Hiperidrose compensatória após simpatectomia toracoscópica: características, incidência e influência na satisfação do paciente

Hyperhidrosis is an idiopathic condition characterized by excessive sweating. Symptoms generally begin in childhood or early adolescence, and rarely improve with age. The excessive localized sweating generally occurs either spontaneously, or in association with stressful or emotionally charged situations. This prospective study aimed to investigate predictive factors for compensatory hyperhidrosis after thoracoscopic sympathicotomy. From 2000 to 2002, 80 patients (53 female and 27 male) underwent hyperhidrosis surgery. The patients, ranging from 12 to 56 years old, were studied and followed-up for 42.51 ±5.98 months. A satisfaction grading using a visual analogue scale -VAS (0 = not at all satisfied, and 10 = fully satisfied) was used. The surgical procedure was performed bilaterally on the second ganglion (T2) for facial hyperhidrosis, on the third and fourth ganglia (T3 and T4) for axillary hyperhidrosis, and on the third ganglion (T3) for palmar hyperhidrosis. The results showed that, 68 patients (85%) presented with compensatory sweating (CS), which was classified as mild (33.8%), moderate (33.8%) and severe (32.4%). Considering the final surgical results, 70 patients (87.5%) were satisfied with the outcome of the operation, while 10 patients (12.5%) were dissatisfied. Degrees of satisfaction varied according to sex, age, BMI and extent of denervation. Moreover, the compensatory hyperhidrosis was more severe in abdomen and back than in legs. In conclusion, although CS is a frequent adverse effect of sympathicotomy, the degree of patient satisfaction was high. Some factors were related to the occurrence and severity of CS and the most adequate patients to be submitted to this operation are young adult women whose BMI is less than 24.9

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

O lugar pedagógico da educação física na educação infantil: saberes (re)construídos na formação continuada do PAIDÉIA/UFRN

The present study aimed to investigate the overview of teachers in continuing education program who work in kindergarten, about the continuing education developed by the Paideia/UFRN through the Course of Specialization in Art Teaching and Physical Education in Childhood, having as key focus, the knowing / doing related to physical education in Childhood. From this general goal, it was elected some specific objectives as: to know the interests and expectations that motivated the teachers to participate of that referred training; the evaluation by teachers on regard of the continuing education proposed: boosters factors for possible changes in teaching activities regarding the practice of teaching physical education in kindergarten. The methodology took the principles and techniques of qualitative research strategy and the characteristics of descriptive and interpretive strategy. The locus of this research was the Course of Specialization in Art Education and Physical Education in childhood, having as the citizens of this research twenty three teachers taking that specialization course. For building and systematization of the data, we used the following tools and procedures: a questionnaire, a semi structured interview and documents analysis. The data was constructed based on the technique of content analysis, focusing the reflections and speech of the teachers about the creation of new meanings and senses for the knowing / doing in Physical Education. It was found, among other results, the need and quest for improvement of teacher education, in order to improve educational practice. It was also evident that the situations of dialogues (interactions with peers, with their professors and other professionals in the related area or not) were mentioned by most teachers in the course as a relevant moment of redefinition of knowledge. In relation to Physical Education, it was found that participation in the course of specialization provided the recognition of teaching practice of physical education as part of the curriculum and the importance of inclusion of its specificities in their educational planning. From these elaborations, we come to the conclusion that knowing the perspectives of the teachers about continuing education can contribute to the theoretical and methodological discussions in teachers education and the creation of new actions - projects and programs of continuing education constructing increasingly ways towards a successful teacher formation, able to provide new forms of acting in the educational context

Concepões e práticas pedagógicas de professoras da educação infantil na inclusão de alunos com deficiência

This research focuses on inclusive in childhood education. Its purpose was to investigate and analyze the conceptions and expectations of teachers of childhood education, childhood education center form Natal/RN, on the inclusion students with disabilities, school and pedagogical practices developed and implications for students learning. Theoric base of the cultural historic perspective, the search took by qualitative analysis of numbers form the case study method. It was used methodological procedures: documentary analysis, participant observation, field journal and semi structures interview.Three teachers participated in the survey of that school had student with disabilities in their classrooms. These teachers were called: Rapunzel, Snow white e Pretty. The teacher s nouns involved the refered kind of education. The data obtained from the observation indicated the regular school of childhood education provides educational practices that promote the participation and participation and development of students with disabilities, live situation that may create barriers to learning and to the development of these children. The analysing data of interview from Bardin content analysis (1994) was based in Cunha s studies (2001) Brun (2006, 2008), Mantoam (2006, 2008), Palacios, Paniagua (2007), among others. The dada showed that correlation and divergence of perceptions and expectations about the issues surrounding inclusion in childhood education. The results shaved that teaching strategies, affective ties, sensitivity and own routine of childhood education are factors that can promote inclusive proposal, but also needs a greater fulfillment individual differences of each child in order to their potentiality. The study also shaved that the negative of pedagogic support to teacher, the ignorance of them as guidelines and strategies that include the student s diversity, the importance having positive conceptions about the learning and development of student with severe learning disabilities and the need for a pedagogic training and of a collective work at school which everybody collaborates : parents, direction, coordination getting inclusive school. Believe that this study pointed relevant issues to be focus new research, since the theme is still lacking in study, therefore emphasize, the importance of conducting research that continuous this job

Já li muita coisa, então, eu posso inventar mais! A leitura literária e o desenvolvimento do pensamento criativo na infância

This study investigates the contributions of reading literature for the development of creative thinking in childhood. Its relevance consists in exploring practices that contemplate the creative thinking development in apprentices at school space and understanding the literature like a significant way to promote the creative thinking. The study is connected to the qualitaty strand. The exploratory observation and the intervention were adopted as research techniques. The field diary and the audio and video recording of the reading sections were adopted as methodological instruments. The research was conducted in the application s college from the Federal University of Rio Grande do Norte, in a 1th grade class, with 18 students between 6 and 7 years old. During the intervention, 8 readind class happened, with varied strategies and literary genres. The reading sessions were conducted through the principles of scaffolding, defended by Graves and Graves (1995). The corpus is made of speaks episodes, whose encoding semantics allowed the grouping into two central categories: divergent thinking and coauthoring of literary reader. It was taken as a theoretical framework the studies of Amarilha (2011; 2006; 2001; 1991; 1993; 1994), Alencar (2001), Coelho (2000; 1997), Culler (1999), De Masi (2005), Gallo (2000), Guilford (1977), Iser (1996), Jouve (2002), Kneller (1978), Martínez (1997), Smith (2003), Stierle (1979), Vigotski (2009; 1998), Wechsler; Nakano (2003; 2002). The analysis points to the formation of creative individuals in the classroom, through the reading of literature. Reposition the literary education front of the new social demands. Resizes the function of school in children s development, considering the children s skill in exploring, testing hypotheses and making use of their creative thinking, in climate of freedom mental. It signals, in this way, the teacher like a mediator, promoting a favorable to the development of creative thinking environment, a stimulating atmosphere, which enhances the expression of creative thinking in community

Identificação de crianças e adolescentes com suspeita de câncer: uma proposta de intervenção

Unlike adult cancer, where cells usually originate from epithelial tissue and is linked to environmental factors, malignant tumors in childhood are mostly of embryonic origin and have a phase of rapid proliferation. When not started chemotherapy at this stage, the tumor increases in size, reducing their growth rate, thus reducing the response to chemotherapy. Childhood cancer is in Brazil, the second cause of mortality among children and adolescents from one to nineteen. His impact on the ranking of diseases becomes significantly important to public health since the first issue is related to accidents and violence. Many children are still sent to the centers of high complexity for cancer treatment with advanced stage disease. The delay in referral to diagnosis can be family, or the difficulty of access to the health sector, or the characteristics of the disease and lack of health staff regarding theme of childhood cancer. Before this problem, we aimed to assess the performance of health teams in the identification of child and adolescent symptoms of cancer in primary care, through the action research methodology, which includes the teaching-learning, seminars, describing the actions of the group and discussing the activities after the training. This study involved thirty-seven health professionals who provide care for children and adolescents in the USF Felipe Shrimp II, the Support Center for Children with Cancer and the pediatric hospital UFRN during the period from March to December 2010. The data were analyzed simultaneously to evaluate actions, following the direction of the analysis of ideas Freires, having as theoretical reference the primary health care. The diagnosis of current reality, as knowledge of the health team targeted for early identification of signs and symptoms raised through questioning, presented as generative themes: resistance to change, awareness of the need for apprehension of knowledge; prior knowledge through the media, fragmentation of the healthcare network, interfering with the operation of the reference and counter, the stigma of death, among others. The selected themes enabled the choice of content for the preparation of four seminars, such as implementation of collective action for discussion problematical. The teaching-learning process has allowed the study participants awareness of the problem and work through the knowledge acquired by interfering in decreasing the time interval between the identification of signs and symptoms of cancer and early specialist treatment. Their difficulties we are faced with a diagnosis of terminal cancer and associated with delayed access to laboratory tests and imaging necessary for the diagnosis of neoplasms. Thus, we find that when the team is consciously involved in the education process from identification of the problem situation, there may be significant changes in daily activities through awareness of being. However, we also realize that acquisition of knowledge and interest of the team are not enough, since to be efficiency of our service, we need an organization of cancer care network operating in the state of Rio Grande do Norte

A experiência de adolescentes portadores de diabetes Mellitus Tipo 1: seus significados e sentido

Worldwide, the diabetes mellitus is considered a serious problem of public health; it also involves high costs for its treatment and its complications. Even though the onset of diabetes mellitus type 1 is on 5% to 10% of the diabetic population, it is the most aggressive type of anifestation; furthermore, it is the commonest chronic disease in childhood and adolescence. Such data show the importance of understanding the development of this disease from the moment the individual perceives it, according to their experience, observing the complexity of the phenomenon thoroughly. This study aimed to comprehend the experience of the adolescent with onset of diabetes mellitus type 1 in order to learn how these young individuals perceive and reason their place in the world when they experience this illness. The methodological strategy was based on qualitative research of phenomenological inspiration. We applied the main ideas of heideggerian ontology and some concepts of existential phenomenological psychology to guide our reflexive path. The participants were 10 young individuals (06 female and 04 male), ages between 15 and 18, under treatment in the city of Recife, Pernambuco. The methodological resource was the narrative, which allowed us access to the adolescents experience. The comprehension of the reports was based on the heideggerian hermeneutics, whose priority is the interpretation of the meaning expressed by the participants speech. The results showed that factors such as social, family, economic and cultural context greatly influence the perception and the way the individuals deal with, perceive and reason their experience. We noticed that the diabetes type 1 may often represent a limitation, but it does not make it impossible to be part of the world with others. The data show a significant affective ambivalence regarding the content more directly related to the disease. This demonstrates the unique way which each one gives meaning and reasons their condition of existence. This research points out the need to understand the complexity of this phenomenon in a more complete manner, considering the adolescent in their timely and historical context. We believe we can encourage thinking that may become actions which are more fit to the reality researched regarding all the parties involved with the subject, such as health professionals, adolescents, family, support programs and public health policies

Experiências maternas de perda de um filho com câncer infantil: uma compreensão fenomenológico-existencial

Death due to childhood cancer reflects an early outcome of life, which can cause a strong repercussion in the mother s existence - figure to whom the greatest part of responsibilities during the child s illness is commonly allocated. The aim of this study is to understand the experience of mothers who have lost a kid as a consequence of childhood cancer, approaching the personal senses of this fact. Following a qualitative research design, with an exploratory and comprehensive approach, the study used the narrative method, which was obtained from a semi-structured interview, as the data generation procedure. The research counted on the participation of three adult mothers who had lost their kids because of childhood cancer, after - at least - a six-month period of oncologic treatment. The proposal of analysis follows the parameters of the phenomenological method and the data are based on Martin Heidegger s existential analytic. The results were structured into three thematic axes: previous History, child illness and its repercussions; The network of support and care; Loss and after loss: facing and signifying. It was possible to comprehend that the emergence of cancer in childhood promotes, since the diagnosis, a disruption of everyday meanings, accentuating the fragile condition of human life. In this specific circumstance of childhood illness, all the participants restricted their possibilities of being-in-the-world, dedicating exclusively to the practice of maternity. Concerning their relationship with their children in treatment, the narratives unveiled, in a convergent manner, the existence of care in a substitutive mode. In the network of support - primarily constituted by family, the health team and the support institutions - the relations were marked by proximity and detachment movements. With the child s death, mothers began to live a way of being-with the absent child , ensuring the continuity of the relationship with the dead infant. From the results exposed above, we can understand the motherly mourn as a singular experience in constant resignification, in which the subjective time overlaps the cronological time. The increment of anguish, resulting from the mother s confrontation to the question of finitude, mobilizes a process of change in their way of being-in-the-world, promoting an openness to new possibilities in their lives. Singular attention to the mother, during the process of illness and child loss, turns out to be fundamental