Valores de referência para cobre e zinco no plasma e no eritrócito em adultos universitários na cidade de Natal-RN

This study aimed builds reference values for copper and zinc, of healthy adults in Natal-RN, and to identify the influence of the gender, age, body mass index (BMI) and diet, on those values. They were assessed 123 healthy students of the Universidade Federal do Rio Grande do Norte (UFRN), both genders, with age between 19 and 41 years. The project was approved by the Ethics Committee in Research of UFRN. BMI was determined and the food consume was accomplished through a 24h recordatory. Dietary was evaluated as the energy, macronutrients, copper and zinc, according to the recommendations of National Academy of Sciences (2001; 2002). Analyses of the copper and zinc concentrations in the plasma and erythrocytes were accomplished by flame atomic absorption spectrometry. The casuistic came quite homogeneous as for the distribution for gender and age, being the largest number of individuals between the 19 and 24 years old. Most of the volunteers presented anthropometric nutritional state inside of the normality patterns. Chronic diseases family antecedents and sedentarysm were observed. Diet was characterized with low consumption of zinc, appropriate of copper and of lipids. Average concentrations of plasma copper (p=0,002), erythrocyte copper (μg/dL, p=0,036; μg/gHb, p=0,038), and plasma zinc (p=0,022) were different among the genders, what was demonstrated by the largest values of copper in the female gender and larger of zinc in the masculine. Plasma copper values still suffered interference of the variables: energy, carbohydrate and copper consumption, all classified in agreement with the median, besides the protein classified according to the percentage contribution for the dietary total energy. The study allowed to establish reference values for erythrocyte zinc (1.261,6-1.344,0 μg/dL e 51,0-54,3 μg/gHb) and to suggest "indicative" of reference values for plasma (108,4 130,2 μg/dL) and erythrocyte (female = 85,0 91,4 μg/dL; masculine = 80,2 86,5 μg/dL) copper and plasma zinc (female = 98,8 105,8 μg/dL; masculine = 104,6 111,6 μg/dL)

Associação do receptor toll-like 2 com o estado pró-inflamatório do diabetes tipo 1

Inflammation has been pointed out as an important factor in development of chronic diseases, as diabetes. Hyperglycemia condition would be responsible by toll-like receptors, TLR2 and TLR4, and, consequently by local and systemic inflammation induction. Thus, the objective of present study was to evaluate type 1 Diabetes mellitus (T1DM) pro-inflammatory state through mRNA expression of TLRs 2 and 4 and proinflammatory cytokines IL-1β, IL-6 and TNF-α correlating to diabetic nephropathy. In order to achieve this objective, 76 T1DM patients and 100 normoglycemic (NG) subjects aged between 6 and 20 years were evaluated. T1DM subjects were evaluated as a total group DM1, and considering glycemic control (good glycemic control DM1G, and poor glycemic control DM1P) and considering time of diagnosis (before achieving 5 years of diagnosis DM1< 5yrs, and after achieving 5 years of diagnosis DM1 <5yrs). Metabolic control was evaluated by glucose and glycated hemoglobin concentrations; to assess renal function serum urea, creatinine, albumin, total protein and urinary albumin-to-creatinine ratio were determined and to evaluate hepatic function, AST and ALT serum activities were measured. Pro-inflammatory status was assessed by mRNA expression of TLRs 2 and 4 and the inflammatory cytokines IL-1β, IL-6 and TNF-α. Except for DM1G group (18.4%), DM1NC patients (81.6%) showed a poor glycemic control, with glycated hemoglobin (11,2%) and serum glucose (225,5 md/dL) concentrations significantly increased in relation to NG group (glucose: 76,5mg/dL and glycated hemoglobin: 6,9%). Significantly enhanced values of urea (20%) and ACR (20,8%) and diminished concentrations of albumin (5,7%) and total protein (13,6%) were found in T1DM patients, mainly associated to a poor glycemic control (DM1P increased values of urea: 20% and ACR:49%, and diminished of albumin: 13,6% and total protein:13,6%) and longer disease duration (DM1 <5yrs - increased values of urea: 20% and ACR:20,8%, and diminished of albumin: 14,3% and total protein:13,6%). As regarding pro-inflammatory status evaluation, significantly increased mRNA expressions were presented for TLR2 (37,5%), IL-1β (43%), IL-6 (44,4%) and TNF-α (15,6%) in T1DM patients in comparison to NG, mainly associated to DM1P (poor glycemic control TLR2: 82%, IL-1β: 36,8% increase) and DM1 <5yrs (longer time of diagnosis TLR2: 85,4%, IL-1β: 46,5% increased) groups. Results support the existence of an inflammatory state mediated by an increased expression of TLR2 and pro-inflammatory cytokines IL-1β, IL-6 and TNF-α in T1DM

Emprego da citometria de fluxo na avaliação do perfil imunofenotípico de pacientes com leucemia linfocítica crônica

Chronic lymphocytic leukemia (B-CLL) is a clonal proliferation of mature B lymphocytes characterized by indolent clinical course. Biologically this clonallity is characterized by low expression of surface immunoglobulin (sIg) with restriction to a single immunoglobulin light chain associated with high expression of CD5 antigen and positivity to B cell antigens lymphocytes such as CD19, CD20 and CD23 and negativity to FMC7. The immunological profile and morphological analysis of lymphoid cells are the main means for the differential diagnosis of B-CLL from other chronic lymphoproliferative diseases. The aim of this study was to evaluate the expression pattern of a variety of membrane antigens in leukemic cells originating from patients with B-CLL. In this study, peripheral blood samples from 80 patients with B-CLL were analyzed by multiparametric flow cytometry in addition to routine hematologic exams, using a panel of monoclonal antibodies (MoAb): CD45/CD14, CD3/CD19/CD45, CD4/CD8 / CD3, CD20/CD5/CD3, CD3/CD16-56/CD45, CD2/CD7, FMC7/CD23, CD103/CD22/CD20, HLADR/CD38, CD10/CD19, CD1a, CD11b and also IgM/gD, kappa and lambda immunoglobulin light chains for the detection of surface immunoglobulin and clonal restriction for immunoglobulin light chain. The Hematological data were obtained from the hematological analyzer and cytomorphological analysis in blood film stained by Leishmann. The study samples consisted of 45 men and 35 women, ages ranging from 55 to 84 years (mean 65 years). Complete white blood count showed count ranging from 10.0 to 42.0 x 109/l. (mean 50.0 x 109/l) and lymphocytes count greater than 5.0 x 109/l in all cases. The neoplastic cells displayed B-CLL phenotype (CD5+/CD19+/CD20+/HLADR+/CD23+) in the vast majority of the cases, associated to failed to stain for T cell markers (CD1a, CD2, CD4, CD3, CD7, CD8), CD103, CD14 and FMC7. Leukemic cells of most patients also expressed low intensity of IgM and IgD with restricted kappa light chain, in most cases (59,7%). This observation highlights the importance of immunophenotyping for correct diagnosis of chronic lymphoproliferative syndromes and the panel of MoAb used was sufficient for diagnostic confirmation of B-CLL

Avaliação da presença de osteopatia decorremte do diabetes tipo 1 em criança e adolecentes do Rio Grande do Norte

Diabetes Mellitus (DM) and osteoposes are chronic diseases with great socioeconomic consequences, mainly due to the late complications and consequent disabilities. The potential effects of DM on bone metabolism remain a very conroversial issue, and disagreement exists with regard to the clinical implications of diabetic osteopenia and the mechanism of its ocurrence. The issue is further complicated by the contribuicion of the especific factors, such as duration of disease an dthe degree of metabolic control. The objective of this study is to identify the osteopathy in children and adolescents with DM 1 assisted in the hospital of pediatrics, UFRN, through biochemical markers of bone and mineral metabolism and the extent of bone mineral density. The study was composed by 74 diabetics type 1 patients (DM1) of both gender and aged 6 to 20 yars. Normoglicêmic group was composed by 97 healthy subjects of both genders, which showed the same age range of DM1, in addition to same socioeconomic class. These individuals qere students from the networks of public education in the city of Natal-RN, randomly invited to paticipate in our study. Both groups DM1 and NG were divided intofour subgroups, according to the classification of tanner , T1, T2, T3, T4 for achieving a benchmark. Diabetic individuals showed up with a poor glycemic control. the group DN1 T4 showed an incresead value for total protein, albumin, urea and microalbumiuria are predictors of grumelura injury in DM1 patients . The total alkaline phosphatase activitywas kept on high levels for both groups because they are in a stature development age. For osteocalcin there were decreased levels for groups Dm1 T1, T2, and T3 when compared to their NG (s), suggesting that this decrease could be associated with reduction in the number and/or differentiation os osteoblasts thereby contributing to reducing bone formation. There were no changes in the activity of TRAP. The serum concentrations of total and ionized calcium, phosphorus and magnesium were included within the RV. It was observed that the BMD (Z- SCORE ) has always been within the RV for both groups, despite to DM1 T4. Taking all together, our results support the hypothesis that children and adolescents with type 1 DM present the risk in the long run to suffer a reduction in the bone mass, associated to poor glicemic control and disease duration. It could limit the bone growth and increase the probality of development of osteopenia, as well as other complications surch as retinopathy and renal failure

A transformação da Associação de Professores do Rio Grande do Norte (APRN) em Sindicato dos Trabalhadores em Educação (1986-1990)

El estudo que ahora apresentamos habla a respecto ala transformaçión de la Asociación de maestros del Rio Grande del Norte (APRN en sindicato de los trabajadores en educación (SINTE) en el período de 1986 1990. Tratase basicamiente de las razones que llebaran historicamente la APRN la reorganizar sus luchas, su cultura política y el su movimiento reivindicatório; que impulsionaran la construción del próprio sindicato el único de la categoria, após el regime militar em el país especialmente en el gobierno Sarney, y en el ánbito estadual com la resistência la política econômica y la repreción policial del gobierno Geraldo Melo, la época. El estudo también apunta algunas caraterísticas marcantes del contexto histórico de la educación nacional, enfatizando la asención de la escuela nueva en el Brasil en las décadas de 1920 y 1930, inclusive delante del movimiento sindical, controlado por el gobierno Vargas que tênia uma praetica corporativista. Es importante decir que esas características estavan juntas del contexto local, en el rato en que se percebia la primer gestan del prof Anfilóquio Cámara, como el primer presidente de la APRN, al partir de la su fundación (1920), y que tênia um relacionamento bastante estrecho com el poder público estadual de caráter liberal. Habia una discución sobre la abertura política y la atuación política de las clases médias brasileñas ya em 1979, y al mismo tiempo analisabase el desencandeamiento del nuevo sindicalismo en el ABC Paulista, mientras uno movimiento sindical, autônomo y democrático que tênia el objetivo de juntar lãs luchas de los operários dentro y fuera de las fábricas reivindicando basicamiente: la redución de la jornada del trabajo, reajuste de sueldo y condición del trabajo, bien como lãs sus consecuencias para el movimiento de los educadores potigurares. Al hacer en septembre de 1989, el sindicato de los trabajadores en educación del Rio Grande del Norte se desvincula definitivamiente de uma estructura sindical vertical (tradicional), que la ex-APRN herdo al longo de su História del gobierno Vargas, siempre controlada pelo Estado y que en las décadas de 1980 y 1990 fue fortalecido por la CNTE (Confederación Nacional de los Trabajadores en la, educación), principalmente, a partir del Congreso Nacional de Unificación de los Trabajadores en la Educación, realizado en Aracaju/SE em el período de 25 a 28 de enero de 1990 en el sentido tambien de las sus principais reivindicaciones: escuela pública, gratuita y de cualidades en todos los pasos, verbas públicas solamiente para las escuelas públicas, reposición de los reajustes de sueldo, condición del trabajo, sueldo unificado nacional y la eradicación del analfabetismo

Narrativas do Brasil nas memórias de Pedro Nava

This thesis is a translation of work of the Brazilian doctor, Pedro da Silva Nava (1903-1984), in particular, his memoirs and chronicles, articulated with the writings of medicine history, aiming to defend that the autobiographical narratives are sources of research capable of promoting discussions on the expansion of the present at the confluence of complex and unequal society in constant changing process as the Brazilian. The theoretical and methodological support circulates around studies, proposals and thesis by Boaventura Santos about empowering past, destabilizing subjectivity, sociology of absences, cosmopolitan reason and translation work. The empirical support drawn from the literature produced by Nava were analyzed with reference this reasoning and studies that have facilitated the flow of translation among others, the studies of Antonio Candido, Arrigucci Jr., Boris Cyrulnik, Beatriz Sarlo, Ecléa Bosi, Ítalo Calvino, José Willington Germano, José Maria Cançado, Lev Vygotsky, Marilena Chauí, Paul Ricöeur and Walter Benjamim, without neglecting what we consider indispensable to scientific research, the production of relevant knowledge and prudent, in view of a decent life. The initial inflections reflect the subject of the Memoirs and its education/training, to then place the Memoir subject in the literary context, scientific, historical and Brazilian poetic (1972-2010), bringing great interpreters and discussing the rationale used by the Narrator that we defend stand closer to the cosmopolitan, showing the formation of narratives whose presence insert itself beforehand to modernist verve, linked to the discursive array against the literature as domination space, disseminated in Brazil in the early twentieth century. So, it articulate with those in which the concerns adjust the construction of the social formation of Brazil as a national heritage through literary narrative that focuses on a historical principle that becomes the past empowering, allowing his rereading, whose converge to memory, the lifestyles, the plurality of language and Brazilian culture, formed by several people, converging into a design not of culture but multiculturalism in Brazil. The memory issue was addressed in the space-time of experiences of being that narrates, shaped by a destabilizing subjectivity that sought to order the testimony of a time, a history and society, retelling them by creative imagination, almost fictional, to make circulate his knowledge about Brazil attached to his medical knowledge, as well as other subjects in his living group and other groups with whom they maintained contact. Thus, he portrayed both tangible and intangible cultural assets of the country as a form of preservation, giving them meanings and sense. It approaches, therefore, from the perspective of sociology of absences, the expansion of the present and by the logic inherent in his narratives of self and Brazil

Jornalismo, literatura e sociedade em Lima Barreto

This work has as objective approaches the relationship among journalism, literature and society in Lima Barreto, especially in fiction book Recordações do escrivão Isaías Caminha and in several of their chronicles, detecting the superficiality notion that author sees in the journalistic activity and to point that the literature brings the particularity of presenting as an alive laboratory for the social sciences. The used theoretical-methodological elements draw a corpus through an interactive process in which additional layers of the author's texts are submitted to the analysis. As theoretical support is worked the notion of magmas of social significances, idealized by Cornelius Castoriadis

Atrás das grades: redes sociais, habitus e interação social no sistema carcerário do RN

Esta tesis trata de discutir y entender los diversos tipos de redes sociales y formas de interacción social presentes en el sistema penitenciario de Rio Grande do Norte. Nuestro problema se basa en un incremento significativo en las tasas de encarcelamiento y la prisión en Brasil y el mundo en los últimos diez años. Asimismo, la aparición del crimen organizado ya, en cierta medida, el control de las prisiones brasileñas, como el Comando Vermelho (CV) y el Primeiro Comando da Capital (PCC), una consecuencia directa de las terribles condiciones de las prisiones de Brasil y aumento de la violencia y el crimen en nuestro país. Para resolver el problema, se optó por utilizar las categorías de análisis de Michel Foucault (prisión y la disciplina), Pierre Bourdieu (habitus y campo), Ervirng Goffman (institución total, de interacción, de fachada y de equipo) y Mark Granovetter, Ricardo Abramovay e João Peixoto, entre otros, la nueva sociología económica (Redes, nodos y lazos) como principal apoyo. También construyó una revisión histórica de la cárcel en Brasil y Rio Grande do Norte hasta llegar al objeto. Esto, en términos de investigación cualitativa, se sumergió en el mundo de las prisiones Dr. Francisco Nogueira Fernandes, conocido como Penitenciario de Alcaçuz, ubicado en el municipio de Nísia Bosque, Rio Grande do Norte. Penitenciaría del Estado de origen, las casas de Alcaçuz seiscientos cuarenta y tres reclusos, divididos en cinco pabellones, un total de ciento cuarenta y siete células. Mediante la observación sistemática y la entrevista cualitativa s semi-estructurada como las principales fuentes de recopilación de datos, hemos tratado de explicar el universo que acabamos de analizar por las Ciencias Sociales. Nos dimos cuenta de que, para cumplir con la escena nacional, regaliz viola de manera flagrante lo que se denomina en la Constitución de 1988 y LEP (Ley de Ejecución Penal), sin tener en cuenta los derechos de los individuos a una porción de una oración con un mínimo de dignidad. Se ha demostrado que las personas que permean el universo proviene de un ambiente de la prisión, la sociabilidad violenta, sedo también tienen un habitus precario. La prisión, espacio disciplinario y un tipo específico de interacción social marcada por el control, contribuye a la profundización de habitus, pero que muestra que no es también como un espacio cerrado en absoluto, sino un lugar donde penetran las redes y dinámicas muy social. Al mismo tiempo, se encontró que más de la presencia de "grupos organizados" es el espacio en las cárceles para la interacción social y las redes sociales que pasan dentro y fuera de su espacio

A educação da mulher em Lima Barreto

Lima Barreto has built an educational conception of women in his fictional productions despite nuances inciting scholars to debate his writings and label him as misogynist and philogynist. Thus, the objective of this study is to comprehend, through signs present in his literary works, how women used to be educated in early twentieth century to accomplish the historical differences in gender relations. The main reason for this extract is the periodicity of his publications that started in 1900 by means of chronicles in newspapers and ended in 1922 after his death. For this, we identified codes and rules forged in the social processes to be assimilated by children through diverse institutions, aiming to incite the production of behaviors and social practices represented by the existence men and women in an ever changing society. Gender relations are analyzed within a society for their configuration concept by Nobert Elias (1970) as interdependence bonds among individuals. An investigative method proposed by Ginzburg (1989) was the most adequate to conduct the research on the work of Lima Barreto because it enables us to reconstruct the education concept for women. The dramas and novels analyzed point out the construction of categories such as women education, family, love and seduction revealing the engagement of Lima Barreto with the social problems of the period investigated. It was concluded that gender differentiation has come from family education which kept men and women in opposing sides giving them a marriage perspective that, after consummated, would bring frustration to women causing them to adopt confronting practices against domination strategies through celibacy or adultery. This research constitutes a reflection based on determined representations like justice, respect and duties that were the ideas defended by Lima Barreto in his writings, concerning both broader situations in social life and particular gender relations

Palmyra Wanderley e a educação da mulher no cenário Norte-rio-grandense (1914 -1920)

The present work has the intention to analyze the contribution of the writer and journalist Palmyra Guimarães Wanderley to the education, throughout her writings in the period between 1914 to 1920. I search through her journalist writings produced in the feminine magazine Via Láctea (1914-1915) her idealization, and as in the newspaper A República e Diário de Natal, in the decade of 1920 establishing relationships with education, mostly because of her production in the pages of the paper articles regarding feminine education and women condition. At the same time I sketch the biographic profile of Palmyra Wanderley relating her to the historical moment that she lived. To achieve the proposed goals I begin with a documental research within the available archives and use other sources like pictures and interviews with her relatives. The results of the research show that the worry of Palmira Wanderley with the education in our state, goes beyond her published writings in magazines and newspapers. She has been ahead of Escola de Comércio Feminino and Aliança Feminina, she has also done a conference in the House of the Young Single Ladies' Protection (Casa de Proteção às Moças Solteiras), institution of the Aliança s responsibility that offered shelter, food, formal and religious education to the workers of the Fabric Factory of Natal (Fábrica Tecidos de Natal). Her involvement evidences her contribution to the historiography of the education in Rio Grande do Norte, specially the history of women education ensuring her presence in the day by day history

O ensino de portugês para crianças estrangeiras: reflexões sobre um fazer docente.

La presencia de personas extranjeras radicadas en la província de Rio Grande del Norte trae a la escuela el desafio de recibir alumnos hablantes de otros idiomas. En esa perspectiva, el estudio tiene como objetivo investigar la practica pedagógica desarrollada por una profesora de Pipa - RN, con destaque en la enseñanza de Portugués para niños inmigrantes en la Enseñanza Fundamental. Esa temática se hace relevante al proponer posibles alternativas para el desarrollo de una acción docente reflexiva y mediatizadora de la enseñanza de una língua segunda. Para la concretización de este trabajo disertativo, se há realizado un estudio de caso de tipo etnográfico y de naturaleza qualitativa en una institución privada de la playa de Pipa - RN, en el período de noviembre de 2007 a agosto de 2008. Se há utilizado como procedimientos, la observación participante, la entrevista semiestruturada gravadaen áudio, la análise documental, el registro en diário de campo y el registro fotográfico. Se há elegido como referencial teórico las discusiones de Almeida Filho (1992, 1997, 2002, 2005), Cunha (1999, 2002), Freire (1996, 2004), Moita Lopes (1996), Vygotsky (1998), Wachowicz (1995) y Zabala (1998). La análise revela que, aunque la profesora observada no tenga conocimientos específicos sobre la enseñanza de PL2 en la escuela regular, su acción educativa há demonstrado avanzos, especialmente, al considerar los aprendizes como sujetos del processo de enseñanza aprendizaje, entre ellos los niños extranjeros; contemplar la identidad y las diferencias culturales y linguísticas de estos educandos; incluyese el aspecto lúdico en la preparación de las actividades; articular vínculos sociales, afectivos y cognitivos, entre otros aspectos destacados. Sin embargo, evidenciase la necesidad de una formación pedagógica específica para el trabajo con niños inmigrantes, a través de la interlocución entre los currículuns de los cursos de Filología y Pedagogia de las Universidades brasileñas, a partir del cual estudios y debates podran ser fomentados en la busqueda por uma enseñanza de PL2 verdaderamente comunicativo y democrático.

Narrativas infantis: o que nos contam as crianças de suas experiências no hospital e na classe hospitalar

This dissertation focuses on the narratives of children hospitalized with chronic diseases. The overall goal is to deduce, from the look of the child health care, hospital class contributions to the process of school inclusion. The research is part of the qualitative ethnographical approach and is based on the principles and research methods (auto)biographical in education and schooling in hospital. Participated in the investigation 05(five) children, aged between 06 (six) and 12 (twelve) years of age, treated at the Center for Children s Onco-Hematology, Varela Santiago Children s Hospital in Natal-RN. The corpus used for the analysis comprises five (05) narrative interviews, 03 (three) drawings made by children as well as records in the researcher s field diary. The sources were collected during the months of August 2010 to February 2011. The analysis revealed that the inclusion of the hospital class, and ensure the right to education, contributes to the construction of strategies for coping with illness and hospitalization, as it promotes autonomy, comfort, playfulness and self-knowledge, the rand the world, easing the stress of hospitalization. The figure of the teacher took the class hospital in the voices of children, a reliever and minimizing the role of double exclusion that cause illness and hospitalization, showing the contributions to (re) construction of identity and subjectivity constitution strengthened. The children interviewed said that the hospital class leave the hospital more cheerful. The playfulness and learning experiences in the hospital are seen by children as actions that go beyond the physical treatment of the disease, since it provides them with acceptance and understanding of hospitalization and illness, to give them affective security and emotional. In conclusion, the narratives of children confirm that the service class hospital ensures continuity of schooling, but they reveal, namely, that this service provides them socialization among peers and with adults, strengthening the emotional, social and cognitive biopsychosocial perspective of attention

Avaliação da qualidade da assistência aos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário em Natal/RN

Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

Qualidade de vida de pessoas com úlceras venosas atendidos no ambulatório de um hospital universitário

Descriptive study aimed to analyze the quality of life (QOL) of patients with venous ulcers (UV) outpatient clinic of a university hospital in Natal / RN. The aim of the study population was composed of 50 patients with UV treated at the cardiology clinic of a university teaching hospital at the tertiary level. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol 279/09). Data collection was performed over a period of two months by the very a masters degree and an academic nursing through the application of a form concerning the socio-demographic, clinical, and health care, and the instruments WHOQOL and WHOQOL - old. The data were analyzed with SPSS 15.0, using descriptive and inferential statistics presented in the form of tables, charts and graphs. Of the surveyed, female predominance, age range 59 years, Catholic, low education, married, with up to 03 children, not working, retired, or with occupations requiring long periods in one position, wage income of up to 02 minimum wages, inadequate sleep, patients with chronic venous insufficiency and other chronic diseases such as diabetes and hypertension, were taking medications for treatment, being a minority to IVC. In patients with predominant only one injury, time of injury up to five years, inadequate rest, pain, edema and lesions colonized. The assistance the UV patients began treatment of the injury until four months after the onset of the ulcer, and services primary health care most wanted, access to angiologist by reference form, commuted by public transportation, received support regarding the treatment of injuries. The topical product most used in the lesion was healing, and few were using compression therapy. respondents suffer discrimination in society, showed changes in quality of life after the occurrence of ulcer in relation to leisure, pain, restriction of social / school / transportation; barring employment / financial / social ladder; Physical appearance / discrimination and restriction of domestic activity. These changes were related to the time of injury and found that the more chronic injury is the most negative changes occur in their QV (ρ = 0.000). Analyzing the characteristics of QV measured by the WHOQOL-bref, we found for the two general questions they are dissatisfied with their health (ρ = 0.023) and all areas have significant difference compared with the worst QV have the injury of more than 5 years (ρ = 0.000). The QV measured by the WHOQOL-old, we found that these patients had no changes from the time of injury. We conclude that the QV of patients with UV was considered unsatisfactory when compared to the time of injury on more than 5 years which shows that the quality of life worsens with time the chronic UV.

Assistência aos portadores de úlceras venosas: proposta de protocolo

Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequié/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K ≥ 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference