Influência dos aspectos clínicos e assistenciais na qualidade de vida das pessoas com doença venosa crônica com e sem úlcera venosa

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Efeitos da sintomatologia depressiva na mobilidade de idosos de um centro urbano do nordeste brasileiro

O processo de envelhecimento da humanidade é um fenômeno mundial e nas últimas décadas a população brasileira tem acompanhado essa tendência. No entanto, este fenômeno somente pode ser considerado como uma real conquista em termos sócios demográficos na medida em que se agregue qualidade aos anos adicionais de vida para a população. Em populações idosas, a incapacidade funcional e os sintomas depressivos tornaram-se importantes conceitos tanto por suas consequências para a saúde pública, quanto pelo impacto na qualidade de vida dessas populações. Este estudo tem como objetivo verificar se há associação entre os sintomas depressivos e o desempenho funcional de idosos comunitários. Foram avaliados 313 idosos de um centro urbano do nordeste brasileiro através das baterias de testes; Center for Epidemiologic Studies Depression CES-D e Short Physical Performance Battery - SPPB; além de variáveis relacionadas ao estado físico, condições crônicas, função cognitiva e características sócio demográficas. Foram utilizadas medidas de correlação e aplicado método de análise multivariada para construir um modelo explicativo da influência da sintomatologia depressiva no desempenho funcional. Os resultados revelaram que as mulheres apresentaram mais sintomas depressivos (p< 0.01) e pior desempenho funcional (p< 0.01) que os homens. Os indivíduos com sintomatologia depressiva apresentaram pior desempenho funcional, especialmente as mulheres. A idade, o sexo feminino, o estado de saúde percebido, o nível de função cognitiva e o Índice de massa corporal foram identificados como fatores associados ao desempenho funcional na amostra estudada. Os resultados deste estudo permitem inferir a relação de associação entre sintomas depressivos e desempenho funcional em uma população de idosos de um centro urbano no nordeste do Brasil. Estes resultados fornecem informações úteis para intervenções terapêuticas adequadas voltadas para a prevenção do declínio na mobilidade em idosos

Condições de saúde bucal e capacidade funcional em idosos

Population aging is one of the greatest challenges to contemporary public health and, in this perspective, the functional capacity emerges as an important feature in geriatric assessment. The oral health of elderly, in turn, deserves special attention because, historically, in the dental services, this population group was not considered a priority for attention, which is verified by high rates of edentulism found even among these individuals. The present study proposes to examine the relationship between oral health status and functional capacity in an elderly population. To this end, intra-oral epidemiological examination was performed to assess the degree of dental caries, periodontal status, use and need of prosthesis and the presence of lesions. Functional capacity was assessed by the Independence in Activities of Daily Living, which considers the independence or not in the performance of six self-care functions. Socioeconomic and demographic characteristics and general health status were also investigated, in view of the possibility of intervention of these variables in the investigated relation. An factor analysis of the principal components was conducted which resulted four indicators of oral health conditions, representative of the population studied. 441 seniors were enrolled with mean age of 71.7 (± 8.7) years, the majority being female (68%). Functional capacity was dichotomized into completely independent individuals (89.6%) and dependent on at least one of the functions considered (10.4%). There was an association between functional capacity and the indicators related to the presence of many teeth and dental caries, and to that associated with the use and need of prostheses. These associations in turn, lost statistical significance when adjusting for confounding variables, combined in separate models for each indicator. Some of these variables, however, remained associated with functional capacity. It is considered that the study of oral health status of elderly, associeted with the search for an association with functional capacity is important in the construction of indicators necessary for planning preventive and therapeutic interventions that reduce the risk for loss of ability in daily physical functions and their consequences, as the harm in the oral self-care

Aplicabilidade do Rorshach na avaliação psicológica do autismo

This study investigates the applicability of the Rorschach Method for evaluating the personality of people with Autism Spectrum Disorder (ASD).The relevance of this study is justified by the limited number of investigations published in the research literature concerning the use of psychological tests used for evaluating the personality of individuals with ASD. The Rorschach Method was chosen as an appropriate instrument considering it reveals the personality s basic structure, including characteristics of the affectivity, sensuality, inner life, mental resources, psychic energy and general characteristics and intellectual state of the individual. The general objective of this investigation consisted of verifying the applicability of the use the Rorschach Method in the evaluation of the characteristics of people's personality with autism spectrum disorder (ASD).The study also sought to identify perceptive factors of the personality structure of individuals with ASD, provide contributions of the understanding of this syndrome, seeking the establishment of possible therapeutic interventions starting from diagnostic by Rorschach Method. In addition, this investigation aims at verifying the adequacy of using the Rorschach Method as an instrument for evaluating the personality characteristics of individuals with ASD and its possible use in Brazil, starting from preliminary normative results. Participants consisted of 44 youngsters and adults, both genders with age range 14 - 39 years-old (average: 23.5 years-old) distributed in 2 groups. Group 1: composed with 22 youngsters and adults with clinical diagnosis of autism spectrum disorder (communication impairments, social interaction deficits, restricted and repetitive interests and activities); Group 2: composed with 22 youngsters and adults with typical behavior. The participants were paired to gender and age, individually. The Mann-Whitney and Wilcoxon tests were applied to evaluate statistical differences between the groups, considering demographic and social data. The results indicate the presence of restricted interest or difficulty in the expression of the social and affective interaction of people with ASD. However, the need of broader normative studies concerning the use of personality evaluation instruments for people with ASD is warranted. These investigations could help understand the psychic dynamism of this population, offering subsidies that can be added to the current techniques of diagnosis. The Rorschach Method is susceptible to application but it is necessary to respect the individual limitations of these people and to establish more criterions about the spectrum

Atenção precoce do câncer de mama :um olhar sobre o cotidiano institucional de uma unidade de saúde de Natal

Breast cancer has been considered a grave global public health problem due to its increase in incidence, in women s mortality and in the amount of financial resources spent on the therapeutic interventions used in the treatment of this neoplasia. However, this scenario presents some variations. In developing countries, the incidence of breast cancer is increasing but, on the other hand, the mortality is declining among patients because of public health actions toward early diagnostic that also result in cure of patients and decreasing levels of physical and psychosocial stress. In Brazil, we face of both the increasing number of breast cancer incidence and number of mortalities. Almost always the reason for that is a delayed detection that will provide a late diagnostic. The early detection of breast cancer has been studied in several researches. Some of them are concerned with women s experiences. Despite that, there is a lack of researches on dynamic comprehension of early attention to breast cancer from the health professionals points of view. The present research was carried out at the Unidade Mista de Felipe Camarão (UMFC) and it was conducted with 11 professionals who work in the Family Health Program (PSF). The aim was to understand how early diagnostic and attention to breast cancer is being planned, discussed and accomplished by health professionals in their day-to-day actions. Semi-structure interviews were held individually with each professional, in a way that they could feel free to express their ideas about several issues. All the information from these interviews was analyzed and discussed using an Institutional Ethnographic approach. It was observed that the actions of health professionals working with early detection of breast cancer does not take place in a vacuum; they occur within institutional, relational and social ways. This interdependence influences their actions and points of view on the theme

Perfil das condições de seguimento terapêutico em portadores de hipertensão arterial

A proposta foi investigar os aspectos comportamentais referentes ao seguimento da terapêutica farmacológica e não farmacológica e o grau de adesão ao tratamento anti-hipertensivo de um grupo específico. Estudo observacional descritivo com análise quantitativa, realizado no Centro de Referência da Assistência Social em Fortaleza-CE, de agosto/2008 a maio/2009. Dados obtidos de 49 indivíduos por entrevista e exame físico. Mais de 50% dos participantes seguiam as terapêuticas não farmacológicas. Prevaleceram a terapia combinada (53%) e as classes medicamentosas de diuréticos (72%) e inibidores da enzima conversora de angiotensina (55%). Muitos participantes (49%) referiram reações adversas. Destas, as mais citadas foram poliúria e tontura (29%). Quanto ao grau de adesão, a média correspondeu ao conceito não adesão leve. A avaliação dos comportamentos de seguimento terapêutico e a caracterização clínico-epidemiológica são necessárias para o enfermeiro planejar estratégias educativas. Ambas possibilitam ajustes no planejamento das intervenções, contribuindo para a melhor adesão terapêutica dos indivíduos

O Ofício das Rezadeiras: um estudo antropológico sobre as práticas terapêuticas e a comunhão de crenças em Cruzeta/RN

The present Master´s dissertation aims to study the practices of the rezadeiras, Brazilian women healers, through an anthropological perspective. Special attention will be given to the understanding of these practices as a dynamic process in relation to those women who heal in Cruzeta (Seridó, Rio Grande do Norte), where is located our ethnographic research. For this research, twenty four rezadeiras were contacted and colaborated with our work plan. Among them, two were pentecostal rezadeiras and another one was member of the Jurema cult, an afro-brazilian religious cult. Similarities among these women healers were perceived in the research process, mostly in terms of their learning process and the use of certain objects and ritual techniques. However, apparent differences among them gave us the chance for understanding and reflecting on the actual heterogeneity of this world of specialists. Furthermore, i tried to capture the relations between the rezadeiras and the therapeutic practices from health professionals or the religious practices of religious leaders (Catholic, pentecostal, etc). It is possible to ascertain about the complementarity between therapeutic practices from different cultural logics. This complementarity is also perceived through the religious interchanges and transits among different healers, including those who have different religious beliefs. In this work, rituals are also described and they are a crucial factor to the understanding of this particular religious and therapeutic practice conducted by women. Following these ideas, our basic aim is to understand how the rezadeiras make interpretations about health and illness, specially those ones which are particular associated with their practices, the so called "doenças de rezadeiras"

Intervenções urbanas em espaços de desvalia. Transformar para valorizar.

The worldwide transformations that took place in the 20th century redefined the cities fate in this new century. The consolidation of urbanization, the technological revolution that fostered globalization, the economic restructuration and informalization, modified space and time concepts, bringing populations closer together and provoking political transformations. They made contemporaries cities protagonists of world events and as a consequence of such processes, worthlessness spaces appeared and cities all over the world started to bet on the strategy of acting in this problematic areas through initiatives aimed at promoting intentional transformations to obtain a multidimensional valorization urban, financial, environmental, cultural and social. In short, such urban initiatives intend to make cities more competitive, sustainable, creative, productive and fair. Also in Brazil, countless worthless spaces appeared in waterfronts, central areas, and deactivated industrial/urbanized areas, as well as in sub-used or misused areas lacking infrastructure and public services where it is imperative and urgent to perform urban initiatives. This research proposes as a thesis that urban initiatives, when carried out based on an adequate politicalinstitutional model, transform and give value to worthless spaces in their multiple dimensions, offering better quality of life to their residents and helping to fulfill the social role of the city. We intend to prove this thesis through the analysis of national and international cases and by introducing thoughts, critique and guidelines as a contribution to the improvement of the urban initiatives implementation processes, in particular to those regarding worthless areas of Brazilian cities

Desenvolvimento de sistemas magnéticos com potencialidades terapêuticas para vetorização de fármacos

Magnetic targeting is being investigated as a means of local delivery of drugs, combining precision, minimal surgical intervention, and satisfactory concentration of the drug in the target region. In view of these advantages, it is a promising strategy for improving the pharmacological response. Magnetic particles are attracted by a magnetic field gradient, and drugs bound to them can be driven to their site of action by means of the selective application of magnetic field on the desired area. Helicobacter pylori is the commonest chronic bacterial infection. The treatment of choice has commonly been based upon a triple therapy combining two antibiotics and an anti-secretory agent. Furthermore, an extended-release profile is of utmost importance for these formulations. The aim of this work was to develop a magnetic system containing the antibiotic amoxicillin for oral magnetic drug targeting. First, magnetic particles were produced by coprecipitation of iron salts in alkaline medium. The second step was coating the particles and amoxicillin with Eudragit® S-100 by spray-drying technique. The system obtained demonstrated through the characterization studies carried out a possible oral drug delivery system, consisting in magnetite microparticles and amoxicillin, coated with a polymer acid resistant. This system can be used to deliver drugs to the stomach for treatment of infections in this organ. Another important finding in this work is that it opens new prospects to coat magnetic microparticles by the technique of spray-drying.

Reflexões sobre o dito e o feito nas intervenções pedagógicas no Programa Segundo Tempo

Ao longo desta pesquisa, defendemos que projetos sociais como o Programa Segundo Tempo podem ampliar seus objetivos e ações interventivas para além da inclusão social de pessoas excluídas socialmente do acesso a direitos sociais, considerando esses espaços também como promotores de possibilidades educativas. Dialogamos com diversos autores da área da Educação, da Educação Física e das Ciências Sociais, para fortalecer nossos argumentos. Nesse sentido, nossa proposta de pesquisa orientou-se pelo método de pesquisa ação e pelas estratégias e técnicas de pesquisa que o apoiam, desenvolvendo uma proposta de intervenção e acompanhamento sistemático caracterizado basicamente pela realização de seminários e ciclos de observação da prática pedagógica dos monitores e coordenadores de núcleo do PST no convênio da Prefeitura Municipal de Riacho da Cruz, a fim de contribuir para processos de tomada de consciência e mudanças na prática pedagógica que se apresentassem indesejáveis às orientações teóricas e metodológicas do PST. Para tanto, buscamos analisar os problemas da transição das orientações teóricas e metodológicas do PST e contribuir para essa transição por meio de acompanhamento pedagógico sistemático. Partimos de uma questão de estudo que não se encerra em si mesma, mas que foi constantemente alimentada por novas problemáticas e objetivos emergidos do campo empírico durante a pesquisa: quais são os limites e possibilidades encontrados pelos monitores e coordenadores de núcleo do PST para aplicar as orientações teóricas e metodológicas nos núcleos do programa? Os resultados demonstraram que as principais limitações enfrentadas pelos recursos humanos do convênio da Prefeitura Municipal de Riacho da Cruz para aplicar as orientações do PST são: não formação específica na área de Educação Física ou Esporte; experiências de trabalho com o ensino do esporte anteriores ao trabalho no PST, insuficientes ou inexistentes; fragilidades no processo de capacitação segundo modelo do PST que não possibilitaram mais exemplos de experiências para o ensino do esporte nos núcleos; e fragilidades no formato de acompanhamento pouco assíduo realizado pela Equipe Colaboradora. Sobre as possibilidades para superação desse quadro encontramos, justamente na participação e envolvimento do próprio grupo sujeito em tentar minimizar essas limitações, buscando na proposta de acompanhamento pedagógico por seminários e ciclos de observações das atividades desenvolvidas, uma alternativa importante para a resolução das situaçõesproblemas emergidas nesta pesquisa. Desse modo, o sucesso da proposta desenvolvida nos levou a algumas conclusões, dentre as quais está a de que o sucesso do PST não reside somente na cobrança da especificidade da área ou grau de formação dos monitores e coordenadores de núcleo que lidam com o trabalho pedagógico nos núcleos dos convênios, mas na realização de um acompanhamento mais assíduo das Equipes Colaboradoras aos núcleos, que possibilite maiores momentos de troca de experiências entre as Equipes Colaboradoras do PST e o recursos humanos, inclusive considerando as variantes de contexto, estreitando assim a relação teoria e prática no PST. Por fim, reconhecemos as limitações do nosso estudo, o que abre perspectivas para futuras reformulações, mas esperamos contribuir para a interface estabelecida entre as áreas de Educação Física e Ciências Sociais, ampliando os conhecimentos relativos à prática pedagógica em projetos sociais

Prevalência de doença arterial obstrutiva periférica (DAOP) e alterações sensoriais em pacientes diabéticos tipo 2: impacto da DAOP sobre a qualidade de vida, nível de atividade física e composição corporal

Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rhô= -0,26), diabetes duration (p=0,02; rhô= -0,28) and blood pressure (p= 0,0007; rhô= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population

Nem tudo que reluz é ouro: oficinas terapêuticas no cenário da Reforma Psiquiátrica

The purpose of this study is to discuss the therapeutic workshops function, while questioning if they constitute a mechanism for change of the traditional asylum logic. The Psychiatric Reform was materialized with the financing and regulation of alternative services that substitute the psychiatric hospital. This change was promoted by the anti asylum debate and the deinstitutionalization besides psychosocial rehabilitation paradigms. Mental health care, therefore, acquired a new form and the Centers for Psychosocial Care (CAPS) are considered the main services of the health network presently under construction. They are services that offer a variety of therapeutics and amongst them is the workshop, considered essential for the advancement of the Reform ideas. The study was conducted in a CAPS II in Natal, RN. Systematic visits were made using the Institutional Analysis perspective, futhermore were made interviews with professionals who was related to workshops. In the end, data were then discussed according to Schizoanalysis. Results denot that workshops represents, in the same time, progress and regress of Psychiatric Reform. It was observed that workshops were oftentimes reduced to strategies for the occupation of time, and as a means for the transmission of social values considered correct. The relationship between professionals and the user of the service was hierarchical and both players was seeing the workshop as a task to be met. Although users expressed intreresting about wokshops, was reported that the work was boring. Besides, except for some cases, the therapeutic workshops wasn t helping clients to create other possibilites in theirs life and stops the job inside the mental care service

Por uma pedagogia do oprimido midiático: meios de comunicação e suas intervenções na escola

En este trabajo nos ocupamos de la convergencia de la fotografía, el vídeo y la música, intermediado por una estación de radio en la escuela, instalada en la escuela Municipal de Djalma Maranhão, Natal, Rio Grande do Norte, en una clase de 5º año de jóvenes y adultos en el año escolar 2007. Se analizan las intervenciones causados los que participan en la vida escolar, a partir de las actividades realizadas por ellos, en la producción de programas de radio. Los procedimientos metodológicos sobre la base de la etnometodologia (COULON, 1995a, 1995b), en la investigación cualitativa (BOGDAN, BIKLEN, 1999, DENZIN y LINCOLN, 2006), participante como observador (MAY, 2004) y la investigación-acción (THIOLLENT, 1992). La comprensión de Paulo Freire en la comunicación e la educación es nuestro principal referente teórico. Los experimentos citados en los medios de comunicación revelaron varias posibilidades de mejora en la enseñanza y el aprendizaje, como el aumento de la autoestima de los estudiantes, social y de inclusión educativa de personas con discapacidad, disminución de la timidez y facilitar la comunicación entre los sujetos, lo que permite el diálogo entre ellos, intervino en sus relaciones sociales, más allá de los límites de la escuela. La investigación confirma, entonces, que la comunicación y la educación son parte de la misma naturaleza

Caracterização das intervenções em grupo na rede básica de saúde em Natal-RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estudo in silico das interações da protease NS3-NS2B de DENV-2 com o inibidor peptídico Bz-nKRR-H com finalidades terapêuticas

Dengue virus is an important patogen that causes Dengue desease in all world, and belongs to Flavivirus gender. The virus consists of enveloped RNA with a single strand positive sense, 11Kb genome. The RNA is translated into a polyprotein precursor, wich is cleaved into 3 structural proteins (C, prM e E) and 7 non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B e NS5). The NS3 is a multifunctional protein, that besides to promote the polyprotein precursor cleavage, also have NTPase, helicase and RTPase activity. The NS3 needs a hydrophilic segment of 40 residues from the transmembrane NS2B protein (who acts like cofator) to realize this functions. Actually, there's no vacines available on the market, and the treatment are just symptomatic. The tetrapeptide inhibitor Bz-Nle-Lys-Arg-Arg-H (Ki de 5,8-7,0 M) was showed as a potent inhibitor μ for NS3prot in Dengue virus. That is a inteligent alternative to treat the dengue desease. The present work aimed analyse the interactions of the ligand bounded to the activity site to provid a clear and depth vision of that interaction. For this purpouse, it was conducted an in silico study, by using quantum mechanical calculations based on Density Functional Theory (DFT), with Generalized Gradient approximation (GGA) to describe the effects of exchange and correlation. The interaction energy of each amino acid belonging to the binding site to the ligand was calculated the using the method of molecular fragmentation with conjugated caps (MFCC). Besides energy, we calculated the distances, types of molecular interactions and atomic groups involved. The theoretical models used were satisfactory and show a more accurate description when the dielectric constant = 20 ε and 80 was used. The results demonstrate that the interaction energy of the system reached convergence at 13.5 A. Within a radius of 13,5A the most important residues were identified. Met49, Met84 and Asp81 perform interactions of hydrogen with the ligant. The Asp79 and Asp75 residues present high energy of attraction. Arg54, Arg85 and Lys 131 perform hydrogen interactions with the ligand, however, appear in BIRD graph having high repulsion energy with the inhibitor. The data also emphasizes the importance of residue Tyr161 and the involvement of the catalytic triad composed by Asp75, His51 and Ser135