Controle da neoplasia maligna do colo de útero: a resolutividade na atenção básica

A quantitative, descriptive, cross-sectional and retrospective study, using technical procedures of document consultation from secondary sources and health household survey with application form for face to face inter views, with the assent nº.039/2011 from the Ethics Committee of the Federal University of Rio Grande do Norte. The aim of this study was to analyze the cervix cancer control in the area47 of the Health Family Centre Nova Natal II. The cancer cervix is the second most common cancer among women worldwide. In Brazil screening for early detection and treatment of disease has been poorly done and follow-up to reduce mortality has not been executed. From a total of1170women belonging to area 47, who under went screening by the Pap test in the period from 2005 to 2010,was elected a sample of 38 women with positive cervical changes, over 18 years old. The calculation of frequency analysis of socio demographic and clinical and epidemiological selected variables with the results of cervical changes, using the X2 test and taking as significance level of p<0.05 was not statistically significant. The predominant age range was 25 to 64 years (68.9%), most no white women (60.5%), predominantly with primary education (57.9%), most married (68.4%) and housewives (68.4%) with early age of sexual activity (86.8%), the minority smokers (13.2%), with a sexual partner (36.8%). At the time of interview, 42.1% of the women voiced complaint of discharge, while only 2.6% reported bleeding. In relation to the occurrence of STDs (including HPV), 10.5% of women reported being a carrier. The use of oral contraceptives was 32.3% of women, from 2 to 4 years (44.4%). The result of the last screening test performed, showed prevalence of immature squamous metaplasia (55.3%), followed by intraepithelial low- grade lesion (including the cytopathologic HPV effect and cervical intra epithelial neoplasia grade I) (31.6%); intraepithelial high-grade lesion (including cervical intraepithelial neoplasia grade II and III) (7.9%), atypical squamous non neoplastic cells (5.3%). There was no squamous cell carcinoma and adenocarcinoma. Most women received information about the action that should be done after the last screening test result (55.3%), but how to perform follow, most women did not report having done so (55.3%). The follow-up group of women studied, with varying degrees of cervical abnormalities, should only be completed with the discharge by cure, established inconsecutive negative cytology, a goal that is not being achieved in the area 47 of the Health Family Centre of Nova Natal II

Neoplasia papilar cística do pâncreas

Papyllary cystic tumor of the pancreas, so-called Frantz’s tumor, is rare. Clinical presentation of this disease is usually a slowly growing abdominal mass with or without abdominal pain, affecting predominantly young females. Its pathogenesis is still unknown . Surgical resection is usually curative, and prognosis is excellent. The authors report two pancreatic tumor cases(Frantz’s tumor) in women aged 26 and 31 years old. Pre operative assessment showed a solid-cystic tumor of the tail and body of the pancreas. An extended distal pancreatectomy was performed without splenic preservation

Caminhos que estruturam cidades: redes técnicas de transporte sobre trilhos e a conformação intra-urbana de Natal

The railroad, from 1870 and on, becomes an usual complaining in the press s and politician elite s speeches, especially because of Natal s geographic isolation. The implantation of two railroads in the capital territory Estrada de Ferro de Natal a Nova Cruz, afterwards part of Great Western Railway Company network, and Estrada de Ferro Central do Rio Grande do Norte had serious implications in the urban environment. While railroad s structures were already consolidated, other transportation mechanisms were being implanted in the first decades of the 20th century, such as trams lines, which, by the way, was a transport modal that also used rails as a dislocation meaning. Considering these questions, we may ask: how come railroads and tramways demands, roads and buildings had influenced the internal organization of Natal? We work with the general hypothesis that the influence of technical networks, composed by tramways and railroads, over Natal s urban space happened in a diversified way, sometimes consolidating social aspects in certain areas, sometimes improving the occupation of others. The impact over the city s territory also happens in a diversified way between the buildings/railroad s complexes and the pathways. The different scale of the train in comparison to the trams velocity, size, noise level, flow, among others is also a cause to the different consequences in urban environment. The main objective of this work is to understand the role of circulation technical networks in the construction process of urban space in Natal, as a way to contribute to the urban historiography about the subject. The time frame adopted, between 1881 and 1937, marks the time path of railroads and tramways in Rio Grande do Norte: 1881 is the year of railroad s first section inauguration from Natal to São José do Mipibu as well of the railroad complex in the Republic Square in Natal; the year of 1937 marks the beginning of tramways declination process in the city. At this time railroads and tramways had to face more intensively the competition of motor vehicles. The theory reference adopted is based on concepts and analysis of authors, such as Flávio Villaça and Roberto Lobato Corrêa references to the concepts of urban structure , localization and accessibility and Gabriel Dupuy to explain the concept of urban technical networks . These references reveal the conflict of different realities in the urban universe interests and values which is an important factor about the construction of urban space. The information sources used were from two distinctive natures: primary, journals of the time studied and official government reports, and secondary, based on other works about the subject. It was also used by this study iconographic source, especially images from the data base of the research group História da Cidade, do Território e do Urbanismo .

Indução de morte celular em células de adenocarcinoma cervical humano (HeLa) pela lectina da esponja Cinachyrella apion (CaL)

Cancer is a term used to represent a set of more than 100 diseases, including malignant tumors from different locations. The malignancies are the second leading cause of death in the population, representing approximately 17% of deaths of known cause. Strategies that induce differentiation have had limited success in the treatment of established cancers. In this work, a lectin purified from the marine sponge Cinachyrella apion (CaL) was evaluated due to its hemolytic, cytotoxic and antiproliferative properties, besides the ability to induce cell death via apoptosis in tumor cells. The antiproliferative activity of CaL was tested against cell lines, with the highest inhibition of tumor growth for HeLa, reducing cell growth at a dose dependent manner, with a concentration of 10 μg/mL. The hemolytic activity and toxicity against peripheral blood cells were tested using the concentration of IC50 for both trials and twice the IC50 for analysis in flow cytometry, indicating that CaL is not toxic to these cells. To assess the mechanism of cell death caused by CaL in HeLa cells, we performed flow cytometry and western blotting. The results showed the lectin probably induces cell death by apoptosis activation by pro-apoptotic protein Bax, promoting mitochondrial membrane permeabilization, cell cycle arrest in S phase, with accumulation of cells of approximately 57% in this phase, and acting as both dependent and/or independent of caspases pathway. These results suggest that CaL has the potential to be used as drug treatment against cancer.

Caracterização do perfil imunológico em mulheres portadoras do papilomavírus humano

O câncer de colo uterino consiste em um problema de grande relevância social, visto que se trata da segunda malignidade ginecológica mais freqüente no mundo. O principal precursor do câncer da cérvice uterina consiste na infecção pelo Papiloma vírus humano (HPV). O HPV tem despertado grande interesse na comunidade científica, devido à relação estabelecida entre a sua epidemiologia e o câncer de cérvice uterina. Apesar do grande avanço na biologia do HPV, pouco se sabe acerca da resposta imunológica a este vírus. O Papilomavírus humano (HPV) é um DNA vírus epiteliotrófico, que está vinculado à carcinogênese do colo uterino por meio de evidências epidemiológicas e laboratoriais. As infecções pelo HPV ocorrem em mulheres em todo o mundo. Existe consenso na literatura quanto à associação do DNA HPV com as neoplasias intra epiteliais cervicais e o câncer cervical. Por este motivo é de grande importância a detecção precoce deste tipo de infecção para que seja efetuado um tratamento específico. Esse trabalho está caracterizando o perfil imunológico de pacientes portadoras de HPV através da quantificação linfocitária (TCD4, TCD8, células NKT e células NK), e correlacionou esse material à técnica de captura híbrida, para poder comprovar a infecção pelo HPV, esperando assim contribuir precocemente para o diagnóstico do câncer de colo uterino.

Juventude e vulnerabilidade social :no contexto intra-urbano de Natal, RN

The use of the term social vulnerability in the study of the reproduction of the social inequalities in Brazil, still, is recent. The social vulnerability is linked to the indicators of social risk. The work approaches the youth's social vulnerability and your relationship with the education, considering the youth a, among other groups socially excluded, vulnerable, in the Brazilian metropolises. It is guided by the methodological theoretical formulations on this thematic one developed by the Rede Metrópoles in the ambit of the project, " Observatory of the Metropolises: territory, social cohesion and democratic governability ( Project Millennium CNPq) and your unfoldings in the Natal group. Empirically, forehead a methodological proposal - still in construction - and it accomplishes a " pilot " study for the city of Natal with base in the data of the Census of IBGE 2000, that proposes mensurar the importance of the social characteristics of the neighborhood on the considered youths' educational acting those that are in the strip from 15 to 24 years. It considers that the youths' educational " earnings as being influenced not only for the social context of the family, also, for your space location in the city - social context of the neighborhood. With base in the results can verify that the youths of the city of Natal present situations of social vulnerability so much in the ambit of the family as expresses in the social space of the neighborhood. Such vulnerability are verified in the low educational indexes, in the high unemployment rates and in the presented social conditions of the researched areas. The youths, residents of those neighborhoods, they are considered vulnerable socially because original of a precarious source of " assets " and opportunities. There is in Natal a low " structure of assets and opportunities " - accessible to the youth

Estratégias de intervenção utilizadas por enfermeiros da ESF do município de Natal/RN no controle do câncer do colo de útero

Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN.

Análise de Handover inter e intra-célula em um sistema de telefonia celular através de método de medição simplificado

This dissertation has the purpose to present a portable device named PlugData MG100G, equipped with a cellular module, to analyze the radiofrequency coverage in a GSM network situated in João Pessoa city, state of Paraíba, at four distinct regions. The equipment, originally, was developed to be used in fixed environments, so it was adapted so that it could be used in conditions of mobility. From the Mobile Measurement Reports (MMRs) RF coverage and the handover process are analyzed. The MMRs enable the identification of the serving cell and the list of the closest neighboring cells monitored by the mobile. This work analyses only data referent to the serving cell and the two closest neighboring cells. Inter-cell and intra-cell handovers are identified. The frequency planning and quality of service offered by the network related to the regions are discussed as well

Revisitando o eletrocorticograma intra-operatório na epilepsia mesial do lobo temporal: relevância das oscilações de alta frequência

Epilepsies are neurological disorders characterized by recurrent and spontaneous seizures due to an abnormal electric activity in a brain network. The mesial temporal lobe epilepsy (MTLE) is the most prevalent type of epilepsy in adulthood, and it occurs frequently in association with hippocampal sclerosis. Unfortunately, not all patients benefit from pharmacological treatment (drug-resistant patients), and therefore become candidates for surgery, a procedure of high complexity and cost. Nowadays, the most common surgery is the anterior temporal lobectomy with selective amygdalohippocampectomy, a procedure standardized by anatomical markers. However, part of patients still present seizure after the procedure. Then, to increase the efficiency of this kind of procedure, it is fundamental to know the epileptic human brain in order to create new tools for auxiliary an individualized surgery procedure. The aim of this work was to identify and quantify the occurrence of epilepticform activity -such as interictal spikes (IS) and high frequency oscillations (HFO) - in electrocorticographic (ECoG) signals acutely recorded during the surgery procedure in drug-resistant patients with MTLE. The ECoG recording (32 channels at sample rate of 1 kHz) was performed in the surface of temporal lobe in three moments: without any cortical resection, after anterior temporal lobectomy and after amygdalohippocampectomy (mean duration of each record: 10 min; N = 17 patients; ethic approval #1038/03 in Research Ethic Committee of Federal University of São Paulo). The occurrence of IS and HFO was quantified automatically by MATLAB routines and validated manually. The events rate (number of events/channels) in each recording time was correlated with seizure control outcome. In 8 hours and 40 minutes of record, we identified 36,858 IS and 1.756 HFO. We observed that seizure-free outcome patients had more HFO rate before the resection than non-seizure free, however do not differentiate in relation of frequency, morphology and distribution of IS. The HFO rate in the first record was better than IS rate on prediction of seizure-free patients (IS: AUC = 57%, Sens = 70%, Spec = 71% vs HFO: AUC = 77%, Sens = 100%, Spec = 70%). We observed the same for the difference of the rate of pre and post-resection (IS: AUC = 54%, Sens = 60%, Spec = 71%; vs HFO: AUC = 84%, Sens = 100%, Spec = 80%). In this case, the algorithm identifies all seizure-free patients (N = 7) with two false positives. To conclude, we observed that the IS and HFO can be found in intra-operative ECoG record, despite the anesthesia and the short time of record. The possibility to classify the patients before any cortical resection suggest that ECoG can be important to decide the use of adjuvant pharmacological treatment or to change for tailored resection procedure. The mechanism responsible for this effect is still unknown, thus more studies are necessary to clarify the processes related to it

Estudo comparativo da expressão imuno-histoquímica do ki-67 em carcinoma epidermóide de língua em pacientes jovens e idosos

The squamous cell carcinoma (SCC) is the most common malignant neoplasm of epithelial origin in oral cavity and present high capacity to invade adjacent structures. Traditionally, SCC has a predominance of 50 years male patients with long-time use of tobacco and alcohol, and the tongue is the most affected anatomic site. At present, there is an increasing incidence of SCC in patients below 40 years of age, who has been exposed or not to risk factors, mainly for tongue lesions. This study aims to analyze cell proliferation index using Ki-67 antigen in SCC of the tongue for two groups of different age range: until 40 years and older than 50 years. The first group was composed by 16 patients and the second one was composed by 20 patients. Clinicopathological features of the cases were also assessed. There was a male predominance in both groups. Tobacco and alcohol habits were common for patients until 40 years (72,2%), as well as for patients older than 50 years (52,9%). The first group had statistical association with the presence of regional metastases (p = 0,036) and with the most advanced stages of the disease (p = 0,012). Considering the histological malignancy grading, there was higher incidence (56,2%) of high malignancy grade tumors in the group of patients until 40 years old, but no statistical difference has found between groups and histologic malignancy grading. Regarding the immunohistochemical expression of Ki-67, there was no statistically significant difference between the antibody expression of the groups, as well as between other clinical and histopathological parameters. This study identified no significant difference regarding cell proliferation between the analyzed groups

Avaliação imuno-histoquímica das galectinas -1, -3 e -7 em displasia epitelial ora

Introdução: A displasia epitelial oral (DEO) é uma lesão potencialmente maligna, cujo diagnóstico e gradação se baseia na histologia das alterações arquiteturais e citológicas, preconizados pela OMS, que divide a lesão em leve, moderada e severa, o qual é subjetivo. Maior concordância é observada no uso do sistema binário (baixo/alto risco), o qual está relacionado ao risco de transformação maligna. As galectinas constituem uma família de lectinas e estão envolvidas na tumorigênese, sendo a -1, -3 e -7 as mais investigadas, devido a expressão alterada em cânceres orais. Materiais e métodos: Foi analisada a expressão imuno-histoquímica dessas proteínas em 50 espécimes de DEO (21 baixo/ 29 alto risco) e 5 de mucosa oral normal e relacionamos com a presença/ausência de marcação, padrão de distribuição, intensidade, localização epitelial (estratificação) (1/3 inferior, médio e superior), e localização celular (compartimento) (núcleo, citoplasma e membrana) . Resultados: Dos 29 casos de alto e dos 21 de baixo risco, 21 (72,4%) e 12 (57,1%) foram positivos para a galectina -1, respectivamente. Dessa forma, de 50 casos, 33 foram positivos. O núcleo e citoplasma foram positivos em 91,7% nas de baixo risco e em 90,5% nas de alto. Todos os casos de mucosa normal foram negativos. Com relação a galectina -3, dos 21 casos das DEOs de baixo risco, 12 (57,1%) apresentaram expressão e dos 29 casos das DEOs de alto risco, 15 (51,7%) foram positivos, havendo imunoexpressão em um total de 27 casos. O padrão difuso, assim como a fraca intensidade foram os mais freqüentes para os 2 graus. O núcleo e o citoplasma foram a localização mais comum tanto nas lesões de baixo (58,3%), quanto nas de alto risco (66,7%). Quatro casos de mucosa normal foram positivos, com marcação membranar e intensidade fraca. Dos 21 casos das DEOs de baixo risco, 17 (81%) apresentaram expressão imuno-histoquímica para a galectina -7 e das 29 DEOs de alto risco, 27 (93,1%) foram positivos. Então, a expressão imuno-histoquímica da galectina -7 foi observada em 44 casos, a maioria com intensidade de moderada a forte. O núcleo e o citoplasma foram a localização mais freqüente, nas de baixo (70,6%) e alto risco (66,7%). Quatro espécimes de mucosa normal marcaram membrana em terço médio e superior, com intensidade moderada a forte. Conclusões: Alterações na expressão das galectinas -3 e -7 e principalmente da -1 sugerem seu envolvimento na fisiopatologia das displasias, participando do processo de transformação de fenótipo normal para o displásico.

Expressão imuno-histoquímica das integrinas α2ß1, α3ß1, e α5ß1, em mucosa oral normal, hiperplasia fibroepitelial inflamatória oral e displasia epitelial oral

The objective of this study was perform by the streptoavidin-biotin technique an immunohistochemical analysis of α2β1, α3β1e α5β1 integrins in 11 normal oral mucosa (NOM), 16 oral inflammatory fibroepithelial hyperplasia (OIFH) and 25 oral epithelial dysplasia (OED) (16 mild, 2 moderates and 7 severe), to determine if exists qualitative alteration in the expression of these integrins and if this guard relation with the oral epithelial modifications. It was observed that for the α2β1 integrin the majority of the sample showed a predominantly intense labeling diffusely distributed in the intercellular contacts and the cytoplasm of cells of the basal and suprabasal layers, without difference of this profile between the different types of specimens, however with a trend to weak or loss of expression in 21.1% of the OEDs, being all the specimens that had not expressed this heterodimer, severe OEDs. For the α3β1 integrin the majority of the sample showed a weak or absent labeling in basal layer. The α5β1 integrin showed a predominant strong diffuse labeling in the intercellular contacts and cytoplasm in the suprabasal layer, with difference only in the labeling intensity between the types of specimens, inhabiting this difference in the OEDs, where 12 (48%) specimens had shown a weak labeling. It was concluded that the evaluated integrins can be involved in the cell-cell, cell-ECM interactions modulating the cellular differentiation and maintenance of the epithelial structural arrangement. The variable expression of the α5β1 integrin in the OEDs, could suggest, respectively, a role of this molecule in the cellular survival, with intention to perpetuate the modified phenotype in these lesions, or a suppressor role on the modified phenotype due to lack of interaction of this molecule with the fibronectina of the MEC

Percepção de estigma e qualidade de vida em crianças com neoplasia

The increase in survival time and cure requires more extensive care about the quality of life of cancer patients, which begins soon after diagnosis. Thus, it seems reasonable to the emphasis on development of studies covering the psychosocial variables, such as stigma, treatment of childhood cancer aiming thereby to the attention of the overall needs of the child. Thus, this research aims to investigate the perception of stigma and quality of life in children with cancer. This is a cross-sectional research and understanding of the descriptive type, the type specimen being adopted for convenience. This consisted of thirty children with cancer and thirty children without chronic disease. The instruments used were the Quality of Life Questionnaire, the Perceived Stigma Scale and Technical Drawing Story with a Theme. The results indicate that the chronic condition, no interfered significantly in satisfaction with the quality of life in children with cancer and identified that the quality of life is not related to the stigma. Comparison with children with no chronic disease with infants with cancer, no significant differences were observed. However, the group mean contrast was lower, suggesting a greater impairment in quality of life of children with cancer compared to those without chronic disease. It is worth noting that the psychosocial effects and the limitations imposed by disease and treatment are presented as important factors in the design mode of subjective manifestations of children with cancer. Therefore, it is expected that knowledge elucidated by this study will assist, greatly to the promotion of improved emotional, biological and social development itself and the involvement of children with cancer treatment

Coeficientes de incidência do dengue e sua relação com os diferenciais intra-urbanos segundo condições de vida no município do Natal, Rio Grande do Norte

This study sprang from the hypothesis that spatial variations in the morbidity rate for dengue fever within the municipality of Natal are related to intra-city socioeconomic and environmental variations. The objective of the project was to classify the different suburbs of Natal according to their living conditions and establish if there was any correlation between this classification and the incidence rate for dengue fever, with the aim of enabling public health planners to better control this disease. Data on population density, access to safe drinking water, rubbish collection, sewage disposal facilities, income level, education and the incidence of dengue fever during the years 2001 and 2003 was drawn from the Brazilian Demographic Census 2000 and from the Reportable Disease Notification System -SINAN. The study is presented here in the form of two papers, corresponding to the types of analysis performed: a classification of the urban districts into quartiles according to the living conditions which exist there, in the first article; and the incidence of dengue fever in each of these quartiles, in the second. By applying factorial analysis to the chosen socioeconomic and environmental indicators for the year 2000, a compound index of living condition (ICV) was obtained. On the basis of this index, it was possible to classify the urban districts into quartiles. On undertaking this grouping (paper 1), a heterogeneous distribution of living conditions was found across the city. As to the incidence rate for dengue fever (paper 2), it was discovered that the quartile identified as having the best living conditions presented incidence rates of 15.62 and 15.24 per 1000 inhabitants respectively in the years 2001 and 2003; whereas the quartile representing worst living conditions showed incidence rates of 25.10 and 10.32 for the comparable periods. The results suggest that dengue fever occurs in all social classes, and that its incidence is not related in any evident way to the chosen formula for living conditions

Vende-se uma vila: análise intra-urbana das vilas na Vila de Ponta Negra e no bairro de Nova Descoberta - Zona Sul de Natal

This dissertation is about low-income rental housing vilas in the South Zone in the city of Natal. Vilas are a string of houses, built privately in an urban plot of land, usually a backyard, facing a narrow street beco. This type of housing is originated in the 19th century in the Brazilian scenario. In Natal, this has become more popular since the late 1960s. This study is aimed at analyzing the urban integration of the vilas, considering that these house a low income population, vis à vis the speedy development of Natal s most economically dynamic area. The study starts with a discussion of the production of space, taking into consideration categories such as use value, exchange value, commodity and land rent. Field work was undertaken through structured interviews with dwellers of vilas in Nova Descoberta and Ponta Negra neighbourhoods. Owners of vilas were also interviewed. Data collected indicated worrisome housing conditions. Vilas, in the areas researched, are increasingly becoming unwelcome, constituting guetos in a place where landscape is changing rapidly. Gentrification is fast under way, first because of rise in rent and taxes; second because of general rise in living costs