A experiência de depressão na contemporaneidade: uma compreensão fenomenológico-existencial

The depression is one of the most common forms of getting ill nowaday. Due to the increase in incidence of depression cases registered worldwide, this theme has been the subject of important studies, especially regarding the symptomatological description and biological etiology of the disease. This research had the objective to understand the unique experience of depression experienced by people who recognize themselves in depression, under the focus of existential phenomenology of Martin Heidegger. To reach the proposed objective, individuals narratives interviews were conducted with four participants, starting from the triggering question, "from your experience, how is for you to being depressed?". The survey revealed that depression affects the whole person and is related to stressful life contexts. Depression was narrated as an experience of disempowerment and lack of self esteem and personal worth. The collaborators of the research referred to the depression from sad, angry, bored and pessimistic mood. The time is experienced as a restriction to the projective opening towards the possibilities of being in which the future is seen as catastrophic and the past lived as debt and guilt. The corporeality, in depression is experienced through the weight, fatigue and pains for no reason. The space is lived from the notion of fall and collapse. We also realized the desire for isolation and avoidance of social contact. Suicide is desired and represents the end of the suffering in life. The depression has proved, still, very stigmatized, because it is discredited and misunderstood. The stigma also addressed to the experience of hospitalization and the unsuitability to the socially imposed standards of beauty, which generates enough suffering to the depressed person. The medication was described based on its positive effects, as a balance and suffering reducer, but also as a producer of dependence. Were also identified according to the collaborators, traces of selfdemand, ordenality and being-for-others, characteristic of typus melancholicus. This study contributes to an understanding of the depression that goes beyond the merely biological perspective and symptomatology of the pathology. The investigation of the depressive experience, through the lens of Heidegger's phenomenology, showed us the phenomenon of the depression in their singularity, complexity and multiple meanings, showing the close relationship between the formation of the depression and the context of personal and social life of the participants

Hidrocarbonetos policíclicos aromáticos no meio ambiente: diferenciação de fontes em sedimentos e metabólitos em bile de peixes

Many studies on environmental ecosystems quality related to polycyclic aromatic hydrocarbons (PAH) have been carried out routinely due to their ubiquotus presence worldwide and to their potential toxicity after its biotransformation. PAH may be introduced into the environmet by natural and anthropogenic processes from direct runoff and discharges and indirect atmospheric deposition. Sources of naturally occurring PAHs include natural fires, natural oil seepage and recent biological or diagenetic processes. Anthropogenic sources of PAHs, acute or chronic, are combustion of organic matter (petroleum, coal, wood), waste and releases/spills of petroleum and derivatives (river runoff, sewage outfalls, maritime transport, pipelines). Besides the co-existence of multiples sources of PAH in the environmental samples, these compounds are subject to many processes that lead to geochemical fates (physical-chemical transformation, biodegradation and photo-oxidation), which leads to an alteration of their composition. All these facts make the identification of the hydrocarbons sources, if petrogenic, pyrolytic or natural, a challenge. One of the objectives of this study is to establish tools to identify the origin of hydrocarbons in environmental samples. PAH diagnostic ratios and PAH principal component analysis were tested on a critical area: Guanabara Bay sediments. Guanabara Bay is located in a complex urban area of Rio de Janeiro with a high anthropogenic influence, being an endpoint of chronic pollution from the Greater Rio and it was the scenario of an acute event of oil release in January 2000. It were quantified 38 compounds, parental and alkylated PAH, in 21 sediment samples collected in two surveys: 2000 and 2003. The PAH levels varied from 400 to 58439 ng g-1. Both tested techniques for origin identification of hydrocarbons have shown their applicability, being able to discriminate the PAH sources for the majority of the samples analysed. The bay sediments were separated into two big clusters: sediments with a clear pattern of petrogenic introduction of hydrocarbons (from intertidal area) and sediments with combustion characteristics (from subtidal region). Only a minority of the samples could not display a clear contribution of petrogenic or pyrolytic input. The diagnostic ratios that have exhibited high ability to distinguish combustion- and petroleum-derived PAH inputs for Guanabara Bay sediments were Phenanthrene+Anthracene/(Phenanthrene+Anthracene+C1Phenanthrene); Fluorantene/(Fluorantene+Pyrene); Σ (other 3-6 ring PAHs)/ Σ (5 alkylated PAH series). The PCA results prooved to be a useful tool for PAH source identification in the environment, corroborating the diagnostic indexes. In relation to the temporal evaluation carried out in this study, it was not verified significant changes on the class of predominant source of the samples. This result indicates that the hydrocarbons present in the Guanabara Bay sediments are mainly related to the long-term anthropogenic input and not directly related to acute events such as the oil spill of January 2000. This findings were similar to various international estuarine sites. Finally, this work had a complementary objective of evaluating the level of hydrocarbons exposure of the aquatic organisms of Guanabara Bay. It was a preliminary study in which a quantification of 12 individual biliar metabolites of PAH was performed in four demersal fish representing three different families. The analysed metabolites were 1-hydroxynaphtalene, 2-hidroxinaphtalene, 1hydroxyphenanthrene, 9-hydroxyphenanthrene, 2-hydroxyphenanthrene, 1hydroxypyrene, 3-hidroxibiphenil, 3- hydroxyphenanthrene, 1-hydroxychrysene, 9hydroxyfluorene, 4-hydroxyphenanthrene, 3-hydroxybenz(a)pyrene. The metabolites concentrations were found to be high, ranging from 13 to 177 µg g-1, however they were similar to worldwide regions under high anthropogenic input. Besides the metabolites established by the used protocol, it was possible to verified high concentrations of three other compounds not yet reported in the literature. They were related to pyrolytic PAH contribution to Guanabara Bay aquatic biota: 1-hydroxypyrine and 3-hydroxybenz(a)pyrine isomers

Tontura em idosos institucionalizados da cidade do NATAL/RN: Um estudo caso-controle em vestibulopatas e não-vestibulopatas

the institutionalized elderly presents for being more fragile a lot of body balance s changes, which can induce falls and health frailty. One of the consequences of it is the appearance of dizziness, vestibular or not. This study aims to identify the risk factors related to dizziness in institutionalized elderly, with and without vestibular disorders, in the city of Natal-RN. Method: a case-control study realized in 12 regulated by Health Surveillance Long Term Care Institutions for the elderly in Natal-RN. Elected seniors with good cognitive level and able to walk, totaling 115 individuals, and of these, 102 were selected according to the presence of dizziness in the last year (n = 51) and their controls (n = 51), paired by sex and age. The 51 elderly patients with dizziness were divided into 3 groups case: case one, for elderly with dizziness and without vestibulopathy (n=38); case two, for elderly with dizziness and vestibulopathy (n=13) and case three, for all the seniors with dizziness, or added to the case 1 case 2 (n=51). The 51 seniors who served as controls were also divided into three groups, according to the number of individuals of each case: control 1, n = 38, control 2, n = 13 control and 3 (sum of 1 control with control 2), n = 51. As possible risk factors were analyzed variables related to characteristics of the institution, to the habits of life of older people and those concerned with the health of the elderly. For statistical analysis, we used the chi-square or Fisher exact test for a significance level of 5% and calculating the association magnitude between variables by measuring the Odds Ratio. Results: as risk factors for dizziness without vestibular disorders were found the presence of hypertension and cardiovascular disease, as well as the presence of three or more disorders for elderly and use of gastric protector drugs. For the elderly group from case two were found no associated risk factor. For elderly patients with dizziness in the case group three, we observed the same risk factors found for the elderly in the case group one, plus the presence of osteoarthritis pathology, which was also significant for this group. Conclusion: dizziness in institutionalized elderly is associated with systemic common diseases in this age group and the vestibulopathy presents itself as pathology on an isolated way, not being possible, with our data, associate it with non-risk factors

Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

Câncer de mama: vivência das usuárias dos serviços prestados pela Liga Norte Riograndense Contra o Câncer

This study is about the users' experiences of the services offered by League Against Câncer that are in treatment of breast cancer, focusing on how the health/illness process develops. It is distinguished, in this context, the National Politics of Health, approaching the sprouting, implantation and consolidation process of the Unified Health System and its shocks on the installment of health services to the low-income population as a legit right from Citizen Constitution. It has as an objective to analyze how the social-economic extract of these women intervenes with such process, the aspects who involve the cancer while a pathology, approaching the signals, symptoms, forms of prevention, diagnosis, among other aspects that configure themselves as important points to the understanding of these experiences, since the diagnosis, treatment and control phases. The research was carried out with 25 women, between the months of January and February of year of 2005. The used technique was the scriptstructured interview, whose universe was defined through intentional sample. The following distinguishes as a result of the research: The majority of the women has its origins on the interior of the state, possesses a familiar income from one to three minimum wages and didn't make any kind of prevention before diagnosis, currently make treatment, beyond other aspects. It becomes necessary posterior studies on this social problematic, with respect to the personal, professional, familiar and social daily behavior of these women. It is worth mentioning that the role of the social assistant in the developed work with these women, understanding all the impediments associated with such experiences, as well as giving information about the rights of the patients with cancer, conquered through the years

Teorias f(R) de gravidade na formulação de Palatini

In this dissertation, after a brief review on the Einstein s General Relativity Theory and its application to the Friedmann-Lemaitre-Robertson-Walker (FLRW) cosmological models, we present and discuss the alternative theories of gravity dubbed f(R) gravity. These theories come about when one substitute in the Einstein-Hilbert action the Ricci curvature R by some well behaved nonlinear function f(R). They provide an alternative way to explain the current cosmic acceleration with no need of invoking neither a dark energy component, nor the existence of extra spatial dimensions. In dealing with f(R) gravity, two different variational approaches may be followed, namely the metric and the Palatini formalisms, which lead to very different equations of motion. We briefly describe the metric formalism and then concentrate on the Palatini variational approach to the gravity action. We make a systematic and detailed derivation of the field equations for Palatini f(R) gravity, which generalize the Einsteins equations of General Relativity, and obtain also the generalized Friedmann equations, which can be used for cosmological tests. As an example, using recent compilations of type Ia Supernovae observations, we show how the f(R) = R − fi/Rn class of gravity theories explain the recent observed acceleration of the universe by placing reasonable constraints on the free parameters fi and n. We also examine the question as to whether Palatini f(R) gravity theories permit space-times in which causality, a fundamental issue in any physical theory [22], is violated. As is well known, in General Relativity there are solutions to the viii field equations that have causal anomalies in the form of closed time-like curves, the renowned Gödel model being the best known example of such a solution. Here we show that every perfect-fluid Gödel-type solution of Palatini f(R) gravity with density and pressure p that satisfy the weak energy condition + p 0 is necessarily isometric to the Gödel geometry, demonstrating, therefore, that these theories present causal anomalies in the form of closed time-like curves. This result extends a theorem on Gödel-type models to the framework of Palatini f(R) gravity theory. We derive an expression for a critical radius rc (beyond which causality is violated) for an arbitrary Palatini f(R) theory. The expression makes apparent that the violation of causality depends on the form of f(R) and on the matter content components. We concretely examine the Gödel-type perfect-fluid solutions in the f(R) = R−fi/Rn class of Palatini gravity theories, and show that for positive matter density and for fi and n in the range permitted by the observations, these theories do not admit the Gödel geometry as a perfect-fluid solution of its field equations. In this sense, f(R) gravity theory remedies the causal pathology in the form of closed timelike curves which is allowed in General Relativity. We also examine the violation of causality of Gödel-type by considering a single scalar field as the matter content. For this source, we show that Palatini f(R) gravity gives rise to a unique Gödeltype solution with no violation of causality. Finally, we show that by combining a perfect fluid plus a scalar field as sources of Gödel-type geometries, we obtain both solutions in the form of closed time-like curves, as well as solutions with no violation of causality

Análise imuno-histoquímica de proteínas relacionadas às respostas Th1, Th2 e Th17 na doença periodontal

Periodontal disease is an inflammatory condition of infectious nature characterized by destruction of protecting and supporting dental tissues. It happens as a response produced by the host when attacked by microorganisms. Several factors are involved in this process. Among them, cytokines are key regulatory molecules in this immune response, playing a role either protective and/or destructive in lesion progression. Thus, this study investigated the immunohistochemical expression of IFN- , GATA-3, IL-17, IL-23, IL-6 and TGF- in gingival tissues of humans, in an attempt to gain a better understanding of the participation of Th1, Th2 and Th17 immune responses in the development of periodontal disease processes. To this end, eighty-two samples of gingival tissues were divided into three groups: Group 1 = 15 (samples of healthy gum tissue as controls), Group 2 = 36 (samples with chronic gingivitis) and Group 3 = 31 (samples with chronic periodontitis). All cases were submitted to morphological analysis from sections stained with hematoxylin and eosin and then subjected to staining by immunohistochemistry using the streptavidin-biotin method. Results showed positive labeling for all proteins. Nonetheless, we observed a greater expression of Th1 cytokines and Th17 cells in group 3. We found statistically significant difference between TGF- expression and the clinical condition of the samples (p=0.02). We conclude that Th1 and Th17 responses may act synergistically in the destructive process of periodontal tissue, overlapping the Th2 response that was also present in these tissues

Estudo imuno-histoquímico da presença de miofibroblastos e da expressão do fator transformador de crescimento-beta1, interferon gama, metaloproteinase de matriz 13 e indutor de metaloproteinases de matriz em lesões odontogênicas epiteliais

Myofibroblasts are cells that exhibit a hybrid phenotype, sharing the morphological characteristics of fibroblasts and smooth muscle cells, which is acquired during a process called differentiation. These cells then start to express -SMA, a marker that can be used for their identification. Studies suggest that myofibroblasts are related to the aggressiveness of different tumors and that TGF-1 and IFN- play a role in myofibroblast differentiation, stimulating or inhibiting this differentiation, respectively. The objective of this study was to investigate the role of myofibroblasts in epithelial odontogenic tumors, correlating the presence of these cells with the aggressiveness of the tumor. Immunohistochemistry was used to evaluate the expression of TGF-1 and IFN- in myofibroblast differentiation, as well as the expression of MMP-13, which is activated by myofibroblasts, and of EMMPRIN (extracellular matrix metalloproteinase inducer) as a precursor of this MMP. The sample consisted of 20 solid ameloblastomas, 10 unicystic ameloblastomas, 20 odontogenic keratocysts, and 20 adenomatoid odontogenic tumors. For evaluation of myofibroblasts, anti- -SMA-immunoreactive cells were quantified in connective tissue close to the epithelium. Immunoexpression of TGF-1, IFN-, MMP-13 and EMMPRIN was evaluated in the epithelial and connective tissue components, attributing scores of 0 to 4. The results showed a higher concentration of myofibroblasts in solid ameloblastomas (mean of 30.55), followed by odontogenic keratocysts (22.50), unicystic ameloblastomas (20.80), and adenomatoid odontogenic tumors (19.15) (p=0.001). No significant correlation between TGF-1 and IFN- was observed during the process of myofibroblast differentiation. There was also no correlation between the quantity of myofibroblasts and MMP-13 expression. Significant correlations were found between MMP-13 and TGF-1 (r=0.087; p=0.011), between MMP- 13 and IFN- (r=0.348; p=0.003), as well as between EMMPRIN and MMP-13 (r=0.474; p<0.001) and between EMMPRIN and IFN- (r=0.393; p=0.001). The higher quantity of myofibroblasts observed in solid ameloblastomas, odontogenic keratocysts and unicystic ameloblastomas suggests that these cells are one of the factors responsible for the more aggressive biological behavior of these tumors, although the myofibroblast population was not correlated with TGF-1, IFN-, MMP-13 or EMMPRIN. The correlation between MMP- 13 and TGF-1 suggests that the latter induces the expression of this metalloproteinase. The present results also support the well-established role of EMMPRIN as an inducer of MMP-13. Furthermore, the relationship between EMMPRIN and IFN- and between MMP-13 and IFN- suggests synergism in the antifibrotic effect of these markers

Efeitos da laserterapia na atividade biológica de células de carcinoma epidermóide de língua humano

The low level laser therapy (LLLT) has shown to be effective in promoting the proliferation of different cells in vitro, including keratinocytes, osteoblasts, endothelial cells and stem cells. It has been speculated that the biostimulatory effect of LLLT could cause undesirable enhancement of tumor growth in neoplastic diseases, since the malignant cells are more susceptible to proliferative stimuli. Within this context, this study evaluated the effect of LLLT on epidermoid carcinoma of the tongue cell line (SCC25) proliferation and invasion. Cultured cells were irradiated with an InGaAIP diode laser, 660nm, 30mW using two energy densities (0.5J/cm2 and 1.0J/cm2). Proliferative activity was assessed through trypan blue staining method and through cell cycle analysis using flow cytometry. The invasive potential was measured through cell invasion assay using matrigel. Cyclin D1, E-cadherin, -catenin and MMP-9 expressions were analyzed by immunofluorescence and flow cytometry and related to the investigated biological activities. Proliferation curve demonstrated that SCC25 irradiated with 1.0J/cm2 had the highest proliferative rate when compared to the control group and the group irradiated with 0.5J/cm2 (p<0.05). LLLT affected cell cycle distribution and energy density of 1.0 J/cm2 promoted a higher percentage of cells in S/G2/M phases, with statistically significant differences at 24h interval (p<0.05). LLLT, mainly with 1.0J/cm2, revealed significantly higher potential for invasion and influenced the expression of cyclin D1, E-cadherin, -catenin and MMP-9, promoting the malignant phenotype. In conclusion, our results indicate that LLLT has an important stimulatory effect on proliferation and invasion of SCC25 cells, likely due to altered expression of proteins associated with these processes