Melhoria da Atenção à Saúde de Hipertensos e/ou Diabéticos na ESF Gaspar Bartholomay Em Santa Cruz do Sul/RS

GUERRA, Juan Carlos Esquivel. Melhora da atenção à saúde de Hipertensos e/ou Diabéticos na ESF Gaspar Bartholomay em Santa Cruz do Sul/RS. 2015. 96f. Trabalho de Conclusão de Curso (Curso de Especialização em Saúde da Família) - Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, 2015. A Hipertensão Arterial Sistêmica (HAS) e Diabetes Mellitus (DM) são das causas de maior redução da expectativa de vida dos indivíduos, de incidência crescente, que apresenta alta morbimortalidade e também afetam prejudicialmente a qualidade de vida da população. A escolha do foco de intervenção voltado à atenção aos hipertensos e diabéticos tornou-se necessário para promover e desenvolver ações de prevenção, proteção, e promoção da saúde para melhorar a atenção aos adultos portadores de Hipertensão Arterial Sistêmica e/ou Diabetes Mellitus na área de abrangência da ESF Gaspar Bartholomay, em Santa Cruz do Sul-RS. O projeto foi estruturado para ser desenvolvido no período de 16 semanas e as ações foram planejadas de acordo com os quatro eixos pedagógicos, monitoramento e avaliação, organização e gestão do serviço, engajamento público e qualificação da Prática Clínica. A intervenção foi desenvolvida na ESF Gaspar Bartholomay, localizada no bairro Bom Jesus, na periferia da cidade. Há um grande grupo de fatores de risco na população, como tabagismo, abuso de drogas e hábitos alimentares inadequados. Ao longo da intervenção foram acompanhados 390 usuários residentes a área de abrangência da USF, sendo 284 (88,6%) portadores de Hipertensão Arterial, e 106(100%) usuários portadores de Diabetes Mellitus. Ao longo da intervenção os indicadores de qualidade foram mantidos em 100% durante todo o período. A implementação do projeto de intervenção foi de grande importância para comunidade assistida devido ao aumento do número de atendimentos deste grupo da população, melhorou a organização e qualidade da atividade de promoção de saúde, assim como aumento conhecimento da população referente ao autocuidados para diminuir fatores de riscos e melhorar qualidade de vida. Melhorou o engajamento com líderes comunitários e com os gestores para maior apoio nas atividades. Os líderes comunitários em atividades de divulgação e gestores em fornecimento de recursos necessários para atendimento integralizado, com mais organização do serviço e planejamento das ações do HIPERDIA. Ao término da intervenção a equipe ficou mais capacitada para prestar atendimento de qualidade.

A quantidade de matéria nas ciências clássicas

The chemical amount values vary in a discrete or continuous form, depending on the approach used to describe the system. In classical sciences, the chemical amount is a property of the macroscopic system and, like any other property of the system, it varies continuously. This is neither inconsistent with the concept of indivisible particles forming the system, nor a mere approximation, but it is a sound concept which enables the use of differential calculus, for instance, in chemical thermodynamics. It is shown that the fundamental laws of chemistry are absolutely compatible to the continuous concept of the chemical amount.

Condições de equilíbrio termodinâmico: a função disponibilidade

The thermodynamic equilibrium is a state defined by conditions which depend upon some characteristics of the system. It requires thermal, mechanical, chemical and phase equilibrium. Continuum thermodynamics, its radical restriction usually called homogeneous processes thermodynamics, as well as the classical thermodynamic science of reversible processes, each of them defines equilibrium in a differing way. But these definitions lead to the same physical contents.

A segunda lei da termodinâmica

Considering intrinsic characteristics of the system exclusively, both statistical and information theory interpretations of the second law are used to provide more comprehensive meanings for the concepts of entropy, temperature, and Helmholtz and Gibbs energies. The coherence of Clausius inequality to these concepts is emphasized. The aim of this work is to re-discuss the second law of thermodynamics in accordance to homogeneous processes thermodynamics, a temporal science which is the very special oversimplification of continuum mechanics for spatially constant intensive properties.

Efeitos cardiorrespiratórios e analgésicos da cetamina por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur

A cetamina tem demonstrado efeito analgésico em doses subanestésicas, além da manutenção da estabilidade dos parâmetros fisiológicos. O estudo objetivou avaliar os efeitos cardiorrespiratórios e a analgesia pós-operatória da cetamina administrada por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur. Foram utilizadas 25 cadelas, hígidas, distribuídas aleatoriamente em quatro grupos: CEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural), CIV (lidocaína 2% via epidural e 1mg kg-1 de cetamina IV seguido de infusão contínua IV com 100µg kg min-1 da mesma), CIVEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural e 1mg kg-1 de cetamina IV, seguido de infusão contínua IV com 100µg kg min-1) e CON (anestesia epidural com lidocaína 2%). Avaliaram-se FC, f, PAS, PAM, PAD, T°C, tempo de bloqueio motor e analgesia pós-operatória por meio de escala analógica visual. Houve elevação da FC no CIV e diminuição desse parâmetro no CEP. As pressões arteriais mantiveram-se dentro dos valores fisiológicos e não foram observadas diferenças na f e T°C. O tempo de duração do bloqueio anestésico foi potencializado nos grupos que receberam cetamina epidural, diferindo significativamente em relação ao controle. O tempo para a analgesia resgate não diferiu entre os grupos. Conclui-se que a administração de cetamina pela via epidural, por infusão contínua intravenosa ou pela associação de ambas promoveu estabilidade cardiorrespiratória no período transcirúrgico, porém não foi capaz de prolongar a duração da analgesia pós-operatória em cães submetidos à osteossíntese de fêmur.

Psicologia da Religião no Brasil: a produção em periódicos e livros

Apresenta-se apreciação crítica da Psicologia da Religião no Brasil, no período de 1956 a 2005, realizada com base em artigos publicados principalmente em periódicos nacionais de Psicologia. Avaliaram-se 125 artigos, segundo o tema, a teoria e a metodologia. Observou-se tendência de aumento gradativo do número de publicações. Os temas preferidos foram saúde, experiência religiosa, vocação, identidade e relações entre psicologia e religião. A produção revela utilização de teorias, conceitos e métodos da linha-mestra da Psicologia. A apreciação crítica é contextualizada em termos da origem da Psicologia da Religião no Brasil, da sua institucionalização acadêmica e dos eventos que resultaram numa literatura científica específica.

New insights into Vogt-Koyanagi-Harada disease

Vogt-Koyanagi-Harada disease (VKH), a well-established multiorgan disorder affecting pigmented structures, is an autoimmune disorder of melanocyte proteins in genetically susceptible individuals. Several clinical and experimental data point to the importance of the effector role of CD4+ T cells and Th1 cytokines, the relevance of searching a target protein in the melanocyte, and the relevance of the HLA-DRB1*0405 in the pathogenesis of the disease. Vogt-Koyanagi-Harada disease has a benign course when early diagnosed and adequatey treated. Full-blown recurrences are rare after the acute stage of Vogt-Koyanagi-Harada disease is over. On the other hand, clinical findings, such as progressive tissue depigmentation (including sunset glow fundus) and uveitis recurrence, indicate that ocular inflammation may persist after the acute phase. Additionally, indocyanine green angiography findings suggest the presence of choroidal inflammation in eyes without clinically detectable inflammation. The aim of this paper is to review the latest research results on Vogt-Koyanagi-Harada disease pathogenesis and chronic/convalescent stages, which may help to better understand this potentially blinding disease and to improve its treatment.

Relationship between median nerve somatosensory evoked potentials and spinal cord injury levels in patients with quadriplegia

Study design: Cross-sectional study. Objectives: To observe if there is a relationship between the level of injury by the American Spinal Cord Injury Association (ASIA) and cortical somatosensory evoked potential (SSEP) recordings of the median nerve in patients with quadriplegia. Setting: Rehabilitation Outpatient Clinic at the university hospital in Brazil. Methods: Fourteen individuals with quadriplegia and 8 healthy individuals were evaluated. Electrophysiological assessment of the median nerve was performed by evoked potential equipment. The injury level was obtained by ASIA. N(9), N(13) and N(20) were analyzed based on the presence or absence of responses. The parameters used for analyzing these responses were the latency and the amplitude. Data were analyzed using mixed-effect models. Results: N(9) responses were found in all patients with quadriplegia with a similar latency and amplitude observed in healthy individuals; N(13) responses were not found in any patients with quadriplegia. N(20) responses were not found in C5 patients with quadriplegia but it was present in C6 and C7 patients. Their latencies were similar to healthy individuals (P > 0.05) but the amplitudes were decreased (P < 0.05). Conclusion: This study suggests that the SSEP responses depend on the injury level, considering that the individuals with C6 and C7 injury levels, both complete and incomplete, presented SSEP recordings in the cortical area. It also showed a relationship between the level of spinal cord injury assessed by ASIA and the median nerve SSEP responses, through the latency and amplitude recordings. Spinal Cord (2009) 47, 372-378; doi:10.1038/sc.2008.147; published online 20 January 2009

Oxidative stress biomarkers of exposure in the blood of cichlid species from a metal-contaminated river

The oxidative stress biomarkers of exposure, such as reduced glutathione (GSH), activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) and the levels of lipid peroxidation (LPO), were measured in the blood of three cichlid fish (Oreochromis niloticus, Tilapia rendalli, and Geophagus brasiliensis) taken during two seasons from two sites, unpolluted and polluted by industrial effluents, to evaluate the effectiveness of these biomarkers in assessing the impact of water contamination. The LPO levels in the blood were higher in fish from the metal-contaminated site and the chronic exposure led to significant changes in GPx, CAT, and SOD activities in all three cichlid species. The considerable variation of responses in these cichlids to water contamination evidenced differences in sensitivity to the metal contamination and/or in the potential to respond to it highlighting the importance of using a set of related biomarkers to assess the impact of water contamination. (C) 2007 Elsevier Inc. All rights reserved.

Brassinosteroids interact negatively with jasmonates in the formation of anti-herbivory traits in tomato

Given the susceptibility of tomato plants to pests, the aim of the present study was to understand how hormones are involved in the formation of tomato natural defences against insect herbivory. Tomato hormone mutants, previously introgressed into the same genetic background of reference, were screened for alterations in trichome densities and allelochemical content. Ethylene, gibberellin, and auxin mutants indirectly showed alteration in trichome density, through effects on epidermal cell area. However, brassinosteroids (BRs) and jasmonates (JAs) directly affected trichome density and allelochemical content, and in an opposite fashion. The BR-deficient mutant dpy showed enhanced pubescence, zingiberene biosynthesis, and proteinase inhibitor expression; the opposite was observed for the JA-insensitive jai1-1 mutant. The dpyxjai1-1 double mutant showed that jai1-1 is epistatic to dpy, indicating that BR acts upstream of the JA signalling pathway. Herbivory tests with the poliphagous insect Spodoptera frugiperda and the tomato pest Tuta absoluta clearly confirmed the importance of the JA-BR interaction in defence against herbivory. The study underscores the importance of hormonal interactions on relevant agricultural traits and raises a novel biological mechanism in tomato that may differ from the BR and JA interaction already suggested for Arabidopsis.

Skin Penetration of Epigallocatechin-3-Gallate and Quercetin from Green Tea and Ginkgo biloba Extracts Vehiculated in Cosmetic Formulations

Green tea (Camellia sinensis) and Ginkgo biloba extracts in cosmetic formulations have been suggested to protect the skin against UV-induced damage and skin ageing. Thus, it is very important to assess the human skin penetration of their major flavonoids to verify if they penetrate and remain in the skin to exert their proposed effects. The aim of this study was to evaluate the human skin penetration of epigallocatechin-3-gallate (EGCG) and quercetin from green tea and G. biloba extracts vehiculated in cosmetic formulations. This study was conducted with fresh dermatomed human Caucasian skin from abdominal surgery mounted on static Franz diffusion cells. Skin samples were mounted between two diffusion half-cells and 10 mg/cm(2) of formulations supplemented with 6% of green tea or G. biloba extract were applied on the skin surface. The receptor fluid was removed after 6 and 24 h and analyzed by high-performance liquid chromatography for the quantification of the flavonoids. The stratum corneum was removed by tape stripping and immersed in methanol and the epidermis was mechanically separated from the dermis and triturated in methanol to extract EGCG and quercetin. The results showed that the flavonoids under study penetrated into the skin, without reaching the receptor fluid. The majority of EGCG was quantified in the stratum corneum (0.87 mu g/cm(2)), which was statistically higher than the EGCG concentrations found in viable epidermis (0.54 mu g/cm(2)) and in the dermis (0.38 mu g/cm(2)). The majority of quercetin was quantified in the viable epidermis (0.23 mu g/cm(2)), which was statistically higher than the EGCG concentration found in the stratum corneum layer (0.17 mu g/cm(2)). Finally, it can be concluded that EGCG and quercetin from green tea and G. biloba extracts vehiculated in cosmetic formulations presented good skin penetration and retention, which can favor their skin effects. Copyright (C) 2009 S. Karger AG, Basel

In vitro antioxidant activity and in vivo efficacy of topical formulations containing vitamin C and its derivatives studied by non-invasive methods

Background/purpose: Vitamins C and its derivatives, mainly due to their antioxidant properties, are being used in cosmetic products to protect and to reduce the signs of ageing. However, there are no studies comparing the effects of vitamin C [ascorbic acid (AA)] and its derivatives, magnesium ascorbyl phosphate (MAP) and ascorbyl tetra-isopalmitate (ATIP), when vehiculated in topical formulations, mainly using objective measurements, which are an important tool in clinical efficacy studies. Thus, the objective of this study was to determine the in vitro antioxidant activity of AA and its derivatives, MAP and ATIP, as well as their in vivo efficacy on human skin, when vehiculated in topical formulations. Methods: The study of antioxidant activity in vitro was performed with an aqueous and a lipid system. The in vivo methodology consisted of the application of these formulations on human volunteers` forearm skin and the analysis of the skin conditions after 4-week period daily applications in terms of transepidermal water loss (TEWL), stratum corneum moisture content and viscoelasticity using a Tewameter (R), Corneometer (R) and Cutometer (R), respectively. Results: In vitro experiments demonstrated that in an aqueous system, AA had the best antioxidant potential, and MAP was more effective than ATIP, whereas in the lipid system ATIP was more effective than MAP. In in vivo studies, all formulations enhanced stratum corneum moisture content after a 4-week period daily applications when compared with baseline values; however, only the formulation containing AA caused alterations in TEWL values. The formulations containing MAP caused alterations in the viscoelastic-to-elastic ratio, which suggested its action in the deeper layers of the skin. Conclusion: AA and its derivates presented an in vitro antioxidant activity but AA had the best antioxidant effect. In in vivo efficacy studies, only the formulation containing AA caused alterations in TEWL values and the formulation containing MAP caused alterations in the viscoelastic-to-elastic ratio. This way, vitamin C derivatives did not present the same effects of AA on human skin; however, MAP showed other significant effect-improving skin hydration, which is very important for the normal cutaneous metabolism and also to prevent skin alterations and early ageing.

Influence of the Photostabilizer in the Photoprotective Effects of a Formulation Containing UV-Filters and Vitamin A

Vitamin A palmitate has been used in cosmetics; however, studies report that this substance shows photoreactivity that can lead to loss of safety and efficacy. On the other hand, photostabilizers have been used to increase sunscreen photostability and consequently their safety and effectiveness. Thus, this study aimed to evaluate the influence of photostabilizers on the photoprotective effects of a cosmetic formulation containing UV-filters and vitamin A palmitate. The formulation containing UV-filters was supplemented with vitamin A palmitate and the photostabilizers diethylhexyl 2,6-naphthalate (DEHN), bumetrizole and benzotriazolyl dodecyl p-cresol (BTDC). Hairless mice were treated daily by topical applications and irradiated (UVA/B). Erythema index, transepidermal water loss, histological/histometric analysis and number of sunburn cells (SBC) were evaluated. The results showed that all formulations protected from UV-induced enhancement of erythema and SBC but there was no difference among them. The formulation with no stabilizers reduced viable epidermis thickness due to atrophy induced by UV radiation. Thus, it can be concluded that the presence of photostabilizers influenced the effects of formulations containing UV-filters and vitamin A palmitate, which could be seen by histological and histometric analysis. Furthermore, the formulations containing the stabilizers DEHN and BTDC showed better protective effects on hairless mice skin.

A HPLC method to evaluate the influence of photostabilizers on cosmetic formulations containing UV-filters and vitamins A and E

This paper reports a simple and reliable HPLC method to evaluate the influence of two currently available photostabilizers on cosmetic formulations containing combined UV-filters and vitamins A and E. Vitamins and UV-filters, widely encountered in products of daily use have to be routinely evaluated since photoinstability can lead to reductions in their efficacy and safety. UV-irradiated formulation samples were submitted to a procedure that included a reliable, precise and specific HPLC method employing a C18 column and detection at 325 and 235 nm. Methanol, isopropanol and water were the mobile phases in gradient elution. The method precision was between 0.28 and 5.07. The photostabilizers studied [diethylhexyl 2,6-naphthalate (DEHN) and benzotriazolyl dodecyl p-cresol (BTDC)], influenced the stability of octyl methoxycinnamate (OMC) associated with vitamins A and E. BTDC was considered the best photostabilizer to vitamins and OMC when the UV-filters were combined with both vitamins A and E. (C) 2010 Elsevier B.V. All rights reserved.

Evaluation of dermatological effects of cosmetic formulations containing Saccharomyces cerevisiae extract and vitamins

Saccharomyces cerevisiae extract (SCE) is used in cosmetics since it can act in oxidative stress and improve skin conditions. This study investigated dermatological effects of cosmetic formulations containing SCE and/or vitamins A, C and E. The formulation studied was supplemented or not (F1: vehicle) with vitamins A, C and E esters (F2) or with SCE (F3) or with the combination of vitamins and SCE (F4). Formulations were patch tested on back skin of volunteers. For efficacy studies, formulations were applied on volunteers and transepidermal water loss (TEWL), skin moisture (SM), skin microrelief (SMR) and free radicals protection were analysed after 3 h, 15 and 30 days of application. Volunteers were also asked about efficacy perception. It was observed that F4 provoked a slight erythema in one volunteer. All formulations enhanced forearm SM. Only F3 and F4 presented long term effects on SMR and showed higher texture values; F3 had the highest brightness values. Our results suggest that vitamins and SCE showed effects in SM and SMR. Only formulations containing SC had long term effects in the improvement of SMR. Thus, these kinds of evaluations are very important in cosmetics development to evaluate the best risk and benefit correlation. (C) 2008 Elsevier Ltd. All rights reserved.