Incentivo à prática regular de atividade física e redução do sedentarismo no distrito de São José de Almeida, Jaboticatubas - MG

O sedentarismo é caracterizado como a ausência ou baixos níveis de atividade física. A prática regular de atividade física está associada de forma positiva ao funcionamento dos sistemas cardiovascular, respiratório e musculoesquelético, bem como contribui para a saúde psicológica, bem estar e redução dos riscos de desenvolvimento de diversas doenças crônicas não transmissíveis. O sedentarismo constitui-se, portanto, como principal fator de risco para a morte súbita, causa ou agravamento da grande maioria das doenças. O objetivo do estudo é propor um plano de intervenção para redução do sedentarismo na população adstrita à equipe Azul da UBS Cecília Rodrigues Miranda do Distrito de São José de Almeida, município de Jaboticatubas, Minas Gerais. A realização de um diagnóstico situacional identificou altos níveis de inatividade física nesta população associados a diversos problemas de saúde. O plano prevê ações que incentivem uma mudança comportamental, principalmente relacionada à prática regular de atividade física, capaz de atingir aspectos relacionados à busca pelo bem estar e que, de forma sustentável, possa reverter alguns hábitos locais nocivos à saúde.

Alto índice de pacientes tabagistas na equipe de Programa da Saúde da Família da zona rural do município de Bom Sucesso - Minas Gerais: proposta de intervenção

O tabagismo é considerado pela Organização Mundial de Saúde uma doença crônica e epidêmica, e é a maior causa isolada de adoecimento e morte precoce e evitável em todo o mundo. Em torno de 80% dos tabagistas vivem em países em desenvolvimento. De acordo com o Ministério da Saúde, a incidência do tabagismo tem diminuído anualmente no Brasil, sendo encontrado uma taxa de 11,3% de fumantes entre os adultos no ano 2014. O consumo de tabaco expõe o indivíduo a mais de 4700 substâncias, a maior parte tóxicas ao organismo e capazes de causar diversos tipos de câncer, bem como doenças dos aparelhos respiratório e cardiovascular. Além disso, o hábito de fumar provoca dependência física e psicológica, o que dificulta a cessação do mesmo e exige como tratamento a esta doença estratégias que vão além do uso de medicamentos. Com o objetivo de reduzir a incidência de pacientes maiores de 18 anos tabagistas atendidos pela Equipe de Saúde da Família da Zona Rural da cidade do Bom Sucesso - MG (20,7% dos adultos) foi desenvolvida esta proposta de intervenção. Foi utilizado o método de Planejamento Estratégico Situacional (PES), com avaliação quantitativa dos pacientes tabagistas em uma microárea, revisão bibliográfica sobre o tema e planejamento das ações práticas a serem realizadas. O projeto visa a equiparação do cuidado aos tabagistas àquele oferecido aos demais doentes crônicos da área e o desenvolvimento de grupos operativos de combate ao tabagismo. A configuração incompleta da equipe e a ausência de unidade de referência, bem como a necessidade de capacitação dos profissionais para atuação nos grupos operativos, ainda são desafios a serem alcançados.

Ausência de contrarreferência na Estratégia Saúde da Família Córrego das Calçadas, município de Santa Luzia/MG

A Atenção Primária é a porta de entrada para o Sistema Único de Saúde e é, também, responsável pela coordenação do cuidado dos pacientes. Entretanto, para que a Atenção Primária possa exercer sua função de modo eficaz, é necessária uma contrarreferência adequada da Atenção Secundária e Terciária. A ausência de contrarreferência é um problema na Atenção Primária e resolvê-lo é um desafio para o sistema de saúde, porque depende da conscientização de profissionais especialistas e de uma rede integrada de prontuários eletrônicos. O objetivo deste estudo é elaborar um Projeto de Intervenção para aumentar, significativamente, o preenchimento de relatório de contrarreferência pelos profissionais especializados no município de Santa Luzia, Minas Gerais. Foi realizada uma revisão de literatura, contendo as informações nas bases de dados do SCIELO, Núcleo de Educação Em Saúde Coletiva (NESCON) - biblioteca virtual da Faculdade de Medicina da UFMG e site do Instituto Brasileiro de Geografia e Estatística (IBGE), utilizando como palavras-chaves: Contrarreferência, Atenção Primária, Unidade Básica de Saúde, Estratégia Saúde da Família e Atenção Especializada, com a finalidade de delimitar o objeto de estudo e o campo de investigação para a realidade que se pretende apreender. Optou-se por selecionar apenas as produções na forma de artigos publicados em periódicos nacionais nos últimos cinco anos. Para elaboração do Plano de Intervenção foram utilizados os passos do Planejamento Estratégico Situacional (PES), descrito no Módulo de Planejamento Estratégico Situacional (PES), descrito no módulo de Planejamento e Avaliação das Ações de Saúde do Curso de Especialização em Estratégia Saúde da Família/NESCON.

Estudo dos prejuízos ambientais e sociais, causados pela ausência do gerenciamento dos resíduos sólidos dos serviços de saúde do município de Santa Helena de Minas - MG

A autora procedeceu a um levantamento prospectivo, observacional sobre a forma do gerenciamento transporte, prejuízos ambientais e sociais dos resíduos provenientes dos procedimentos de saúde do município, segundo tipos, eficácia de função e potenciais impactos negativos a saúde humana e ambiental. A estrutura do repositório foi analisada e classificada segundo o seu potencial de eficácia e periculosidade. Os achados coincidem com os demais grupos de estudiosos, no que diz respeito a lixões de céu aberto como ocorre em Santa Helena de Minas-MG, a potencial infiltração nos extratos mais profundos do solo levando um risco ao aqüífero subjacente e, na vigência de enxurradas, o citado potencial de risco ameaça as águas de um córrego, que cruza a área circunvizinha. Outro fato diz respeito às pessoas que realizam a catação seletiva de materiais passíveis de serem vendidos bem como de restos alimentares para uso imediato pondo em risco sua própria saúde e transformando-se em agente transmissor de diversas patologias. Todos esses agravos têm sua causa em um gerenciamento descuidado, sobre um descarte não criterioso e um substrato de solo sem tratamento

Estudo dos prejuízos ambientais e sociais, causados pela ausência do gerenciamento dos resíduos sólidos dos serviços de saúde do município de Santa Helena de Minas - MG

A autora procedeceu a um levantamento prospectivo, observacional sobre a forma do gerenciamento transporte, prejuízos ambientais e sociais dos resíduos provenientes dos procedimentos de saúde do município, segundo tipos, eficácia de função e potenciais impactos negativos a saúde humana e ambiental. A estrutura do repositório foi analisada e classificada segundo o seu potencial de eficácia e periculosidade. Os achados coincidem com os demais grupos de estudiosos, no que diz respeito a lixões de céu aberto como ocorre em Santa Helena de Minas-MG, a potencial infiltração nos extratos mais profundos do solo levando um risco ao aqüífero subjacente e, na vigência de enxurradas, o citado potencial de risco ameaça as águas de um córrego, que cruza a área circunvizinha. Outro fato diz respeito às pessoas que realizam a catação seletiva de materiais passíveis de serem vendidos bem como de restos alimentares para uso imediato pondo em risco sua própria saúde e transformando-se em agente transmissor de diversas patologias. Todos esses agravos têm sua causa em um gerenciamento descuidado, sobre um descarte não criterioso e um substrato de solo sem tratamento

[meanings Of The Sickening Process For Patients With Systemic Lupus Erythematosus: A Review Of The Literature.]

Systemic lupus erythematosus is an autoimmune disease that causes many psychological repercussions that have been studied through qualitative research. These are considered relevant, since they reveal the amplitude experienced by patients. Given this importance, this study aims to map the qualitative production in this theme, derived from studies of experiences of adult patients of both genders and that had used as a tool a semi-structured interview and/or field observations, and had made use of a sampling by a saturation criterion to determine the number of participants in each study. The survey was conducted in Pubmed, Lilacs, Psycinfo e Cochrane databases, searching productions in English and Portuguese idioms published between January 2005 and June 2012. The 19 revised papers that have dealt with patients in the acute phase of the disease showed themes that were categorized into eight topics that contemplated the experienced process at various stages, from the onset of the disease, extending through the knowledge of the diagnosis and the understanding of the manifestations of the disease, drug treatment and general care, evolution and prognosis. The collected papers also point to the difficulty of understanding, of the patients, on what consists the remission phase, revealing also that this is a clinical stage underexplored by psychological studies.

Variation of the anal resting pressure induced by postexpiratory apnea effort in patients with constipation

CONTEXT: Intestinal constipation - a common symptom among the general population - is more frequent in women. It may be secondary to an improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and anal sphincter during evacuation. OBJECTIVE: To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation. METHODS: Twenty-one patients (19 females - 90.4%) with a mean age of 47.5 years old (23-72) were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1) and distal (2) portions of the anal orifice. The elevation of the pressure values in relation to the resting with the evacuation effort was present in all patients. The Agachan score was used for clinical evaluation of constipation. The variables studied were: mean anal pressure of the anal orifice for 20 seconds at rest, the effort of evacuation using Valsalva maneuver and the effort of evacuation during apnea after forced expiration, as well as the area under the curve of the manometric tracing at moments Valsalva and apnea. RESULTS: The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (P = 0.007), independent of the moment and tendency to differ during moments Valsalva and apnea (P = 0.06). The mean of values of the area under the manometric tracing curve showed differences between moments Valsalva and apnea (P = 0.0008), either at the proximal portion or at the distal portion of the anal orifice. CONCLUSION: The effort of evacuation associated with postexpiratory apnea, when compared with the effort associated with the Valsalva maneuver, provides lower elevation of anal pressure at rest by the parameter area under the curve.

Saphenous vein graft bypass in the treatment of giant cavernous sinus aneurysms: report of two cases

Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA) and branches of the middle cerebral artery (MCA) are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA) is the treatment of choice in many cases. This procedure has however a high risk of brain infarction. Revascularization of the brain by extra-intracranial anastomosis between the superficial temporal artery (STA) and branches of the MCA is frequently performed. This procedure provides however a low flow bypass and brain infarction may occur. We report two cases of giant cavernous sinus aneurysms treated by high flow bypass and endovascular balloon occlusion of the ICA. Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.

Efeito da temperatura e do teor de umidade na iniciação e desenvolvimento do rizoma de Kohleria eriantha (Benth.) Hanst. (Gesneriaceae)

Kohleria eriantha (Benth.) Hanst is a plant belonging to the family Gesneriaceae, with an underground organ, which is associated with vegetative reproduction. This organ is a rhizome, whose stem bears buds covered with modified leaves that store up starch. In small sections of this rhizome, containing six buds (1.5 to 2.0cm long), only one bud sprouted. The sprouted bud could be differentiated into two morphological pattern: aerial part or rhizome. Sprouting of the rhizome pattern occurred in sections kept on substrate with low water content (1mL of water), or lacking water, whereas sprouting of the aerial part pattern occurred in sections on substrate with high water content (12mL of water). Temperature at 20ºC also stimulated sprouting of the rhizome pattern, regardless of the water volume in the substrate. Sprouting of the rhizome pattern occurred still in sections on substrate to which polyethylene glycol 6000 (PEG) solution was added at the concentrations of 161.2, 235.2 and 340.0g/L, resulting in potentials of -3, -6 and -12 MPa, respectively. Sections kept on substrate with low water content (1 ml of water) showed a reduction in the dry matter content and high osmotic concentration in comparison with those on substrate with high water content. The results obtained revealed that forming of the rhizome pattern was influenced by water content and temperature. It is suggested that sprouting of the rhizome pattern was induced by the low water potential in the sections, when kept on substrate with low water content. Moreover, it was observed that the rhizome buds of Kohleria eriantha showed a high degree of plasticity.

Florivory and sex ratio in Annona dioica St. Hil. (Annonaceae) in the Pantanal at Nhecolândia, southwestern Brazil

Annona dioica St. Hil. is a species that grows to approximately 2 m tall and is very widespread in the cerrados. Individual plants of this androdioecious species produce numerous hermaphroditic or male flowers, but few fruits. The aim of this study was to determine the sex ratio among the plants and to compare the frequency of herbivory between male and hermaphroditic flowers. The fieldwork was done by studying flowering plants in grasslands used as pasture for cattle at Fazenda Nhumirim. One hundred and forty-seven male plants and 71 hermaphroditic plants were examined and produced a total of 194 and 94 flowers, respectively, during the study period. The male:hermaphrodite sex ratio was 2.07:1, and was similar to the male:hermaphrodite flower ratio of 2.06:1. The frequency of florivory rate in hermaphrodites was significantly higher than in male flowers (33.0%, n = 31, and 25.7%, n = 50, respectively; G = 14.83; d.f. = 1; p < 0.001). The mean fresh weights of male and hermaphroditic flowers were significantly different (8.38 ± 2.40 g vs. 6.93 ± 2.68 g, respectively; 0 ± SEM; n = 50 each; t = 2.479; d.f. = 49; p = 0.017). These results indicate that the low fruit set in this species can be explained by the sex ratio, the greater herbivory of hermaphroditic flowers and the probable absence of pollinators.

Germinação de Ternstroemia brasiliensis Cambess. (Pentaphylacaceae) de floresta de restinga

The main purpose of this work was to study the germination of Ternstroemia brasiliensis seeds both in laboratory and field conditions in order to contribute to understanding the regeneration ecology of the species. The seeds were dispersed with relatively high moisture content and exhibit a recalcitrant storage behaviour because of their sensitivity to dehydration and to dry storage. The germinability is relatively high and is not affected either by light or aril presence. The absence of the dormancy and the low sensitivity to far red light can enable to seeds to promptly germinate under Restinga forest canopy, not forming a soil seed bank. The constant temperatures of 25 ºC and 30 ºC were considered optimum for germination of T. brasiliensis seeds. Temperature germination parameters can be affected by light conditions. The thermal-time model can be a suitable tool for investigating the temperature dependence on the seed germination of T. brasiliensis. The germination characteristics de T. brasiliensis are typical of non pioneer species, and help to explain the distribution of the species. Germination of T. brasiliensis seeds in Restinga environment may be not limited by light and temperature; otherwise the soil moisture content can affect the seed germination.

Protocolos de investigação de variáveis psicológicas na epilepsia infantil

Epilepsy is a common chronic condition in the childhood and its diagnosis reveals psychological, social and family difficulties, that seem to be related with beliefs and quality of parents-children interaction. The purpose of this paper is to schematize investigation strategies for the psychological variables: beliefs, impact of the disease, family relationship, identification of changes. Based upon collected reports of epileptic children's parents and upon surveyed aspects of the literature, psychological questionnaires were elaborated to identify important variables that affect the child's epilepsy life and his family. The use of more appropriate investigation procedures facilitates the psychological evaluation and ensures the collection of data.

As vozes da sociedade: letramento, consciência e poder

The dialectic tension between the phenomenon of illiteracy and the remedial efforts of the literate to provide a voice for those who don t have one, reflects at the same time the difficulties that the emerging discourses have to struggle with, and highlights the importance of this struggle as one that belongs to the opressed, not the well-meaning educators and political activists. It also informs the latter s efforts on behalf of the uneducated. Naturally these issues have attracted a good deal of attention of some specialists in South America. There is now a movement afoot there that aims at placing illiterate discourse inside the societal discourse proper without letting the latter manipulate the former for its own ends. I will address the typical exigencies and limitations inherent in such efforts, but at the same time point to new ways of understanding and handling the problem of literacy in a developing country.

Projeto de caixa de madeira para manga (Mangifera Indica L.)

Losses of horticulture product in Brazil are significant and among the main causes are the use of inappropriate boxes and the absence of a cold chain. A project for boxes is proposed, based on computer simulations, optimization and experimental validation, trying to minimize the amount of wood associated with structural and ergonomic aspects and the effective area of the openings. Three box prototypes were designed and built using straight laths with different configurations and areas of openings (54% and 36%). The cooling efficiency of Tommy Atkins mango (Mangifera Indica L.) was evaluated by determining the cooling time for fruit packed in the wood models and packed in the commercially used cardboard boxes, submitted to cooling in a forced-air system, at a temperature of 6ºC and average relative humidity of 85.4±2.1%. The Finite Element Method was applied, for the dimensioning and structural optimization of the model with the best behavior in relation to cooling. All wooden boxes with fruit underwent vibration testing for two hours (20 Hz). There was no significant difference in average cooling time in the wooden boxes (36.08±1.44 min); however, the difference was significant in comparison to the cardboard boxes (82.63±29.64 min). In the model chosen for structural optimization (36% effective area of openings and two side laths), the reduction in total volume of material was 60% and 83% in the cross section of the columns. There was no indication of mechanical damage in the fruit after undergoing the vibration test. Computer simulations and structural study may be used as a support tool for developing projects for boxes, with geometric, ergonomic and thermal criteria.

46,XX Male - Testicular Disorder of Sexual Differentiation (DSD): hormonal, molecular and cytogenetic studies

The XX male syndrome - Testicular Disorder of Sexual Differentiation (DSD) is a rare condition characterized by a spectrum of clinical presentations, ranging from ambiguous to normal male genitalia. We report hormonal, molecular and cytogenetic evaluations of a boy presenting with this syndrome. Examination of the genitalia at age of 16 months, showed: penis of 3.5 cm, proximal hypospadia and scrotal testes. Pelvic ultrasound did not demonstrate Mullerian duct structures. Karyotype was 46,XX. Gonadotrophin stimulation test yielded insufficient testosterone production. Gonadal biopsy showed seminiferous tubules without evidence of Leydig cells. Molecular studies revealed that SRY and TSPY genes and also DYZ3 sequences were absent. In addition, the lack of deletions or duplications of SOX9, NR5A1, WNT4 and NROB1 regions was verified. The infant was heterozygous for all microsatellites at the 9p region, including DMRT1 gene, investigated. Only 10% of the patients are SRY-negative and usually they have ambiguous genitalia, as the aforementioned patient. The incomplete masculinization suggests gain of function mutation in one or more genes downstream to SRY gene.