Resposta imune à saliva de flebotomíneos (diptera: psychodidae) em indivíduos residentes em áreas urbana e periurbana no nordeste do brasil

Visceral leishmaniasis (VL) has a wide geographical distribution in tropical and subtropical areas of the planet, which is a protozoan parasite of the genus Leishmania. This pathogen is transmitted to the host through the sandflies bite, with its saliva, the immune response that leads to both. In the state of Rio Grande do Norte, 85% of the sand flies captured is Lutzomyia longipalpis, but the second most abundant, Lutzomyia evandroi, it deserves emphasis because its wide distribution and eclectic behavior. The exposure of people living in endemic areas for the insect vector VL greatly increases the chances of infection. This study aimed to evaluate aspects of the epidemiological profile of VL in endemic areas of human and nonendemic in the metropolitan area of Natal, as well as verify the abundance and seasonal fluctuations of sandflies species in two counties endemic for VL. Were collected in the municipalities of Nísia Floresta, Parnamirim, São Gonçalo do Amarante and Macaíba, of which groups of females were separated for further dissection of the salivary glands and identification of species. The blood samples used were from individuals of two Natal s districts where it has never been reported cases of VL and neighborhoods of Parnamirim applicants who present cases of VL. In the municipality of Nísia Floresta, the most abundant species was L. evandroi with 38.39%, followed by L. longipalpis with 36.22%, L. walkeri 19.67% L. lenti 3.81%, L. wellcomei 1.39% and L. whitmani 0.52%. Already in Parnamirim the proportions were L. walkeri with 73.15%, L. evandroi with 10.55%, L. wellcomei 7.63%, L. longipalpis 6.37%, L. whitmani 1.46%, L. sordellii 0.52%, L. intermedia 0.21 and L. shanonni 0.1%. In both municipalities was observed higher abundance of species distributed in the initial months of the year, as February and March. The study showed that no difference in exposure to the vector of VL among individuals from endemic and non endemic area for this disease. But there are differences in exposure between individuals of L. longipalpis and L. evandroi, confirming the great powers of the first vector. It was also characterized as predominant phenotype in the population of endemic areas who had negative serologic responses to antigens of Leishmania and result in negative Montenegro skin test (DTH), indicating that much of the population hasn t been bitten by infected insects

O FUNDEF e o FUNDEB como política de financiamento para a valorização do magistério: efeitos na carreira e na remuneração dos professores da rede pública e estadual de ensino do RN.

Este estudio analiza los efectos de la política de financiamiento de la educación básica, por intermedio de los Fundos contables, Fundef y Fundeb, y su proposición en valorar el magisterio, considerando las dimensiones de carrera y de la remuneración de los profesores de la red pública estadal de enseñanza del estado de Rio Grande do Norte, en el período entre 1996 y 2010. Para entender las condicionantes de la evaluación de las políticas públicas, se buscó también las contribuciones de Marx (1996) segundo quién “el concreto es concreto” y que la dialéctica del concreto se puede auxiliar en el intento de captar el fenómeno estudiado. Se utilizó aún, el referencial teórico bibliográfico relacionado al financiamiento de la educación y a la valoración del magisterio, a partir de la literatura referente a las dimensiones del objeto (fundef y Fundeb) y (carrera y remuneración). En la investigación documental, además de las legislaciones, directrices nacionales y locales pertinentes, se utilizaron datos referentes a los recursos disponibles en la Finbra. Tesoro Nacional, SIOPE/RN, INEP/MEC, datos de resumen del folio y folio de pagamiento de Secretaria de Estado, de la Educación e de la Cultura (SEEC), y 289 sueldos de 21 profesores. Se realizó entrevista semi estructurada con nueve profesores, referente a la carrera, además de un cuestionario aplicado a 12 profesores relacionado a remuneración. Se considera que en los resultados referentes a los indicadores educacionales, en el período Fundef ocurrió una reducción en las inscripciones de la red pública de enseñanza, como también en las funciones docentes, de la enseñanza base (fundamental), que corresponde a 37%. A partir de la vigencia del Fundeb (2007 – 2010), estos indicadores fueron puestos en ecuación. En todo el período entre 1996 a 2010, ocurre un aumento en las inscripciones de 119,03% y en las funciones docentes de 77,44%. Sobre los datos de financiamiento, se constató que, del mínimo exigido (60%) en la aplicación de recursos de los Fundos en la remuneración del magisterio se aplica en el período de los dos Fundos, pero el mínimo exigido, o sea, 83,29% a 98,89% de los recursos. Los efectos de los Fundos en la carrera de los nueve profesores, considerando la promoción y la progresión, no han sido satisfactorios. En la promoción de los nueve de estos docentes, apenas uno evolucionó el Nivel (titulación), pero retrocedió en la progresión. En la progresión de los nueve profesores, ocho se hallan con la progresión retrasada, entre dos y cinco clases, acumulando un perjuicio que varía de 10% a 45% en su ganancia. La diferencia de una clase a otra corresponde a 5% en la renta anual. Se observa que las ventajas pecuniarias contribuyen con la remuneración con porcentaje más alto que la renta, disminuyendo esta diferencia en el período de Fundeb. Sobre la remuneración, un profesor con 24 años de carrera, con formación (magisterio), no consigue, después de años de profesión, ganar ni siquiera dos salarios mínimos. El profesor con 30 años de carrera, con maestría, tiene una renta, en 2010, correspondiente a menos de tres salarios mínimos, o sea, 2,82 y una remuneración que equivale a poco más de tres salarios mínimos, o sea, 3,66. Si comparamos la profesión de magisterio con otras que igual exigen formación superior, la primera es, en general, de bajo nivel, causando un resultado negativo sobre la búsqueda de la profesión del magisterio. Por los efectos en la remuneración, se concluye que hubo una mejoría, pero aún insuficiente, sobre todo al comparar con el Salario Mínimo Anual. Se evalúa, una vez que los fundos – Fundef y Fundeb – no fueron capaces de promover la valoración del magisterio en las dimensiones de la carrera y de la remuneración. Se constatan algunos resultados negativos en la política de Fundo ya que tendría que ver, principalmente, con la incapacidad de la referida política a valoración de magisterio, siendo una de las causas, o financiamiento con restricción de presupuesto.

Resposta imune à saliva de flebotomíneos (diptera: psychodidae) em indivíduos residentes em áreas urbana e periurbana no nordeste do brasil

Visceral leishmaniasis (VL) has a wide geographical distribution in tropical and subtropical areas of the planet, which is a protozoan parasite of the genus Leishmania. This pathogen is transmitted to the host through the sandflies bite, with its saliva, the immune response that leads to both. In the state of Rio Grande do Norte, 85% of the sand flies captured is Lutzomyia longipalpis, but the second most abundant, Lutzomyia evandroi, it deserves emphasis because its wide distribution and eclectic behavior. The exposure of people living in endemic areas for the insect vector VL greatly increases the chances of infection. This study aimed to evaluate aspects of the epidemiological profile of VL in endemic areas of human and nonendemic in the metropolitan area of Natal, as well as verify the abundance and seasonal fluctuations of sandflies species in two counties endemic for VL. Were collected in the municipalities of Nísia Floresta, Parnamirim, São Gonçalo do Amarante and Macaíba, of which groups of females were separated for further dissection of the salivary glands and identification of species. The blood samples used were from individuals of two Natal s districts where it has never been reported cases of VL and neighborhoods of Parnamirim applicants who present cases of VL. In the municipality of Nísia Floresta, the most abundant species was L. evandroi with 38.39%, followed by L. longipalpis with 36.22%, L. walkeri 19.67% L. lenti 3.81%, L. wellcomei 1.39% and L. whitmani 0.52%. Already in Parnamirim the proportions were L. walkeri with 73.15%, L. evandroi with 10.55%, L. wellcomei 7.63%, L. longipalpis 6.37%, L. whitmani 1.46%, L. sordellii 0.52%, L. intermedia 0.21 and L. shanonni 0.1%. In both municipalities was observed higher abundance of species distributed in the initial months of the year, as February and March. The study showed that no difference in exposure to the vector of VL among individuals from endemic and non endemic area for this disease. But there are differences in exposure between individuals of L. longipalpis and L. evandroi, confirming the great powers of the first vector. It was also characterized as predominant phenotype in the population of endemic areas who had negative serologic responses to antigens of Leishmania and result in negative Montenegro skin test (DTH), indicating that much of the population hasn t been bitten by infected insects

Definições para o resultado de enfermagem comportamento de prevenção de quedas: uma revisão integrativa

Devido à necessidade de mensurar o risco de quedas em concordância à linguagem padronizada de enfermagem, foi selecionado o resultado de enfermagem Comportamento para Prevenção de Quedas da Nursing Outcomes Classification (NOC), com objetivo de identificar evidências sobre seus elementos, mensuração, comparação com indicadores existentes e construir definições constitutivas. Foi efetuada revisão integrativa entre abril e novembro de 2009, mediante identificação da questão, estabelecimento de critérios de inclusão/exclusão, extração das informações, avaliação, interpretação e síntese. Destacaram-se pesquisas transversais e perspectivas de especialistas. Os indicadores Uso de recursos de correção da visão e Uso de sapatos amarrados e do tamanho adequado foram considerados insuficientes para avaliar fatores de risco como déficits sensoriais e roupas/calçados inadequados. Percebe-se que algumas definições precisam ser melhor desenvolvidas e que esse resultado de enfermagem merece refinamento sobretudo referente aos indicadores. Foram identificados 22 indicadores e definições foram propostas baseadas nas evidências da literatura

Efeito da salinidade da água do mar no rendimento, composição e atividades biológicas de frações polissacarídicas da Chlorophyta Caulerpa cupressoides var. flabellata

Seaweeds sulfated polysaccharides have been described as having various pharmacological activities. However, nothing is known about the influence of salinity on the structure of sulfated polysaccharides from green seaweed and pharmacological activities they perform. Therefore, the main aim of this study was to evaluate the effect of salinity of seawater on yield and composition of polysaccharides-rich fractions from green seaweed Caulerpa cupressoides var. flabellata, collected in two different salinities beaches of the coast of Rio Grande do Norte, and to verify the influence of salinity on their biological activities. We extracted four sulfated polysaccharides-rich fractions from C. cupressoides collected in Camapum beach (denominated CCM F0.3; F0.5; F1.0; F2.0), which the seawater has higher salinity, and Buzios beach (denominated CCB F0.3; F0.5; F1.0; F2.0). Different from that observed for other seaweeds, the proximate composition of C. cupressoides did not change with increased salinity. Moreover, interestingly, the C. cupresoides have high amounts of protein, greater even than other edible seaweeds. There was no significant difference (p>0.05) between the yield of polysaccharide fractions of CCM and its CCB counterparts, which indicates that salinity does not interfere with the yield of polysaccharide fractions. However, there was a significant difference in the sulfate/sugar ratio of F0.3 (p<0.05) and F0.5 (p<0.01) (CCM F0.3 and CCB F0.5 was higher than those determined for their counterparts), while the sulfate/sugar ratio the F1.0 and F2.0 did not change significantly (p>0.05) with salinity. This result suggested that the observed difference in the sulfate/sugar ratio between the fractions from CCM and CCB, is not merely a function of salinity, but probably also is related to the biological function of these biopolymers in seaweed. In addition, the salinity variation between collection sites did not influence algal monosaccharide composition, eletrophoretic mobility or the infrared spectrum of polysaccharides, demonstrating that the salinity does not change the composition of sulfated polysaccharides of C. cupressoides. There were differences in antioxidant and anticoagulant fractions between CCM and CCB. CCB F0.3 (more sulfated) had higher total antioxidant capacity that CCM F0.3, since the chelating ability the CCM F0.5 was more potent than CCB F0.5 (more sulfated). These data indicate that the activities of sulfated polysaccharides from CCM and CCB depend on the spatial patterns of sulfate groups and that it is unlikely to be merely a charge density effect. C. cupressoides polysaccharides also exhibited anticoagulant activity in the intrinsic (aPTT test) and extrinsic pathway (PT test). CCB F1.0 and CCM F1.0 showed different (p<0,001) aPTT activity, although F0.3 and F0.5 showed no difference (p>0,05) between CCM and CCB, corroborating the fact that the sulfate/sugar ratio is not a determining factor for biological activity, but rather for sulfate distribution along the sugar chain. Moreover, F0.3 and F0.5 activity in aPTT test was similar to that of clexane®, anticoagulant drug. In addition, F0.5 showed PT activity. These results suggest that salinity may have created subtle differences in the structure of sulfated polysaccharides, such as the distribution of sulfate groups, which would cause differences in biological activities between the fractions of the CCM and the CCB

O argumento dos contrários e a hipótese sobre a imortalidade no Fédon de Platão

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care

Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

A Zona Incerta no sagüi (Callithrix jacchus): Análise Citoarquitetônica, Neuroquímica e Projeção Retiniana

The retinal projections in mammals usually reach, classically, three major functional systems: the primary visual system, the accessory optic system, and the circadian timing system. But the retinal projections also reach areas classically considered non-visual, one of which groups the neurons of the zona incerta (ZI), target this study. The primary visual system includes thalamic lateral geniculate complex is formed by the dorsal lateral geniculate nucleus, intergeniculate leaflet and the ventral lateral geniculate nucleus and other Components. The accessory optic system is composed of the small nuclei: nuclei terminal dorsal, lateral, medial and the interstitial nucleus of the superior posterior fasciculus. These nuclei are involved in visuo-motor activities. The circadian timing system is comprised of the suprachiasmatic nucleus of the hypothalamus, that act as master circadian pacemaker, entraining pathways and efferents pathways to the efectors, and the intergeniculate leaflet, that seems to act as a modulator of the pacemaker. The retinal projections too reach classically considered non-visual areas, including the zona incerta. This region is localized in the ventral thalamus and has been implicated in various functional properties including nociceptive and somatosensory processing, motor response, sociosexual behaviour, feeding and drinking, in symptoms of neurodegenerative diseases, arousal and attention. It also displays connection with several areas of central nervous system. The aim of this study was characterize the retinal projection in the zona incerta of Callithrix jacchus (sagüi), a primate of the New World through the anterograde axonal transport of the cholera toxin subunit b and analyze the citoarchicteture using Nissl and NeuN, and neurochemical substances such as serotonin, GABA, VIP, VP, GFAP and binding-calcium proteins. The zona incerta showed a different division of the literature in citoarquitetura, both by means of Nissl as neurochemical by NeuN, with a subdivision ventrolateral and dorsomedial. The neurochemical to the other substances corroborate with this subdivision. The GFAP was almost completely negative for the zona incerta, result non evidenced in previous studies yet. The 16 retinal projection in sagüi, unlike other primates and rodents, reached the caudal portion only. This work helps to make further studies are conducted based on this subdivision and the localization of the neurochemical substances associated with possible behaviors that the zona incerta is involved

Efeito da coesão semântica sobre a discriminação de itens emocionais em testes de memória de reconhecimento de palavras

Highly emotional itens are best remembered in emotional memory tasks than neutral items. An example of emotional item that benefits declarative memory processes are the taboo words. These words undergo from a conventional prohibition, imposed by tradition or custom. Literature suggests that the strongest recollection these words is due to emotional arousal, as well as, the fact that they form a cohesive semantic group, which is a positive additive effect. However, studies with semantic lists show that cohesion can have a negative effect of interference, impairing memory. We analyzed, in two experiments, the effect of arousal and semantic cohesion of taboo words on recognition tests, comparing with into two other word categories: semantically related and without emotional arousal (semantic category) and neutral, with low semantic relation (objects). Our results indicate that cohesion has interfered whith the performance of the test by increasing the number of false alarms. This effect was strongly observed in the semantic category of words in both experiments, but also in the neutral and taboo words, when both were explicitly considered as semantic categories through the instruction of the test in Experiment 2. Despite the impairment induced by semantic cohesion in both experiments, the taboo words were more discriminated than others, and this result agrees with the indication of the emotional arousal as the main factor for the best recollection of emotional items in memory tests

Avaliação da eficiência da técnica de obturação pela compressão hidrùlica vertical após instrumentação automatizada

The purpose of this study was to evaluate through radiographic and microscopic analysis the efficiency of the filling techniques by vertical hidraulic compression after the root canal mechanical instrumentation in vitro as well to evaluate the marginal apical leakage through macroscopic and microscopic analysis. Thirty human mandibular molars were used , they were divided on three groups, these were subdivided on six subgroups with five specimens each, come down to 106 root canals filled. Initially, the teeth were instrumented with Profile system series 29 and filled with two ways: single accessory cone or single cone associated with gutta-percha secundary cone, with Fill Canal sealer or Sealer 26. Completed the filling, the teeth were coated with araldit and finger -nail polish except for the apical 2 mm and dried for 3 hours, thep radiographs were taken of the teeth in orto and disto-radiai directions. Next, the coronal seal was carried out with composite resin photopolymerized and with their process of making impermeable. Teeth of positive controls were used without araldit and finger-nail polish whereas the negative controls were used with total coat of araldit and finger-nail polish. The specimens were placed in 2% Methylene Blue dye for 24 hours and thermocycled for 7 days. Afterwards, sections were made of each tooth at mesial and distal roat, after this the teeth were radiographed at buccolíngual direction for a macroscopic analysis and at buccolingual and mesiodistal directions for assessment of the marginal apical leakage. Cross sections were made 3 mm to 3mm since the tooth apice. The sections obtained for each group were observed with a stereomicroscope to evaluate the quality of the root canal filling and the marginal apical leakage. The results showed that: In the four techniques the marginal dye leakage was present in the apical third; in all groups the quality of the root canal filling in the radiography was better at mesial root canal and the single cone technique showed inefficient when only a single distal root canal was present. In the radiographic evaluation the best quality of the root canal filling was observed in the 1A group (single accessory cone + FiIl Canal), as in the mesial root as in the distal root wich Shcwed twe root canals: when the distaI root had only one canal. the best result was showed by 28 group (single accessory cone associated with secundary cone + Fill Canal) In the macroscopic analysis of longitudinal !eaKage (outside surface). less leakage was showed as In the mesial root as in the distal root in the negative control group (3) followed 2A group (single accessory cone + Sealer 26). When the microscopic analysis of tranversal leakage of both roots (inside surface) was carried out. the groups that showed less dye leakage were the negative control (38) followed the 28 group (single acessory cone associated with secundary cone + Sealer 26). The homogeneity o filling was best noted in the 1 A group (.single accessoty cone + Fill Canal). The groups that showed less dye penetration in the tranversal leakage (total area) were negative control (3B) and 2B

Trissoralen um medicamento de baixa dosagem: estudos termoanalíticos da compatibilidade do fármaco-excipientes e determinação de parâmetros de qualidade para cápsulas magistrais

The trioxsalen (Tri) is a low-dose drug used in the treatment of psoriasis and other skin diseases. The aim of the study was applying the thermal analysis and complementary techniques for characterization, evaluation of the trioxsalen stability and components of manipulated pharmaceutical formulations. The thermal behavior of the Tri by TG/DTG-DTA in dynamic atmosphere of synthetic air and nitrogen showed the same profile with a melting peak followed by a volatilization-related event. From the curves TG / DTG is observed a single stage of mass loss. By heating the drug in the stove at temperatures of 80, 240 and 260 °C, it had no change in chemical structure through the techniques of XRD, HPLC, MIR, OM and SEM. From the non-isothermal and isothermal TG kinetic studies was possible to calculate the activation energy and reaction order for the Tri. The drug showed good thermal stability. Studies on drug-excipient compatibility showed interaction of trissoralen with sodium lauryl sulfate 1:1. There was no interaction with aerosol, pregelatinized starch, sodium starch glycolate, cellulose, croscarmellose sodium, magnesium stearate, lactose and mannitol.The characterization of three trioxsalen formulations at concentrations of 2.5, 5, 7.5, 10, 12.5 and 15 mg was performed by DSC, TG / DTG, XRD, NIR and MIR. The PCA classification method based on spectral data from the NIR and MIR of trissoralen formulations allows successful differentiation into three groups. The formulation 3 was the one that best showed analytical profile with the following composition of aerosil excipients, pre-gelatinized starch and cellulose. The activation energy of the volatilization process of the drug was determined in binary mixtures and formulation 3 through fitting and isoconversional methods. The binary mixture with sodium starch glycolate and lactose showed differences in kinetic parameters compared to the drug isolated. The thermoanalytical techniques (DSC and TG / DTG) were shown to be promising methodologies for quantifying trioxsalen obtained by the linearity, selectivity, no use solvents, without sample preparation, speed and practicality.

Relação entre a biodiversidade de plantas e os serviços do ecossistema na caatinga

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeito do topiramato sobre o craving em usuários de crack

The study aims to analyze the effects of topiramato on the craving of crack users. It is an open crossover clinical trial involving users from the Psychosocial Care Center for Alcohol and Drugs (CAPSad) in city of Parnamirim, RN, approved by the CEP CAAE: 38710614.1.0000.5537, respecting the norms of the resolution n. 466/2012/CNS. The study produced preliminary two scientific papers: a theoretical essay and an integrative review, as a way of seeking the state of art. The first paper was based in the theoretical framework of Hinds, Chaves and Cypress, which focuses different contexts, from the issues of individual use to the coping policies in Brazil, highlighting that the situation and the complexity of the phenome requires coping strategies for the full attention to the user, family and society. As a result of the integrative review, among the 902 retrieved records, eight of them presented therapeutic schemes with positive effects for the craving of cocaine. They used nine different drugs. It is important to spot out that there was no result for the craving of crack. The data collection was conducted from December 2014 to July 2015 and has as sample predominantly single males. The sample was composed of 30 subjects who met the inclusion criteria: adults, age from 18 years, diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for cocaine/crack; cognitive capacity preserved; attendance to the service, participated at least three visits in the 12 months prior to data collection; and accepted to be monitored in the proposed treatment. Data was analyzed using descriptive statistics from the Statistical Package of Support for Social Sciences (SPSS) on the instruments: 1) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), pointing out, among other results, that only 14% used crack/cocaine weekly during treatment, while 83% used daily or weekly after the washout period; 2) Barratt Impulsiveness Scale, with an average of 80.23 and 77.47 with and without drug treatment, respectively. An analysis from the Student t test show no significant differences in impulsivity with or without the drug; and 3) Cocaine-Craving Questionnaire-Brief (CCK-B), indicating that the number of users with craving intensity level is significantly higher without drug treatment (86%) than with treatment (33%). The analysis between craving and level of impulsivity showed that there is a low correlation (Pearson) between these two variables during treatment and after the washout, demonstrating that impulsivity has low influence on the outcome of drug therapy. As conclusion, it was noted that the topiramate produces positive effect on reducing the craving for crack users and their use is a relevant strategy for efficacy in the treatment of crack users.

Efeito do topiramato sobre o craving em usuários de crack

The study aims to analyze the effects of topiramato on the craving of crack users. It is an open crossover clinical trial involving users from the Psychosocial Care Center for Alcohol and Drugs (CAPSad) in city of Parnamirim, RN, approved by the CEP CAAE: 38710614.1.0000.5537, respecting the norms of the resolution n. 466/2012/CNS. The study produced preliminary two scientific papers: a theoretical essay and an integrative review, as a way of seeking the state of art. The first paper was based in the theoretical framework of Hinds, Chaves and Cypress, which focuses different contexts, from the issues of individual use to the coping policies in Brazil, highlighting that the situation and the complexity of the phenome requires coping strategies for the full attention to the user, family and society. As a result of the integrative review, among the 902 retrieved records, eight of them presented therapeutic schemes with positive effects for the craving of cocaine. They used nine different drugs. It is important to spot out that there was no result for the craving of crack. The data collection was conducted from December 2014 to July 2015 and has as sample predominantly single males. The sample was composed of 30 subjects who met the inclusion criteria: adults, age from 18 years, diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for cocaine/crack; cognitive capacity preserved; attendance to the service, participated at least three visits in the 12 months prior to data collection; and accepted to be monitored in the proposed treatment. Data was analyzed using descriptive statistics from the Statistical Package of Support for Social Sciences (SPSS) on the instruments: 1) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), pointing out, among other results, that only 14% used crack/cocaine weekly during treatment, while 83% used daily or weekly after the washout period; 2) Barratt Impulsiveness Scale, with an average of 80.23 and 77.47 with and without drug treatment, respectively. An analysis from the Student t test show no significant differences in impulsivity with or without the drug; and 3) Cocaine-Craving Questionnaire-Brief (CCK-B), indicating that the number of users with craving intensity level is significantly higher without drug treatment (86%) than with treatment (33%). The analysis between craving and level of impulsivity showed that there is a low correlation (Pearson) between these two variables during treatment and after the washout, demonstrating that impulsivity has low influence on the outcome of drug therapy. As conclusion, it was noted that the topiramate produces positive effect on reducing the craving for crack users and their use is a relevant strategy for efficacy in the treatment of crack users.