LIVER BIOPSY: IMPORTANCE OF SPECIMEN SIZE IN THE DIAGNOSIS AND STAGING OF CHRONIC VIRAL HEPATITIS

Liver biopsy is the gold standard method for the grading and staging of chronic viral hepatitis, but optimal biopsy specimen size remains controversial. The aim of this study was to evaluate the quality of liver specimen (number of portal tracts) and to evaluate the impact of the number of portal tracts in the staging of chronic hepatitis. Material and Methods: 468 liver biopsies from consecutive patients with hepatitis C virus and hepatitis B virus infection from 2009 to 2010 were evaluated. Results: The length of fragment was less than 10 mm in 43 cases (9.3%), between 10 and 14 mm in 114 (24.3%), and ≥ 15 mm in 311 (64.4%); of these, in 39 (8.3%) cases were ≥ 20 mm. The mean representation of portal tracts was 17.6 ± 2.1 (5-40); in specimens ≥ 15 mm the mean portal tract was 13.5 ± 4.7 and in cases ≤ 15 mm was 11.4 ± 5.0 (p = 0.002). Cases with less than 11 portal tracts were associated with F3, and cases with 11 or more portal tracts with F2 (p = 0.001). Conclusion: this study demonstrated the good quality of liver biopsy and a relationship between the macroscopic size of the fragment and the number of portal tracts.

Solvability of mental health care in the Family Health Strategy: social representation of professionals and users

Objective To aprehend the social representations about the solvability in mental health care with users of the Family Health Strategy and professionals of family health teams and of the Center for Psychosocial Care. Method A qualitative study using semi-structured interviews for data collection, and the Alceste software for analysis. This software uses the Hierarchical Descending Classification based on the examination of lexical roots, considering the words as units and providing context in the corpus. Results The representations emerge in two opposing poles: the users require satisfaction with care and the professionals realize the need for improvement of health actions. Although the matricial support in mental health and the home visits are developed, the barriers related to investment in health, continuing education and organization of care persist. Conclusion The different representations enable improvements in customer service, solvability of care and aggregate knowledge and practices in the expanded perspective of health needs in the family, social and therapeutic context.


Social representation of domestic violence against women among Nursing Technicians and Community Agents

OBJECTIVE To analyze the social representations of the Nursing Technicians and Community Health Agents about domestic violence against women. METHOD A qualitative study carried out in the city of Rio Grande, RS, in which evocations and interviews were collected between July and November 2013. For the treatment of data were used the EVOC 2005 software and the context analysis. RESULT It is a structured representation, in which the central nucleus contains conceptual, imaging and attitudinal elements, namely: abuse, aggression, physical aggression, cowardice and lack of respect. Such terms were present in the context of the interviews. The professionals acknowledged that violence is not limited to physical aspects and were judgemental about the acts of the aggressor. CONCLUSION This knowledge may enable the problematization of the studied phenomenon with the team, and facilitate the search for prevention and intervention strategies for victims, offenders and managers of health services.

Social representation of Alzheimer's disease for family caregivers: stressful and rewarding

Abstract OBJECTIVE To understand the content of Social Representation (SR) of family caregivers of Alzheimer's disease patients. METHOD Interviews were conducted with 26 caregivers and analyzed by the ALCESTE software. RESULTS The SR content was structured in two thematic axes called Daily Life and Care and Medical and Emotional Concepts and Outcomes. The first axis creates images related to the routine of interaction with the sick person, and contains a description of care procedures, experiences, and practices applied every day. The second is composed of subjective and conceptual aspects that make up the social representation of Alzheimer's disease, with meanings related to the emotional, medical, and biological contexts. CONCLUSION Due to the importance of topics related to patients' dependence and the personal and emotional consequences of the disease, overload is the main content of the SR of Alzheimer's disease for caregivers, and the understanding of these SR by health professionals should support the planning of interventions addressing this group of individuals.

Models, truth and realism: assessing Bas van Fraassen's views on scientific representation

This paper is devoted to an analysis of some aspects of Bas van Fraassen's views on representation. While I agree with most of his claims, I disagree on the following three issues. Firstly, I contend that some isomorphism (or at least homomorphism) between the representor and what is represented is a universal necessary condition for the success of any representation, even in the case of misrepresentation. Secondly, I argue that the so-called "semantic" or "model-theoretic" construal of theories does not give proper due to the role played by true propositions in successful representing practices. Thirdly, I attempt to show that the force of van Fraassen's pragmatic - and antirealist - "dissolution" of the "loss of reality objection" loses its bite when we realize that our cognitive contact with real phenomena is achieved not by representing but by expressing true propositions about them.

Correlation between the Alvarado Scale and the macroscopic aspect of the appendix in patients with appendicitis

Objective: To evaluate the possible association between the scale of Alvarado (EA) and macroscopic appearance (MA) of the appendix in patients with acute appendicitis.Methods: after receiving the diagnosis of acute appendicitis, EA data were collected. During appendectomy, MA data were collected. Data from patients without appendicitis were excluded. The Spearman correlation test was used to compare EA with Appendix MA (p < 0.05). Other variables were represented by simple frequency. The confidence interval (CI) of 95% was calculated for the correlation test.Results: Data were collected from 67 consecutive patients. The mean age was 37.1 ± 12.5 years and 77.6% of patients were male. The Spearman correlation test used for EA and MA was + 0.77 (95% CI 0.65-0.85, p < 0.0001).Conclusion: although correlation was not perfect, our data indicate that a high score on the scale of Alvarado in patients with appendicitis is correlated with advanced stages of the inflammatory process of acute appendicitis.

Macroscopic aspects of Saimiri sciureus dura mater

Saimiri sciureus is a small New World primate (NHP) commonly called macaco-de-cheiro that inhabits the tropical forests of the Amazon basin. Anatomical features are not well studied in most primates, and the encephalic morphology and related structures are still quite unknown. Comparative anatomy of the meninges in South American primates is still scarce. Dura mater, arachnoid and pia mater are a group of stratified layers that surrounds and promotes protection to the medulla spinalis. This study aimed to shed light on the anatomy of dura mater in Samiri sciureus in order to contribute to the neuroscience in primates. We investigated three young females and two males of S. sciureus. Specimens were fixed through perfusion with a 10% formaldehyde aqueous solution. In S. sciureus encephalus few gyrus and circunvolutions, and a very delicate system consisting of eight sinus venosus was found between the dura mater layers. Based on our findings, we can conclude that the Saimiri sciureus dura mater is quite similar to other mammals, however we detected a new sinus venosus formation at the level of parietal bone, named sinus parietalis, what appears to be its first description.

Macroscopic description of teeth of Azara's agouti (Dasyprocta azarae)

The teeth of Azara's agouti (Dasyprocta azarae) were described macroscopically in order to provide biological data on one of the largest wild rodents of the Americas. Radiography was taken on six heads and the teeth were described. Enamel surrounds the coronal dentin, projects to the roots and is present as parallel inner laminae in buccolingual direction. The dentin is located among the enamel laminae and surrounds the pulp horns. The cementum is located internally to the enamel laminae. On the lingual surface, the cementum and dentin are the outer elements.

Macroscopic description of the external and middle ear of paca (Cuniculus paca Linnaeus, 1766)

Abstract: Paca (Cuniculus paca), one of the largest rodents of the Brazilian fauna, has inherent characteristics of its species which can conribute as a new option for animal experimantation. As there is a growing demand for suitable experimental models in audiologic and otologic surgical research, the gross anatomy and ultrastructural ear of this rodent have been analyzed and described in detail. Fifteen adult pacas from the Wild Animals Sector herd of Faculdade de Ciências Agrárias e Veterinárias, Unesp-Jaboticabal, were used in this study. After anesthesia and euthanasia, we evaluated the entire composition of the external ear, registering and ddescribing the details; the temporal region was often dissected for a better view and detailing of the tympanic bulla which was removed and opened to expose the ear structures analyzed mascroscopically and ultrastructurally. The ear pinna has a triangular and concave shape with irregular ridges and sharp apex. The external auditory canal is winding in its path to the tympanic mebrane. The tympanic bulla is is on the back-bottom of the skull. The middle ear is formed by a cavity region filled with bone and membranous structures bounded by the tympanic membrane and the oval and round windows. The tympanic membrane is flat and seals the ear canal. The anatomy of the paca ear is similar to the guinea pig and from the viewpoint of experimental model has major advantages compared with the mouse ear.

A Well Stated Time Domain Integral Representation for Elastodynamic Analysis and Applications

This article discusses three possible ways to derive time domain boundary integral representations for elastodynamics. This discussion points out possible difficulties found when using those formulations to deal with practical applications. The discussion points out recommendations to select the convenient integral representation to deal with elastodynamic problems and opens the possibility of deriving simplified schemes. The proper way to take into account initial conditions applied to the body is an interesting topict shown. It illustrates the main differences between the discussed boundary integral representation expressions, their singularities and possible numerical problems. The correct way to use collocation points outside the analyzed domain is carefully described. Some applications are shown at the end of the paper, in order to demonstrate the capabilities of the technique when properly used.