As repercussões dos serviços hospitalares em diferentes contextos: uma análise de profissionais de saúde

This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance

Emprego dos ácidos graxos de cadeia curta na colite de derivação fecal : estudo em ratos Wistar

Diversion colitis is a chronic inflammatory process affecting the dysfunctional colon, after a colostomy. It is postulated that nutritional deficiency of the colonic epithelium by the absence of short-chain fatty acids (SCFA) is one of the factors responsible for the appearance of DC and that their employment could reverse the morphological changes of the mucosa. The treatment of choice for fecal diversion colitis (DC) is the reconstruction of the intestinal tract, although they suggested therapeutic options using enemas. This study evaluates the effect of SCFA in atrophy and inflammation in excluded colonic segments before and after the installation DC. Forty Wistar rats were divided into four groups (n = 10 for each group), submitted colostomy with distal colon exclusion. Two control groups (A1 and B1) received rectally administered physiological saline, whereas two experimental groups (A2 and B2) received rectally administered short-chain fatty-acids. The A groups were prophylactically treated (5th to 40th days postoperatively), whereas the B groups were therapeutically treated (after postoperative day 40), for 07 days. Histological sections stained with HE were used for histological analysis of the thickness of the colonic mucosa excluded (t- Student p ≤0.05). Inflammatory reaction of the lamina propria and mucosa were measured with scores previously established (Mann Whitney p ≤ 0.05). There was a significant thickness recovery of the colonic mucosa in group B2 animals (p = 0.0001), which also exhibited a significant reduction in the number of eosinophilic polymorphonuclear cells in the lamina propria (p = 0.0126) and in the intestinal lumen (p = 0.0256). Group A2 did not prevent the mucosal atrophy and significant increases in the numbers of lymphocytes (p=0.0006) and 50 eosinophilic polymorphonuclear cells in the lamina propria of the mucosa (p = 0.0022). Therapeutic use of short-chain fatty-acids significantly reduced eosinophilic polymorphonuclear cell numbers in the intestinal wall and in the colonic lumen; it also reversed the atrophy of the colonic mucosa. Prophylactic use did not impede the development of mucosal atrophy

Avaliação de efeitos DW extratos de sambucus australis E sambucus nigra na marcação de constituintes sanguineos com tecnécio-99M, na morfologia de Hemácias de ratos wistar, na topologia plasmidial e na ação do cloreto estanoso no DNA Plasmidial

Radiobiocomplexes are used in nuclear medicine to obtain images and to treat diseases. Blood constituents have been used as radiobiocomplexes. Natural or synthetic products can influence on the labeling of blood constituents with technetium-99m (99mTc), the morphology of red blood cells and on the stannous chloride (SnCl2) action on plasmid DNA. Sambucus australis and Sambucus nigra are used in popular culture for treating diseases. The aim of this work was to evaluate the effects of the extracts of Sambucus australis and Sambucus nigra on the labeling of blood constituents with 99mTc, on morphology of red blood cells of Wistar rats, on the topology of plasmids DNA and the action against the SnCl2 effects on the DNA of plasmids pBSK. On the labeling of blood constituents with 99mTc it was verified that both extracts were capable to decrease significantly the radioactivity in the cellular compartment and in the insoluble fraction of plasma. Sambucus australis also decreased the labeling of insoluble fraction of blood cells with 99mTc. Both extracts did not alter the morphology of red blood cells. Moreover, it was verified that Sambucus nigra did not alter the electrophoretic profile of plasmid DNA, but decreased the effect of SnCl2 on plasmid DNA. These last results sugest a genotoxic effect and a protective action of Sambucus nigra extract against the SnCl2 action on plasmid DNA. This work was developed with the contribution of several Departments of biomedical area of the Hospital Universitário Pedro Ernesto, of the UERJ, characterizing a multidisciplinary experimental research

Novo sistema de aplicação de drogas em cirurgias oftalmológicas

The topical corneal application of antimitotic mitomycin-C (MMC) during refractive surgery is still characterized by a lack of standardization and considerable empirism. For this reason the creation of a system capable of reliable drug delivery represents a beneficial innovation for patients submitted to these procedures. Objective: Elaborate a new MMC delivery system during the transoperatory period of photorefractive keratectomy (PRK) followed by patent application. Methods: The project consists of an in vitro experimental study to create an MMC (0.02%) release system. The drug was impregnated in sterile Whatman® 41 paper filter discs with a diameter of 8 mm. After drying, the discs were applied to antibiogram plates seeded with Staphylococcus epidermidis (American Type Culture Collection ATCC 12228), followed by the addition of a drop of sterile water. At the end of 1 minute, the discs were removed and the plates incubated for 48 hours at 35oC. Mean drop volume in the collyrium flasks was measured using analytical balance weighing. The inhibition halo (mm) was correlated with the MMC impregnated into the disc. After completion of the invention design a patent application was lodged at the National Institute of Industrial Property. Results: The correspondence between MMC-produced inhibition halos indicated that a dose of 16μg was ideal for impregnating into the discs. The mean drop volume obtained from the collyrium flasks was 37.7 μL. A minute after the application of one drop of balanced saline solution, the system released an adequate concentration for PRK surgery. Conclusion: A new MMC delivery system was created for transoperatory application in photorefractive keratectomy (PRK). Publication of the patent application (number PI 0704739-8) gives the authors exclusive intellectual property rights. The study was sponsored by Ophthalmos Indústria e Comércio de Produtos Farmacêuticos S.A. (São Paulo-SP, Brazil) and received the indispensable scientific contribution of researchers from the fields of Pharmacy, Medicine, Biology, Statistics and Law, characterizing the work as multidisciplinary, in accordance with norms established by the Postgraduate Health Sciences Program of the Federal University of Rio Grande do Norte (UFRN)

Prescrição de exercício físico para mulheres com síndrome dos ovários policísticos: impacto sobre a aptidão cardiorrespiratória e resposta afetiva

analisar o efeito do treinamento aeróbio periodizado sobre a aptidão cardiorrespiratória e respostas afetivas em mulheres com síndrome dos ovários policísticos (SOP) e II) investigar se o exercício aeróbio realizado na zona de prazer para essa população atende a recomendação do American College of Sports Medicine (ACSM) no que se refere à intensidade para melhoria da saúde. Metodologia: foram incluídas mulheres na faixa etária entre 18 e 34 anos, com diagnóstico de SOP de acordo com o Consenso de Rotterdam. Para o subestudo I, oito pacientes sedentárias participaram de 16 semanas de treinamento aeróbio com incrementos mensais de intensidade: fase 1 = 60-70% da frequência cardíaca máxima (FCmax); fase 2 = 70-75% da FCmax; fase 3 = 75-80% da FCmax; fase 4 = 80-85% da FCmax. A intervenção foi realizada três vezes por semana, 40 minutos por sessão. Em todas as sessões foram registradas as respostas afetivas (Feeling Scale -5/+5) e a percepção subjetiva do esforço (escala de Borg CR 6-20). Antes e após a intervenção, as voluntárias realizaram teste ergoespirométrico. Para o subestudo II, 11 pacientes realizaram duas sessões de exercício aeróbio na zona de prazer, sendo registrados parâmetros relativos à demanda física através de receptor de GPS (Global Positioning System) de pulso com cardiofrequencímetro acoplado. As pacientes foram instruídas a realizar 40 minutos de exercício guiadas pelas âncoras verbais bom e muito bom (+3 e +5 na Feeling Scale). Resultados: no subestudo I, após 16 semanas de treinamento, houve aumento da aptidão cardiorrespiratória máxima (17,3%) e submáxima (21,5%). As respostas afetivas variaram entre bom (+3,1 ± 0,8) e razoavelmente bom xi (1,0 ± 0,9) e a percepção subjetiva do esforço entre muito leve a leve (10,2 ± 0,7) e um pouco difícil (12,7 ± 0,6) durante a intervenção. No subestudo II, as pacientes exercitaram-se a ~72,5 ± 6% da FC máxima, ~78,5 ± 6% da FC no limiar anaeróbio e passaram > 95% do tempo em intensidade moderada (~82%) e vigorosa (~16%) durante as sessões experimentais. Em média, as voluntárias reportaram as sessões como fácil (percepção subjetiva do esforço da sessão ~2,2 ± 0,7). Conclusões: o programa de treinamento aeróbio periodizado aumentou a aptidão cardiorrespiratória das pacientes analisadas e foi percebido como uma intervenção prazerosa. Adicionalmente, exercício aeróbio realizado de forma prazerosa atende a recomendação do ACSM no que se refere à intensidade para melhoria da saúde

Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

Camarão Litopenaeus vannamei: componentes de importância nutricional na carne e nos resíduos do beneficiamento

Farming of marine shrimp is growing worldwide and the Litopenaeus vannamei (L. vannamei) shrimp is the species most widely cultivated. Shrimp is an attractive food for its nutritional value and sensory aspects, being essential the maintenance of this attributes throughout storage, which takes place largely under freezing. The aim of this research was to evaluate quality characteristics of Litopenaeus vannamei shrimp, during freezing storage and to verify the effect of rosemary (Rosmarinus officinalis) adding. Considering the reutilization of processing shrimp wastes, total carotenoids analysis were conducted in waste of Litopenaeus vannamei shrimp and in the flour obtained after dryer. Monthly physicochemical and sensorial analysis were carried out on shrimp stored at 28,3 ± 3,8ºC for 180 days. Samples were placed in polyethylene bags and were categorized as whole shrimp (WS), peeled shrimp (PS), and PS with 0,5% dehydrated rosemary (RS). TBARS, pH, total carotenoid and sensorial Quantitative Descriptive Analysis (QDA) were carried out. Carotenoid total analysis was conducted in fresh wastes and processed flour (0 day) and after 60, 120 and 180 days of frozen storage. After 180 days, RS had lower pH (p = 0.001) and TBARS (p = 0.001) values and higher carotenoids (p = 0.003), while WS showed higher carotenoid losses. Sensory analysis showed that WS were firmer although rancid taste and smell were perceived with greater intensity (p = 0.001). Rancid taste was detected in RS only at 120 days at significantly lower intensity (p = 0.001) than WS and PS. Fresh wastes had 42.74μg/g of total carotenoids and processed flour 98.51μg/g. After 180 days of frozen storage, total carotenoids were significantly lower than 0 day (p<0,05). The addition of rosemary can improve sensory quality of frozen shrimp and reduce nutritional losses during storage. Shrimp wastes and flour of L. vannamei shrimp showed considerable astaxanthin content however, during storage it was observed losses in this pigment

Risco ocupacional no contexto hospitalar

O presente estudo tem como objetivo conhecer as representações sociais sobre o risco ocupacional construídas por trabalhadores da saúde no contexto hospitalar. Trata-se de um estudo exploratório fundamentado no referencial teórico da Teoria das Representações Sociais realizado com duzentos e vinte trabalhadores da saúde pertencentes ao quadro permanente de um hospital público na cidade do Natal- RN. Os dados foram coletados através da Entrevista semi-estruturada e da Técnica da Associação Livre de Palavras. Na análise das informações utilizou-se o software Evoc 2000 e o Alceste. Os resultados indicam condições de trabalho desfavoráveis com desgaste físico e mental ao trabalhador da saúde, e, patologias pouco reconhecidas como ocupacionais em sua origem. Pode-se observar que as representações sociais construídas pelos trabalhadores da saúde, revelam o nível de conscientização desses trabalhadores referentes às consequências do ambiente de trabalho para sua saúde, referindo-se ao processo de trabalho hospitalar, como múltiplo e complexo pela dimensão tecnológica e pelos aspectos físicos, psíquicos e cognitivos

Identificação e avaliação de propriedades de polissacarídeos sulfatados de diferentes fontes naturais que possibilitem sua aplicabilidade biotecnológica

Sulfated polysaccharides (SP) are widely distributed in animals and seaweeds tissues. These polymers have been studied in light of their important pharmacological activities, such as anticoagulant, antioxidant, antitumoral, anti-inflammatory, and antiviral properties. On other hand, SP potential to synthesize biomaterials like as nanoparticules has not yet been explored. In addition, to date, SP have only been found in six plants and all inhabit saline environments. However, the SP pharmacological plant activities have not been carrying out. Furthermore, there are no reports of SP in freshwater plants. Thus, do SP from marine plants show pharmacological activity? Do freshwater plants actually synthesize SP? Is it possible to synthesize nanoparticles using SP from seaweed? In order to understand this question, this Thesis was divided into tree chapters. In the first chapter a sulfated polysaccharide (SPSG) was successfully isolated from marine plant Halodule wrightii. The data presented here showed that the SPSG is a 11 kDa sulfated heterogalactan contains glucose and xylose. Several assays suggested that the SPSG possessed remarkable antioxidant properties in different in vitro assays and an outstanding anticoagulant activity 2.5-fold higher than that of heparin Clexane® in the aPTT test; in the next chapter using different tools such as chemical and histological analyses, energy-dispersive X-ray analysis (EDXA), gel electrophoresis and infra-red spectroscopy we confirm the presence of sulfated polysaccharides in freshwater plants for the first time. Moreover, we also demonstrate that SP extracted from E. crassipes root has potential as an anticoagulant compound; and in last chapter a fucan, a sulfated polysaccharide, extracted from the brown seaweed was chemically modified by grafting hexadecylamine to the polymer hydrophilic backbone. The resulting modified material (SNFuc) formed nanosized particles. The degree of substitution for hydrophobic chains of 1H NMR was approximately 93%. SNFfuc-TBa125 in aqueous media had a mean diameter of 123 nm and zeta potential of -38.3 ± 0.74 mV, measured bydynamic light scattering. Tumor-cell (HepG2, 786, H-S5) proliferation was inhibited by 2.0 43.7% at SNFuc concentrations of 0.05 0.5 mg/ mL and RAEC non-tumor cell line proliferation displayed inhibition of 8.0 22.0%. On the other hand, nanogel improved CHO and RAW non-tumor cell line proliferation in the same concentration range. Flow cytometric analysis revealed that this fucan nanogel inhibited 786 cell proliferation through caspase and caspaseindependent mechanisms. In addition, SNFuc blocks 786 cell passages in the S and G2-M phases of the cell cycle

Diagnóstico molecular da talassemia ALFA+ (DELEÇÃO -3.7) em indivíduos com microcitose e/ou hipocromia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fatores genéticos e étnicos relacionados à evolução da infecção por Leishmania infantum

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Atividade física na terceira idade: Uma análise de sua contribuições para o estilo de vida através das representações sociais

Temáticas emergentes e estratégicas da política de saúde em nível mundial têm suscitado reflexões para ações sócio educativas com idosos. Esta pesquisa questiona as aspirações desse segmento social face às experiências de qualidade proporcionadas pela atividade física. Objetivo: investigar as representações sociais da atividade física na terceira idade. Método: pesquisa de corte transversal com abordagem quanti-qualitativa. A amostra foi nãoprobabilística e por conveniência apoiada na Teoria das Representações Sociais e a Teoria do Núcleo Central. O estudo foi realizado com alunos de um projeto para a terceira idade com sede no Centro Federal de Educação Tecnológica do Rio Grande do Norte (CEFET), no município de Natal/RN, Brasil. Para a coleta dos dados utilizou-se de questionário semi-estruturado, composto de três partes: A Parte I, para a caracterização social da amostra e identificação da percepção da atividade física para a saúde; a Parte II, com evocação livre de palavras e a Parte III, com uma questão aberta. Análise dos dados: A exploração do material deu-se a partir dos seguintes softs: do SPSS para análise de freqüência simples (parte I); do EVOC (parte II) e do ALCESTE (parte III). Complementarmente, foi utilizada a análise de conteúdo a fim de inferir/corroborar sobre os núcleos de sentido da comunicação. Resultados: O núcleo central da representação foi composto por felicidade/saúde/dança e ginástica, revelando diferentes entendimentos e mostrando também que o conhecimento construído da atividade física assume um papel preponderante na vida de idosos, adquirindo gradativamente, a representação de vida com mais saúde e qualidade na velhice . A composição do núcleo central ao considerar elaborações mentais, emoções, práticas e explicações oriundas do cotidiano que se introduzem na constituição da representação social em foco, poderá influenciar as escolhas e estratégias de se desenvolver melhora nos padrões de saúde e na qualidade de vida dos idosos.

Distribuição regional da ventilação pulmonar em indivíduos com insuficiência cardíaca crônica após serem submetidos a um programa de treinamento da musculatura inspiratória e sua correlação com dados funcionais

Introduction: Chagas Disease is a serious public health problem, with 5 million infected individuals in Brazil. Of these, approximately 30% develop chronic Chagas cardiomyopathy (CCC), where the main symptoms are fatigue and dyspnea. Objective: To correlate maximal exercise capacity with pulmonary function, inspiratory muscle strength and quality of life in patients with CCC. Methodology: Twelve individuals suffering from CCC were evaluated (7 men), with a mean age of 54.91± 8.60 years and the following inclusion criteria: functional class II and III according to the New York Heart Association (NYHA); left ventricle ejection fraction below 45%; clinical stability (> 3 months); symptom duration > 1 year, body mass index (BMI) < 35Kg/m2 and non-smokers or ex-smokers with a history of smoking <10 packs/day. All subjects were submitted to spirometry, manometer testing, maximal cardiopulmonary exercise testing (CPX) and a quality of life questionnaire (Minnesota). Results: A negative correlation was observed between VO2máx and MLHFQ scores (r=-0.626; p=0.03) and a positive association with MIP (r=0.713; p=0.009). Positive correlations were also recorded between MIP and spirometric variables [FEV1(r=0.825;p=0.001 ), FVC(r=0.66;p=0.01 and FEF25-75%(r=0.639;p=0.02)]. Conclusion: The present study demonstrated that in patients with CCC: VO2MAX is directly related to inspiratory muscle strength and quality of life, while deteriorating lung function is directly associated with respiratory muscle weakness

Maternidade e sindrome do down: Um estudo sobre o sentimento vinculado frente ao diagnóstico

Trata-se de um estudo de delineamento transversal de caráter multidisciplinar, o qual conta com um estatístico que contribuiu para o delineamento do estudo, realizando o cálculo amostral e contribuindo efetivamente para análise dos dados e alunos de psicologia e pediatrias que contribuíram para a coleta de dados. A literatura aponta que a transmissão inadequada do diagnóstico da Síndrome de Down pode prejudicar o vínculo mãe-bebê e o posterior desenvolvimento da criança. Sendo assim, este estudo objetivou analisar os sentimentos maternos frente a este diagnóstico, verificando diferentes formas de transmissão e possíveis facilitadores da aceitação da Síndrome. A amostra foi constituída por 20 mães cujos filhos apresentam Síndrome de Down, na faixa etária de 0 à 03 anos e que recebem atendimento em ambulatório de um Hospital Universitário de Pediatria. Para coleta dos dados fez-se uso de um questionário, após a assinatura do Termo de Consentimento Livre e Esclarecido. Os dados foram analisados através de dois softwares de processamento de dados, o SPSS e o ALCESTE (Análise Lexical por Contexto de um Conjunto de Segmento de Texto). Os dados indicaram que 90% das mães receberam o diagnóstico de Síndrome de Down depois do parto. 75% dos diagnósticos foram comunicados pelo médico pediatra e 15% pelas enfermeiras. As mãe referiram que o diagnóstico foi tardio, inadequado e insuficiente no informativo. Observouse que as entrevistadas viveram os mesmos sentimentos observados na literatura como: choque, negação, tristeza e ira, adaptação e reorganização. Tais resultados permitem concluir que o diagnóstico de SD nas mães investigadas foi em sua maioria tardio, realidade comum no Brasil, principalmente quando se trata de classes econômicas baixas. As mães apontam que percebem este diagnóstico como tardio, inadequado e insuficiente no informativo, e gera sentimentos que a literatura já cita como comuns frente a esse tipo de diagnóstico. Portanto, observamos que a notícia pode ser um fator que dificulte ou facilite o estabelecimento do vínculo mãe-bebê, comprometendo a busca de recursos para o desenvolvimento da criança

Determinantes envolvidos na resposta imune celular humana à infecção por Leishmania infantum chagasi

Visceral leishmaniasis (VL) is a disease caused by protozoa of the Leishmania donovani complex, whose infection has clinical spectrum ranging from asymptomatic infection to active disease characterized by fever, cachexia, hepatosplenomegaly, and immunosuppression. The healing or protective immunity require an antigen-specific type 1. The Montenegro skin test (DTH) has been interpreted as a marker of protective immunity. However, there is no known correlation between the DTH response to type 1 and DTH and immunity of type 1 are maintained in the long term. Thus, a longitudinal study of 8 years, nested in a cohort family held in Brazil, documented the status of DTH and cytokine production by peripheral blood mononuclear cells in response to antigen-specific stimulation. This study was the interdisciplinary approach of physicians, biochemists, nutritionists, veterinary medicine, biology and statistics. The results show that 46.2% of subjects were analyzed DTH positive at baseline. The prevalence of positive and DTH induration size increased with age (p = 0.0021). 15.7% of individuals positive DTH "retro-converted" the negative and 50.4% (64) of individuals negative DTH became positive. The size of DTH induration was correlated significantly with the antigen-induced production of IFN-γ (r = 0.6186, p = 0.0001). IL-6 was secreted at higher levels in peripheral blood mononuclear cells of individuals who "retro-converted" DTH positive to negative than individuals who remained stable DTH status (p = 0.005). Thus, IFN-γ produced by peripheral blood mononuclear cells, may be a surrogate marker for protective immunity instead of the DTH response. In addition, differences in innate immune response may determine whether individuals maintain or eliminate the infection by Leishmania infantum chagasi in asymptomatic patients