Quadro clínico do transtorno obsessivo-compulsivo

Obsessive-compulsive disorder is a very heterogeneous condition, not always easy to be identified. Obsessions are intrusive thoughts, impulses or images that cause anxiety or other emotional discomfort, whereas compulsions are repetitive behaviors or mental acts voluntarily performed to counterbalance or minimize the discomfort, or magically prevent any feared events. The most common symptoms are contamination, aggressive, somatic and sexual obsessions and washing, checking, repeating, counting and ordering compulsions. Patients usually have multiple symptoms simultaneously, which often change over time. Although the insight is typically preserved, it varies among patients and also fluctuates in the same patient in different ocasions. The main features are: exacerbated appraisal of risks, pathological doubts and incompleteness, as well as excessive sense of responsibility and guilt and thought/action fusion. As patients frequently feel ashamed of their symptoms, they can be reticent about them. Consequently, it usually takes time till they get adequate treatment.

Tragedy on grade crossing: driver failure or systemic fragility?

In 2010, an accident occurred in Americana-SP, Brazil, involving two trains and one bus on a Grade Crossing, when 10 people died and 17 were injured including workers. This paper aims to analyze the accident using the Model of Analysis and Prevention of Work Accidents (MAPA). The method provides observation of work, interviews and analysis of documents to understand precedents of the event in the following stages: to understand the usual work from the involved people, the changes occurred in the system, the operation of barriers, managerial and organizational aspects. By the end, measures are suggested to avoid new occurrences. The accident took place at night in a site with insufficient lighting. The working conditions of bus drivers, train operators and watchmen are inadequate. There were only symbolic barriers (visual and acoustic signals) triggered manually by watchman upon train operator radio communication. The fragility of the barrier system associated to poor lighting and short time to trigger the signaling seem to play a critical role in the event. Contrary to the official report which resulted in guilt of the bus driver, the conclusion of the paper emphasizes the fragility of the safety system and the need of level crossing reproject.

Armadilhas cognitivas: o caso das omissões na gênese dos acidentes de trabalho

Neste artigo discute-se o tema das omissões na gênese de acidentes do trabalho, tendo como referência contribuições de James Reason. Os autores descrevem três acidentes de trabalho ocorridos em atividades de manutenção, e nos quais a omissão de passos na execução da atividade foi apontada como causa nas análises efetuadas pelas empresas, acarretando atribuição de culpa aos acidentados. Nos três casos, a análise efetuada pelos autores revelou que, na seqüência de passos da atividade havia presença simultânea de pelo menos quatro das características apontadas por Reason como geradoras de omissões, caracterizando as denominadas armadilhas cognitivas.

Maternal exposure to aqueous extract of Jacaranda decurrens: Effects on reproductive system in male rats

Context: Jacaranda decurrens subsp. symmetrifoliolata Farias & Proenca (Bignoniaceae) is a species widely used for their medicinal properties. At least to our known, no study has been conducted concerning its toxicological profile after gestational and lactational exposure.Objective: The present study was carried out to evaluate the effects of J. decurrens on development of the reproductive system in male rats.Materials and methods: Pregnant rats were treated daily (gavage) with 250 or 500 mg/kg/day of aqueous extract of J. decurrens or vehicle, from day 12 of pregnancy to day 21 of lactation.Results and Discussion: Both doses of J. decurrens significantly anticipated (p < 0.05) the age of testicular descent to the scrotum, a parameter indicative of puberty initiation. Furthermore, at puberty, there was a significant reduction (p < 0.05) in testicular and epididymis weights in the offspring exposed to the higher dose of extract, without effect on sperm production and the histology of reproductive organs. on the other hand, at adulthood, the reproductive parameters analyzed did not differ among groups.Conclusions: J. decurrens, in this experimental model, interfered with the initial development of the reproductive system, but without lasting effects on sperm production in adulthood.

Inibição da ação do etileno retarda o desenvolvimento de injúrias de frio em tangor 'Murcott'

O bloqueio de eventos dependentes da sinalização do etileno pode afetar de maneira positiva ou negativa a qualidade de frutos tropicais após o armazenamento refrigerado. Dessa forma, os objetivos do presente trabalho foram estudar o envolvimento do etileno no desenvolvimento de injúrias de frio em tangor 'Murcott' e avaliar as respostas envolvidas no processo de resistência às injúrias. Os frutos foram expostos a 500nL L-1 de 1-metilciclopropeno (1-MCP) durante 12 horas ou imersos em soluções contendo 2000nL L-1 de ethephon ou ácido salicílico durante cinco minutos antes de serem armazenados a 1°C, por 90 dias. Como controle, parte dos frutos foi armazenada a 1°C. O tratamento de frutos com ethephon ou ácido salicílico antecipou e intensificou as injúrias de frio. Por outro lado, a inibição do etileno pelo 1-MCP retardou o surgimento dos sintomas e resultou em menor índice de injúrias e percentual de frutos podres ao final do armazenamento. A atividade da superóxido dismutase (SOD) foi intensificada aos 45 dias, contudo em menor intensidade nos frutos tratados com ácido salicílico. Nas avaliações subsequentes, houve decréscimo na atividade da SOD em todos os tratamentos, porém aos 90 dias a intensidade manteve-se levemente superior à observada nos primeiros 30 dias de armazenamento. Os teores de putrescina (Put) e espermina (Spm), no flavedo dos frutos, não sofreram significativa alteração durante o armazenamento. em contrapartida, os teores de espermidina (Spd) foram mais afetados pelo estresse ocasionado pelo frio.

Transtorno mental: dificuldades enfrentadas pela família

Utilizando uma metodologia qualitativa (entrevistas abertas, desenho-estória e análise temática) identificamos e analisamos 4 categorias (descompasso temporal, culpa, conflitos e perdas) presentes no discurso de mães (e uma irmã) de pacientes psiquiátricos do Núcleo de Atenção Psicossocial (NAPS) de Ribeirão Preto/SP, e avaliamos sua importância conforme o objetivo de se entender a dinâmica da relação entre serviço de saúde mental, paciente psiquiátrico e sua família.

Sistemas de adubação e consórcio de culturas intercalares e seus efeitos nas variáveis de colheita da cultura do milho

A colheita é a operação final de campo do processo produtivo, e por isso os fatores que interferem na mesma devem ser observados e avaliados atentamente para reduzir ao mínimo as perdas nessa etapa. O objetivo deste trabalho foi avaliar a influência dos sistemas de adubação (em pré-semeadura e na semeadura) e dos consórcios de culturas intercalares (milho+mucuna-cinza-anã, milho+guandu-anão e milho+lablab) nas variáveis de colheita da cultura do milho em sistema plantio direto. O experimento foi realizado na UNESP de Jaboticabal - SP, no período de safra normal, utilizando-se do delineamento em blocos ao acaso, no esquema fatorial (2 x 3), com quatro repetições. Os componentes avaliados na colheita foram: diâmetro do colmo, altura de inserção da primeira espiga, altura da planta, número de espigas por planta, índice de espiga, número de fileiras na espiga, biomassa seca da palhada no solo, estande final, produtividade de grãos, fluxos de grãos, de palha e de sabugo e perdas na colheita. Os resultados demonstraram que o diâmetro do colmo, a altura de inserção da primeira espiga e a altura de plantas apresentaram maiores valores para o sistema de adubação na semeadura. O número de fileiras, espigas viáveis, índice de espiga, estande final, biomassa seca da palhada, produtividade, fluxos de palha, de sabugo, de grãos e as perdas na colheita não foram afetados pelos sistemas de adubação e os consórcios.

Encontrando-se em casa: uma proposta de atendimento domiciliar para famílias de idosos dependentes

OBJETIVO: Este estudo qualitativo teve por objetivo descrever como um sistema familiar reage perante a situação de dependência em um membro idoso, quais recursos utiliza para manter sua estabilidade e a assistência de enfermagem disponibilizada neste contexto. MÉTODOS: Utilizou-se como referencial teórico a abordagem dos sistemas familiares e como método a pesquisa-ação. Os dados foram colhidos de novembro de 2004 a janeiro de 2005, utilizando-se o genograma, o ecomapa e o levantamento de problemas. RESULTADOS: Principais demandas familiares: luto antecipado, sobrecarga do papel de cuidador, falta de conhecimento sobre a doença e desajustamento familiar perante a crise. Principais intervenções: incentivar a narrativa da enfermidade, oferecer sugestões e informações, elogiar as forças familiares e assegurar pronto atendimento. CONCLUSÕES: Com o atendimento à família sob o enfoque sistêmico foi possível propor as intervenções de ajuda para a melhoria da qualidade de vida familiar, de maneira que ela também vislumbrasse suas próprias soluções para o enfrentamento das adversidades.

Adhesives with different pHs: Effect on the MTBS of chemically activated and light-activated composites to human dentin

Purpose: To evaluate the bond strength between human dentin and composites, using two light-activated single-bottle total-etch adhesive systems with different pHs combined with chemically activated and light-activated-composites. The tested hypothesis was that the dentin bond strength is not influenced by an adhesive system of low pH, combined with chemically activated or light-activated composites. Material and Method: Flat dentin surfaces of twenty-eight human third molars were allocated in 4 groups (n=7), depending on the adhesive system: (One Step Plus-OS and Prime & Bond NT-PB) and composite (light-activated Filtek Z-100 [Z100] and chemically activated Bisfil 2B [B2B]). Each adhesive system was applied on acid-etched dentin and then one of the composites was added to form a 5 mm-high resin block. The specimens were stored in tap water (37 degrees C/24 h) and sectioned into two axes, x and y. This was done with a diamond disk under coolant irrigation to obtain beams with a cross-section area of approximately 0.8 mm(2). Each specimen was then attached to a custom-made device and submitted to the microtensile test (1 mm.min(-1)). Data were analyzed using two-way ANOVA and Tukey's tests (p<0.05). Results: the anticipated hypothesis was not confirmed (p<0.0001). The bond strengths (MPa) were not statistically different between the two adhesive systems when light-activated composite was used (OS+Z100 = 24.7 +/- 7.1(a); PB+Z100 = 23.8 +/- 5.7(a)). However, with use of the chemically activated composite (B2B), PB (7.8 +/- 3.6(b) MPa) showed significantly lower dentin bond strengths than OS (32.2 +/- 7.6(a)). Conclusion: the low pH of the adhesive system can affect the bond of chemically activated composite to dentin. on the other hand, under the present conditions, the low pH did not seem to affect the bond of light-activated composites to dentin significantly.

CHARACTERISTICS OF ZINC-BINDING TO HUMAN RED-BLOOD-CELL MEMBRANES

The objective of the present study was to standardize the analysis of zinc binding on human red blood cell (RBC) membranes in 20 normal adults. The displacement studies revealed that at the maximal stable zinc concentration tested (600 muM), 57% (mean) of the bound Zn-65 was displaced and to displace half maximal Zn-65, the stable zinc concentration was 300 muM. Scatchard plots revealed two classes of binding sites for zinc on RBC membranes: one with higher affinity, Kd = 1.20 x 10(-5) M (site I), and the other with lower affinity, Kd = 2.77 x 10(-4) M (site II). Binding sites occupancy was 97% means and 58.5% means for sites I and 11, respectively. The displacement was affected by temperature, membrane protein concentration, freezing, thawing, and dialysis. Other metal cations, including Co++, Fe++, and Mn++, had very little effect on Zn-65 displacement, in contrast copper displaced Zn-65 from its binding sites on RBC membranes. Zinc binding to RBC membranes was rapid and readily reversible in a dynamic equilibrium with its binding sites. It is anticipated that this method will be applicable to studies of a wide variety of diseases specifically related to zinc metabolism in humans as well as in animals. (C) 1994 Wiley-Liss, Inc.

Aircraft accident in Brazil: Boeing vs. Legacy?

Air accidents represent a small proportion of the flights registered worldwide. Airplane collisions in the air are rare. In September of 2006, a Boeing 737-800 collided in midair with a Legacy Jet. It was the largest accident registered in the history of Brazilian aviation until that time. The present study explores aspects of press coverage of the accident. Data and information reported in the media about the accident from September 2006 to August 2007 were collected and discussed. Media coverage called attention to two unusual aspects: politicisation of the discussion, culminating in the opening of congressional inquiries, and equally the concomitance of police investigations interfering in the work of agencies responsible for the official accident investigation. Emphasis on assigning guilt and establishing penalties may close the windows of opportunity an accident had opened for discussions on the improvement of air safety. In Brazil, political imperatives and organizational pressures have interfered and the possibilities of organizational learning from the accident have been drastically curtailed.

Determination of the geometrical diarylpropenamine isomers in feces by high-performance liquid chromatography

Diarylpropenamine derivatives are a class of compounds which have been evaluated as potential drug candidates. Here a specific and reproducible HPLC method for the determination of cis- and trans-isomers of the unsubstituted derivative, 3-(4'-bromo-[1,1'-biphenyl]-4-yl)-3-(4-X-phenyl-N,N-dimethyl-2-propen-1-amine (I, where X=H) in feces is described. The analyte I and internal standard, nitro derivative (II, where X=NO2), were isolated from the basified biological matrix using a liquid-liquid extraction with ethyl acetate followed by a solid-phase procedure performed on a silica cartridge. The organic phase was evaporated to dryness, the residue was reconstituted in mobile phase and injected into the HPLC system. The analytes were eluted with ethyl acetate-hexane-triethylamine (59:40:1) in HPLC column (silica) and detected by UV spectrophotometry at 272 nm. Linearity, precision and accuracy data for feces standards after extraction were acceptable. The method has been applied to analyses of feces samples from rats dosed with I, in which it could be anticipated that fecal excretion is quantitatively the major route for I elimination. Copyright (C) 1999 Elsevier Science B.V.

Gli infortuni sul lavoro in Brasile. Studio nello Stato di San Paolo del Brasile, regione di Botucatu, utilizzando il metodo dell'albero delle cause

This paper discusses, within the prevaling Brazilian situation, the possibility of applying 'Causal Tree' (CT) method in investigating occupational accidents by safety personnel in the public health services and workers' unions. The method was developed during the seventies in France, for use by plant safety personnel. The authors used this method in Botucatu, State of Sao Paulo, Brazil, in order to investigate 40 serious occupational accidents that occurred in industrial plants during the second half of 1993, that had been registered by Social Security. In these cases, the predominance of situations in which the lack of safety measures were identified by inspection indicates that in most instances, the use of CT is unnecessary. However, the authors discuss its use by safety personnel from the public health services and workers' unions to investigate certain accidents to contribute to the knowledge base and help overcome the cultural based guilt which, in Brazil, has turned the victim into the person responsible for the accident.

Psicoterapia grupal no transtorno obsessivo-compulsivo

There are few published papers about group psychotherapy for patients with obsessive-compulsive disorder (OCD), and usually restricted psychoeducational, support or cognitive-behavioral approaches. This article describes the experience of group psychotherapy for OCD patients started in 1996 in Botucatu Medical School - Unesp, São Paulo, Brazil. The two-hour sessions occur once a month, with 6 to 10 female patients, and are based on psychodramatic techniques. Psychotropic prescriptions are given after the sessions. In the beginning, aggressive obsessions were more prominent and were reported with much anguish and shame. Gradually, the themes changed from OCD specific issues (symptoms, pharmacological treatment, outcome, need of exposure and response prevention) to deeper and more personal psychodynamic aspects. The psychodramatic approach (techniques of double, mirror, role inversion, search for prymary scenes) has mostly shown: difficulty in accepting their own human mistakes or negative emotions due to excessive personal demands. This seems to generate guilt, low self-esteem, idealization of others, difficulty in enjoying pleasant situations, fear of taking responsibilities and of losing control (madness/aggressiveness). The group has been considered very important by the patients, since sharing experiences helps to diminish feelings of isolation, shame and guilt, stimulates the exposure to feared situations and enhances self-esteem. The fact that all participants have the same disorder favors group cohesion and provides relief, as they see in the others some of their afflictions and are able to share similar feelings and experiences. Many times the burden of the symptoms are dealt with humor. The confidence in such therapeutic setting is helping the identification and resolution of personal conflicts and contributing to the adherence to pharmacological treatment. The group also provides valuable training experiences for resident physicians in psychiatry.

Acúmulo de sacarose, produtividade e florescimento de cana-de-açúcar sob reguladores vegetais

Plant regulators have been used successfully for early ripening and flowering control in sugarcane (Saccharum spp. Hybrid). However, little information is available about the interactions between new genotypes and two plant regulators with regard to those variables. This study determined the effect of the regulators on the sucrose content, stalk production and flowering of seven sugarcane genotypes. The experiment was installed in March 2004 near Ja-, SP, Brazil A randomized complete block design was used with four blocks with a split plot treatment arrangement where the main plots were the genotypes IAC87-3396, IAC87-3410, IAC89-3124, IAC91-2195, 1AC91-5155, P088-62 and SP80-1842 and the subplots were sulfomethuron-methyl (15g i.a.·ha -1), etefon (480g i.a.·ha-1) and unsprayed control. Pol in cane was evaluated at 0, 21, 42, 63, 84, 105 and 126 days after the plant regulators application (DAA). Flowering, pith, stalk production and sucrose content were evaluated at 126 DAA. In most of the genotypes the use of plant regulators anticipated maturation in 21 days when compared with the unsprayed control. Etefon was more efficient for harvesting sugarcane between 42-84 DAA, whereas sulfomethuron-methyl was between 105 and 126 DDA. Both products controlled flowering. For most genotypes, the ripeners did not affect the productivity of stalks, except for sulfomethuron-methyl that reduced it in SP80-1842, and for ethephon that increased it in IAC91-2195. Sugar productivity of IAC89-3124 increased with both regulators, while it was higher in IAC91-2195 with ethephon application and lower in SP80-1842 with sulfomethuron-methyl use.