Estudo sobre início precoce da atividade sexual em adolescentes no Distrito Simão Campos - São João da Ponte, MG

Homens e mulheres têm iniciado sua vida sexual, em grande parte, na adolescência e de formas um tanto diferenciadas. As práticas sexuais na juventude têm sido descritas como dinâmicas e em constantes transformações, sendo que seus perfis podem acarretar impacto importante na vida reprodutiva dos jovens. Gestações indesejadas, aquisição de doenças sexualmente transmissíveis, uso de drogas e violência envolvem sérias implicações, limitando ou adiando o desenvolvimento e engajamento dos adolescentes na sociedade. Ao assumir comportamentos de risco, os adolescentes geralmente têm seus projetos de vida alterados, o que pode contribuir para o abandono escolar e a perpetuação dos ciclos de pobreza. Ao realizar o diagnóstico situacional da ESF Simão Campos notou-se que os adolescentes iniciam atividade sexual precocemente, sem os cuidados necessários. A imaturidade dos adolescentes e os riscos associados à prática de sexo sem proteção demandam preocupação da equipe de saúde da família. Neste sentido, o objetivo deste trabalho é elaborar um projeto com vistas à redução do início precoce da atividade sexual em adolescentes. Para realização do trabalho foi utilizado o método de Planejamento Estratégico Situacional (PES), onde primeiramente foi feito o diagnóstico/análise situacional em saúde. O problema foi definido utilizando a Estimativa Rápida. Em seguida foi elaborado um plano de ação para intervenção e enfrentamento do problema. Este plano é aplicável, pois possui os recursos necessários para realização e superação dos nós críticos. É reconhecido por todos que, no momento atual, a educação sexual se faz impostergável, por sua influência na formação integral da criança e do adolescente. A omissão, diante desta evidência, trará repercussões que podem comprometer não só o presente como o futuro das gerações.

Alta incidência da gravidez na adolescência - uma proposta de intervenção

A gravidez na adolescência é uma realidade que não para de crescer no Brasil e no mundo, e não é diferente no município onde trabalho. Após discussões para a identificação dos problemas que mais afetam a comunidade, toda a equipe concordou que a gravidez precoce é o mais relevante pelas repercussões sociais, biológicas, psicológicas, familiares, econômicas e culturais que envolvem esse problema. Para muitos autores a gravidez na adolescência é uma situação de risco psicossocial que pode ser reconhecida como um problema para os jovens; por outro lado, muitas adolescentes planejaram sua gravidez e se sentem realizadas com ela. Este estudo teve como objetivo: Elaborar um projeto de intervenção para diminuir o número de gestantes adolescentes em nossa área de abrangência. Por meio do diagnóstico situacional foi realizada a analise dos problemas da área, de forma a mapear os nós críticos, tendo sido possível elaborar ações estratégicas seguindo o método de Planejamento Estratégico Situacional. As informações foram obtidas através do contato diário com os pacientes, reuniões com profissionais da unidade e contato direto com técnicos da Secretaria Municipal de Saúde. Também foram levantados dados em registros da unidade e realizadas entrevistas e observação ativa na comunidade. Foram propostos os seguintes projetos: Aprendendo a lidar com o adolescente, Conversando a gente se entende, Conhecendo o que é realmente sexualidade, Sexo seguro e responsável, Ter filhos na hora certa. Este estudo apontou para à importância do planejamento de ações que visem uma formação mais adequada da equipe de saúde para a abordagem dos adolescentes quanto aos temas sexualidade, uso dos métodos contraceptivos, consequências e riscos de uma gestação na adolescência, assim como na abordagem à família, fortalecendo o seu papel na atenção aos seus filhos adolescentes.

Proposta de intervenção para gravidez precoce no território do Programa Saúde da Família Salu Alves Ferreira do município de Monte Carmelo - Minas Gerais

A equipe da unidade básica de saúde Salu Alves Ferreira, que está localizada no município de Monte Carmelo, observou no período de janeiro a setembro de 2015, que cerca de dois terços das gestantes atendidas estavam classificadas como precoces. A atenção em saúde sexual e em saúde reprodutiva é uma das áreas de atuação prioritária da Atenção Básica à Saúde. Este trabalho tem como objetivo propor estratégias para enfrentamento da gestação precoce na população de faixa etária de 14 a 19 anos residente na área de abrangência da Unidade Básica de Saúde Salu Alves Ferreira, no município de Monte Carmelo, Minas Gerais. Para contribuir na elaboração do projeto de intervenção foi realizada uma pesquisa bibliográfica nos bancos de dados da Biblioteca Virtual em Saúde para levantar as evidências já existentes sobre o tema. O projeto proposto foi elaborado seguindo dos passos do planejamento estratégico situacional. Nesse aspecto, o presente trabalho abordou formas de intervenção para o enfrentamento da gravidez na adolescência, que incluem: educação sexual por meio de parceria com a escola local; planejamento familiar; conscientização sobre o exame de pré-natal; e de forma geral buscar a melhoria e ampliação dos programas já existentes. A partir dessa intervenção busca-se conscientizar os adolescentes sobre a gravidez indesejada e minimizar os riscos da gravidez precoce

Dos conceitos de morte aos critérios para o diagnóstico de morte encefálica

The authors present considerations about death and brain death concepts, as well the legal aspects for its diagnosis in Brazil. They also present the UNICAMP Protocol for the Diagnosis of Brain Death, revised and according with the current law, with standard techniques for the diagnostic exam. They emphasize the importance of a mature ethical position for this frequent and challenging situation.

Ressonância magnética e características clínicas em adultos com doenças desmielinizantes monofásicas: encefalomielite aguda disseminada ou uma variante da esclerose múltipla?

Acute disseminated encephalomyelitis (ADEM) is a widespread monophasic inflamatory disease affecting the central nervous system, that usually follows an infection or vaccination. In this study, we present an analysis of magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) and clinical aspects in four patients with clinical diagnosis of ADEM. The presence of MRI demyelinating lesions was crucial, but not in itself sufficient for definitive diagnosis. Clinical and MRI follow up, in order to exclude new lesions and to reevaluate the former ones, as well as CSF, were important for the differential diagnosis with other demyelinating diseases, particularly multiple sclerosis. In addition, we have shown that early treatment with methylprednisolone after the initial symptoms was effective for improving clinical manifestations as well as for reducing MRI lesions.

Transtorno do déficit de atenção e hiperatividade: proposta de avaliação neuropsicológica para diagnóstico

Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity/impulsivity. The aim of this research was to contribute more precisely to the diagnosis of ADHD, to propose a battery of neuropsychological assessment and to analyze the contribution of each test. We studied 10 matched pairs of children with ADHD and normal controls (7 to 11 years). Inclusion criteria were: presence of ADHD typical behavior, positive diagnosis of ADHD based on DSM-IV, normal IQ, normal neurological examination and parental consent. We used extensive neuropsychological battery. The results showed differential sensitivity for detection of attentional problems in children with ADHD, although most tests did not reach statistical significance. The item, errors, of WCST revealed statistically significant difference between the two groups: ADHD performance was inferior to controls . In conclusion the neuropsychological assessment battery used in this research contributed to the diagnosis of ADHD.

Diagnóstico da Educação Ambiental no ensino de Geografia: Piracicaba, Capivari and Jundiaí hidrographic basins

The goals of this study are to identify the potencialities avaiable in elementary public schools for the development of an educational process wich includes environmental issues helpping to find its integration with university in order to contribuite raises teaching levels for a better comprehension of regional environmental problems. Research data were collected through questionnaires and interviews with geography teachers analyising theirs activities and perspectives on the environmental crisis and environmental education. The study also offers sugestions for the devellopment of interdisciplinaires programs trying to contibute for the construction of citizenship showing the importance of better comprehension from environmental problems which includes physical, economics, social, political and cultural aspects.

Métodos probabilístico e determinístico para diagnóstico da necessidade de subsolagem de solos agrícolas

This paper presents two techniques to evaluate soil mechanical resistance to penetration as an auxiliary method to help in a decision-making in subsoiling operations. The decision is based on the volume of soil mobilized as a function of the considered critical soil resistance to penetration in each case. The first method, probabilistic, uses statistical techniques to define the volume of soil to be mobilized. The other method, deterministic, determines the percentage of soil to be mobilized and its spatial distribution. Both cases plot the percentage curves of experimental data related to the soil mechanical resistance to penetration equal or larger to the established critical level and the volume of soil to be mobilized as a function of critical level. The deterministic method plots showed the spatial distribution of the data with resistance to penetration equal or large than the critical level. The comparison between mobilized soil curves as a function of critical level using both methods showed that they can be considered equivalent. The deterministic method has the advantage of showing the spatial distribution of the critical points.

Identificação eletrônica para avaliação do comportamento dos suínos na fase de gestação

The efficiency of swine production performance depends on the herd administration, such as good nutrition, sanitary control, facilities and appropriate environmental conditions. The concept of this production model is directly related with the reduction of selective losses and the process control. Each production segment is controlled to reach the optimization in the system totality, it is necessary to apply animals handling concepts, environmental control implementation, diseases control, nutrition control, information concerning in guaranteeing the animal welfare and individual identification. The present work presents as objective the development of the mathematical model to evaluate interactions among the internal atmosphere of the installation and the thermal animals preference, in the expectation of detecting a relationship among the frequency access to the drinking fountain and the atmosphere conditions - temperature, black globe temperature and relative humidity, using as tool the electronic identification. The results obtained by the mathematical model, allowed to conclude accurately the evaluation of the swine thermal preference correlating with the climatic variables in the pregnancy stage.

Compreensão da sexualidade por jovens com diagnóstico de deficiência intelectual

The study describes the comprehension of concepts about sexuality by youths diagnosed with intellectual deficiency, during classes on sexual education. The analysis of selected episodes from video transcriptions of five classes (Human Body, Kiss, Flirting, Coitus, Condom/STD) showed: the appropriation and understanding of concepts, partial difficulties of comprehension, and inhibition. The analysis of the transcripts indicated that all students were attentive to the classes, participated in the proposed tasks, and answered the questions. The observed signs of inhibition and the expression of values were similar to those observed in other youngsters, indicating the appropriation of culturally established values. The obtained evidences contrast with mythical visions related to sexuality in these youngsters, and suggest more studies about their competences.

Avaliação in vitro do aparelho DIAGNOdent para diagnóstico oclusal

The aim of this study was to determine the effectiveness and reliability of laser fluorescence measurements in relation to occlusal caries diagnosis. DIAGNOdent 2095 (Kavo, Biberach, Germany), which has been developed especially for caries diagnosis, was utilized. Five (5) teeth were examined in the pilot test; after that, ten (10) teeth were examined in order to calibrate both examiners. Data were obtained from 66 teeth (36 molars and 30 premolars), totalizing 144 sites identified through photographs of the occlusal surfaces. Reproducibility was evaluated in 10 teeth. The interexaminer Spearman correlation (r) was 0.89 and the intra-examiner, 0.93 and 0.97 (examiner A and B, respectively). Validation was carried out by histological examination (stereomicroscope). For the two examiners the sensitivity of the device was relatively high, varying from 0.81 to 1.00, while specificity varied according to which validation criterion was used (0.77 - 0.86: enamel lesion / 0.52 - 0.59: dentin lesion). It was concluded that DIAGNodent presented good capacity of identifying any alteration of the dental surface, nevertheless it presents the disadvantage of accomplishing many false-positive diagnosis when the validation criterion is dentin lesion.

Phenotypic variability in a family with x-linked adrenoleukodystrophy caused by the p.Trp132Ter mutation

X-linked adrenoleukodystrophy (X-ALD) is an inherited disease with clinical heterogeneity varying from presymptomatic individuals to rapidly progressive cerebral ALD forms. This disease is characterized by increased concentration of very long chain fatty acids (VLCFAs) in plasma and in adrenal, testicular and nervous tissues. Affected individuals can be classified in different clinical settings, according to phenotypic expression and age at onset of initial symptoms. Molecular defects in X-ALD individuals usually result from ABCD1 gene mutations. In the present report we describe clinical data and the ABCD1 gene study in two boys affected with the childhood cerebral form that presented with different symptomatic manifestations at diagnosis. In addition, their maternal grandfather had been diagnosed with Addison's disease indicating phenotypic variation for X-ALD within this family. The mutation p.Trp132Ter was identified in both male patients; additionally, three females, out of eleven family members, were found to be heterozygous after screening for this mutation. In the present report, the molecular analysis was especially important since one of the heterozygous females was in first stages of pregnancy. Therefore, depending on the fetus outcome, if male and p.Trp132Ter carrier, storage of the umbilical cord blood should be recommended as hematopoietic stem cell transplantation could be considered as an option for treatment in the future.

Consenso brasileiro para a abordagem clínica e tratamento do hipotireoidismo subclínico em adultos: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

INTRODUCTION: Subclinical hypothyroidism (SCH), defined as elevated concentrations of thyroid stimulating hormone (TSH) despite normal levels of thyroid hormones, is highly prevalent in Brazil, especially among women and the elderly. Although an increasing number of studies have related SCH to an increased risk of coronary artery disease and mortality, there have been no randomized clinical trials verifying the benefit of levothyroxine treatment in reducing these risks, and the treatment remains controversial. OBJECTIVE: This consensus, sponsored by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism and developed by Brazilian experts with extensive clinical experience with thyroid diseases, presents these recommendations based on evidence for the clinical management of SCH patients in Brazil. MATERIALS AND METHODS: After structuring the clinical questions, the search for evidence in the literature was initially performed in the MedLine-PubMed database and later in the Embase and SciELO - Lilacs databases. The strength of evidence was evaluated according to the Oxford classification system and established based on the experimental design used, considering the best available evidence for each question and the Brazilian experience. RESULTS: The topics covered included SCH definition and diagnosis, natural history, clinical significance, treatment and pregnancy, and the consensus issued 29 recommendations for the clinical management of adult patients with SCH. CONCLUSION: Treatment with levothyroxine was recommended for all patients with persistent SCH with serum TSH values > 10 mU/L and for certain patient subgroups.

Contribuição da tomografia computadorizada no diagnóstico e no estudo pós-operatório dos tumores selares

The computerized tomography (C.T.) of 18 pacients with sellar tumours were analysed. The C.T. made before surgery in 6 cases was positive in 3 and the type of tumour suggested by C.T. was confirmed in 3. Twelve pacients had a C.T. investigation after surgery and the examination suggest recurrent tumour in 5. Two of these were re-operated. One pacient with colesteatoma had the recurrent tumour verified by surgery and the other, with a pituitary adenoma during re-operation was noted only cicatricial tissue at sellar region.

Escala de autoaceitação para pessoas com cegueira congênita ou precoce : desenvolvimento e investigação psicométrica = Self-acceptance acale for people with congenital or early blindness : development and psychometric analysis

Universidade Estadual de Campinas . Faculdade de Educação Física