Influência da laparoscopia e da laparotomia na gasometria, leucometria diferencial e citocinas em modelo de sepse abdominal em ratos

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory and immune response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals

A concepção de professores do ensino fundamental (1ª e 4ª) sobre a saúde do escolar

Com a criação dos Parâmetros Curriculares Nacional (PCNs), a saúde passou a ser um tema transversal que deve ser trabalhado por todos os níveis de ensino em toda a escola, principalmente pelos professores do ensino fundamental, os quais têm uma grande responsabilidade no processo de formação dos valores e de condutas dos escolares. Com o objetivo de investigar a concepção dos professores de ensino fundamental (1ª a 4ª séries) sobre a saúde do escolar, este estudo teve como amostra 45 professoras lotadas em 04 escolas públicas e 04 escolas privadas no município de Natal/RN. Para a coleta dos dados foi utilizado um questionário semi-estruturado, sendo os mesmos analisados por meio da análise temática. A faixa etária com maior prevalência foi a superior a 40 anos, com 58% de professoras. Com relação ao grau de formação acadêmica das docentes investigadas, 47% delas tem o terceiro grau completo e, 40% possuem apenas formação no magistério. No que se refere ao tema transversal saúde, 27% das professoras não realizaram estudos sobre o mesmo e, 40% das docentes não se sentiam preparadas para desenvolver esse conteúdo, apontando como principal fator limitante à falta de conhecimento mais profundo sobre saúde e a falta de material didático adequado. Sobre a importância em se trabalhar a saúde, 29% das respostas referiram-se aos cuidados com a saúde, e 20% em prevenir e conhecer doenças. Pode-se concluir que é necessária uma capacitação específica referente à temática em questão, o que deve ser acompanhada de políticas públicas que incentivem o profissional da educação e ofereça estrutura ao ambiente escolar

Freqüência e etiologia das dermatomicoses em pacientes atendidos no Hospital Giselda Trigueiro, Natal, RN

Dermatomycoses are fungal infections that attack the skin, hair and nails, in addition to the mucosal and cutaneous-mucosal zones. Objective: Observe the frequency of dermatomycoses, identify etiological agents and establish an association between the results and sex. Age, collection site, time and lesion location. Methods: Between February, 2002 and December, 2004, samples were collected from patients at Giselda Trigueiro Hospital in Natal, Brazil, by lesion scraping and hair removal, following 70% alcohol disinfection, and submitted to direct and culture examination. Results: Of the 817 lesions collected, 325 (39.8%) were fungus positive, with the hair collection site yielding the highest number of positive results (65.8%) and the scalp and hair representing the most frequent lesion sites (65.9%). Negative results occurred mainly in the lower limbs (78.6%). Of the species identified, 55.9% were yeasts, 41.6% dermatophytes and 2.5% Fusarium spp. Non-albicans Candida was the most isolated yeast (43.3%), mainly in females (61.7%) over the age of 40 years (56.4%). T. rubrum was the most isolated dermatophyte (67.9%),notably in males (59.2%) in the 0-20 age group (44.7%). With respect to collection site, 73.9% of the dermatophytes were present in the skin and 61.1% of the yeasts in the nails. When assessing the collection site, the inguinocrural regional was 22.6% positive for dermatophytes, and the nails and hands, 41.8% for yeasts. Conclusions: The results obtained verified that: most of the positive lesions were found in the hair, whereas skin and nail lesions yielded more negative results; T. rubrum was the most isolated dermatophyte and non-albicans candida the most commonly found yeast; positivity was greater in males in the 0-20 year age group at the skin site and in the inguinocrural region, while yeasts were more frequent in females in the over-40 age group at the nail sites

Avaliação da eficácia de um programa de "Escola de Coluna" para lombalgia crônica inespecífica

The Back School has been used to prevent and to treat back pain since 1969, however its effectiveness still is controversy in literature. The objective of this study was to evaluate the effectiveness of a program of "Back School" in patients with nonspecific chronic low back pain, directed by rheumatologists and orthopedic doctors to Physiotherapy School Clinic of Universidade Potiguar (UnP) Natal/RN- Brazil, in period of May/2002 to December/2003. Seventy patients, with age varying from 18 to 60 years, were randomized in two groups: Experimental group (group A) with 34 patients, which was subdivided in groups with 6 to 8 components. This group participated of a theoretician and practical program of Back School with 4 lessons, one day per week, with 60 minutes of duration; to the Control group (group B), with 36 patients, was explained that the group should stay four months in a waiting list . Both groups, had been carried through three evaluations, by a blind, to patient group, independent observer: initial evaluation, after four and sixteen weeks. The following variables were analyzed: pain intensity, measured by analog visual scale (AVS), functional disability, measured by disability questionnaire of Roland and Morris and the spinal mobility measured by Schöber s method. In statistical analysis it was used variance analysis ANOVA, the test of Newman-Keuls multiple comparations, and the Pearson correlation coefficient, with significance level p<0.05. Thirteen patients (18,6%) didn t complete the evaluations, (5 from experimental group and 8 from control group). At last, 57 patients were studied, (29 from Experimental group and 28 from Control group), it was observed a significant statistical improve just for Experimental group in variables pain intensity (p=0,0001), functional disability

Abordagem dos aspectos psicológicos da mulher infértil :um estudo quali-quantitativo

Purpose: assess the frequency of stress and anxiety levels in infertile women, correlate these aspects with risk factors and qualitatively analyze feelings resultant from the inability to conceive, in order to obtain data for specific psychological guidance. Methods: the case-control study included a total of 302 women, 152 being infertile (case group: 30.3 ± 5.4 years), and 150 non-fertile (control group: 25.7 ± 7.9 years). The quantitative approach involved the application of Lipp s Stress Symptoms Inventory (LSSI) and State-Trait Anxiety Inventory (STAI), whereas the qualitative approach consisted of a semi-structured interview. Response variables considered were: stress frequency and anxiety scores (State and Trait). Statistical analysis compared frequencies and medians between groups, by means of qui-squared and Mann-Whitney tests, respectively, and constructed logistical regression models to test associations between response variables and risk factors considered. Qualitative data were analyzed descriptively and categorized in order to perform correspondence analysis. The level of significance was 5%. Results: in the study sample, stress frequency was higher in the case group than in the control(61.8 and 36.0%, respectively), however, significant differences were not observed between groups in relation to stress phases and predominant symptomology type. With respect to anxiety, there were no significant differences between case and control groups as to median state scores [39.5 (35.0 46.0) and 41.0 (35.7 47.0 ); respectively) and anxiety trait scores [44.0 (34.0 51.0) and 42.0 (36.0 49.2); respectively). Risk factors significantly associated with greater risk for high anxiety scores in the case group were: primary infertility, unawareness of the causal factor, diagnostic phase investigation, religion, lack of children from other marriages and the fact that the woman was previously married. The qualitative approach demonstrated that infertility provokes emotional responses, such as sadness, anxiety, anger, fear and guilt. Conclusions: it can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting to stressful events without serious physical or psychological compromising

Estudo da correlação das características dermatoglífica e somatotípica com as qualidades físicas das atletas de voleibol da Seleção Infanto-juvenil do Estado do Rio Grande do Norte

The purpose of the present study is to identify the dermatoglyphic and somatotypic characteristics and the physical qualities of athletes from the under-17 State volleyball team, in Rio Grande do Norte, Brazil. The sample was composed of athletes, n = 14, aged 15.0 ± 0.88 years, weight (Kg) 58.3 ± 5.90 and height (cm) 169.4 ± 7.97, members of the referred team. For data collection Cummins & Midlo s (1942), o dermatoglyphic method and Heath & Carter s (1967) somatotypic method were used and to evaluate physical qualities, 2400m, 50m, Shuttle Run, abdominal , Sargent test and medicine-ball toss were performed. Fingerprints show that the group presents genetic predisposition for the following physical qualities: explosive force and velocity. As to somatotype, the group was endo-ectomorphic. At physical evaluation the group presented low Vo2 max values and reasonable levels of explosive force, local muscular endurance, agility and velocity. We conclude that: according to the dermatoglyphic model observed, the group needs training strategies to improve coordination and agility; somatotype reveals the necessity for reducing fat levels and increasing muscular mass; the evaluation of physical qualities demonstrates the need for better physical preparation. This study traces the profile of the under-17 volleyball player from Rio Grande do Norte, with respect to genetic and somatotypic aspects and physical qualities, which will serve as a parameter for future state teams

Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

A compreensão do corpo na formação profissional do fisioterapeuta

Physical therapy has suffered of a mechanistic influence, with the superspecialization and fragmentation of learning, which interfers directly in the professional s understanding of the body, besides affecting his therapeutic performance. Worried about this reality, this research analyzed perceptions of Physical therapy students from Universidade Federal do Rio Grande do Norte and Universidade Potiguar about the human body. This is a descriptive study where 167 students were evaluated through objective and subjective responses to questionnaires designited QUEB Questionnare of understanding body evaluation. Searching the complement of the datas the QUEB open-ended was created, which gives freedom to students to answer freely. This questionnnaire was applicated on a subgroup composed by 21 students of the Health Sociology subject of the Physical therapy course. The validation process of these questionnaires included strategies of a panel of experts and face validity. The theorical reference analyzed based on the studies which favor the rejoining of knowledge represented by transdisciplinary support. The analysis of the results were performed quantitativavely and qualitatively through categorization of the responses selectioning key-words and the most expressive discourses , besides using descritive statistics interpretation. According to the responses, the body thought only thought biologically, ignoring the understanding of man as a cultural and social construction, confirming the presence of the reductionist model, with overvalorization of early specialization, technical training and purely biological and mechanical considerations of the body and its mobility. Probably, the dialogic knowledge of the body human inside Physical Therapist s learning can promote a growth of health s concept and a true activeness of Physical therapy on it, being the body a link with social environment. So, through understanding of the body as a complex form, the physical therapy will be able to attend your patients considerating their biological characteristics, but so the religious, political, social and ethics. Finally, this reflection suggests a search for a less technical vision, which allows the professional to discern more than segments of the body and which will contribute to a wider understanding of the patient and his social context, leading to greater humanization of the body , improvement in services and consequently, in the quality of life of these patients

Prevalência e fatores associados à dor em bailarinos profissionais

To investigate the prevalence and factors associated to painful symptomatology in professional ballet dancers. Methodos: An analytical transversal cut study was performed with 141 professional ballet dancers in the main capital cities of the Brazilian Northeast. McGill`s Pain Questionnaire and the Wisconsin Brief Pain Inventory, both validated for Portuguese, were used to assess painful symptomatology. Descriptive statistical analysis of the results was carried out, followed by Student`s t-test and Pearson s correlation with pvalue < 0.05. Results: High pain tolerance levels were observed in 70.2% of the subjects, where the intensity varied from moderate to severe. Pain in the lumbar region was present in 85.8% of the individuals. Positive correlations were verified between the degree of pain intensity and activities how to dance (60,3%), general activities (32,6%), sleep (28,4%), mood (27,7%), march (20,6%) and relations with others (16,3%). Conclusions: High pain prevalence was found in professional ballet dancers in the main capital cities of the northeast, and the most affected area was the lumbar followed by knees, neck, hip and feet, with substantial interference of pain symptoms in several activities of the personal and professional lives of these people

Estudo do efeito dos metabólitos do benzeno e tolueno sobre as mitocôndris cerebrais e hepáticas de ratos

Aim: The aim of this work was to investigate the hypothesis that catechol and 3MC inhibit FADH2-linked basal respiration in mitochondria isolated from rat liver and brain homogenates. Moreover, catechol ability to induce DNA damage in rat brain cells through the comet assay (alkaline single-cell gel electrophoresis assay) was also observed. Methods: Two different catechols were evaluated: pirocatechol (derived from benzene) and 3-methylcatechol (derived from toluene); rat liver and brain homogenates were incubated with 1mM catechol at pH 7.4 for up to 30 minutes. After that, mitochondrial fractions were isolated by differential centrifugation. Basal oxygen uptake was measured using a Clark-type electrode after the addition of 10 mM sodium succinate for a period of 12 minutes. In additional experiments, rat brain cells were treated with 1, 5 and 10mM pirocatechol for up to 20 minutes at 37º C, and submitted to electrophoresis. Results: Catechols (pirocatechol and 3methylcatechol) induced a time-dependent partial inhibition of FADH2-linked basal mitochondrial respiration. Indeed, pirocatechol was able to produce a dosedependent DNA oxidative damage in rat brain cells by 2 and 4 injury levels. These results suggest that reactive oxygen species generated by the oxidation of catechols, induced an impairment on mitochondrial respiration and a DNA damage, which might be related to their citotoxicity. Conclusion: Catechols produced an inhibition of basal respiration associated to FADH2 in isolated liver and brain mitochondria; 3-methylcatechol, at the same concentration, produced similar toxicity in the mitochondrial model. Indeed, pirocatechol induced a DNA damage in rat brain cells, mainly observed in comets formation and consequent DNA degradation

Influência de fármacos lipofílicos na estabilidade de emulsões de uso terapêutico

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Determinação dos fatores neuroepidemiológicos das crises convulsivas em recém nascidos internados em unidades de terapia intensiva

O objetivo do nosso projeto foi determinar as características dos recém nascidos com crises convulsivas internados em unidades de terapia intensiva. Foi realizada uma pesquisa multicêntrica, observacional, prospectiva, cuja população alvo foi os recém nascidos com crises convulsivas internados em unidades de terapia intensiva, envolvendo equipe multidisciplinar constituída por neurologista infantil, neonatologistas, intensivistas pediátricos, enfermeiros, técnicos de enfermagem e fisioterapêutas. As crises foram definidas pelo critério clínico, com classificação de Volpe. Variáveis relacionadas à gestação, ao parto, características dos recém nascidos, aspectos das crises convulsivas e mortalidade foram analisadas. Estatística: descritiva (freqüências, medidas de tendência central e dispersão) e análise (teste de probabilidade, teste de risco e de acurácia). Comparamos as crises clínicas entre os recém nascidos de termo e pretermo e observamos diferenças com significância estatística na idade de início das crises, mais tardia nos prematuros, na etiologia predominante: hemorragia peri-intraventricular no prematuro e encefalopatia hipóxico-isquêmica no termo e tipo clínico de crise, clônica no pretermo e sutil no termo. Os testes de acurácia utilizados para determinar se o tipo clínico de crise convulsiva é predictor da etiologia da mesma não revelaram resultados positivos. Quanto às características associadas à mortalidade de prematuros com crise convulsiva, observamos associação entre ventilação mecânica e pneumonia com a mortalidade. Existem diferenças clínicas quando comparamos os recém nascidos pretermo e de termo com crises convulsivas, confirmando dados da literatura

Fisioterapia e sociedade: ações do Sistema Único de Saúde no Rio Grande do Norte

The work has objective to present actions of Physiotherapy, developed by SUS in the State of Rio Grande do Norte; discuss under the humanization point of view such actions of health; discuss the importance of physioterapy to the Norte-Riograndense, or maybe its role in the perpetuation of actions of health centered in the binomial cause/efect. The study was done in the State of Rio Grande do Norte. The data were obtained through public sources gathered in the health secretrary ship of this State. The collected data talks about physiotherapy sections developed by SUS in several areas of the State; such data was collected and analysed after the aproval of Ethic and Resarch Committee of Federal University of Rio Grande do Norte. Concerning the physiotherapy, along with the State Health Secretaryship of the State fo Rio Grande do Norte, there were only records of attending based on cure/rehabillitation, not being observed during the curse of study, any record or action of prevention, promotion and protection towards health. It s possible to notice that there is a highligth to the interventions focusing on the treatment of illness of rheumatic origin and general complaints related to the vertebral column. Such research evidenced that the Physiotherapy in the SUS in the State priorizes the individualized attending centered in the carteziano health/illness model, where the developde actions are turned to the curative and rehabilliting attention, with role fo some or no highligth in the primary attention

Nanosistemas de penicilina G benzatina para tratamento profilático da febre reumática: estudo analítico

Investigations in the field of pharmaceutical analysis and quality control of medicines require analytical procedures with good perfomance characteristics. Calibration is one of the most important steps in chemical analysis, presenting direct relation to parameters such as linearity. This work consisted in the development of a new methodology to obtain calibration curves for drug analysis: the stationary cuvette one. It was compared to the currently used methodology, and possible sources of variation between them were evaluated. The results demonstrated that the proposed technique presented similar reproducibility compared to the traditional methodology. In addition to that, some advantages were observed, such as user-friendliness, cost-effectiveness, accuracy, precision and robustness. Therefore, the stationary cuvette methodology may be considered the best choice to obtain calibration curves for drug analyis by spectrophotometry

Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante

Post-menarche patients with clinical signs of vulvovaginitis were analyzed in this study, whose aims were the following: identify the frequency of C. albicans and non C. albicans species and negative results, correlate the vaginal culture for yeast with risk factors and symptomatology; compare positive and negative results for yeast in the vaginal and anal cultures; compare the positive results for C. albicans with other results found in the vaginal and anal cultures; and compare concomitant positivity for C. albicans and non C. albicans in the vaginal and anal cultures. Sample selection occurred between May, 2003 and May, 2005, and included 99 patients from Natal, Brazil. The laboratory methods used consisted of CHROMagar Candida culture medium, thermotolerance test at 42-45°C and hypertonic NaCL, in addition to the classic methods of carbohydrate assimilation and fermentation. We used absolute numbers, percentages, means of central tendency, chi-squared test (χ2) with Yates correction, Fisher s exact test and odds ratio for statistical analysis. The most frequent species was C. albicans in 69% of the cases. The positivity for Candida spp showed an association with the use of tight-fitting intimate clothing and/or synthetics, allergic diseases and the occurrence of itching, leukorrhea and erythema. Anal colonization increased the likelihood of vaginal contamination by 2.8 and 4.9 times, respectively, for Candida spp and C. albicans. When compared to the other species, C. albicans-positive anal colonization increased by 3.7 times the likelihood of vaginal positivity. These data suggest likely vaginal contamination originating in the anus