Influence of Pleural Drain Insertion in Lung Function of Patients Undergoing Coronary Artery Bypass Grafting

Background and objectives: Longitudinal, prospective, randomized, blinded Trial to assess the influence of pleural drain (non-toxic PVC) site of insertion on lung function and postoperative pain of patients undergoing coronary artery bypass grafting in the first three days post-surgery and immediately after chest tube removal. Method: Thirty six patients scheduled for elective myocardial revascularization with cardiopulmonary bypass (CPB) were randomly allocated into two groups: SX group (subxiphoid) and IC group (intercostal drain). Spirometry, arterial blood gases, and pain tests were recorded. Results: Thirty one patients were selected, 16 in SX group and 15 in IC group. Postoperative (PO) spirometric values were higher in SX than in IC group (p < 0.05), showing less influence of pleural drain location on breathing. PaO2 on the second PO increased significantly in SX group compared with IC group (p < 0.0188). The intensity of pain before and after spirometry was lower in SX group than in IC group (p < 0.005). Spirometric values were significantly increased in both groups after chest tube removal. Conclusion: Drain with insertion in the subxiphoid region causes less change in lung function and discomfort, allowing better recovery of respiratory parameters.

Microbiota benefits after inulin and partially hydrolized guar gum supplementation - a randomized clinical trial in constipated women

Introduction: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation. Objectives: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids. Methods: Our study enrolled 60 constipated female health worker volunteers. Participants reported less than 3 bowel movements per week. Volunteers were randomized to treatment with prebiotic or placebo. Treatment consisted of 3 weeks supplementation with 15 g/d I-PHGG (fiber group) or maltodextrin (placebo group). Abdominal discomfort, flatulence, stool consistency, and bowel movements were evaluated by a recorded daily questionnaire and a weekly interview. Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography, respectively. Results: There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences. Total Clostridium sp significantly decreased in the fiber group (p = 0.046) and increased in the placebo group (p = 0.047). There were no changes in fecal short chain fatty acid profile. Conclusions: Consumption of I-PHGG produced clinical results comparable to placebo in constipated females, but had additional protective effects on gut rnicrobiota by decreasing the amount of pathological bacteria of the Clostridium genera.

Anatomical, Clinical and Radiographic Characteristics of Styloid Syndrome (Eagle Syndrome): a Case Report

Styloid syndrome is characterized by an elongated styloid process or calcification of the stylomandibular and stylohyoid ligament. This study describes a case of a 65-year-old woman who presented to the Stomatology Clinic, University of Marilia with temporomandibular joint pain, ear ringing and a reduced ability to open the mouth. Panoramic and posteroanterior digital radiographs showed bilateral elongation of the styloid processes, especially of the right side, whose length extended beyond the mandible angle. The diagnosis was confirmed with the association of clinical data and image examinations. The treatment options for styloid Syndrome include clinical follow-up, surgical removal of the styloid process or fracture of the elongated process. The case was managed by providing prosthetic rehabilitation and clinical follow-up, observing the level of discomfort and the benefit that could be achieved by the therapy, and avoiding surgical intervention.

Comparison of different dosimetric methods for red marrow absorbed dose calculation in thyroid cancer therapy

Several dosimetric methods have been proposed for estimating red marrow absorbed dose (RMAD) when radionuclide therapy is planned for differentiated thyroid cancer, although to date, there is no consensus as to whether dose calculation should be based on blood-activity concentration or not. Our purpose was to compare RMADs derived from methods that require collecting patients' blood samples versus those involving OLINDA/EXM software, thereby precluding this invasive procedure. This is a retrospective study that included 34 patients under treatment for metastatic thyroid disease. A deviation of 10 between RMADs was found, when comparing the doses from the most usual invasive dosimetric methods and those from OLINDA/EXM. No statistical difference between the methods was discovered, whereby the need for invasive procedures when calculating the dose is questioned. The use of OLINDA/EXM in clinical routine could possibly diminish data collection, thus giving rise to a simultaneous reduction in time and clinical costs, besides avoiding any kind of discomfort on the part of the patients involved.

Differences in Evolution of Children with Non-severe Acute Lower Respiratory Tract Infection With and Without Radiographically Diagnosed Pneumonia

Objective: To identify differences in the evolution of children with non-severe acute lower respiratory tract infection between those with and without radiographically diagnosed pneumonia. Design: Prospective cohort study. Setting: A public university pediatric hospital in Salvador, Northeast Brazil. Patients: Children aged 2-59 months. Methods: By active surveillance, the pneumonia cases were prospectively identified in a 2-year period. Each case was followed-up for changes in various clinical symptoms and signs. Demographic, clinical and radiographic data were recorded in standardized forms. Exclusion was due to antibiotic use in the previous 48 hours, signs of severe disease, refusal to give informed consent, underlying chronic illness, hospitalization in the previous 7 days or amoxicillin allergy. Chest X-ray (CXR) was later read by at least 2 independent pediatric radiologists. Main Outcome Measures: Radiographic diagnosed pneumonia based on agreed detection of pulmonary infiltrate or pleural effusion in 2 assessments. Results: A total of 382 patients receiving amoxicillin were studied, of whom, 372 (97.4%) had concordant radiographic diagnosis which was pneumonia (52%), normal CXR (41%). and others (7%). By multivariate analysis, age (OR=1.03; 95% CI: 1.02-1.05), disease >= 5days (OR = 1.04; 95% CI: 1.001-1.08), reduced pulmonary expansion (OR = 3.3; 95% CI: 1.4-8.0), absence of wheezing (OR = 0.5; 95% CI: 0.3-0.9), crackles on admission (OR = 2.0; 95% CI: 1.2-3.5), inability to drink on day 1 (OR = 4.2; 95% CI: 1.05-17.3), consolidation percussion sign (OR = 7.0; 95% CI: 1.5-32.3), tachypnea (OR = 2.0; 95% CI: 1.09-3.6) and fever (OR = 3.6; 95% CI: 1.4-9.4) on day 2 were independently associated with pneumonia. The highest positive predictive value was at the 2nd day of evolution for tachypnea (71.0%) and fever (81.1%). Conclusion: Persistence of fever or tachypnea up to the second day of amoxicillin treatment is predictive of radiographically diagnosed pneumonia among children with non-severe lower respiratory tract diseases.

High-frequency TENS in post-episiotomy pain relief in primiparous puerpere: A randomized, controlled trial

Aim: We evaluated the effectiveness of high-frequency transcutaneous electrical nerve stimulation (TENS) as a pain relief resource for primiparous puerpere who had experienced natural childbirth with an episiotomy. Methods: A controlled, randomized clinical study was conducted in a Brazilian maternity ward. Forty puerpere were randomly divided into two groups: TENS high frequency and a no treatment control group. Post-episiotomy pain was assessed in the resting and sitting positions and during ambulation. An 11-point numeric rating scale was performed in three separate evaluations (at the beginning of the study, after 60 min and after 120 min). The McGill pain questionnaire was employed at the beginning and 60 min later. TENS with 100 Hz frequency and 75 mu s pulse for 60 min was employed without causing any pain. Four electrodes ware placed in parallel near the episiotomy site, in the area of the pudendal and genitofemoral nerves. Results: An 11-point numeric rating scale and McGill pain questionnaire showed a significant statistical difference in pain reduction in the TENS group, while the control group showed no alteration in the level of discomfort. Hence, high-frequency TENS treatment significantly reduced pain intensity immediately after its use and 60 min later. Conclusion: TENS is a safe and viable non-pharmacological analgesic resource to be employed for pain relief post-episiotomy. The routine use of TENS post-episiotomy is recommended.

Análise de desconforto térmico local em ambientes cirúrgicos com o uso de manequim, medição de variáveis ambientais e avaliação subjetiva

Na avaliação de conforto térmico em ambientes interiores não basta analisar as condições de conforto para o corpo como um todo, pois há a necessidade de se analisar também as condições de desconforto térmico local. Em ambientes complexos, tais como os ambientes cirúrgicos, onde os membros da equipe cirúrgica ocupam diferentes posições no ambiente e desempenham atividades distintas, a análise de condições de desconforto térmico local torna-se ainda mais premente. No presente trabalho foram analisadas condições de desconforto térmico local devido a assimetrias da temperatura radiante, diferença vertical de temperatura do ar e risco de correntes de ar utilizando manequim, medição de variáveis ambientais e avaliação subjetiva. Resultados da avaliação subjetiva mostraram níveis de insatisfação de até 35 % dos anestesistas e enfermeiros com correntes de ar e de até 85% dos cirurgiões com o calor do foco cirúrgico. Resultados similares foram obtidos a partir da medição de variáveis ambientais e com o uso de manequim. Estes resultados ressaltam ainda mais a grande dificuldade de se prover condições de conforto térmico neste tipo de ambiente. Entretanto, a utilização de diferentes ferramentas de análise pode auxiliar na busca de se prover condições de conforto térmico as melhores possíveis para todos os membros da equipe cirúrgica.

Medication reconciliation and adherence: a call for clinical pharmacist

Introduction and Objectives: With the population ageing, there is a growing number of people who have several comorbidities and make use of a variety of drugs. These factors lead to a greater predisposition to adverse drug events, as well as to medication errors. The clinical pharmacist is the most indicated health professional to target these issues. The aims of this study were to analyze the profile of medication reconciliation and assess the role of the clinical pharmacist regarding medication adherence. Material and Methods: Prospective observational cohort study conducted from Jan-Mar 2013 at the Surgical Clinic of the University Hospital of the University of Sao Paulo. 117 admitted patients - over the age of 18 years, under continuous medication use and with length of hospitalization up to 120h - were included. Discrepancies were classified as intentional/unintentional and according to their risk to cause harm, and interventions were divided into accepted/not accepted. Medication adherence was measured by Morisky questionnaire. Results and Conclusions: Only 30% of hospital prescriptions showed no discrepancies between the medications that the patient was using at home and those which were being prescribed at the hospital and more than one third of those had the potential to cause moderate discomfort or clinical deterioration. One third of total discrepancies were classified as unintentional. About 90% of the interventions were accepted by the medical staff. In addition, about 63% of patients had poor adherence to drug therapy. The study revealed the importance of the medication reconciliation at patient admission, ensuring greater safety and therapeutic efficacy of the treatment during hospitalization, and orienting the patient at discharge, assuring the therapy safety.

Scatola di luce,un polo scolastico per Bertinoro: riqualificazione e ampliamento della scuola media "P. Amaducci"

Questa tesi ha come oggetto la riqualificazione energetica e funzionale della scuola media statale “P. Amaducci” di Bertinoro e la realizzazione, all’interno della stessa area, di una scuola elementare che condivida, con la struttura esistente, spazi per attività parascolastiche e sportive. Il lotto di intervento è situato ai margini del centro urbano, circondato da un’area identificata dalla pubblica amministrazione come di possibile espansione residenziale; esso presenta diverse criticità, tra cui la poca sicurezza dei percorsi pedonali, la frammentarietà del sistema degli spazi aperti, la mancanza di adeguate aree di sosta e di parcheggio. Grazie alla sua posizione elevata e alla collocazione all’interno di un ambito di interesse paesaggistico, dall’area si gode di un’ampia visuale sul territorio circostante, caratterizzato dalla coltivazione della vite. L’attuale scuola media statale “P. Amaducci”, realizzata nel 1990, è un edificio di circa 17800 mc con disposizione planimetrica a corte aperta, sviluppato su tre piani, ad est del quale nel 2000 è stato collocato un edificio a blocco di 12000 mc, che ospita un palazzetto dello sport di rilevanza provinciale. Nonostante la sua recente costruzione, la struttura presenta diverse carenze progettali, tra cui lo sfavorevole orientamento delle aule per la didattica, che determina un elevato livello di discomfort, la scarsa prestazione energetica che colloca l’edificio in classe energetica E, e il generale sovradimensionamento del complesso e dei singoli spazi interni (circa 180% di spazio in più rispetto a quanto previsto dal D.M.del 1975 sull’edilizia scolastica. La scuola era originariamente progettata per ospitare tre sezioni, per un totale di 225 alunni; attualmente è frequentata da solo 132 studenti, con conseguente mancata utilizzazione di una parte consistente dell’edificio. Gli obiettivi dell’intervento sono quelli fissati dall’Amministrazione comunale e consistono essenzialmente in: - Riunificazione della scuola media con la scuola elementare in un unico polo scolastico, mettendo in comune una serie di ambienti quali l'auditorium, la mensa, le aule speciali, l’adiacente palazzetto dello sport. - Realizzazione di un ampliamento per la nuova scuola elementare, con capacità di 10 aule. Esso andrebbe realizzato a monte dell'attuale scuola media favorendo un ingresso separato dei due ordini di scuola. - Revisione di alcune soluzioni progettuali ed energetiche errate o non funzionali presenti nell'attuale struttura. A seguito di alcune analisi effettuate sulla popolazione di Bertinoro e sull’accesso ai plessi scolastici dalle frazioni vicine (Fratta Terme, Capocolle, Panighina) è emersa la scarsa dinamica demografica del comune, la quale ha suggerito di prevedere la riduzione degli spazi destinati alla scuola media e l’utilizzo dei locali eccedenti per ospitare aule per la didattica ad uso della nuova scuola elementare, prevedendo inoltre l’uso congiunto degli spazi per attività parascolastiche tra le due scuole (mensa, biblioteca, auditorium e palestra) e progettando un ampliamento per ospitare le altre attività necessarie al funzionamento della nuova scuola elementare. Il progetto ha assunto la sostenibilità e il minimo impatto sull’ambiente come principi generatori gli elementi del contesto naturale come risorse: mantiene l’edificio adagiato sul declivio del terreno e valorizza la vista verso la vallata circostante, in modo da aprirlo sul paesaggio. Per limitare una delle criticità funzionali rilevate, il progetto si è proposto di separare i percorsi pedonali da quelli carrabili inserendo zone filtro con la funzione di proteggere l’accesso al polo scolastico e al palazzetto dello sport e, al fine di evitare la promiscuità delle utenze, di differenziare altimetricamente gli ingressi dei diversi edifici e di prevedere due parcheggi, uno a monte dell’area (di pertinenza della nuova scuola primaria), e uno a valle (ad uso degli utenti della scuola secondaria di primo grado e della palestra). Nella nuova configurazione spaziale dell’edificio esistente, le aule per la didattica sono collocate sul fronte principale orientato a sud-est e dotate di ampie aperture provviste di schermature studiate sulla radiazione solare locale. Per raggiungere un ottimo livello di illuminamento si è “scavato” un canale di luce all’interno dell’edificio, che fornisce alle aule un apporto di luce naturale aggiuntivo rispetto a quello che entra dalle facciate. Sul fronte nord-ovest si localizzano invece le aule speciali e i servizi, affacciati sulla corte. L’ingresso e il vano scala esistenti, in rapporto al volume ridimensionato della scuola media, risultano così in posizione baricentrica. La tesi presenta due diverse ipotesi di ampliamento, che prevedono entrambe la collocazione dei nuovi volumi a monte dell’edificio esistente, connessi ad esso tramite lo spazio dell’ingresso e la localizzazione di quattro aule per la didattica in una parte dell’edificio esistente. Il primo progetto di ampliamento si propone di ridefinire e valorizzare la corte interna attraverso l’inserimento a monte dell’edificio esistente di un volume su un solo piano, che si va ad inserire nel profilo della collina, secondo il principio del minimo impatto sul paesaggio circostante. Il secondo progetto di ampliamento punta invece sulla continuità visiva tra gli spazi aperti e il paesaggio: per questo si è collocato il nuovo volume, che si sviluppa su due piani (nella ricerca di un ottimale rapporto di forma) in adiacenza all’edificio esistente,dando luogo ad un ampio spazio verde su cui si affacciano le aule esposte a sud-est.

Studio di ausili tecnologici compensativi di supporto all'iter di apprendimento matematico secondario e universitario degli studenti con dislessia

Data coming out from various researches carried out over the last years in Italy on the problem of school dispersion in secondary school show that difficulty in studying mathematics is one of the most frequent reasons of discomfort reported by students. Nevertheless, it is definitely unrealistic to think we can do without such knowledge in today society: mathematics is largely taught in secondary school and it is not confined within technical-scientific courses only. It is reasonable to say that, although students may choose academic courses that are, apparently, far away from mathematics, all students will have to come to terms, sooner or later in their life, with this subject. Among the reasons of discomfort given by the study of mathematics, some mention the very nature of this subject and in particular the complex symbolic language through which it is expressed. In fact, mathematics is a multimodal system composed by oral and written verbal texts, symbol expressions, such as formulae and equations, figures and graphs. For this, the study of mathematics represents a real challenge to those who suffer from dyslexia: this is a constitutional condition limiting people performances in relation to the activities of reading and writing and, in particular, to the study of mathematical contents. Here the difficulties in working with verbal and symbolic codes entail, in turn, difficulties in the comprehension of texts from which to deduce operations that, once combined together, would lead to the problem final solution. Information technologies may support this learning disorder effectively. However, these tools have some implementation limits, restricting their use in the study of scientific subjects. Vocal synthesis word processors are currently used to compensate difficulties in reading within the area of classical studies, but they are not used within the area of mathematics. This is because the vocal synthesis (or we should say the screen reader supporting it) is not able to interpret all that is not textual, such as symbols, images and graphs. The DISMATH software, which is the subject of this project, would allow dyslexic users to read technical-scientific documents with the help of a vocal synthesis, to understand the spatial structure of formulae and matrixes, to write documents with a technical-scientific content in a format that is compatible with main scientific editors. The system uses LaTex, a text mathematic language, as mediation system. It is set up as LaTex editor, whose graphic interface, in line with main commercial products, offers some additional specific functions with the capability to support the needs of users who are not able to manage verbal and symbolic codes on their own. LaTex is translated in real time into a standard symbolic language and it is read by vocal synthesis in natural language, in order to increase, through the bimodal representation, the ability to process information. The understanding of the mathematic formula through its reading is made possible by the deconstruction of the formula itself and its “tree” representation, so allowing to identify the logical elements composing it. Users, even without knowing LaTex language, are able to write whatever scientific document they need: in fact the symbolic elements are recalled by proper menus and automatically translated by the software managing the correct syntax. The final aim of the project, therefore, is to implement an editor enabling dyslexic people (but not only them) to manage mathematic formulae effectively, through the integration of different software tools, so allowing a better teacher/learner interaction too.

Analog Signal Acquisition and Conditioning for Near-Field Capacitive Communication and Active Combined EEG-EIT Monitoring

The work of the present thesis is focused on the implementation of microelectronic voltage sensing devices, with the purpose of transmitting and extracting analog information between devices of different nature at short distances or upon contact. Initally, chip-to-chip communication has been studied, and circuitry for 3D capacitive coupling has been implemented. Such circuits allow the communication between dies fabricated in different technologies. Due to their novelty, they are not standardized and currently not supported by standard CAD tools. In order to overcome such burden, a novel approach for the characterization of such communicating links has been proposed. This results in shorter design times and increased accuracy. Communication between an integrated circuit (IC) and a probe card has been extensively studied as well. Today wafer probing is a costly test procedure with many drawbacks, which could be overcome by a different communication approach such as capacitive coupling. For this reason wireless wafer probing has been investigated as an alternative approach to standard on-contact wafer probing. Interfaces between integrated circuits and biological systems have also been investigated. Active electrodes for simultaneous electroencephalography (EEG) and electrical impedance tomography (EIT) have been implemented for the first time in a 0.35 um process. Number of wires has been minimized by sharing the analog outputs and supply on a single wire, thus implementing electrodes that require only 4 wires for their operation. Minimization of wires reduces the cable weight and thus limits the patient's discomfort. The physical channel for communication between an IC and a biological medium is represented by the electrode itself. As this is a very crucial point for biopotential acquisitions, large efforts have been carried in order to investigate the different electrode technologies and geometries and an electromagnetic model is presented in order to characterize the properties of the electrode to skin interface.

La città divisa. Conflittualità, confini, prove di comunità

Il presente lavoro approfondisce le tematiche della conflittualità e della separazione etnica, sociale, religiosa, generazionale e culturale. In particolare, riporta i risultati di ricerche condotte in alcuni degli attuali contesti urbani più carichi di tensioni conflittuali, cercando di individuare i motivi vicini e remoti del confligere, le attività messe in atto per contenere le tensioni e le relative necessità educative poste in primo piano. L’elaborato si compone di cinque parti. La prima parte consiste in una riflessione teorica sulle dinamiche che caratterizzano le interazioni sociali nello spazio cittadino. Nella seconda parte viene trattato il tema del settarismo in Scozia, che vede contrapposti i cattolici di origine irlandese (generalmente tifosi della squadra di calcio dei Celtic) e i protestanti di sangue scozzese (generalmente tifosi dei Rangers). La terza parte ricostruisce la storia e il presente della lunga convivenza tra tatari musulmani e russi cristiano-ortodossi nei territori dell’attuale Repubblica etnica del Tatarstan, situata nel cuore della Russia europea, ponendo particolare attenzione agli aspetti religiosi, linguistici, culturali ed educativi. La quarta parte parla del disagio nelle periferie europee, manifestatosi in modo eclatante con le rivolte giovanili in Francia (2005) e nel Regno Unito (2011). La parte conclusiva, infine riprenderà alcuni degli elementi emersi per proporre una riflessione di tipo pedagogico atta ad affrontare in tutta la sua complessità, e con approcci nuovi, il tema della città divisa, con le relative conflittualità, i confini e le prove di comunità.

Stimulus-induced gamma activity in the electrocorticogram of freely moving telemetric implanted rats: the neuronal signature of novelty detection

During this thesis a new telemetric recording system has been developed allowing ECoG/EEG recordings in freely behaving rodents (Lapray et al., 2008; Lapray et al., in press). This unit has been shown to not generate any discomfort in the implanted animals and to allow recordings in a wide range of environments. In the second part of this work the developed technique has been used to investigate what cortical activity was related to the process of novelty detection in rats’ barrel cortex. We showed that the detection of a novel object is accompanied in the barrel cortex by a transient burst of activity in the γ frequency range (40-47 Hz) around 200 ms after the whiskers contact with the object (Lapray et al., accepted). This activity was associated to a decrease in the lower range of γ frequencies (30-37 Hz). This network activity may represent the optimal oscillatory pattern for the propagation and storage of new information in memory related structures. The frequency as well as the timing of appearance correspond well with other studies concerning novelty detection related burst of activity in other sensory systems (Barcelo et al., 2006; Haenschel et al., 2000; Ranganath & Rainer, 2003). Here, the burst of activity is well suited to induce plastic and long-lasting modifications in neuronal circuits (Harris et al., 2003). The debate is still open whether synchronised activity in the brain is a part of information processing or an epiphenomenon (Shadlen & Movshon, 1999; Singer, 1999). The present work provides further evidence that neuronal network activity in the γ frequency range plays an important role in the neocortical processing of sensory stimuli and in higher cognitive functions.

Chitosan based hydrogels for transmucosal drug delivery

The aim of this thesis was the formulation of new chitosan based delivery systems for transmucosal drug administration. Transmucosal routes, such as buccal, vaginal and nasal routes, allow the circumvention of the hepatic first pass metabolism and avoid the gastrointestinal chemical and enzymatic degradations. Moreover, transmucosal drug administration can allow to avoid pain or discomfort caused by injections, when drugs are administered through parenteral routes, thus increasing patient compliance. On the other side, the major disadvantage of transmucosal drug administration is represented by the presence of biological fluids and mucus that can remove drug systems from the application site, thus reducing the contact time between drug and mucosa and consequently, decreasing drug bioavailability. For this reason, in this study, the investigation of chitosan delivery systems as mucoadhesive formulations able to increase drugs residence time and to improve their bioavailability, was taken into account. In the paper 1, buccal films based on chitosan-gelatin complexes were prepared and loaded with propranolol hydrochloride. The complexes were characterized and studied in order to evaluate their physical- chemical properties and their ability to release the drug and to allow its permeation through buccal mucosa. In the paper 2, vaginal inserts based on chitosan/alginate complexes were formulated for local delivery of chlorhexidine digluconate. Tests to evaluate the interaction between the polymers and to study drug release properties were performed, as well as the determination of antimicrobial activity against the patogens responsible of vaginitis and candidosis. In the project 3, chitosan based nanoparticles containing cyclodextrin and other excipients, with the capacity to modify insulin bioavailabity were formulated for insulin nasal delivery. Nanoparticles were characterized in terms of size, stability and drug release. Moreover, in vivo tests were performed in order to study the hypoglycemic reduction in rats blood samples.

Representaciones Sociales de la Medicina Popular en el paciente oncológico adulto, la familia del paciente y los miembros del equipo de salud

Esta investigación tuvo como objetivo general develar las representaciones sociales sobre la Medicina Popular en tres grupos poblacionales, pacientes oncológicos (n=100), familiares de los pacientes (n=25) y miembros del equipo de salud (n=26). Para ello, se realizaron tres estudios cualitativos con cada grupo poblacional y un cuarto en el que se describen las similitudes y las diferencias entre ellos en relación con el objeto de representación. En general, se utilizaron entrevistas en profundidad, ejercicios de asociaciones libres y grupos focales (7 con 62 pacientes). Resultados: paciente oncológico: Medicina Popular representada como una salida optimista a la angustiante situación que está viviendo frente al cáncer; una apuesta a la vida. Para la familia: una contra capaz de mantener con vida y fortaleza al paciente y para el equipo de salud, una realidad incombatible de los pacientes y de la familia, que tiene efecto placebo sobre ellos y que está relacionada con el pensamiento mágico religioso, la fé y la ignorancia de quienes la realizan. En cuanto a las diferencias, el paciente y la familia consideran que la Medicina Popular es una alternativa en la que depositan su fé y confianza; el personal de salud no cree en sus efectos sobre el cáncer y la considera como estafa y engaño para el paciente. En las similitudes, todos coinciden en que es una alternativa, generadora de esperanza, basada en compuestos naturales que le permiten al paciente contribuir a la curación del cáncer y a sobrellevar el malestar provocado por la quimioterapia. Finalmente, se presentan conclusiones generales, se discuten algunos de los hallazgos y la importancia de las RS de la Medicina Popular y su impacto sobre la atención y la calidad de vida del paciente y se plantean algunos interrogantes que podrían favorecer el desarrollo de una línea de investigación en el tema.