Análise das mutações C282Y e H63D no gene da proteína HFE em pacientes com hiperferritinemia

Hereditary Hemochromatosis (HH) is a genetic disease caused by high iron absorption and deposition in several organs. This accumulation results in clinical disturbances such as cirrhosis, arthritis, cardiopathies, diabetes, sexual disorders and skin darkening. The H63D and C282Y mutations are well defined in the hemochromatosis etiology. The aim of this paper was that of identifying the H63D and C282Y genetical mutations in the hemochromatosis gene and the frequency assessment of these mutations in the HFE protein gene in patients with hyperferritin which are sent to the DNA Center laboratory in Natal, state of Rio Grande do Norte. This paper also evaluates the HH H63D and C282Y gene mutations genotype correlation with the serum ferritin concentration, glucose, alanine aminotransferasis, aspartato aminotransferasis, gama glutamil transferasis and with the clinical complications and also the interrelation with life habits including alcoholism and iron overload. The biochemical dosages and molecule analyses are done respectively by the enzymatic method and PCR with enzymatic restriction. Out of the 183 patients investigated, 51,4% showed no mutation and 48,6% showed some type of mutation: 5,0% were C282Y heterozygous mutation; 1,1%, C282Y homozygous mutation; 31%, H63D heterozygous mutation; 8,7%, H63D homozygous mutation; and 3,3%, heterozygous for the mutation in both genes. As to gender, we observed a greater percentage of cases with molecular alteration in men in relation to women in the two evaluated mutations. The individuals with negative results showed clinical and lab signs which indicate hemochromatosis that other genes could be involved in the iron metabolism. Due to the high prevalence of hemochromatosis and taking into account that hemochromatosis is considered a public health matter, its gravity being preventable and the loss treatment toxicity, the early genetic diagnosis is indicated, especially in patients with high ferritin, and this way it avoids serious clinical manifestations and increases patients' life expectation. Our findings show the importance of doing such genetic studies in individuals suspected of hereditary hemochromatosis due to the high incidence of such a hereditary disease in our region

IgA sérica, secretora, IgE total e estado nutricional em crianças com infecções por enteroparasitas

Infections for intestinal parasites are one of the main morbidade causes in humans and, its relationships with socioeconomic levels and hygiene conditions in countries in development are already very established. Many works, even so, they are being accomplished to elucidate the complex interactions among nutrition, these infections and answer imunológica, because it is seen that malnutrition commits the immunity increasing the susceptibilidade for infectious diseases and these for its time can harm the state human nutricional. It is known that sponge helmínticos they stimulate synthesis of IgE so much policlonal as specific for the same ones and that IgA secretora, main imunoglobulina of defense of the mucous ones, can act against protozoa as the Giardia lamblia and against helmintos as Trichuris tichiura and Strongyloides stercorales. Some studies show that the malnutrition energy protéica influences in the production of these answers, but some authors show results divergentes. In this work it was evaluated the levels of total IgE, IgA sérica and secretora, contagem of sanguine eosinófilos, levels of proteins séricas and state nutricional, in 103 children of low socioeconomic level, to discover a correlation between those and infection for enteroparasitas. They participated in the study children of both sexes, with age of 3 to 6 years, visitors of the same creche and residents in a neighborhood with precarious hygiene conditions and basic saneamento, in the city of Christmas. The obtained results showed that the faulty environmental and socioeconomic conditions favored to a high infection frequency for enteroparasitas, mainly Trichuris trichiura and Ascaris lumbricoides between the helmintos and Endolimax sleep and Giárdia lamblia among the protozoa. Light malnutrition without deficit protéico was observed in 30% of the children, which didn't also present significant deficiencies of IgA sérica and secretora. The sponged children

Estudo dos fatores associados à infecção chagásica em área endêmica do Rio Grande do Norte

The Chagas disease is a infectious and parasite disease that has as the causative agent a Trypanosoma cruzi, a protozoan parasite that can be transmitted to humans by the faeces of triatomines ( barbeiros ) in the blood-sucking. To understand the relationship between factors associated with chagasic infection and the risk of transmission of Trypanosoma cruzi, this work aimed to make a correlation between the results of serology, obtained by different immunological techniques, used for diagnosis of Chagas disease and risk factors to which the population of the city of Apodi-RN is exposed, to be considered a endemic area. The case-control study was conducted with 199 individuals, which initially was applied a questionary about socio-economic questions and some risk factors which they were exposed and also favor the spread of disease. Then was given the diagnosis by immunological techniques of serology by indirect hemagglutination, ELISA and indirect immunofluorescence. From the diagnosis, the subjects were divided into case group (presence of infection) and control group (no infection). Regarding the descriptive characteristics of the sample, were found a higher frequency of female individuals (59.3%), between 36 and 50 years of age (36.7%), with low education level (91%) and income monthly up to 1 minimum wage (67.8%). The serology, performed by three techniques of different principles, had a reactivity of 38.9% by Indirect Hemagglutination, 39.7% by ELISA and 38.7% by Indirect Immunofluorescence. As the result of the serology, 71 of samples showed reactivity in 2 or more techniques. On some risk variables, was found a significant relationship between individuals who had been bitten by the triatomines and had positive serology for Chagas disease (93.3%). Other variables of risk revealed individuals who had positive serology and had domestic animal (80.3%), lived in poorly maintained homes (97.2%) and near the forest (84.5%). A better understanding of the dynamics of transmission of T. cruzi and the risk factors that contribute to its occurrence in a region are needed to develop effective strategies for control of Chagas disease in these áreas

Avaliação dos marcadores celulares por citometria de fluxo nos portadores de leucemia mieloide aguda atendidos no Hemocentro do Rio Grande do Norte-Hemonorte

The acute myeloid leukemia (AML) is a disease in which malignant myeloblasts expand, build up and suppress normal hematopoietic activity would represent a major diagnostic challenge. With the advent of immunophenotyping by flow cytometry, the diagnosis of these tumors have become more faithful, facilitating the treatment and monitoring of patients. The objectives of this study: diagnosis and classification of AML based on immunophenotyping by flow cytometry with a panel of AcMo specific for acute leukemias, set the frequency of AML in samples from patients with acute leukemias sent to the Department of Hematology Blood Center of Rio Grande do Norte - HEMONORTE, establish standards of antigen expression for different subtypes of acute leukemia and its correlation with the newly diagnosed cases refractory to treatment and recurrence of the disease, standardization of methods for detection and labeling of surface antigens by flow cytometry and intracytoplasmic flow, and observe the frequency of acute leukemia with aberrant phenotypes rare. During the study, 351 were diagnosed acute leukemia, and 179 (51%) classified as AML and 172 (49%) and ALL, which were excluded from the present work. Of the 179 AML, 92 (51.4%) were female and 87 (48.6%) were male, with ages ranging from 3 to 95 years of ag, with higher incidence in individuals in the age group of 41 to 65. Splenomegaly was the clinical finding more present, a total of 147 cases (82.1%), followed by hepatomegaly present in 132 cases (73.7%). The hemorrhagic events were observed in 55 cases (30.7%). Lymphadenopathy in turn was detected in 20 of 179 cases (11.2%). In order to classify subtypes of AML, we used a large panel of monoclonal antibodies, obtaining the following results: AML M0, 02 (1.1%) AML M1, 40 (22.3) AML M2, 60 (33.5) AML M3, 22 (12.3%) AML M4, 10 (5.6) AML M5, 13 (7.3%) AML M6 06 (3.4%) and AML M7 01 (0.6%). We observed some cases with aberrant expression of some antigens such as CD7, CD4, CD19, CD3, CD5 and TdT, CD 7 was present in 30 (16.8%), CD4 in 5 (2.8%), the CD 3 in 5 (2.8%), the CD19 in 3 (1.7%), the CD5 in 3 (1.7%) and TDT was in 7 (3.9%) cases of AML .the CD8 and CD79a was present in only a 1 case.

Investigação das alterações citogenéticas em pacientes pediátricos com leucemia linfóide aguda do Rio Grande do Norte

Leukemia is a heterogeneous group of hematologic malignancies that result from partial or total transformation of the blast cells. The Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in childhood, especially in male, Caucasian children younger than 14 years. Several criteria are adopted to classify ALL, including the cell morphology, cytochemistry, immunophenotyping and cytogenetic analysis. Cytogenetic studies allow a more detailed analysis to detect chromosomal abnormalities of leukemic cells. These modifications will determine the diagnosis, classification, stage characterization, remission assessment and prognosis. In this study were evaluated 30 patients, aged from four months to seventeen years, of both sexes and various ethnicities. The age distribution showed that 67% of patients had between one and ten years (with mean age of XX years old), the most prevalent ethnic was Caucasian (50%) and 57% were males. According to immunophenotype, 93% of patients had B-cells progenitor ALL and 7% early lineage T. Considering the total studied population, the most frequent medical findings were lymphadenopathy (37%), hepatomegaly (77%) and splenomegaly (70%), where one patient could present more than one of these medical findings. Regarding the CBC, the majority of patients had hemoglobin below 10 g / dl (73%), leukocyte count less than 10.000/μL (60%) and platelet count below 150.000/μL (83%). Chromosomal abnormalities were observed in 64% of all patients, where hyperdiploidy was the most common numerical change (67%), followed by hypodiploid (33%). All these data are in agreement with the literature. Moreover, complexes structural and/or number changes not yet described in literature were observed, which indicated poor prognosis. Finally, we concluded that this study demonstrated the importance of cytogenetic study in the diagnosis and identification of prognostic factors in pediatric patients with ALL in Rio Grande do Norte. The results obtained in this study are extremely useful and emphasizes that surveys of this nature must be conducted more frequently in our state

Estudo de polimorfismos em genes relacionados ao metabolismo do ácido fólico e sua associação com o desenvolvimento de fendas orais não-sindrômicas

The congenital facial clefts are characterized by incomplete formation of the structures that separate the oral and nasal cavity. It is known that several environmental and genetic factors are involved in its development, among these, polymorphisms associated with folic acid metabolism have been investigated. In this sense, the objective was to observe the frequency of polymorphisms C677T and A1298C methylenetetrahydrofolate reductase gene (MTHFR), methionine synthase A2756G of (MTR), A66G of methionine synthase reductase (MTRR) A80G and the reduced folate carrier (RFC1) in patients with non-syndromic oral clefts, trying to match them with their development. Methods: We studied 140 patients with non-syndromic oral clefts and their mothers and 175 control subjects with their mothers, who underwent a questionnaire to obtain family information. Were collecting blood for DNA extraction from patients and their mothers to identify the genotypes of both by PCRRFLP, in addition to carrying out the determination of glucose, AST, ALT and serum creatinine, folic acid and vitamin B12 Serum and plasma homocysteine, and the hemogram. Results: Most patients have cleft lip and palate (55.8%), followed by isolated cleft palate (24.2%) and cleft lip (20%). Regarding gender, 62% of patients were male and 48% female and, after subdivision of the type of screwdriver according to sex was found a prevalence of males in the cracks of the type lip and palate (69 %) and lip (69.2%) and in the case of cleft palate was a female predominance (59%). The average concentration of serum folate in the group of mothers of cleft patients was significantly lower (13.8 ± 2.4 ng / mL) compared with the group of mothers of control subjects (18.8 ± 3.4 ng / mL) This was also observed for the group of cleft children as compared to controls, the dosage of folic acid had a significant difference with values of 15.6 ± 0.6 (ng / mL) and 17.9 ± 0.6 (ng / mL), respectively. For the biochemical measurements of glucose, AST, ALT and creatinine were not statistically different, nor was observed for haematological parameters performed. In assessing the frequency of polymorphisms C677T and A1298C MTHFR, A2756G MTR, MTRR A66G and A80G of the RFC1 there was no statistically significant difference in genotype distribution between cases and controls both for mothers and in the cleft. Conclusion: Although not observed association of polymorphisms with the development of cracks, the decrease in serum folate in the group of cleft patients and their mothers may reflect a disturbance in the metabolism of this metabolite, necessitating further studies such as studies methylation and expression to further elucidate the involvement of folate in the development of oral clefts

Limites e possibilidades do programa nacional de alimentação escolar enquanto estratégia de promoção da segurança alimentar e nutricional no municipio de Macaíba/RN

This dissertation aims to understand the importance of the National School Feeding as a strategy for ensuring the promotion of food and nutrition security in the municipality of Macaíba / RN, taking into account the implementation of the Law School Feeding, 11,947, 2009. The program was extended to all public basic education, youth and adults, in addition to ensuring that 30% of transfers from FNDE, were intended for the purchase of products from family farms. The survey was conducted with 160 students from public schools and farmers nesting Quilombo dos Palmares II, who produce on their land vegetables, fruits and cereals for their own consumption, for sale in local markets, in addition to providing for PNAE. The reciprocity between neighbors, such as mutual aid and sharing of common goods was noticeable in this group of farmers, since it was necessary to meet weekly deliveries of products to schools. As students, we applied a test of acceptability in two schools located in rural and in urban areas, to learn the opinion of ourselves in relation to school food consumed. It was concluded that to be most effective program in the region, there must be a better match in school menus, so that it can be attractive to students and to ensure greater use of fresh food, the main ingredient of same, practice of nutrition education in schools, to teach students the importance of food to health. In relation to local management, noted the need for adjustments bureaucratic as hiring staff for the departments, in order to be more agile in releasing payments to farmers, in addition to hiring assistants general services for schools, one Since the cooks exert dual role, the cooking while being responsible for cleaning the entire school environment. Government investments in the rural sector would be extremely valuable for farmers, since they need financial resources to purchase inputs, irrigation projects for gardens, availability of land for planting, transportation to facilitate the delivery of its products to schools and technical assistance more frequently

O som do silêncio :a angústia social que encobre o luto : um estudo sobre isolamento e sociabilidade entre enlutados do cemitério Morada da Paz (Natal/RN)

Nowadays, the act of mourning configures as a circumstance of isolation and social anguish due to the impossibility to express the pain by those who suffer the loss of a dear one. At the same time, the symbolic relations established between society and the cemetery contains interpretations about death, pain and fear which confer to the visits a special and individual feature. In this context, this dissertation tries to analyse the formation of a sociability observed among visitors of the Morada da Paz a private cemetery located in Natal/RN as well as the frequency of the visitors to the necropolis. Therefore, the research was accomplished from the observation of the existent relations among these actors whose meetings have procured links based on the experiences´ exchange about pain and bereavement. In this sense, this study tries to analyse, as its principal point, in which way the Morada da Paz space and the relations established there are being appropriate by the visitors in their mourning process, trying to understand what are the role of these bond in the elaboration of the loss for these people

Efeitos do enriquecimento com nutrientes (N e P) em diferentes condições de luz sobre o crescimento do fitoplâncton em um reservatório eutrófico no semi-árido brasileiro

The increasing of pollution in aquatic ecosystems in the last decades has caused an expansion of eutrophication and loss of water quality for human consumption. The increase of frequency and intensity of cyanobacteria blooms have been recognized as a major problem connected to water quality and eutrophication. The knowledge of environmental factors controlling these blooms is a key step towards the management for recovering aquatic ecosystems from eutrophic conditions. Primary productivity in aquatic ecosystems is dependent on light and nutrients availability. In the present work we evaluated the relative importance of the concentration of major nutrients, such as phosphorus and nitrogen, and light for phytoplankton growth in the main water reservoir of Rio Grande do Norte State, named Engenheiro Armando Ribeiro Gonçalves (EARG), which is an eutrophic system, dominated by potentially toxic cyanobacteria populations. Limitation of phytoplankton growth was evaluated through bioassays using differential enrichment of nutrients (N and/or P) under two light conditions (low light and high light) and monthly monitoring of chlorophyll-a and nutrients (total nitrogen and phosphorus) concentrations, and water transparency (Secchi depth) at the pelagic region. Our results confirm that EARG reservoir is an eutrophic system with a low water quality. Results of bioassays on the growth of phytoplankton limitation (N or P) were conflicting with the results predicted by the TN:TP ratios, which indicates that these ratios were not a good indicator of algal growth limitation. Nitrogen was the limiting nutrient, considering both frequency and magnitude. Light and hidrology affected phytoplankton response to nutrient enrichment. The extreme eutrophic conditions of this reservoir, dominated by cyanobacteria blooms, demand urgent managing strategies in order to guarantee the multiple uses for this system, including water supply for human population. Although nitrogen is the limiting nutrient, an effective management program must focus on the reduction of both phosphorus and nitrogen input

Padrões de coexistência e utilização do hábitat por duas espécies de Herpsilochmus (Aves: Thamnophilidae)

How ecologically similar species are able to coexist has always generated great interest in the scientific community. Classical niche theory predicts that species coexistence is only possible when they segregate in at least one dimension of the ecological niche, thus leading to ecological differentiation among species. However, recent work has shown that species that are more similar in some ecological traits are the ones more prone to be able to coexist (environmental filter). The knowledge of how these forces act shaping ecological communities can reveal co-existence strategies, providing important information for management and conservation of the species. This study tested these hypotheses using a pair of coexisting species of Herpsilochmus, H. pectoralis and H. sellowi. In this study I use high resolution (50 x 50 m) ecological niche models to Identify which environmental factors best predict species occurrence. Next, I calculate the overlap in habitat use by species and build null models to test the hypothesis of spatial niche segregation. In addition, I obtain the selectivity parameters of habitat use to test whether the species H. pectoralis (larger body size) is less selective than H. sellowi (smaller body size) as stated in the literature for other species. The results reject the ecological equivalence among species, revealing that the species of Herpsilochmus explore the habitat differently, having different environmental niches. The hypothesis of environmental filter was not observed in my analysis, the observed overlap in habitat use among species was lower than expected by chance. Evidence that Herpsilochmus are spatially segregating reinforces the hypothesis of interspecific competition as the predominant force in the selection of microhabitat of the species. However, more data and experiments are necessary to state categorically that the observed pattern is a result of current or past competition

O concreto e o simbólico no cotidiano da educação em saúde: práticas, representações e processo identitário dos agentes comunitários de saúde de João Pessoa PB

The present study is about an etnographic research based on the Theory of Social Representation and its complementary approach, the Theory of Central Core based on the bourdiesianos concepts of field and habitus , concerning that these concepts, articulated to the constructed social representation, may contribute to the study of social identities. Its aim is to acknowledge which identity references community health agents (CHA), agents from Community Health Agent Program (CHAP) and Family Health Program (FHP) from João Pessoa PB and which social representation is constructed by them towards health education. The study had the participation of 119 CHAs, from which 90,3 % were female and 9,7% were male. Since the identity is also built by the representation of others towards the group, 63 professionals of the FHP group (16 nurses, 16 nursing assistents, 12 doctors, 9 dentists, 6 dentistry office assistents, 4 coordinators, 1 psicologist and 1 receptionist) and 1 nurse from CHAP took part of the study, oficial documents from the Health Ministry were analyzed, verbal information from its representatives were also taken into consideration, as well as reports from the many benefitiaries of the CHA, CHAP and FHP. For data collecting, we used the combination of (a) Direct Observation and Participant Observation of the functioning micro-areas of the CHA at the Family Health Units, and the Union of the Agents; (b) Free-Association of words and expressions to stimulate the CHA , Health Education and Health ; (c) Questionnaire; (d) Interviews. The interviews were submitted to a thematic analysis of its topic. The free-association was analyzed taking in consideration the vèrgesiana proposal (a combination of the frequency and average order of evocation) which treatment enabled the identification of the central and peripheral systems of social representation towards health education and the community health agent. A test of central refutation, associated to the analysis of the indicated evocations as the most important, provided empirical evidence of social representation towards health education as orientation , prevention and hygiene , as well as the identity of CHA as supervisor , friend , help , important , and the link between the community and the Family Health Staff. Other professionals from CHAP, FHP and the Health Ministry share all of these representational contents, especially the concepts of friend and link , also shared by the community. A habitus towards the community health agents was identified, as a representation based on trust and friendship, which gives the professional a great importance towards the daily inconsistencies faced by the community

Era um sonho desde criança : a representação social da docência para os professores do município de Queimadas-PB

The objective of this work was to access and understand the teaching social representation (MOSCOVICI, 2005) for the teachers of the children education and fundamental education at Queimadas city, Paraíba. We assume that one representation that allows the teacher to name its profession and to act on it, is a derivative of regularities that are expressed by means of a habitus (BOURDIEU, 1983a), generative matrix of perception and action. This teaching habitus is originated from the experiences and the trajectories of social and professional life of the group. Therefore, from some variables, we tried to access the profile of the group of teachers studied and to get closer of their life style to understand their profession choice and the teaching social representation for this group. In this research, it was used four data sources: a) the questionnaires of characterization; b) the questionnaires of practices and meanings; c) the experience reports and; d) the interviews in depth. The analysis of the data collected was done by means of the simple statistics (frequency), the intersection of variables through cross tables and, the thematic analysis of the contents. The results show that there is a lightly homogeneous group in terms of its social origin and its life style, moreover, they conduct to an overlap between this origin/style and the professional choice. On the other hand, the teacher representation is multi-dimensional such that, all dimensions intercept and articulate with each other to provide a concise teacher representation. They are four dimensions: love and care, help and donation, teaching and learning and, sacrifice and hope. The elements of the teacher representation are substantiated in the schemes of perception and appreciation of the group, in the regularities and life experiences in the context of religion, family, gender and profession. In these regularities we find the elements that comprise the teaching habitus which drives perception and action, representation and daily practice of these teachers. The teaching social representation is still perceived as a threshold for the professional identity of the group of teachers considered. We also observed that there are signs of changes in the practices used by these professionals since they graduate from the course of pedagogy. However, it is not possible to say that these changes are isolated or they lead to a transformation in the teaching habitus or the teaching social representation

Dificuldade de berço? Professores de matemática no ensino médio: práticas, formação continuada e juventude

The present paper is focused on pedagogical practices and continued lecturing formation of High School Mathematic teachers. Knowing the essential importance of the teacher at the educational process since he/she is the mediator on knowledge gathering by the scholars and continued formation meaning on that process, we hereby propose to investigate and compare what Math teachers think about their professional role, the kind of continued formation they receive and their development on teacher s knowledge and doing; to gather and compare what do Math teachers know about young people at public and private schools and their demands and as which find out if they link with the way as their students are taught. To develop our comparative research, we chose a qualitative focus and an investigation of ethnographic type. We took as the subject four Math teachers that work with high school 1st and 2nd grades in public and private schools, morning and afternoon shifts and license titles. The research results reveal differences in structural matter between the spaces, but the comparisons between teacher doings and knowledge reveal that the differences refer to the sort of formation and how often do the teachers search for it. Nevertheless, the reports pointed to continued lecturing formation offering and consistence problems and these reflect on their work and on its basis. The knowledge about youth and adolescence, such as theoric and methodological knowledge that lead their practices, are revealers of teachers difficulties in developing their activities according to the target public and nowadays educational demands

Política de formação docente na América Latina :Argentina, Brasil e Chile

This work aims at studying the policies of teaching training and their impact in the actors and in the education systems of the countries in which these policies were implemented into the context of neoliberal reforms. We particularly studied these policies in three Latin America countries: Argentina, Brazil and Chile. The policies studied here are the ones implemented from the 90 s. However, the horizon of this study is at the beginning of the 80 s, period that starts one of the four intervention initiatives of education here studied: The Main Project of Education For Latin America and Caribbean (PROMEDLAC), which in 2002 goes into a new stage and it is called Regional Project of Education for Latin America and Caribbean (PRELAC), worked out by UNESCO as a request of government representatives of countries of the region, based on the suggestions of Declaration of Mexico , signed by them in 1979. These suggestions will be in the base of the other three initiatives: The Education For All (EPT); Ibero-American Conferences of Education (CIE) and The Hemisphere Action Plan of Education (PAHE), whose documents are the base to the production of an abundant legislation and normatization on education that created the parameters on which the policies of education reforms were worked out and implemented and the dynamism of our education systems from the last two decades of the twentieth century on. All these initiatives intend to work with objectives, projects and programs that, in some cases, in isolation or in groups, are under influence of their actions in a way that frequently it is difficult to identify which of them is the main responsible for some advances. It is important to stand out that not all of the suggestions produced by these initiatives were implemented as policies, and many of them to be implemented were changed in such a way that they were distorted, even they were a result of a multilateral deal, each country gave to them its own interpretation. Moreover, in all these processes the teaching entities had and keep having a fundamental role. The evidences, result of the evaluations of each initiative, show that education policies implemented produced advances in several aspects. They are still not the ideal ones, in truth, but they do exist. In relation to the teaching questions, there were and are still being implemented multiples and varied actions that did not have the expected impact in the education systems of the countries, objects of this study, but, many of them that go on, are promising and start to have a positive impact into the education systems. Even so, the teaching subject matter, even playing a central role in the agenda of all countries of the region, still represents one of the big challenges to the advance and improvement of our education systems

Tuberculose: conhecimentos, representações sociais e experiências da doença na visão do portador

Tuberculosis is considered one of the most ancient human diseases, cases were registered 3900 years before Christ, and it is currently regarded as a serious public health problem in the world due to several factors such as income mismanagement, precarious standard of life and some sort of prejudice comprised by the word tuberculosis. Taking this into consideration, it was developed a descriptive and exploratory study aiming at analyzing the social representations of tuberculosis made by its patient from the Unidades de Saúde da Família (Family Health Units a public health program) in Campina Grande City PB, in relation to the decentralization of the policies that administrate the disease. It was interviewed 34 tuberculosis patient that were being treated from 2007 to 2008. The age group of the interviewees varied from 10 to 60 years old, but most of them were between 36 and 60 years old (58,8%, n=20), some were young adult and adult (21 35 years old), with 11 (32,3%) respondents, and, less frequent, children and teenagers (11 20 years old), with 03 (8,8%) participants. Data was collected through semi-structured interview. The questions that guided the research were elaborated based on the operational recommendations of DOTS strategy; that is: access to laboratory examinations; medication guarantee; directly observed treatment. Besides that, the experiences of the patient were considered in their relation with the family and the different social groups. The analysis of the discursive material was submitted to the Analyse Lexicale par Context d un Ensemble de Segments de Texte software - ALCESTE 4.7. Data interpretation showed five categories for the social representations of the tuberculosis patient that participated in DOTS strategy: 1) the accessibility of the health assistance service; 2) the patient perspective of the disease; 3) the change in the operation of the productive life; 4) the signals and symptoms of the tuberculosis disease; 5) the rearrangement and mechanisms used to face the disease. The Central Nucleus reveals that tuberculosis is a transmissible disease that can be prevented by people through educational practices, health promotion, active search for symptomatic respiratory and control of the carriers communication; these mechanisms should be incorporated to the routine of all participants of the family health groups. The Intermediate Elements, based on quotidian life, as well as the individual experiences of the tuberculosis patient, reveals prejudiced attitude and beliefs that lead to isolation and restriction of interpersonal relationship. Peripheral Elements were constituted by themes that showed the patient feelings of indignation because of the social barriers they had to face in the Family Health Units during the treatment. These elements demonstrate a negative perspective of the representation concerning the accessibility, i.e. inadequate structure of the health service; long distance to the Health Centre, this factormakes it difficult for the patient to continue the treatment; scheduling delay; and limited service regarding other requests (doctor, dentist etc). One expects to contribute for the construction of a new perspective of the health question between the different agents who make the assistencial institutions and formation of professionals, either in central or local scope