Eventos de vida produtores de estresse e queixas de insônia entre auxiliares de enfermagem de um hospital universitário no Rio de Janeiro: estudo Pró-Saúde

OBJETIVO: Avaliar a associação entre eventos de vida produtores de estresse (EVPE) e queixas de insônia (QI). MÉTODOS: Foram analisados dados seccionais de 695 auxiliares de enfermagem de um hospital universitário, participantes do Estudo Pró-Saúde - coorte de funcionários de uma universidade no Rio de Janeiro. As informações foram obtidas através de um questionário multidimensional e autopreenchido, que avaliou a ocorrência de EVPE nos últimos 12 meses, variáveis socioeconômicas e demográficas e QI. As QI foram analisadas como desfecho politômico (frequente, ocasional, e ausente). Odds ratios brutos e ajustados foram calculados através de regressão logística multinomial. RESULTADOS: A prevalência total de QI foi de 45,8% (16,7% frequentes e 29,1% ocasionais). Após ajuste por sexo, idade, estado civil, renda familiar per capita e regime de trabalho, os EVPE associados com QI frequentes foram: "rompimento de relação amorosa" (OR = 3,32; IC95% 1,90 - 5,78), "ter tido problemas graves de saúde" (OR = 2,82; IC95% 1,73 - 4,58); "dificuldades financeiras graves" (OR = 2,38; IC95% 1,46 - 3,88), e "mudança forçada de moradia" (OR = 1,97; IC95% 1,02 - 3,79). Com relação às QI ocasionais, houve associação apenas com rompimento de relação amorosa (OR = 2,30; IC95% 1,42 - 3,74) e dificuldades financeiras graves (OR = 1,87; IC95% 1,27 - 2,75). CONCLUSÕES: Dada a responsabilidade com vidas humanas que os auxiliares de enfermagem assumem durante seu horário de trabalho, nossos achados podem contribuir para ações mais efetivas, por parte dos serviços de saúde ao trabalhador, para lidar com o estresse nessa categoria

Vidas arriscadas: uma reflexão sobre a relação entre o número de gestações e mortalidade materna

Este estudo teve por objetivo identificar o risco e os fatores associados à mortalidade materna de multigestas (cinco ou mais gestações). Descreve a tendência da Taxa de Fecundidade Total (TFT) e da Razão de Mortalidade Materna (RMM) de 1998 a 2004 no Paraná. Apresenta uma análise dos 822 óbitos maternos deste período, o cálculo da Razão de Mortalidade Materna Específica, o Risco Relativo, a freqüência e o Odds Ratio para algumas variáveis segundo número de gestações. Analisa também as causas e a evitabilidade dos óbitos maternos. Os resultados apontaram TFT baixa (1,8 filhos por mulher) e a RMM elevada (69,7/100.000 nascidos vivos) no Paraná em 2004. Um quarto dos 822 óbitos maternos (206) era de multigestas (cinco ou mais gestações), o risco relativo de morte materna foi seis vezes superior do que para as mulheres com até duas gestações, e os perfis sociodemográfico e o reprodutivo foram mais desfavoráveis para aquele grupo de mulheres. A baixa escolaridade, a idade igual ou acima de 30 anos e o pré-natal com menos de quatro consultas apresentaram associação com o maior número de gestações. A proporção de mortes por causas obstétricas indiretas, hemorragias e aborto, foi maior entre as multigestas, e cerca de 90% dos óbitos deste grupo foi considerado evitável. Concluiu-se que o monitoramento das multigestas com idade avançada e em desvantagem social, bem como ações efetivas de planejamento familiar, e serviços obstétricos qualificados para gestação de alto risco são medidas que podem contribuir para a redução da mortalidade materna

Contraceptive methods with male participation: a perspective of brazilian couples

OBJECTIVE: To assess the perspectives of couples who requested vasectomy in a public health service on the use of male participation contraceptive methods available in Brazil: male condoms, natural family planning/calendar, coitus interruptus and vasectomy. METHODS: A qualitative study with semi-structured interviews was held with 20 couples who had requested vasectomy at the Human Reproduction Unit of the Universidade Estadual de Campinas, Brazil. Data analysis was carried out through thematic content analysis. FINDINGS: The couples did not, in general, know any effective contraceptive options for use by men and/or participating in their use, except for vasectomy. The few methods with male participation that they knew of were perceived to interfere in spontaneity and in pleasure of intercourse. Men accepted that condom use in extra-conjugal relations offered them protection from sexually transmitted diseases; that their wives might also participate in extra-marital relationships was not considered. DISCUSSION: The few contraceptive options with male participation lead to difficulty in sharing responsibilities between men and women. On the basis of perceived gender roles, women took the responsibility for contraception until the moment when the situation became untenable, and they faced the unavoidable necessity of sterilization. CONCLUSIONS: Specific actions are necessary for men to achieve integral participation in relation to reproductive sexual health. These include education and discussions on gender roles, leading to greater awareness in men of the realities of sexual and reproductive health

Medicamentos e outros recursos utilizados no enfrentamento das doenças infantis no cotidiano familiar: estudo qualitativo

O estudo propõe analisar o consumo de medicamentos, plantas medicinais e outros recursos terapêuticos na construção de itinerários terapêuticos, em resposta aos agravos à saúde de crianças com menos de cinco anos de idade no âmbito doméstico, em área urbana. Pesquisa qualitativa, etnográfica, com 15 famílias, ao longo de 10 meses com 20 encontros quinzenais com as responsáveis pelas crianças no cotidiano familiar. Foram constatados 180 eventos de doenças, 74,5 por cento foram tratados, em primeira instância, em casa, resultando no uso de 212 recursos terapêuticos. O principal tipo de recurso terapêutico utilizado neste âmbito foi medicamentos industrializados, utilizados para prevenir e tratar doenças, diferenciando consideravelmente de suas indicações clínicas. Os serviços de saúde aparecem como segunda opção de tratamento. Na comunidade foram tratadas doenças conhecidas pela experiência popular, benzimentos e orações. As famílias usam medicamentos como práticas culturais e a aceitação de qualquer tipo de tratamento depende de suas expectativas e experiências

Efetividade de programa de agentes comunitários na promoção da saúde bucal

OBJETIVO:Avaliar mudanças em conhecimentos, atitudes e acesso/utilização de serviços odontológicos decorrentes de um programa de promoção da saúde bucal com agentes comunitários de saúde. MÉTODOS:Um projeto de capacitação combinando ensino-aprendizagem, apoio e supervisão, foi desenvolvido entre os meses de julho de 2003 a agosto de 2004. As mudanças foram avaliadas por meio de entrevistas estruturadas em que participaram 36 agentes comunitários de saúde e uma amostra de 91 mulheres e mães, representativa de donas de casa com 25 a 39 anos de idade, alfabetizadas e residentes em domicílios de três a seis cômodos no município de Rio Grande da Serra (SP). Foram colhidos dados sobre conhecimentos de saúde-doença bucal, práticas e capacidades auto-referidas em relação ao auto-exame, higiene bucal, número de residentes e de escovas dentais individuais e coletivas em cada domicílio e acesso e uso de serviços odontológicos. Por meio do teste t de Student pareado, foram comparadas as médias dos valores obtidos antes e depois do programa para cada um dos grupos estudados. As respostas foram analisadas adotando-se um nível de significância de 5%. RESULTADOS: Foram observadas diferenças estatisticamente significativas para questões relativas ao conhecimento de saúde bucal entre os agentes e entre as mulheres antes e depois da capacitação (p<0,05). Desequilíbrio entre o número de escovas e de indivíduos em cada família diminuiu. A freqüência da escovação e do uso do fio dental se elevou depois da atuação dos agentes. Os valores de auto-avaliação da higiene bucal aumentaram. Modificação nas práticas e capacidades auto-referidas mostrou significativa elevação da auto-confiança. O acesso ao serviço foi mais fácil (p<0,000) e seu uso mais regular (p<0,000) entre mulheres. CONCLUSÕES: Houve mudanças positivas na percepção em relação a aspectos de saúde bucal, na auto-confiança e no acesso e uso de serviços odontológicos. Tais mudanças po

Saúde bucal e cuidado odontológico: representações sociais de mães usuárias de um serviço público de saúde

Objetivo: identificar as representações sociais de mães de crianças da faixa etária de zero a cinco anos de idade do Núcleo de Saúde da Família IV, em Ribeirão Preto-SP, procurando saber o que pensam sobre saúde bucal e tratamento odontológico. Método: trata-se de pesquisa qualitativa, sendo utilizada a entrevista semi-estruturada para a coleta dos dados e a análise de conteúdo. Resultados: constatou-se grande dificuldade das mães em se expressar a respeito do que é, para elas, saúde. Para essas mães a saúde bucal está relacionada com normas de higiene e dietéticas e também com a ida ao dentista, restringindo-se na preocupação com a estética e pouco com a função. Já em relação ao tratamento odontológico, a grande maioria demonstrou apresentar medo, causado pela sua experiência anterior com o tratamento. A assistência particular está associada à pontualidade e ao atendimento da maneira desejada enquanto o tratamento oferecido pelo setor público à demora e à falta de equipamentos e materiais. A humanização no atendimento e competência do profissional emergiram como dois aspectos importantes, e podem estar determinando a decisão de ir ou não ao dentista. Conclusões: A expressão saúde bucal foi associada à assistência odontológica. O atendimento pelo setor privado foi referido como o que mais se aproxima do tipo ideal de assistência odontológica

Interleukin-22 forms dimers that are recognized by two interleukin-22R1 receptor chains

Interleukin-22 (IL-22) is a class 2 cytokine whose primary structure is similar to that of interleukin 10 (IL-10) and interferon-gamma (IFN-gamma). IL-22 induction during acute phase immune response indicates its involvement in mechanisms of inflammation. Structurally different from IL-10 and a number of other members of IL-10 family, which form intertwined inseparable V-shaped dimers of two identical polypeptide chains, a single polypeptide chain of IL-22 folds on itself in a relatively globular structure. Here we present evidence, based on native gel electrophoresis, glutaraldehyde cross-linking, dynamic light scattering, and small angle x-ray scattering experiments, that human IL-22 forms dimers and tetramers in solution under protein concentrations assessable by these experiments. Unexpectedly, low-resolution molecular shape of IL-22 dimers is strikingly similar to that of IL-10 and other intertwined cytokine dimeric forms. Furthermore, we determine an ab initio molecular shape of the IL-22/IL-22R1 complex which reveals the V-shaped IL-22 dimer interacting with two cognate IL-22R1 molecules. Based on this collective evidence, we argue that dimerization might be a common mechanism of all class 2 cytokines for the molecular recognition with their respective membrane receptor. We also speculate that the IL-22 tetramer formation could represent a way to store the cytokine in nonactive form at high concentrations that could be readily converted into functionally active monomers and dimers upon interaction with the cognate cellular receptors.

1-Benzyl-2,5-dioxopyrrolidine-3,4-diyl diacetate

The pyrrolidine-2,5-dione ring in the title compound, C(15)H(15)NO(6), is in a twisted conformation with the acetyl C atoms projecting to opposite sides of the ring. The acetyl groups lie to opposite sides of the five-membered ring. The benzene ring is roughly perpendicular to the heterocyclic ring, forming a dihedral angle of 76.57 (14)degrees with it. In the crystal, molecules are connected through a network of C-H center dot center dot center dot O and C-H center dot center dot center dot pi interactions.

2,2,6-Trimethyl-5-[2-(4-methylphenyl)ethynyl]-4H-1,3-dioxin-4-one

The 1,3-dioxin-4-one ring in the title compound, C(16)H(16)O(3), is in a half-boat conformation with the quaternary O-C(CH(3))(2)-O atom lying 0.546 (1) angstrom out of the plane defined by the remaining five atoms. The crystal structure is consolidated by C-H center dot center dot center dot O contacts that lead to supramolecular layers.

1-Benzoyl-5-phenyl-2-(propan-2-yl)-1,2,3,4-tetrahydropyrimidin-4-one

The tetrahydropyrimidinone ring in the title compound, C(20)H(20)N(2)O(2), is in a half-boat conformation with the N-C-N C atom 0.580 (2) angstrom out of the plane defined by the remaining five atoms. In the crystal structure, molecules are connected into centrosymmetric dimers via N-H center dot center dot center dot O interactions. The dimeric aggregates are linked into supramolecular chains along the a axis via C-H center dot center dot center dot pi interactions.

An AC-5 cathepsin B-like protease purified from Haemonchus contortus excretory secretory products shows protective antigen potential for lambs

The immunogenic properties of cysteine proteases obtained from excretory/secretory products (ES) of Haemonchus contortus were investigated with a fraction purified with a recombinant H. contortus cystatin affinity column. The enrichment of H. contortus ES for cysteine protease was confirmed with substrate SDS-PAGE gels since the cystatin-binding fraction activity was three times higher than total ES, despite representing only 3% of total ES. This activity was inhibited by a specific cysteine protease inhibitor (E64) and by recombinant cystatin. The one-dimensional profile of the cystatin-binding fraction displayed a single band with a molecular mass of 43 kDa. Mass spectrometry showed this to be AC-5, a cathepsin B-like cysteine protease which had not been identified in ES products of H. contortus before. The cystatin binding fraction was tested as an immunogen in lambs which were vaccinated three times (week 0, 2.5 and 5), challenged with 10 000 L3 H. contortus (week 6) before necropsy and compared to unvaccinated challenge controls and another group given total ES (n = 10 per group). The group vaccinated with cystatin-binding proteins showed 36% and 32% mean worm burden and eggs per gram of faeces (EPG) reductions, respectively, compared to the controls but total ES was almost without effect. After challenge the cystatin-binding proteins induced significantly higher local and systemic ES specific IgA and IgG responses.

Phylogenetic relationships within the speciose family Characidae (Teleostei: Ostariophysi: Characiformes) based on multilocus analysis and extensive ingroup sampling

Background: With nearly 1,100 species, the fish family Characidae represents more than half of the species of Characiformes, and is a key component of Neotropical freshwater ecosystems. The composition, phylogeny, and classification of Characidae is currently uncertain, despite significant efforts based on analysis of morphological and molecular data. No consensus about the monophyly of this group or its position within the order Characiformes has been reached, challenged by the fact that many key studies to date have non-overlapping taxonomic representation and focus only on subsets of this diversity. Results: In the present study we propose a new definition of the family Characidae and a hypothesis of relationships for the Characiformes based on phylogenetic analysis of DNA sequences of two mitochondrial and three nuclear genes (4,680 base pairs). The sequences were obtained from 211 samples representing 166 genera distributed among all 18 recognized families in the order Characiformes, all 14 recognized subfamilies in the Characidae, plus 56 of the genera so far considered incertae sedis in the Characidae. The phylogeny obtained is robust, with most lineages significantly supported by posterior probabilities in Bayesian analysis, and high bootstrap values from maximum likelihood and parsimony analyses. Conclusion: A monophyletic assemblage strongly supported in all our phylogenetic analysis is herein defined as the Characidae and includes the characiform species lacking a supraorbital bone and with a derived position of the emergence of the hyoid artery from the anterior ceratohyal. To recognize this and several other monophyletic groups within characiforms we propose changes in the limits of several families to facilitate future studies in the Characiformes and particularly the Characidae. This work presents a new phylogenetic framework for a speciose and morphologically diverse group of freshwater fishes of significant ecological and evolutionary importance across the Neotropics and portions of Africa.

Ecdysteroid-Dependent Expression of the Tweedle and Peroxidase Genes during Adult Cuticle Formation in the Honey Bee, Apis mellifera

Cuticle renewal is a complex biological process that depends on the cross talk between hormone levels and gene expression. This study characterized the expression of two genes encoding cuticle proteins sharing the four conserved amino acid blocks of the Tweedle family, AmelTwdl1 and AmelTwdl2, and a gene encoding a cuticle peroxidase containing the Animal haem peroxidase domain, Ampxd, in the honey bee. Gene sequencing and annotation validated the formerly predicted tweedle genes, and revealed a novel gene, Ampxd, in the honey bee genome. Expression of these genes was studied in the context of the ecdysteroid-coordinated pupal-to-adult molt, and in different tissues. Higher transcript levels were detected in the integument after the ecdysteroid peak that induces apolysis, coinciding with the synthesis and deposition of the adult exoskeleton and its early differentiation. The effect of this hormone was confirmed in vivo by tying a ligature between the thorax and abdomen of early pupae to prevent the abdominal integument from coming in contact with ecdysteroids released from the prothoracic gland. This procedure impaired the natural increase in transcript levels in the abdominal integument. Both tweedle genes were expressed at higher levels in the empty gut than in the thoracic integument and trachea of pharate adults. In contrast, Ampxd transcripts were found in higher levels in the thoracic integument and trachea than in the gut. Together, the data strongly suggest that these three genes play roles in ecdysteroid-dependent exoskeleton construction and differentiation and also point to a possible role for the two tweedle genes in the formation of the cuticle (peritrophic membrane) that internally lines the gut.

Phenotypic variation among four family members with congenital hypothyroidism caused by two distinct thyroglobulin gene mutations

Background: Thyroglobulin (Tg) is a large glycoprotein that is intimately involved in the biosynthesis of thyroxine and triiodothyronine. At least 38 mutations have been described in the Tg gene that are associated with varying degrees of hypothyroidism. We studied the Tg gene in four related subjects with congenital hypothyroidism. Summary: We found a novel compound heterozygous constellation (IVS30 + 1G>T/A2215D) in a brother and sister and one previously described related mutation (IVS30+1G>T) in their two sibling second degree cousins. The brother with the IVS30 + 1G>T/A2215D mutation and the two siblings with the IVS30+1G>T mutation had fetal or neonatal goiter and all had hypothyroidism. Conclusions: This study further confirms the association of the IVS30+1G>T mutation of the Tg gene with hypothyroidism. Computer analysis predicts that the A2215D mutation, first reported here, should cause structural instability of Tg but when present as a compound heterozygous mutation with IVS30+G>T/A its effect is unclear but is likely to be influenced by iodine intake.

Evaluating gene by sex and age interactions on cardiovascular risk factors in Brazilian families

Background: In family studies, it is important to evaluate the impact of genes and environmental factors on traits of interest. In particular, the relative influences of both genes and the environment may vary in different strata of the population of interest, such as young and old individuals, or males and females. Methods: In this paper, extensions of the variance components model are used to evaluate heterogeneity in the genetic and environmental variance components due to the effects of sex and age (the cutoff between young and old was 43 yrs). The data analyzed were from 81 Brazilian families (1,675 individuals) of the Baependi Family Heart Study. Results: The models allowing for heterogeneity of variance components by sex suggest that genetic and environmental variances are not different in males and females for diastolic blood pressure, LDL-cholesterol, and HDL-cholesterol, independent of the covariates included in the models. However, for systolic blood pressure, fasting glucose and triglycerides, the evidence for heterogeneity was dependent on the covariates in the model. For instance, in the presence of sex and age covariates, heterogeneity in the genetic variance component was suggested for fasting glucose. But, for systolic blood pressure, there was no evidence of heterogeneity in any of the two variance components. Except for the LDL-cholesterol, models allowing for heterogeneity by age provide evidence of heterogeneity in genetic variance for triglycerides and systolic and diastolic blood pressure. There was evidence of heterogeneity in environmental variance in fasting glucose and HDL-cholesterol. Conclusions: Our results suggest that heterogeneity in trait variances should not be ignored in the design and analyses of gene-finding studies involving these traits, as it may generate additional information about gene effects, and allow the investigation of more sophisticated models such as the model including sex-specific oligogenic variance components.