Dropouts or Discontinuity of the Treatment of Tuberculosis in Rio Branco, Acre

This research investigates the factors related to the discontinuity of the treatment of tuberculosis in Rio Branco-Acre. To the fulfillment of this research, a contribution to ethnography has been adopted, for the successful apprehension of the reality to be studied. The research has been developed in two mapping steps: on the first, a search for information on the SINAN (System of National Injuries Notification - Sistema de Notificacao de Agravos Nacionais) and on the Municipal Coordination of the Tuberculosis Program databases was taken; the second aimed to record facts from the observation of the care given on a health care unit, which serves assistance to tuberculosis carriers in treatment, and the interviews of the elected subjects. On the analysis of the observations, narrative and interview collection, it was observed that the professionals of health services label some people as auspicious to discontinue the treatment and don't consider the different ways of life on the approach of their patients, complicating the formation of the bond and favoring the discontinuity. It was also identified people treating for tuberculosis that had many ways of dealing with the limitations generated by the disease, such as restrictions for the work, among others, and people that discontinued the treatment took in consideration their system of beliefs and values, as well as the perception of health/disease, due to the feeling of cure when the treatment was interrupted.

Investigating South American biogeographic history using patterns of skull shape variation on Cerdocyon thous (Mammalia: Canidae)

Patterns of geographic variation of the canid Cerdocyon thous have historically been obscured by its remarkable intraspecific morphological variability. The observed distribution is highly associated with phytophysiognomy, a feature considered highly dynamic along geological time. In the present study, we tested whether vegetation distribution during the Holocene Glacial Maximum of South America (HGM) explains the patterns of morphological variation within Cerdocyon thous. The species was divided in groups according to paleohabitats that could support their presence during the HGM, and then tested for differences in skull morphometrics. The results obtained demonstrate that the climatic changes during the HGM influenced the population structure of this species, resulting in the establishment of geographical groups with different degrees of morphological cohesion. Higher morphological cohesion found in the Northern group might be explained by the marked discontinuity between its geographical range and the rest of the species`distribution. The Eastern and Southern morphological divergence is less striking and, although this could be related to past vegetation distribution, the disappearance of those barriers leads to a population structure that could be slowly breaking down. (C) 2009 The Linnean Society of London, Biological Journal of the Linnean Society, 2009, 98, 77-84.

Prenatal detection and postnatal management of an intranasal glioma

Nasal gliomas are rare benign congenital midline tumors composed of heterotopic neuroglial tissue. They have potential for intracranial extension through a bony defect in the skull base. Neuroimaging is essential for identifying nasal lesions and for determining their exact location and any possible intracranial extension. Computed tomography is often the initial imaging study obtained because it provides good visualization of the bony landmarks of the skull base; it is not, however, well suited for soft tissue imaging. Magnetic resonance imaging has better soft tissue resolution and may be the best initial study in patients seen early in life because the anterior skull base consists of an unossified cartilage and may falsely appear as if there is a bony dehiscence on computed tomography. A frontal craniotomy approach is recommended if intracranial extension is identified, followed by a transnasal endoscopic approach for intranasal glioma. A case is presented of a huge fetal facial mass that was shown by ultrasound that protruded through the left nostril at 33 weeks of gestation. Computed tomography of the neonate suggested a transethmoidal encephalocele. Magnetic resonance imaging showed a huge mass occupying the nasopharynx and the nasal cavity and protruding externally to the face but ruled out bony discontinuity in the skull base and, therefore, any intracranial connection. The infant underwent an endoscopic resection of the mass via oral and nasal routes and pathologic examination revealed intranasal glioma. (C) 2012 Elsevier Inc. All rights reserved.

Relationships between gender, age, family conditions, physical and mental health, and social isolation of elderly caregivers

Background: In an aging population an increasing number of elderly caregivers will be called upon to provide care over a long period, during which time they will be burdened both by caregiving and by the physiological effects of their own aging. Among them there will be more aged male caregivers, who will probably be less prepared than women to become caregivers. The aim of this study was to investigate the relationship between caregivers' gender, age, family income, living arrangements and social support as independent variables, and depressive symptoms, comorbidities, level of frailty, grip strength, walking speed and social isolation, as dependent variables. Methods: 176 elderly people (123 women) were selected from a sample of a population-based study on frailty (n = 900), who had cared for a spouse (79.3%) and/or parents (31.4%) in the past five years (mean age = 71.8 +/- 4.86 years; mean monthly family income in minimum wages = 4.64 +/- 5.14). The study used questionnaires and self-report scales, grip strength and walking speed tests. Results: 65% of participants evaluated caregiving as being very stressful. Univariate analyses of regression showed low family income as a risk factor for depression; being female and low perceived social support as a risk for comorbidities; being 80 years of age and above for low grip strength; and being male for social isolation indicated by discontinuity of activities and social roles. In multivariate analyses of regression, poverty arose as a risk factor for depression and being female for comorbidities. Conclusions: Gender roles, age, income and social support interacted with physical and emotional health, and with the continuity of social participation of elderly caregivers. Special attention must be given to male caregivers.

Enhancement of optical absorption by modulation of the oxygen flow of TiO2 films deposited by reactive sputtering

Oxygen-deficient TiO2 films with enhanced visible and near-infrared optical absorption have been deposited by reactive sputtering using a planar diode radio frequency magnetron configuration. It is observed that the increase in the absorption coefficient is more effective when the O-2 gas supply is periodically interrupted rather than by a decrease of the partial O-2 gas pressure in the deposition plasma. The optical absorption coefficient at 1.5 eV increases from about 1 x 10(2) cm(-1) to more than 4 x 10(3) cm(-1) as a result of the gas flow discontinuity. A red-shift of similar to 0.24 eV in the optical absorption edge is also observed. High resolution transmission electron microscopy with composition analysis shows that the films present a dense columnar morphology, with estimated mean column width of 40nm. Moreover, the interruptions of the O-2 gas flow do not produce detectable variations in the film composition along its growing direction. X-ray diffraction and micro-Raman experiments indicate the presence of the TiO2 anatase, rutile, and brookite phases. The anatase phase is dominant, with a slight increment of the rutile and brookite phases in films deposited under discontinued O-2 gas flow. The increase of optical absorption in the visible and near-infrared regions has been attributed to a high density of defects in the TiO2 films, which is consistent with density functional theory calculations that place oxygen-related vacancy states in the upper third of the optical bandgap. The electronic structure calculation results, along with the adopted deposition method and experimental data, have been used to propose a mechanism to explain the formation of the observed oxygen-related defects in TiO2 thin films. The observed increase in sub-bandgap absorption and the modeling of the corresponding changes in the electronic structure are potentially useful concerning the optimization of efficiency of the photocatalytic activity and the magnetic doping of TiO2 films. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4724334]

Morphological evidence of neurotoxicity in retina after methylmercury exposure

The visual system is particularly sensitive to methylmercury (MeHg) exposure and, therefore, provides a useful model for investigating the fundamental mechanisms that direct toxic effects. During a period of 70 days, adult of a freshwater fish species Hoplias malabaricus were fed with fish prey previously labeled with two different doses of methylmercury (0.075 and 0.75 mu g g(-1)) to determine the mercury distribution and morphological changes in the retina. Mercury deposits were found in the photoreceptor layer, in the inner plexiform layer and in the outer plexiform layer, demonstrating a dose-dependent bioaccumulation. The ultrastructure analysis of retina revealed a cellular deterioration in the photoreceptor layer, morphological changes in the inner and outer segments of rods, structural changes in the plasma membrane of rods and double cones, changes in the process of removal of membranous discs and a structural discontinuity. These results lead to the conclusion that methylmercury is able to cross the blood-retina barrier, accumulate in the cells and layers of retina and induce changes in photoreceptors of H. malabaricus even under subchronic exposure. (c) 2012 Elsevier Inc. All rights reserved.

Abandono ou descontinuidade do tratamento da tuberculose em Rio Branco, Acre

Esta pesquisa investiga os fatores que estão relacionados à descontinuidade do tratamento da tuberculose em Rio Branco-Acre e foi realizada com uma contribuição da etnografia para uma apreensão da realidade a ser estudada. Foi desenvolvida em duas etapas de mapeamento: na primeira, procedeu-se à busca de informações na base de dados do SINAN (Sistema de Notificação de Agravos Nacional) e na Coordenação Municipal do Programa de Tuberculose, a segunda etapa procurou registrar fatos a partir da observação do atendimento numa unidade de saúde que presta assistência aos portadores de tuberculose em tratamento, e entrevistas com eles, assim como de profissionais que prestavam assistência. Na análise das observações, coletas de narrativas e entrevistas, observou-se que os profissionais dos serviços de saúde caracterizam algumas pessoas como propícias a descontinuarem o tratamento e não consideram os diferentes modos de vida na abordagem de seus pacientes, dificultando, assim, a formação do vínculo e favorecendo a descontinuidade ou o abandono. Identificou-se também que as pessoas que faziam o tratamento da tuberculose tinham várias formas de lidar com as limitações que foram geradas pela doença, como a restrição para o trabalho, entre outras, e as pessoas que o descontinuaram levavam em consideração seu sistema de crenças e valores, bem como a própria percepção de saúde/doença, devido a estarem se sentindo curados quando o interromperam.