As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Uma Aplicação do Algoritmo QT Clustering para Marcação Colaborativa de Pontos Perigosos em Vias Públicas

This work proposes a collaborative system for marking dangerous points in the transport routes and generation of alerts to drivers. It consisted of a proximity warning system for a danger point that is fed by the driver via a mobile device equipped with GPS. The system will consolidate data provided by several different drivers and generate a set of points common to be used in the warning system. Although the application is designed to protect drivers, the data generated by it can serve as inputs for the responsible to improve signage and recovery of public roads

Conectores sequenciadores em artigos de opinião escritos por vestibulandos: uma questão de marcação linguístia com implicações para o ensino

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Dupla marcação p53/AgNOR em carcinoma epidermóide oral

The utilization of the immunohistochemical/histochemical double staining technique comes permitting the analysis of two molecular parameters at the same time in an even tissue. Starting from this, the objective of this study was to investigate the existence of differences between the number of NORS/NUCLEUS between p53 positive and p53 negative cells, as well as the existence of correlation between the medium of the NORs of the p53 positive and negative cells and the histological scores of maligninancy in 16 cases of oral squamous cell carcinoma. It was first classified in agreement with the histological grade system of maligninancy proposed by Bryne (1998) and the double staining technique immunohistochemistry/histochemistry was utilized for the achievement to quantify of the NORs in p53 positive and negative cells. It had not significant differences between the medium number of NORs of the p53 positive cells and of the p53 negative cells, and they were not correlated with the histological scores of malignancy. We conclude that the related phenotype to the p53 immunohistochemical expression did not influence the average of NORS/NUCLEUS and this medium, in both positive and negative cells, is not correlated with the degree of histological aggressivity of the oral squamous cell carcinoma

A prática do enfermeiro da atenção primária à saúde nas consultas ao paciente com tuberculose

This study aimed to analyze the practice of nurses regarding the development of the nursing process in the consultation to the patient with tuberculosis. This is a descriptive study with quantitative approach, performed with 60 nurses of the Primary units of the city of Natal, RN Health. The project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte. To collect data, we used a structured questionnaire, developed from the "Consultation of Nursing," the Nursing Protocol for the Treatment of Tuberculosis Directly Observed in Primary Care, Ministry of Health. The instrument was subjected to pre- -test and contained questions regarding the elements used by the nurse in consultation with the patient with tuberculosis and an open question about the feasibility of implementing the Nursing Process in Primary Health Care. data collection was conducted between September and October 2014, in health units work of each participant. Data were analyzed using SPSS 20. The answers to the open question were analyzed for themes and quantified for analysis. With respect to the elements of nursing process used in consultation with the patient with tuberculosis, were on the history of nursing at the expense of survey nursing diagnosis, action planning, implementation and evaluation. Step in the history of nursing, however, the actions were toward complaints and symptoms of the disease (100% of the nurses always investigating). Social and cultural aspects involved in for tuberculosis, as stigma and difficulties in routine work, were less addressed by nurses (43.3% never investigated suffering stigma; 46.7% sometimes investigating changes in the work routine patient ). The physical examination was focused on measuring patient weight (100% held). To the understanding of nurses on the implementation of the nursing process Primary Health Care, favorable factors were identified, such as that this implementation can promote greater scientific basis for nursing (36.7%); and hindering aspects, such as the understanding that Primary Health Care is pervaded by bureaucratic issues and high demand (13.3%). Be established in consultation with the nurse fragmentations, since elements as identification of nursing diagnoses, action planning and evaluation were not made in full by the professionals. Highlights the need for continuing education for nurses who are included in Primary Health Care, seeking to maximize the autonomy of these professionals in developing a practice grounded in scientific knowledge

A rede de marcação e recaptura: o caso de borboletas do gênero heliconius

(The Mark and Recapture Network: a Heliconius case study). The current pace of habitat destruction, especially in tropical landscapes, has increased the need for understanding minimum patch requirements and patch distance as tools for conserving species in forest remnants. Mark recapture and tagging studies have been instrumental in providing parameters for functional models. Because of their popularity, ease of manipulation and well known biology, butterflies have become model in studies of spatial structure. Yet, most studies on butterflies movement have focused on temperate species that live in open habitats, in which forest patches are barrier to movement. This study aimed to view and review data from mark-recapture as a network in two species of butterfly (Heliconius erato and Heliconius melpomene). A work of marking and recapture of the species was carried out in an Atlantic forest reserve located about 20km from the city of Natal (RN). Mark recapture studies were conducted in 3 weekly visits during January-February and July-August in 2007 and 2008. Captures were more common in two sections of the dirt road, with minimal collection in the forest trail. The spatial spread of captures was similar in the two species. Yet, distances between recaptures seem to be greater for Heliconius erato than for Heliconius melpomene. In addition, the erato network is more disconnected, suggesting that this specie has shorter traveling patches. Moving on to the network, both species have similar number of links (N) and unweighed vertices (L). However, melpomene has a weighed network 50% more connections than erato. These network metrics suggest that erato has more compartmentalized network and restricted movement than melpomene. Thus, erato has a larger number of disconnected components, nC, in the network, and a smaller network diameter. The frequency distribution of network connectivity for both species was better explained by a Power-law than by a random, Poissom distribution, showing that the Power-law provides a better fit than the Poisson for both species. Moreover, the Powerlaw erato is much better adjusted than in melpomene, which should be linked to the small movements that erato makes in the network

Análise da indexação da Biblioteca Setorial de Química da Universidade Federal do Rio Grande do Norte através de um estudo informétrico

Analisa a indexação dos documentos da Biblioteca Setorial de Química através de um estudo informétrico na ferramenta de busca do Sistema de Bibliotecas (SISBI) da Universidade Federal do Rio Grande do Norte (UFRN). Descreve um estudo informétrico realizado na ferramenta de busca do SISBI da UFRN, sendo feita direcionada para os documentos Biblioteca Setorial de Química. Enfoca a importância do estudo informétrico para analisar a recuperação da informação relacionada à indexação. Aborda a relação da informetria com a indexação e recuperação da informação com o intuito de que o profissional bibliotecário seja mais analítico e tenha uma compreensão maior do campo da ciência da informação. Utiliza de uma metodologia de consultas de assuntos pré-definidos, sendo feita uma filtragem de forma quantitativa com o objetivo de verificar se a indexação dos documentos está sendo satisfatória para a recuperação da informação na ferramenta de busca do SISBI. Constata a relevância dos documentos em cada busca sua precisão e revocação, mostrando que para haver uma boa recuperação da informação tem que a indexação seja feita de forma que não haja ambiguidade com outros termos, com isso mostra a importância de sempre ser feito um estudo informétrico com que verifique a recuperação da informação para que possa sempre haver uma melhora na mesma.

A cidade-jardim de Ebenezer Howard: um estudo de sua influência para a circulação de ideias e modelos no urbanismo do século XX

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fucana ativa via das Map quinases e inibe a proliferação de células de ovário de hamster chinês (CHO)

Fucan is a term used to denominate L-fucose rich sulfated polysaccharides. The fucans have been studied due their pharmacological activities like antithrombotic, antiproliferative and antioxidant. We have extracted three fucan fractions from the brown seaweed Spatoglossum schröederi. These fucans were denominated Fuc B 1, Fuc B 1.5 and Fuc B 2. The chemical analyzes show that the fucans have very similar composition as demonstrated by agarose electrophoresis gel, sugar and sulfate content. The antiproliferative effect was determined by MTT and BrdU methodologies in CHO cells. The inhibition of proliferation effect of the three fractions was about 40%. Therefore this we proceed just with the Fuc B 2 due the higher yield. There is no apoptosis indication using the anexin V/propidium iodide test. We found a cell cycle phase G1 arrest. The western blotting show that the PKC; pFAK; pERK 1/2 are activated when the cells were treated with fucans. The treatement with inhibitor of MAPK PD98059 extinguished the fucan effect. These results indicates that fucan act by the ERK pathway inducing the cell death.

Efeitos biológicos in vitro de agentes físicos utilizados em fisioterapia

The uses of radiobiocomplexes labeled with technetium-99m contributed to health science advances. Stannous chloride (SnCl2) has been used as a reducing agent for the labeling process. Cytotoxic and genotoxic effect of the SnCl2 have been described in several studies and with this experimental models alterations in molecular and cellular level can be evaluated. In the last years the physicals therapists acquired new devices which emits electromagnetic radiation such us Extremely Low Frequency Pulsated Electromagnetic Fields (E.L.F. P.E.M.F.), radiofrequency, Intense Pulsed Light (I.P.L.) and others which emits sonic waves such us Biorresonance. Scientific evidence of the effects and dosage is important to protect public health and to reach exposition levels that result in significant biological effects. The aim of this project is to verify the effects of these physical agents in plasmid DNA and E. coli AB1157 cultures in presence or absence of SnCl2 and the effects in blood constituents labeled with technetium-99m. Wistar rats blood was exposed to the cited sources and the labelling of blood constituents with 99mTc was carried through. Cultures of E. coli AB1157 and plasmidial samples DNA had been also exposed the physical agents. The results suggest that these agents are capable of altering neither the survival of E. coli cells or plasmid DNA electrophoresis mobility. The multidiscipline character was clearly in this study due the interaction between Nuclear Medicine department of the UERJ and the Laboratory of Physical Agents of the Maimonides University in Argentina until the union between the teacher (biomedical and physiotherapist) and student (physiotherapist), besides collaborators of the area of Physics and Biology, promoting new ideas and perspectives and also adding the knowledge of different areas and origins

Comparação de efeitos dos extratos de Hypericum perforatum (Hipérico) e de Mentha crispa (Hortelã) em diferentes modelos experiemtais

Several clinic evaluations have been possible with radiobiocomplexes labeled with technetium-99m (99mTc). Some natural and synthetic drugs are capable of to interfere on the labeling of blood constituents with 99mTc, as well as on the biodistribution of radiobiocomplexes. Authors have also reported about the toxicity of several natural products. The aim of this study was to compare the effects of the Mentha crispa (hortelã) and of the Hypericum perforatum (hipérico) in different experimental models. On the labeling of red blood cells (RBC) and plasma and cellular proteins with 99mTc, both extracts were capable of to decrease the radioactivity percentage on the cellular compartment and on the fixation on plasma and cellular proteins. On the morphometry of the RBC, only the hortelã was capable to alter the shape and the perimeter/area ratio of the RBC. On the biodistribution of the radiobiocomplex sodium pertechnetate (Na99mTcO4), the hortelã increased the Na99mTcO4 distribution in the kidney, spleen, liver and thyroid, meanwhile the hipérico decreased the Na99mTcO4 distribution in the bone, stomach, lungs and thyroid, and increased the Na99mTcO4 distribution in the pancreas. On the bacterial cultures survival, the hipérico was capable of to protect the bacteria against the stannous chloride (SnCl2) effect. The hipérico did not alter the topology of plasmidial DNA and did not protect the plasmidial DNA against the SnCl2 action. Probably, the effects presented by both extracts could be due to chemical compounds of the extracts that could alter the morphology of the RBC and the plasma membrane ions transport, and/or by phytocomplexes that could be formed with different effects dependent on the biological system considered

Avaliação de efeitos biológicos de antiinflamatórios derivados do ácido propiônico através de modelos experimentais em nível molecular e celular

Derivatives of propionic acid NSAIDs are irreversible inhibitors of cyclooxygenase enzyme widely used. The aim of this study was to evaluate, through different experimental models, biological effects of derivatives of propionic acid (fenoprofen, naproxen, ibuprofen and ketoprofen) in cellular and molecular level. The labeling of blood constituents with technetium-99m (99mTc) and morphological analysis of erythrocytes of blood of rats, as well as growth, survival of cultures of Escherichia coli (E. coli) and the assessment of bacterial plasmid electrophoretic profiles were models used for experimental evaluation of possible biological effects of antiinflammatory drugs. The results show that, in general, anti-inflammatory drugs evaluated were not able to alter the labeling of blood constituents with 99mTc, the morphology of red blood cells from blood of rats, as well as the growth of cultures of E. coli and the electrophoretic profile of plasmid DNA. However, naproxen appears to cytotoxic effect on bacterial cultures, plasmids and genotoxic effects in reducing the action of stannous chloride in cultures of E. coli. The use of experimental fast performance and low cost was important for assessment of biological effects, contributing to a better understanding of the properties of propionic acid derivatives studied. anti-inflammatory, blood constituents, technetium-99m, stannous chloride, Escherichia coli; DNA

Avaliação de efeitos de um extrato de "três bailarinas" em modelos experimentais em diferentes níveis de organização biológica

Drogas naturais ou sintéticas podem ser capazes de alterar a sobrevivência de culturas bacterianas, interferir na marcação de estruturas sanguíneas com tecnécio- 99m (99mTc) e alterar a morfologia das hemácias. De acordo com as instruções do fabricante, a formula denominada de Três Bailarinas (TB) é sugerida para ser usada, como bebida, por pessoas que desejam ajustar o peso sem dieta. Os ingredientes dessa fórmula são a Cassia angustifolia e a Malva verticellate. Informações cientificas sobre TB não foram encontradas no indexador PubMed, e esse fato tem estimulado nossas investigações sobre seus efeitos biológicos. O objetivo deste estudo foi avaliar, em diferentes modelos experimentais, o efeito de um extrato aquoso de Três Bailarinas: (i) na sobrevivência de culturas de E. coli AB1157, ii) efeito do SnCl2 em culturas bacterianas, iii) na marcação das hemácias e proteínas plasmáticas e celulares com 99mTc e iv) na morfologia de hemácias de sangue de ratos Wistar. Os resultados encontrados demonstram que o extrato de TB não alterou a sobrevivência de cultura de E. coli AB1157 e aboliu o efeito letal do SnCl2 na sobrevivência dessa cultura bacteriana. Na marcação de estruturas sangüíneas com 99mTc o extrato de TB reduziu a percentagem de atividade (%ATI) referente ao 99mTc no compartimento celular e nas proteínas plasmáticas, mas não alterou a %ATI nas proteínas celulares. O extrato de TB não foi capaz de alterar a morfologia das hemácias. Os modelos experimentais realizados mostram a importância dos mesmos na avaliação de efeitos biológicos de agentes químicos, e contribui para um melhor entendimento das propriedades do extrato de Três Bailarinas. Esse trabalho abrange varias áreas do conhecimento, tais como: radiobiologia, botânica, fitoterapia e hematologia

Consequências da colectomia associada à hepatectomia no metabolismo hepático e na forma e função de hemácias em ratos

This study investigated the influence of partial colectomy associated with hepatectomy on the biodistribution of the 99mTc-phytate, on metabolic parameters, as well as labeling and morphology of red blood cells. Wistar rats were distributed into three groups (each with 6), nominated as colectomy, colectomy+hepatectomy and sham. In the 30th postoperative day all rats were injected with 99mTc-phytate 0.1mL i.v. (radioactivity 0.66 MBq). After 15 minutes, liver sample was harvested and weighed. Percentage radioactivity per gram of tissue (%ATI/g) was determined using an automatic gamma-counter. Serum AST, ALT, alkaline phosphatase and red blood cells labeling were determined. The liver %ATI/g and red blood cells labeling were lower in colectomy and colectomy+hepatectomy rats than in sham rats (p <0.05), and no difference was detected comparing the colectomy and colectomy+hepatectomy groups. Red blood cells morphology did not differ among groups. Serum levels of AST, ALT and alkaline fosfatase were significantly higher in colectomy+hepatectomy than in colectomy rats (p<0.001). Hepatectomy associated with colectomy lowered the uptake of radiopharmaceutical in liver and in red blood cells in rats, coinciding with changes in liver enzymatic activity

Avaliação dos marcadores celulares por citometria de fluxo nos portadores de leucemia mieloide aguda atendidos no Hemocentro do Rio Grande do Norte-Hemonorte

The acute myeloid leukemia (AML) is a disease in which malignant myeloblasts expand, build up and suppress normal hematopoietic activity would represent a major diagnostic challenge. With the advent of immunophenotyping by flow cytometry, the diagnosis of these tumors have become more faithful, facilitating the treatment and monitoring of patients. The objectives of this study: diagnosis and classification of AML based on immunophenotyping by flow cytometry with a panel of AcMo specific for acute leukemias, set the frequency of AML in samples from patients with acute leukemias sent to the Department of Hematology Blood Center of Rio Grande do Norte - HEMONORTE, establish standards of antigen expression for different subtypes of acute leukemia and its correlation with the newly diagnosed cases refractory to treatment and recurrence of the disease, standardization of methods for detection and labeling of surface antigens by flow cytometry and intracytoplasmic flow, and observe the frequency of acute leukemia with aberrant phenotypes rare. During the study, 351 were diagnosed acute leukemia, and 179 (51%) classified as AML and 172 (49%) and ALL, which were excluded from the present work. Of the 179 AML, 92 (51.4%) were female and 87 (48.6%) were male, with ages ranging from 3 to 95 years of ag, with higher incidence in individuals in the age group of 41 to 65. Splenomegaly was the clinical finding more present, a total of 147 cases (82.1%), followed by hepatomegaly present in 132 cases (73.7%). The hemorrhagic events were observed in 55 cases (30.7%). Lymphadenopathy in turn was detected in 20 of 179 cases (11.2%). In order to classify subtypes of AML, we used a large panel of monoclonal antibodies, obtaining the following results: AML M0, 02 (1.1%) AML M1, 40 (22.3) AML M2, 60 (33.5) AML M3, 22 (12.3%) AML M4, 10 (5.6) AML M5, 13 (7.3%) AML M6 06 (3.4%) and AML M7 01 (0.6%). We observed some cases with aberrant expression of some antigens such as CD7, CD4, CD19, CD3, CD5 and TdT, CD 7 was present in 30 (16.8%), CD4 in 5 (2.8%), the CD 3 in 5 (2.8%), the CD19 in 3 (1.7%), the CD5 in 3 (1.7%) and TDT was in 7 (3.9%) cases of AML .the CD8 and CD79a was present in only a 1 case.