Motivos do abandono do seguimento médico no cuidado a portadores de hipertensão arterial: a perspectiva do sujeito

A hipertensão arterial é um expressivo problema de saúde pública enquanto fator de risco para as doenças cardiovasculares e principal grupo de causas de mortalidade no Brasil. A baixa adesão e o abandono do tratamento estão entre os principais obstáculos às estratégias individuais de controle. Estudam-se os motivos do abandono do seguimento médico em uma coorte de pacientes em tratamento de hipertensão arterial, em serviço de atenção primária à saúde, acompanhados por um período de quatro anos. Foram realizadas entrevistas semiestruturadas com cinquenta pessoas com hipertensão que abandonaram o seguimento médico. As respostas foram analisadas mediante a técnica de análise temática de conteúdo. Os motivos relatados para o abandono do seguimento mostraram predomínio de razões ligadas ao próprio serviço de saúde - sua organização, estrutura e a relação médico-paciente - e, ainda, tratamento em outro serviço de saúde. Razões de natureza psicossocial, como a ausência de sintomas, a melhora e/ou a normalização da pressão arterial e o consumo de álcool também contribuíram para o abandono do cuidado. Estudar os motivos do abandono na perspectiva do próprio sujeito permitiu verificar a riqueza e diversidade de problemas envolvidos no cuidado requerido.

Alcohol use disorders in patients with obsessive-compulsive disorder: The importance of appropriate dual-diagnosis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Association between distressing non-work-related events and occupational injuries

The following is a report on a case-control study whose objective was to investigate the association between distressing non-work-related events and occupational injures. Ninety three injured workers (cases) were matched with 372 non-injured controls in a large metallurgical factory in southeastern Brazil. Exposure to distressing non-work-related events was measured through a questionnaire focusing on situations pertaining to personal problems unrelated to work activities. The data were analyzed by adjusting a conditional logistic regression model, where occurrence of the work injury was the dependent dichotomous variable and answers from the questionnaire were independent continuous variables. The analysis showed an association between some distressing non-work-related events and occupational injuries. These findings imply expanding the horizon of preventive measures used in targeting. work injuries which have traditionally been focused on the control of strictly workplace risks.

Health-related behavior and quality of life among the elderly: a population-based study

OBJETIVO: Analisar a associação de comportamentos saudáveis com a qualidade de vida relacionada à saúde em idosos. MÉTODOS: Estudo transversal de base populacional que envolveu 1.958 idosos residentes em quatro áreas do estado de São Paulo, em 2001/2002. A qualidade de vida foi aferida com o uso do instrumento Medical Outcomes Study SF-36-Item Short Form Health Survey. As oito escalas e os dois componentes do instrumento constituíram as variáveis dependentes e as independentes foram atividade física, freqüência semanal de ingestão de bebida alcoólica e hábito de fumar. Modelos de regressão linear múltipla foram usados para controlar o efeito de sexo, idade, escolaridade, trabalho, área de residência e número de doenças crônicas. RESULTADOS: Atividade física foi positivamente associada com as oito escalas do SF-36. As maiores associações foram encontradas em aspectos físicos (β = 11,9), capacidade funcional (β = 11,3) e no componente físico. Idosos que ingeriam bebida alcoólica pelo menos uma vez por semana apresentaram melhor qualidade de vida do que os que não ingeriam. Comparados com os que nunca fumaram, os fumantes tiveram pior qualidade de vida no componente mental (β = -2,4). CONCLUSÕES: Os resultados apresentam que praticar atividade física, consumir bebida alcoólica moderadamente e não fumar são fatores positivamente associados a uma melhor qualidade de vida em idosos.

Selecting appropriate bedding to reduce locomotion problems in broilers

Two experiments were carried out at the Poultry Sector of the School of Agrarian Sciences of the Federal University of Grande Dourados to evaluate the incidence of leg problems in broilers reared on two distinct types of bedding material: rice husks or wood shavings, both new and reused. In both trials, a randomized experimental design was applied in factorial arrangement (2 x 2 x 2) using two genetic strains (Cobb® or Ross®); two sexes (male or female), and two litter materials (rice husks or wood shavings). In each trial 1080 one day pullets were reared equally divided in the treatments. The birds were placed in 4.5 m² boxes at a density of 10 birds m-2. All birds were fed diets with equal nutritional density, and water was offered ad libitum. Feeds were divided in three phases: starter diet (1 - 21 days), grower diet (22 - 35 days), and finisher diet (36 - 45 days). on day 45, fifty birds were randomly selected in each experiment to evaluate flock leg problems. The following parameters were analyzed: gait score, incidence of valgus and varus disorder, footpad dermatitis, femoral degeneration, tibial dyschondroplasia, and spondylolisthesis. Ambient temperature during rearing and litter caking and moisture content were recorded in four boxes per treatment. The analytical hierarchy process was used to organize the data into specific criteria. Several criteria, related to the attributes that were determinant according to the statistical analysis, were chosen in order to provide the best input to the process. Results indicated that new wood-shavings bedding was the most appropriate bedding to prevent locomotion problems, followed by new rice husks, reused wood shavings, and reused rice husks. However, when leg problems were associated to sex and genetic strain, male Ross birds strain presented less problems when reared on new rice husks, followed by new wood shavings

Major developments in conulariid research: problems of interpretation and future perspectives

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

Hydrochemical evaluation of the quality of some Brazilian waters

This investigation was carried out within the Parane sedimentary basin and neighbourhood in Brazil and involved the sampling of different water types with the purpose of evaluating its quality. Several methods were utilized for acquiring the hydrochemical data and a novel technique has been developed for evaluating the gross alpha and beta radioactivities in water, through a combined gamma-alpha spectrometry technique. The results obtained for the analyzed samples were compared with the guideline values established by the São Paulo State and Brazilian Health Ministry legislations for defining potable water standards and for the prevention and control of pollution in the environment. The hydrochemical data allowed evaluation of diverse problems related to the interaction between society and the environment such as sugarcane production and the releases associated with gas stations suppliers. The geogenic input of sulfate in groundwater was also identified. The established radiometric technique was properly calibrated and successfully applied to the analysis of different water types utilized for human consumption.

Suggestion of an inverse relationship between perception of occupational risks and work-related injuries

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

A experiência da toxicomania e da reincidência a partir da fala dos toxicômanos

Este estudo teve como objetivo examinar o fenômeno da toxicomania e sua reincidência a partir da fala dos toxicômanos. Foi realizado em instituição especializada no tratamento da dependência química e problemas relacionados ao uso de álcool e outras drogas, contando com dados do acompanhamento de onze sujeitos. Utilizou-se o referencial teórico psicanalítico para a escuta de indivíduos em situação de toxicomania, com o dispositivo das entrevistas preliminares, dentro do referencial da clínica da urgência em psicanálise. Os resultados do trabalho de escuta e da reflexão apontaram uma série de características psicológicas dos indivíduos estudados de clara relevância para o planejamento de estratégias individuais ou coletivas de atenção ao problema. Destacamos a hipótese de duas modalidades de toxicomania relacionadas com as formas particulares da subjetividade em que ocorre. A questão da reincidência na toxicomania aparece como um falso problema para os sujeitos, que demonstraram que a desintoxicação, concomitante à abstinência e provocada pela internação, é somente um momento de privação, simultaneamente necessária e forçada, do gozo propiciado pela droga. Finda a internação segue-se, geralmente, um novo período de uso. A aceitação da abstinência não significa que os sujeitos fazem uma renúncia, correlata, ao desejo pela droga. É apenas uma parada provavelmente ligada à menor tolerância psíquica à modalidade de gozo em ação na toxicomania, um gozo capaz de confrontar o sujeito com a morte. A abstinência forçada, como estratégia da política pública de saúde, presente no tratamento comum da toxicomania, mostrou conseqüências altamente negativas para o resultado do tratamento, parecendo indicar a necessidade de sua revisão urgente. Procurou-se problematizar a questão da abertura à dimensão subjetiva da experiência dos toxicômanos como estratégia capaz de interferir na trajetória dos sujeitos na relação com as drogas a partir do momento em que buscam ajuda.

Quantitative real-time PCR identifies a critical region of deletion on 22q13 related to prognosis in oral cancer

Quantitative real time PCR was performed on genomic DNA from 40 primary oral carcinomas and the normal adjacent tissues. The target genes ECGFB, DIA1, BIK, and PDGFB and the microsatellite markers D22S274 and D22S277, mapped on 22q13, were selected according to our previous loss of heterozygosity findings in head and neck tumors. Quantitative PCR relies on the comparison of the amount of product generated from a target gene and that generated from a disomic reference gene (GAPDH-housekeeping gene). Reactions have been performed with normal control in triplicates, using the 7700 Sequence Detection System (PE Applied Biosystems). Losses in the sequences D22S274 (22q13.31) and in the DIA1 (22q13.2-13.31) gene were detected in 10 out of 40 cases (25%) each. Statistically significant correlations were observed for patients with relative copy number loss of the marker D22S274 and stages T3-T4 of disease (P=0.025), family history of cancer (P = 0.001), and death (P = 0.021). Relative copy number loss involving the DIA1 gene was correlated to family history of cancer (P<0.001), death (P=0.002), and consumption of alcohol (P=0.026). Log-rank test revealed a significant decrease in survival (P=0.0018) for patients with DIA1 gene loss. Relative copy number losses detected in these sequences may be related to disease progression and a worse prognosis in patients with oral cancer.

A class of multiobjective control problems

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

Analysis of bone microarchitecture related to anthropometry in climateric women

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

Alternative uses for vinasse, an alcohol industry residue. A review

Recent studies on the recycling of vinasse, its potential use in agriculture and possible environmental problems resulting from the use and disposal of this residue are reviewed.

Ultrastructural study of the lateral lobe of the prostate of Wistar rats submitted to experimental chronic alcohol ingestion

Alcoholism is considered today one of the most serious social and medical problems. Different investigators have demonstrated that chronic exposure to alcohol causes morphological and physiological changes in the testes and in the accessory sex glands, in the prostate in particular. In the present study, experimental rats were divided into groups receiving sugar cane brandy diluted to 30° G.L. (30%, v/v) and Purina ration ad libitum for 60, 120, 180, 240 and 300 days, respectively. At the end of each period the animals were sacrificed and the lateral lobe of the prostate was collected for histological examination. The results showed atrophied epithelium, accumulation of lipidic droplets and rupture of the microvilli that line the cell surface facing the lumen of cells of the secretory epithelium of the lateral lobe of the prostate.

Mineralización de la paja de caña de azúcar en suelo adicionado con viñaza (suproducto de la industria del alcohol de caña de azúcar) y fertilizante nitrogenado

Cellulose is the most abundant vegetable organic compound, being derived mainly from plant residues. The decomposition of sugar-cane (Saccharum officinarum L.) straw was studied in a period up to 90 days, through variables related to the carbon cycle, such as respiratory activity and CM-cellulase (CM, cellulose microcrystalline) and CMC-cellulase (CMC, carboxymethylcellulose) activities. The treatments consisted of 0, 0.5 and 1.0% of straw, in the presence and absence of vinasse (a sugar-cane alcohol industry byproduct) and nitrogen fertilizer. The respiratory and cellulase activities increased up to the 14th day of incubation and later decreased. The respiratory activity was 1.9 and 2.3 fold larger (P < 0.05) in the soil with 0.5 and 1.0% of straw added, respectively, in relation to the control. CM- and CMC- cellulase activities also increased from 1.8 to 2.9 and from 2.3 to 2.7 fold, respectively. The vinasse addition enhanced CO 2 production and CM-cellulase activity, however, no significant effect was observed on CMC-cellulase activity. The addition of N reduced both respiratory and cellulase activities. The decomposition of the sugar-cane straw may enhance soil nutrient cycling increasing agricultural production. © 2006 Instituto de Investigaciones Agropecuarias, INIA.