Abordagem psicossociologica das implicações legais da infecção hospitalar e de seu controle

Pesquisas acerca das Infecções Hospitalares mostram a gravidade do problema na saúde e a existência de poucos profissionais das áreas do Direito e da Saúde especializados nas implicações jurídicas relacionadas com o controle das Infecções Hospitalares. Assim, este estudo multidisciplinar tem como objetivos: apreender as Representações Sociais das Implicações Jurídicas das Infecções Hospitalares e de seu Controle, elaboradas pelos profissionais do direito e da saúde e analisar o impacto destas representações sobre Infecções Hospitalares e seu controle no âmbito do Hospital Getúlio Vargas, em Teresina, no Estado do Piauí. Trata-se de um estudo de caráter exploratório, desenvolvido em hospital público com profissionais do Direito e da Saúde, subsidiado na Teoria das Representações Sociais, de Serge Moscovici. Os dados foram coletados através de entrevista em profundidade e da observação. As informações apreendidas foram processadas no software Alceste 4.8, possibilitando a análise lexical e estatística pela Classificação Hierárquica Descendente, que permitiu identificar no discurso classes representativas de palavras de interesse da investigação. Os resultados indicaram que os sujeitos do estudo, através das suas representações sociais, defendem os direitos dos usuários da saúde e conhecem a prática das políticas de saúde, prevenção das Infecções Hospitalares e de seu Controle. Porém, demonstraram pouca preocupação com as implicações jurídicas inerentes às sua práticas mesmo estando sujeitos a responder civil e penalmente pelas ocorrências geradas por iatrogenia no exercício da profissão

Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

Risco de doença cardiovascular em mulheres com história de distúrbio hipertensivo da gravidez

OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pré-eclâmpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbuminúria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 (± 4.8) while this ratio in normotensive women was of 23.5 (± 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension

Avaliação neuropsicológica de crianças com hemiparesia congênita e adquirida

A hemiparesia consiste no déficit da força muscular, com consequente debilidade na mão e no pé, afetando um dos lados do corpo. A literatura mostra poucos estudos enfocando detalhadamente as funções cognitivas e emocionais de crianças afetadas por essa condição neurológica. Este estudo teve como objetivo realizar avaliação neuropsicológica de 23 crianças e adolescentes, de ambos os gêneros, com idades entre 5 anos e 4 meses e 16 anos e 6 meses, com hemiparesia congênita e adquirida. Aplicou-se uma bateria de testes específica para avaliação de funções cognitivas superiores incluindo processos intelectuais, atenção, função perceptiva, função motora, praxias, gnosias, linguagem, memória e função visuomotora. Em relação aos aspectos emocionais, foi usado o teste do desenho da figura humana, visando-se a avaliação da percepção da imagem corporal dos pacientes. Os resultados mostraram que a hemiparesia da criança conduz a déficits em funções neuropsicológicas importantes, além de déficit motor e alterações na esfera emocional, mais precisamente aquelas relacionadas com a representação da imagem corporal. A abrangência multidisciplinar, envolvendo a neurologia pediátrica e a psicologia, engrandeceu o trabalho, referendando os resultados obtidos em todos os seus aspectos

Determinação dos intervalos de referência para lipídios, lipoproteínas e apolipoproteínas no estado do Rio Grande do Norte

The lipid profile is a group of lab tests that include triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). However, serum non-HDL-C, Apo A-I and Apo B levels, as well as the lipids ratios (TC/HDL-C, LDL-C/HDL-C and Apo B/Apo A-I), have been described as better predictors of cardiovascular diseases. Reference intervals are tools often used to help the evaluation of the people s health state. These days, Brazilian studies still use the reference intervals of lipids and lipoproteins from other countries, ignoring differences between the populations. Therefore, this study aimed to establish reference intervals for lipids, lipoproteins and apolipoproteins in adults of Rio Grande do Norte/Brazil. Healthy individuals (96 men and 283 women) between 18 and 59years old formed the reference sample group. The samples were collected after fasting 12 to 14 hours. Information on lifestyle and dietary habits of the participants were obtained through questionnaire. The serum glucose level and renal and liver activity were evaluated by laboratory testing. The results of lipid profile were analyzed according to sex, age and mesoregion of Rio Grande do Norte, with significance level of 5% (p < 0,05). The lower and upper reference limits were identified by the 2.5 percentile and 97.5 percentile, respectively, and assurance intervals of 90% was calculated for each of these limits. Among the determinants of lipid profile analyzed, only a few significant differences were observed according to sex, but in terms of age, the groups of smaller and older ages were most likely different. When evaluated by region, the means of West region shown the most significant variations. Not many studies were useful to compare the reference intervals determined in this study. Thus, it becomes necessary to carry out similar studies in other regions of Brazil and of the world given the clinical importance of reference intervals

Avaliação in vitro da eficácia de produtos homeopáticos contendo momordica charantia através de bioensaios

Homeopathic medicines have been used for over two hundred years without the examination of their effects on in vivo and in vitro assays, due to the peculiarity of homeopathic preparations, the high dilution, which creates a challenge for the use of usual analytical techniques of quality control of medicine.Although there is scarcity of literature and variety of experiments, recently there have been some studies with few in vitro assays which have shown positive responses when evaluating the mechanism of action of homeopathic medicines which are able to act on a specific system.The present study aims to evaluate the efficacy of homeopathic products containing Momordica charantia through bioassays.Homeopathic products were tested by the MTT to assess cytotoxicity in RAW 264.7 (macrophage-like cells) and in tumor cells HeLa (human cervical adenocarcinoma cells), CHO K1 (Chinese hamster ovary cells), PANC-1 (human pancreas cancer cells) and PC-3 (human prostate cancer cells), dosage of inflammatory mediators NO, TNF-α and IL-6 released by RAW 264.7 cells, analysis of the death process and cell cycle changes of PC-3 by flow cytometry. The data demonstrate that homeopathic products of Momordica charantia did not show cytotoxicity to RAW 264.7, increased the production of inflammatory mediators by RAW 264.7 synergistically with LPS, showed cytotoxicity to PC-3 with change in its cell cycle inhibiting its proliferation, being the 30CH the most potent sample. Correlation studies were conducted in order to evaluate the possible in vitro applicable models to the quality control of homeopathic products with Momordica charantia. The data showed that the best applicable models in assessing the quality are the MTT to assess cytotoxicity in RAW 264.7 and PC-3 in 24 hours for Momordica charantia fruit products and dosage of NO production by RAW 264.7 with and without LPS

Caracterização dos marcadores químicos e avaliação de atividades biológicas do extrato de Spondias mombim

Spondias mombin is a fruitful species dispersed in tropical regions of America, Africa and Asia. In Brazil, the species can be found mainly in the northern and northeastern regions. Scarce chemical and pharmacological studies have been reported for S. mombin and until this moment studies about chemical markers were not developed. In this context, the aims of this study were to characterize the chemical markers from S. mombin leaves and evaluate their anti-inflammatory, antioxidant and antiproliferative potentials. The chemical profile of the hydroethanolic extract from S. mombin leaves analyzed by HPLC-DAD, through a validated method, allowed the identification and quantification of ellagic acid and chlorogenic acid. This extract showed anti-inflammatory potential in acute peritonitis model induced by carrageenan. The hydroethanolic extract from S. mombin leaves was subjected to a liquid-liquid partition with the solvents: n-hexane, dichloromethane, ethyl acetate and n-butanol. Regarding the anti-inflammatory potential of the fractions obtained they were active; however, ethyl acetate fraction at 200 mg/kg showed highlighted results. The compounds ellagic acid and chlorogenic acid also inhibited the leukocyte migration to the site of inflammation at 2.5, 5 and 10 mg/kg. The hydroethanolic extract, fractions and the chemical markers showed significant antioxidant potential when evaluated in different assays: DPPH Free-Radical Scavenging, Superoxide Radical Scavenging, Hydroxyl Radicals Scavenging and Reducing Power. Taken together our results showed that hydroethanolic extract of S. mombin leaves has ellagic acid and chlorogenic acid as bioactive markers and it demonstrated antiinflammatory and antioxidant properties besides no cytotoxicity against 3T3 cells. It enables us to suggest S. mombin as an important species to develop herbal drugs

Dadi e o teatro de bonecos: memória, brinquedo e brincadeira

The puppet theater is the theme of this dissertation, with a particular treatment of Memory, Toy and Jokes, focused especially on a Calungueira, maker of dolls, Ieda Maria Medeiros da Silva, known by Dadi. Currently with 71 years old, Dadi resides in Carnauba dos Dantas / RN and not only restricted to "get" the dolls to play, to enact stories by various characters. Build the dolls, dresses, give life, movement. In Rio Grande do Norte, the Puppet Theater, named "João Redondo," is measured by a historically male character of tradition, represented by some masters who have died or by their pupils, or even by the players who have no lineage of masters in their families but learned from several of them and, gradually, were included in this playful universe. Dadi passes this potiguar genealogy and going to suggesting a variety of transgressions, beyond, with its inventiveness, both in their presentations and in her life, which I did elect her and choose as a singular object in the course of my inquiries. In this study, I use the theoretical and methodological framework of social sciences, in particular the references coming from studies of culture, such as approaches of memory and tradition of authors such as Maurice Halbwachs and Paul Zumthor, among others. The field work was systematized, prioritizing the observation participant and permanent dialogue. I used different strategies for registration, as semi-open interviews, documentary video, audio narratives, photographic and videographic record, giving the work a current relevance to the dialogue with various elements, expanding the initial project, which turned into research for the dissertation

Estado e sociedade civil no Acre (1970-1980)

The relation between State and civil society is not a very recent discussion, but it does not mean that debate is exhausted, since is in the historical context that the novelty is seized. Thinking like this, we may analyze how the relation between state and civil society happened in Acre during the decade of 1970. But, to understand how this relation is established in faraway Acre, we have available to the reader historical analyses, in a tireless attempt to clarify minimally aspects that characterize acreana society. To do this, we take on as a departure point, in general not differentiating of the given structure at national level, the conformation of this society was guided in a passive revolution, in another way, by high transformismo, relegating to the civil society, which is incipient, pífia a simple participation in the hegemonic policy direction. All this brings us to the thought that both state bureaucracy structure and the civil society organization, were influenced decisively for a traditional political elite. In addition, we begin the work with the lifting bibliographic reference searching and then we analyze the empirical reality, such as newspapers, official media publications and private, a few documents and last, interviews with political actors associated with the process consolidation of civil society in the 1970 decade. The interviewees were selected, firstly for their location in the region, and for their outstanding contribution to the consolidating process of recent Acre history. Thus, the interviews followed up on a semi-structured way, leading up, also, for the informations that the interviewees would have to pass on. The systematization and analysis of these surveys have shown us that, in the period before of the Acre Federal State lifting had, of course, a transformismo by high, but at 1970decade, the society with a more heterogeneous social formation, is not allowed, or at least, organize itself, to counter a systematic imposition. Thus, the hegemonic area of dispute between State and civil society occurs from the "reconciliation" with the adoption of public policies that amenizasse the dispute between both spheres, and to build up some bodies, settling a acreana civil society.

Histórias e relatos sobre Pipa: a praia internacional do Rio Grande do Norte

The overwhelming gear that boosted tourism as the main economic activity of Pipa a district formerly agricultural and fishery, that belongs to the municipality of Tibau do Sul/RN produced significant changes in the social, economic and cultural rights of the native population of the place where social relations were narrow and justified in some cases, the line of kinship in an environment where all residents knew each other. However, we can not observe the emergence of this activity just as voracious disarticulator of old local forms of sociability that in a linear process, destroys the old, replacing it with the new. New compositions are generated by merging elements of past and present. Overcoming opposition to simplistic positive or negative impacts of tourism sought especially in this dissertation, review the history of Pipa (told in narrative form), showing how slowly this district has become a major international tourist destination and how its residents were being swallowed by the "whirlwind" that led to this reality. The research used qualitative methodology and was based on photographic, literature and survey, observation, experience, oral and written reports acquired in the field. We conducted in-depth interviews (oral history) with subjects that are the living memory of the place local residents (mostly natives). We found that before the process of "modernization" resulting from the pressure of globalization itself and the capital investment in tourism resulting from the native population is not passive. On the contrary, natives resist, creating mechanisms of material and symbolic reformulations. The present moment is always dynamic. Because of that, the identity of a place is not the crystallization of its past. Many landscapes still reveal materialities of yesteryear, such as registration of social practices in the construction of the place

Sociedade civil no espaço de atuação com juventude: uma cartografia social

This report has as its objective the setting up of a social cartography, mapping and characterizing non-governmental organizations working with adolescents and young people (OSC) in the western districts of the city of Natal. Characteristics such as the profile, themes and principal activities, how the organizations fit into the public sector and their participation in social networks are observed. Thus common differences and similarities which serve as a means of indentification, take as reference the symbolic cartography of Boaventura of Sousa Santos. Since there are relatively few studies relating to civil society of Rio Grande do Norte and in particular, Natal, the starting point was the setting up of a database allowing for a general overview. Hence a panorama of the organizations could be observed: where they are located, when they were formed how they operate and their relationships with other sectors (the state, the market and civil society) in addition to basic facts and location. The principal lines of enquiry were a) the OSC which operate with the public comprising adolescents and young people and b) the OSC operating or having branches in four suburbs on the periphery of the western administrative region of the city (Felipe Camarão, Bom Pastor, Cidade Nova and Guararapes).The present report has identified the impacts of ongoing social transformation caused by the process of globalization ,by the various currently contested political projects which are as follows: the project of neoliberal globalized capitalism(hegemonic)and the project of social emancipation (contra-hegemonic),how these are seen from the local viewpoint and how they influence the profiles and operation of the cartographic organizations. The area of the OSC is a heterogenous one with political, cultural and ideological strains, characterized by its infiltration, its local/global and multicultural dimensions. As civil organizations are fundamental in the processes of transformation within society, and following the idea of social emancipation referred to by Boaventura Santos, the enquiry classified the organizations according to the afore-mentioned characteristics, establishing eight types of associations. These different types and their respective characteristics were analysed from a related perspective using the mechanisms of symbolic cartography: scale, projection and symbolisation. The theoretical references underpinning this research arise from the debate on civil society which becomes redefined as a result of the dispute involving the two afore-mentioned political projects. These demand the theoretical application of the comprehension of heterogeneity in its diversity and complexity together with the idea of social emancipation.The main authors consulted were Boaventura de Sousa Santos, Antonio Gramsci, through the texts translated by Marco Aurelio Nogueira; Carlos Nelson Coutinho and Alberto Rivera ,who supported the construction of the types of associations identified by the local reality.Finally this research enabled an understanding of the current form of social action happening in the Space of the Four Neighbourhoods (Espaço dos 4 Bairros) and how the distinct profiles analysed together with the ares of operation of the organizations define their emancipatory potencials within the following two poles: regulation/adaptation and emancipation/transformation

A Eficácia dos direitos fundamentais nos contratos civis e de consumo: uma teoria contratual baseada na colisão dos direitos ou bens constitucionalmente protegidos

The apparent virtuosity that if could wait of the globalization and the neoliberalism has given signals of deterioration in the contractual relations, especially in contracts of mass consumption, generating innumerable offensive situations to the basic rights and the goods constitutionally protected of the contractors. In the world of today, still that it does not reveal any desire, the individual practically is compelled to contract, for force of necessities and customs completely imposed, mainly in face of the essentiality of the services or agreed to goods. Ahead of as much and unexpected changes in the civil liames and of consumption, dictated for the globalization, it comes to surface the reflection if the private law e, more specifically, the civil law, meet prepared adequately to deal with these new parameters of the economy. The present dissertation has the intention to investigate if the globalization and the consequent neoliberalism, in this beginning of third millennium, will imply to revive of the principles and the basics paradigms of the contracts that consolidated and had kept, for more than two centuries, the liberal State. One notices that the study of this phenomenon it gains importance to the measure where if it aggravates the decline of the social State (Welfare State), with the embrittlement and the loss of the autonomy of the state authority, over all in countries of delayed modernity, as it is the case of Brazil, that presents deep deficiencies to give or to promote, with a minimum of quality and efficiency, essential considered public services to the collective and that if they find consecrated in the Federal Constitution, as basic rights or as goods constitutionally protecting, the example of the health, the education, the housing, the security, the providence, the insurance, the protection the maternity, the infancy and of aged and deficient. To the end, the incidence of constant basic rights of the man in the Constitution is concluded that, in the process of interpretation of the right contractual conflicts that have as object rights or goods constitutionally proteges, in the universe of the globalized perhaps economy and of the neoliberalismo, it consists in one of the few ways - unless the only one - that still they remain to over all deal with more adequately the contractual relations, exactly that if considers the presence of clauses generalities in the scope of the legislation infraconstitutional civil and of consumption, front the private detainers of social-economic power. To be able that it matters necessarily in disequilibrium between the parts, whose realignment depends on the effect and the graduation that if it intends to confer to the basic right in game in the private relation. The Constitution, when allowing the entailing of the basic rights in the privates relations, would be assuming contours of a statute basic of all the collective, giving protection to the man against the power, if public or independently private

Licenciamento ambiental em postos de revenda de combustíveis à luz dos princípios constitucionais de defesas do meio ambiente: o caso do município de Natal/RN

This study approaches the question of the administrative procedure of the environmental licensing of ranks of fuel resale, taking as basis a study case of the reality of the City of Natal/RN (Brazil). For in such a way, it was done a retrospect on the evolution of the system of road transport in Brazil, having started to briefly analyze the urbanization process that if after accented in the capitals of the Brazilian States the decade of 1950, relating these subjects with the growth of the sector of fuel resale. After that, it was transferred boarding of the defense of the national environment to the light of ambient principles constitutional. In the sequence, a boarding on the ambient guardianship in the Federal Constitution of 1988 was made, treating basically specifies and on the national urban politics and the national politics of the environment, with its instruments. In the sequence, it was transferred the analysis of the abilities and attributions of the National Advice of the Environment (CONAMA) and its Resolutions, for then only enter in the most important part of this work: an analysis of the environmental licensing of ranks of fuel resale, in the reality of the City of Natal/RN. Before this specific boarding, it was proceeded specifically a survey and communication from the applicable norms to such establishments (Resolutions of the CONAMA and norms of the ABNT), for after that carrying through an geo-ambient characterization of the City of Natal/RN. Finally, a reflection was made on the possibility of magnifying of the state activity, in terms of guarantees for the responsible members for the environmental policy and of administrative efficiency, through the idea of the ambient regulation. For the accomplishment of this study, it was proceeded research in diverse sources such as books, magazines, sites of the Internet, periodicals, thesis and dissertations, among others material, beyond visits the agencies that direct or indirectly act with the ambient defense and as fuel resale, such as Secretariat of Environment and Urbanism of the City of Natal (SEMURB), Institute of Economic Development and Environment of RN (IDEMA), Brazilian Institute of the Environment and the Natural resources You renewed, Executive Management of RN (IBAMA/RN), Public prosecutor's office of the Environment of Natal (Public prosecution service of the RN), National Agency of Oil (ANP) and Union of the Retailing of Derivatives of Oil of the RN, among others. To the end, satiated regulation is observed that although on the substance of the ambient licensing in ranks of fuel resale, also with federal, state and municipal norms, the municipal Public Power is very far from the fulfilment of its institutional functions, in the question environmental policy of these establishments, a time that few are the permitted ranks of resale in the city of Natal/RN

Análise dos remanescentes de mata atlântica do Estado do Rio Grande do Norte : uma perspectiva em alta resolução

The habitat loss and fragmentation are considered the main threats to the biodiversity. These threats operate at the landscape level, which drives the need to manage entire landscapes, not just its components. Although systematic monitoring of the Atlantic Forest biome has been ongoing since the late eighties, current data on forest fragmentation for the sub-region of Pernambuco are practically nonexistent. This study aimed to map out, with high spatial resolution, the remnants of Atlantic forest in Rio Grande do Norte, and conduct a landscape level analysis. The results show that the landscape is highly fragmented, where about 13.6% to 17% of biome remains. Most of the fragments is less than 10 ha, while a few fragments have area larger than 100 ha. Although the high degree of fragmentation, the average distance between fragments found was small (128 m), this estimate is lower than has been observed for the biome (1440m). There is evidence that abrupt changes in the quantification of landscape structure can occur when one observes the fragmentation at high spatial resolution. The results presented here can be used in management actions, in order to make the scenario more conducive to maintaining biodiversity.

Ingestão alimentar e nutricional de callithrix jacchus: relaçao com hierarquia social e disponibilidade de alimento

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