Heart transplantation experiences: a phenomenological approach

Aim. The aim of this study was to understand the heart transplantation experience based on patients' descriptions.Background. To patients with heart failure, heart transplantation represents a possibility to survive and improve their quality of life. Studies have shown that more quality of life is related to patients' increasing awareness and participation in the work of the healthcare team in the post-transplantation period. Deficient relationships between patients and healthcare providers result in lower compliance with the postoperative regimen.Method. A phenomenological approach was used to interview 26 patients who were heart transplant recipients. Patients were interviewed individually and asked this single question: What does the experience of being heart transplanted mean? Participants' descriptions were analysed using phenomenological reduction, analysis and interpretation.Results. Three categories emerged from data analysis: (i) the time lived by the heart recipient; (ii) donors, family and caregivers and (iii) reflections on the experience lived. Living after heart transplant means living in a complex situation: recipients are confronted with lifelong immunosuppressive therapy associated with many side-effects. Some felt healthy whereas others reported persistence of complications as well as the onset of other pathologies. However, all participants celebrated an improvement in quality of life. Health caregivers, their social and family support had been essential for their struggle. Participants realised that life after heart transplantation was a continuing process demanding support and structured follow-up for the rest of their lives.Conclusion. The findings suggest that each individual has unique experiences of the heart transplantation process. To go on living participants had to accept changes and adapt: to the organ change, to complications resulting from rejection of the organ, to lots of pills and food restrictions.Relevance to clinical practice. Stimulating a heart transplant patients spontaneous expression about what they are experiencing and granting them the actual status of the main character in their own story is important to their care.

Familiares de portadores de transtorno mental: vivenciando o cuidado em um centro de atenção psicossocial

Esta investigação teve por objetivo apreender como os familiares de portadores de transtorno mental têm convivido com um serviço de saúde mental. Foi utilizado o método exploratório/descritivo, de natureza qualitativa. Como instrumento de coleta de dados, utilizou-se uma entrevista semiestruturada, sendo sujeitos dessa pesquisa seis familiares que já conviviam há mais de três anos com o adoecimento psíquico. A análise dos dados permitiu inferir que os familiares que acompanham o usuário têm de lidar com um aprendizado que adquiriram na vivência cotidiana e são sujeitos à rejeição de membros da família e da comunidade; com relação ao centro de atenção psicossocial, os familiares se sentem acolhidos em suas queixas, recebendo um atendimento singular; porém, desconhecem os mecanismos para a sua participação social, o que aponta para uma deficiência do serviço, à medida que este deve estimular formas de inserção na comunidade, e da ampliação dos direitos de cidadania dos usuários.

Role of Peritubular Capillaries and Vascular Endothelial Growth Factor in Chronic Allograft Nephropathy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

SUBSTITUIÇÃO do LIGAMENTO da CABEÇA do FÊMUR COM AUTO-ENXERTO DE FÁSCIA LATA NA LUXAÇÃO COXOFEMORAL em CÃES

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Structural alterations in the seminiferous tubules of rats treated with immunosuppressor tacrolimus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Changes in taste reactivity to intra-oral hypertonic NaCl after lateral parabrachial injections of an alpha(2)-adrenergic receptor agonist

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of physical and chemical factors during foraging and culture of the symbiont fungus in Atta sexdens rubropilosa (Hymenoptera : Formicidae)

The aim of this paper is to investigate the influence of physical and chemical factors on transport and use of substrate for Atta sexdens rubropilosa workers. Three types of rectangular fragments were used to study the physical influence factors: filter paper with paraffin, filter paper without paraffin and polyester film. To study the chemical factors, some fragments were impregnated with organic extract of orange albedo, others were soaked with soybean oil and for the remaining ones nothing was applied. The following parameters were evaluated: (i) attractiveness of substrate for transport and number of loading workers per treatment; (ii) foraged material incorporation; (iii) rejection by numbers of fragments deposited in the garbage or beside the fungus garden. All the polyester film fragments carried out to the fungus garden were subsequently rejected. We verified that chemical factors of the substrate were more quickly detected by the workers, whereas physical factors were used as a criterion in the decision-making to reject or accept the substrate collected.

Docking and small angle X-ray scattering studies of purine nucleoside phosphorylase

Docking simulations have been used to assess protein complexes with some success. Small angle X-ray scattering (SAXS) is a well-established technique to investigate protein spatial configuration. This work describes the integration of geometric docking with SAXS to investigate the quaternary structure of recombinant human purine nucleoside phosphorylase (PNP). This enzyme catalyzes the reversible phosphorolysis of N-ribosidic bonds of purine nucleosides and deoxynucleosides. A genetic deficiency due to mutations in the gene encoding for PNP causes gradual decrease in T-cell immunity. Inappropriate activation of T-cells has been implicated in several clinically relevant human conditions such as transplant rejection, rheumatoid arthritis, lupus, and T-cell lymphomas. PNP is therefore a target for inhibitor development aiming at T-cell immune response modulation and has been submitted to extensive structure-based drug design. The present analysis confirms the trimeric structure observed in the crystal. The potential application of the present procedure to other systems is discussed. (C) 2003 Elsevier B.V. All rights reserved.

Influence of Prey Size on the Predatory Behavior of Ectatomma brunneum (Hymenoptera: Formicidae) Under Laboratory Conditions

The influence of prey size on the predatory behavior and behavioral sequence of Ectatomma brunneum under laboratory conditions was evaluated. Two behaviors were characterized: rejection and attack, the latter divided into individual and group attack. In the group attack, prey transport (Tenebrio molitor larvae) into the nest prevailed, whether immobilized as a consequence of the ant venom or not. on the other hand, in the individual attacks such behavior was not observed. There was no significant relation between the predatory behavior and the size of the larvae offered, indicating that prey dimensions do not interfere with predation. The high rejection rates registered in the experimental trials may have been a consequence of the absence of immatures in the nests used in the research and/or the decrease in the activities observed, considering that the experiments were carried out in the coldest time of the year.

Cyclosporin A causes impairment of the ventral prostate tissue structure of Wistar rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Homogenous amniotic membrane as a biological dressing for oral mucositis in rats: Histomorphometric analysis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Inclusive search for squarks and gluinos in pp collisions at root s=7 TeV

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Representações de estudantes universitários sobre alunos cotistas: confronto de valores

A inclusão da política de cotas, nas universidades brasileiras, é recente. Apesar da adesão de várias instituições de ensino, esse tipo de política tem gerado posições contraditórias. Este estudo teve como objetivo investigar quais valores estão mais presentes na avaliação que universitários fazem a respeito de supostos usuários das cotas. Na pesquisa, foram aplicados diferentes tipos de questionários em 403 estudantes de uma universidade pública paulista, os quais objetivaram verificar se suas representações sobre esse tema variavam conforme as possibilidades de ingresso na universidade, a saber: vestibular simples, cursinhos para alunos carentes e cotas e, conforme os públicos-alvo enfocados, negros ou alunos de escolas públicas. Como método de análise, foi utilizado o programa ALCESTE e, como recurso complementar, a análise de conteúdo. Os resultados demonstraram que há uma rejeição às políticas relacionadas às cotas, uma vez que estas foram percebidas como mais ameaçadoras do que aquelas referentes ao vestibular e ao cursinho gratuito. Na grande parte das respostas dadas pelos alunos, fica evidente o conflito de valores: mérito versus igualdade compensatória. O vestibular, baseado apenas no mérito, é representado como o sistema mais justo para ingresso de alunos de escola pública e, principalmente de negros, na universidade. Valores como justiça, igualdade, esforço próprio, sobre os quais a maioria dos universitários respalda suas respostas contrárias às cotas, estão sendo questionados pelas políticas de ação afirmativa, o que indica que enfrentá-los é o grande desafio posto a essas políticas.

Cuidando de pacientes em fase terminal: a perspectiva de alunos de enfermagem

Este estudo busca compreender como alunos de graduação em Enfermagem percebem a si mesmos ao cuidar de pacientes em fase terminal e expor os significados da experiência vivida. Foram entrevistados 14 alunos, respondendo à questão: Como se mostra a você o cuidar do paciente na fase terminal? Para os alunos, é sempre uma experiência dolorosa, que os coloca face a face com suas fragilidades e inseguranças. Eles atribuem suas dificuldades à própria incapacidade de aceitar a morte e ao despreparo e inexperiência. Relatam que falta apoio dos profissionais com quem compartilham esse cuidado. No que se refere à formação profissional, para alguns a experiência foi positiva, apesar das dificuldades; outros a avaliam negativamente, resultando em rejeição a situações semelhantes. Novas investigações sobre o tema são necessárias para aprofundar e ampliar a reflexão para o âmbito da formação dos enfermeiros em nível nacional.

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .