Expressão imuno-histoquímica do cd8, foxp3, Tgf β, tnf α e nf-кb em displasias epiteliais e Carcinomas epidermóides orais

The Oral Epithelial Dysplasia (OED) is the lesion that precedes or co-exists with the Oral Squamous Cell Carcinoma (OSCC), presenting molecular and/or histological similar alterations. The divergences about the malignization potential of OEDs and the role of inflammation in this process make hard the early diagnosis and evaluation of OSCCs aggressiveness. Thus, it became the goal of this study to evaluate the role of inflammation in oral carcinogenesis and tumoral aggressiveness. For this purpose a morphological study was performed in 20 OED cases and 40 OSCC cases to detect the malignization potential of OEDs and the histologic malignancy grading (HMG) of OSCCs, analyzing superficial masses for dismorphism evaluation and the invasive front for evaluation of tumoral growing; and immunohistochemical, using anti-CD8, anti-FOXP3, anti-TGFβ, anti-TNFα and anti-NF-кB antibodies, comparing their with the types lesion, histological degree and intensity of the inflammatory infiltrate. The results were statistically significant for the parameters: cell maturity (p=0,0001), masses presence (p=0,038) and dismorphism (p=0,037), when associated to HMG. To compare the expression of the markers with the types lesion, a significantly higher expression of CD8 (p=0,001) and NF-кB (p=0,002) in the OED, and also a smaller expression of the epithelial TGFβ in the severe OEDs (p=0,011), without significant expression between OSCC degrees. By relating the expression of the studied markers with the inflammatory infiltrate intensity, a positive relation was observed with: inflammatory TNFα(p=0,003), epithelial TNFα and NF-кB (p=0,051 and p=0,004), in OEDs; and with CD8 (p=0,021) and TNFα (p=0,015) in conjunctive OSCCs; and a negative relation with epithelial TNFα (p=0,034) in OSCCs. No significant relation was found between FOXP3 with any of the studied variables. These findings lead to the conclusion that, the study of the invasive front is as important as the study of superficial masses for the evaluation of tumoral aggressiveness; the intensity of the inflammatory infiltrate has no use as a parameter for prognostic evaluation of OSCC in routine exams, but, the molecular events detected in this study may be necessary to give basis for determining the malignant potential in OEDs and aggressiveness in OSCCs

Doadores de sangue: qualidade de vida e atendimento em hemocentro de Natal / RN

The context of blood donation in Brazil faces problems since the start of its operations in the 1940, in the beginning the biggest obstacle was obtain safe and qualified blood, and then, established criteria for donations, the barrier is the low number of suitable candidates for donation. This suitability is associated with the good health of those who goes to the services of blood banks and the return of the donor is often conditioned by the way care is given and perceived by the user. The quality of life, defined as a perception that a person has of her/his position in the world, can influence the health and emerges as a way to focus on the subjectivity in a context dominated by objective and practical exams; listen to the views about the received services increases the focus on the user and provides feedback to the institution, guiding and planning its future actions. The purpose of this study was to verify the quality of life in blood donors and their perceptions of care in a blood center in Natal/RN. This is a descriptive cross sectional study conducted with blood donors from Dalton Cunha Barbosa blood center. The used protocols were: a structures questionnaire with questions on sociodemographic and services perception data, and SF-36 quality of life instrument. The sociodemographic and SF-36 data ware analyzed using descriptive and inferential statistics, using the statistical package PASW 18.0; those related to treatment were submitted to thematic content analysis. The results revealed a sample mainly composed by men, married people, who attended high school and had already made previous donations, with the first two groups returning more often for donations. The scores of the SF-36 confirm the certificated of good health of the screens, beind high in all areas and featuring a healthy population; statistically significant differences were denoted between sexes, levels of education and marital status. The speeches about the service were mostly positive and had as main focus acess, agility, technical aspects and subjective feelings. The data regarding the Rio Grande do Norte blood donors profile confirmed some characteristics of the Brazilian ones, those data of the SF-36 were similar to those found in studies with healthy groups and the impressions about the care received show similarities with national and international studies about the attendance at blood banks

Sofrimento solitário, mal-estar compartilhado :um estudo sobre a doença dos nervos

Nerves has been perceived as generalized suffering with multiple complaints, such as pain and other physical sensations, usually followed by symptoms of anxiety and/or depression. Even after medications have been prescribed, mainly psychotropic drugs to reduce these symptoms, exams aiming to discover the causes of the disorders, and a significant referral to health services, the problem tends to get progressively worse. The objective of this study is to characterize the diseases of clients who complain of nerves at the Unidade Mista de Felipe Camarão, Natal/RN, through in depth interviews, allowing for the clarification of ideas, beliefs and the meanings attributed to nerves by that person; to identify the symptoms and to know how they interfere in daily activities; to investigate the causes attributed to the problem and their relation to the biographical and psychosocial context of the patient. Thirteen women, health service clients, aged 30 to 59 years old, participated in the research. It was observed that they perceive, feel and act in unique ways with relation to symptoms, as well as to the attributed explanations and treatments given, showing the influence of life conditions, family context and their own subjectivity. Daily concerns and overwhelming responsibilities in the domestic environment, which usually stem from their precarious survival conditions, as well as marital conflicts motivated by the inequity of gender relations, contribute to trigger this type of suffering. The methodology of the research itself proved to be crucial to the comprehension and understanding of the meanings attributed to the complaints as well as to the argumenting process and the redefinition of the illness experience. Therefore, the importance of interdisciplinary intervention must be emphasize and specially the role of listening as relevant intervention resource

RR3D: Uma solução para renderização remota de imagens médicas tridimensionais

The visualization of three-dimensional(3D)images is increasigly being sed in the area of medicine, helping physicians diagnose desease. the advances achived in scaners esed for acquisition of these 3d exames, such as computerized tumography(CT) and Magnetic Resonance imaging (MRI), enable the generation of images with higher resolutions, thus, generating files with much larger sizes. Currently, the images of computationally expensive one, and demanding the use of a righ and computer for such task. The direct remote acess of these images thruogh the internet is not efficient also, since all images have to be trasferred to the user´s equipment before the 3D visualization process ca start. with these problems in mind, this work proposes and analyses a solution for the remote redering of 3D medical images, called Remote Rendering (RR3D). In RR3D, the whole hedering process is pefomed a server or a cluster of servers, with high computational power, and only the resulting image is tranferred to the client, still allowing the client to peform operations such as rotations, zoom, etc. the solution was developed using web services written in java and an architecture that uses the scientific visualization packcage paraview, the framework paraviewWeb and the PACS server DCM4CHEE.The solution was tested with two scenarios where the rendering process was performed by a sever with graphics hadwere (GPU) and by a server without GPUs. In the scenarios without GPUs, the soluction was executed in parallel with several number of cores (processing units)dedicated to it. In order to compare our solution to order medical visualization application, a third scenario was esed in the rendering process, was done locally. In all tree scenarios, the solution was tested for different network speeds. The solution solved satisfactorily the problem with the delay in the transfer of the DICOM files, while alowing the use of low and computers as client for visualizing the exams even, tablets and smart phones

Avaliação do potencial tóxico de águas oriundas de irrigação agrícola no Baixo-Açu/RN: um problema socioambiental

For many decades the problematic raised about the indiscriminate use of pesticides in modern agriculture has incited the interest of many researchers to discover the effects caused by such products in the environment and consequently in the life of the ones which use that products (farmers) and those people who live in places next to the agricultural areas. Facing these facts, this research had the intention of comprehend the environmental perception of habitants of the Distrito Irrigado do Baixo-Açu (DIBA), located in the semiarid of Rio Grande do Norte, by using agro toxics and its possible environmental effects, as well as evaluate the levels of toxicity of waters from agricultural runoff in this region by using eco-toxicological exams with Ceriodaphnia silvestii. Were done 86 interviews with dwellers and farmers from DIBA. With the results reached in the evaluation of the interviews it was possible to identify that one of major problems is the inappropriate discard of empty packs of the pesticides used at that place. The samples collected for eco-toxicological evaluation showed a variation in its toxicity, once that the point of collect which receives waters from different cultures presented in four out of five samples toxicity for the tested species. Therefore, it concludes that the indiscriminate use of pesticides agricultural practice presented a potential to pollute to the irrigation waters, and the absence of elucidation by the farmers about the manipulation of these products contribute to the risk of environmental contamination and the possible decrease of the quality of life of the dwellers of the region

Estudo epidemiológico da Toxoplasmose em gestantes atendidas na Maternidade Escola Januário Cicco, Natal, Rio Grande do Norte

Congenital Toxoplasmosis results in severe systemic disease. If mother is infected for the first time during gestation, she can infect the fetus causing substantial damage. However, relatively little is known about the seroprevalence and epidemiological and economic factors of Toxoplasmosis infection in pregnancy in the most state in northeastern Brazil and knowledge about this can be essential in determining effective and acceptable prevention strategies. Our aim was to determine the prevalence of Toxoplasmosis in pregnant woman consulted by reference Maternity Escola Januário Cicco in Natal, a city in Northeastern Brazil, which belongs to the public health system, correlating to the risk factors involved in the infection and to accomplish active Search in the Hospital of Pediatrics Profº Heriberto Bezerra of the damages caused by the Toxoplasmic infection in children up to 12 years of age. The study was conducted from March to December 2007 and sera obtained from 190 pregnant women were tested for IgM and IgG antibodies avidity to Toxoplasma by Microparticle enzyme immunoassay (Abbott AxSYM system - Abbott Laboratories, Chicago, IL, USA). Data were examined with univariate analysis. Chi-squared (x2) and Odds ratio was calculated (IC 95% p 0,05). Of these women, 126 (66,3%) had only IgG antibodies high-avidity against T. gondii; 01 (0,52%) had a IgM and IgG high-avidity antibodies against T. gondii and 63 (33,1%) have neither IgM nor IgG against T. gondii. Our studies shown that the direct contact with cats or dogs was highly associated with the Toxoplasma gondii infection (OR, 2.72, p<0.001, 95% CI 1.46 5.02). The years school (p<0,001), socioeconomic status and knowledge about the disease (both p value 0.05) also were associated with Toxoplasmosis. The pattern of risk factors for infection presents regional variations, however our data corroborate others studies in Brazil. In children up to 12 years, one case of Congenital Toxoplasmosis was just registered in seven years (2000 - 2006). There were several suggestive cases, with signs and characteristic symptoms, but that the infection was not confirmed due to lack in the researches through laboratorial and images exams that addressed that it zoonosis

A geografia no currículo do ensino médio e no vestibular da UFRN: 2001-2007

This work examines the results of the selecting process to enter Universidade Federal do Rio Grande do Norte called Vestibular, in 2001, 2003, 2005 and 2007, in relation to the necessary knowledge presented by the candidates in the Geography area. It observes the contents in the discursive exams and its corresponding results discussing them from the official curriculum of the Secondary School, as it is stated in the official documents of Ministério da Educação(MEC): Parâmetros Curriculares Nacionais do Ensino Médio (PCNEM), Orientações Curriculares Nacionais para o Ensino Médio (OCNEM) e Orientações Educacionais Complementares aos Parâmetros Curriculares Nacionais (PCN+ do Ensino Médio). We aim to highlight what are the contents and background of the Geography curriculum according to the orientations of the official curriculum; discuss in what measure these contents are present in the questions and in the correct answers of the candidates as well as reflect upon what possibly is suggested by those results concerning the knowledge presented in the answers. In this investigation process, the history of the teaching in Brazil is taken up together with the statistical data about the Fundamental School and about Higher Education in the last years. Both map the scenario in which this research takes place as well as make knowledgeable some variables such as: cultural, economical, political and social structures. The discussion takes place between the curriculum and the teaching, Geography teaching and Secondary School in Brazil articulating these variables with the question of accessibility to Higher Education through the Vestibular . Despite the limitations of this research in terms of methodology and deepening of analysis, the results led us to important observations which can contribute to the understanding of that the students´ performance in the Geography examination has several outspreads. These must be thought with scientific exactness in order to avoid any rushed and careless explanations leading to conclusions that may have serious consequences for the teaching systems and the students

A utilização da pesquisa operacional para o gerenciamento dos leitos em um hospital particular: estudo de caso baseado em simulação computacional

The hospital is a place of complex actions, where several activities for serving the population are performed such as: medical appointments, exams, surgeries, emergency care, admission in wards and ICUs. These activities are mixed with anxiety, impatience, despair and distress of patients and their families, issues involving emotional balance both for professionals who provide services for them as for people cared by them. The healthcare crisis in Brazil is getting worse every year and today, constitutes a major problem for private hospitals. The patient that comes to emergencies progressively increase, and in contrast, there is no supply of hospital beds in the same proportion, causing overcrowding, declines in the quality of care delivered to patients, drain of professionals of the health area and difficulty in management the beds. This work presents a study that seeks to create an alternative tool that can contribute to the management of a private hospital beds. It also seeks to identify potential issues or deficiencies and therefore make changes in flow for an increase in service capacity, thus reducing costs without compromising the quality of services provided. The tool used was the Computational Simulation –based in discrete event, which aims to identify the main parameters to be considered for a proper modeling of this system. This study took as reference the admission of a private hospital, based on the current scenario, where your apartments are in saturation level as its occupancy rate. The relocation of project beds aims to meet the growing demand for surgeries and hospital admissions observed by the current administration.

Argumentação em foco: a perspectiva de avaliação do ENEM

Nowadays ENEM is the main large-scale evaluation instrument of Brazilian education. Universities also often use it in order to select their candidates. Reading exam seeks to evaluate student’s capacity of producing argumentative and dissertation prose writing about a social, scientific, cultural or political theme. This paper is located in this context: we want to discuss the evaluation of ENEM’s Writing Exam argumentation. Our startpoint is presuppose that the capacity to develop a well-argued text evaluation goes through several specific skills, which cover different aspects of what is understood about argumentation process. Therefore, considering argumentation as an object of different theoretical approaches and covers different concepts, we intend to verify not only the approaches, but also subjacent concepts and how they were converted into skills and competences established on the ENEM Writing Exam’s matrix of correction. With regard to the nature, it is a theoretical paper, in other words, we intend to offer only a discussion about the theme, not necessarily offering a practical application. Concerning to the goals, it has an exploratory character as we intend to offer a problem treatment, in order to make it more explicit and them construct some hypotheses. In these terms, we surveyed some theoretical approaches about argumentation and presented three conceptions: rhetorical argumentation, textual argumentation and linguistics argumentation. At next, we analyzed the participant’s guide (ENEM’s 2013 Writing Exam ) and how each one of these conceptions are mobilized in the writing evaluation, beginning from how they are considered on the description of competences and skills up to used on correction. This analysis shows that is not assumed a very well established theoretical base, which can contribute to a certain fragility on the Writing Exam evaluation process.

Características dos programas de residência médica em cardiologia do estado do Rio Grande do Norte

The present study had as goal to evaluate Rio Grande do Norte state’s medical residency programs (MRP) in Cardiology. It’s a descriptive study, including a documental analysis of the program’s accreditation processes (PAP) of cardiology’s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident’s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book’s publications. The private institution presents a better Urgency’s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital’s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Coração Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences’ National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident’s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.

A compreensão de reação química como um sistema complexo a partir da discussão dos erros e dificuldades de aprendizagem de estudantes do ensino médio

The study of chemical reactions is among the most important contents to the understanding of Chemistry discipline in basic education. However, there are still few studies about chemical reactions as a complex system because, generally, this content is presented in textbooks, taught and even researched in a fragmented form. The thesis here presented aims to investigate, identify and characterize the mistakes and learning difficulties of the students about chemical reactions as a complex system, using for that purpose the analysis of the answers of 126 exams of candidates for the bachelor’s degree in Chemistry Teaching on the entrance exam for the Federal University of Rio Grande do Norte (UFRN). The mistakes and learning difficulties about the parameters ΔG°, Kp, Ea and of the calculation of the amount of substance in a chemical reaction have been identified, as well as the levels of development of the ability to interpret the chemical reaction as a system. The main theoretical source of this study is structured based on the mistakes and learning difficulties (NÚÑEZ, RAMALHO, 2012), of the chemical reactions as complex systems (NÚÑEZ, 1994; RESHETOVA, 1988; SANDERSON, 1968). As methodology, it was prioritized the analysis of the answers to the exams and the interview with the teachers. The results showed typical mistakes in the study of this subject, especially low levels and skill development. No student was able to integrate the different aspects in the systemic understanding of the chemical reaction. From the interviews with Chemistry teachers from High School, it was determined the reasons the teachers assign to those mistakes and learning difficulties. The interviews revealed that the teachers do not work in the perspective of integration of the contents which leads the students to present difficulties and make mistakes related to the content previously mentioned. The study presents a proposal for the organization of the contents of Chemistry discipline for High School as a possibility of a dialectic systemic integration of contents, understanding that this systematic vision, leads to important contributions to the development of the theoretical thinking of the students. We can mention as one of the conclusions of this study, the fact that the non-systemic organization of contents do not favor this kind of thinking in students.

Eleição nas escolas: uma análise do impacto do diretor eleito sobre o desempenho educacional no Estado da Bahia

In Brazil, the selection of school principals is set in a decentralized manner by each state and city, such that processes may vary with time for a specific locality. In the state of Bahia, school principals were appointed by a higher political hierarchy until 2008, when schools under state administration started selecting principals by elections. The main goal of this work is to evaluate whether changing this specific rule affected students proficiency levels. This is achieved by using a panel data and difference-in-differences approachs that compares state schools (treatment group) to city schools (control group) that did not face a selection rule change and thus kept having their principals politically appointed. The databases used are Prova Brasil 2007, 2009 and 2011, the first one prior and the other two former to the policy change. Our results suggest that students attending schools with principals that are selected and elected have slightly lower mean proficiency levels both in mathematics and in portuguese exams than those attending schools with appointed principals. This result, according to the literature, could be related to perverse effects of selecting school administrators by vote, such as corporatism, clientelism and politicization of the school environment

Estudo clínico-laboratorial e histopatológico de cães naturalmente infectados por Leishmania chagasi com diferentes graus de manifestação física

Canine Visceral Leishmania (CVL) is an important zoonotic disease that has a world wide distribution and has a large impact on public health on the American Continent, especially in Brazil, where the nature of endemic diseases in humans affects a large part of the nation. The influence of the prevalence of CVL in the increased rate of human cases in endemic areas and in the unleashing of epidemic outbreaks shows the need for a more profound understanding, that would generate significant advances in the current measures used to control the reservoirs of sickness that are practiced by the Programa Nacional de Vigilância e Controle da Leishmaniose Visceral. The present work describes and compares the clinical-laboratorial and histopathological findings of twenty-three dogs that were naturally infected by Leishmania chagasi, from endemic areas in metropolitan Natal, Rio Grande do Norte, Brazil. These animals, that were selected and given physical and serological exams (IFI and ELISA rK-39), were classified according to the degree of clinical severity and had blood samples drawn (whole blood and serum) for a complete hemogram and a coagulogram to be done as well as biochemical tests for kidney and liver function. The confirmation of infection by L. chagasi was done after the euthanasia of the animals, through the direct demonstration of the parasite in the impression of the spleen and liver crowned with GIEMSA and through a cultivation by means of NNN/Schneider. According to the clinical evaluation, the animals were classified as asymptomatic (7), oligosymptomatic (7) and polysymptomatic (9). Among the animals that were chosen to be autopsied, there were 2 asymptomatic, 3 oligosymptomatic and 3 polysymptomatic, for the purpose of studying their histopathology, having collected fragments of the spleen, liver, kidneys and skin and were fixed in 10% tamponed formol. The comparison between the average parameters of the clinical-laboratory tested animals in the groups was done through the Student t test (a<0.05). The main clinical signals observed were lymphadenomegaly, alopecy, dermatitis, exfoliation, cutaneous ulcers, onicogriphosis and emaciation. The main clinical-laboratorial alterations established, mainly in the polysymptomatic group, were anemia, hyperproteinemia, hyperglobulinemia, alterations in the albumin/globulin ratio and increased ALT activity. Renal alterations were not verified (urea and creatinine levels were normal). Thrombocytopenia was observed in three clinical groups. However, the other indicators of coagulation function (TAP and TTPA) did not have abnormal variations. There were inflammatory infiltrations and leishmania amastigotes in the skin of polysymptomatic dogs, however, they were not found in the skin of asymptomatic animals. Hypertrophy and hyperplasia of the phagocyte mononuclear system, leishmania amastigote parasites were found in the macrophages, extramedullary hematopoiesis and degenerative alterations were detected in the spleen and liver of 8 of the animals submitted to histopathological exams. In accord with these results, it was demonstrated that the expected alterations in the hematological and biochemical parameters in function of their viscerotropic nature of CVL are mainly observed in the more advanced stages of the disease. The absence of inflammatory infiltration and parasite load in the skin suggest that infected animals without symptoms may have an importance irrelevant to the infectiousness of the vector