Fatores de risco individuais e familiares no desenvolvimento da pré-eclâmpia

Preeclampsia is a spectral disease, with different clinical forms which can evolve with severe multisystemic complications. This present study aimed to determine the risk factors associated with preeclampsia (PE); to validate the existence of aggregation of hypertensive disease in families of women with preeclampsia and verify the existence of association between polymorphisms in the VEGF gene and level of VEGF and its soluble receptor (sFlt1). A case-control study was performed (n = 851). Genotyping of VEGF was performed and serum levels of VEGF and sFlt1 were measured by ELISA. It was observed that 38% of mothers (173, 455) of a case of preeclampsia and 30.8% (78 of 361) of controls had history of hypertension (p <0.0001). Similarly, when examining the history of maternal preeclampsia, we observed that 14.6% (48 of 328) of mothers of women with preeclampsia and 9.6% (12 of 294) of mothers of controls had a history of preeclampsia (p = 0.0001). As for maternal history of preeclampsia, we found that 5.1% (15 of 295) of cases and 3.6% (7 of 314) of controls had a history of preeclampsia (p = 0.0568). Sisters of women with preeclampsia also had a history of hypertensive disease in 9% (41 of 455) versus 6.6% (13 of 361), p = 0.002. Similarly when examining the history of preeclampsia in sisters, it was observed that 22.7% (57 of 251) of a sister of case versus 11.4% (26 of 228) of controls had a history of preeclampsia (P = 0.0011). We observed a decrease in free VEGF in the serum of patients (P <0.05) and increased soluble VEGF receptor. There was no association between polymorphisms in the VEGF gene and preeclampsia. The data obtained in this work validate that hypertensive disease in mothers and sisters with preeclampsia are risk factors for preeclampsia. The risk of illness in the family is higher according to disease severity. High incidence of preeclampsia can be assumed by the high incidence of this disease among the controls. Significant differences between the frequency of preeclampsia in mothers of cases and controls indicate familial factors. Work is being conducted with the to eventually perform genome wide association studies to identify susceptibility loci

O outro diálogo: uma compreensão do diálogo interno

This thesis aims to enable a wider comprehension on thought operation as well as suggest alternatives for the formation of reflexive, critical, autonomous and creative individuals. The research defends the idea that it is possible for an individual to develop vigilant attention that makes thought flexibilization and change in the course of action, possible. This operation is called Internal Dialogue and is essentially characterized by a continuous openness towards novelty and learning. This makes it possible to minimize the usual way thought operates, in a automatic fashion (automatism). The research was based on theoretical references and ideas of David Bohm (1989;1994;2005) and Michael Polanyi (1983). The main emphasis was the understanding that a crisis situation enables awareness and state of alert that favors a more flexible thought pattern (Aragão Gomes, 1994, 1997). The methodology used was presentation and analysis of these moments through autobibliographical records with indication of crisis on behalf of the subjects. Other criteria were also used that enabled the composition of the analyzed material such as the fact that: the subjects were public and real, the data was available through accessible material; the subjects identified themselves as in crisis; these crisis were of varied kinds; they had different social, cultural and professional profiles. Thus, three auto-bibliographical elements were selected: the Infidel: the story of a woman that challenged Islam (2007), written by the political Muslim author Ayaan Hirsi; Still me: memories (2001), of the actor Christopher Reeve as well as Confessions of a Philosopher (2001), by the philosopher Bryan Magee. In these books an analysis was made related to parts that stated action an though operation that express internal dialogue. These were organized into categories that were pointed out as relevant for the identification of internal dialogue such as: Perceptions of physical reaction; emotions, beliefs and issues, individual actions, self judgment and thought, self questioning, comprehension, observation and empirical investigation, perception of the changes they performed in the world, escape of conditioning as well as action that resulted in new meaning. The analysis performed reinforces our goal once it sated that internal dialogue is an important tool that allows thought awareness, minimizing common automatism and making consciousness possible as well as favoring the occurrence of critical and reflexive thought. Thus, final considerations deal with the need for the development of teaching methodologies that address internal dialogue as a counterpoint to the many daily action that reinforce the automatism of thought

Outro diálogo: uma compreensão do diálogo interno

This thesis aims to enable a wider comprehension on thought operation as well as suggest alternatives for the formation of reflexive, critical, autonomous and creative individuals. The research defends the idea that it is possible for an individual to develop vigilant attention that makes thought flexibilization and change in the course of action, possible. This operation is called Internal Dialogue and is essentially characterized by a continuous openness towards novelty and learning. This makes it possible to minimize the usual way thought operates, in a automatic fashion (automatism). The research was based on theoretical references and ideas of David Bohm (1989;1994;2005) and Michael Polanyi (1983). The main emphasis was the understanding that a crisis situation enables awareness and state of alert that favors a more flexible thought pattern (Aragão Gomes, 1994, 1997). The methodology used was presentation and analysis of these moments through autobibliographical records with indication of crisis on behalf of the subjects. Other criteria were also used that enabled the composition of the analyzed material such as the fact that: the subjects were public and real, the data was available through accessible material; the subjects identified themselves as in crisis; these crisis were of varied kinds; they had different social, cultural and professional profiles. Thus, three auto-bibliographical elements were selected: the Infidel: the story of a woman that challenged Islam (2007), written by the political Muslim author Ayaan Hirsi; Still me: memories (2001), of the actor Christopher Reeve as well as Confessions of a Philosopher (2001), by the philosopher Bryan Magee. In these books an analysis was made related to parts that stated action an though operation that express internal dialogue. These were organized into categories that were pointed out as relevant for the identification of internal dialogue such as: Perceptions of physical reaction; emotions, beliefs and issues, individual actions, self judgment and thought, self questioning, comprehension, observation and empirical investigation, perception of the changes they performed in the world, escape of conditioning as well as action that resulted in new meaning. The analysis performed reinforces our goal once it sated that internal dialogue is an important tool that allows thought awareness, minimizing common automatism and making consciousness possible as well as favoring the occurrence of critical and reflexive thought. Thus, final considerations deal with the need for the development of teaching methodologies that address internal dialogue as a counterpoint to the many daily action that reinforce the automatism of thought

Vivendo e aprendendo no ambiente hospitalar: Percepções de crianças sobre a doença

This study focuses on the child within the hospital environment. Its purpose is to describe children s perceptions of their illness and time in hospital and to identify their main hardships during treatment. This study has a qualitative nature and is theoretically and methodologically supported by the creative and sensitive method developed by Cabral (1998), studies by Piaget, Vygotsky and Wallon on child development, and studies conducted by Pinto (2005), Collet (2004), Chiattone (2003), Silva (2002), Lima et.al (1999) on in-patient children. For this study, 13 children between the ages of 7 and 12 at a public hospital institution specialized in child care in the city of Natal, Rio Grande do Norte, were interviewed. As a criterion for taking part in this study the children would have to have been in hospital for over three days and be fully capable of physically and emotionally interacting with the researcher at the time the interview took place. Analysis drew on the study of the empirical material made up of interviews and a field diary where notes had been entered for the children s reactions, expressions and gestures. Results show that there is some understanding, on the part of these children, of their illness, with their parents as the main informants. They accept being in hospital because they need treatment, but they realize that life becomes different especially on account of the constraints resulting from the illness and the hospital itself. The main hardships during treatment are: lack of recreational activities in the evenings and on the weekends within the hospital environment; absence of family members, especially brothers and sisters; and lack of explanation on the part of health professionals regarding some procedures as these are being carried out. Our conclusion is that children perceive illness and the hospital environment as something that changes the rhythm of their lives bringing on them perturbations, fears and anxieties. Hence, we suggest that professionals working with in-patient children should be especially prepared to deal with these children and their parents, aiming at bringing down fears and anguishes, clear their doubts and, in addition, advise the parents in respect of their children s treatment while in hospital and after hospital discharge. The hospital environment should also be cheerful and colorful and have a toy room under the coordination of persons especially prepared for that purpose