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au:MORAES, WALTER DOS SANTOS

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Interaction between apolipoprotein E genotypes, excessive daytime sleepiness, and cognitive function in obstructive sleep apnea patients
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Balthazar, Fernanda Maurer

; Moraes, Walter André dos Santos

; Hunter, James Richard

; Prado, Gilmar Fernandes do

; Carvalho, Luciane Bizari Coin de

Arquivos de Neuro-Psiquiatria

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nov 2022, Volume 80 N. 11 Pages 1104 - 1111

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background Some studies show an association between the apolipoprotein E ε4 allele (ApoEε4) and obstructive sleep apnea syndrome (OSAS), and other studies, an association between ApoEε4 and excessive daytime sleepiness (EDS), but there are no data in the literature on the interaction between EDS, cognitive function, and ApoEε4 in patients with OSA. Objective To examine the cognitive function of adults with and without EDS and with and without ApoEε4. Methods A total of 21 male and female patients aged between 33 and 79 years, underwent a clinical interview, ApoE genotyping, neuropsychological evaluation, polysomnography, and the application of the Epworth Sleepiness Scale. Results Excessive daytime sleepiness was associated with lower intelligence quotient (IQ; total performance) and worse immediate visual memory, regardless of the ApoE genotype. Patients carrying the ApoEε3/ε4 genotype had a worse performance in divided attention, constructional praxis, perceptual organization, and cognitive flexibility. A combination of the ε4 allele and EDS potentiates the negative effect on cognition, except for immediate visual memory. In this case, patients had a worse performance in terms of processing speed, selective attention, and visuomotor coordination. Conclusions Excessive daytime sleepiness and the ApoEε3/ε4 genotype are associated with worse cognitive performance in OSA patients. The combination of EDS and ε4 allele potentiates cognitive impairment.

Resumo Antecedentes Alguns estudos mostram uma associação entre o alelo ε4 da apolipoproteina E (ApoEε4) e a síndrome da apneia obstrutiva do sono (SAOS), e outros, entre ApoEε4 e a sonolência excessiva diurna (SED), mas não há dados na literatura sobre a interação entre SED, função cognitiva e ApoEε4 em pacientes com SAOS. Objetivo Avaliar a função cognitiva em adultos com SAOS com e sem SED e com e sem ApoEε4. Métodos Ao todo, 21 pacientes, de 33 a 79 anos, homens e mulheres, foram avaliados clinicamente, e submetidos a genotipagem ApoE, avaliação neuropsicológica, polissonografia, e aplicação da Escala de Sonolência de Epworth. Resultados A SED esteve associada com menor quociente de inteligência (QI; desempenho geral) e pior memória visual imediata, independentemente do genótipo ApoE. Pacientes com genótipo ApoEε3/ε4 apresentaram pior desempenho na atenção dividida, praxe construcional, organização perceptiva e flexibilidade cognitiva. A combinação do alelo ε4 com a SED potencializa esse efeito deletério na cognição, exceto na memória visual imediata. Nesse caso, os pacientes tiveram uma menor velocidade de processamento cognitivo, e piores atenção seletiva e coordenação visiomotora. Conclusões A SED e o genótipo ApoEε3/ε4 estão associados a um pior desempenho cognitivo em pacientes com SAOS. A combinação de SED e do alelo ε4 potencializa esse efeito.

https://doi.org/10.1055/s-0042-1758399

Comparing dextrose prolotherapy with other substances in knee osteoarthritis pain relief: A systematic review
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Cortez, Vitor Santos

; Moraes, Walter Augusto

; Taba, João Victor

; Condi, Alberto

; Suzuki, Milena Oliveira

; Nascimento, Fernanda Sayuri do

; Pipek, Leonardo Zumerkorn

; Mattos, Vitoria Carneiro de

; Torsani, Matheus Belloni

; Meyer, Alberto

; Hsing, Wu Tu

; Iuamoto, Leandro Ryuchi

Clinics

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2022, Volume 77 elocation 100037

Abstract: En | Text: En | PDF: En

Abstract The objective of this study is to compare the effectiveness of dextrose-prolotherapy with other substances for pain relief in patients with primary knee osteoarthritis. The literature screening was done in January 2021 through Medline (PubMed), EMBASE, and Database of the National Institute of Health based on the following criteria: randomized clinical trials that subjected patients with primary knee osteoarthritis who underwent treatment with dextrose-prolotherapy and other substances for pain relief. Paired reviewers independently identified 3381 articles and included 8 trials that met the eligibility criteria. According to the findings of this review, participants that underwent dextrose-prolotherapy showed improvements between baseline and posterior assessments and when compared to saline injections, but when compared to other substances, the results were not clear. Although dextrose-prolotherapy is a useful treatment method by itself, it is still not possible to clearly affirm that it is superior or inferior to its counterparts. There is an urgent need for further studies to bring more evidence to the field. HIGHLIGHTS Dextrose injections promote deposition of collagen into injured structures through growth factors and inflammatory cells. Dextrose-prolotherapy is a useful treatment method, but it is not superior or inferior to its counterparts.

https://doi.org/10.1016/j.clinsp.2022.100037

MICRObiota on BILIOpancreatic malignant diseases [MICROBILIO]: A systematic review
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Mattos, Vitoria Carneiro de

; Nascimento, Fernanda Sayuri do

; Suzuki, Milena Oliveira

; Taba, Joao Victor

; Pipek, Leonardo Zumerkorn

; Moraes, Walter Augusto Fabio

; Cortez, Vitor Santos

; Kubrusly, Marcia Saldanha

; Torsani, Matheus Belloni

; Iuamoto, Leandro

; Hsing, Wu Tu

; Carneiro-D’Albuquerque, Luiz Augusto

; Meyer, Alberto

; Andraus, Wellington

Clinics

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2022, Volume 77 elocation 100101

Abstract: En | Text: En | PDF: En

Abstract Introduction: The increase in the incidence of pancreatic and biliary cancers has attracted the search for methods of early detection of diseases and biomarkers. The authors propose to analyze new findings on the association between microbiota and Pancreatic Ductal Adenocarcinoma (PDAC) or Cholangiocarcinoma (CCA). Methods: This systematic review was carried out according to the items of Preferred Reports for Systematic Reviews and Protocol Meta-Analysis (PRISMA-P). This study was registered by the Prospective Register of Systematic Reviews (PROSPERO), identification code CRD42020192748 before the review was carried out. Articles were selected from the PUBMED, EMBASE, and Cochrane databases. Results: Most studies (86.67%) used 16s rRNA as a sequencing method. The main comorbidities found were diabetes mellitus, systemic arterial hypertension, and dyslipidemia. Many studies were limited by the small number of participants, but the biases were mostly low. There was very little concordance about the composition of the microbiome of different sites, for both case and control groups when compared to other studies’ results. Bile sample analysis was the one with a greater agreement between studies, as three out of four studies found Escherichia in cases of CCA. Conclusion: There was great disagreement in the characterization of both the microbiota of cases and control groups. Studies are still scarce, making it difficult to adequately assess the data in this regard. It was not possible to specify any marker or to associate any genus of microbiota bacteria with PDAC or CCA.

https://doi.org/10.1016/j.clinsp.2022.100101

Recursos competitivos no empreendedorismo internacional: uma análise qualitativa em empresas exportadoras
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Pereira, Yákara Vasconcelos

; Moraes, Walter Fernando Araújo de

; Salazar, Viviane Santos

Gestão & Produção

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sep 2017, Volume 24 N. 3 Pages 477 - 487

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo A perspectiva teórica da visão baseada em recursos vem contribuindo para a compreensão da administração estratégica e das ações de empreendedores. Diante da sua significativa relevância, este artigo tem por objetivo identificar os recursos competitivos desenvolvidos por empreendedores internacionais de empresas exportadoras. Um estudo de múltiplos casos foi realizado com quatro empresas localizadas no semiárido do Nordeste brasileiro, assim, 31 entrevistas foram realizadas e analisadas em conjunto com documentos e material bibliográfico. A análise de conteúdo foi apoiada pelo software ATLAS.ti. Os recursos conhecimento, equipe, liquidez, marca, produção, qualidade e relacionamentos são os que se destacam nos resultados. Portanto, a natureza tangível e intangível dos recursos é evidenciada e revela a importância do desenvolvimento de recursos por parte dos empreendedores internacionais para a internacionalização.

Abstract The theoretical perspective of the resource based view has contributed to the understanding of strategic management and entrepreneurs actions. Given its significant relevance, this article aims to identify the competitive resources developed by international entrepreneurs of exporting companies. A multiple case study was carried out with four companies located in the Brazilian Northeastern semi-arid region. We carried out 31 interviews and analyzed them along with documents and bibliographic material. Content analysis was supported by the ATLAS.ti software. The resources knowledge, team, liquidity, brand, production, quality and relationships stand out in the results. Therefore, the tangible and intangible nature of resources is evidenced and reveals the importance of the development of resources for internationalization by international entrepreneurs.

https://doi.org/10.1590/0104-530x2361-17 1873 downloads

Social inequalities in the prevalence of common mental disorders in adults: a population-based study in Southern Brazil
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Moraes, Ramona Sant’Ana Maggi de

; Silva, Diego Augusto Santos

; Oliveira, Walter Ferreira de

; Peres, Marco Aurélio

Revista Brasileira de Epidemiologia

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mar 2017, Volume 20 N. 1 Pages 43 - 56

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: Objetivo: O objetivo do estudo foi investigar a prevalência e os fatores associados com Transtornos Mentais Comuns (TMC) entre adultos de Florianópolis, Sul do Brasil. Métodos: Estudo de base populacional conduzido com 1.720 adultos de 20 a 59 anos. Os TMC foram investigados pelo Self-Reporting Questionnaire (SRQ-20). As variáveis independentes foram as demográficas, socioeconômicas, comportamentos relacionados com a saúde, condições de saúde e uso de serviços de saúde. A regressão multivariável de Poisson foi empregada para a estimativa de razões de prevalência e IC95%. Resultados: A prevalência de TMC foi de 14,7%, sendo as maiores prevalências nas mulheres, nas pessoas de cor da pele preta, com baixo nível educacional, pobres, divorciados, inativos durante o lazer, fumantes pesados, pessoas com doenças crônicas, com percepção negative de saúde, que tiveram consultas médicas e foram internados nos últimos 12 meses. Conclusão: Os subgrupos populacionais mais vulneráveis aos TMC foram aqueles mais vulneráveis às iniquidades sociais e com piores condições relacionadas aos indicadores de saúde.

ABSTRACT: Objective: This study aimed to investigate the prevalence and factors associated with Common Mental Disorders (CMD) in adults in a capital city in Southern Brazil. Methods: Population-based survey conducted on 1,720 adults aged 20 - 59 years from Florianópolis, Southern Brazil. The CMD were investigated through the Self-Reporting Questionnaire (SRQ-20). The independent variables were demographic, socioeconomic, health-related behaviors, health conditions and use of health services. Multivariable Poisson regression was used for the estimation of prevalence ratios (PR) and 95%CI. Results: The prevalence of CMD was 14.7%. Adjusted analyses showed that the prevalence was higher among women, those self-reported as blacks, with lower educational level, poor, divorced/separated/widowed, inactive in leisure time, heavy smokers, people with chronic diseases, those who reported negative health self-rating, those who had medical appointments and who were hospitalized before the interview. Conclusion: CMD is relatively high among population subgroups most vulnerable to social inequalities and with worse conditions related to health indicators.

https://doi.org/10.1590/1980-5497201700010004 355 downloads

Social inequalities in the prevalence of common mental disorders in adults: a population-based study in Southern Brazil
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Moraes, Ramona Sant’Ana Maggi de

; Silva, Diego Augusto Santos

; Oliveira, Walter Ferreira de

; Peres, Marco Aurélio

Revista Brasileira de Epidemiologia

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mar 2017, Volume 20 N. 1 Pages 43 - 56

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1980-5497201700010004 1514 downloads

Brazilian consensus on guidelines for diagnosis and treatment for restless legs syndrome
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Fröhlich, Alan Christmann

; Eckeli, Alan Luiz

; Bacelar, Andrea

; Poyares, Dalva

; Pachito, Daniela Vianna

; Stelzer, Fernando Gustavo

; Coelho, Fernando Morgadinho Santos

; Rizzo, Geraldo Nunes Vieira

; Prado, Gilmar Fernandes do

; Sander, Heidi Haueisen

; Goulart, Leonardo Ierardi

; Lucchesi, Ligia Mendonça

; Gitai, Lívia Leite Góes

; Prado, Lucila Bizari Fernandes do

; Ataíde-Junior, Luiz

; Bezerra, Marcio Luciano de Souza

; Lopes, Maria Cecília

; Trentin, Marine Meliksetyan

; Rodrigues, Raimundo Nonato Delgado

; Hasan, Rosa

; Alves, Rosana S. Cardoso

; Schönwald, Suzana Veiga

; Moraes, Walter André dos Santos

Arquivos de Neuro-Psiquiatria

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mar 2015, Volume 73 N. 3 Pages 260 - 280

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O Consenso em síndrome das pernas inquietas contou com a participação de neurologistas de vários estados brasileiros, os quais incansavelmente revisaram a literatura dos últimos anos em busca de evidências, tanto no que se refere ao diagnóstico como ao tratamento, de acordo com a Classificação do Centro de Oxford para Medicina Baseada em Evidências.

The Consensus on restless legs syndrome is an effort of neurologists from several Brazilian states, which tirelessly reviewed the literature of recent years in search of evidence, both in regard to diagnosis and treatment, according to the Oxford Centre for Evidence-based Medicine.

https://doi.org/10.1590/0004-282X20140239 7813 downloads

Efeito do exercício físico sobre os parâmetros hemodinâmicos
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Pigatto, Camila

; Santos, Caroline Mombaque dos

; Santos, Wendel Mombaque dos

; Neme, Walter Santos

; Portela, Luiz Osório Cruz

; Moraes, Edson Nunes de

; Gallarreta, Francisco Maximiliano Pancich

Revista Brasileira de Ginecologia e Obstetrícia

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nov 2014, Volume 36 N. 11 Pages 527 - 528

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/SO100-720320140005229 1300 downloads

Efeito do exercício físico sobre os parâmetros hemodinâmicos fetais
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Pigatto, Camila

; Santos, Caroline Mombaque dos

; Santos, Wendel Mombaque dos

; Neme, Walter Santos

; Portela, Luiz Osório Cruz

; Moraes, Edson Nunes de

; Gallarreta, Francisco Maximiliano Pancich

Revista Brasileira de Ginecologia e Obstetrícia

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may 2014, Volume 36 N. 5 Pages 216 - 221

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Avaliar as alterações das repercussões fetais ao estudo da dopplervelocimetria após sessão de exercício físico aeróbico em gestantes sem complicações clínicas ou obstétricas.MÉTODOS: A pesquisa compreendeu um estudo transversal realizado com 10 gestantes hígidas, de baixo risco, em 2 períodos gestacionais distintos (início da gravidez: 26ª à 29ª semana e 6 dias; final da gravidez: 30ª à 35ª semana), que foram submetidas a exercício físico aeróbico em esteira até a fadiga. Foram obtidos os dados ultrassonográficos de repouso e após o exercício (índices da dopplervelocimetria da artéria umbilical, da cerebral média, do ducto venoso e das artérias uterinas). A análise foi efetuada por meio do teste t de Student pareado e independente, com o Statistical Package for the Social Sciences(SPSS) versão 21.0.RESULTADOS:Demonstrou-se vasodilatação do índice de pulsatilidade com valor mediano pré-exercício físico de 1,1±0,1 e pós-exercício de 1,0±0,1, índice de resistência apresentando valor mediano pré-exercício físico de 0,7±0,04 e pós de 0,6±0,07 e da relação sístole/diástole da artéria umbilical com p=0,03 (valor mediano pré-exercício físico de 3,1±0,4 e pós de 2,9±0,2) após a atividade física no início da gravidez. Não foi demonstrada alteração nos parâmetros da dopplervelocimetria das artérias uterinas, da cerebral média e do ducto venoso após a atividade física em nenhum dos períodos estudados. Ao analisarmos de forma pareada pré e pós-atividade física entre os períodos, o estudo hemodinâmico das artérias umbilicais e da cerebral média demonstrou diminuição da resistência entre os períodos (p<0,04).CONCLUSÕES:A realização de exercício físico em gestantes hígidas não leva a alterações no fluxo sanguíneo sistêmico e feto-placentário após a atividade, podendo ser prescrita a realização de atividades de intensidade leve a moderada.

PURPOSE: To assess the effects of aerobic physical exercise on the Doppler velocimetry of fetal vessels in pregnant women with no clinical or obstetrical complications.METHODS: A cross-sectional study was conducted on 10 healthy low-risk pregnant women at 2 different gestational times: between the 26th and 29th week and 6 days, and at the end of pregnancy, between the 30th and 35th week. The patients were submitted to aerobic physical exercise on a treadmill until reaching fatigue. Ultrasonographic data were obtained at rest and after physical exercise (Doppler velocimetry indices for the umbilical artery, middle cerebral artery, ductus venosus, and uterine arteries). Data were analyzed statistically by the paired and independent Student's t-test using the Statistical Package for the Social Sciences (SPSS) package, version 21.0.RESULTS:A change in the pulsatility index was observed, with an indication of vasodilatation, with a median value of 1.1±0.1 before exercise and of 1.0±0.1 after exercise; the median value of the resistance index was 0.7±0.04 before exercise and 0.6±0.07 after exercise. The median systole/diastole ratio of the umbilical artery was 3.1±0.4 before exercise and 2.9±0.2 (p=0.03) after exercise at the beginning of pregnancy. No changes in the Doppler velocimetry parameters were observed for the uterine arteries, the middle cerebral artery or the ductus venosus after physical activity at either testing time. Paired analysis of pre- and post-activity data showed a reduction of resistance from the first to the second period (p<0.04).CONCLUSIONS: Physical exercise does not lead to changes in systemic blood flow or fetal-placental flow in healthy pregnant women, confirming that exercises of mild to moderate intensity can be prescribed.

https://doi.org/10.1590/S0100-7203201400050006 6589 downloads

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Relationship between structural abnormalities in the cerebellum and dementia, posttraumatic stress disorder and bipolar disorder
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Baldaçara, Leonardo

; Borgio, João Guilherme Fiorani

; Araújo, Célia

; Nery-Fernandes, Fabiana

; Lacerda, Acioly Luiz Taveres

; Moraes, Walter André dos Santos

; Montaño, Maria Beatriz Marcondes Macedo

; Rocha, Marlos

; Quarantini, Lucas C.

; Schoedl, Aline

; Pupo, Mariana

; Mello, Marcelo F.

; Andreoli, Sergio B.

; Miranda-Scippa, Angela

; Ramos, Luiz Roberto

; Mari, Jair J.

; Bressan, Rodrigo Affonseca

; Jackowski, Andrea Parolin

Dementia & Neuropsychologia

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dec 2012, Volume 6 N. 4 Pages 203 - 211

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Novas evidências sugerem que o cerebelo apresenta alterações estruturais e funcionais nos transtornos psiquiátricos. Objetivo: Medir o volume do cerebelo e de suas sub-regiões em indivíduos portadores de transtornos psiquiátricos e relacionar tais achados aos sintomas. Métodos: Foi realizada a identificação de pacientes com diferentes graus de prejuízo cognitivo proveniente de um estudo populacional (Epidemiologia do Idoso - UNIFESP), pacientes com transtorno do estresse pós-traumático proveniente de outro estudo populacional e portadores de transtorno bipolar proveniente de um ambulatório especializado (Universidade Federal da Bahia). Todos os sujeitos foram submetidos à ressonância magnética estrutural de 1.5T. As medidas de volume, assim como os sintomas medidos por escalas psicométricas foram comparadas entre pacientes e controles. Resultados: Foi observado que o volume do cerebelo está reduzido nos portadores de prejuízo cognitivo sem demência e com demência, no transtorno do estresse pós-traumático e no transtorno bipolar quando comparados aos controles. Na demência e no transtorno do estresse pós-traumático o volume do hemisfério cerebelar esquerdo e do vérmis estão reduzidos. No transtorno bipolar os volumes de ambos os hemisférios e do vérmis estão reduzidos. Nos dois primeiros estudos estas reduções correlacionaram com os sintomas. Conclusão: A natureza exata do envolvimento do cerebelo nos processos mentais ainda não é compreendida. Entretanto, anormalidades na estrutura cerebelar e em suas funções têm sido relatadas em algumas dessas doenças. Pesquisas futuras, com amostras maiores, ainda são necessárias para esclarecer tais achados e investigar se são importantes para o tratamento e prognóstico.

ABSTRACT. New evidence suggests that the cerebellum has structural and functional abnormalities in psychiatric disorders. Objective: In this research, the goal was to measure the volume of the cerebellum and its subregions in individuals with psychiatric disorders and to relate these findings to their symptoms. Methods: Patients with different degrees of cognitive impairment (Epidemiology of the Elderly - UNIFESP) and patients with post-traumatic stress disorder (PTSD) from population studies were analyzed. Also, patients with bipolar disorder from an outpatient clinic (Center for the Study of Mood and Anxiety Disorders, Universidade Federal da Bahia) were recruited for this study. All subjects underwent a 1.5T structural magnetic resonance scan. Volumetric measures and symptom measurements, by psychometric scales, were performed and compared between patients and controls. Results: The cerebellum volume was reduced in patients with cognitive impairment without dementia and with dementia, in patients with PTSD, and in patients with bipolar disorder compared to controls. In dementia and PTSD, the left cerebellar hemisphere and vermis volume were reduced. In bipolar disorder, volumes of both hemispheres and the vermis were reduced. In the first two studies, these cerebellar volumetric reductions correlated with symptoms of the disease. Conclusion: The exact nature of cerebellar involvement in mental processes is still not fully understood. However, abnormalities in cerebellar structure and its functions have been reported in some of these diseases. Future studies with larger samples are needed to clarify these findings and investigate whether they are important for treatment and prognosis.

https://doi.org/10.1590/S1980-57642012DN06040003 1551 downloads

11.

Hippocampal volume and CDR-SB can predict conversion to dementia in MCI patients
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Borgio, João Guilherme Fiorani

; Baldaçara, Leonardo

; Moraes, Walter dos Santos

; Lacerda, Acioly L. T.

; Montaño, Maria Beatriz

; Jackowski, Andrea Parolin

; Tufik, Sérgio

; Ramos, Luiz Roberto

; Bressan, Rodrigo Affonseca

Arquivos de Neuro-Psiquiatria

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nov 2012, Volume 70 N. 11 Pages 839 - 842

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Avaliar a combinação de dois fatores: clinical dementia rating sum of boxes scores (CDR-SB) e volume hipocampal (VH) como preditores de conversão de ditúrbio cognitivo leve (DCL) em demência. MÉTODO: Vinte e oito indivíduos (9 normais e 19 com DCL) foram classificados de acordo com a soma dos escores CDR-SB em 3 grupos. RESULTADOS: O volume do hipocampo foi significativamente menor no grupo de alto risco e naqueles que desenvolveram demência depois de dois anos. A taxa de conversão foi crescente entre os três grupos. CONCLUSÃO: Propusemos uma medição adicional do volume do hipocampo que pode ser útil no prognóstico. No entanto, notou-se que a CDR-SB é um método tão eficiente quanto neuroimagem para prever demência com a vantagem de ser um processo de baixo custo e de fácil implementação, mais consistente com a política pública.

OBJECTIVE: To evaluate the combination of two factors: clinical dementia rating sum of boxes scores (CDR-SB) and hippocampal volume (HV) as predictors of conversion from mild cognitive impairment (MCI) to dementia. METHODS: Twenty-eight individuals (9 normal and 19 with MCI) were classified according to their CDR sum of boxes scores into 3 groups. RESULTS: The hippocampal volume was significantly lower in the high-risk group and in those who developed dementia after two years. The rate of conversion was crescent among the three groups. CONCLUSION: We were proposed an additional measurement of the hippocampal volume which may be helpful in the prognosis. However, we noted that the CDR-SB is a method as efficient as neuroimaging to predict dementia with the advantage of being a procedure for low cost and easy implementation, more consistent with public policy.

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12.

Proceso de internacionalización de servicios: Un estudio en una cadena de restaurantes del nordeste brasileño
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Santos Salazar, Viviane

; Araújo de Moraes, Walter Fernando

; Pereira Leite, Yákara Vasconcelos

Estudios y perspectivas en turismo

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aug 2012, Volume 21 N. 4 Pages 1035 - 1049

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

The restaurants have an important role in tourist destinations. The development of appropriate business strategies can support the delivery of appropriate services to consumers and expansion. This paper is a theoretical and empirical research in order to analyze the process of internationalization of the Bonaparte Group. In the theoretical framework identifies the main concepts related to the internationalization of enterprises, the service features and how they impact the process of international expansion. The methodology used was qualitative case study as the unit of analysis was the brand of the Brazilian group Bossa Grill Bonaparte. The results show that the main reason was to expand the search for new markets and for this, we developed a totally different product that the company was already operating in Brazil. The choice by the United States was due to maturity and size of the market for food away from home, beyond the political and economic stability that allows for greater planning firms. It is also evident that the social networks of executives were instrumental in the early development and internationalization of the supply chain, seeking partners in Brazil and the United States for the design of society. As input mode, the company chose the franchise system. It is noticed that despite their idiosyncrasies the process of internationalization of the Group does not differ from Bonaparte conducted by manufacturing companies.

Los restaurantes poseen un papel relevante en los destinos turísticos. La creación de estrategias empresariales adecuadas es capaz de subsidiar el ofrecimiento de servicios adecuados a los consumidores y la expansión internacional. El presente trabajo es una investigación teórico-empírica con el propósito de analizar el proceso de internacionalización del grupo Bonaparte. En el marco teórico se identifican los principales conceptos relativos a la internacionalización de empresas, las características de los servicios y cómo impactan en el proceso de expansión internacional. La metodología usada fue el estudio de caso cualitativo que tuvo como unidad de análisis la marca Bossa Grill del grupo brasileño Bonaparte. Los resultados demuestran que la principal razón para la expansión fue la búsqueda de nuevos mercados y para eso se desarrolló un producto totalmente diferente de los que la empresa ya operaba en Brasil. La elección de Estados Unidos respondió a la madurez y al tamaño del mercado de alimentación fuera del hogar, más allá de la estabilidad política y económica que permite una mayor planificación de las empresas. Se percibe también que las redes de relaciones de los ejecutivos fueron fundamentales para el inicio de la internacionalización y el desarrollo de la cadena de suministro, en la búsqueda de socios en Brasil y Estados Unidos. La empresa optó por el sistema de franquicias. Se observa que a pesar de su idiosincrasia el proceso de internacionalización del Grupo Bonaparte no difiere del presentado por las empresas manufactureras.

1930 downloads

13.

Cerebellar volume in patients with dementia
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Baldaçara, Leonardo

; Borgio, João Guilherme Fiorani

; Moraes, Walter André dos Santos

; Lacerda, Acioly Luiz Tavares

; Montaño, Maria Beatriz Marcondes Macedo

; Tufik, Sérgio

; Bressan, Rodrigo Affonseca

; Ramos, Luiz Roberto

; Jackowski, Andrea Parolin

Brazilian Journal of Psychiatry

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jun 2011, Volume 33 N. 2 Pages 122 - 129

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: O objetivo deste estudo foi examinar o volume cerebelar em indivíduos em diferentes fases da doença de Alzheimer e investigar se sua redução estaria relacionada com o declínio cognitivo. MÉTODO: Noventa e seis indivíduos de um estudo epidemiológico foram submetidos à ressonância magnética e avaliados por meio do Mini Exame do Estado Mental e do Questionário de Atividades Funcionais. Os sujeitos foram divididos em cinco grupos de acordo com a Escala de Gravidade da Demência. Vinte e seis indivíduos do grupo original que não tinham o diagnóstico de demência no início do estudo foram reavaliados após dois anos para detectar o desenvolvimento da doença. RESULTADOS: Os volumes dos hemisférios cerebelares, lobo cerebelar posterior, vermis e lobo temporal estavam diminuídos proporcionalmente à gravidade da doença. Houve correlações positivas e significativas entre o Questionário de Atividades Funcionais, Mini Exame do Estado Mental e seus respectivos subtestes para linguagem e atenção com os volumes do lobo temporal e cerebelar. A análise de regressão logística demonstrou que o volume reduzido do lobo temporal, lobo cerebelar posterior e vermis pode ser um fator de risco para o futuro desenvolvimento de demência. CONCLUSÃO: Este é o primeiro estudo que demonstrou que o volume do cerebelo pode estar reduzido na fase pré-demência e reforça o papel dessa estrutura na progressão da doença de Alzheimer. Considerando que o cerebelo pode não estar diretamente associado com a origem da doença de Alzheimer, este achado tem valor para o prognóstico.

OBJECTIVE: The aim of this study was to examine the cerebellar volume of subjects at different stages of Alzheimer's disease and to investigate whether volume reductions in this structure are related to cognitive decline. METHOD: Ninety-six subjects from an epidemiological study were submitted to a magnetic resonance imaging scan and evaluated using the Mini-Mental State Examination and the Functional Activities Questionnaire. Subjects were divided into five groups according to the Clinical Dementia Rating scale. Twenty-six subjects from the original group who had no dementia diagnosis at baseline were re-evaluated for the onset of dementia after two years. RESULTS: The volumes of the cerebellar hemispheres, posterior cerebellar lobe, vermis and temporal lobe were found to be reduced as a function of the severity of the disease. There were significant positive correlations between the volume of the temporal lobe and cerebellum and the language, attention, and total scores in the Mini-Mental State Examination and the Functional Activities Questionnaire. A logistic regression analysis demonstrated that reduced temporal lobe, posterior cerebellar lobe and vermal volume at baseline is a risk factor for the onset of dementia. CONCLUSION: This is the first study demonstrating that reduced cerebellar volume is already apparent at the predementia stage. The results of this study support the involvement of the cerebellum in the progression of dementia. Whereas the cerebellum might not be directly associated with the origin of Alzheimer's disease, it may provide useful information related to its prognosis.

4321 downloads Cited 2 times in SciELO

14.

Sedative antidepressants and insomnia
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Moraes, Walter André dos Santos

; Burke, Patrick Rademaker

; Coutinho, Pablo Lorenzon

; Guilleminault, Christian

; Bittencourt, Aline Gomes

; Tufik, Sergio

; Poyares, Dalva

Brazilian Journal of Psychiatry

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mar 2011, Volume 33 N. 1 Pages 91 - 95

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Esta atualização aborda a relação entre sono e depressão e como a transmissão serotoninérgica está envolvida em ambas condições. MÉTODO: Foi realizada uma busca na literatura no PubMed e MedLine até março de 2010 com os termos "insônia", "depressão", "antidepressivos sedativos" e "serotonina". A fim de contemplar os antidepressivos sedativos mais utilizados no tratamento da insônia, 34 artigos ISI, principalmente revisões e estudos clínicos placebo-controlados, foram selecionados entre 317 artigos encontrados na busca inicial. RESULTADOS: Alterações de sono podem aparecer meses antes do diagnóstico clínico de depressão e persistir após a resolução da depressão. O tratamento dos sintomas de insônia pode melhorar essa doença associada. Alguns antidepressivos também podem levar à insônia ou sonolência diurna. A serotonina (5-HT) demonstra um padrão complexo no que diz respeito ao sono e vigília, o que está relacionado com a variedade de subtipos do receptor 5-HT envolvidos em diferentes funções fisiológicas. Acredita-se, atualmente, que a estimulação do receptor 5-HT2 esteja envolvida nas alterações da organização do sono e insônia relacionada a alguns antidepressivos. CONCLUSÃO: Alguns medicamentos normalmente prescritos para o tratamento de depressão podem piorar a insônia e dificultar a completa recuperação da depressão. Os antagonistas do receptor 5-HT2 são drogas promissoras para o tratamento, pois podem melhorar a insônia e depressão associadas.

OBJECTIVE: The present review addresses the relationship between sleep and depression and how serotonergic transmission is implicated in both conditions. METHOD: Literature searches were performed in the PubMed and MedLine databases up to March 2010. The terms searched were "insomnia", "depression", "sedative antidepressants" and "serotonin". In order to pinpoint the sedative antidepressants most used to treat insomnia, 34 ISI articles, mainly reviews and placebo-controlled clinical trials, were selected from 317 articles found in our primary search. RESULTS: Sleep problems may appear months before the diagnosis of clinical depression and persist after the resolution of depression. Treatment of insomnia symptoms may improve this comorbid disease. Some antidepressant drugs can also result in insomnia or daytime sleepiness. Serotonin (5-HT) demonstrates a complex pattern with respect to sleep and wakefulness that is related to the array of 5-HT receptor subtypes involved in different physiological functions. It is now believed that 5HT2 receptor stimulation is subjacent to insomnia and changes in sleep organization related to the use of some antidepressants. CONCLUSION: Some drugs commonly prescribed for the treatment of depression may worsen insomnia and impair full recovery from depression. 5-HT2 receptor antagonists are promising drugs for treatment strategies since they can improve comorbid insomnia and depression.

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15.

Novos sedativos hipnóticos
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Sukys-Claudino, Lucia

; Moraes, Walter André dos Santos

; Tufik, Sergio

; Poyares, Dalva

Brazilian Journal of Psychiatry

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sep 2010, Volume 32 N. 3 Pages 288 - 293

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Nas últimas décadas houve um esforço para o desenvolvimento de hipnóticos mais seguros e eficazes. Zolpidem, zaleplona, zopiclona, eszopiclona (drogas-z) e indiplona são moduladores do receptor GABA-A, os quais agem de forma seletiva na subunidade α1, exibindo, desta forma, mecanismos similares de ação, embora evidências recentes sugiram que a eszopiclona não seja tão seletiva para a subunidade α1 quanto o zolpidem. Ramelteon e tasimelteon são novos agentes crono-hipnóticos seletivos para os receptores de melatonina MT1 e MT2. Por outro lado, nos últimos anos, o consumo de drogas antidepressivas sedativas tem aumentado significativamente no tratamento da insônia. Como droga experimental, a eplivanserina tem sido testada como um potente agonista inverso do subtipo 5-HT2A da serotonina, com um uso potencial na dificuldade da manutenção do sono. Outro agente farmacológico para o tratamento da insônia é o almorexant, o qual apresenta um novo mecanismo de ação envolvendo antagonismo do sistema hipocretinérgico, desta forma levando à indução do sono. Finalmente, também discutiremos o potencial papel de outras drogas gabaérgicas no tratamento da insônia.

There has been a search for more effective and safe hypnotic drugs in the last decades. Zolpidem, zaleplon, zopiclone, eszopiclone (the z-drugs) and indiplon are GABA-A modulators which bind selectively α1 subunits, thus, exhibiting similar mechanisms of action, although recent evidence suggests that eszopiclone is not as selective for α1 subunit as zolpidem is. Ramelteon and tasimelteon are new chrono-hypnotic agents, selective for melatonin MT1 and MT2 receptors. On the other hand, the consumption of sedative antidepressant drugs is significantly increasing for the treatment of insomnia, in the last years. As an experimental drug, eplivanserin is being tested as a potent antagonist of serotonin 2-A receptors (ASTAR) with a potential use in sleep maintenance difficulty. Another recent pharmacological agent for insomnia is almorexant, which new mechanism of action involves antagonism of hypocretinergic system, thus inducing sleep. Finally we also discuss the potential role of other gabaergic drugs for insomnia.

85234 downloads Cited 2 times in SciELO

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