Quem é o doente? Um estudo sobre as vivências dos acompanhantes de pacientes adultos em hospital público no Rio Grande do Norte

The aim of this research is to reveal how caregivers have lived the experiences from adult patients admitted in a Rio Grande do Norte’s state hospital. This is a study where the use of the participant observation, associated with the use of interviews and informal conversations handled categories such as the mismatch between the prerogatives of Brazilian Health Care Policies (HumanizaSUS) and practices performed in hospitals, the relationships established between the caregivers and the other subjects of the research field, family relationships, permanence of women as caregivers, therapeutic itineraries, dramas, religiosity and secrets. To sew up it appears the role of a caregiver is more than emotional support or help, it is a complex act in several directions.

Itinerários e marcas na formação do sujeito formador: reflexões acerca de um caminho na educação matemática

This Study inserts in Mathematical Education & Education that search to investigate the (self) formation of formers that gets graduation e pass to graduate others that get graduation and are formers in Mathematical Education. This Is a qualitative search in a perspective from search-formation.The work is formed of four topics. First topic talks about : The self-formation of formers. Second topic: at way of suppositions theorical-methodological from search. Third topic tells over: The life of a former life. Fouth topic A Station called Ubiratan D´Ambrosio created in his reverence and for build all the Knowledge´s Corpus developed by his studies and searches. It´s in sense of come and go from knowledge created at action by mankind to get finality of Transcendency and Survive. Look for to investigate aspects of academical, professional and personal life where are translated in language, thinking and practices oriented for one know-how holistical and transdiciplined in a reflexion, search and the critical it constitute to be a Professor, Teacher, Searcher and Etnomathematic that confered him the merit in 2005 the Prize Félix Klein, that declared Valente (2007), maximum distinction that can receive someone from Mathematical Education. The results point that the narratives of life´s stories are prominences to one re-direction of teach practical in formation´s courses of Mathematical teachers, opening spaces for what the teachers and particularly of Mathematical thinking and take position about your process of formation to be Formers. The Study also given possibilities to propose fourteen stoppages in Station that are beginnings with direction that emerge from studies and searches about the trajectory of life of Professor Ubiratan D´Ambrosio in perspective of re-signify the formative process in education and Mathematical Education

Colite de derivação fecal

A colite de derivação fecal (CD) é um processo inflamatório que ocorre no segmento colorretal desfuncionalizado, após uma cirurgia de desvio do trânsito intestinal. As principais características dessa entidade clínica são: apresenta-se na desfuncionalização do cólon ou reto; não há doença inflamatória intestinal preexistente; nunca acomete o sítio proximal à colostomia e ocorre resolução do processo após a restauração do trânsito intestinal. Diversas são as hipóteses postuladas para explicar o seu aparecimento; todavia, a deficiência nutricional do epitélio colônico, pela ausência dos ácidos graxos de cadeia curta (AGCC), no segmento desfuncionalizado, é a mais aceita na atualidade. Os autores fazem uma revisão da literatura enfocando os aspectos clínicos, histopatológicos e terapêuticos desta doença

Potencial terapêutico de um heparinóide isolado do invertebrado marinho Litopenaeus vannamei

The occurrence of bioactive compounds in marine organisms comes awaking the interest of the pharmaceutical industry. Heparin, a sulfated polysaccharide which presence was already identified in several marine invertebrates, is very attractive due its remarkable functional versatility. Besides to intervene in blood coagulation, this molecule has a great anti-inflammatory potential. However, its strong anticoagulant activity difficult the clinical exploitation of its anti-inflammatory properties. Thus, the aims of this work were to evaluate the effect of a heparin-like compound (heparinoid), isolated from the cephalotorax of the Litopenaeus vannamei shrimp, on the inflammatory response, hemostasia and synthesis of antithrombotic heparan sulfate by endothelial cells, besides studying some aspects concerning its structure. The purified heparinoid was structurally characterized following an analytical boarding, involving electrophoresis and chromatography. The structural analysis have shown that this compound possess a high content of glucuronic acid residues and disulfated disaccharide units. In contrast to mammalian heparin, the heparinoid was incapable to stimulate the synthesis of heparan sulfate by endothelial cells in the tested concentrations, beyond to show reduced anticoagulant activity and hemorrhagic effect. In a model of acute inflammation, the compound isolated from the shrimp reduced more than 50% of the cellular infiltration. Besides reduce the activity of MMP-9 and proMMP-2 of the peritoneal lavage of inflamed animals, the heparinoid also reduced the activity of MMP-9 secreted by activated human leukocytes. These results demonstrate the potential of heparinoid from L. vannamei to intervene in the inflammatory response. For possessing reduced anticoagulant activity and hemorrhagic effect, this compound can serve as a structural model to direct the development of more specific therapeutical agents to the treatment of inflammatory diseases

Atividades anticoagulante e antioxidante de extratos brutos ricos em polissacarídeos sulfatados das macroalgas marinhas marrons Canistrocarpus cervicornis, Dictyota mertensii e Dictyopteris delicatula e de Heterofucanas de Canistrocarpus cervicornis

In the present study, extracts rich-sulfated polysaccharides were obtained from three different species of Dictyotales (a class of brown macroalgae): Canistrocarpus cervicornis, Dictyota mertensii and Dictyopteris delicatula and their anticoagulant and antioxidant activities were evaluated. All extracts showed anticoagulant activity on aPTT assay, but not on PT assay. Extracts also exhibited total antioxidant activity, superoxide radical scavenging capacity and ferric chelating property. The extract from C. cervicornis showed the best results and was choose to have their sulfated polysaccharides fractioned and subsequently analysed. Thus, six fractions (CC-0.3, CC-0.5, CC-0.7, CC-1.0, CC-1.2 and CC-2.0) were obtained by proteolysis followed by sequential acetone precipitation. Agarose gel eletrophoresis stained with blue toluidine, confirmed the presence of sulfated polysaccharides in all fractions. Chemical analyses showed that all fractions presented heterofucans mainly constitued by fucose, galactose, glucuronic acid and sulfate. Any fraction changed the PT. However, all fractions were able to double the aPTT on a dose-dependent manner. CC- 0.3, CC-0.5, CC-0.7 and CC-1.0 needed only 0.100 mg/mL to double the aPTT, result only 1.25 times higher than the Clexane® (0.080 mg/mL), a commercial low molecular heparin. The heterofucans presented appreciable total antioxidant capacity, low capacity on scavenging hydroxyl radical and good efficiency on scavenging superoxide radicals (except CC-1.0). CC-1.2 showed 43.1 % on superoxide radical scavenging. This result was higher than that showed by the same concentration of gallic acid (41.8 %), a known antioxidant. Furthermore, the heterofucans showed excelent activity on ferrous chelating activity (except CC-0.3). CC-0.5, CC-0.7 and CC-1.0 showed the highest activities with 47.0 % of ferrous chelating activity, a result 2.0 times lesser than that exhibited by the same concentration of EDTA. These results clearly indicated the beneficial effects of heterofucans extracted from C. cervicornis as potential anticoagulant and antioxidant agents. However additional steps of purification, structural studies, besides in vivo experiments are needed for these fucans may be used as therapeutic agents

Análise da contribuição de fatores genéticos e ambientais na manutenção da hanseniase nos estados do Rio Grande do Norte e Pará

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Efeito anti-inflamatório do heparinóide isolado do camarão Litopenaeus vannamei sobre a peritonite aguda

In recent years the heparin has been the subject of several studies that aim to expand its use as a therapeutic agent, due to its ability to modulate the activity of various proteins that play important roles in the regulation of pathophysiological processes. In several experiments and preclinical trials, heparin has demonstrated an anti-inflammatory role. However, its clinical use is limited, due to its strong anticoagulant activity and hemorrhagic complications. For this reason, considerable efforts have been employed in discovery of heparin analogous (heparinoid) with reduced side effects, that retain the anti-inflammatory properties of heparin. In this context, a heparinoid obtained from the head of Litopenaeus vannamei shrimp, which presents a structural similarity to heparin, showed, in previous studies, anti-inflammatory activity in a model of acute peritonitis with reduced anticoagulant effect in vitro and low hemorrhagic activity. Thus, the present work had as objective to evaluate the effect the heparinoid of the cephalothorax of gray shrimp on the acute inflammatory response in different times (3 or 6 hours after the induction of inflammatory stimulus), using the model of acute peritonitis induced in mice. It was also analyzed the HL effect over the activity of elastase, an enzyme involved in leukocyte recruitment. Furthermore to check if the different doses of heparin and heparinoid change the hemostatic balance in vivo, was assessed the effect of these compounds on the plasma clotting time in animals submitted to inflammation. The results show that in 3 hours, all doses of heparinoid were able to prevent efficiently in the acute inflammatory process without any anticoagulant effects, unlike the extrapolation dose of heparin, which has induced a large hemorrhage due its high anticoagulant activity. However, 6 hours after induction of inflammation, only the dosages of 0.1 and 1.0 μg/Kg of heparin and 1.0 μg/Kg of heparinoid kept anti-migratory effect, without changing of the hemostatic balance. These results indicate that the anti-migratory effect of theses compounds depends on the dosage and time of inflammatory stimulus. The HL and heparin were also able to inhibit the activity of the enzyme elastase. The discovery of this bioactive compound in the cephalothorax of shrimps can arouse great interest in biotechnology, since this compound could be useful as a structural model interesting for the development of new therapeutic agents for peritonitis

Desenvolvimento de uma formulação cólon específica visando o tratamento da colite ulcerativa

Micro and nanoparticulate systems as drug delivery carriers have achieved successful therapeutic use by enhancing efficacy and reducing toxicity of potent drugs. The improvement of pharmaceutical grade polymers has allowed the development of such therapeutic systems. Microencapsulation is a process in which very thin coatings of inert natural or synthetic polymeric materials are deposited around microsized particles of solids or around droplets. Products thus formed are known as microparticles. Xylan is a natural polymer abundantly found in nature. It is the most common hemicellulose, representing more than 60% of the polysaccharides existing in the cell walls of corn cobs, and is normally degraded by the bacterial enzymes present in the colon of the human body. Therefore, this polymer is an eligible material to produce colon-specific drug carriers. The aim of this study was to evaluate the technological potential of xylan for the development of colon delivery systems for the treatment of inflammatory bowel diseases. First, coacervation was evaluated as a feasible method to produce xylan microcapsules. Afterwards, interfacial cross-linking polymerization was studied as a method to produce microcapsules with hydrophilic core. Additionally, magnetic xylan-coated microcapsules were prepared in order to investigate the ability of producing gastroresistant systems. Besides, the influence of the external phase composition on the production and mean diameter of microcapsules produced by interfacial cross-linking polymerization was investigated. Also, technological properties of xylan were determined in order to predict its possible application in other pharmaceutical dosage forms

Obtenção de sistemas multiparticulados de isoniazida revestidos com polímero de liberação entérica

Known for thousands of years, tuberculosis (TB) is the leading cause of mortality by a single infectious disease due to lack of patient adherence to available treatment regimens, the rising of multidrug resistant strains of TB (MDR-TB) and co-infection with HIV virus. Isoniazid and rifampicin are the most powerful bactericidal agents against M. tuberculosis. Because of that, this couple of drugs becomes unanimity in anti-TB treatment around the world. However, the rifampicin in acidic conditions in the stomach can be degraded rapidly, especially in the presence of isoniazid, which reduces the amount of available drug for absorption, as well as its bioavailability, contributing to the growing resistance to tuberculostatic drugs. Rifampicin is well absorbed in the stomach because of its high solubility between pH 1 and 2 and the gastric absorption of isoniazid is considered poor, therefore it is mostly intestinal. This work has as objective the development of gastro-resistant multiple-systems (granules and pellets) of isoniazid aiming to prevent the contact with rifampicin, with consequent degradation in acid stomach and modulate the release of isoniazid in the intestine. Granules of isoniazid were obtained by wet method using both alcoholic and aqueous solutions of PVP K-30 as aggregating and binder agent, at proportions of 5, 8 and 10%. The influence of the excipients (starch, cellulose or filler default) on the physical and technological properties of the granules was investigated. The pellets were produced by extrusionesferonization technique using isoniazid and microcrystalline cellulose MC 101 (at the proportion of 85:15) and aqueous solution of 1% Methocel as platelet. The pellets presented advantages over granular, such as: higher apparent density, smaller difference between apparent and compaction densities, smoother surface and, especially, smaller friability, and then were coated with an organic solution of Acrycoat L 100 ® in a fluidized bed. Different percentages of coating (15, 25 and 50%) were applied to the pellets which had their behavior evaluated in vitro by dissolution in acidic and basic medium. Rifampicin dissolution in the presence of uncoated and coated isoniazid pellets was evaluated too. The results indicate that the gastro resistance was only achieved with the greatest amount of coating and isoniazid is released successfully in basic step. The amount of rifampicin in the dissolution medium when the isoniazid pellets were not coated was lower than in the presence of enteric release pellets. Therefore, the polymer Acrycoat L 100 ® was efficient for coating with gastro-resistant function and can solve the problem of low bioavailability of rifampicin and help to reduce its dosage

Ação da β-1,3 glucana no sistema imune de camundongos com sepse por Candida albicans

The frequency of disseminated candidiasis caused by yeast has enhancing in intensive care unit. Despite the availability of new antifungal drugs, C. albicans sepsis mortality causes can be as high as 30-40%. So, it has been needed to looking for a new therapeutic medicament that helps in treatment and prevention of this infection. Previous data that demonstrated that particulated β-glucan stimulates the immune system and experiments of this work were conducted to investigating if β-glucan extracted from Saccharomices cerevisiae, could modified the evolution of mouse model C. albicans systemic infection. Balb/c mice with sepsis and β-1,3 glucan treated or not were analyzed the influence of β-1,3 glucan in survival of the animals, in the fungal burdens in kidney, in the production of urea and TNF even in the histopathology of kidney. The experiments shown that the infected animals a nd glucan treated had great survival (p<0,05), less unit form colony in kidney and normal levels of urea. In the kidney histopathology of not glucan treated animals it has seen more lesions when compared with treated animals. So we conclude that β-1,3 glucan could stimulate the immune system against disseminated C. albicans

Atenção ao usuário em um centro de referência HIV/Aids: perspectiva de profissionais e usuários

We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Serviço Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed

Instâncias da representação imagética hiper-real

The approach that undertakes this work revolves around the emergence of iconic structures on reflecting about the meaning of different methods of image representation through which the contemporaneity reveals itself. At baseline, three aspects are considered looking for an analytical ontology of the act of representation and imagery: the transition of representation in the oral culture of societies for writing, from these to typography, and finally the creation of a representation device. Resorted to, therefore, the argument by some genealogy reference points that technological instances such as writing, printing and photography, the evolution of this process, correspond, in itself, a consequent shift technique, for each representation precedent. In the area of the image, the most salient aspect of this change in foward process is the emergence of hyper-reality: the instances of hyper-realistic representation. In the Western context, the 'simulation of the world' - essential idea of mimesis is the work of an autonomous an conventional system. It should be noted, then the fact that under unreflective of the post-industrial societies, the mass-media image is coating with natural or fake code including - according to Baudrillard - tends to replace the real world in the "perpetuation of a large chain of simulacra." Hence in modern times, in the postindustrial society, during the crisis of the representation regimen and perception, centered in the referent. In this limit, new settings are established by aesthetic representations of imagery in contemporary culture: establishing spaces of simulation [Jean Baudrillard] the spectacle [Guy Debord] and hypermodernity [Gilles Lipovetsky] in which they operate. In these assemblages, saps the emergence of Hyper-reality Representation Instances - as seen in this study aesthetic events to configure itineraries of a new sensibility. It is the nature of this practice sign-iconic, ingrained in the creation of current artistic expression, which this research engaged in peering: the hyper-realistic setting, taking empirical support central to contemporary imagery production, diverse formats of analog representation.

Diálogos da Alma: uma outra história da loucura

The tesis intends to awake a new way of looking at madness. It presents as reference the Psychiatric Hospital Doctor João Machado (Natal/RN) and histories of life and narratives of four intern residents. The research in an ethical horizon, intends to give back to the subjects the voices long silented behind the institutions walls by their families and society in general. As well as to open the interpretations of science to receive and to dialogue with other itineraries of thought that, if on one hand does not restitute the explanation of the Real, on the other hand expresses other forms to see the world. Dislocated of the bigger social environment, the people identified as insane, construct their histories endowed with autonomy and displacements in relation to the social rules and structures that characterize our society, as much as in relation to the logical principles of thought that assume an objective and rational reality. As well as a remnants bedspread configured in a complex and unfinished object, the break up of histories of life of the interns, interviews with medical on psychiatrists to the Doctor João Machado Hospital, documents of the institution and depositions of that house, were the raw material to construct, with this tesis, another chapter of the 'history of madness'. In elapsing of the work innumerable voices have been heard. Some that study the phenomenon of madness, others that live this 'state of the being' in the world. We opt to detaching the first of an open conception on the theme through intellectuals as: João da Costa Machado, Ulysses Pernambucano, Nise da Silveira and Boris Cyrulnik. They express ethics compromised to the humanity of the being

A Poética do corpo no mito e na dança butô: por uma educação sensível

The thesis presents the body poetry and its inscribing in the myth and Butô dance. The argumentation highlights the sensitive dimension present in these itineraries, as a possibility to operate the emergency of knowing inscribed in the body, bringing a kind of rationality that links the fragments, that allows the knowing to break through the barriers of disciplinary isolation, that abandons the certainties and goes through the ways of creation and that gives the body new space and time, featuring epistemological elements, ethical and esthetical, that can permit a sensitive education. All along the way, we comprehend by sensitive education, a education that considers the relinking of logical, analogical, symbolic and artistic knowledge and therefore reconsiders the own act of knowing as a continuous and inconcluded process. That sensitive education is also understood as retaking the body experience, its sensitive nature, as well as being meaningful to reading the world. It includes the body memory, its history and creativity, opening it to innovation, change, sense amplification and dialogue with other bodies and world, because it is within them. It is about an investigation of phenomenologic nature, that dialogues philosophy and art, pointing breakdowns of this reflection foe the body and education studies. We find it necessary to notice the body language, that allows one to think through movements, articulate a thought that is risen from articulations, guts and all the body. This incarnated reason starts the expressive body action, that makes us move to mean, communicate, inaugurate senses. Among these senses, we present a possibility of approach of the elements of Butô dance teaching and physical education, as ways of sensitive education showings of body poetry

Paisagens sonoras, tempos e autoformação

Les sociétés actuelles vivent des temps de vitesse, de l'individualisme, de l'absence d'enracinement historique: en harmonie avec le processus de formation de la civilisation du monde occidental contemporain profondément marqué par le paradigme de la globalisation. La pollution visuelle et sonore des grandes villes est, en même temps, l'expression de la pollution des sens et des affections humaines. En reflétant sur ce processus, la thèse discuter em faveur d'une formation réglée dans la logique du sensible qu'il a dans l'écouter près de la nature (Lévi-Strauss) un de leurs piliers épistémologiques ondamentales. Cette forme de penser et vivre reconnaît dans l'autoformation (Edgar Morin), et dans l'exercice de construction, par le sujet, de leurs propres paysages sonores (Murray Schafer), deux opérateurs cognitifs capables de nourrir les principes de la diversité, complexité, interdépendance et respect à la nature (Fritjof Capra). Dans le parcours argumentatif de la thèse gagnent emphase les savoirs de la tradition, les pratiques et les connaissances produites par les sociétés le plus proche de la nature qui, par des stratégies cognitives ouvertes et des polyphoniques, donnent importance aux facultés sensibles et à la complémentarité des deux itinéraires de la pensée: symbolique/mythologique/magique et empirique/technique/rationnel (Edgar Morin). Proche d'une perspective autobiographique, la thèse se présente dans la forme narrative d'un registre avec des évocations poétiques, philosophiques et musicales germées de l'écouter d'un paysage particulier, la Lagon du Piató, localisé dans la région de l'Assu (Rio Grande do Norte) et, en particulier, des récits et des évocations de mémoire d'un de leurs habitants auxlesquels nous pourrions appeler d'un philosophe de la nature , Francisco Lucas da Silva (Chico Lucas). Ensuite, ils sont décrits non-place (Marc-Augé) des scénarios métropolitains, en discutant ainsi les excès de pollution sonore, visuelle et de l'afection. En ayant comme estimé une éducation complexe ancrée dans non séparation il entre réforme de l'éducation et reforme de la pensée, de la formation et autoformation (Edgar Morin), à la fin, la thèse propose des ateliers d'expérimentation de l'écouter sensible entre des jeunes et des enfants sur le contexte scolaire, en pariant dans les futures générations (Ilya Prigogine) pour la reconstruction d'un monde plus juste et solidaire