Identificação e fatores de virulência de Candida spp isoladas da cavidade bucal de transplantados renais do hospital universitário Onofre Lopes em Natal-RN

Despite Candida species are often human commensals isolated from various oral sites such as: tongue, cheek and palatal mucosa plus subgingival region, there are some properties linked to the organism commonly known as virulence factors which confer them the ability to produce disease. Oral candidiasis is one of the main oral manifestations reported in literature related to kidney transplant patients. The objectives of the present study were to identify and investigate virulence factors of yeasts isolated from the oral cavity of kidney transplant recipients admitted at the Hospital Universitário Onofre Lopes, in Natal RN. Seventy Candida species isolated from 111 kidney transplant recipients were investigated in this study. Identification of the isolates was performed by using the evidence of germ tube formation, hypertonic broth, tolerance to grow at 42°C, micromorphology and biochemical profiles. We observed a high rate of isolation of yeasts from the oral cavity of kidney transplant recipients (63.1%) being C. albicans was the most prevalent species. Oral candidiasis was diagnosed in 14.4% of transplant recipients. We evaluated virulence properties of the isolates regarding to: biofilm formation on polystyrene microplates as well as XTT reduction, adherence to acrylic resin and human buccal epithelial cells and proteinase activity. Most isolates were able to form biofilm by the method of adhesion to polystyrene. All isolates of Candida spp. remained viable during biofilm formation when analyzed by the method of XTT reduction. The number of CFU attached to the acrylic resin suggested high adherence for C. parapsilosis. C. albicans isolates showed higher median adherence to human buccal epithelial cells than non-C. albicans Candida isolates. Nevertheless, this difference was not statistically significant. C. dubliniensis showed low ability to adhere to plastic and epithelial cells and biofilm formation. Proteolytic activity was observed for all the isolates investigated, including the unique isolate of C. dubliniensis. There was a statistically significant association between proteinase production and the presence of oral candidiasis. Studies related to oral candidiasis in renal transplant recipients are limited to clinical and epidemiological data, but investigations concerning Candida spp. virulence factor for this group of individuals are still scarce. We emphasize the importance of studies related to virulence factors of yeasts isolated from this population to contribute to the knowledge of microbiological aspects of oral candidiasis

Características genotípicas e fenotípicas de Candida Albicans isoladas da cavidade bucal de pacientes transplantados renais com ênfase na ação do extrato bruto de Eugenia uniflora em fatores de virulência

Candida albicans is a diploid yeast that in some circumstances may cause oral or oropharyngeal infections. The investigation of natural products is mandatory for the discovery of new targets for antifungal drugs development. This study aimed to determine the genotypes of 48 clinical isolates of C. albicans obtained from the oral cavity of kidney transplant patients from two distinct geographic regions of Brazil. In addition, we investigated three virulence factors in vitro: phospholipase activity, morphogenesis and the ability to evade from polymorphonuclear neutrophils. The expression of these virulence factors in vitro was also investigated in the presence of the crude extract of Eugenia uniflora. The genotype A was the most prevalent (30 isolates; 62.5%), followed by genotype C (15 isolates; 31.5%) and genotype B (3 isolates; 6.25%). When microsatellite technique with primer M13 was applied, 80% of the isolates from the South were placed within the same cluster. All Genotype C strains were grouped together within two different clusters. Genotype C was considered more resistant to PMNs attack than genotypes A and B. Strains isolated from the South of Brazil showed higher ability to combat PMNs phagocytosis. We found a high rate of genotype C strains isolated from the oral cavity of this group of patients. The crude extract of E. uniflora inhibited proper hypha formation and phagocytosis by PMNs, but had no significant effect on phospholipase activity. This study characterized oral C. albicans strains isolated from kidney transplant recipients and will contribute for the better understanding of the pathogenesis and alternative therapeutics for oral candidiasis

Efeito do ácido alfa-lipóico sobre biomarcadores de estresse oxidativo, inflamação e fatores de risco cardiovascular em hipertensos

Alpha-lipoic acid (ALA) is a potent antioxidant with favourable anti-inflammatory, metabolic and endothelial effects, and has been widely investigated due to its potential against cardiovascular risk factors. This study aimed to evaluate the effect of oral ALA supplementation on oxidative stress biomarkers, inflammation and cardiovascular risk factors in patients with hypertension. This is a double-blind placebo-controlled randomized clinical trial, where the intervention was evaluated prospectively comparing results in both groups. The sample consisted of 64 hypertensive patients who were randomly distributed into ALA group (n = 32), receiving 600 mg / day ALA for twelve weeks and control group (n = 32), receiving placebo for the same period. The following parameters were evaluated before and after intervention: lipid peroxidation, content of reduced glutathione (GSH), enzymatic activities of glutathione peroxidase (GPx) and superoxide dismustase, ultrasensitive C-reactive protein (hs-CRP), triglycerides, total cholesterol and fractions, fasting glucose and anthropometric indicators. There was a statistically significant reduction (p <0.05) in serum concentrations of total cholesterol, very low density lipoprotein (VLDL), high density lipoprotein (HDL), triglycerides and blood glucose. There was a reduction in body weight and waist, abdominal and hip circumferences in the group that received ALA. In addition, there was a statistically significant increase (p <0.05) in the contents of reduced glutathione (GSH) and glutathione peroxidase (GPx) in the group receiving ALA. Oral administration of ALA appears to be a valuable adjuvant therapy, which may contribute to decrease the damage caused by oxidative stress and other risk factors associated with the atherosclerotic process

Úlcera de pressão em pacientes internados em um hospital universitário em Natal/RN: condições predisponentes e fatores de risco

The pressure ulcers (PU), also known as decubitus ulcers, are defined as injuries caused by the constant pressure exerted on a particular point of the body, causing impairment of blood supply with a decrease or interruption of tissue irrigation, causing occlusion of blood vessels and capillaries, ischemia and cell death. This is a descriptive study with longitudinal design, and panel type, with quantitative approach that aimed to examine the association between predisposing conditions (PC), intrinsic factors (IF) and extrinsic factors (EF) with the occurrence of PU, in hospitalized patients in the Intensive Care Unit (ICU), pain clinical, surgical clinical and neurology wards of a university hospital. The study population was composed of all patients who were restricted to bed during the period from December 2007 to February 2008. The study was approved by the Ethics Committee of HUOL / UFRN (No 135/07). The data-collection took place through a structured formulary of observation, data from medical records and physical examination of patients skins. The results were organized in SPSS 15.0 software, tabulated, categorized and analyzed by descriptive and inferential statistics. Of the 30 patients studied, 43.3% had been hospitalized in the pain clinical and surgical clinic wards, 20.0% in the ICU, 20.0% in the ICU / ward and 16.7% in neurology, being the length of hospitalization in those units of 7 to 18 days (63.3%) and from 19 to 30 days (36.7%), predominantly female and aged ≥ 60 years (60.0%). 19 PU were diagnosed in 43.3% of patients monitored, being 38.5% with one PU between 7 to 18 days and 46.2% with two or more between 19 to 30 days of hospitalization, showing significant relationship (ρ-value = 0029) between length of hospital stay and the number of PU. Was found an association of 35.7% of the PC (cardio-respiratory, hematological, metabolic and psychogenic), IF (age group, oedema, skin changes in humidity and change of body temperature) and EF (type of mattress and strength of body pressure) for all patients studied, statistically significant (ρ-value = 0001), between the average scores in patients with and without PU, with reason chance to 12.0 for the development of PU and there was moderate correlation ( r = 0618) in the presence of this association. Results show the influence of the multiplicity of factors and conditions on the occurrence of PU, which brings us to reflect on the assistance focused on prevention and reduction of these injuries which will encourage the reduction of hospitalization length, physical and psychological suffering, and the possibility of improving the clinical condition of the patient.

Satisfação da equipe de enfermagem do serviço de atendimento móvel às urgências (SAMU) no ambiente de trabalho

Descriptive exploratory study, prospective with quantitative approach, performed on the Medical Regulation Central of SAMU/Natal, aiming to identify the level of professional satisfaction of the members of the nursing team working at SAMU/Natal; and verify the degree of importance attributed by the professionals to each of the components Professional Satisfaction: autonomy, interaction, professional status , work requirements, organizational rules and remuneration. The population was of 60 professionals, with data collected from january to february 2005. We used an instrument translated and validated by Lino (1999) to the portuguese language, the Professional Satisfaction Rate (PSR). The results demonstrate that there was a slight predominance of the female gender (54,9%); aged between 36 and 45 years old (60,8%); married (58,8%), 82,4% with children, 30,8% aged between 05 and 09. Regarding formation, we observed that 78,4% were nursing technicians and 21,6% nurses, formed for 11 to 15 years (17,5%). From the 11 nurses, 09 (81,8%) informed they have specialization, 29,4% of the team has been working for 11 to 15 years on the urgency area, 58.8% works for more than 02 years on SAMU, 72,6% of the team members have fixed work schedules. There was homogeneity on the work shifts: 41,2% on the day shift and 53% on the night shift. Regarding the reason to be working on SAMU, 64% chose to work in the service, and among these 76,3% predominantly perform direct care to the patients, 96,1% like and are satisfied to work in the service. Regarding the remuneration, 90,9% informed they receive 05 to 10 minimum wages; 70% of the technicians informed they receive -2 to 05 minumum wages, 50,1% informed they receive no additional benefit. The analysis of PSR through Cronbach s Alpha Coeficient resulted on the value of 0,94 and through Kendall s Tau Coeficient on 0,87, demonstrating to be a trustworthy instrument to measure the level of professional satisfaction of the SAMU nursing team, in our environment. As for the level of importance attributed to the components of professional satisfaction, we indentified that the nursing team considered the Autonomy component as the most important, followed by the component Remuneration, Interaction, Work Requirements, Work Requirements, Organizational Rules and Professional Status . Regarding the current level of professional satisfaction, we identified they were most satisfied with the Professional Status , Autonomy, Interaction, Remuneration, Work Requirements and Organizational Rules. The real professional satisfaction level, calculated through statistics, however, tells these professionals are more satisfied with Autonomy, Remuneration, Interaction, Work Requirements, professional Status and Organizational Rules. The PSR in our work was of 8,6, indicating the SAMU Natal nursing team has little satisfaction on their work environment

Hipertensão arterial e fatores de risco em servidores atendidos pelo departamento de assistência da Universidade Federal do Rio Grande do Norte

Systemic arterial hypertension is a multifactorial disease that contributes to the country´s high cardiovascular morbi-mortality rates. Considering that hypertension affects individuals in their most productive age while facing work and living risk factors, it is important to investigate its occurrence and predisposing factors in different occupational segments. The objective of this study was to identify the prevalence of hypertension among workers attended to in a medical service of a public university, their hypertension levels, the risk factors present, and their knowledge of the factors that influence the arterial pressure. The epidemiologic study was conducted in the Health Department of the Federal University of Rio Grande do Norte with 102 workers that sought care in the medical clinic during the months of March to May 2009. Data were collected by means of a questionnaire and measurements of systolic and diastolic arterial pressure (SAP and DAP) that were classified in stages according to the Brazilian Society of Hypertension and the degree of risk for cardiovascular events according to the criteria of the Brazilian Society for Cardiology. Data were analyzed using descriptive statistics. The workers were, on average, 54 years of age; the majority (67%) was male and had primary or middle educational level; they worked mainly in supplemental units and deanship offices conducting different functions such as security guards, administrative assistants, health auxiliaries and constructions workers; 48 (47%) of the workers identified themselves as hypertensive for 8 years on average, with the majority executing hard labor and administrative functions. Among the workers with hypertension, the number of the pressure levels classified as pre-hypertensive, stage I and II were: (12% in the SAP and 20% in the DAP); (16% in the SAP and 9% in the DAP); and (15% in the SAP and 5% in the DAP), respectively. The workers that did not identify themselves as hypertensive presented classifications with greater frequencies were: normal (16% in the SAP and 30% in the DAP); and pre-hypertensive (21% in the SAP and 16% in the DAP). The risk factors identified in more than 50% of the workers were: tobacco smoking, alcohol consumption and indices of being overweight, although physical activities are also present. Of the 48 workers diagnosed as hypertensive, those that had 5 risk factors present and limitrophic pressure levels (12%), in stage I hypertension (16%) and stage II hypertension (15¨%) were categorized as being in high risk for vascular events. The number of workers that indicated they had knowledge of the factors that influence their hypertension was less than 39% for each factor. It is concluded that there is a high prevalence of systemic arterial hypertension in the university workers, even amongst those already under treatment. They constitute a population at risk considering their age group, their work functions, and their inadequate life habits. Health care of these hypertensive workers that seek attention in the Health Department is an important aspect of the internal workers health policy in the institution. Educational interventions are recommended for the improvement of quality of life and of work in these workers

Fatores associados à efetividade da doação de órgãos e tecidos para transplantes

The transplantation of organs and tissues presents itself as an important therapeutic option, both from a medical standpoint, the social or economic. Thus, the identification of variables that can interfere in the effectiveness of organs and tissues donation for transplantation needs to be investigated adequately, because it stands before increasing index of chronic and degenerative diseases in the population, what makes the waiting list for transplantation grow disproportionately and patients come to death without the opportunity of realization the treatment due to a lack of donors. In this context, has defined as objective of this study evaluate the factors associated with the effectiveness of organs and tissues donation for transplantation. It is a evaluative research, quantitative, prospective, with longitudinal design, developed at Central of Catchment, Notification and organ donation for transplant, Organ Procurement Organization and in six accredited hospitals to collect and transplantation of organs and tissues, in Natal/RN, between august 2010 and february 2011, after the approval of the Research Ethics Committee, under No. 414/10 and CAAE 007.0.294.000-10. The probabilistic sample without replacement was composed of 65 potential donors. It was used as an instrument of data collection a structured script non-participant observation of checklist type. Data were analyzed using descriptive statistics and presented in tables, charts, graphs and figures. For this, was used Microsoft Excel 2007 and statistical program SPSS version 20.0. To check the level of significance was chosen by applying the chi-square test (χ2) and Mann Whitney and caselas for less than five, it is considered the Fisher exact test. It was adopted as the significance level p-value <0.05. Among the surveyed it was observed that most of the individuals were male (50,8%), in the age group 45 years (53,8%), mean age of 42,3 years, minimum 5 and maximum 73 years (± 17,32 years). Single / widowers / divorced (56,9%), with up to completed elementary school (60,0%) in the exercise of professional activity (86,2%), catholic (83,1%) and residents in metropolitan region of Natal (52,3%). Was obtained donation effectiveness of 27,7%. There was no statistical significance between structure and effectiveness of the donation, but were observed inadequacies in physical resources (36,9%), materials (30,8%), organizational structure (29,2%) and human resources (18,5%). In the process, the maintenance phase (p= 0.004), diagnosis of brain death (p= 0.032), family interview (p≤ 0.001) and documentation (p= 0.001) presented statistical significance with effectiveness. Thus, it is accepts the alternative hypothesis of the study, in which is evidenced that the adequacy of the factors related to structure and process is associated to effectiveness of organs and tissues donation for transplantation. In this way, the effectiveness of organ and tissue donation ends in an essential way the rapidity and accuracy with which the donation process is conducted, requiring appropriate structure, with appropriate physical and material resources and skilled human resources to optimize the reduction of time and the suffering of those waiting for an organ or tissue transplant queued in Brazil

Análise numérica do efeito de fatores influentes da reação álcali-agregado no desempenho de estruturas de concreto

The aim of this work is the numerical simulation of the mechanical performance of concrete affected by Alkali-Aggregate Reaction or RAA, reported by Stanton in 1940. The RAA has aroused attention in the context of Civil Engineering from the early 80, when they were reported consequences of his swelling effect in concrete structures, including cracking, failure and loss of serviceability. Despite the availability of experimental results the problem formulation still lacks refinement so that your solution remains doubtful. The numerical simulation is important resource for the assessment of damages in structures caused by the reaction, and their recoveries The tasks of support of this work were performed by means of the finite element approach, about orthotropic non-linear formulation, and, thermodynamic model of deformation by RAA. The results obtained revealed that the swelling effect of RAA induced decline of the mechanical performance of concrete by decreasing the margin of safety prior to the material failure. They showed that the temperature influences, exclusively, the kinetics of the reaction, so that the failure was the more precocious the higher the temperature of the solid mass of concrete

Balanced Scorecard: fatores relevantes de sua implantação na diretoria de mercado de capitais do Banco do Brasil

Este trabalho objetiva determinar que características do corpo funcional da DIMEC (Diretoria de Mercado de Capitais do Banco do Brasil) estão associadas aos principais entraves considerados relevantes pelos funcionários da área durante a implementação do Balanced Scorecard (BSC). Pretende-se salientar como entraves tais como a falta de apoio de Tecnologia de Informação e a falta de hábito dos funcionários em lidar com indicadores não financeiros podem se relacionar com as características de interesse do corpo funcional, tais como nível hierárquico , formação acadêmica e nível de conhecimento da ferramenta BSC , de forma a influenciar na implementação do modelo. Para tanto foi realizada revisão de literatura e estudo de caso no qual figuraram, como instrumentos de coleta de dados, a aplicação de questionários e a entrevista não-estruturada através dos quais funcionários da DIMEC demonstraram as relações entre as variáveis descritas de forma a destacar fatores de relevância para o desenrolar do processo de implantação da ferramenta BSC na referida empresa

Fatores de decisão da adoção do gás natural na geração de energia elétrica em pequena escala em postos de combustíveis: um estudo de anális de decusão usando o processo de hierarquia analítica AHP

A modeling of criterias and alternatives is through and applied a questionnaire based on method AHP to proprietors of gas stations. The considered alternatives had been the maintenance of the current state with electric energy of the deliverer and the generation in small scale based on the natural gas. The used criteria had been Cost of the Investment, Final Cost of the Energy, Operational cost, Ambient Benefits, Risk and Variation of Costs. The study it was carried through in the city of Natal, RN in ranks that make use of the natural as for resale, where the generation alternative on the basis of the available gas is present. The main results evidence in a dimension the viability of use of method AHP with questionnaire by means of validation of the judgments with analysis of variance beyond proper the normal mechanisms of analysis of consistency to the method. The main results of the analysis help to show that in this in case that the profile of models of criteria and judgments of the actors is similar, with the final evidence of that it has a dominance of the maintenance of the energy of the deliverer. The main criterion to influence this decision was the risk

Fatores que afetam a competitividade na produção de hortaliças orgânicas no Estado do Rio Grande do Norte

The Brazilian organic market has growing year by year, and this commercialization is extremely important to the country, because it allows a bigger preoccupation with the environmental preservation, as well as to create employments and income to the rural workers. However, is necessary that these producers define forms of competition in the market, the way how they will compete, focusing aspects that really matters to the clients. So, the work objective is investigate, based in the rural producers perceptions, the facts which affect the competition the production of organics vegetables in the state of Rio Grande do Norte. With the aim of contribute to the made of strategic decisions related to the production and commercialization of these products in the agriculture scenery norte-rio-grandense, besides to contribute with information about the competition, helping as reference to others important researches. In the methodological view, this study can be qualified as an applied research study, with descriptive objective and quantitative approach. The instrument used was the formulary, resuming to producers of organics products in Rio Grande do Norte state, that grows the segment of organic types of vegetables and greens, been thirty two producers. The data was treated through of the descriptive analyze and the Cluster s analyze. The descriptive research results indicate that the main factors which affect the competition of the organics products in our State are the cost, the diversification and reliability. The Cluster s analyze shows that exists am group of organics producers who uses frequently a specialized technique and they give support to the bigger retail market, as supermarkets

Fatores que afetam a competitividade do queijo artesanal: um estudo exploratório no Seridó/RN

This article presents a study on the research of the factors that affect the competitiveness of cheese produced in a craft in the Seridó of Rio Grande do Norte in the perception of rural producers. His theory is based on factors of competitiveness and definitions of craft production. This research was performed in the important area of production and marketing of cheeses from the state. The methodology used was exploratory research descriptive type survey. The research field of 213 returned questionnaires validated. those interviewed were rural producers of artisanal cheese, with properties distributed in the districts located in the region. The results showed the production of artisanal cheese in Seridó / RN's main points of difficulty to compete: the great marketing in the informality, workforce has low skills and education, has little technical assistance, low acceptance by technological innovations and absence of integration between producers which creates low productivity and qualification of the production chain

Método de avaliação do gerenciamento de resíduos em canteiro de obras da construção civil : proposta baseada em empresas construtoras da cidade de Natal-RN

According to great concern between the developed industrial activities and resultant impacts over the environment, an association of several factors have occurred, procedures to the efficient management of the rotation between economical development and the environment have been improved. A research in field have been realized inside building sites of companies in order to provide knowledge about the implemented and accomplish actions according to the resolution from CONAMA nº307. Trough the interview among the representations of the companies and photographic survey in loco, such as, what makes the companies implement this management, reutilization and recycling, transport and disposition. The present study had as objective: analyze the insertion of the used tools to residuals management, proposing improvements, in a way that it can be easily identified during the procedures execution in the building sites of the building companies of the city of Natal/RN. To reach the goal, in the first place a revision of the pertinent literature was performed; there for, it can be seen the relation between residues management and environment sustainability, once it happens in a continued way it may prevent the waste and reduces the risk that the activities way bring to the employees, community and environment; once found the great difficult faced with regard to labors, material, equipment, project, planning, costumer s interference, furnisher. And still, it could be verified wich materials generate greater indexes of residues in the works and the main occurrences of waste and loss. However a greater transparency is needed coming from the high administration in the commitment with the continued actions, to make it so, there must be a cultural change inside the company. There for there will be a greater productivity and quality of the under taking such as costumer s satisfaction

Relacionamentos cooperativos como fator de sustentabilidade na economia solidária no RN: um estudo de caso múltiplo no setor apícola

We are observing, particurlarly in the last two decades an aggravation of social problems inherent in contemporary society, such as high rates of unereloyment and social exclusion. In this context, the social economy appears as an alternative to generate employment and income, especially for the country man through the production and distribution of developed products in a collective way where the actions of cooperation gain significant importance this study aims to determine how the collective actions affect the sustainability of cooperative socio-political and economic developments of the economy and so it was adopted a methodology of multiple case study in three organizations in the apiculture sector of Rio Grande do Norte the Beekeepers Association of São Rafael City (AAMSR); Beekeepers Association of Serra do Mel (APISMEL) and Family Agriculture Cooperative of Apodi (COOAFAP). To evaluate relationship in collaborative ventures solidarity it is constructed a matrix that identify and develop relationship in the organization and, to measure the level of sustainability of these ventures are calculated the indices of socio-political sustainability and economic sustainability. The research results shows a fully collaborative relationship in all cases based on factors such as effective communication between beekeepers involved/and also cooperated with these organization; availability of beekeepers to perform adjustments in production process; an organizational culture focused on collaboration and high level of situation described above and taking into account that the business of solidarity economy better positioned in the matrix of relationships are those that have best indices of sustainability, it is evidence the importance of collaborative relationships for the sustainability of joint ventures

A gestão do conhecimento e a inovação tecnológica como fatores de sobrevivência e de competitividade na sociedade do conhecimento: uma análise exploratória das MPEs do Rio Grande do Norte

The study examines the process of Knowledge Management and Technological Innovation in Small and Micro Enterprises (SME) in Rio Grande do Norte, Brazil, and proposes actions that can contribute to regional development and competitiveness of SME. Presents as technological innovation can help to make the SME entrepreneurial activities with innovative and competitive. Defines the phases and activities of the construction of knowledge in small organizations. Examines the process of Innovation, Research and Development (R & D) in SME. Identifies the use of knowledge management and technological innovation in management practices and social interaction to influence the competitiveness of SME. Covers the communities of practice as a diffuser of knowledge and learning. To obtain the data were used questionnaires with closed questions with multiple choice, direct observations and interviews with companies. The questionnaires and interviews covered the topics of Innovation, Knowledge Management and Competitive Intelligence on SME. The sample consisted of a total of 13 Small and Micro Enterprises Award winning MPE Brazil Competitiveness, sponsored by SEBRAE in the State of Rio Grande do Norte. The assessment questionnaires dealing with the Knowledge Management (KM Diagnostics - Model Bukowitz and Williams, 2002) and the process of Technological Innovation (Adaptation of ANPEI - National Association for Research, Development and Engineering of Innovative Companies). With the analysis, we concluded that the SME perceive knowledge management, but not formalized management practices so as to facilitate the dissemination of information. Soon, these companies need additional supports to direct them to the innovative activities that generate added value and competitiveness in the market