% and 10%) were studied. Means and standard deviations of haematological parameters analysed immediately after collection were: RBC: 2,07 x106/µL ± 0,40; hematocrit: 38,08%± 5,93; haemoglobin: 11.33g/dL±2.15; MCV:186.52 fL±21.72; MCHC: 29.68g/dL±2.56; MCH: 55.08pcg±5,94; total leucocytes: 8.142/µL±2.441; neutrophils: 5.913/µL±2.168; lymphocytes: 1.460/µL±740; eosinophil: 522/µL±385; monocytes: 247/µL±176; thrombocytes: 123.458/µL±31.362 and total plasma protein: 6.23g/dL±0.49. This data shows evidence of the existence of important differences between these values and others from other areas, either from Brazil or from other South American countries. Those variations might be connected to environment, genetic, nutritional and/or management factors. Regarding the storage effect analysis, it can be concluded that in giant anteaters, haematological analysis can be performed until 24h after collection without any significant alterations on the haematological parameters, except for thrombocytes. Concerning the different EDTA concentrations, it can be concluded that there are no quantitative differences in haematological variables. Nevertheless, relevant morphologic alterations in blood cells can be observed after a 24h storage period, being most noticeable in the leucocytes. Those alterations can lead to misinterpretation of the results, interfering diagnosis, prognosis and treatment.(AU)

O tamanduá-bandeira (Myrmecophaga tridactyla) é uma espécie vulnerável devido à destruição progressiva do seu habitat natural, sendo afetado por queimadas e atropelamentos. O aumento na casuística de atendimentos de animais silvestres reforça a necessidade de se ter conhecimento dos parâmetros hematológicos, em especial para os que vivem no bioma do cerrado. Por isso, este trabalho teve por objetivos realizar o hemograma de tamanduás-bandeiras de cativeiro localizados no cerrado brasileiro, a fim de estabelecer valores de referência para essa espécie e compará-los a estudos prévios. Além disso, verificar quais alterações podem ser encontradas em amostras armazenadas por 24 e 48 horas após a colheita, em temperatura de refrigeração (4oC) e tratadas com duas concentrações distintas de EDTA (5% e 10%). A média e o desvio padrão das variáveis hematológicas encontradas nas amostras processadas logo após a colheita foram: hemácias (2,07x106/µL±0,40); volume globular (38,08%± 5,93); hemoglobina (11,33g/dL±2,15); VCM (186,52 fL±21,72); CHCM (29,68g/dL±2,56); HCM (55,08pcg±5,94); leucócitos totais (8.142/µL±2.441); neutrófilos (5.913/µL±2.168); linfócitos (1.460/µL±740); eosinófilos (522/µL±385); monócitos (247/µL±176); plaquetas (123.458/µL±31.362) e proteínas plasmáticas totais (6,23g/dL±0,49). Tais dados permitem afirmar que existem importantes diferenças entre os valores hematológicos destes em relação aos animais provenientes de outras regiões, tanto do Brasil quanto de outros países da América do Sul. Provavelmente, tais divergências estão associadas a fatores ambientais, genéticos, nutricionais e/ou de manejo. Quanto à análise das amostras estocadas, conclui-se que, em tamanduás-bandeiras, as amostras para a realização de hemograma podem ser processadas até 24 horas após a colheita, sem alteração significativa das variáveis hematológicas, com exceção das plaquetas. Com relação às duas concentrações de EDTA, pode-se inferir que não há diferença quantitativa entre ambas para as variáveis hematológicas. Contudo, é possível constatar que o EDTA promove alterações morfológicas relevantes nas células sanguíneas após 24 horas de armazenamento, sendo os leucócitos os mais afetados. Tais alterações, quando relatadas, podem induzir interpretações equivocadas, interferindo no diagnóstico, prognóstico e tratamento.(AU)

Cotidiano da prática de atividade física de crianças e jovens com deficiências da Rede Municipal de Pelotas – RS / Everyday physical activity of children and youth with disabilities from Pelotas-RS municipal schools / Prácticas diarias de actividades físicas de niños y jóvenes con discapacidades en el município de Pelotas – RS

O objetivo desta pesquisa foi mapear, de acordo com a visão dos pais e professores, o perfil dos alunos comdeficiências pertencentes à Rede Pública Municipal de Ensino de Pelotas, descrevendo as práticas de atividades físicas nos ambientes internos e externos à escola. A amostra foi composta por 76 pais/responsáveis e 32 professores. Quanto ao tipo de deficiência, houve predomínio de déficit intelectual.De acordo com os professores, a maioria dos alunos participa das aulas de Educação Física. Os resultados demonstram que o processo inclusivo está sendo aprimorado no momento em que eles se inserem na sociedade e, consequentemente,estão cada vez mais obtendo oportunidades de se desenvolverem.

This paper intended, from the point of view of parents and teachers, to establish the profile of disabled students from municipal schools in Pelotas,and to explore their daily habits with respect to physical activity in and out of school environment. The sample included 76 parents and 32 teachers. The most common disability was the intellectual deficit. According to teachers, most students participate in Physical Education Classes. The results demonstrate that the inclusive process is improved in the moment that disabled students are included in society and,consequently, achieve opportunities to develop themselves.

La meta es mapear, de acuerdo con ló que piensan los padres y maestros, el perfil de lós estudiantes con discapacidades pertenecientes a La Rede Pública Municipal de Ensino de Pelotas y explorar sus prácticas diarias relacionadas con las actividades físicas en la escuela en interiores y exteriores. La muestra estuvo conformada por 76 padres y 32 profesores. En cuanto a los tipos de discapacidad,hubo predominio el déficit intelectual. Según losprofesores, la mayoría de los estudiantes participa em clases de educación física. Los resultados muestran que el proceso de inclusión se mejora cuando lós estudiantes participan en la sociedad y, em consecuencia, tienen cada vez más y más oportunidades para desarrollarse.

Prevalência de fatores de risco da síndrome metabólica em adultos com síndrome de Down na cidade de Pelotas / Prevalence risk factors metabolic syndrome in adults with Down syndrome from the city of Pelotas

Compreender fenômenos relacionados com a Síndrome de Down (SD) auxilia a implementação de programas de promoção à saúde para esse público, melhorando a qualidade de vida. O objetivo desse trabalho foi descrever a prevalência de SM de adultos com SD maiores de 18 anos. A população desse estudo foi constituída por 30 adultos com SD selecionados intencionalmente, com média de idade de 25,5 (DP=5,6) e prevalência de SM de 23,3% (n=7). Foi utilizado o programa SPSS 13.0 for Windows, para as análises estatísticas sendo adotado um nível de significância de 5% (p?0,05). O estudo baseou-se nas análises do NCEP-ATP III (2002), que observou os seguintes fatores de risco para a SM: triglicerídeos, HDL, glicemia de jejum, circunferência abdominal e pressão arterial. Na população masculina, os fatores de risco com maiores prevalências foram os triglicerídeos e colesterol HDL com 42,1% (n=8) e circunferência abdominal com 47,4% (n=9). Na população feminina, os fatores de risco de maiores prevalências foram o colesterol HDL com 63,3% (n=7). Assim percebe-se a necessidade de um aprofundamento maior nos estudos relacionados com AF e essa população, auxiliando na redução dos riscos para SM.

Understand phenomena related to Down Syndrome (DS) assists the implementation of health promotion programs to this population, improving their quality of life. The aim of this work was to describe the MS prevalence in adults with DS over 18 years. The study population consisted of 30 adults with DS, intentionally selected, with average age 25,5 (DP=5,6) and MS prevalence of 23,3% (n=7). The software SPSS 13.0 for Windows was used for statistical analyses, being adopted a level of significance of 5% (p?0,05). The study was based on NCEP-ATP III (2002) that observed the following risk factors to MS: triglycerides, HDL, fasting glucose, abdominal circumference and blood pressure. In male population, risk factors with higher prevalence were triglycerides and HDL cholesterol with 42,1% (n=8) and abdominal circumference with 47,4% (n=9). In the female population, risk factor with highest prevalence was cholesterol HDL with 63,3% (n=7). Therefore, it is noted a need of further studies related to PA and this population, helping to reduce risks for MS.

Qualidade da atenção básica mediante internações evitáveis no Sul do Brasil / Quality of primary care as measured by preventable hospitalizations in the South of Brazil

Realizou-se estudo para avaliar mediante taxa de internações hospitalares evitáveis a qualidade dos cuidados oferecidos pela rede básica de saúde em Pelotas, Rio Grande do Sul, Brasil, no período entre 1995 a 2004. Foram consideradas como internações evitáveis: diabetes mellitus, insuficiência cardíaca, hipertensão arterial sistêmica, doença pulmonar obstrutiva crônica e doenças imunopreveníveis (poliomielite, difteria, tétano, coqueluche, sarampo). Foram incluídos homens e mulheres de 20 a 59 anos. Os percentuais entre as mulheres foram superiores aos encontrados nos homens. Foi observada uma diminuição dos percentuais de internações tanto nos homens como nas mulheres no decorrer do período. Mesmo após a padronização direta revelou-se que as taxas de internação de Pelotas foram inferiores às do Rio Grande do Sul. Os custos das hospitalizações evitáveis acompanharam a queda observada nas taxas de internações. Aparentemente, a diminuição verificada nas taxas de internações evitáveis pode estar relacionada à qualificação dos serviços de atenção básica. Contudo, os resultados podem ser conseqüências do financiamento do sistema de saúde. Os valores de pagamento desses procedimentos são baixos e podem estar direcionando os hospitais a uma diminuição da oferta de leitos.

This study assessed the quality of primary care in Pelotas, Rio Grande do Sul, Brazil, through preventable hospitalization rates (1995-2004). Preventable hospitalizations were defined as those related to the following diseases: diabetes mellitus, congestive heart failure, hypertension, chronic obstructive pulmonary disease, and vaccine-preventable diseases (polio, diphtheria, tetanus, whooping cough, and measles). Men and women from 20 to 59 years of age were included in the study. The proportion of preventable causes among hospital admissions was higher for women than for men. From 1995 to 2004 there was a decrease in preventable hospitalization rates. Even after direct standardization, analysis showed that admission rates in Pelotas were lower than for the State of Rio Grande do Sul as a whole. Preventable hospitalization costs decreased in parallel with the drop in hospital admission rates. The decrease in hospitalizations is consistent with improvement in primary health care. However, the findings may result from the system's financial model. Reimbursement for hospital procedures is low, which could induce the hospitals to curtail admissions.

Orientaçäo a pais de crianças com distúrbio de comunicaçäo: relato de experiência / Guidance for parents of the childrens with communication deficiency

Diante de nossa experiência clínica , percebemos quanto o atendimento fonoaudiológico é abrangente näo se restringindo à habilitaçäo do distúrbio de comunicaçäo como um fenômeno isolado. Näo podemos considerar o paciente como um ser acontextual. Ele é parte integrante da família e seu comportamento, inclusive o comunicativo, afeta e é afetado na relaçäo com os demais membros. Partindo desse pressuposto devemos propiciar a participaçäo do núcleo familiar no processo terapêutico. Foi através da vivência e consequentes questionamentos junto a pais, cujos filhos, em idade pré-escolar e com alteraçöes de fala e/ou linguagem já em atendimento fonoaudiológico individual e em grupo, que refletimos sobre um melhor proceder terapêutico através da interlocuçäo no sentido mais amplo da palavra, entre família, criança e terapeuta