O prontuário da família na perspectiva da coordenação da atenção à saúde

No Brasil, a saúde da família é uma estratégia de reorganização da atenção básica. Neste cenário, a coordenação da atenção, cuja essência é a disponibilidade de informações, apresenta-se como uma ferramenta para a qualificação das ações de saúde. Na Saúde da Família, o prontuário da família representa uma rica fonte de informações para a equipe de saúde desenvolver a coordenação da atenção. Os objetivos do estudo, descritivo com abordagem qualitativa, foram analisar o prontuário da família e seu conjunto informacional e identificar a "percepção" da equipe de saúde frente a sua sistematização, uso e importância para a coordenação e qualificação da atenção. Observou-se pequena padronização do registro da informação, da classificação e do arquivamento dos prontuários, além de pouco uso de seu conteúdo informacional. Notou-se que o emprego do prontuário da família para o exercício da coordenação não ocorreu a contento. Faz-se necessária uma melhor gestão deste documento, bem como sua efetiva utilização para favorecer a coordenação e a qualificação da atenção.

Elementi postmoderni nell'horror americano contemporaneo. Forme testuali e culturali della mutazione 1968-1998

This research argues for an analysis of textual and cultural forms in the American horror film (1968- 1998), by defining the so-called postmodern characters. The “postmodern” term will not mean a period of the history of cinema, but a series of forms and strategies recognizable in many American films. From a bipolar re-mediation and cognitive point of view, the postmodern phenomenon is been considered as a formal and epistemological re-configuration of the cultural “modern” system. The first section of the work examines theoretical problems about the “postmodern phenomenon” by defining its cultural and formal constants in different areas (epistemology, economy, mass-media): the character of convergence, fragmentation, manipulation and immersion represent the first ones, while the “excess” is the morphology of the change, by realizing the “fluctuation” of the previous consolidated system. The second section classifies the textual and cultural forms of American postmodern film, generally non-horror. The “classic narrative” structure – coherent and consequent chain of causal cues toward a conclusion – is scattered by the postmodern constant of “fragmentation”. New textual models arise, fragmenting the narrative ones into the aggregations of data without causal-temporal logics. Considering the process of “transcoding”1 and “remediation”2 between media, and the principle of “convergence” in the phenomenon, the essay aims to define these structures in postmodern film as “database forms” and “navigable space forms.” The third section applies this classification to American horror film (1968-1998). The formal constant of “excess” in the horror genre works on the paradigm of “vision”: if postmodern film shows a crisis of the “truth” in the vision, in horror movies the excess of vision becomes “hyper-vision” – that is “multiplication” of the death/blood/torture visions – and “intra-vision”, that shows the impossibility of recognizing the “real” vision from the virtual/imaginary. In this perspective, the textual and cultural forms and strategies of postmodern horror film are predominantly: the “database-accumulation” forms, where the events result from a very simple “remote cause” serving as a pretext (like in Night of the Living Dead); the “database-catalogue” forms, where the events follow one another displaying a “central” character or theme. In the first case, the catalogue syntagms are connected by “consecutive” elements, building stories linked by the actions of a single character (usually the killer), or connected by non-consecutive episodes about a general theme: examples of the first kind are built on the model of The Wizard of Gore; the second ones, on the films such as Mario Bava’s I tre volti della paura. The “navigable space” forms are defined: hyperlink a, where one universe is fluctuating between reality and dream, as in Rosemary’s Baby; hyperlink b (where two non-hierarchical universes are convergent, the first one real and the other one fictional, as in the Nightmare series); hyperlink c (where more worlds are separated but contiguous in the last sequence, as in Targets); the last form, navigable-loop, includes a textual line which suddenly stops and starts again, reflecting the pattern of a “loop” (as in Lost Highway). This essay analyses in detail the organization of “visual space” into the postmodern horror film by tracing representative patterns. It concludes by examining the “convergence”3 of technologies and cognitive structures of cinema and new media.

Proteolysis of the receptor for advanced glycation end products by matrix metalloproteinases

RAGE mediates diverse physiological and pathological effects by binding a variety of ligands. Despite incomplete understanding of RAGE-mediated disorders soluble RAGE (sRAGE) has been identified as a potential biomarker for RAGE-related diseases and possibly represents a hopeful pharmaceutical against RAGE-mediated disorders. Nevertheless, the source of sRAGE remains poorly investigated. Currently sRAGE is thought to be derived exclusively from alternative splicing of mRNA. In this thesis it was investigated whether sRAGE can also be released as a result of ectodomain shedding of full-length RAGE. Using cells overexpressing RAGE as a model system, it was demonstrated clearly that RAGE undergoes ectodomain shedding in both constitutive and regulated manner. Several stimuli including PMA, AMPA, calcium and chelerythrine stimulated the release of sRAGE into cell culture medium. Moreover, possible mechanisms that regulate ectodomain shedding of RAGE were investigated and it was found that shedding of RAGE is likely independent from PKC and MAPK pathways. By using gain of function and loss of function approaches MMP9 but not ADAM10, ADAM17 or MT1-MMP was characterized as the metalloproteinase that mediates shedding of RAGE. Furthermore, it was shown that cytoplasmic domain of RAGE is not essential for shedding of RAGE. In addition, the potential cleavage site of RAGE by MMP9 was investigated and a lack of sequence specificity for the RAGE processing proteinase was demonstrated by mutation analysis. Finally the physiopathological significance of shedding of RAGE is discussed. In conclusion, for the first time ectodomain shedding of human RAGE and the underlying regulatory mechanisms were investigated. The data open a new field for modulation of RAGE shedding as a novel intervention approach against RAGE-mediated diseases.

Sodium nitroprusside induces cell death and cytoskeleton degradation in adult rat cardiomyocytes in vitro: implications for anthracycline-induced cardiotoxicity

Sodium nitroprusside (SNP) is used clinically as a rapid-acting vasodilator and in experimental models as donor of nitric oxide (NO). High concentrations of NO have been reported to induce cardiotoxic effects including apoptosis by the formation of reactive oxygen species. We have therefore investigated effects of SNP on the myofibrillar cytoskeleton, contractility and cell death in long-term cultured adult rat cardiomyocytes at different time points after treatment. Our results show, that SNP treatment at first results in a gradual increase of cytoskeleton degradation marked by the loss of actin labeling and fragmentation of sarcomeric structure, followed by the appearance of TUNEL-positive nuclei. Already lower doses of SNP decreased contractility of cardiomyocytes paced at 2 Hz without changes of intracellular calcium concentration. Ultrastructural analysis of the cultured cells demonstrated mitochondrial changes and disintegration of sarcomeric alignment. These adverse effects of SNP in cardiomyocytes were reminiscent of anthracycline-induced cardiotoxicity, which also involves a dysregulation of NO with the consequence of myofibrillar degradation and ultimately cell death. An inhibition of the pathways leading to the generation of reactive NO products, or their neutralization, may be of significant therapeutic benefit for both SNP and anthracycline-induced cardiotoxicity.

Disclosing Sexual Assault Victimization to Others

Previous research has demonstrated that victims of sexual assault disclose their assaults most frequently to members of their intimate social circle. Unfortunately, some friends and family members give support in ways that are perceived as unhelpful by victims. The present study found that victims' reports and non-victims' expectations of positive support after disclosure differed significantly. These results indicate that significant efforts are needed to change the campus culture by increasing support for sexual assault victims.

[Long-term follow up after antithyroid drug treatment in Graves' disease]

In Europe antithyroid drug (ATD) therapy is the preferred initial treatment for patients with a first episode of Graves' disease. Results of long-term recurrence rates following ATD therapy are conflicting. The main goal was to assess long-term recurrence rate after ATD treatment. Secondarily we tried to verify chemical and clinical findings (thyrotropin receptor antibodies (TRAb), duration of primary treatment, age and goitre size) as predictive factors.

False positive dipstick for urinary blood in childhood

BACKGROUND: In view of the obvious practical advantages, the most common test for hematuria is currently a reagent strip. METHODS: A standardized microscopic examination of the sediment was performed in 20 asymptomatic children referred for evaluation of chronic isolated microhematuria detected by means of a reagent strip. RESULTS: In 6 of the 20 children the microscopic examination failed to confirm the result of the dipstick test. CONCLUSIONS: Confirmation for the presence of hematuria by microscopy is the most important step in children with a positive dipstick for urinary blood.