Tuberculose ocular

Relato de quatro casos de tuberculose ocular presumida, com comprometimento do segmento posterior em três destes casos. Nos dois primeiros casos, relata-se comprometimento do segmento anterior do olho e antecedente de tuberculose, em um caso sistêmica e no outro ocular. No terceiro caso, paciente apresenta lesão coriorretiniana no olho esquerdo. No quarto caso, descrita lesão serpiginosa-like. Os pacientes evoluíram favoravelmente com o tratamento específico. As lesões oculares da tuberculose são diversas e devemos continuar atentos a esta enfermidade.

Retinal nerve fiber layer analysis using GDx® in 49 patients with chronic phase DUSN

To describe retinal nerve fiber layer changes in late-stage diffuse unilateral subacute neuroretinitis eyes and compare these results with healthy eyes observed through nerve fiber analyzer (GDx®). Methods: This is a retrospective case-control study in which 49 eyes in late-stage diffuse unilateral subacute neuroretinitis were examined from May/97 to December/ 01. First, eyes with diffuse unilateral subacute neuroretinitis and healthy contralateral eyes (Control Group I) were statistically matched. Subsequently, eyes with diffuse unilateral subacute neuroretinitis were compared with eyes of healthy patients (Control Group II). Results: Eyes from Control Groups I and II had higher relative frequency of “within normal limits” status. Eyes from the diffuse unilateral subacute neuroretinitis (DUSN) Group had higher frequency of “outside normal limits” and “borderline” status. Control Groups I and II had absolute values different from the DUSN Group regarding all parameters (p<0.05), except for Symmetry in Control Groups I and II, Average thickness and Superior Integral in control group II. Conclusion: Patients with late-stage diffuse unilateral subacute neuroretinitis presented presumed decrease in nerve fiber layer thickness shown by GDx®. Retinal zones with larger vascular support and larger amount of nerve fibers presented higher decrease in the delay of the reflected light measured by the nerve fiber analyzer

Abordagem dos aspectos psicológicos da mulher infértil :um estudo quali-quantitativo

Purpose: assess the frequency of stress and anxiety levels in infertile women, correlate these aspects with risk factors and qualitatively analyze feelings resultant from the inability to conceive, in order to obtain data for specific psychological guidance. Methods: the case-control study included a total of 302 women, 152 being infertile (case group: 30.3 ± 5.4 years), and 150 non-fertile (control group: 25.7 ± 7.9 years). The quantitative approach involved the application of Lipp s Stress Symptoms Inventory (LSSI) and State-Trait Anxiety Inventory (STAI), whereas the qualitative approach consisted of a semi-structured interview. Response variables considered were: stress frequency and anxiety scores (State and Trait). Statistical analysis compared frequencies and medians between groups, by means of qui-squared and Mann-Whitney tests, respectively, and constructed logistical regression models to test associations between response variables and risk factors considered. Qualitative data were analyzed descriptively and categorized in order to perform correspondence analysis. The level of significance was 5%. Results: in the study sample, stress frequency was higher in the case group than in the control(61.8 and 36.0%, respectively), however, significant differences were not observed between groups in relation to stress phases and predominant symptomology type. With respect to anxiety, there were no significant differences between case and control groups as to median state scores [39.5 (35.0 46.0) and 41.0 (35.7 47.0 ); respectively) and anxiety trait scores [44.0 (34.0 51.0) and 42.0 (36.0 49.2); respectively). Risk factors significantly associated with greater risk for high anxiety scores in the case group were: primary infertility, unawareness of the causal factor, diagnostic phase investigation, religion, lack of children from other marriages and the fact that the woman was previously married. The qualitative approach demonstrated that infertility provokes emotional responses, such as sadness, anxiety, anger, fear and guilt. Conclusions: it can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting to stressful events without serious physical or psychological compromising

Proteção constitucional do trabalhador portador de incapacidade laboral

Social security has constitutional protection and encompasses health policies, social security and welfare, which are explicitly recognized as a fundamental social right. When workers suffering from work disability are unable to earn income with your work force to support themselves and their families. The State, through the public welfare, contributory and compulsory, has a duty to protect workers in times of misfortune, replacing these income through the provision of social security benefits. Disability the employee has a higher degree of vulnerability, and the granting of disability claims a right sensitive, which can‟t suffer postponements, lest cause legal uncertainty and violating the dignity of the human person. There isn‟t legal definition of disability. The main purpose of the study is the constitutional protection of the worker carrying work disability, seeking to highlight the factors affecting work disability and proposing the use of objective criteria for the grant of social security benefits, because the criteria used are purely medical, based the subjectivity and agency of medical assessor, which hinders the judicial and administrative control of the State. At the time of preparing the expert report, the expert should not consider only tangible aspects, but also social and environmental issues, which contribute to the inability to work and therefore should be considered in granting social security benefits. The granting of social security benefits for incapacity for work is intended to prevent or lessen the impact of individual and social risks in relation to the worker incapacitated, ensuring that the constitutional protection to be effective. The presumed inability, the institute reversing the burden of proof and free conviction motivated are important tools for resolving conflicts between the insured and welfare, finding basis in the insured`s vulnerability, sensitivity and little reliance right at issue in relation to the employee social pension

Responsabilidade civil como função social na distribuição e revenda de combustível face ao direito do consumidor e ao meio ambiente

The civil liability of the distribution and retail fuel stems from the fact business activity developed to be high risk and can be said as risk inherent or latent danger that has predictability and normality characterized by placing the consumer in a position of vulnerability, such as the environment, both public policies defined and constitutional protection. Consumer protection as a fundamental right and the environment as the primacy of social order aims the welfare and social justice, as inserted right to the third dimension, are guarded by the State when it creates operational standards through public policies and indirectly intervenes in the economic order. This intervention is due to consumer protection and the environment are economic order principles, founded on free initiative and free competition, ensuring everyone a dignified existence which underlies the irradiation of fundamental rights in private initiative, before the commercial evaluation, mass consumption, the emergence of new technologies that link consumers to the environment before the protection of life, health and safety and ensuring a better quality of life for present and future generations. To repair this damage and the right to information are provided as fundamental rights that put the person at the epicenter of the relations and collective interest stands out against individual interests that to be done need public-private partnership. In such a way that the used methodology was an analysis of documents correlating them with bibliographic sources whose goals are to recognize the civil responsibility as limit to subjective right, having to develop a social function where guilt and risk grow distant and the damage is configured as a consequence of inherent risk, requiring the State interventional postures in fulfilling its public policy; prevailing in these risky activities the solidarity of those involved in the chain of production and socialization of damage forward those are provided directly of products of hazardous nature that put in a position of vulnerability the environment and the consumer

Sentimentos de profissionais de enfermagem diante da morte de recém-nascidos em uma unidade de terapia intensiva

To understand the feelings of nursing professionals when faced with the death of newborn babies in an intensive care unit is the purpose of this investigation. Motivation was triggered by the countless hardships we go through everyday, as professionals, and the scarcity of publications in this specific area of knowledge. The aim is to describe the experience of the nursing professionals and identify their feelings when faced with the death of newborn babies in an intensive care unit. As a methodological procedure, this research is based on a qualitative, phenomenology-focused approach and on the following leading question addressed to the interviewed nurses and nursing technicians who work at the unit: How do you feel when you are faced with the death of a newborn baby in the ICU at which you work? Answers to this question on such phenomenon revealed a diversity of feelings, such as, loss, guilt, failure, negation, compassion, and sorrow, coupled with anguish, fear, and anxiety, resulting in an experience of the sensitive world of everyone. Theoretical support to this analysis was based on works by authors who discuss phenomenology, as well as authors who study the theme of death. An understanding of the phenomenon thus studied enables us to affirm that the death of a newborn baby is, for the nursing professional who takes care of the baby in the space of the ICU, an experience of conflicting, sometimes painful feelings, on account of their complexity. This is true not only in respect of their feelings for the baby, but for the family as well, especially the parents

Simulação do sistema de esgotamento sanitário de Ponta Negra- Natal: mitigação dos riscos ambientais e estratégia de manutenção preditiva

The simulation of SES-Natal Ponta Negra: mitigation of environmental risks and predictive maintenance strategy was developed in the context of several operational irregularities in the pumping stations and sewage systems in the system Ponta Negra. Thus, the environmental risks and complaints against the company due to overflows of sewage into the public thoroughfare became common. This neighborhood has shown in recent years an increase of resident higher than the initial expectation of growth. In this sense presumed the large population growth and generation of sewers higher than expected, associated to the use of corrective maintenance and misuse of the system may be the main causes of operational failures occurring in the SES. This study aimed at analyzing the hydraulic behavior of SES Ponta Negrathrough numerical simulation of its operation associated to future scenarios of occupation. The SES Ponta Negra has a long lengthof collection networks and 6 pumping stations interconnected, being EE 1, 2, 4 coastal way, and beach Shopping interconnected EE3 to receives all sewers pumped from the rest pumping station and pumped to the sewage treatment station of neighborhood which consists of a facultative pond followed by three maturation ponds with disposal of treated effluent into infiltration ditches. Oncethey are connected with each other, the study was conducted considering the days and times of higher inflow for all lifts. Furthermore, with the aim of measuring the gatherer network failures were conducted data survey of on the networks. Thephysical and operational survey data was conducted between January/2011 and janeiro/2012. The simulation of the SES was developed with the aim ofdemonstrating its functioning, eithercurrently and in the coming years, based in population estimates and sewage flow. The collected data represents the current framework of the pumping stations of the SES Ponta Negra and served as input to the model developed in MS Excel ® spreadsheet which allowed simulating the behavior of SES in future scenarios. The results of this study show thatBeach Shopping Pumping Station is actually undersized and presents serious functioning problemsthatmay compromise the environmental quality of surrounding area. The other pumping stations of the system will reach itsmaximum capacity between 2013 and 2015, although the EE1 and EE3 demonstrateoperation capacity, even precariously, until 2017. Moreover, it was observed that the misuse of the network system, due to the input of both garbage and stormwater, are major factors of failures that occur in the SES. Finally, it was found that the corrective maintenance appliance, rather than predictive,has proven to beinefficient because of the serious failuresin the system, causing damage to the environment and health risks to users

Helena de Machado de Assis; Imagens literárias e a retórica da morte da nação inconclusa

Helena is the romance of perishable and discontinuous title character denominator of a dialectic that does not consume and build the narrative by sequential fragmentation combined with episodic frame. The novel is a lightning stroke to the romantic literary project. Therefore, this study aims to find "objective" elements of the novel that would constitute a conception of literary nation proposed by Machado de Assis, as in classical writing, where women are engaged as a metaphor for the nation by a non-cultural heroism, as the example of the Greek myth of Helena, where the feminine represents a mythical image of the nation. The paper's theoretical conception of the history of Walter Benjamin, that is, that is constructed as an allegorical appeal, the conclusions about the disciplinary society of nineteenth century of Michel Foucault, the construction of the nation as a subtle game to remember and forget of Wander Miranda and the rhetoric of death and loss reflected in the speeches of the cultural heritage of José Reginaldo Santos Gonçalves, which allow you to analyze the work permeated by subjectivity and existential conflicts by Machado, who has it arranged in dialectic with the avant-garde literary romanticism and realism. In this relationship with the Greek myth of Helen, explained that characters with the nickname of Helena in Machado's work are not uncommon. As in classical Helena, Machado s Helena uses three rhetorical are the cause of the seizure of the nation. In this game of remembering and forgetting, in the daily plebiscite, Machado draw ideal images that forged our mythical past and commitment to the future. The suffering love of Helena is suffering from failure of the nation which would have led the author to the use of allegorical language, seeking a balance in the chaos generated by the opposition between cruelty and pity widespread view in an area where only left the character's confession guilt for the death. It is a simulacrum of unfinished nation, the space for the game of remembering and forgetting, while the rhetoric of negotiation of our Brazilianness

Entre o sagrado e o profano: os efeitos de sentido revelados nos testemunhos de um blog evangélico

The testimonial is a way of statement that demonstrates or admit the existence of a reality with which the enunciator has contacted. This is, thus, pushed to say what he saw, heard or touched. In this paper, we verified the effects of senses produced in the blog of Bishop Macedo, founder of the Universal Church of the Kingdom of God (UCKG), from a corpus which consists of nine testimonies of presumed believersselected among 64 statements distributed during the year, 2012. Instead of instantaneous testimonials, on a live presentation, these media narratives are underpinned by attributes such as hyperlinks, visuals, language translators, besides mechanisms of interaction and sharing in other spheres from mediatic slant. The problem of this analysis was born from the observation of regular points in the discursive architecture of these testimonials, when was identified the existing relation force between the sacred and the profane, everyday practices. During six months, analysis of the empirical material, we found some effects of the senses on the testimonials, as the dialectic structure and the need for denuding a precarious past, an engagement to shield the figure of Macedo and the UCKG towards society; a update of a crusade against other religions; and the presence of certain sensuality in self-deprecation of the deponents, and an unequal relation of forces (sacred and profane) in the construction of truth. In order of succeeding in this investigation, we used the theoretical and methodological assumptions of Analysis of French Discourse (AD), denouncing the qualitative nature of the research. As a methodological principle, we still use transdisciplinarity, which validated some of our dialogues, especially with philosophy. The conception of discourse modeled by a media support and transpassed by the subject(s) and story (ies) characterized the perspective of the research

A auto-estima da criança que sofre violência física pela família

This research investigates the self-esteem of children who suffered physical violence by family members. Seven children took part in the research: three boys and four girls, aged between six and twelve years old. The analysis were done from the constructed data obtained from: semi-structured interview, activities about human feelings, activities that included facial expressions, unfinished phrases, Pinocchio s story, a drawing of a family and a drawing of their own family. Data were analyzed from the Content Analysis. The Thematic Units were: violence, intrafamily violence, and self-esteem. The synthesis of the categories studied evidenced that the physical violence and the psychological violence present in the lives of children affect the positive development of their self-concept and, consequently, of their self-esteem. Among the results, we emphasize some negative feelings that are present in children s lives such as fear, a sense of guilt, and sadness, arising out of the situations of violence they have experienced

Os significados de ludoterapia para as protagonistas do processo: crianças em atendimento

The ludic therapy in a Phenomenological-Existential perspective is conceived as a psychotherapeutic process in which, the listening and talking, mediated by playing activities, allow the child to deal with their grief/suffering. This study is based on the need to broaden the understanding of this modality of clinical intervention by emphasizing the speech of the protagonists in the process: children in therapy. The objective was to understand the ludic therapy from the children s perspective, knowing the meanings assigned to the therapeutic process, to the psychologist and to the involvement of the children in clinical consultations. The main ideas that underlie this research are presented in three theoretical chapters covering, respectively, the suffering of children and the demand for psychotherapy, the Phenomenological-Existential clinical psychology, and the psychotherapy for children, in Brazil, under this theoretical-methodological approach. The study was qualitative, on a phenomenological basis, and included six children as participants, aged between six and ten years, undergoing ludic therapy for at least six months, and referred by their own therapists. In the research s corpus construction, individual meetings were held and mediated by tools to support expressiveness (ludic and pictures/figures boxes), added by the storytelling of an incomplete story about a child s visit to the therapy session, and the request for the elaboration of a message to be passed to a child who will go to see a psychologist. The analysis of the data was based on a variant of the phenomenological method proposed by Amedeo Giorgi. The results reveal a lack of knowledge by the children about the psychologist s activities. Thus, the children develop fantasies about this intervention modality because of lack of information. These observations are consistent with the historical meanings assigned to clinical psychology, involving ideas of normality and guilt. The meanings associated with the motives for a referral to a psychologist highlight the conflict "be a problem versus having a problem" and an elitist conception of clinical psychology. Children understand the characteristics of the therapeutic process, such as the specifics of the therapist-client relationship and the notion of freedom. They also demonstrate remarkable pleasure in the therapeutic process. Finally, it was concluded that the meanings attributed to the ludic therapy by the children are consistent with that proposed in the literature about the children s psychotherapy process in the Phenomenological-Existential perspective. Moreover, the relevance of both the children s experience in the therapeutic setting and the meanings of these proceedings understood by the children are highlighted by the listening to the protagonists in the ludic therapeutic process. The comprehension of these aspects and their transference from the clients experience to the reflective field, promote advances in the understanding of child psychotherapy and indicate the need for further studies with children using this approach.

A experiência de depressão na contemporaneidade: uma compreensão fenomenológico-existencial

The depression is one of the most common forms of getting ill nowaday. Due to the increase in incidence of depression cases registered worldwide, this theme has been the subject of important studies, especially regarding the symptomatological description and biological etiology of the disease. This research had the objective to understand the unique experience of depression experienced by people who recognize themselves in depression, under the focus of existential phenomenology of Martin Heidegger. To reach the proposed objective, individuals narratives interviews were conducted with four participants, starting from the triggering question, "from your experience, how is for you to being depressed?". The survey revealed that depression affects the whole person and is related to stressful life contexts. Depression was narrated as an experience of disempowerment and lack of self esteem and personal worth. The collaborators of the research referred to the depression from sad, angry, bored and pessimistic mood. The time is experienced as a restriction to the projective opening towards the possibilities of being in which the future is seen as catastrophic and the past lived as debt and guilt. The corporeality, in depression is experienced through the weight, fatigue and pains for no reason. The space is lived from the notion of fall and collapse. We also realized the desire for isolation and avoidance of social contact. Suicide is desired and represents the end of the suffering in life. The depression has proved, still, very stigmatized, because it is discredited and misunderstood. The stigma also addressed to the experience of hospitalization and the unsuitability to the socially imposed standards of beauty, which generates enough suffering to the depressed person. The medication was described based on its positive effects, as a balance and suffering reducer, but also as a producer of dependence. Were also identified according to the collaborators, traces of selfdemand, ordenality and being-for-others, characteristic of typus melancholicus. This study contributes to an understanding of the depression that goes beyond the merely biological perspective and symptomatology of the pathology. The investigation of the depressive experience, through the lens of Heidegger's phenomenology, showed us the phenomenon of the depression in their singularity, complexity and multiple meanings, showing the close relationship between the formation of the depression and the context of personal and social life of the participants

Percepção de cuidadores de crianças acerca da prevenção de acidentes domésticos infantis: análise à luz do modelo de crenças em saúde

This study aimed to analyze the perception of home caregivers of children from zero to five years-old on child domestic accidents and their influence in preventing these events. Exploratory and descriptive study with a qualitative approach, conducted with 20 caregivers attended at the Family Health Unit of Cidade Nova in Natal/Rio Grande do Norte, Brazil. The participants should have age less than 18 years-old, being a caregiver of at least a five year-old child and living in the area ascribed of Family Health Unit in the neighborhood Cidade Nova. Data collection occurred between March and April 2013 and a semistructured interview script was used. This stage was preceded by the acquiescence of the director of health institution where the research was developed, the Health Department of the Municipality of Natal as well as the Ethics Committee in Research of Universidade Federal do Rio Grande do Norte under Opinion nº 219 872 and CAAE nº 12236013.7.0000.5537. It is noted that respondents were asked to formal authorization by the Term of Consent. The data were treated according to the technique of the Collective Subject Discourse and analyzed based on three dimensions of the Health Belief Model, relating to perceptions of susceptibility to infant domestic accidents, self-efficacy to prevent infant and indicia domestic accidents for action of preventing domestic accidents in childhood. The results revealed that all the respondents were women, who, in their majority, they are mothers of the children they care, and predominantly they are aged between 18 and 30 years-old, full high school education and unemployed. Concerning the perception of susceptibility, it was unveiled understanding of deponents on various types of accidents, which are considered preventable. For this purpose, it was highlighted that the constant surveillance of the children is essential, keeping in view their high degree of curiosity and immaturity. On the perceived selfefficacy, the participants reported adopting preventive measures; however, they reported experiencing falls, burns, electric shocks and dog bites. In regard to the meaning attributed to experienced accidents they highlighted their feelings of guilt and despair, particularly about the cases understood as serious. Regarding the last dimension analyzed, related to indications for action, family, friends and television were the main source of information about household accidents and their prevention methods; however, health professionals were rarely cited as issuers of such knowledge. It is concluded that there is a widespread perception of women about prevention of domestic accidents and the weakness in the view of health professionals, including nurses, as disseminators of this information. This suggests the need to strengthen the dialogue on the issue and encouraging the participation of caregivers actively in the prevention of child domestic accidents

Tuberculose ocular

Relato de quatro casos de tuberculose ocular presumida, com comprometimento do segmento posterior em três destes casos. Nos dois primeiros casos, relata-se comprometimento do segmento anterior do olho e antecedente de tuberculose, em um caso sistêmica e no outro ocular. No terceiro caso, paciente apresenta lesão coriorretiniana no olho esquerdo. No quarto caso, descrita lesão serpiginosa-like. Os pacientes evoluíram favoravelmente com o tratamento específico. As lesões oculares da tuberculose são diversas e devemos continuar atentos a esta enfermidade.

Retinal nerve fiber layer analysis using GDx® in 49 patients with chronic phase DUSN

To describe retinal nerve fiber layer changes in late-stage diffuse unilateral subacute neuroretinitis eyes and compare these results with healthy eyes observed through nerve fiber analyzer (GDx®). Methods: This is a retrospective case-control study in which 49 eyes in late-stage diffuse unilateral subacute neuroretinitis were examined from May/97 to December/ 01. First, eyes with diffuse unilateral subacute neuroretinitis and healthy contralateral eyes (Control Group I) were statistically matched. Subsequently, eyes with diffuse unilateral subacute neuroretinitis were compared with eyes of healthy patients (Control Group II). Results: Eyes from Control Groups I and II had higher relative frequency of “within normal limits” status. Eyes from the diffuse unilateral subacute neuroretinitis (DUSN) Group had higher frequency of “outside normal limits” and “borderline” status. Control Groups I and II had absolute values different from the DUSN Group regarding all parameters (p<0.05), except for Symmetry in Control Groups I and II, Average thickness and Superior Integral in control group II. Conclusion: Patients with late-stage diffuse unilateral subacute neuroretinitis presented presumed decrease in nerve fiber layer thickness shown by GDx®. Retinal zones with larger vascular support and larger amount of nerve fibers presented higher decrease in the delay of the reflected light measured by the nerve fiber analyzer