Análise da adesão ao tratamento e da qualidade de vida de pessoas com úlcera venosa

The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ

Produção pesqueira artesanal: diagnóstico ergonômico e bases para um planejamento nutricional situado e a promoção da saúde dos jangadeiros

The traditional fishing with rafts is characterized by unpredictability, high stakes and inadequate work conditions. The extensive working hours, physical wear, inadequate nutrition, unsanitary conditions, lack of salvage equipment and instruments suitable working, added by the presence of changes in the nutritional status of fisherman, that contribute to the picture of insecurity in high seas, injuries and health. This study aimed to analyze the activity of the fisherman s from Ponta Negra, Natal / RN, and check the conditions of supply of these fishermen and their implications on health and development of their work. To this finality, was used a methodology based on the ergonomic work analysis employing techniques such as observational and interactional conversational action, listening to the answers, observation protocols, photographic and video records. The script conversational dynamic action was developed from literature searches about the artisanal fisheries, culture and food habits of this population, and analyzes the overall situation of focus and two reference situations. To collect data on the usual diet of fisherman as well as quantitative and qualitative analysis that was used for data analysis and 24h recall the Food Frequency Questionnaire (FFQ). The impact of this power to the health of fisherman was evaluated performing a nutritional assessment. The results revealed that the fishermen carry out their activities with poor working conditions, health and nutrition. Feeding practices of these fishermen undertake development work, making it even more stressful, as well contributing to the emergence of Chronic Noncommunicable Diseases. The management of the activity, as well as the current structure of the vessel, also contributes to the adoption of inappropriate feeding practices during the shipment of catch. The results of this indicate the need for adequate interventions in order to assist in recovery and / or maintenance of health of fisherman minimizing reflections of nutritional disorders for the development activity by improving the quality of life in this population

Os espaços poéticos de um cronista contador

This study discusses chronicler Rubem Braga and his chronicles published in O Estado de São Paulo newspaper (supplement Caderno 2), from 1988 to 1990. The analysis of the 84 chronicles focuses on the study of poetic spaces, mainly based on Gaston Bachelard s book The Poetics of Space. Narrator s characteristics are also shown in the analyzed chronicles, as he resembles a traditional storyteller, even though participates in a genre that belongs to a modern vehicle: the newspaper. The storyteller-chronicler moves in time and space, reporting his experiences to the readers, and also travels inside of himself, discovering places which were kept in his memory

Os rostos da pobreza brasileira: análise crítica dos discursos do governo federal, da Veja e da Cufa

Brazilian constitution says that all Brazilians have basic survival rights such as education, sanitation and food, but these basic rights are luxury for some. So, thinking about this, this paper aims to develop a critical analysis about the (re)production of the discourse on poverty, and consequently on the poor, given by the federal government, through the official website of the program Brazil Without Poverty (Brasil Sem Pobreza), the media, represented by Veja magazine, and by those who affirm to be representatives of the poor; like the Single Central Slums (Central Única das Favelas CUFA). Our aim is to present a critical reflection on the discourses about the poverty in the voices of the government, Veja magazine (media representative) and CUFA (poor representative) and their contribution to the development of the meanings of the theme in Brazilian society. In order to do so, we have identified categories based upon Bajoit (2006a) to classify which the author calls faces of poverty . We have used the Sociological and Communicational Discourse Approach (ASCD) as developed by Pedrosa (2012a, 2012b, 2012c), within the Critical Discourse Analysis as theoretical apparatus, and also the studies in which the ASCD is built upon such as Sociology for Social Change (BAJOIT, 2006), the Cultural Studies (HALL, 2005), and the Functional Systemic Linguistic, especially the Evaluating System (MARTHIN & WHITE, 2005, VIAN JR et al, 2011). Thus, the discourse on poverty or on fighting poverty, extracted from news, chronicles and other genres of the mentioned vehicles, are taken as object of study to understand identities that are created and renewed on poverty and on the Brazilian poor, as their dependence on the government and civil society, their exploitation by the economy, and even the media that sometimes features them as delinquent

Respostas lactacidêmicas de ratos ao treinamento intermitente de alta intensidade

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

Efeitos do ultrassom terapêutico sobre parâmetros morfométricos e clínicos e método de extração de metaloproteinases em sujeitos com úlceras venosas

Venous wounds cause physical, psychological and financial problems that impact the quality of life of patients. Treatment alternatives are investigated in order to reduce healthcare costs and improve quality of life of people affected by this problem. Physical resources, such as therapeutic ultrasound (US), are being considered in the treatment of ulcers as a potential healing agent. This study aimed to investigate the application of US as a treatment for venous ulcers. Subjects were divided into two groups: US group, where treatment consisted of 5 sessions of pulsed US (3 MHz, 1W/cm²) associated with compression and kinesiotherapy; and sham group, where individuals went through the same procedures, but with sham US therapy. Subjects were evaluated for wound size by planimetry and digital photography, visual analogue scale for pain, quality of life by the questionnaires SF- 36 and VEINES-QoL/Sym and enzymatic activity of metalloproteinases 2 and 9 by zymography. It was observed mean reduction in wound area of 41.58±53.8% for the US group and 63.47±37.2% for the placebo group, maintenance of quality of life scores in the US group and significant improvement (p<0.05) in the placebo group by VEINES questionnaire. It was observed decreased perception of pain in the placebo group. Sample feasibility for analysis of the protein activity of metalloproteinases 2 and 9 by zymography collected by swab method was also confirmed. Our data did not give us evidence to support the theory that the US accelerates healing of venous ulcers in a short-term analysis. However, we observed that standard care associated with compression therapy and kinesiotherapy were able to significantly shorten the progression of chronic venous ulcers

Efeitos do tratamento com Hidrogel na cicatrização de úlceras venosas de membros inferiores: revisão sistemática

Chronic venous disease (CVD) is evident among the chronic diseases and affects the elderly population and primarily is responsible for leg ulcers in this population. The use of dressings in the care of a venous ulcer is a fundamental part of the treatment for healing, however, evidence to assist in choosing the best dressing is scarce. The main objective of this study was to evaluate the effectiveness of treatment with hydrogel in the healing of venous ulcers using search methods, synthesis of information and statistical research through a systematic review and meta-analysis. Randomized controlled trials were selected in the following databases: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Beyond these databases three websites were consulted to identify ongoing studies: ClinicalTrials.gov, OMS ICTRP e ISRCTN. The primary outcomes were analyzed: complete wound healing, incidence of wound infection and the secondary were: changes in ulcer size, time to ulcer healing, recurrence of ulcer, quality of life of participants, pain and costs of treatment. Four studies are currently included in the review with a total of 250 participants. The use of hydrogel appears to be superior to conventional dressing, gauze soaked in saline, for the healing of venous leg ulcers; 16/30 patients showed complete healing of ulcers (RR 5,33, 95%CI [1,73,16,42]). The alginate gel was shown to be more effective when compared to the hydrogel dressing in reduction of the wound area; 61,2% (± 26,2%) with alginate e 19,4% (± 24,3%) with hydrogel at the end of four weeks of treatment. Manuka honey has shown to be similar to the hydrogel dressings in percentage of area reduction. This review demonstrated that there is no evidence available about the effectiveness of the hydrogel compared to other types of dressings on the healing of venous leg ulcers of the lower limbs, thus demonstrating the need of future studies to assist health professionals in choosing the correct dressing.

Habitação e modernização: Cidade Nova e maneiras de viver em Natal no início do século XX

Analyses the presence of new standards of habitation detected in the construction of the region called Cidade Nova, in the first s years of the XX century. Associates the presence of these new patterns with the historical moment lived by the capital, marked by the urban modernization and by the changes of local life. Map voices that, introduced by the republican groups since 1889, pronounced the overcome of the old city of the XIX century asseverated a new model of town. Make use, as fundamental fonts of research, of the urban chronicles produced by the local intellectuals and the newspapers, like A República. Dialog with chronics that includes since propositions about the colonial past until the preoccupations about the acting of the State on how to order the public space. Identifies on those texts the political motivations and the elements whose where inherent to capitalism that accelerated the changes occurred in the urban space. Demonstrates the gradual occupation of Cidade Nova as an important modification happened in the city from that time on. That neighborhood adopted a new model on how to construct the houses of their citizens and helped to promote the urban life as a whole. From now on, Natal has a space meant for the home of their richest families. Recognizes, from many ways, many discourses, manners of living that was legitimized by the changing of the XIX to the XX century and has his highest point in the 1920´s. And it was representative of the strong attachment about the habits of refinery and order in the essence of the private life of the local urban elites

As memórias cortesãs de Olivier de La Marche : o nascimento do indivíduo e a espacialização da cortesia na escrita das Mémoires (1472-1501)

Cette dissertation propose l analyse des Mémoires de Olivier de La Marche, homme de la cour qui a vécu comme serviteur des maisons de Bourgogne et d Autriche de l année 1439 jusqu à 1502. Nous avons compris sa littérature comme particulière pour l époque, car elle est née motivé par les questions personnelles de l auteur. C est pourquoi qu elle s est éloignée des genres littéraires liés à la fonction de servir aux propos du prince, particulièrement les chroniques. Nous avons cru que ces intentions particulières ont eu l origine dans la tradition de la mémoire médiévale, qui a répandu de l oral pour l écrit pendant la fin de la Moyen Âge. Cette écriture de la mémoire, réglementée à l expérience de qui écrivait, a promu la naissance de l individu quand il a cherché assumer les lieux du personnage et du témoin des événements dans l espace du texte . Telle affirmation nous avons conduit jusqu à la fonction des discours qui ont créé des espaces dans l oeuvre. Motivé par la vision spécialisée comme maître d hôtel, tels discours ont produit un espace de la cour idéal, capable de justifier la personnalité de l auteur et de lui consacrer comme le maître de la pratique de la courtoisie

Viagem-memória de Nilo Pereira: do Ceará Mirim ao Recife e do Recife ao Ceará Mirim

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Cantos de bar: sociabilidades e boemia na cidade de Natal

The academic work Bar Corners: sociability and bohemia in the Natal City (1946-1960) has as objective the study of a representation of the literary bohemia in Natal in the second half of the 1940 s and 50 s, by means of analyses of the memory books and the chronicles of the newspapers A Ordem and A República. In order to have a better understanding concerning the subject, in the first chapter we try to show the transformations which have occurred in Natal and, consequently, within Natal sociability during the first half of the twentieth century. The bohemia, demonstrated in this dissertation as a way of sociability, expressed itself through the meetings in bars and the serenades. In the second chapter, the study conducted a mapping of the bohemian spaces (cafes, candy stores, bars and prostituition houses) and established the differences between these spaces. We ideated the spaces as the stage of interpersonal relations, as people went to these places in the attempt to participate of the conversation groups that were found there, choosing them according to their affinity and personal interests. The last chapter has the purpose of investigating the bohemia in Natal through the experience of the chronicler Newton Navarro, who used to roam the dark streets of Ribeira in search for open bars, extending bohemia until dawn. The intellectual activity was associated with his bohemian practices. As he frequented the marginal areas in Natal, Navarro wrote about them in the major newspapers of the city

O padre, o filósofo e o profeta : a América de Simão de Vasconcelos

To build an Portuguese America, after discovering at the beginning of XVI century, the Europeans used the physic, politic colonization and also a space ideological domain using write texts, chronicles, and started making a conceive America that was more European than American. One of those chronicles was the Society of Jesus Chronicle written by father Simão de Vasconcelos, a Jesuit. So our object is recognizing in this chronicle the ways that this father had imagined the America. We are looking to answer how the Jesuit use some references to Classic Antiquity (meanly Aristotle and Samuel) because how this action until happen in the Renascence (XVII century) the intellectual production certainly involve renascent topoi. To get this we used some authors that study Intellectual/ Cultural History like Burckhardt e Ginzburg and some authors from Speech Analyses like Certeau and Foucault, to, in the end, can understand how Simão de Vasconcelos created his Brazil

Detecção de bactérias periodontopatogênicas cultiváveis e não cultiváveis em placas ateromatosas

Periodontal infections consist of a group of inflammatory conditions caused by microorganisms that colonize the tooth surface through the formation of dental biofilm. Chronic infections such as periodontitis have been associated to the development and progression of atherosclerosis. AIM: Detect cultivatable and non-cultivatable periodontopathogenic bacteria in atheromatous plaques; search for factors associated to the presence of these bacteria in the atheromatous plaques and characterize the presence of cultivatable and non-cultivatable bacteria in these plaques. METHODOLOGY: A cross-sectional study was performed with a sample of 30 patients diagnosed with atherosclerosis in the carotid, coronary or femoral arteries and surgically treated with angioplasty and stent implant, bypass or endarterectomy. The plaques were collected during surgery and analyzed using the PCR molecular technique for the presence of the DNA of the cultivatable bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Treponema denticola and of the non-cultivatable Synergistes phylotypes. The patients were examined in the infirmary, after the surgery, where they also responded to a questionnaire aimed at determining factors associated to the presence of periodontopathogenic bacteria in the atheromatous plaques. RESULTS: All patients with tooth (66,7%) possessed disease periodontal, being 95% severe and 65% widespread. No periodontopathogenic bacteria were found in the atheromatous plaques. However, four samples (13.3%) were positive for the presence of bacteria. Of these, three participants were dentate, being two carriers of widespread severe chronic periodontite and one of located severe chronic periodontitis. None of them told the accomplishment of procedures associated to possible bacteremia episodes, as treatment endodontic, extraction the last six months or some procedure surgical dental. CONCLUSION: The periodontopathogenic bacteria studied were not found in the atheromatous plaques, making it impossible to establish the prevalence of these pathogens or the factors associated to their presence in plaques, the detection of positive samples for bacteria suggests that other periodontal and non-periodontal pathogens be studied in an attempt at discovering the association or not between periodontal disease and/or others infections and atherosclerosis, from the presence of these bacteria in atheromas

Expressão imuno-histoquímica de IL-17, TGF-β1 e FOXP3 em ganulomas periapicais, cistos radiculares e cistos radiculares residuais

Periapical lesions are chronic inflammatory conditions of periradicular tissues considered direct consequences of infectious diseases resulting from pulp necrosis and subsequent progression to periapical region. The participation of the immune response and bone resorption in the formation of these lesions has been investigated, so that different cell types and cytokines have been identified as contributors to this process. In this perspective, this study aimed to evaluate the immunohistochemical expression of IL-17, TGF-β1 and FoxP3 in periapical granulomas (PGs), radicular cysts (RCs) and residual radicular cysts (RRCs), seeking a better understanding of the etiopathogenesis these periapicopatias. To this end, we selected 20 cases of GPs, 20 CRs and 10 RRCs to undergo morphological analysis and immunohistochemistry for biomarkers above, the latter being performed quantitatively using scores and average percentages of immunostaining for the analysis of IL-17 and TGF- β1, while for the FoxP3 were counted only the positive lymphocytes. The results showed statistically significant differences between TGF-β1 and FoxP3 imunoexpressions, in relation to the periapical lesions studied (p = 0.002, p <0.001, respectively) but not between IL-17 and these (p = 0.355). Furthermore, the analysis of lymphocytes FoxP3-positive revealed significant statistical differences in that refers to the intensity of inflammatory infiltrate (p = 0.003) and also regarding thickness of the epithelial lining (p = 0.009). Finally, it was observed in the case of PGs, strong positive correlation between the amount of FoxP3- positive lymphocytes and the immunohistochemical expression of TGF-β1 (r = 0.755, p<0.001), as well as moderate positive correlation between IL-17 and TGF-β1 imunoexpressions (r = 0.503, p = 0.024). Thus, we can conclude that interactions between Th17 and Treg cells seem to be established at the site of injury, suggesting the involvement of both pro-inflammatory and immunoregulatory cytokines in the pathogenesis of periapical lesions

Análise imuno-histoquímica das proteínas VEGF e HIF-1α na doença periodontal

Periodontal disease is a complex inflammatory and infectious condition that immune host, front of the microbial aggressions, can lead to disease progression, resulting in tissue destruction. The tissue damage induces the release of regulatory molecules, which protective roles and / or destructive, including proteins VEGF (vascular endothelial growth factor vascular) and HIF-1 α (hypoxia-induced factor α -1). Thus, this study investigated, quantitatively and comparatively, the immunohistochemical expression of VEGF (vascular endothelial growth factor) and HIF-1 α (hypoxia induced factor 1-α), proteins involved in inflammation, angiogenesis and hypoxia, in human gingival tissues. Therefore, 75 samples of gingival tissues were examined. Thirty samples were chronic periodontitis, 30 with chronic gingivitis and 15 healthy gingival. After sections analysis, positives and negatives inflammatory and endothelial cells in the connective tissue were counted and converted into percentage. Data were statistically analyzed using Kruskal-Wallis test and Spearman correlation. The results showed that both proteins marked. It was observed higher immunoreactivity for HIF-1 α at chronic gingivitis and periodontitis specimens compared to healthy sites, however, no statistically significant differences were observed among them (p>0.05). The VEGF immunostaining showed similarity among the cases of periodontitis, gingivitis and healthy gingiva. Moderate and positive correlation statistically significant differences were verified for the expressions of VEGF and HIF-1α in gingival health (r = 0,529, p = 0.04). Thus, it can be conclude that possibly the route of HIF-1 α, is activated in periodontal disease may have involvement of the protein in pathogenesis and progression of disease, and that activation of VEGF, can be in addition to being triggered transcription by HIF-1 α may be also influenced by other additional factors such as the action of periodontal microorganisms endotoxins