Compreendendo a experiência de pessoas portadoras de transtorno mental: histórias de vidas severinas repletas de possibilidades

This study aims to understand the experience of people suffering from mental disorder. The patients are enrolled in a mental health ambulatory clinic in the city of Natal (RN). Mental disorders are growing rapidly in the contemporary world and are a source of intense mental suffering. Besides patients being strongly marked by a history of isolation and prejudice, they have been the target of real atrocities committed in the name of preservation of a supposed normality. The understanding and treatment of this disorder is influenced by cultural and historical inferences, depending on the period in which it is experienced. Semi-directed Interviews were conducted with a group of users, with the emphasis on giving voice to their uniqueness and individuality, highlighting how each one perceives his or her own experience. These were recorded and later transcribed by identifying the core of meanings. The results were analyzed under the gaze of the Humanist Phenomenology Existential perspective, which aims to unravel the phenomenon, without truths from volatility, highlighting the existence of the mental disorder as a way of living, being permeated by suffering mental and influenced by social problems, assuming contours very particular to each individual. Some progress has been perceived, even by users, with respect to the change of paradigm in the way of care, but still there is a consistent emphasis on medical and drug use. The changes point to the need for offering services to replace the asylum hospital model, and in addition to accept the bearer of mental disorder as a citizen, a bearer of rights who should be accepted and respected by society. Despite the pain expressed and its close liaison with suicide, their reports are full of perspectives and attitudes of confrontation facing life, pointing to new possibilities to be, recreating itself

Em defesa da reforma psiquiátrica :por um amanhã que há de renascer sem pedir licença

Insanity was victim of several arbitrary acts perpetrated on behalf of the science. Psychiatric reform constitues an important movement which has attempted to rescue dignity and humanity in the treatment of mental disorder patients. Some countries have advanced in the implement of substutive models that work on the construction of a new social place for madness. The model of attention to mental health in Brazil has also suffered extensive modifications due to the wearing out of the psychiatric hospital model. In Santos, a town in the State of Sao Paulo, we have found a landmark in the development of an anti internment politics, through the creation of a dail care service, including psychosocial assistance. It is in this context that it has been founded in Natal, Rio Grande do Norte, the NAPS and CAPS ( Nucleus and Centres of Psychosocial Attention), municipal strategies that put into effect the law # 10.216/2001, which estabilishes the gradual extinction of psychiatric hospitals. This work has the purpose of carrying out a study about the historical process of psychiatric reform implantation in the State of Rio Grande do Norte, emphasizing the actors involved in process, their trajectory, achievements, improvements, and the movement s perspectives of achieving the ideal of reinstating mental disorder patients. In order to accomplish this purpose, it was necessary to understand the process occurred at the Municipal Secretary s Office for Health, since 1992, for it was the impelling experience towards the reflections about the psychiatric reform in the State of Rio Grande do Norte. The instruments used for this work were documentary analysis, through reports, legislation and handbooks, as well as the staments of people involved in this process. Through the statements analysis, we attempted to estabilish the social actors identity, their perception, emphasizing congruences and incongruences concerning the history of psychiatric reform in the State of Rio Grande do Norte. It is also analyzed the contribution of Psychology in this process, which has become a protagonist in the struggle for the rights of mental disorder patients

Ajuda mútua nos CAPS: o papel dos serviços no empoderamento dos usuários

The research objective is explore practices to mutual help between CAPS users from the east and west regions of the city of Natal, RN, in Brazil. In the mental health field, we observe the care from substitutive services is based on technical knowledge where the person of the mental health professional is predominant. The Brazilian psychiatry reform invests in equipments and mental health care protocols, but it is necessary to invest more vigorously in new strategies and actors capable of obtaining resources to achieve this goal, such as the users. If one cornerstone of the psychiatric reform consists of changing the type of relationship established with the person with mental disorders, why this relationship, nowadays, is still dominated by technique and unevenness, where on one side we have a person who knows something and who needs take care of someone, and on other side we have another who knows nothing and thus needs to be cared for? Starting from this problematization of the traditional methods of health/mental health care, an attempt was made to investigate in what ways the mutual help practices between people with mental disorders can realize potential avenues not yet explored within the scope of psychiatric reform. The objective of this research was to map possible mutual help practices among the users, and the technical understanding of such practices. For that, we took part in the daily activities of the CAPS, mapping the experiences of mutual help among users. In addition, we accompanied the users in external activities (such as return home, trips, etc), and we had roundtables with the professionals. The research was guided by theoretical methodological references of the institutional analysis. The results pointed to a lack of behaviors of mutual help or support among users, something that can probably be explained by the service work dynamics, as well as the relationship between technicians and users, which has a tendency to create hurdles for meetings among users, as well as being non-conducive to theirempowerment

Caminhos e descaminhos da adesão ao tratamento anti-hipertensivo :um estudo com usuários do Pacha (Programa de Assistência e Cuidado da Hipertensão Arterial) do Hospital Universitário Onofre Lopes

The high blood pressure is a multifactorial chronic disease which possesses emotional and social features in the illness appearance and evolution and in the adherence to the treatment which involves a decision-making through patient so that he or she process the necessary changes on harmful living habits. Adhesion, traditionally, it is referred to the patient to answer to the doctor orientations or of other health professional, about the appearance to the appointment with a doctor, about the use of medicine or lifestyle changes and maintaining this adhesion is the main problem to be overcame. It is expected the adhesion will ever be a continual, stable and satisfactory action, disregarding the complexity of subjectivity processes which permeate the sicken. This research aimed to investigate the difficulties which the person with high blood pressure has to adhere to the treatment, from the signification processes which give sense to the actions dealing with the adhesion. The study was carried out with 48 users of assistance program to the high blood pressure patient from Hospital Universitário from Natal RN, between 40-65 age. The answers were submitted to a double analysis process: 1) answer systematization in categories and codes and admission in statistical program SPSS (Statistical Package of Social Science), for generation of descriptive statistics; 2) Sense and signification analysis which permeated the deepener statement and interpretatively. The greater difficulties found are present on low-salt and law-calorie diets, in the dealing with everyday feeling and stress, being these factors cited as direct motive to the high blood pressure, regardless of interviewee s sex. It is observed there is not adhesion, but adhering, as an experienced everyday process. This work contributes with its results, assessing the used strategies by program with the aim of increasing the adhesion rates

O Serviço Social e a exclusão/inclusão social dos portadores de HIV/AIDS :demandas e desafios nos hospitais públicos

This research presents the labors developed by the Social Service unto socially excluded HIV/Aids positives at public hospitals in Rio Grande do Norte (RN). It purposes to identify and to analyze the demands brought by the holder onto the Social Service professional as well as the challenges the latter face to minister to the former. It privileges, from the methodological viewpoint, the qualitative and quantitative analysis with the application of questionnaires, direct observation, semi-structured interviews and bibliographic references. Data were collected from 12 (twelve) social assistants who work at Giselda Trigueiro Hospital in Natal (7) and Rafael Fernandes Hospital in Mossoró (5). The central hypothesis that guided this study is that the social inclusion/exclusion process experienced by the HIV/Aids positive on society implies a demand for the Social Service that is inserted in the public health context (specially in HIV-referred public hospitals), whose agents, however, when attempting to answer those demands, meet obstacles due to both the precariousness of public health services and the social complexity that concerns the HIV/Aids epidemic. Results point out that, de facto, the HIV/Aids epidemic, because of the social exclusion/inclusion process to which the holder is subject results a demand for the social agents at hospitals. Demands rise principally from the patient s life condition, considering the increasing pauperization in the epidemic context. As to what it is concerned, social assistants, responding to the needs, come across concrete twofold challenges: the illness in itself, for all social, negative aspects that make part of quotidian life of holders; and the precarious state of the public health service in RN State, since that working conditions are unsatisfactory

BSmart: desenvolvimento rigoroso de aplicações Java Card com base no método formal B

Java Card technology allows the development and execution of small applications embedded in smart cards. A Java Card application is composed of an external card client and of an application in the card that implements the services available to the client by means of an Application Programming Interface (API). Usually, these applications manipulate and store important information, such as cash and confidential data of their owners. Thus, it is necessary to adopt rigor on developing a smart card application to improve its quality and trustworthiness. The use of formal methods on the development of these applications is a way to reach these quality requirements. The B method is one of the many formal methods for system specification. The development in B starts with the functional specification of the system, continues with the application of some optional refinements to the specification and, from the last level of refinement, it is possible to generate code for some programming language. The B formalism has a good tool support and its application to Java Card is adequate since the specification and development of APIs is one of the major applications of B. The BSmart method proposed here aims to promote the rigorous development of Java Card applications up to the generation of its code, based on the refinement of its formal specification described in the B notation. This development is supported by the BSmart tool, that is composed of some programs that automate each stage of the method; and by a library of B modules and Java Card classes that model primitive types, essential Java Card API classes and reusable data structures

Caracterização de um modelo experimental de Diabetes Mellitus, induzido pela aloxana em ratos: estudo clínico e laboratorial

OBJETIVO: O presente estudo teve por objetivo caracterizar as alterações clínicas e laboratoriais do rato portador de Diabetes Mellitus induzido pela administração endovenosa de aloxana. MÉTODOS: Os animais foram distribuídos, por sorteio, em dois grupos experimentais: Grupo Controle Normal (G1), constituído de 25 animais sadios, e Grupo Diabético (G2), formado por 25 animais diabéticos graves, que foram avaliados em cinco momentos (1, 3, 6, 9 e 12 meses) de seguimento, tendo sido estudados os seguintes parâmetros: evolução clínica (peso, ingestão hídrica, ingestão alimentar e diurese) e exames bioquímicos (glicemia de jejum, glicose urinária, glicosúria, cetonúria, colesterol total, colesterol HDL, triglicérides e lipídios). RESULTADOS: A injeção de aloxana 2% na via endovenosa do rato acompanhou-se de um índice de mortalidade de 39%, tendo produzido diabetes grave também em 39% dos animais. O diabetes foi caracterizado por queda progressiva do peso corporal, elevação substancial da ingestão hídrica, ingestão alimentar e da diurese, com valores glicêmicos acima de 300 mg/dl, glicosúria 3+ e, eventualmente, cetonúria. O diabetes não altera o perfil de colesterol e lípides de ratos a longo prazo. CONCLUSÃO: Nossos estudos revelam que a aloxana produz, no rato, alterações clínicas e laboratoriais características de diabetes grave, as quais possibilitam estudos a longo prazo do diabetes.

Condroma de sela turca associado a hipopituitarismo: relato de um caso

Os condromas intracranianos são raros, sendo mais comumente encontrados na base do crânio e na região esfenoetmoidal. Nesta localização podem ser confundidos com meningiomas, neurinomas e craniofaringiomas. Os autores apresentam a evolução clínica e as características pela imagem de um paciente portador de condroma da sela turca submetido a excisão tumoral.

Esporotricose do gato doméstico (Felis catus): transmissão humana

No presente trabalho relata-se caso de paciente, funcionário de hospital veterinário, infectado através de arranhadura de gato doméstico portador de esporotricose. Inquérito domiciliar junto aos proprietários do animal fonte de infecção, revelou dois outros casos presuntivos de esporotricose humana transmitida por gatos, e confirmou o diagnóstico, por cultivo do Sporotrix schenckii, em 3 gatos domésticos adicionais. A esporotricose felina caracteriza-se por lesões cutâneas ulceradas e tendência à disseminação sistêmica e evolução fatal. A transmissão intra e inter-espécie é facilitada pela exuberância de fungos nas lesões cutâneas de felinos infectados.

Caso para Diagnóstico

Descreve-se caso clínico de paciente do sexo masculino, jovem, imunocompetente, portador de melanoníquia fúngica no terceiro pododáctilo causado por Scytalidium dimidiatum. Discutem-se a semiotécnica diagnóstica, seus diferenciais e a terapêutica adequada. Os autores destacam que a etiologia fúngica deva ser considerada no diagnóstico das melanoníquias.

Sistematização da assistência de enfermagem a paciente com luxação de coluna cervical: estudo de caso

Trata-se de um estudo de caso de paciente portador de luxação de coluna cervical. Sem comprometimento medular, no qual as autoras operacionalizaram o processo de enfermagem, segundo Modelo Conceitual de Horta, adaptando a Taxonomia I dos Diagnósticos de Enfermagem proposta pela North American Nursing Diagnosis Association (NANDA). Os resultados demonstraram que as intervenções propostas ao caso contribuíram na sua reabilitação, prevenindo complicações, bem como ajudando-o a retomar ao seu ambiente social para reassumir a sua autonomia.

Acidente com material perfurocortante entre profissionais de enfermagem de um hospital universitário

Os riscos ocupacionais a que os profissionais da equipe de enfermagem estão sujeitos no desempenho de suas funções são consideráveis. Assim estabeleceu-se como objetivo deste estudo analisar os acidentes perfurocortantes no período de 2002 a 2006, envolvendo a equipe de enfermagem de um hospital universitário, para compreender o contexto em que ocorrem. A utilização destas informações pode ser ferramenta de prevenção. Estudo descritivo, retrospectivo quantitativo e qualitativo. Na análise quantitativa foi utilizada estatística descritiva e na qualitativa o discurso do sujeito coletivo. Por meio das fichas de notificação do Núcleo de Vigilância Epidemiológica do Hospital, foi possível identificar acidentes do gênero no período pesquisado. Entrevistas foram direcionadas às vítimas de acidentes que tiveram como paciente-fonte portador de Síndrome da Imunodeficiência Adquirida/ Vírus da Imunodeficiência Humana, hepatite B e C. Os achados demonstraram que ainda persiste um grau significativo do desconhecimento ou banalização dos acidentes entre profissionais da saúde.

Proposta metodológica para o imageamento digital e modelagem virtual 3d de um bloco de rochas travertinas

In this paper we present the methodological procedures involved in the digital imaging in mesoscale of a block of travertines rock of quaternary age, originating from the city of Acquasanta, located in the Apennines, Italy. This rocky block, called T-Block, was stored in the courtyard of the Laboratório Experimental Petróleo "Kelsen Valente" (LabPetro), of Universidade Estadual de Campinas (UNICAMP), so that from it were performed Scientific studies, mainly for research groups universities and research centers working in brazilian areas of reservoir characterization and 3D digital imaging. The purpose of this work is the development of a Model Solid Digital, from the use of non-invasive techniques of digital 3D imaging of internal and external surfaces of the T-Block. For the imaging of the external surfaces technology has been used LIDAR (Light Detection and Range) and the imaging surface Interior was done using Ground Penetrating Radar (GPR), moreover, profiles were obtained with a Gamma Ray Gamae-spectômetro laptop. The goal of 3D digital imaging involved the identification and parameterization of surface geological and sedimentary facies that could represent heterogeneities depositional mesoscale, based on study of a block rocky with dimensions of approximately 1.60 m x 1.60 m x 2.70 m. The data acquired by means of terrestrial laser scanner made available georeferenced spatial information of the surface of the block (X, Y, Z), and varying the intensity values of the return laser beam and high resolution RGB data (3 mm x 3 mm), total points acquired 28,505,106. This information was used as an aid in the interpretation of radargrams and are ready to be displayed in rooms virtual reality. With the GPR was obtained 15 profiles of 2.3 m and 2 3D grids, each with 24 sections horizontal of 1.3 and 14 m vertical sections of 2.3 m, both the Antenna 900 MHz to about 2600 MHz antenna. Finally, the use of GPR associated with Laser Scanner enabled the identification and 3D mapping of 3 different radarfácies which were correlated with three sedimentary facies as had been defined at the outset. The 6 profiles showed gamma a low amplitude variation in the values of radioactivity. This is likely due to the fact of the sedimentary layers profiled have the same mineralogical composition, being composed by carbonate sediments, with no clay in siliciclastic pellitic layers or other mineral carrier elements radioactive

Carcinoma de Meibômio como segundo tumor em portadores de retinobastoma: relato de dois casos

O retinoblastoma pode acometer um ou os dois olhos, ocorrendo de forma hereditária ou esporádica. O portador dessa doença pode desenvolver, a longo prazo, outros tipos de tumores não oculares. Relatamos dois pacientes: o filho, portador de cavidade anoftálmica bilateral após remoção dos olhos devido ao retinoblastoma, que apresentou segundo tumor palpebral unilateral, afetando a pálpebra superior; e o pai, portador de cavidade anoftálmica unilateral também por remoção de retinoblastoma e que apresentou tumoração de crescimento rápido na pálpebra superior ipsilateral ao olho enucleado. O exame imuno-histoquímico de ambas as lesões excisadas revelou que se tratava de carcinoma de glândulas sebáceas. Os pacientes evoluíram bem após a remoção do tumor palpebral e, até o momento, não apresentam sinais de recidiva ou metástase.

Exposição de fibroblastos provenientes de pterígios recidivados e da cápsula de Tenon normal ao tacrolimus (FK-506)

OBJETIVO: Avaliar a taxa de proliferação de fibroblastos provenientes de pterígios recidivados e da cápsula de Tenon normal, quando expostos in vitro ao tacrolimus (FK 506). MÉTODOS: Foi realizado estudo prospectivo, controlado, avaliando-se 8 amostras de explantes de cápsula de Tenon de pterígios recidivados e 6 de cápsula de Tenon normal, obtidas na Faculdade de Medicina de Botucatu - UNESP. A cápsula de Tenon normal foi colhida da região temporal inferior, do mesmo portador de pterígio. As amostras foram cultivadas em meio específico e posteriormente expostas ao tacrolimus 1M (FK 506), em única exposição, com avaliação da taxa de proliferação celular 1, 5, 12 e 19 dias após a exposição. RESULTADOS: Avaliando-se a proliferação dos fibroblastos provenientes de cápsula de Tenon de pterígios recidivados e da cápsula de Tenon normal, os fibroblastos expostos ao tacrolimus tiveram taxa de proliferação significativamente menor (p<0,05) do que quando não houve exposição a droga, quando a avaliação foi feita 1 dia após a exposição. Quando a avaliação foi feita 19 dias após a exposição, a taxa de proliferação foi maior nos grupos expostos a droga. CONCLUSÃO: Os fibroblastos provenientes da cápsula de Tenon de pterígios recidivados apresentaram taxa de proliferação significativamente menor um dia após a exposição ao tacrolimus. Novos estudos devem ser realizados para definir dose e tempo de exposição dos fibroblastos a droga, com o intuito de definir se o tacrolimus pode ser útil como tratamento coadjuvante do pterígio.