Estudo clínico-laboratorial e histopatológico de cães naturalmente infectados por Leishmania chagasi com diferentes graus de manifestação física

Canine Visceral Leishmania (CVL) is an important zoonotic disease that has a world wide distribution and has a large impact on public health on the American Continent, especially in Brazil, where the nature of endemic diseases in humans affects a large part of the nation. The influence of the prevalence of CVL in the increased rate of human cases in endemic areas and in the unleashing of epidemic outbreaks shows the need for a more profound understanding, that would generate significant advances in the current measures used to control the reservoirs of sickness that are practiced by the Programa Nacional de Vigilância e Controle da Leishmaniose Visceral. The present work describes and compares the clinical-laboratorial and histopathological findings of twenty-three dogs that were naturally infected by Leishmania chagasi, from endemic areas in metropolitan Natal, Rio Grande do Norte, Brazil. These animals, that were selected and given physical and serological exams (IFI and ELISA rK-39), were classified according to the degree of clinical severity and had blood samples drawn (whole blood and serum) for a complete hemogram and a coagulogram to be done as well as biochemical tests for kidney and liver function. The confirmation of infection by L. chagasi was done after the euthanasia of the animals, through the direct demonstration of the parasite in the impression of the spleen and liver crowned with GIEMSA and through a cultivation by means of NNN/Schneider. According to the clinical evaluation, the animals were classified as asymptomatic (7), oligosymptomatic (7) and polysymptomatic (9). Among the animals that were chosen to be autopsied, there were 2 asymptomatic, 3 oligosymptomatic and 3 polysymptomatic, for the purpose of studying their histopathology, having collected fragments of the spleen, liver, kidneys and skin and were fixed in 10% tamponed formol. The comparison between the average parameters of the clinical-laboratory tested animals in the groups was done through the Student t test (a<0.05). The main clinical signals observed were lymphadenomegaly, alopecy, dermatitis, exfoliation, cutaneous ulcers, onicogriphosis and emaciation. The main clinical-laboratorial alterations established, mainly in the polysymptomatic group, were anemia, hyperproteinemia, hyperglobulinemia, alterations in the albumin/globulin ratio and increased ALT activity. Renal alterations were not verified (urea and creatinine levels were normal). Thrombocytopenia was observed in three clinical groups. However, the other indicators of coagulation function (TAP and TTPA) did not have abnormal variations. There were inflammatory infiltrations and leishmania amastigotes in the skin of polysymptomatic dogs, however, they were not found in the skin of asymptomatic animals. Hypertrophy and hyperplasia of the phagocyte mononuclear system, leishmania amastigote parasites were found in the macrophages, extramedullary hematopoiesis and degenerative alterations were detected in the spleen and liver of 8 of the animals submitted to histopathological exams. In accord with these results, it was demonstrated that the expected alterations in the hematological and biochemical parameters in function of their viscerotropic nature of CVL are mainly observed in the more advanced stages of the disease. The absence of inflammatory infiltration and parasite load in the skin suggest that infected animals without symptoms may have an importance irrelevant to the infectiousness of the vector

A manifestação da vontade da criança na disputa judicial da guarda: escuta psicanalítica/

Currently, in custody disputes, the child has the right to be heard and to have its opinion considered, according to its age and maturity. The psychologist/psychoanalyst who works in the Family Court is required to produce a Report with the purpose of helping the Court´s decision. The present research aims to discuss and to find guiding principles for the hearing of the declaration of the child´s will in a custody dispute by its parents, from a psychoanalytical perspective. The case of a nine year old girl that affirmed in Court the desire of living with the mother and seeing the father only once a year is the starting point of this theoretical research over the psychoanalytic fundaments of the hearing of the case, how it appeared in that experience and how it was reflected in the report. Throughout this work, the peculiarities of psychoanalysis as a way of understanding the subject and the conditions that must be observed so that a sctrictu sensu analytic hearing is possible are studied. Then we present a reflection of the case, in the light of the theories studied, verifying that we could observe in the experience: i) the assumption of a subject of the unconscious, divided and desire full that constitutes itself from the oedipic structuration, that leads to the difference between speech and speak; ii) the concept of the child as having a sexuality of its own; iii) a hearing based on the ethic principles of psychoanalysis and the analysts'' formation. In the final considerations, we state that the institutional demand of a meaning for the case is a great difficulty for the analyst since he works from a place of 'not-knowing"

O papel da violência interpessoal compreendida como a manifestação de uma endemia social: uma análise geográfica sobre o fenômeno no Brasil e Rio Grande do Norte

En Brasil, la violencia interpersonal (homicidios) se ha incrementado de forma significativa, convirtiéndose en una preocupación cada vez mayor en todos los ámbitos políticos de la sociedad. Hoy es uno de los más graves problemas sociales y de salud pública. Se refiere a los problemas sociales, ya que interfiere en la distribución de la oferta de bienes y servicios a los ciudadanos; sino también un problema de salud, porque la violencia es uno de los fenómenos que causan gran impacto en la morbilidad y mortalidad del país, y genera un alto costo para el Sistema Único de Saúde (SUS). Esta es una crisis social, que es el resultado de un mundo capitalista globalizado, que exige a todos sus instrumentos de dominación (dinero, poder y competitividad en estado puro), en virtud del cual la violencia y los conflictos interpersonales se materializan en el territorio. El Río Grande do Norte (RN) ha estado siguiendo esta realidad que es nacional, con el aumento de las tasas de mortalidad por homicidios. En este sentido, este estudio tuvo como objetivo analizar la violencia interpersonal (agresión / homicidio), en Brasil y en el estado del RN, para entender cómo esto afecta a su población, en la morbilidad y mortalidad durante los años 2001 a 2011. Para ambos hicimos uso de método descriptivo / cuantitativo para determinar la magnitud, el tamaño, el perfil de las víctimas y los costos del SUS generados por el problema. Como resultado, podemos diagnosticar que en Brasil, la violencia se ha presentado una nueva dinámica regional, promovida por un proceso de interiorización del fenómeno en todo el país, este proceso de internalización se ha reflejado en la última década, el crecimiento de la violencia en el estado del RN, que ha causado un gran impacto en las tasas de la mortalidad del estado. Acerca la victimización, se puede ver que hay un perfil vulnerable formado por, varón, baja instrucción joven, sola y negro. Con respecto a los datos de morbilidad hospitalaria, la demanda creciente del fenómeno genera costes para el sistema de salud, y las graves consecuencias humanas, como la escalada del miedo y la destrucción de una generación de jóvenes brasileños. Por lo tanto, la falta de una política pública para afrontamiento, prevención y mitigación del problema revela el fracaso de la gestión pública, con consecuencias sociales y de salud, tanto individual como colectivamente.

Estudo clínico-laboratorial e histopatológico de cães naturalmente infectados por Leishmania chagasi com diferentes graus de manifestação física

Canine Visceral Leishmania (CVL) is an important zoonotic disease that has a world wide distribution and has a large impact on public health on the American Continent, especially in Brazil, where the nature of endemic diseases in humans affects a large part of the nation. The influence of the prevalence of CVL in the increased rate of human cases in endemic areas and in the unleashing of epidemic outbreaks shows the need for a more profound understanding, that would generate significant advances in the current measures used to control the reservoirs of sickness that are practiced by the Programa Nacional de Vigilância e Controle da Leishmaniose Visceral. The present work describes and compares the clinical-laboratorial and histopathological findings of twenty-three dogs that were naturally infected by Leishmania chagasi, from endemic areas in metropolitan Natal, Rio Grande do Norte, Brazil. These animals, that were selected and given physical and serological exams (IFI and ELISA rK-39), were classified according to the degree of clinical severity and had blood samples drawn (whole blood and serum) for a complete hemogram and a coagulogram to be done as well as biochemical tests for kidney and liver function. The confirmation of infection by L. chagasi was done after the euthanasia of the animals, through the direct demonstration of the parasite in the impression of the spleen and liver crowned with GIEMSA and through a cultivation by means of NNN/Schneider. According to the clinical evaluation, the animals were classified as asymptomatic (7), oligosymptomatic (7) and polysymptomatic (9). Among the animals that were chosen to be autopsied, there were 2 asymptomatic, 3 oligosymptomatic and 3 polysymptomatic, for the purpose of studying their histopathology, having collected fragments of the spleen, liver, kidneys and skin and were fixed in 10% tamponed formol. The comparison between the average parameters of the clinical-laboratory tested animals in the groups was done through the Student t test (a<0.05). The main clinical signals observed were lymphadenomegaly, alopecy, dermatitis, exfoliation, cutaneous ulcers, onicogriphosis and emaciation. The main clinical-laboratorial alterations established, mainly in the polysymptomatic group, were anemia, hyperproteinemia, hyperglobulinemia, alterations in the albumin/globulin ratio and increased ALT activity. Renal alterations were not verified (urea and creatinine levels were normal). Thrombocytopenia was observed in three clinical groups. However, the other indicators of coagulation function (TAP and TTPA) did not have abnormal variations. There were inflammatory infiltrations and leishmania amastigotes in the skin of polysymptomatic dogs, however, they were not found in the skin of asymptomatic animals. Hypertrophy and hyperplasia of the phagocyte mononuclear system, leishmania amastigote parasites were found in the macrophages, extramedullary hematopoiesis and degenerative alterations were detected in the spleen and liver of 8 of the animals submitted to histopathological exams. In accord with these results, it was demonstrated that the expected alterations in the hematological and biochemical parameters in function of their viscerotropic nature of CVL are mainly observed in the more advanced stages of the disease. The absence of inflammatory infiltration and parasite load in the skin suggest that infected animals without symptoms may have an importance irrelevant to the infectiousness of the vector

A confiança interorganizacional nas compras

This research is part of the field of organizational studies, focusing on organizational purchase behavior and, specifically, trust interorganizational at the purchases. This topic is current and relevant by addressing the development of good relations between buyer-supplier that increases the exchange of information, increases the length of relationship, reduces the hierarchical controls and improves performance. Furthermore, although there is a vast literature on trust, the scientific work that deal specifically at the trust interorganizational still need further research to synthesize and validate the variables that generate this phenomenon. In this sense, this investigation is to explain the antecedents of trust interorganizational by the relationship between the variable operational performance, organizational characteristics, shared values and interpersonal relationships on purchases by manufacturing industries, in order to develop a robust literature, most consensual, that includes the current sociological and economic, considering the effect of interpersonal relationships in this phenomenon. This proposal is configured in a new vision of the antecedents of interorganizational trust, described as significant quantitative from models Morgan and Hunt (1994), Doney and Cannon (1997), Zhao and Cavusgil (2006) and Nyaga, Whipple, Lynch (2011), as well as qualitative analysis of Tacconi et al. (2011). With regard to methodological aspects, the study assumes the form of a descriptive, survey type, and causal trace theoretical and empirical. As for his nature, the investigation, explicative character, has developed a quantitative approach with the use of exploratory factor analysis and structural equation modeling SEM, with the use of IBM software SPSS Amos 18.0, using the method of maximum verisimilitude, and supported by technical bootstraping. The unit of analysis was the buyer-supplier relationship, in which the object under investigation was the supplier organization in view of the purchasing company. 237 valid questionnaires were collected among key informants, using a simple random sampling developed in manufacturing industries (SIC 10-33), located in the city of Natal and in the region of Natal. The first results of descriptive analysis demonstrate the phenomenon of interorganizational trust, in which purchasing firms believe, feel secure about the supplier. This demonstration showed high levels of intensity, predominantly among the vendors that supply the company with materials that are used directly in the production process. The exploratory and confirmatory factor analysis, performed on each variable alone, generated a set of observable and unobservable variables more consistent, giving rise to a model, that needed to be further specified. This again specify model consists of trajectories was positive, with a good fit, with a composite reliability and variance extracted satisfactory, and demonstrates convergent and discriminant validity, in which the factor loadings are significant and strong explanatory power. Given the findings that reinforce the model again specify data, suggesting a high probability that this model may be more suited for the study population, the results support the explanation that interorganizational trust depends on purchases directly from interpersonal relationships, sharing value and operating performance and indirectly of personal relationships, social networks, organizational characteristics, physical and relational aspect of performance. It is concluded that this trust can be explained by a set of interactions between these three determinants, where the focus is on interpersonal relationships, with the largest path coefficient for the factor under study

Diagnóstico da cultura organizacional em hospitais da rede privada de Natal/RN

As peculiaridades presentes no ser humano são observadas a partir da manifestação de sua cultura. Estas manifestações podem ser influenciadas pelo contexto social do indivíduo. A cultura nacional é uma destas influências. A brasileira, por exemplo, possui alguns traços nacionais peculiares ao seu povo que amenizam a sua complexidade e pluralidade. Estes traços podem se tornar influentes na cultura organizacional, através da manifestação das práticas e dos valores utilizados pela organização. Diante disso, o presente trabalho teve como objetivo diagnosticar a cultura organizacional dos hospitais, enfatizando as práticas e os valores organizacionais e a percepção dos colaboradores sobre a cultura organizacional. A metodologia utilizada na pesquisa foi de caráter descritivo e explicativo. A pesquisa ocorreu através da aplicação do Instrumento Brasileiro para a Avaliação da Cultura Organizacional IBACO, com 283 sujeitos distribuídos em três hospitais da rede privada de Natal/RN. As evidências encontradas pelo estudo foram analisadas através do software estatístico SPSS, com as técnicas multivariadas de análise fatorial, análise de aglomerados e análise discriminante. A partir dessas análises, foram obtidos cinco fatores distribuídos entre práticas e valores apresentados pelo IBACO, que foram: as práticas de recompensa e treinamento; integração externa e promoção do relacionamento interpessoal; e, os valores de satisfação, bem-estar e cooperação dos empregados e profissionalismo competitivo. Os grupos encontrados na análise apresentaram divergências de opinião quanto às práticas e os valores utilizados nos hospitais. Concluiu-se, portanto, que o Hospital A apresentou uma cultura mais proativa e voltada mais para a satisfação e bem-estar dos funcionários. Já os outros dois hospitais apresentaram culturas semelhantes, com limitações quanto à valorização do bem-estar e da cooperação entre os colaboradores, porém com uma boa prática do relacionamento interpessoal

Cravo do canavial: "entre" o maracatu rural e a mímesis corpórea: a construção de uma dramaturgia cênica

The present dissertation has begun with an investigation about the application of the Technique of the Corporeal Mimesis, systematized by the Lume, Interdisciplinary Center for Theatrical Research of Unicamp, associated with the matrix of Rural Maracatu, specifically of the group Cambinda Brasileira (Nazaré da Mata PE), with the purpose of promote the training and the composition work of the actor. Starting from an empirical methodology, which used the analysis of practical experiences the application process of the Corporeal Mimesis and the construction of a theater play associated with bibliographical research, I could investigate possible ways of re-signification of this technique, using components related to the ritual and the game present in the popular event in question, and experience such paths through the conception of the play Cravo do Canavial

Para transvalorar a dança contemporânea: potências de dança no (do) corpo-artista

Tanto no contexto acadêmico quanto no artístico e mercadológico, é crescente a discussão sobre o espaço de conceituação da dança contemporânea e suas fissuras, que deixam de abarcar esta ou aquela manifestação artística ou mesmo acaba por abarcar aquelas manifestações que não se encaixam em outros espaços de conceituação. No presente trabalho objetivamos a investigar, a Dança na Contemporaneidade, para além do que se entende por dança contemporânea, em sua capacidade de atravessar os espaços de conceituação já estabelecidos, para implicar em uma pluralidade de fazeres. Objetivamos também pensar a potência que a Dança imprime no corpo do artista criador, pensando também como este se comporta no espaço de entre linguagens . A dissertação que aqui se apresenta encontrou enquanto estratégia metodológica o recurso da metáfora, partindo das ideias de travessia, cartografia e cidades invisíveis para a construção do pensamento sobre o corpo do artista e suas relações com as diferentes linguagens artísticas, tomando por base uma retomada das experiências estéticas e artísticas de sua proponente. Dialogando experiências práticas e referenciais teóricos, inicialmente tratamos da dança contemporânea em seus problemas de classificação que apontam para a necessidade de um pensamento contemporâneo em dança, que pense as manifestações artísticas em seus pontos convergentes, e não nos divergentes que as situam sob diversas nomenclaturas. No capítulo seguinte discutimos a possibilidade de contaminação entre as linguagens artísticas a partir do próprio corpo-artista. Discorremos também sobre a dança enquanto agenciamento e resposta aos impulsos resultantes da relação com o espaço e outros corpos, pensando como o corpo do vivente se organiza nesta relação de compartilhamento de experiências. Mostrando uma potência do corpo artista criador que se dedica à transvaloração das fronteiras entre as linguagens para a organização do seu fazer. Por fim, apontamos para a diversidade na metodologia de processos de criação que variam de acordo com as possibilidades técnicas e necessidades estéticas de cada artista criador

Mover/se(r) a gênese do corpo entre/corpos e seus trajetos no processo coreográfico

This paper proposes a reflection on the body between/bodies, especially in contemporary dance, in their path that starts from the choreographic construction, permeating the body of the choreographer, the dancer s body and when fulfills themselves as artistic expression, the body of the spectator. Initially discusses the body in dance as a body/space for convergence, connectedness and continuity, from the thought of the Greek philosopher Epicurus of Samos, in dialogue with the thought of Maurice Merleau-Ponty, Gilles Deleuze and José Gil. Reflect about the creation of this body/space in the relationship choreographer/dancer using as connecting thread the experiences of the author in his artistic path. Finally describes the process of creating the scenic experiment (h)áporos, which constitutes the practice scene of this dissertation, having as main objective the creation of spaces of convergence and interaction between a proponent and an affluent body that, in this move, transforms itself and the space that now cohabits / is

Avaliação demográfica, clinico-laboratorial e genética de indivíduos com lupus eritematoso sistêmico e artrite reumatóide residentes em região tropical

The aetiology of autoimmunes disease is multifactorial and involves interactions among environmental, hormonal and genetic factors. Many different genes may contribute to autoimmunes disease susceptibility. The major histocompatibility complex (MHC) genes have been extensively studied, however many non-polymorphic MHC genes have also been reported to contribute to autoimmune diseases susceptibility. The aim of the present study was to evaluate the influence of SLC11A1 gene in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Ninety-six patients with SLE, 37 with RA and 202 controls enrolled in this case-control study, were evaluated with regard to demographic, genetic, laboratorial and clinical data. SLE mainly affects females in the ratio of 18 women for each man, 88,3% of the patients aged from 15 to 45 years old and it occurs with similar frequency in whites and mulattos. The rate of RA between women and men was 11:1, with 77,1% of the cases occurring from 31 to 60 years. The genetic analysis of the point mutation -236 of the SLC11A1 gene by SSCP did not show significant differences between alleles/genotypes in patients with SLE or RA when compared to controls. The most frequent clinical manifestations in patients with SLE were cutaneous (87%) and joint (84.9%). In patients with RA, the most frequent out-joint clinical manifestation were rheumatoid nodules (13,5%). Antinuclear antibodies were present in 100% of the patients with SLE. There was no significant relation between activity of disease and presence of rheumatoid factor in patients with RA, however 55,6% of patients with active disease presented positive rheumatoid factor. Significant association between alleles/genotypes of point mutation -236 and clinical manifestations was not found

Avaliação das atividades anti-toxoplásmica, antioxidante e antiinflamatória dos monoterpenos timol (lippia sidoides) e estragol (croton zenhtneri)

Toxoplasmosis, a benign disease in normal healthy individuals, can have serious effects in pregnant women and immunocompromised patients. It is a parasitic disease caused by Toxoplasma gondii (Tg), an obligatory intracellular protozoan. The prophylactic and therapeutic arsenal against this parasite is very restricted. Thus, there is an ongoing search for novel drugs and therapeutic strategies. A promising alternative is a rational approach using medicinal plants. This study aimed to standardize methodologies for assessing the toxicological, antiproliferative, antioxidant, antiinflammatory and anti-Toxoplasma effects of Estragole and Thymol compounds isolated from species of plants (Lippia sidoides and Croton zenhtneri) commonly used in the Cariri region of Ceara State, Brazil. First we evaluated in vivo toxicity and conducted a pathological analysis of mice livers. In vivo antiinflammatory activity was assessed using air pouch and paw edema methods. Cytotoxicity assays were performed and antiproliferative, antioxidant and nitric oxide production analyzed. Anti-Toxoplasma activity was evaluated in a congenital experimental model with varying stages of maternal infection using the ME-49 strain and a non- congenital model by using ME-49 and RH strains. The results suggest low to moderate toxicity for both compounds. Thymol was more toxic in vivo and in vitro, having greater pathological repercussion than Estragole. The compounds were inactive for antiproliferative activity. Thymol showed better antioxidant activity, while Estragole stimulated nitric oxide production in macrophages. Both showed significant antiinflammatory activity. In non-congenital Tg infection, both compounds were active only against the ME49 strain. In congenital infection, Estragole (oral route) improved the newborn weight of infected mothers compared with untreated controls. Subcutaneous administration of the two compounds increased the weight of offspring born to infected mothers compared with untreated controls. We concluded that Estragole and Thymol exhibit important biological and anti-Toxoplasma activities. Further studies are needed to elucidate the mechanism of action of these compounds and other possible activities not investigated in the present study

Hemiparesia congênita e adquirida na criança: interrelação entre presença de crises epilépticas, os achados eletrencefalográficos e de neuroimagem por ressonância nuclear magnética

The purpose of this paper was to study patients with congenital and acquired hemiparesis, their clinical aspects, the presence or not of epileptic seizures, and electroencephalographic (EEG) and Magnetic Resonance Imaging (MRI) findings. We analyzed the interrelation between etiology, the presence and seriousness of epileptic seizures (ES) and the possible causes of refractoriness. This is a prospective study using the clinical diagnosis of a child neurologist, who attested to the presence of unilateral motor lesions. We compared the electroencephalographic findings in patients with or without epileptic seizures, and investigated if among the former, these seizures were controlled or not, their likely etiology and risks of refractoriness. EEG background activity on the lesion and contralateral side was analyzed, in addition to the presence of concomitant epileptiform activity. Encephalon MRIs of all the patients were studied to correlate etiology and the control or not of epileptic seizures. The disorganization of bilateral EEG activity correlated with the difficult-to-control epileptic seizures. Suitably organized background activity contralateral to the lesion is a good prognosis in relation to epileptic seizures. Focal epileptogenic activity does not necessarily predispose to epileptic manifestation. The MRI is more important in determining etiology than in prognosing epileptic seizures. This study used a multidisciplinary approach involving child neurologists, a physical therapist and a neuroradiologist. This meets the criteria of multidisciplinarity of the Postgraduate Program in Health Sciences

Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

Avaliação clínica e microbiológica das condições de saúde oral dos receptores de transplante renal do Hospital Universitário Onofre Lopes, Natal RN

Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant

Efetividade da terapia fisica descongestiva na cicatrização de úlceras venosas

A venous ulcer is the most serious clinical manifestation of chronic venous failure, and the most frequent in lower limbs, accounting for 70% of all ulcers. Patients may suffer from this infirmity for several years without healing of the lesion if treatment is inadequate. The aim of this investigation was to verify the effectiveness of decongestive physical therapy in the healing of venous ulcers. This is a quasi-experimental, interventionist study, with paired, non-probabilistic sampling, composed of 50 patients divided into two groups: control and intervention, each composed of 25 patients. Both groups were identically treated for six months with daily dressings and the latter also underwent complex physical therapy consisting of a combination of the following techniques: manual lymphatic drainage, compression bandaging, lower limb elevation, myolymphokinetic exercises and skin care. The study was approved (Protocol no. 59/2007) by the Ethics Committee of the State University of Southeast Bahia. The Mann-Whitney and Chi-square tests were applied for data analysis. After statistical analysis the patients who underwent therapy showed a statistically significant difference with respect to wound contraction starting in the second month of treatment. Compared to the control, the intervention group showed a greater reduction in both pain and edema starting in the third and fourth month of therapy, respectively. To reinforce these findings, the mean percentage of tissue present at the base of the ulcer (granulation/fibrin ratio) was calculated. The intervention group showed greater granulation at the base of the ulcer compared to the control, significant from the second month of treatment on. It was observed in this study that lymphotherapy, when compared between the intervention and control groups, accelerated the healing process, and reduced pain and edema in the affected limbs. It is expected, therefore, that these results widen scientific knowledge and we suggest that this therapy be used 78 not only to reduce lymphedema, but also as a treatment option for venous ulcers, given its easy application and low cost. The data, therefore, demonstrated the importance of basic care on the part of a multiprofessional and transdisciplinary health team involved in the healing process of these infirmities, thereby contributing to better quality of life in these individuals