Associação entre depressão na vida adulta e trauma psicológico na infância

Objetivos: Avaliar a associação entre depressão (DSM IV) na vida adulta e trauma psicológico na infância em uma amostra clínica de pacientes do ambulatório do Hospital de Clínicas de Porto Alegre (HCPA). Por trauma na infância considerou-se abuso sexual, maus tratos, exposição a violência e perdas, por morte ou separação da criança de seus pais, antes dos 18 anos de idade. Métodos: Em um estudo caso controle, foram avaliados pacientes deprimidos (n = 90) e pacientes não deprimidos (n = 50). Através do M.I.N.I. e M.I.N.I plus (Mini International Neuropsychiatric Interview / Brazilian Version 5.0.0.) avaliou-se a presença de depressão e comorbidades. Utilizou-se as escalas Screening Survey of Children's Exposure to Community Violence Richters & Martinez, 1993 Modified by Osofsky, 1995 and Zeannah, 1996 e a Familial Experiences Interview 1988 de Naomi Ogata para avaliar traumas na infância. Resultados: encontrou-se uma maior prevalência de abuso sexual (P = 0,018), história de maus tratos físicos por parte dos pais ou cuidadores (P = 0,005) e exposição à violência (P = 0,007) no grupo de pacientes deprimidos em relação ao grupo de pacientes não deprimidos. Quanto a perdas na infância não se encontrou diferença entre os dois grupos. Quando estas variáveis foram controladas para potenciais fatores confundidores (sexo, etnia, estado civil, doença mental na família, e renda per capita), somente a exposição a múltiplos episódios de violência e história de maus tratos físicos por parte dos pais ou cuidadores se mantiveram como variáveis independentes. Conclusões: Nossos achados, à semelhança de outras pesquisas, encontraram uma associação entre traumas psicológicos na infância e depressão na vida adulta, sugerindo que múltiplos estressores, em maior ou menor grau, na infância, se encontram associados a depressão na vida adulta.

Violência como objeto da assistência em um hospital de trauma : o "olhar" da enfermagem

Este estudo trata da violência sob o olhar das trabalhadoras de enfermagem no cuidado aos pacientes hospitalizados vítimas de violência, em um hospital de pronto socorro em trauma. O Hospital de Pronto Socorro de Porto Alegre / HPS – RS atende pacientes vítimas de trauma de toda a região metropolitana e do interior do Estado. As internações decorrentes da violência, nos últimos anos, representam um aumento significativo na demanda dos atendimentos e internações. O estudo tem como objetivo geral conhecer e compreender o modo de olhar e o fazer das trabalhadoras de enfermagem no cuidado ao paciente vítima de violência, hospitalizado nesse serviço. Para tanto, se propõe caracterizar, do ponto de vista sociodemográfico e epidemiológico, o paciente hospitalizado no HPS por violência. Apóia-se na tipologia dos estudos híbridos que articulam bases teóricas e metodológicas de múltiplas origens e quantificações associadas a dados qualitativos. As unidades de internação do HPS são o campo de estudo. Os sujeitos são os pacientes hospitalizados por traumas decorrentes de violência, no período de janeiro a junho de 2001, e as trabalhadoras de enfermagem desse hospital Entre os resultados encontraram-se 697 pacientes hospitalizados, nesse período, vítimas de violência; 90,5% do sexo masculino; 73% brancos e 27% negros ou descendentes dessa etnia; 59% da faixa etária dos 20 aos 39 anos; a faixa etária dos 11 aos 39 anos corresponde a um percentual de 78,9% das internações; 47,9% agredidos por arma de fogo, 26,5% por arma branca, 25% vitimas de agressão física 0,3% foram vítimas de estupro. Entre os diagnósticos mais freqüentes encontram-se trauma abdominal, trauma torácico, traumatismos múltiplos, traumatismo crânio encefálico. 59.5% (415) são procedentes de Porto Alegre, e os bairros mais freqüentes são Partenon, Lomba do Pinheiro e Cristal. Em relação ao “olhar” da enfermagem no cuidado a esse paciente ficou evidente a preocupação das trabalhadoras e a dificuldade desse enfrentamento, visto que, no hospital, não existem estratégias definidas em relação à violência, num âmbito mais amplo, além do tratamento da lesão causada pelo trauma. Cada trabalhadora lida com esse cuidado da forma que acredita ser a mais adequada e utiliza as estratégias que dispõe para suportar e enfrentar essa realidade. Além disso, os serviços públicos de saúde necessitam se auto-avaliar e propiciar a criação de espaços e co-responsabilizar-se nesse processo.

Estudo da diastereosseletividade simples e facial envolvendo íons imínio e N-acilimínio

Resumo não disponível.

Long-term facial artery catheter implantation for serial arterial blood sampling and invasive arterial blood pressure measurement in horses

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

Eficácia da imunoterapia no tratamento de pitiose facial em equino

Background: Pythiosis in horses is a proliferative and ulcerative disease that primarily affects the skin and subcutaneous tissue of limbs, thoracic-abdominal region and head. This disease sometimes can also affect limb bones or cause tumoral masses in abdomen. Usually, the cutaneous cases are confused with habronemiasis. The disease is more common in marshy areas, places with formation of slow drainage ponds and aquatic vegetation under high temperatures. The aim of this study was to describe the development of facial lesions in a horse caused by pythiosis in Cuiaba, Mato Grosso, and, additionally to discuss relevant issues regarding the diagnosis, clinical course and response to immunotherapy treatment.Case: One five years old mare of unknown breed, created in property located in the Cerrado region, had a wound on its face difficult to be healed and non-responsive to several treatments based on ivermectin and organophosphate administrated by either topical or systemic via. The animal was assisted on the farm of origin by the veterinary team of the Clinical Medicine sector, of the Veterinary Hospital, Universidade Federal de Mato Grosso (HOVET-UFMT). on the occasion of the visit, which occurred 60 days after onset of signs, the animal showed a circular single large lesion, ulcerative with serous discharge on the right part of its face, between the eyes and nostrils. There were some necrotic foci with sinus, from which kunkers were extracted; a condition compatible with pythiosis. The diagnosis was confirmed by histology, ELISA and PCR.Discussion: Assuming pythiosis from data obtained from the survey and profile of the lesion (secretory aspect, emaciation and presence of sinus and kunkers), immunotherapy treatment was immediately applied. The advanced clinical aspects and the fact that early diagnosis and treatment are essentials to satisfactory therapeutic response were also taken into consideration for starting the treatment. The remission of signs was achieved after five subcutaneous applications with 14 days between each application. From the second application, it was observed clinical improvement and after 60 days of treatment there was almost complete remission of signs. The signs for a satisfactory response in the injury site followed the order of decreasing secretory aspect, decreasing borders, decrease the itching and bringing the edges together with the formation of a thin layer of crust on the surface. Pythiosis cases with lesions on the face and lower abdomen are commonly confused with habronemiasis by macroscopic and widespread similarity between technicians and attendants, and essential support to the diagnosis through laboratory tests, which in turn are still underutilized. In this case, the authors demonstrated the therapeutic efficacy of immunotherapy as an advantage, considering the possibility of applying it in cases of lesions in areas of difficult surgical access, treatment conditions in the field, with low cost and ease of application. Further studies approaching this alternative therapy are necessary, since side effects have been observed in some cases.

Avaliação da gravidade do trauma em condutores de motocicleta vítimas de acidentes de trânsito no Rio Grande do Norte

Descriptive exploratory study, prospective, with quantitative approach, performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGHC), in Natal/RN, aiming to identify injuries by body area and wound severity on drivers who suffered motorcycle accidents, evaluate the severity of injuries and trauma on these drivers and identify the existence of association between wound and trauma severity and some of the accident s characteristics. The population comprised 371 motorcycle drivers, with data collected between October and December 2007. We used as instruments the Abberviated Injury Scale (AIS), Injury Severity Score (ISS) and the Glasgow Coma Scale (GCE1). The results show that, concerning characterization, there was a predominance of the male gender (88.4%), aged between 18 and 24 years (39.90%), originating from the Natal metropolitan region (55.79%), with fundamental-level instruction (51.48%), catholic (75.78%), married (47.98%). 23.18% work on commerce-related activities and 75.20% have income of up to 2 minimum wages. As for the accident s characteristics, the predominant shift was the afternoon (46.36%), received up to one hour after the event (50.67%), transported by countryside ambulances colleagues and relatives (51.21%), 25.34% had the accident on Sunday; 53.91% suffered falls and vehicle rolls; among the collisions there was a predominance of the motorcycle-automoblie type (28.03%); 52,6% were licensed and among these 50.76% had up to one year of license; 65.50% declared not having suffered previous accidents; 65.77% declared waring helmets in the time of the accident; 57.41% said not to have used drugs, and among those who used, alcohol was the most consumed (98.10%). The lowest score evaluated by GCS1 (3 to 8) was linked to drivers who suffered accidents on Saturday (10.3%), those who were not wearing helmets (14.29%) and the victims of motorcycle-pedestrian/animal crashes (13.33%). The body areas most affected had AIS between 1 and 3 (95.76%) and were: external surface (39.90%) and head/neck (33.20%). As for trauma severity, the highest scores (ISS>25) belonged to those who consumed alcohol (30.73%), suffered falls or vehicle rolls (48.9%) and those attended to 3 hours or longer after the accident (50%). We conclude that for motorcycle drivers who suffered accidents, age, gender, weekday, type of accident, use of drugs and the absence of helmet use signal both to the risk of occurrence of these events, as well as for the greater severity of injuries and trauma.

Caracterização do acidente de trânsito e gravidade do trauma: um estudo em vítimas de um hospital de emergência de Natal

Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Um método para localização facial Invariante a rotação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Electromyographic analysis of the masseter and buccinator muscles with the Pro-Fono Facial Exerciser use in bruxers

The aim of this study was to evaluate the efficiency of the Pro-Fono Facial Exerciser (Pro-Fono Productos Especializaclos para Fonoaudiologia Ltda.., Barueri/SP, Brazil) to decrease bruxism, as well as the correlation between the masseter and the buccinator muscles using electromyography (EMG). In this study, 39 individuals ranging from 23 to 48 years of age were selected from a dental school and then underwent surface EMG at three different periods of time: 0, 10, and 70 days. They were divided into a normal control group, a bruxer control group (without device), and an experimental bruxer group who used the device. The bruxer group showed a greater masseter EMG amplitude when compared to the normal group, while the experimental group had deceased activity with a reduction in symptoms. The buccinator EMG spectral analysis of the experimental bruxist group showed asynchronous contractions of the masseter muscle (during jaw opening) after using the Pr6-Fono Facial Exerciser. The normal group also showed asynchronous contractions. Upon correlation of the data between these muscles, the inference is that there is a reduction in bruxism when activating the buccinator muscle.

Plasticidade de células tronco mesenquimais de medula óssea de ratos na presença de meio condicionado do nervo facial e do fator de crescimento fibroblástico 2

A number of evidences show the influence of the growth of injured nerve fibers in Peripheral Nervous System (PNS) as well as potential implant stem cells (SCs) to make it more suitable for nerve regeneration medium. In this perspective, this study aimed to evaluate the plasticity of mesenchymal stem cells from bone marrow of mice in the presence of culture medium conditioned with facial nerve explants (D-10) and fibroblast growth factor-2 (FGF-2). In this perspective, the cells were cultivated only with DMEM (group 1), only with D-10(group 2), only with FGF-2(group 3) or with D-10 and FGF-2(group 4). The growth and morphology were assessed over 72 hours. Quantitative phenotypic analysis was taken from the immunocytochemistry for GFAP, OX-42, MAP-2, β-tubulin III, NeuN and NF-200 on the fourth day of cultivation. Cells cultured with conditioned medium alone or combined with FGF-2 showed distinct morphological features similar apparent at certain times with neurons and glial cells and a significant proliferative activity in groups 2 and 4 throughout the days. Cells cultived only with conditioned medium acquired a glial phenotype. Cells cultured with FGF-2 and conditioned medium expressed GFAP, OX-42, MAP-2, β-tubulin III, NeuN and NF-200. On average, area and perimeter fo the group of cells positive for GFAP and the área of the cells immunostained for OX-42 were higher than those of the group 4. This study enabled the plasticity of mesenchymal cells (MCs) in neuronal and glial nineage and opened prospects for the search with cell therapy and transdifferentiation