A pessoa com tuberculose e o cuidado de si

Tuberculosis is a serious disease with high incidence and prevalence, and in many countries a priority public health problem, with persisting high epidemiological significance. Seeing the person with tuberculosis it is important to observe his/her self care, as well as the difficulties intertwined in this process, since it can be directly impacting the health/disease process. The aim of this study was to analyze the self care of people with tuberculosis. Descriptive study with qualitative approach, conducted in West Sanitary District of the city of Natal, RN. Data collection occurred through a semi-structured interview guided by questions concerning sociodemographic and about the disease, treatment, and self care, between the months of July to September 2012 and met the ethical precepts of research with human beings. To analyze the results we used the technique of thematic content analysis of Laurence Bardin, through the prism of the theoretical-philosophical self care discussed by Michel Foucault. From the analysis emerged two categories, the first being, Meaning of tuberculosis, with subcategories: tuberculosis as sadness and unhappiness and tuberculosis as a normal issue, and the second, Beware yourself to tuberculosis, which had subcategories: self care as attention to the health care of oneself as satisfaction of basic needs and difficulties to self care. Tuberculosis represents for some people, something really sad, causing psychological suffering, however the other presents as normal. Self care of persons with tuberculosis in this study are related in great part to seek health care and the satisfaction of basic needs. About the difficulties related to the practice of self-care, it is observed that these are tied to food, time for rest, slowness of health services for scheduling appointments and tests, as well as related habits and dependencies in the lives of these people. This study contributed to a reflection of the users with tuberculosis and self care, revealing aspects that healthcare professionals should pay attention to watch these people, being able to see everyday on the run, the need for a space and time for oneself

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Podridão de raízes causada por Pythium aphanidermatum, em cultivares de alface produzidas em sistema hidropônico

A podridão de raízes, causada por Pythium aphanidermatum e outras espécies de Pythium, é a principal doença da alface cultivada em sistemas hidropônicos no Brasil. O presente trabalho teve como objetivo avaliar quatro cultivares comerciais de alface em relação à sensibilidade a podridão de raízes, causada por P. aphanidermatum. Os estudos foram realizados em placas de Petri contendo ágar-água com plântulas de alface das cultivares crespa (Vera e Verônica) e lisa (Regina e Elisa), infestadas ou não com o patógeno. Com as mesmas cultivares foram realizados quatro experimentos em sistemas hidropônicos (Nutrient Film Technique), sendo dois em estufa coberta com plástico e sombrite e dois em estufa coberta apenas com plástico. As plântulas, infectadas ou não com P. aphanidermatum, foram transplantadas para os sistemas infestados ou não. Foi avaliada a severidade da doença e o desenvolvimento das plantas. Todas as cultivares foram suscetíveis à podridão de raízes nos experimentos realizados in vitro e in vivo. A presença do sombrite não reduziu a podridão de raízes em cultivares de alface produzidas no sistema hidropônico. A cultivar Regina apresentou maior massa de matéria seca da parte aérea e das raízes, na presença ou ausência do patógeno, sendo a mais indicada para o cultivo hidropônico na época mais quente do ano.

Dermatophyte-host relationship of a murine model of experimental invasive dermatophytosis

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

Ánálise da capacidade funcional e da distribuição regional da ventilação pulmonar em pacientes com doença de chagas

INTRODUCTION: Cardiac and pulmonary manifestations of the Chagas disease (CD) affect between 20-30% of the infected subjects. The chronic Chagas cardiomyopathy (CCC) has some peculiarities such as arrhythmias and, especially heart failure (HF) and is potentially lethal due to left ventricular dysfunction. How respiratory disorders, patients get progressive loss of functional capacity, which contributes to a poor quality of life related to disease. Measurements of lung volume by the movement of the chest wall surface are an alternative evaluation of lung function and kinematics of complex thoracoabdominal for these patients. OBJECTIVE: evaluate the kinematics of the thoracoabdominal complex through the regional pulmonary volumes and to correlate with functional evaluation of the cardiorrespiratory system in patients with Chagas disease at rest. MATERIALS AND METHODS: a cross-section study with 42 subjects had been divided in 3 groups, 15 composed for patients with CCC, 12 patients with HF of different etiologies and 15 healthful presented control group. An optoelectronic plethysmography (POE), Minnesota questionnaire, six minute walk test, spirometer and manovacuometer was used. RESULTS: It was observed in the 6MWT where group CRL presented greater distance 464,93±44,63m versus Group HF with 399,58± 32,1m (p=0,005) and group CCC 404±68,24m (p=0,015), both the groups presented difference statistics with regard to Group CRL. In the manovacuometer 54,59±19,98; of the group CCC and 42,11±13,52 of group IC found group CRL presented 81,31±15,25 of the predicted versus, presenting in relation to group CRL. In the POE it observed a major contribution in abdominal compartment in patients with IC if compared like CCC and control groups. On the basis of the questionnaire of quality of life of Minessota, verified a low one groups CCC and IC 43,2±15,2 and 44,4±13,1, respectively (p<0,05) when compared with the control group (19,6±17,31). CONCLUSION: it seems that the patients with CCC possess same functional and respiratory characteristics, observed for the POE, 6MWT, manovacuometer and spirometer to the patients of group HF, being able to consider similar interventions for this complementary group as therapeutical of this neglected disease

A escrita do tempo e a poética do espaço:história e espaço no livro Geografia do Brasil Holandês de Luís da Câmara Cascudo

In 1956, Luís da Câmara Cascudo published his book Geografia do Brasil Holandês. In this book, he studied and described a space - the Dutch Brazil - from a geographical and historical perspective. To do this, he articulated both perspectives from the point of view of his own reading of the History of Nordeste , establishing a dialogue with the historiographical tradition of the study of the Dutch Brazil in Pernambuco. When portraying the Dutch presence in Nordeste, Cascudo articulated a drama in which the Dutch would have their history described as a typically tragic plot, portrayed as if they were already condemned to failure in advance. To this tragedy he opposed a predominantly comic Portuguese plot, as if the Portuguese victory over the Dutch was as desirable as inevitable for the space of Nordeste . When narrating the clash between the Dutch and the Portuguese for the space of Nordeste , however, Cascudo ended up delineating his own place of speech, as a spokesperson for the identity of the potiguar space in opposition to the pernabucano space described by Freyre and Gonsalves de Mello. In this way, the space of Rio Grande do Norte would have its own identity, constructed from de Dutch absence and constituted from the Portuguese legacy contrarily to the space of Pernambuco, narrated from an articulation and a conciliation of the Flemish and Lusitan legacy, even though highlighting the latter. While the Dutch would had been a constant presence in the history of Pernambuco for Freyre and Gonsalves de Mello, they wouldn t have gone beyond legend in the space of Rio Grande do Norte, removed from its geography and erased from its history. When describing de geography of the potiguar space, therefore, Cascudo articulates the inexistence of the History of a time dominated by the Fleming with the search of a Portuguese space, trough the narration of its origins and constitution, as well as the registry of the characteristics of its legacy

O mundo criado pelas imagens: paisagens e espaços coloniais na obra do holandês Frans Post

The aims of this dissertation is to study formation of the Dutch view seeing the colonial scenery in screens by Frans Post, as well as, to perceive a colonial world constitution through landscape paintings by him with his natural and human representation. The artist was the first to portray South American views, after he landed in Pernambuco with retinue of Dutch governor of colony, John Maurice, Prince of Nassau-Siegen. Post, by his 24 years old, was designated to represent for Dutch people their colony. The text reflects on visual construction of natural and human aspects in landscapes by Dutchman and how that aspects were included in colonizer imaginary about the strange world of America. European (Dutch) look about their conquered possessions in the New World was charged with exoticism and imagination. In order to understand that view, it`s paramount to study imaginary pictures reared by Frans Post, on his return to the Netherlands, and notions of landscape and exotic, wild and unspoiled nature which the Dutch people had when they thought about the Dutch colony in America. Our principal (visual) sources of research are six paintings: Vista da Sé de Olinda (1662), Vista das ruínas de Olinda (undated), Engenho (undated), Engenho (1660), Vista da cidade Maurícia e do Recife (1653), e Paisagem com rio e tamanduá (1649), all these canvases were painted when Frans Post returned to Europe. We seek to work through a methodology that focuses on investigation of primary visual and textual material, because these textual and pictorial representations reflect the 17th-century colonial view of colonial history themes of the - here called - Dutch America

Vicus Judæorum: os judeus e o espaço urbano no Recife neerlandês

This work broaches the participation of the Jewish community in the urban expansion of Recife, Brazil, during the Dutch period (1630-1654). With the arrival of the Dutch, the village of Olinda, former capital of Pernambuco, was destroyed and Recife received the juridical statute of city (stad), becoming the capital of Dutch Brazil or New Holland. It became the main West Indians Company s entrepot in South Atlantic, serving as naval base, port of call for ships, and point of export of the sugar production of Pernambuco, and import of European goods and African slaves. In order to such administrative, military and economic functions be carried out, the sand isthmus where Recife used to stay, and the fluvial island of Antônio Vaz, received improvements of many sort. The Dutch hydraulic technology was put in practice, with a posture of opposition between civilization and nature. Among military works and production of urban equipments, the rivers shores were land-filled, canals were built, bridges were lifted, and hundreds of buildings were erected. The civil Dutch population of Recife engaged in the process of production of physical space, which brought a sense of collective action towards the formation of the urban, or burgher, community. From the physical to the social space, there was an effort towards Dutch cultural standards in the urban environment. The Zur Israel Jewish community, formed by private civilians, it is, nonemployees of the WIC, engaged in those processes. It produced physical space through the land-filling and improvement of non healthy areas, and was also responsible for the construction of a significant section of the town s buildings and some of urban equipments, such as stores, markets and slave-warehouses, making more dynamic their economical activities. But their social traffic was due to the adaptation of their behavior to the standards of Dutch sociability. Thus, the community body made itself part of the social body. Disposing of internal selfregulation, it produced spaces with their cultural references cemetery, synagogue, texts enjoying benefits of the government. Zur Israel inscribed itself in the universal history of the Jews as the first community of Americas, and had a fundamental part on the emancipation of Jews within Western society

Resiliência no trabalho contemporâneo: promoção e/ou desgaste da saúde mental

Este estudo teórico resgata a concepção processual e contextual de resiliência, a qual compreende esse fenômeno enquanto relação complexa entre indivíduo e ambiente na produção de fatores de risco e no provimento de fatores protetores da subjetividade do indivíduo, buscando aplicá-la à realidade organizacional, haja vista que o mundo do trabalho contemporâneo demanda uma força de trabalho específica, qual seja, o trabalhador flexível, polivalente, sujeito a mudanças - portanto, um trabalhador resiliente. A partir dessas considerações, realiza-se um processo de reflexão sobre as situações em que a resiliência pode ser promotora de saúde mental, bem como acerca dos contextos que contribuem para o processo de adoecimento do trabalhador, buscando aventar possibilidades de atuação do profissional psicólogo diante de um contexto de trabalho adverso, considerando-se que o principal objetivo dessa atuação profissional é garantir a proteção/promoção da saúde e qualidade de vida no ambiente de trabalho.

Doença periodontal e angina pectoris estável: um estudo caso-controle

The search which it aim was to analyze the Periodontal Disease as a risk factor for the development of the Stable Angina Pectoris. For that, 120 patients (52 blokes and 68 wenches ), ages ranging from 40 to 65 years old, and attended to the Hemodinamic´s Sector of the Natal Hospital Center, showing the historic of Angina Pectoris to accomplishment of cinecoronariografhy. Before the accomplishment of this exam, the patients were submitted to interview, to investigate the possible risk factors for the Cardiovascular diseases , and it was followed of clinical periodontal examination to evaluate the presence of Periodontal Disease. After the cinecoronariography, the patients who presented diagnosis of important arterial obstruction (above 70%) were enrolled to the case grup. However the individuals with arteries free of obstruction, or obstrution below 30%, were considered without historic of Cardiovascular disease and therefore enrolled for the control grup. The groups were paired by the variables age and gender. From the analysis of the results, a did not observed statisticment the significant association between the presence of the Periodontal Disease, probing depth, periodontal attachment level, severity and extension index of the Periodontal Disease, besides the visible plaque index (VPI) an gingival bleeding index (GBI) regarding to the existence of Stable Angina Pectoris. Nevertheless , it was identified statisticment the significant association between the sistemic arterial hypertension , seric level of total cholesterol, LDL, HDL and triglycerides, showing all of them, classic risk factors appointed by the literature. Therefore, it was conclued that Periodontal Disease did not represent association with the StableAngina Pectoris at least among the studied population

Avaliação dos níveis de proteína C-reativa ultra-sensível em pacientes com periodontite crônica severa generalizada e sem periodontite

INTRODUCTION: The high sensitivity C-reactive protein (hsCRP) constitutes an inflammatory mediator used as predictor of cardiovascular risk that comes being researched as indicative relation factor between cardiovascular and periodontal diseases. PROPOSITION: To compare serumals levels of C-reactive protein between patients with and without generalized severe chronic periodontitis. METHODOLOGY: A seccional study was realized using a sample with 62 patients, being 31 participants carriers of periodontal diseases (Group I) and 31 without periodontal diseases (Group II), grouped to the pairs by age and sex. As inclusion criterio were selected patients with diagnosis of generalized severe chronic periodontitis, being preculeds, individuals which presented systemic disease, recent infection history, historical of CVA or stroke, smokers, pregnants and lactants. The research consisted of two stages, a clinc and other biochemist. The clinical stage is constituted of periodontal examination and the biochemist stage, of the peripheral blood collection for determination hsCRP levels and a hemogram to inquire any panel which could suggest infectious and/or inflammatory process. RESULTS: Periodontal disease group presented a average of 0,36mg/dL, while the group without disease presented 0,17 mg/dL, do not existing significant difference statistically between the averages (p = 0,061). The cardiovascular risk for the group I was classified high for 27,6% of participants and low for 72,4% of them. In the group II, 6,45% presented high risk e 93,5% low risk, being this significant relation statistically gotten for Fisher s Test (p = 0,042) presenting OR = 5,33; IC = 95% (1,02 27,4). The independets variables reseacred do not presented significant association statistically with the levels of hsCRP. CONCLUSION: The study indicated that despite of carriers patients of periodontal diseases do not present differents serumals levels of hsCRP from the other group, the periodontal disease was considered as risk factor for hsCRP plasmatic levels elevation

Análise de células t regulatórias foxp3+no líquen plano oral

T regulatory cells have the function of controlling immune responses and maintaining self-tolerance. The FoxP3 has been considered the most specific marker for Treg cells. The aiming of this paper was to evaluate the immunoexpression of FoxP3 in the inflammatory infiltrate from oral lichen planus (OLP) and to compare it with the infiltrate in fibrous inflammatory hyperplasia (FIH) and then, between reticular and erosive forms of OLP. The samples were composed by 32 cases of OLP (17 reticular and 15 erosive) beyond 10 cases of FIH that were submitted to immunohistochemistry staining for FoxP3. Localization of the staining was classified in underepithelial and intraepithelial and the amount of FoxP3+ cells was evaluated through cells counting in 10 consecutive fields, at 400x power magnification. The values were expressed in mean ± standart deviation, and submitted to statistical tests with 5% of significance level. It was observed a statistical significant difference in the amount of FoxP3+ Treg cells between the two combined forms of OLP (1,6 ± 2,2) and the FIH (0,5 ±0,4) (P<0,05). This maybe could be explained by immunological mechanism of OLP, which involves a permanent antigenic induction likely with consequent perpetuation of lesion, eliciting the proliferation and constant recruitment of Treg cells. Otherwise, FIH presents a different etiopathogenesis, in which there is also generation of a variable inflammatory infiltrate, however qualitatively distinct from that seen in OLP. The erosive form of OLP exhibited a greater number (1,7 ± 2,4) of FoxP3+ Treg cells than reticular form (1,5 ± 2,1). These alterations could have relation with the great disease activity verified in erosive OLP, or also, with abnormalities in the regulatory function of Treg cells that could cause the increase observed. Considering the capacity already well established in the literature, both about Treg cells in modulating immune responses, as in the oral mucosa in showing great potential for regeneration, it is suggested that the possibility of development and implantation of immunotherapeutic strategies that regulate the frequency and function of these cells, may help in future treatment of immune-mediated inflammatory diseases such as OLP

Resposta celular Th1 /Th2 na doença periodontal experimental, em ratos: um estudo imuno-histoquímico

Host response plays a major role in the pathogenesis of periodontal disease. Mediators such as inflammatory cytokines which are secreted during the immune response to bacterial challenges have ambiguous functions that may or may not lead to protection of the attacked tissue. In this context, experimental evidence suggests that T-helper 1 (Th-1) and T-helper 2 (Th-2) mediated responses are potentially important during the disease process. The aims of this study therefore were to further clarify the role played by Th2 cells during different time points of the active phase of periodontal disease, as well as, to investigate whether there was any evidence of a Th1 response in the periodontal disease microenvironment. Experimental periodontitis was induced in 30 Wistar male rats by placing cotton ligatures around the mandibular first molars. The rats were then randomly divided into two groups. Group1 (G1=15) and Group 2 (G2=15). In G1 the ligatures were maintained for 2 days, whereas in G2 the ligatures were left for 15 days, a time point that corresponds to the advanced stage of periodontal disease The contra-lateral teeth served as controls (no ligatures). Immunohistochemical investigation for the presence in gingival tissue of Th2 specific transcription factor (GATA3) and the subunit of the IFN-γ receptor was carried out after the disease induction period. Light microscopy analysis revealed a decrease in the expression of GATA-3 as bone loss progressed. On the other hand, although IFN-γ R1 was detected at an early stage of the active phase of disease its expression remained unaltered during the remaining period of the study. These results indicate that the Th2 response have a protective role during the pathogenesis of periodontal disease and that the progression of the periodontal disease is related with the unbalance of the responses Th1/Th2

Análise imuno-histoquímica das metaloproteinases da matriz ( MMP-1,MMP-2 e MMP-9) na doença periodontal

The tissular destruction found in periodontal diseases is caused mainly by components of the host that have its production stimulated by the products of the microorganisms present on the plaque. Matrix Metalloproteinases (MMPs), a class of enzymes involved both in physiologic and pathologic extracellular matrix degradation are considered the main responsible for the characteristic tissular loss in periodontal disease, and the understanding of how this happens can have a series of beneficial implications for prevention, diagnosis and treatment of this illness. The aim of this work was to study the immunohistochemical expression of MMP-1, MMP-2, and MMP-9 in fragments of gingival biopsies with clinical diagnose of periodontal disease. MMP-1 has expressed significantly more than the others MMPs in gingivitis both in the epithelium (p=0,0008) and connective tissue (p=0,0049). In periodontitis, both MMP-1 and MMP-9 has expressed significantly more than MMP-2 in the epithelium (p<0,0001) and in the connective tissue (p=0,0002). MMP-1 and MMP-9 presented more expression in periodontitis than in gingivitis but MMP-1 only in the connective tissue (p=0,03) and MMP-9 in the epithelium (p=0,003) and in the connective tissue (p=0,04). In conclusion, these results indicate that the MMP-1 presents high expression in every stages of the periodontal diseases, and increases its expression in the connective tissue when the gingivitis evolves to periodontitis. Therefore, it may have an important role in connective tissue degradation and bone loss observed in disease, since early, in gingivitis, until late stages, in periodontitis, of the periodontal disease. MMP-9 has expressed more in periodontitis than in gingivitis, both in epithelium and in connective tissue. It means that this enzyme may have some importance in the progression of gingivitis to periodontitis by acting in bone resorption observed in this desease

Exames parasitológicos, imunoistoquímicos e histopatológicos para detecção de Leishmania chagasi em tecidos esplênicos de cães com leishmaniose visceral

O propósito do presente trabalho foi o estudo da Leishmaniose Visceral Canina - LVC por meio de métodos parasitológicos e imunoistoquímicos para a detecção de formas amastigotas de Leishmania (L.) chagasi em baço, além de descrever a histopatologia das lesões esplênicas em 34 cães, com diferentes manifestações clínicas da LVC, eutanasiados pelo Centro de Controle de Zoonoses de Ilha Solteira, SP. Esses animais foram examinados clinicamente antes da eutánásia e de acordo com os sinais clínicos da LVC, foram classificados em três grupos: assintomáticos (8 cães), oligossintomáticos (17 cães) e sintomáticos (9 cães). Após a realização desses exames, dos 34 cães, 22 (64,7%) estavam positivos e 12 (35,3%) negativos. Desses cães positivos, 1/22 (4,5%) era assintomático, 12/22 (54,5%) eram oligossintomáticos e 9/22 (40,1%) sintomáticos. Pela histopatologia, os cães, especialmente os sintomáticos apresentavam o baço com inflamação crônica e espessamento na região capsular e trabecular, além de extensa alteração morfológica na polpa vermelha e branca pela presença de grande quantidade de macrófagos repletos de amastigotas, pela reação granulomatosa inflamatória e pelas áreas hemorrágicas. Os exames histopatológicos e a detecção microscópica direta da L. (L.) chagasi revelaram que o baço é um órgão útil para auxiliar no diagnóstico da LVC. A coloração imunoistoquímica foi a que detectou o maior número de tecidos esplênicos positivos com amastigotas, além de elucidar os casos suspeitos pelos exames parasitológicos, principalmente, nos animais assintomáticos ou oligossintomáticos.