OBJECTIVES: Inflammatory molecules play a role in the development of atherosclerosis, which is the primary origin of cardiovascular disorders. However, to the best of our knowledge, no study has attempted to investigate the relationship between these circulating molecules and the prediction of cardiovascular risk. The present study aimed to investigate the relationships of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 serum concentrations with the extent of coronary lesions. METHODS: Seventy-four individuals who were undergoing coronary angiography for the first time for diagnostic purposes were enrolled in this study. The extent of the coronary lesion was assessed using the Friesinger Index, and subjects were classified into four groups: no lesions, minor lesions, intermediate lesions and major lesions. Serum biochemical parameters and serum concentrations of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 were analyzed. RESULTS: The vascular cell adhesion molecule-1 concentration was higher than 876 ng/mL in individuals with intermediate and major lesions (p<0.001 and p=0.020, respectively). Moreover, logistic regression analysis showed that these patients had an increased risk of having an intermediate lesion (p=0.007). Interestingly, all individuals with major lesions had vascular cell adhesion molecule-1 concentrations higher than 876 ng/mL. No association was found between the concentrations of the other proteins and the Friesinger Index. CONCLUSIONS: Serum vascular cell adhesion molecule-1 may be associated with the extent of coronary lesions. Moreover, it may represent an alternative to improve the cardiovascular risk classification in patients without acute coronary syndrome.

Resumen Antecedentes: la consulta por teléfono puede ser considerada un método importante incorporado a la consulta tradicional de pacientes con insuficiencia cardíaca, ya que tiene por objetivo reevaluar, reforzar o reorientar cuestiones acerca del manejo de la enfermedad. Objetivo: evaluar la adhesión al tratamiento, autocuidado y calidad de vida, antes y después de la consulta de enfermería por teléfono en pacientes con insuficiencia cardíaca crónica bajo seguimiento en una clínica especializada. Material y método: estudio casi experimental, con 14 pacientes de una clínica especializada en tratamiento de insuficiencia cardíaca de Niterói. Los puntajes de adhesión al tratamiento, autocuidado (mantenimiento, manejo y confianza) y calidad de vida fueron evaluados por medio de cuestionarios validados antes y después de la intervención telefónica. Resultados: de los 14 pacientes, 9 (64,3%) eran del sexo masculino, 11 (78,6%) casados/unidos, con edad media de 64,8 ± 8,7 años, e ingresos de R $ 936,00 y tiempo de escolaridad de cinco años, 7 (50%) jubilados. Etiología hipertensiva, siendo las causas de morbilidad más frecuentes: la hipertensión arterial 13 (92,9%), y el infarto agudo de miocardio (35,7%). Se observó un avance con relación con la adhesión al tratamiento (p <0,0001), en el mantenimiento (p = 0,002), manejo (p <0,0001) y en la confianza del autocuidado (p = 0,004). No hubo diferencia estadística significativa en la calidad de vida. Conclusiones: la mejora de las habilidades para el autocuidado y la adhesión después de la consulta telefónica de enfermería muestran que esta intervención puede traer resultados clínicos benéficos. Registro Brasileño de Ensayos Clínicos (ReBEC) sob nº RBR-6P9FJG.

Objective: To characterize the socioeconomic and demographic aspects of sickle cell disease patients from the state of Rio Grande do Norte (RN), Northeast Brazil, and their adherence to the recommended treatment. Methods: This cross-sectional descriptive study was performed at referral centers for the treatment of hematological diseases. One hundred and fifty-five unrelated individuals with sickle cell disease who went to these centers for outpatient visits were analyzed. All the patients, or their caregivers, were informed about the research procedures and objectives, and answered a standardized questionnaire. Results: The patients were predominantly younger than 12 years old, self-declared as mulatto, lived in small towns fairly distant from the referral center, and had low education and socioeconomic levels. Individuals who were ten or younger were diagnosed at an earlier age. Almost 50% of the patients were taking hydroxyurea, 91.4% reported having received pneumococcal/meningococcal vaccinations and 76.1% received penicillin as antibiotic prophylaxis. However, the majority of them reported having difficulties following the recommendations of the physicians, mainly in respect to attaining the prescribed medications and transportation to the referral centers. Conclusion: These individuals have a vulnerable socioeconomic situation that can lead to an aggravation of their general health and thus deserve special attention from the medical and psychosocial perspectives. Thus, it is necessary to improve public policies that provide Brazilian sickle cell disease patients with better access to medical treatment, living conditions, and integration into society.

Esse artigo analisa o acesso ao auxílio-reclusão no Brasil, no período entre 2002 e 2012. O auxílio-reclusão é um benefício da previdência social que visa à proteção dos dependentes de pessoas presas que estejam em condição de segurada e que tenham baixa renda. Foi realizada análise longitudinal comparativa dos dados dos benefícios previdenciários pagos entre os anos de 2002 a 2012, bem como a análise dos dados sobre a população carcerária no mesmo período. Foi possível verificar o aumento no número de benefícios pagos e no volume de recursos destinados ao auxílio-reclusão, que cresceu mais que a média da maior parte dos benefícios previdenciários. Apesar disto, o auxílio-reclusão ainda é um benefício restritivo e com baixa cobertura, beneficiando 7% da população carcerária do Brasil.

This article analyzes access to incarceration assistance in Brazil in the period from 2002-2012. Incarceration assistance is a benefit of the social security system that is dedicated to the protection of dependents of people who are imprisoned who are eligible for social security benefits and have low income. A comparative longitudinal analysis of the data about social security benefits paid between the years 2002-2012 was conducted, and an analysis of data about the incarcerated population in the same period. The study found an increase in the number of benefits paid and in the volume of resources destined to incarceration assistance, which grew above the average of most of the social security benefits. Despite this, incarceration assistance is still a restricted benefit with low coverage, benefitting 7% of Brazil's incarcerated population.

Resumo Anualmente, 500 mil pessoas são hospitalizadas com lesão cerebral adquirida após traumatismo crânio-encefálico (TCE) no Brasil. Setenta e cinco a cem mil pessoas morrem poucas horas após o evento e 70 a 90 mil evoluem para perda irreversível de alguma função neurológica. Entre as principais causas de TCE estão os acidentes automobilísticos (50%), quedas (21%), assaltos e roubos (12%) e atividades de lazer (10%). Dentro deste contexto, a reabilitação cognitiva, uma área clínica de atuação interdisciplinar em busca de recuperação, tanto quanto a compensação de alterações das funções cognitivas resultantes de lesão cerebral, é extremamente importante para estes indivíduos. Portanto, neste estudo, foram revisados os conceitos básicos relacionados ao TCE, tais como os mecanismos de lesão, os níveis graves de TCE, os achados mais comuns em sobreviventes de TCE moderado e grave e as deficiências cognitivas mais comuns após TCE e discutidas as estratégias utilizadas para lidar com pacientes pós-TCE. Como resultado, nosso estudo irá fornecer informações relevantes relacionadas com um serviço de reabilitação cognitiva estruturada e, certamente, irá oferecer uma alternativa para pacientes e famílias vítimas de TCE e, portanto, gerar múltiplos protocolos de pesquisa.

Abstract Annually, some 500,000 people are hospitalized with brain lesions acquired after traumatic brain injury (TBI) in Brazil. Between 75,000 and 100,000 individuals die within hours of the event and 70,000 to 90,000 evolve to irreversible loss of some neurological function. The principal causes of TBI include motor vehicle accidents (50%), falls (21%), assaults and robberies (12%) and accidents during leisure activities (10%). Within this context, cognitive rehabilitation, a clinical area encompassing interdisciplinary action aimed at recovery as well as compensation of cognitive functions altered as a result of cerebral injury, is extremely important for these individuals. Therefore, the aim of this study was to review the basic concepts related to TBI, including mechanisms of injury, severity levels of TBI, the most common findings in moderate and severe TBI survivors, and the most frequent cognitive impairments following TBI, and also to discuss the strategies used to handle patients post-TBI. The study results yielded relevant information on a structured cognitive rehabilitation service, representing an alternative for patients and families afflicted by TBI, enabling the generation of multiple research protocols.

O mamoeiro (Carica papaya) é uma das mais importantes fruteiras tropicais, e seus frutos contribuem com uma produção de 1,65 milhão de toneladas por ano para o Brasil. Um isolado de Phytophthora sp. obtido de frutos de mamoeiro da cultivar Havaí, em Alagoas, foi caracterizado morfologicamente e sua patogenicidade foi confirmada em frutos e mudas deste hospedeiro. Em meio suco V-8, os esporangióforos apresentaram-se delgados, simples ou pouco ramificados, enquanto os esporângios se apresentaram ovóides a elipsóides, proeminentemente papilados e um pedicelo curto na porção basal, medindo em média 37,68 x 27,52 mm. Através das características apresentadas pelo isolado e os sintomas induzidos, o agente causal foi identificado como Phytophthora palmivora. Apesar de essa doença já ocorrer em outros estados, como Bahia, Espírito Santo, São Paulo, Pernambuco e Pará, este é o primeiro relato de Phytophthora palmivora em mamoeiro no Estado de Alagoas.

The papaya (Carica papaya) is one of the most important tropical fruit crops and its fruit contribute with a production of 1.65 millions tons/year in Brazil. An isolated of Phytophthora sp. gotten from papaya fruits cv. Hawaii, in the state of Alagoas, was characterized morphologically and its pathogenicity to this fruits and seedling was confirmed. In a V-8 medium, the sporangiophores presented to be slim, simple or little ramified, while the sporangia presented ovoid to ellipsoid, prominently papillae and one short pedicel in the basal portion, measuring in average 37,68 x 27,52 (m. Through the characteristics presented by the isolated and the induced symptoms, the causal agent was identified as Phytophthora palmivora. Despite of this disease already occurring in other states like in Bahia, Espirito Santo, São Paulo, Pernambuco and Pará, this is the first report of Phytophthora palmivora on papaya in the state of Alagoas, Brazil.