Vulnerabilidade de famílias de idosos assistidos pela Estratégia Saúde da Família / Vulnerabilidad de las familias de adultos mayores asistidas por la Estrategia Salud de la Familia / Vulnerability of families of elderly citizens cared for by the Family Health Strategy

RESUMO Objetivo: estudo descritivo, exploratório, de corte transversal, cujo objetivo foi identificar a vulnerabilidade de famílias de idosos assistidos pela Estratégia Saúde da Família (ESF). Método: foi desenvolvido por meio de entrevistas domiciliárias realizadas com uma amostra de 500 famílias de idosos assistidas por 32 equipes da ESF da cidade de Dourados, MS. O Índice de Desenvolvimento da Família (IDF) foi adaptado para classificá-las em função da situação de vulnerabilidade. Resultados: os resultados revelaram a presença de famílias multigeracionais, com baixa escolaridade entre os indivíduos com idade superior a 20 anos e alta taxa de analfabetismo entre os idosos. Identificaram-se 403 famílias em situação de vulnerabilidade aceitável, 95 em vulnerabilidade grave e duas famílias em situação de vulnerabilidade muito grave. As dimensões mais críticas do IDF foram os acessos ao conhecimento e ao trabalho. Conclusão: conclui-se que há necessidade de mais investimentos no cuidado a esses idosos e suas famílias na Atenção Básica. .

RESUMEN Objetivo: estudio descriptivo, exploratorio, transversal, con el objetivo de identificar la vulnerabilidad de familias adultos mayores asistidas por la Estrategia Salud de la Familia (ESF). Método: fue desarrollado mediante entrevistas a una muestra de 500 familias de adultos mayores bajo la responsabilidad de 32 equipos de ESF en la ciudad de Dourados, MS, Brasil. El Índice de Desarrollo de la Familia (IDF) fue adaptado para clasificar las familias de acuerdo a la situación de vulnerabilidad. Resultados: los resultados revelaron la presencia de familias multigeneracionales con bajo nivel de educación entre las personas mayores de 20 años y las altas tasas de analfabetismo entre los adultos mayores. Se identificaron 403 familias en situación de vulnerabilidad aceptable, 95 con vulnerabilidad grave y dos familias en situación de vulnerabilidad muy grave. Las dimensiones más críticas en el IDF fueron el acceso al conocimiento y al trabajo. Conclusión: se concluye que existe la necesidad de una mayor inversión, con un enfoque en la atención primaria, con el fin de atender a las personas mayores y sus familias. .

ABSTRACT Objective: the present descriptive, exploratory, cross-sectional study aimed to identify the vulnerability of families of elderly citizens cared for by the Family Health Strategy (FHS). Method: the research employed home interviews and was developed with a sample of 500 families of aged people cared for by 32 FHS teams in the city of Dourados, MS, Brazil. The Family Development Index (FDI) was adapted in order to classify the families according to their degree of vulnerability. Results: the results revealed the presence of multigenerational families with low educational levels among individuals over the age of 20 and high illiteracy rates among elderly citizens. There were 403 families whose vulnerability was acceptable, 95 in severe vulnerability, and two families in a condition of very severe vulnerability. The most critical dimensions of the FDI were the access to knowledge and to work. Conclusion: the study identifi ed that there is still a need for further investments that can assist these aged people and their families in the Primary Health Care. .

Functional Magnetic Resonance Imaging of Motor Cortex Activation in Schizophrenia

Previous fMRI studies of sensorimotor activation in schizophrenia have found in some cases hypoactivity, no difference, or hyperactivity when comparing patients with controls; similar disagreement exists in studies of motor laterality. In this multi-site fMRI study of a sensorimotor task in individuals with chronic schizophrenia and matched healthy controls, subjects responded with a right-handed finger press to an irregularly flashing visual checker board. The analysis includes eighty-five subjects with schizophrenia diagnosed according to the DSM-IV criteria and eighty-six healthy volunteer subjects. Voxel-wise statistical parametric maps were generated for each subject and analyzed for group differences; the percent Blood Oxygenation Level Dependent (BOLD) signal changes were also calculated over predefined anatomical regions of the primary sensory, motor, and visual cortex. Both healthy controls and subjects with schizophrenia showed strongly lateralized activation in the precentral gyrus, inferior frontal gyrus, and inferior parietal lobule, and strong activations in the visual cortex. There were no significant differences between subjects with schizophrenia and controls in this multi-site fMRI study. Furthermore, there was no significant difference in laterality found between healthy controls and schizophrenic subjects. This study can serve as a baseline measurement of schizophrenic dysfunction in other cognitive processes.

Densidad neuronal en la corteza visual primaria (área 17), en dos especies de octodon / Neuronal density in primary visual cortex (17 visual area), in two species of octodon

Estudios experimentales demuestran que modificaciones medioambientales pueden producir alteraciones en el desarrollo normal de la corteza cerebral visual y sus conexiones. Por otra parte, es posible que en condiciones naturales, las especies animales hayan desarrollado adaptaciones genéticas a las distintas condiciones de luminosidad en que realizan su actividad. Recientemente, se han observado variaciones significativas en la densidad neuronal cortical del área 17 (área visual primaria), en roedores silvestres con diferentes períodos diarios de actividad y relación filogenética distante (Abrothrix olivaceus y Phyllotis darwini), pero aún no se ha determinado la naturaleza genética o plástica de dichas diferencias. En este trabajo se compararon especies con una mayor cercanía filogenética, para disminuir al máximo la variable taxonómica. Se estudió la corteza visual primaria (área 17), de roedores silvestres nativos, de las especies Octodon degus (n=5) y Octodon bridgesi (n=3), pertenecientes a la Familia Octodontidae, con el propósito de evidenciar cambios a través de la medición de la densidad neuronal, mediante la técnica del disector óptico, en cortes de 40 µm, incluidos en celoidina y teñidos con Nissl. Complementariamente, se realizó una cuantificación de la densidad neuronal de la corteza motora de las especies en estudio. O. degus, que presenta un período de actividad diurna, evidenció una densidad neuronal menor en la corteza visual (34,32 +/- 2,51 x 104 neuronas/mm3), que la observada en O. bridgesi (39,55 +/- 0,64 x 104 neuronas/mm3), especie de período de actividad nocturna; lo cual fue estadísticamente significativo (t=3,44; p<0,05). Las diferencias encontradas se podrían relacionar con el tipo de condiciones de luminosidad en que se desenvuelven dichas especies, aunque no se puede descartar la influencia de otros factores.

Studies show that environmental modifications can produce profound alterations in the normal development of the visual cortex and its connectivity. For the other hand it is possible that in natural conditions, animal species have developed genetic adaptations to the different conditions of luminance in which they normally behave. Recently have observed significant changes in cortical neuronal density of area 17 (primary visual area), in two sympatric Chilean rodents with different daily activity (Phyllotis darwini and Abrothrix olivaceus), but have not yet determined the genetic nature or plastic such differences. In this paper we compared species with a closer phylogenetic relation so as to minimize the taxonomic variable. We studied the primary visual cortex (area 17) of wild rodents native of the species Octodon degus (n=5) and Octodon bridgesi (n=3), belonging to the Octodontidae family, in order to show changes in the neuronal density, using celloidin-embedded, 40µm-thickness Nissl sections, with the aid of an optical dissector. In addition, we performed a quantification of the neuronal density of the motor cortex of the species under study. O. degus, bearing a crepuscular-diurnal activity pattern, showed a lower neuronal density in the visual cortex (34.32 +/- 2.51 x10(4) neuron/mm³) than that observed in O. bridgesi (39.55 +/- 0.64 x10(4) neuron/mm³), a species that exhibits a nocturnal phase preference, which was statistically significant (t=3.44; p<0.05). These differences might be related to differences in daily activity in two species, but we cannot discount the influence of other factors.

Densidad neuronal en la corteza visual primaria (area 17(, de dos especies de roedores silvestres / Neuronal density in primary visual cortex (17 visual area), in two wild rodent species

Diversos estudios experimentales demuestran que modificaciones medioambientales (por ejemplo: nutricionales y lumínicas), pueden producir alteraciones en el desarrollo normal de la corteza visual y sus conexiones. Por otro lado, es posible que en condiciones naturales, las especies animales hayan desarrollado adaptaciones a las distintas condiciones de luminosidad en que realizan su actividad. Por ende, la finalidad de este trabajo, fue estudiar la corteza visual primaria (área 17), de dos especies de roedores silvestres, relacionados filogenéticamente, pero con diferentes períodos de actividad; Abrothrix olivaceus (n=7) y Phyllotis darwini (n=7), con el propósito de evidenciar cambios detectados a través de la medición de la densidad neuronal, mediante la técnica del disector óptico, en cortes de 40µm de grosor, incluidos en celoidina y teñidos con cresyl violeta (Nissl). A. olivaceus, el cual presenta un periodo de actividad continuo en la zona central de Chile, evidenció una densidad neuronal menor (34.75 x 104 ± 1.35 x 104 neuronas/mm3) que la observada en P. darwini (37.23 x 104 ± 2.20 x 104 neuronas/mm3), especie de actividad nocturna en la misma región del país; siendo lo anterior estadísticamente significativo (t=2.54; p<0.05). Las diferencias encontradas se relacionarían con el tipo de conducta que presentan ambas especies, dado principalmente por las características de luminosidad en que se desenvuelven, así como también, de otros factores que se relacionarían con este parámetro, como son la relación predador-presa y la alimentación, entre otros.

Horizontal projections of area 17 in Cebus monkeys: metric features, and modular and laminar distribution

Metric features and modular and laminar distribution of intrinsic projections of area 17 were studied in Cebus apella. Anterogradely and retrogradely labeled cell appendages were obtained using both saturated pellets and iontophoretic injections of biocytin into the operculum. Laminar and modular distributions of the labeled processes were analyzed using Nissl counterstaining, and/or cytochrome oxidase and/or NADPH-diaphorase histochemistry. We distinguished three labeled cell types: pyramidal, star pyramidal and stellate cells located in supragranular cortical layers (principally in layers IIIa, IIIb alpha, IIIb beta and IIIc). Three distinct axon terminal morphologies were found i.e., Ia, Ib and II located in granular and supragranular layers. Both complete and partial segregation of group I axon terminals relative to the limits of the blobs of V 1 were found. The results are compatible with recente evidence of incomplete segreagation of visual information flow in V 1 of Old and New World primates.

NADPH-diaphorase activity in area 17 on the squirrel monkey visual cortex: neuropil pattern, cell morphology and laminar distribution

We studied the distribution of NADPH-diaphorase activity in the visual cortex of normal adult New World monkeys (Saimiri sciureus) using the malic enzyme "indirect" method. NADPH-diaphorase neuropil activity had a heterogeneous distribution. In coronal sections, it had a clear laminar pattern that was coincident with Nissl-stained layers. In tangential sections, we observed blobs in supragranular layers of V1 and stripes throughout the entire V2. We quantified and compared the tangential distribution of NADPH-diaphorase and cytochrome oxidade blobs in adjacent sections of the supragramular layers of V1. Although their spatial distributions were rather similar, the two enzymes did not always overlap. The histochemical reaction also revealed two different types of stained cells: a slightly stained subpopulation and a subgroup of deeply stained neurons resembling a Golgi impregnation. These neurons were sparsely spined non-pyramidal cells. Their dendritic arbors were very well stained but their axons were not always evident. In the gray matter, heavily stained neurons showed different dendritic arbor morphologies. However, most of the strongly reactive cells lay in the subjacent white matter, where they presented a more homogenous morphology. Our results demonstrate that the pattern of NADPH-diaphorase activity is similar to that previously described in Old World monkeys.

Histochemical characterization of NADPH-diaphorase activity in area 17 of diurnal and nocturnal primates and rodents

NADPH-diaphorase (NADPH-d) activity was studied comparatively in area 17 of four mammalian species, two primates and two rodents. Three brain hemispheres each from adult capuchin-monkeys, owl-monkeys, agoutis and guinea pigs were fixed with aldehyde fixatives by perfusion and 200 mum sections were submitted to NADPH-d histochemistry, using the indirect malic enzyme method. In all species studied the neuropil pattern of enzyme activity presented a clear layered appearance. In primates, histochemical staining was most intense in layer IVc, while in rodents the highest intensity of the neuropil reaction was in supragranular layers (II and III). Comparison of cell density in grey and white matter showed that the majority of NADPH-d-positive neurones were located in the white matter of primates but not of rodents. Since NADPH-d is a nitric oxide synthase the results are very important for comparative functional studies of neuromediators and their correlations with laminar and modular organization of area 17 of the mammalian brain.

Morphometric analysis of intrinsic axon terminals of Cebus monkey area 17

A morphological study of intrinsic projections in area 17 of Cebus monkey was conducted after iontophoretic injection of biocytin. Thirty axon terminals located in supragranular layers were qualitatively and quantitatively analyzed using 3-D automatic microscopy. Three types of axon terminals could be identified: Ia, Ib and II. Group I was characterized by a sparse and/or long-distance branch pattern, while type II presented compact and localized arborization. Ia axon terminals formed "clusters" and "terminaux"boutons while Ib did not. On overage, group II axon terminals tended to present straight or obtuse branching angles and a much more ramified pattern, and occupy a smaller cortical territory with shorter intermediate segments and higher density of synaptic potential sites than group I. The common characteristics of group I included innervation of larger cortical territories, longer intermediate segments, acute branching angles and lower synaptic density compared to group II. The results are compatible with the major subdivisions of neocortical neuronal morphology that classifies them as smooth and spine neurons. Smooth neurons may be related to axon terminals of group II while spine neurons may be related to group I.

Caracterización de las aferencias talámicas a la corteza visual de aves y tipos de neuronas corticales eferentes / Characterization of the thalamic afferents to the avian visual cortex and types of cortical efferent neurons

En este trabajo se describe que las proyecciones talámicas del complejo dorsolateral anterior a la corteza cerebral en aves, son bilaterales. La representación binoclular se establece en los dos tercios laterales de ambos hemisferios, mientras que la representación monocular compromete el tercio medial del hemisferio ipsilateral de cada retina. Además, se describen tres tipos de neuronas eferentes de la corteza visual, uno con abundantes espinas dentríficas, otro sin ellas y uno con escaso número de espinas dendríficas. Llama la atención el hecho de que no existan neuronas piramidales en la corteza cerebral de las aves

Effect of pre and postnatal retinal deprivation on the striate-peristriate cortical connections in the rat

The tangential distribution of the striate-peristriate cortical connections in normal, postnatally eye nucleated and congenitally anophthalmic rats, was studied after a single injection of wheat germ agglutinin conjugated with horseradish peroxidase into the striate cortex. The typical normal pattern of separate fields in the peristriate cortex is altered in eye enucleated animals, in such a way that their areal distribution in the cerebral cortex is increased and each field tends to fuse with the adjacent one. This process is more marked in anophthalmic animals, a finding that is in agreement with the notion that ganglion cells exert their influence before the visual pathway is functional

Cortical streams of visual information processing in primates

1. The topographic organization of the cortical visual areas in the Cebus monkey and their anatomical connections support the subdivision of the visuaol pathways into ventral and dorsal streams of visual information provessing. 2. We propose that the dorsal stream, as defined by Ungerleider and Mishkin (In: Ingle DJ, Goodale MA and Mansfield RJW (Editors), Analysis of Visual Behavior, MIT Press, Boston, 1982), be subdivided into dorsolateral and dorsomedial streams, which are concerned with different aspects of the processing of motion and spatial perception. 3. The data support the hypothesis of concurrent, modular processing of visual attributes in cortical visual areas in the different streams, and highlight some features of the visual field representation in each area which may reflect functional specialization of these streams. 4. The visual topography is locally disrupted in some cortical areas by the existence of functionally different modules, However, a global visuotopic organization is preserved in most areas. 5. The visuotopic organization may provide the address of space coordinates to integrate information concerning the same retinotopic across different visual areas

Pattherns of cytochrome oxidase activity in the visual cortex of a South American opossum

The normal pattern of cytochrome oxidase (CO) activity in the posterior cortical areas of the South American opossum (Didelphis marsupialis aurita) was assessed both in horizontal section of flattened cortices and in transversal cortical sextions. the tangential distribution of CO activity was uniformly high in the strate cortex. In the peristriate region alternating bands of dense and weak staining occupied all the cortical layers with the exception of layer I. This observation suggests the existence of a functional segregation of visual processing in the peristriate cortex of the opossum similar to that present in phylogenetically more recent groups