Influência da dor na capacidade funcional de idosos institucionalizados

The aim of this study was to evaluate the pain influence regarding location, intensity and duration over functional capacity in institutionalized elderly (Fundacao Leur Brito). This is a descriptive exploratory study with a transversal design and quantitative approach. The population of the study was composed of 60 elderly, being 50% males with 60 years-old minimum age and 104 years-old maximum age, with mean age 77,6 (?}11,64) years-old. Data was collected by a structured query formulary divided in four parts: 1) Social, health and demographic characterization; 2) Pain related aspects (time and location); 3) Pain evaluation by numeric scale and 4) Functional capacity measured by Barthel Index. It was observed after evaluation by Squared-chi test (x2) statistical significant difference between pain presence and Barthel Index activities: bath (pvalue=0,015), dressing (p-value= 0,041), intimal hygiene transference (p-value=0,001), chair and bed transference (p-value=0,032), walking (p-value=0,010) and go upstairs (p-value=0,008). It was also observed statistical difference between total Barthel score (dependent/independent) and pain presence, p-value<0, 000. Through data obtained by this study, a multiprofessional approach is necessary to proper pain control and maintenance and/or regain of functional capacity, leading to an increase in life quality with more independence and autonomy to elderly

IL-10 na patogênese da infecção por Leishmania infantum

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Exercício físico, saúde e qualidade de vida em pessoas com HIV/AIDS em Natal/Rio Grande do Norte

A sobrevida das pessoas com AIDS tem aumentado com o uso das terapias com antiretrovirais (TARV), esses, entretanto, possuem efeitos colaterais que interferem no padrão morfofuncional e hematológico, o que pode levar a alterações na qualidade de vida (QV). Este estudo quase-experimental objetivou avaliar parâmetros antropométricos, funcionais, hematológicos e de QV em pessoas com HIV/AIDS submetidas a um programa de exercícios de 16 semanas. Os participantes tinham idade entre 35 e 51 anos (n=15), eram registrados no Núcleo de atendimento do Hospital Giselda Trigueiro em Natal/Rio Grande do Norte e apresentaram CD4350cel/mm3, lipodistrofia e estavam em TARV. Foram avaliados o índice de massa corpórea (IMC), a relação cintura-quadril (RCQ), o percentual de gordura (%G), a força escapular e manual, a contagem de CD4, carga viral e QV, antes e após a intervenção. Essa foi realizada com exercícios de aquecimento e utilizou como base os exercícios resistidos, realizados 3x/semana, com 1h e intensidade de 60 a 75% de 1RM. Observaram-se modificações significativas no %G (p=0,031), força escapular (p=0,007) e preensão manual (p=0,039). Houve aumento no CD4 e a carga viral manteve-se indetectável. Nos domínios da QV, houve mudança significativa no do meio ambiente (p=0,021), espiritualidade, religiosidade e crenças pessoais (p=0,032) e na percepção da qualidade de vida e saúde geral (p=0,005). Os resultados sugerem que os exercícios resistidos para essa população constituem agente terapêutico coadjuvante no controle dos efeitos colaterais advindos da TARV, promovendo modificações na composição corporal, aumento da capacidade funcional e dos níveis de CD4, mantendo estável a carga viral e melhorando a QV. Sugerimos novos estudos com maior tempo de intervenção e com o acompanhamento de equipes multidisciplinares, o que poderá promover melhorias mais significativas na qualidade de vida e efetuar maior controle nas variáveis intervenientes

Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

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

Integridade tissular de pacientes com úlceras venosas: um estudo baseado na Classificação dos Resultados de Enfermagem

The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing

Produção de enzimas por fungos em fermentação semi-sólida utilizando bagaço de coco e pedúnculo de caju como substratos

The production of enzymes by microorganisms using organic residues is important and it can be associated with several applications such as food and chemical industries and so on. The objective of this work is the production of CMCase, Xylanase, Avicelase and FPase enzymes by solid state fermentation (SSF) using as substrates: bagasse of coconut and dried cashew stem. The microorganisms employed are Penicillium chrysogenum and an isolated fungus from the coconut bark (Aspergillus fumigatus). Through the factorial design methodology and response surface analysis it was possible to study the influence of the humidity and pH. For Penicillium chrysogenum and the isolated fungus, the coconut bagasse was used as culture medium. In another fermentation, it was used the mixture of coconut bagasse and cashew stem. Fermentations were conducted using only the coconut bagasse as substrate in cultures with Penicillium chrysogenum fungus and the isolated one. A mixture with 50% of coconut and 50% of cashew stem was employed only for Penicillium chrysogenum fungus, the cultivation conditions were: 120 hours at 30 °C in BOD, changing humidity and pH values. In order to check the influence of the variables: humidity and pH, a 2 2 factorial experimental design was developed, and then two factors with two levels for each factor and three repetitions at the central point. The levels of the independent variables used in ascending order (-1, 0, +1), to humidity, 66%, 70.5% and 75% and pH 3, 5 and 7, respectively. The software STATISTICA TM (version 7.0, StatSoft, Inc.) was used to calculate the main effects of the variables and their interactions. The response surface methodology was used to optimize the conditions of the SSF. A chemical and a physic-chemical characterization of the coconut bagasse have determined the composition of cellulose (%) = 39.09; Hemicellulose (%) = 23.80, Total Lignin (%) = 36.22 and Pectin (%) = 1.64. To the characterization of cashew stem, the values were cellulose (g) = 15.91 Hemicellulose (%) = 16.77, Total Lignin (%) = 30.04 and Pectin (%) = 15.24. The results indicate the potential of the materials as substrate for semisolid fermentation enzyme production. The two microorganisms used are presented as good producers of cellulases. The results showed the potential of the fungus in the production of CMCase enzyme, with a maximum of 0.282 UI/mL and the Avicelase enzyme the maximum value ranged from 0.018 to 0.020 UI/ mL, using only coconut bagasse as substrate. The Penicillium chrysogenum fungus has showed the best results for CMCase = 0.294 UI/mL, FPase = 0.058 UI/mL, Avicelase = 0.010 UI/mL and Xylanase = 0.644 UI/ mL enzyme, using coconut bagasse and cashew stem as substrates. The Penicllium chrysogenum fungus showed enzymatic activities using only the coconut as substrate for CMCase = 0.233 UI/mL, FPase = 0.031 to 0.032 UI/ mL, Avicelase = 0.018 to 0.020 UI/mL and Xylanase = 0.735 UI/ mL. Thus, it can be concluded that the used organisms and substrates have offered potential for enzyme production processes in a semi-solid cultivation

Estudo da influência de linfócitos tcd-8 e das células nk em casos de carcinoma epidermóide de lábio inferior sem metástase e com metástase e sua relação com a progressão da lesão

The presence of inflammatory cells within the tumor microenvironment plays a dual role that may contribute both to the progression and for inhibition of tumor growth. Recent studies suggest that the quality, not the quantity, of the inflammatory infiltrate is the most important determinant for prognosis. Therefore, TCD8 cells and natural killer cells are the main effector cells in combating cancer. The aim of this study was to assess, through the immunohistochemical study, the expression of TCD8 lymphocytes and NK cells in epidermoid carcinoma (EC) of the lower lip. The sample consisted of 32 specimens of EC of the lower lip, of which 16 had regional lymph node metastasis, and the 16 remaining, free of metastases. The total number of positive cells at the front of invasion were evaluated quantitatively and the results were related to clinical TNM staging, histological grade of malignancy and prognostic factors. It was observed for the group with metastasis, prevalence of stages III and IV (p<0.0001). Most patients with metastasis, had a high grade of malignancy (p=0.006). Most cases classified as high grade of malignancy had stages III and IV (p=0.032). Of the total sample, there were three cases of recurrence and five with death, however these variables were not statistically significant when associated with clinicopathological parameters. The immunostaining of CD8 and CD57, respectively, showed no statistically significant association with any of the clinicopathological parameters studied, metastasis (p=0.346, p=0.622), TNM classification (p=0.146, p=0.576), histological grade of malignancy (p=0.936, p=936), recurrence (p=0.075, p=0.075) and death (p=0.897, p=0.856). Believing in the function of the immunological system against malignant cells, it is concluded that the TD8 lymphocytes and NK cells, would be acting in the control of the progression of malignant neoplasms, but not in isolated manner

Imunoexpressão de fatores reguladores da osteoclastogênese na doença periodontal em humanos e sua relação com os parâmetros clínicos

Periodontal disease is an infection initiated by oral periodontal pathogens that trigger an immune response culminating in tissue destruction. This destruction is mediated by the host by inducing the production and activation of lytic enzymes, cytokines and the stimulation of osteoclastogenesis. The aim of this study was to compare the immunohistochemical expression of factors involved in bone resorption, RANKL (Ligand Receptor Activator of Nuclear Factor kappa B), OPG (Osteoprotegerin) and TNF-α (tumor necrosis factor alpha) between the gingival healthy, gingivitis and chronic periodontitis and correlate them with clinical parameters. The sample consisted of 83 cases and 12 clinically healthy gums, 42 gingivitis and 29 periodontitis, from 74 adolescent and adult patients with a mean age of 35 years, without systemic changes and non-smokers, predominantly female and race brown. There was no statistically significant difference for the expression of anti-RANKL (p = 0.581) and RANKL / OPG ratio (p = 0.334) when comparing the three conditions, but the anti-OPG and anti-TNF-α showed statistically significant between the types of injury (p = 0.001 and p <0.001, respectively), showing greatest expression in periodontitis. In cases of periodontitis, the variable clinical attachment loss (PIC) was statistically significant and positive correlation, respectively, with immunostaining of anti-RANKL (p = 0.002, p = 0.001 and r = 0.642), anti-OPG (p = 0.018, p = 0.014 and r = 0.451), anti-TNF-α (p = 0.032, p = 0.014 and r = 0.453) and the percentage ratio of RANKL / OPG (p = 0.018, p = 0.002 and r = 0.544). The tooth mobility (MB) showed a statistically significant difference only with immunohistochemical anti-RANKL (p = 0.026), and probing depth (PD) was positively correlated with anti-RANKL (p = 0.028 and r = 0.409), both in cases of periodontitis. Only in cases of gingivitis TNF-α was positively correlated with RANKL (p = 0.012 and r = 0.384) and the RANKL / OPG ratio (p = 0.027 and r = 0.341). Given these results, we conclude that the greatest expression of TNF-α in periodontitis demonstrates a relationship with the progression and severity of periodontal disease and the correlation between all antibodies and clinical attachment loss demonstrates their involvement in periodontal bone resorption

Caracterização genética de vacas leiteiras por meio de marcadores moleculares e suas implicações na composição e qualidade do leite

The objective of this study was to identify DNA polymorphisms at the genes leptin, β-lactoglobulin and pituitary-specific transcription factor in three genetic groups of Holstein x Guzerat dairy cows and investigate the relationship between their genotypes and the composition and quality of milk of dairy cows. Samples were collected in August 2009, being 113 blood samples from lactating crossbred cows and 58 milk samples. For analysis of DNA polymorphisms blood samples were collected, analyzed later in the Genetic Laboratory affiliated to the Zootechny Institute of São Paulo and individual milk samples were collected according to standards established by the laboratory of Management Program of Northeast Dairy Herds (PROGEN), at Federal Rural University of Pernambuco (UFRPE) for analysis of milk composition and quality. The characterization of genotypes was performed by PCR-RFLP, for which were designed specific primers for each studied gene and restriction enzymes Kpn2I, HaeIII and HinfI that cut the DNA of the following genes: leptin, β-lactoglobulin and a PIT, respectively. The leptin estimate genotypic frequence were CC 0.112, TT 0.225 and CT 0.661, for β-lactoglobulin were AA 0.136, AB 0.323 and BB 0.539, and for PIT were ++ 0.655, -- 0.311 and +- 0.032. The results show that the population is in Hardy-Weinberg disequilibrium for leptin, β-lactoglobulin and a PIT due to excess of heterozygotes in the population, however, as these genes are associated with the milk production it is considered that the animals have genetic potential for milk production in the Brazilian semi-arid conditions. Through the characterization of the studied herd there were not found implications of the polymorphism of leptin, β-lactoglobulin and PIT in the composition and quality of milk from cows in the different genetic groups 1/2, 3/4 and 7/8 Holstein x Guzerat. Key words: β-lactoglobulin, crossbred cows, leptin, PCR-RFLP, PIT1, semi-arid.

A questão do estilo na psicanálise lacaniana

Lacanian psychoanalysis has won a considerable space in brazilian university: a search for Lacan in the field of subject of the CAPES Thesis Bank shows 1.032 results! However the difference in the style of knowledge production and language usage is considerable between academic psychology and lacanian theory. The difficulty in reading and understanding Lacan is something pointed out by supporters and critics alike. In addition to that, his disciples choose many times to imitate his baroque, complex style, full of neologisms, causing perplexity in many unprepared audiences. What is the origin of such an enigmatic and polemic style of expression? How it became so widespread under the sign of repetition? And which are the consequences of this style to the communication, transmission and teaching of lacanian psychoanalysis? Through these questions it is our goal to contribute to the dialogue between lacanian psychoanalysis and the academy, to provide a better understanding of the causes of this style, analyzing the consequences it has to the transmission of psychoanalysis. We chose to perform a theoretical study, using authors that have treated Lacan s style and the history of psychoanalysis from a critical point of view, like Beividas (2000), Roustang (1987, 1988) and Gellner (1988), and also those that have defended and justified its legitimacy, like Glynos e Stavrakakis (2001), Fink (1997) and Souza (1985), using as well some works by Freud and Lacan. The study of these texts has led us to three main themes: 1) the difficulty of the lacanian text; 2) Lacan, heir of Freud; 3) consequences of the lacanian style. In the first one, we enumerate many different explanations and interpretations given by commentators about the difficulty and particularity of the lacanian discourse; in the second, we show how Lacan came to occupy the place of great idealization that was before destined to Freud, what made his style something to be taken as a model, to be imitated by disciples; in the third, we explore the way in which the concepts are treated in lacanian psychoanalysis, arguing that their multiple meanings point out that the final goal is not to build a clear and coherent theory, but to try to aim directly at the subject, to catch him