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A Extensão Universitária tem sido o lugar da prática de pesquisa. O projeto na linha de Patrimônio, desenvolvido junto com o grupo artístico Jongo da Serrinha foi contemplado, nos últimos anos, nos editais de fomento do MEC e também nos editais da própria pró-reitoria de Extensão da Universidade em que atuo. Durante este período, estudantes de diferentes cursos, se formaram nesta relação dialógica com a comunidade do jongo. Neste artigo, apresento um panorama da extensão na UFRJ, apontando alguns direcionamentos dos últimos anos considerando no processo político e pedagógico de implantação da extensão nos currículos dos cursos de graduação.

Ischemic heart disease is a major cause of heart failure in western societies. However, the factors that may influence left ventricular function (LVF) recovery after an acute coronary syndrome (ACS) are still unclear.To identify variables that may influence LVF evolution one year after ACS.104 patients hospitalized with ACS between 7/1/2001 and 12/31/2002 and with systolic dysfunction--defined as an echocardiographic ejection fraction (EF)or = 45%--were randomly allocated to a planned coronary follow-up program (FUP) or a general cardiology clinic (GC); patients from both groups were also randomly referred to a structured cardiac rehabilitation program (CRP). EF was re-assessed at one year. We compared differences between patients who recovered left ventricular function (EF45%; group 1) and those who did not (group 2).One year after discharge, 44.2% of the patients had recovered function. There were no significant differences between the groups in gender (77.7 vs. 76.5% male), age (56 vs. 59 years), hypertension, diabetes, dyslipidemia, smoking habits or family history. A previous history of cardiovascular events was more frequent in group 2 (11.1% vs. 35.3%, p = 0.03). Cardiac catheterization was performed before discharge in 88.8% and 88.2% in groups 1 and 2 respectively (p = NS); no differences were found in coronary anatomy between the two groups. Angioplasty was performed in 54.2% in group 1 and 50% in group 2 (p = NS). There were no differences in the use of angiotensin-converting enzyme inhibitors (83.3% vs. 87.5%), beta-blockers (87.5% vs. 87.5%), nitrates (37.5% vs. 33.3%), aspirin (95.8% vs. 95.8%), statins (79.1% vs. 75%) or diuretics (20.8% vs. 45.8%). There was no significant difference in LVF recovery between patients randomized to FUP or GC (38.5% vs. 54.5%). 87.5% of patients who completed the CRP had normal EF at one year compared to 32.7% of patients not referred to the program (p = 0.009). Although EF improved in both groups, this improvement was greater in patients who completed a CRP (EF 8% vs. 5%, p = 0.003).A previous cardiovascular event and completion of a CRP were the only variables that influenced LVF recovery. Thus, enrollment in a CRP, in addition to standard therapy, could be an important therapeutic measure in patients with systolic dysfunction after ACS; our data suggest that these programs should be more widely used.

Coronary disease in its various forms of presentation is associated with a reduction in the patients' own perception of their quality of life (QoL). QoL is an important measure of effectiveness of treatment; however, the predictors of QoL after admission for acute coronary syndrome (ACS) are not completely clear.To identify the clinical, demographic and psychosocial characteristics of patients admitted for ACS that were predictive of QoL in clinical follow-up.Physical and mental QoL were prospectively evaluated in 278 patients admitted for ACS, using Short Form-36 v2 physical (PCS) and mental (MCS) component summary scales. Based on the median PCS (55) and MCS (56) scores, the population was divided into two groups. Depressive symptoms were assessed using the Beck Depression Inventory.The patients with a better QoL perception were male, young, smokers and had more than 12 years' education. A greater proportion of patients with PCS and MCS below the median score presented prior cardiovascular events and depressive symptoms. A worse physical QoL perception was more common in unmarried, hypertensive and diabetic patients. There was no association between clinical evolution or in-hospital complications and baseline QoL scores. Baseline PCS and MCS were 55 +/- 24 and 55 +/- 27 and at 16 months, 63 +/- 25 and 66 +/- 29. Clinical follow-up was achieved in 181 patients. A worse mental QoL perception at follow-up was related to female gender, baseline MCS56 and depressive symptoms. A PCS below median score at follow-up was more frequent in women and in patients with prior cardiovascular events, hypertension, diabetes, dyslipidemia and a lower level of education. Patients with better physical QoL at follow-up were smokers, presented higher baseline PCS and MCS, and had fewer depressive symptoms. Percutaneous myocardial revascularization was associated with a better physical QoL. In a logistic regression model the independent predictors of PCS were: gender, baseline PCS, level of education and prior cardiovascular events. Gender and depressive symptoms were independent predictors of MCS.In the study population, baseline clinical and psychosocial characteristics were the most important predictors of QoL after ACS. Depression was associated with worse mental QoL. In-hospital evolution and treatment did not appear to strongly affect patients' follow-up perceptions of QoL.

Left ventricular (LV) systolic function is an important prognostic factor in coronary heart disease. Left ventricular ejection fraction (LVEF) should be assessed in all patients after acute myocardial infarction (AMI). Although reperfusion therapy has been found effective in the reduction of complications of AMI, LVEF impairment is a common consequence of an acute coronary event. The aim of this study was to estimate the incidence of LVEF depression after ST-elevation myocardial infarction (STEMI) and to evaluate the effect of previous cardiovascular risk factors on the risk of LV dysfunction.One hundred and forty-seven consecutive patients with a first STEMI were included in this study. Most patients were male (70.7%) and mean age was 60.7 years. LVEF was assessed by echocardiography (using the single-plane area-length method and automatic border detection). LV systolic function was considered depressed when ejection fraction was less than 45 %. The chi-square test was used in the statistical analysis to compare proportions and a logistic regression model was fitted to assess the independent effect of each variable.Incidence of LV dysfunction was 55.8% in STEMI patients. No association was found between gender or age and LVEF impairment. The proportion of patients with diabetes was higher in the impaired LVEF group than in normal LVEF patients (44.7% vs. 31.7%, p = 0.12); the prevalence of smoking was also higher in patients with LV dysfunction (46.9% vs. 33.8%, p = 0.11). On the other hand, dyslipidemia was less common in patients with depressed LV function (35.4% vs. 56.9%, p = 0.01). Hypertension was not associated with impaired LVEF. After adjustment for ST-elevation location and number of vessels with critical stenosis, diabetes and smoking were associated with a significantly higher risk of LVEF impairment (diabetes: OR = 3.73, 95% CI 1.25-11.16; smoking: OR = 3.9, 95% CI 1.37-11.07) and dyslipidemia with a significantly lower risk of LV dysfunction (OR: 0.37, 95% CI 0.15-0.88).In STEMI patients, previous cardiovascular risk factors have a significant impact on the likelihood of LV dysfunction and hence could influence long-term prognosis.

Clinical depression is associated with poor compliance in risk reduction recommendations and has been suggested as an independent risk factor for increased postmyocardial infarction morbidity and mortality.To determine the prevalence of depressive symptoms, their main determinants and their influence on clinical evolution in acute coronary syndromes (ACS) patients.We studied depressive symptoms, sociodemographic variables, cardiovascular status and therapeutic procedures in 240 consecutive patients admitted for ACS. Depressive symptoms were assessed using the Beck Depression Inventory (BDI) after clinical stabilization, in patients with more than 4 years' education.The majority of the patients were male (203); their average age was 59.4 +/- 13 yrs; 31.8% were admitted for unstable angina, 33.1% for acute myocardial infarction with ST elevation and 31.8% without ST elevation. Depressive symptoms (BDIor =10) were present in 100 patients (41.6%). Depressed patients were older (61.1 vs. 58.2 years, p = 0.06) and had a history of previous cardiovascular events /47.5 vs. (34.8% p = 0.05). The proportion of female was higher in the group of patients with BDIor =10 (24% vs. 9.3%, p = 0.02). Traditional cardiovascular risk factors were not associated with depressive symptoms. There were no statistically significant differences between the depressed and non-depressed patients in admission diagnosis, in-hospital clinical evolution and treatment. There were 35 patients (14.6%) with moderate/severe depression (BDIor =19), 12 of whom were women (OR = 3.8, p = 0.001); no relation was established between age and previous cardiac events. These scores were less frequent in patients with a higher level of education (OR = 0.28, p = 0.09) and married (OR = 0.31 vs. not married, p = 0.03). Clinical follow-up of 158 patients was achieved (16 +/- 4 months), in patients with BDIor =19, the presence of cardiovascular symptoms (angina, congestive heart failure) was higher (46% vs. 23%, OR = 2.8, p = 0.03), even after adjustment for age (OR = 2.5; p = 0.06). However, there was no association between the presence of depressive symptoms and readmission and/or fatal events.Depression is a common finding after hospital admission for ACS, particularly in women, and is mainly associated with prehospital factors. In our group of patients, the presence of depressive symptoms was closely related to clinical status during follow-up.

Hypertension is an important risk factor for cardiovascular events. Although several anti-hypertensive agents have shown to be effective in the treatment of hypertension, adequate blood pressure control is not frequent in most populations. The aim of this study was to evaluate the effect of a structured intensive follow-up program (SIFUP) on the control of blood pressure in coronary patients.we performed a prospective, randomized study including 237 patients admitted to the Cardiology Department for acute coronary syndrome. Patients were randomly assigned to a SIFUP (n=129) or to the general cardiology outpatient department (COD) (n=108). An experienced doctor performed a blind assessment of blood pressure in 157 randomised patients, 9 to 18 months after discharge. In statistical analysis, the chi-square test was used to compare proportions and the Student's t test to compare means.Both groups were predominantly male and mean age was similar. The proportion of patients with known hypertension randomised to the SIFUP and the COD did not differ. At the 9 to 18-month assessment there was no statistical significant difference in the proportion of patients with blood pressure under target values (57.5% in SIFUP and 48.5% in COD, p=NS). However, in hypertensive patients, the proportion of controlled patients was significantly higher in the SIFUP than in the COD (44.8% vs. 24.2%, p=0.05) and systolic and mean blood pressure were significantly lower in the SIFUP (respectively 139.0 vs. 148.8 mmHg, p=0.04 and 98.7 vs. 103.9 mmHg, p=0.03); diastolic blood pressure was also lower in SIFUP (78.5 vs. 81.5 mmHg, p=NS).The SIFUP has shown to be effective in lowering blood pressure in hypertensive coronary patients. The proportion of patients with controlled blood pressure was consistently higher in the SIFUP.

The individual awareness of one's own disease, the so called labeling effect, may result in a reduction of one's sense of perceived health. In patients submitted to coronary artery bypass surgery it has been reported that the diagnosis of depression is associated with a higher rate of hospitalization and it's an independent risk factor for cardiac events. The aim of this study was to evaluate the modification of depressive symptoms induced by the information of medical indication for myocardial revascularization surgery.We studied the presence of depressive symptoms, socio-demographic variables, cardiovascular status and therapeutic procedures in two groups of consecutive patients admitted for acute coronary syndrome. In the labeled group the BDI-1 was performed after clinical stabilization and the BDI-2 after the information of myocardial revascularization surgery need. In the control group the BDI-1 was answered after clinical stabilization and the BDI-2 48-72 hours later. The Mann-Whitney test was used to compare the difference of depressive symptoms between the groups.Distribution by age, marital status and education level was similar between the two groups. The cardiovascular risk profile was alike. The difference between BDI-1 and BDI-2 was significantly higher in the labeled group (4.6-/+4.2 vs 0.8-/+3.2; p=0.005). There were no significant differences between the final diagnosis (unstable angina in the labeled group 50% vs control group 45.5%; AMI without Q wave 30% vs 27.3%; AMI with Q wave 20% vs 27.3%) and in hospital clinical evolution.The individual awareness of the need to coronary bypass surgery was associated with a clinical and statistical significant increase of depressive symptoms. Hence, routine evaluation of depressive symptoms as a part of a preoperative protocol, may allow identification of the patients, who may benefit from therapeutic intervention.

A considerable number of patients present a single intermediate lesion (40% and70%) in one coronary artery on coronary angiography, with no clear evidence that the lesion is responsible for the patient's symptoms. Fractional flow reserve is a method of evaluating the functional importance of stenosis, a value of0.75 indicating hemodynamically significant lesions. The aim of this study is to determine the safety of non-revascularization of an angiographically moderate and hemodynamically non-significant lesion.Fractional flow reserve (FFR) was evaluated in 87 patients over a period of 34 months. Retrospective analysis and follow-up were conducted of patients referred for coronary angiography, without acute coronary syndrome, who presented an angiographically moderate lesion of a single epicardial coronary artery with an FFR of 0.75, and in whom intervention was deferred.We found 21 patients with a mean age of 66 years, 66.7% male. All patients presented vascular risk factors, 14 with prior cardiovascular events. Before coronary angiography 7 patients were asymptomatic, 7 had atypical symptoms and 7 presented CCS class 2 angina. Among these patients, 16 performed a non-invasive stress test, which was positive in 11 patients and inconclusive or doubtful in the others. Angiographically most of the lesions were located in the left anterior descending artery (12 patients). In the 19 +/- 12-month follow-up, 16 patients were asymptomatic and the others maintained the same symptoms. There was no change in the amount of antianginal drugs prescribed. No cardiac events occurred.FFR is a useful tool when clinical symptoms and non-invasive tests are inconclusive in the presence of moderate stenosis in a coronary artery. In our group of patients, the decision to defer intervention based on an FFR of 0.75 was found to be safe and associated with absence of clinical events.

COORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO Os avanços na microeletrônica possibilitaram a miniaturização e portabilidade dos equipamentos de computador e, principalmente, do uso individualizado do mesmo. Desse modo, essa tecnologia começou a ser inserida espontaneamente na pesquisa das áreas que tratam do projeto do objeto de desenho industrial - conforme podemos perceber no Laboratório de Investigação em Living Design, LILD do DAD da PUC-Rio - por meio de seus pesquisadores - com seus computadores portáteis - como forma de apoio aos seus estudos. Esta dissertação tem como foco principal a interação que está se dando nas áreas de pesquisa do objeto de uso entre o ferramental técnico/mecânico tradicional de representação e os meios eletrônicos que expõe uma técnica computacional que apresentam hoje um desenvolvimento exponencial. Os meios tradicionais de concepção e viabilização dos objetos de desenho industrial, de arquitetura, e das engenharias em geral vêm sendo, cada vez mais, complementados por essa nova tecnologia. Dessa forma, apresenta-se nesse trabalho o que foi observado quando da aplicação dessa nova tecnologia em estudos que, nesse momento, estão em desenvolvimento; bem como, sua relação interativa com os métodos tradicionais que envolvem modelos mecânicos, sejam em escala reduzida, sejam em estado de uso. Como resultado apresenta-se um enriquecimento das pesquisas em andamento no laboratório, principalmente, em relação aos aspectos de precisão, documentação, e transporte dos modelos; assim como, em relação a novas formas de visualização e reflexão, diferentes das tradicionais e, inexistentes anteriormente a utilização da computação gráfica. Advancements in microelectronics have enabled both miniaturization and portability of computer equipment and, especially, the individual use of it. Thus, this technology have been introduced in the research of the Laboratory for Investigation in Living Design – LILD, Department of Arts and Design from the Pontifícia Universidade Católica do Rio de Janeiro, Brazil – by its members, and their personal computers, as a way to support the development of their studies. This study focuses on the observation of the systematic introduction of computer graphics technology in the LILDs trial and error approach, and aims to present the usage of this tool serving as a new platform to the researches that have been developed in the laboratory. In this manner, this research demonstrates what was observed during the application of this new technology in ongoing studies; as well as their interactive relation with traditional methods, which involves mechanical models, be it in reduced scale or ready to use. As a result, it is verified an enrichment of the researches in course in the laboratory, mainly, in relation to the aspects of precision, documentation and transportation of models; and also concerning new ways of visualization and reflection, different from traditional ones, previously non-existent to the application of computer graphics.

PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO O presente trabalho apresenta a trajetória de pesquisa-ação com o grupo de cipozeiros que se articulam no Movimento Interestadual de Cipozeiros e Cipozeiras - MICI, do Paraná e Santa Catarina. Apresento temas correlacionados à formação da identidade coletiva dos cipozeiros e suas formas de ação, na articulação para a defesa de seus direitos fundamentais. São enfocados então, desde o início da pesquisa em Design, ao ano de 2006, algumas premissas desta área quando relacionada às comunidades tradicionais, levando à reflexão sobre sua forma de atuação em contextos cujas problemáticas locais apresentam complexidade sui generis. Assim, são apresentados os resultados das pesquisas em Design e as estratégias de investigação sobre os conflitos locais, muito relacionados à restrição do livre acesso ao território tradicionalmente ocupado, à restrição do livre acesso aos recursos naturais - de uso histórico pelos cipozeiros, e às formas de repressão que representam a usurpação de seus direitos fundamentais, bem como a exploração do trabalho artesanal. Considero portanto que tal problemática remete ao repensar a ação em Design, em outras palavras à práxis do Design, bem como as formas de ação, articulação e formação política levam ao repensar e ao re-significar os artefatos pelos cipozeiros em sua cultura material, demonstrando seu potencial criativo através dos objetos que traduzem seu discurso, que reflete a percepção sobre seus conflitos e seus direitos. Exponho aqui as reflexões pela epistemologia de um Design sócio-educativo. The present paper presents the action-research path with the group of vine producers that get together in the Movimento Interestadual de Cipozeiros e Cipozeiras - MICI , (The Vine Producers Interstate Gathering), in Paraná and Santa Catarina. I present themes related to the collective identity formation of the vine producers and their ways of action in the articulation of the defense of their fundamental rights. Since the beginning of the research in Design, in 2006, some premises of this area are focused when related to the traditional communities, bringing to the reflection on their way of acting within contexts which local problematics present sui generis complexity. So, the results of the research in Design and the strategies of investigation on the local conflicts are presented. These local conflicts are much related to the restriction of free access to the territory traditionally occupied, to the restriction of the free access to the natural resources - of historical use of the vine producers -, and to the repression ways that represent the usurp of their fundamental rights as well as the exploitation of the handicraft. I consider, therefore, that such problematic makes us rethink the Design action, in other words, the Design praxis. Also, the ways of action, articulation and political formation make us think and re-mean the articles produced by the vine producers in their material culture, demonstrating their creative potential through the objects that translate their speech and reflect the perception on their conflicts and rights. I expose here the reflections by the epistemology of a social educative Design.