Efeito do lítio sobre a hiperatividade locomotora induzida pela lesão eletrolítica da região do núcleo mediano da rafe em ratos

A lesão do núcleo mediano da rafe (NMR) produz sintomas que sugerem validade de face ao episódio maníaco. Esta pesquisa avaliou o efeito do lítio sobre a hiperatividade locomotora induzida por esta lesão. Vinte e um ratos Wistar machos foram submetidos à lesão eletrolítica da região do NMR (LR) e 17 foram submetidos à lesão fictícia (LF). Após recuperação, a atividade locomotora foi avaliada na caixa de atividade (Med Associates/ENV-515). Parte dos animais destes grupos recebeu tratamentos com lítio (47,5 mg/kg/2x dia i.p.) por 10 dias, enquanto o restante foi tratado com salina no mesmo esquema. A reavaliação ao final dos tratamentos demonstrou que o lítio reduziu significantemente a atividade locomotora em relação à avaliação inicial no grupo LR (ANOVA/Bonferroni p < 0,05), tornando-a equivalente aos baixos níveis dos grupos LF. Estes dados sustentam a hipótese de que as manifestações induzidas pela lesão do NMR podem constituir um modelo animal de mania.

Atenção odontológica no Programa de Saúde da Família de Campos dos Goytacazes

Durante décadas, a política de saúde bucal no Brasil foi centrada na prestação de assistência à doença, e ainda hoje grande parcela da população brasileira não tem acesso a cuidados odontológicos. Pela Portaria nº 1.444, de 28 de dezembro de 2000, o Ministério da Saúde estabelece incentivo financeiro para a reorganização da atenção à saúde bucal aos municípios. Insere-se, assim, a Odontologia no programa e, conseqüentemente, a possibilidade de ampliar e reorientar a atenção odontológica no Brasil. Dentro desse contexto, este estudo teve por objetivo avaliar a situação da equipe de saúde bucal inserida no Programa de Saúde da Família (PSF) do município de Campos dos Goytacazes - RJ, em 2002. Os resultados demonstraram algumas limitações na inclusão e funcionamento da Odontologia no PSF da cidade. A atenção odontológica deve ser inserida no PSF, atendendo aos princípios básicos do Plano de Reorganização das Ações de Saúde Bucal na Atenção Básica, proposto pelo Ministério da Saúde, e à consolidação do Sistema Único de Saúde.

Avaliação da atenção à saúde da criança no contexto da Saúde da Família no município de Teixeiras, Minas Gerais (MG, Brasil)

Este estudo tem como objetivo analisar a atenção à saúde da criança pelo Programa de Saúde da Família (PSF) do município de Teixeiras, MG, Brasil. Foi aplicado um questionário a 161 mães de crianças menores de dois anos. Utilizou-se um sistema de escores específicos para análise das dimensões de estrutura, processo e resultado e seus respectivos atributos, classificando o município nos cenários incipiente, intermediário e avançado. Configurou-se, na síntese, um cenário intermediário (49,6%) para o PSF, caracterizado por uma atenção à saúde da criança fragmentada, mas com avanços na organização da atenção para este grupo. Foram consideradas incipientes as instalações físicas, a qualidade do cuidado no controle da diarréia e das infecções respiratórias, a participação comunitária e a intersetorialidade. Os avanços estiveram relacionados ao acolhimento realizado pelo programa, no entanto, as atividades preventivas e promocionais do PSF demonstram que o programa surge como um suporte do hospital e mais um local de atendimento médico. A atuação do PSF na atenção a saúde das crianças distancia-se da proposta de reorientação do modelo assistencial hegemônico, pela qual foi criado, dificultando estratégias na prevenção de doenças e na promoção da saúde.

Qualidade dos medicamentos contendo dipirona encontrados nas residências de Araraquara e sua relação com a atenção farmacêutica

Many studies had described the morbi-mortality related to medicines. As for the strategies to reduce the possible risks for medicine therapy is very important to readvise the pharmaceutical activity, once the pharmacist has potential for constitute an essential part for the solution of problems related to the utilization of medicines. The purpose of this work was to demonstrate that the therapeutic subdosage and the microbiological contamination may be directly involved with the inappropriate manipulation of medicines stored in residences. Liquid dosage forms containing dipyrone market in Brazil and stored at homes in Araraquara (SP) were analyzed regarding quantitative and microbiological analysis. Only in 57% from 128 samples analyzed the drug quantity was in accordance. Moreover, 26.2% from 128 samples analyzed presented S. aureus, E. coli and Salmonella sp. These results demonstrated clear reduction in their quality, as well as the presence of molds and/or bacteria in some medicines that still agreed with the expirations dates, showing the importance of the pharmacist in advising the correct use and store of medicines.

A ótica do usuário na avaliação da qualidade do programa de atenção odontológica à gestante

Objective: To evaluate the pregnant women's perception of the FOA-UNESP's Pregnant Women Dental Care Program (Araraquara, SP, Brazil). Method: The sample included 75 pregnant women and used a questionnaire with 16 closed questions, containing variables grouped in the following categories: the didactic-psychological meetings, clinical treatment, professional's profile, clinical facility, fear/confidence in the treatment, and learning. Except for the variables fear/confidence in the treatment and learning, to which 'yes' or 'no' answers were attributed, the remaining variables were attributed answers varying from weak to excellent. The questionnaire pretested in a pilot-study and applied after informed consent was obtained from all pregnant women treated between 2005 and 2006. Results: Most women rated as excellent the information addressed during the didactic-psychological meetings (81.1%), the clinical treatment (90.6%), the professional as to personal appearance, kindness and attention (88.7%, 96.2% and 90.6%, respectively), and the clinical facility as to cleanness, ventilation and comfort (92.5%, 86.8% and 90.6%, respectively). Most of them stated to feel confident (96.2%) and have no fear (86.8%) during the treatment and also affirmed having learned new information in the didactic-psychological meetings of the program (92.5%). Conclusion: The services and actions developed in the program have reached successful outcomes, providing health to the pregnant women and their forthcoming babies.

Evolução da perda de peso entre indivíduos da fila de espera para a cirurgia bariátrica em um ambulatório multidisciplinar de atenção secundária à saúde

Objective: The objective of this study is to characterize the assistance and analyze patient's adherence to nutritional follow-up while in the waiting line for bariatric surgery in a multidisciplinary, secondary healthcare outpatient clinic. Methods: This retrospective study was based on the nutritional records of 59 patients subjected to bariatric surgery at the Hospital das Clinics de Botucatu, from 2001 to 2008. The population studied was distributed into 8 groups and analyzed according to follow-up duration. The analysis took into account the evolution of body weight and the number of follow-up visits in a given period. The Kruskal-Wallis test was used to compare data between groups while Spearman's coefficient was used to test correlations. Results: Among the 59 studied patients, 42 (71.2%) returned to the clinic at least once in six months. Of these, 67.8% lost weight while in the waiting line and 27.1% of them lost more than 10% of their body weight. The greatest weight losses in the preoperative period were found in the groups that had more than six months of nutrition follow-up. There was a mean delay of three months between return visits, which could have contributed to the low adherence to follow-up. Conclusion: The patients in the waiting line for surgery analyzed in this study presented low adherence to the long-spaced return visits. The greatest weight losses were observed in groups that had been followed for more than six months. This shows that, to achieve the desired weight loss and an adequate education process before surgery, at least six months of follow-up and regular visits are necessary.

Saúde da Família: O desafio de uma atenção coletiva

The Family Health Strategies, incorporated by the Ministry of Health in 1994, has consolidated the national policy of health care that has as its main care focus the family. In this model, this institution constitutes the first object of attention, understood from its environment and interaction. In recent decades, the Brazilian family structure is suffering profound changes that directly affect the practices of health care. This study redeem the family concepts and ideas and their social representations and still prove and present the importance and the necessity of the use of these ample instruments of collective boarding in health area: the APGAR, the genogram and eco-map, using the environment observation and family history - crucial factors to the reality of the nuclear family diagnosis - for further planning of health action strategies. It was concluded that the current structure of the family require training from the health teams, for physical, cultural, biological and social points of the family context for the correct use of the instruments cited, important tools for collective approach in the public health area.

(Em defesa dos) Cuidados Paliativos na Atenção Primária à Saúde

One of the basic principles of the Brazilian Public Health System (SUS) is integral assistance, which considers the integrality of the individual, of service and care, which should necessarily include end of life care. Our aim was to analyze the work process of health professionals at the Family Health Strategy / Primary Care that already cared for people in the dying process to propose viable contributions to the Public Health area as regards the implementation of Palliative Care in Primary Care. We present data referring to the following themes: Singular Therapeutic Project (PTS); death quality as PTS goal (work purpose); the team's ways of doing (bonding as a pact condition). Eleven health professionals (four nurses and seven physicians) linked to the Family Health Strategy (ESF) of Campinas (São Paulo) participated on this research. From the interviews, data analysis followed the Socio-Historical Psychology theoretical and methodological approach. The professionals' activity was analyzed in articulation with the specificities of caring for people in the dying process. We found that action planning in health is oriented by the Singular Therapeutic Project (PTS), with an emphasis in social diagnosis and the need of a bond for attaining a pact. It is understood that the purpose of health professionals' activity is to promote dignity and life quality in the dying process, but integral care should include not only individual and family care, but also the defence of full human development during all phases of life.

Distribuição de fisioterapeutas entre estabelecimentos públicos e privados nos diferentes níveis de complexidade de atenção à saúde

Background: The Brazilian Health System is organized on a regional and hierarchical form with three levels of complexity of health care. The Primary Care represents the first element of a continuing health care process, complemented by specialized actions. However, the centrality of the specialized care is still a problem in Brazil, especially in the private sector. Studies on the distribution of professionals in the health system allowing the formulation of appropriate policies are needed. Objectives: To investigate the distribution of physical therapists in the levels of complexity of health care and between public and private establishments, according to data from the National Register of Health Service Providers (NRHSP). Method: A descriptive cross-sectional study was performed considering NRHSP-national bank data collected in March 2010 and demographic census 2010 data. Data were analyzed through descriptive statistics techniques. Results: We identified 53,181 registries of physical therapists, 60% linked to the private sector. Only 13% of all entries were linked to primary care. The predominance in specialized care occurred in the public sector (65%) and private sector (100%). The specialized establishments of private sector linked to the southeast region (16,043) were the main sites of physical therapists. Only the public sector in the south had a majority in the Primary Care. When considering the sizes of the cities, there is focus on specialist care in bigger cities. Conclusions: This study identified the concentration of physical therapists in the specialized care, mostly in metropolis and big cities and in the private sector, with restricted to participation in the primary care.

Planejamento em saúde bucal no município de João Pessoa, Estado da Paraíba: o cirurgiãodentista enquanto protagonista da atenção básica

The aim was to identify the perception of Oral Health Planning (OHP) of basic care (BC) dental surgeons (DSs) in João Pessoa, Paraíba State, Brazil. Seventeen BC DSs from João Pessoa were interviewed. A qualitative analysis was performed using the Discourse of the Collective Subject (DCS) methodology. DCS obtained: Impact - My work is effective when the user's need remains at the BC. Social Control - The population participates in the organization of promotional activities, but I think it doesn't have enough maturity to opine on OHP. OHP Basis and Organization - The OHP has a diverse organization and is based on user needs. It can be concluded that the knowledge of the DSs on OHP is varied. There is limited understanding about problem-solving. Social control is considered incipient and weak. It is understood that the organization of the local OHP assumes a diverse character and should be based on user demands.

Avaliação de usuários da atenção básica sobre a implantação de protocolo de assistência integral odontológica

Objective: To evaluate the perception of basic attention healthcare users as to the implantation of the Integral Dental Assistance Protocol (PAIO, in Portuguese) and the effect of this program on the oral health condition, oral hygiene, access to and resolubility of the service, in a public basic health unit of João Pessoa-PB. Method: The sample was composed of 32 volunteers, for whom a sixphase intervention was programed: diagnosis of dental needs; resolution of urgencies; restorative interventions; application of promotional measures; evaluation of the health level obtained; and periodic follow-up visits. Data were collected by means of a semistructured interview and a questionnaire, applied before and after PAIO implantation. The interviews were transcribed and analyzed according to the content analysis technique. The effect of PAIO implantation was evaluated by using an increasing scoring system ranging from 1 to 10. The Wilcoxon test was applied with a confidence level of 95%. Results: For the participants that attended the PAIO (n=20), the program contributed to improve oral health condition (100%) and knowledge (100%). The users reported satisfaction (n=12) and had a positive evaluation (n=12), achieved by means of the improvement of oral health condition (n=8), faster and easier access to treatment (n=7), scheduling of dental appoints and warrant of being treated (n=6), welcoming (n=5), motivation for oral care (n=5), and perspective of continuity of PAIO (n=6). The initial evaluation of the users received scores between 5.7 and 7.6. After PAIO implantation, the users' perception was improved (p<0.01), with scores between 9.6 and 9.9. Conclusion: According to the users, the implantation of PAIO contributed to the qualification of health service and oral health care, being a favorable aspect to increase the access to and resolubility of the service.

Intervenções farmacêuticas na atenção à saúde mental: Uma revisão

Uma revisão dirigida foi realizada nas bases de dados IBECS, LILACS e MEDLINE, até fevereiro/2011, para identificar intervenções farmacêuticas (IF) na atenção farmacêutica em saúde mental e os seus resultados. Para a busca utilizaram-se os descritores em saúde: Pharmaceutical Care, Pharmaceutical Services, Medication Adherence, Pharmacists, Mental Health, Mental Health Services, Mental Health Assistance, Community Mental Health Services, Mentally Ill Persons andMental Disorders. Identificaram-se 1686 publicações, das quais 21 contemplaram os critérios de inclusão. Após exploração do material, apenas cinco estudos tratavam-se de IF. Todos foram conduzidos no nível secundário de atenção, com abordagem individual, por meio do acompanhamento da terapia (3), intervenção educativa por cartas a médicos e pacientes (1), aconselhamento farmacêutico presencial e remoto e inserção de terapia com sistema transdérmico de nicotina (1). Os resultados, tais como promoção da adesão e resolução de problemas relacionados a medicamentos foram positivos para a terapêutica. No entanto, é necessário que as IF monitorem os parâmetros clínicos, as mudanças de hábitos, a melhora na qualidade de vida e os aspectos farmacoeconômicos a fim de avaliar os seus impactos. Palavras-chave:Atenção Farmacêutica. Assistência Farmacêutica. Adesão à Medicação. Farmacêuticos. Saúde Mental. ABSTRACT Pharmaceutical interventions in mental health services: a review A directed review was performed in IBECS, LILACS and MEDLINE databases, until February/2011, in order to identify the studies which developed pharmaceutical interventions (PI) in pharmaceutical care in mental health services and estimated their results. The search was carried out using the follow health science descriptors: Pharmaceutical Care, Pharmaceutical Services, Medication Adherence, Pharmacists, Mental Health, Mental Health Services, Mental Health Assistance, Community Mental Health Services, Mentally Ill Persons andMental Disorders. It was identified 1686 manuscripts, of whose 21 contemplated the inclusion criteria. After the content analysis of the eligible manuscripts, only five developed PI. All of them were conducted in the second level of health care, with individual approach, through: therapy follow-up (3), educational interventions by letters to physicians and patients (1), presence or remote pharmaceutical counseling and inclusion of therapy with nicotine transdermal patch (1). The data, such as adherence promotion and solving drug related problems, were positive for the therapeutic. However, it is necessary that the PI monitor the clinical parameters, the habit changes, the improvement in the quality of life and the pharmacoeconomic aspects, in order to assess their impacts. Keywords: Pharmaceutical Care. Pharmaceutical Services. Medication Adherence. Pharmacists. Mental Health. Mental Disorders.

Identificação precoce do risco para transtornos da atenção e da leitura em sala de aula

In this his study the accuracy was investigated of collective pedagogical activities, based on phonological judgments by matching figures and figures to spoken words, to identify students at risk for reading and/or attention disorders. Forty-five second graders (mean age of 7 years, 29 males) were divided into two groups, a control group, without reading difficulties (n=32), and an at-risk group, with reading difficulties (n=13). The low-achievement on these collective activities, defined by scores more than 1.65 SD below the mean of the control group, presented good sensitivity (true positives) and specificity (true negatives) in the early identification of at risk students.

Alterações do colágeno e do sistema elástico induzidas pela hiperatividade do detrusor em coelhos: ação da oxibutinina

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A Influência da atenção dirigida na coordenação bimanual de crianças

Pós-graduação em Ciências da Motricidade - IBRC