O ambulatório de Saúde Mental no contexto da Reforma Psiquiátrica em Natal/RN

The years 1990 disclose the consolidation of the Brazilian Psychiatric Reform project, assumed as official politics by the Health Department, also stirring up discussions, lines of direction and new ways of care. Substitutive services to the psychiatric hospital as CAPS, conviviality centers, therapeutical residences and ambulatory clinics are implemented. This work analyzes the relations that the Specialized Ambulatory Clinic of Ribeira establishes to the services of Mental Health of the public system in the city of Natal/RN, as well as its adjustment to the proposal of the Psychiatric Reform. Through semi-structured interviews and observation, it was possible to gather data which allowed picturing a general characterization of the service: activities, technical group, joint with other institutions, daily routine organization. Such institution develops activities that surpass the traditional character of a clinic- in other words, the psychological/medical appointments - and it mainly greets the ones proceeding from CAPS and psychiatric hospitals. It offers group activities, psychiatric appointments, therapeutical workshops, sheltering and strolls, among others. The institution is composed by a multi-professional team of psychiatrists, psychologists, occupational therapists, nurse s aide and art-educator. The joint of this service with others that make part of the Mental Health Assistance network in Natal is incipient. Due to this fact, some actions and activities that could and should be developed together are just not. Although facing difficulties, the professionals of the Ambulatory Clinic of Ribeira are able to achieve good results and establish care in Mental Health that prioritize sheltering, listening and respect to the user s individuality. The Ambulatory Clinic of Ribeira is organized according to the paradigm of the Psychiatric Reform. Therefore, it offers an attention that stimulates the re-socialization of the users and the exercise of the citizenship and autonomy of those

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Tinea capitis: epidemiologia e ecologia dos casos observados entre 1983 e 2003 na Faculdade de Medicina de Botucatu, Estado de São Paulo, Brasil

FUNDAMENTOS: Tinea capitis é importante infecção fúngica de interesse dermatológico e pediátrico. No Brasil sua prevalência é desconhecida, e os agentes causais principais são o Trichophyton tonsurans nas regiões Norte-Nordeste e o Microsporum canis no Sul-Sudeste do país. Conhecimento sobre gênero e espécies mais prevalentes tem importância sanitária e terapêutica. OBJETIVOS: Identificar espécies de dermatófitos, causa de Tinea capitis, em serviço universitário que atende clientela do Sistema Único de Saúde, de procedência urbana e rural, no interior do Estado de São Paulo. MÉTODOS: Amostras de casos clínicos suspeitos de Tinea capitis, procedentes da área de abrangência da Faculdade de Medicina de Botucatu-Unesp, foram investigadas por exame direto e cultivo visando ao diagnóstico e isolamento do agente causal. RESULTADOS: de 1.055 suspeitas, 594 foram confirmadas por exame direto, em 364 (61,1%) isolou-se o agente: M. canis em 88,2%, seguindo-se T. tonsurans (4,7%), T. rubrum (3,3%), M. gypseum (1,9%), T. mentagrophytes (1,6%). O sexo masculino correspondeu a 55,7% dos casos, e a faixa etária entre 0-5 anos predominou com 62,6% (p < 0,05). CONCLUSÕES: A prevalência detectada do M. canis superou o esperado para a Região Sudeste do Brasil. A freqüência de 88,2% pode estar influenciada por pacientes procedentes da zona rural. Esse dado deve ser considerado quando de decisão terapêutica.

Protective action of propolis on the rat colon carcinogenesis

Propolis is a honeybee product with several biological and therapeutical properties. Its effect on the process of colon carcinogenesis and DNA damage were evaluated in the male Wistar rats using the aberrant crypt foci (ACF) assay and the comet assay, respectively. For both tests, animals were treated with the colon carcinogen 1,2 dimethylhydrazine (DMH, 40 mg/kg, s.c.) for 2 weeks (two injections/week) in order to induce both DNA damage and ACF. The animals were divided into groups that received propolis (ethanolic extract) at three different doses (10, 30, and 90 mg/kg b.w., by gavage), either simultaneously or after DMH treatment. For the comet assay, peripheral blood samples were collected 4 h after the last DMH treatment. All animals were sacrificed at the 5th week for evaluation of ACF. The results show that only the intermediate dose (30 mg/kg) of propolis, administered after DMH initiation, is significantly associated to a smaller number of aberrant crypts in the distal colon. No effect on DNA damage in peripheral blood cells, however, was verified by the comet assay. These data suggest that propolis has a protective influence on the process of colon carcinogenesis, suppressing the development of preneoplastic lesions, and probably exerts no protection against the initiation of carcinogenesis.

Acupuntura: histórico, bases teóricas e sua aplicação em Medicina Veterinária

A acupuntura (AP) é uma técnica terapêutica empírica desenvolvida em uma cultura oriental e que utiliza pensamento mágico (linguagem pré-científica) em seu raciocínio. É uma terapia reflexa que utiliza a estimulação de pontos específicos do corpo com objetivo de atingir um efeito terapêutico ou homeostático. A AP preconiza que a saúde é dependente das funções psico-neuro-endócrinas, sob influência do código genético e de fatores extrínsecos como nutrição, hábitos de vida, clima, qualidade do ambiente, entre outros. O presente artigo faz uma breve revisão sobre a filosofia da AP, seus marcos históricos na China e no Ocidente, a história da AP veterinária no Brasil e no mundo. Também aborda a prática da AP, incluindo as formas de diagnóstico, a definição do protocolo de tratamento, os métodos de estimulação dos pontos, o agulhamento de animais, suas indicações, contra-indicações e reações adversas.

Trombectomia com cateter de Fogarty no tratamento da tromboflebite jugular experimental em eqüinos

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

Processo de reparo em feridas de extração dentária em camundongos tratados com o complexo Symphytum officinale e Calendula officinallis

Medicamentos homeopáticos como o Symphytum officinalle e a Calendula officinallis são dotados de propriedades anti-sépticas, antiinflamatória, cicatrizantes e também agem como promotores da consolidação de fraturas ósseas. Neste trabalho, uniram-se esses dois medicamentos similares em um complexo para verificar o seu efeito no reparo em feridas de extração dentária em camundongos. O complexo Symphytum officinalle e Calendula officinallis nas potências de 6CH e 3CH, respectivamente, foi ministrado por via oral ao grupo tratado durante 5 dias antes e após a extração do incisivo superior direito. No grupo controle, administraram-se 5ml de álcool etílico a 70% diluídos em 30 ml de soro fisiológico. Após a proservação, os animais foram sacrificados, a maxila direita separada da esquerda, fixada e processada para inclusão em parafina. Após a microtomia, os cortes obtidos foram corados pela H/E. A análise histológica mostrou que, tanto no grupo controle como no tratado, o alvéolo dentário estava preenchido por tecido de granulação e tecido ósseo neoformado, com graus variáveis de maturação, rico em osteócitos. No entanto, nos animais tratados, o processo de reparo em feridas após extração dentária do incisivo superior direito mostrou um avanço progressivo de neoformação óssea mais acentuado quando comparado ao grupo controle, em tempos equivalentes. Estes resultados enfatizam as propriedades biológicas do complexo Symphytum officinalle e Calendula officinallis e sua possível utilização como recurso terapêutico na Odontologia.

Mutagenicity of Flavonoids Assayed by Bacterial Reverse Mutation (Ames) Test

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

Observation of initial clinical manifestations and repercussions from the treatment of 314 human injuries caused by black sea urchins (Echinometra lucunter) on the southeastern Brazilian coast

INTRODUÇÃO: Os acidentes causados por ouriços-do-mar são as ocorrências por animais marinhos mais comuns no país. O ouriço-do-mar preto (Echinometra lucunter) é a espécie que mais causa ferimentos em banhistas. MÉTODOS: Este trabalho registrou e estudou 314 agravos com ênfase nas manifestações clínicas iniciais observadas e suas implicações na terapêutica recomendada. RESULTADOS: Todos os acidentes foram causados pelo ouriço-do-mar preto e aconteceram em banhistas. As lesões e a dor foram associadas ao trauma causado pela penetração das espículas (não ocorreu inflamação ou dor imediata sem pressão sobre os pontos comprometidos). As complicações deste tipo de acidente, incluindo infecções e granulomas de corpo estranho, estão associadas com a permanência das espículas nos ferimentos. CONCLUSÕES: Foi confirmado o fato do acidente causado por esta espécie ser o mais comum no Brasil e apresentar caráter traumático, sendo a principal recomendação a retirada precoce dos espinhos para prevenção de complicações tardias como as infecções e formação de granulomas de corpo estranho.

Transtorno bipolar do humor e gênero

Although the bipolar disorder (BD) occurs almost with the same frequency in both genders, the phenomenology and the outcome of the illness differ between them. Nevertheless, there is evidence that women with BD show, more than men, delayed beginning, especially in their fifth decade, more rapid cycling outcome, more depressive episodes, more dysphoric mania, more mixed states and more BD type II. Even so, the findings are not always consistent. Although the risk of comorbidities in BD includes, for both the sorts, excessive alcoholic consumption and drugs, bipolar men would have greater probability of being alcohol dependent, of not seeking treatment and of committing suicide. Suggested hypotheses to explain such differences vary from those centered in cultural or psychological aspects to those that focus on the steroids hormones, and other hormones such as cortisol, thyroid hormones and even on the cerebral anatomy. The reproductive cycle (menstrual cycle, pregnancy and menopause) influences on the BD phenomenology and its relevance to the therapeutical options in the treatment of the BD in women are presented in the last part of this review. Further investigations must to be done in order to clarify this controversy. However, up to now the data indicate that estrogen therapy is not to be primarily indicated to prevent depression, Alzheimer disease or cognition impairment.

Constipação intestinal

It was reviewed the definition, mechanisms and classification of functional constipation. The diagnostic resources available were showed and it was underlined the importance to investigate and exclude the multiple causes of secondary constipation. The therapy was divided in general measures, like diet and specialized, involving laxatives and others alternatives. It was commented the different categories of laxatives, their actions and adverse effects. It was concluded that the best approach to functional defecatory disorder is biofeedback. Otherwise, for defecatory disturbance caused by mechanical obstruction and refractory constipation due to slow transit the therapeutical option is surgery.

Advances in sickle cell disease treatment: From drug discovery until the patient monitoring

Sickle Cell Disease (SCD) is one of the most prevalent hematological diseases in the world. Despite the immense progress in molecular knowledge about SCD in last years few therapeutical sources are currently available. Nowadays the treatment is performed mainly with drugs such as hydroxyurea or other fetal hemoglobin inducers and chelating agents. This review summarizes current knowledge about the treatment and the advancements in drug design in order to discover more effective and safe drugs. Patient monitoring methods in SCD are also discussed. © 2011 Bentham Science Publishers Ltd.

Mutagenic and genotoxic effect of hydroxyurea

The hydroxyurea, a cytotoxic drug, is the mainly available therapeutical strategy for the treatment of sickle cell disease. This study aimed to evaluate the mutagenic and genotoxic potential of the hydroxyurea through the Salmonella/Microsome assay and micronucleus test in peripheral blood of mice. The doses were evaluated at 29.25-468 μmol/plate in Salmonella/Microsome assay in presence and absence of metabolic activation the drug. In the micronucleus test the doses were evaluated at 12.5; 25; 50; 75 and 100 mg/kg. The results show that hydroxyurea present mutagenic activity in TA98 and TA100 in doses above 117 μmol/plate and 234 μmol/plate respectively. The drug induced a significant increase in the frequency of micronuclei in reticulocytes of mice at concentrations of 50, 75 and 100 mg/kg, compared to negative control (water). These results demonstrated the mutagenic and genotoxic potential of hydroxyurea. © 2011 Santos et al.

Causes of resistant hypertension detected by a standardized algorithm

Resistant hypertension (RH) is characterized by blood pressure above 140 × 90 mm Hg, despite the use, in appropriate doses, of three antihypertensive drug classes, including a diuretic, or the need of four classes to control blood pressure. Resistant hypertension patients are under a greater risk of presenting secondary causes of hypertension and may be benefited by therapeutical approach for this diagnosis. However, the RH is currently little studied, and more knowledge of this clinical condition is necessary. In addition, few studies had evaluated this issue in emergent countries. Therefore, we proposed the analysis of specific causes of RH by using a standardized protocol in Brazilian patients diagnosed in a center for the evaluation and treatment of hypertension. The management of these patients was conducted with the application of a preformulated protocol which aimed at the identification of the causes of resistant hypertension in each patient through management standardization. The data obtained suggest that among patients with resistant hypertension there is a higher prevalence of secondary hypertension, than that observed in general hypertensive ones and a higher prevalence of sleep apnea as well. But there are a predominance of obesity, noncompliance with diet, and frequent use of hypertensive drugs. These latter factors are likely approachable at primary level health care, since that detailed anamneses directed to the causes of resistant hypertension are applied. © 2012 Livia Beatriz Santos Limonta et al.

Avaliação do potencial antimutagênico de extrato etanólico de própolis verde e de Baccharis dracunculifolia (Asteraceae), por meio de sistema-teste de Allium e células de mamíferos (HTC)

Pós-graduação em Ciências Biológicas (Biologia Celular e Molecular) - IBRC