Protocolo de biossegurança e gerenciamento de resíduos no ensino de radiologia odontológica da Faculdade de Odontologia de Araçatuba-UNESP

In dentistry, the technic and radiographic processing incur the possibility of cross infection and environmental contamination. The dentist is responsible for the patient and dental team. For this reason he needs to take a protocol to prevent the spread of microorganisms and environmental exposure to risk factors. The protocols are introduced in the dentistry school as an important teaching tool, whose learning and application reinforce the importance of continuity of these actions in the professional activity. The objective of this paper is to present the biosafety and waste management protocol used in the dental radiology clinic of Araçatuba Dental School, including procedures for the prevention of biological and environmental contamination.

Biossegurança na clínica de radiologia odontológica

In the practice of dental radiology, although there was no production of aerosols, there is the contamination of equipment and surfaces by contact with blood and saliva. This is making necessary the adoption infection control procedures to protect patients and staff. The objective of this paper is to present the procedures of prevention during the radiographic examination and radiographic processing in the darkroom. The proposed recommendations for the area of Dental Radiology include efficient cleaning and protection of equipment and surfaces, personal protective measures and to avoid contamination of the darkroom. These recommendations are obtained by simple procedures as cover films and radiological equipment with plastic barriers.

Miedo e inseguridad de la gestante durante el trabajo de parto como motivos para la demanda de internación precoz

Objective. To identify reasons why women look for early health care attention at the end of pregnancy. Methodology. Qualitative study based in socio-existential phenomenology proposed by Alfred Schütz. Nine pregnant women who consulted to the maternity service without being in real labor were interviewed. Results. The following analysis categories emerged: Having different symptoms or signals from the ones they had felt or been informed about, not being able to identify real labor, fear to fetal complications for being close to the probable labor date, feeling calmer when being seen by professionals of the institution, lack of problem solving by other services of the health institution, fearing out of hospital delivery, imitating real labor, looking for tranquility in the idealization of labor and modifying behaviors to guarantee attention. Conclusion. Women are insecure and fear because of a fragmented health care, where they do not perceive themselves linked to the prenatal control program anymore, and at the same time they don’t find the health care assistance they want.

Construindo significados sobre gerência da assistência: um estudo fenomenológico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Contato com gatos: um fator de risco para a toxoplasmose congênita?

Toxoplasmosis is an important zoonosis and one of the most common parasitic infections throughout the world, which may cause among other problems several fetal pathologic alterations. Congenital toxoplasmosis is a result of transplacental transmission of Toxoplasma gondii due to a prime infection of the mother during pregnancy. Several studies have determined that the main risk factor for infection in pregnant women is the consumption of uncooked meat, which contributed from 30 to 63% of cases; other 6% to 17% of infections were related to contaminated soil. The relationship between pregnant women and their cats constitutes nothing more than a healthy experience when main transmission mechanisms and risk factors related to the disease are known.

Rabies in Experimentally Infected Bears, Ursus spp., with Epizootiologic Notes

Ten black bears, Ursus americanus Pallas, and three brown bears, U. arctos Linnaeus, were inoculated with rabies virus from naturally infected foxes in Alaska. The bears were more resistant than canine species, requiring at least 1,000 MLD50 of virus for infection. Low titres or negative results were obtained in salivary glands titrated in mice. Clinical course of the disease, post mortem findings, and microscopic lesions are described. Microscopic lesions were more· severe in brown bears, in which the inflammatory response was distinguished by the presence of numerous eosinophils in the perivascular infiltrate and among cells diffusely infiltrating the parenchyma. In both species, inclusion bodies were found only in the Purkinje cells of the cerebellum. Rabies is discounted as a factor in unprovoked attacks by bears on man at high latitudes. The epizootiology of rabies in a region where bears are numerous is discussed, with the conclusion that rabid foxes usually do not excrete sufficient quantities of virus in the saliva to infect bears. German title: Tollwut bei experimentell infizierten Bären, Ursus spp., mit epizootiologischen Anmerkungen German abtract: Zehn Schwarzbären, Ursus americanus Pallas, und drei Braunbären, U. arctos Linnaeus, wurden mit einem von Füchsen in Alaska isolierten Feldstamm des Tollwutvirus infiziert. Die Untersuchungsergebnisse lassen erkennen, daß Bären eine größere Resistenz gegenüber Tollwutinfektion aufweisen als hundeartige Karnivoren, und zwar konnten sie nicht mit weniger als 1000 MLD50 des Tollwutvirus infiziert werden. Das Virus war selten nachweisbar in den Speicheldrüsen der tollwuterkrankten Bären. Klinik und Pathologie der Tollwut bei Bären wurden kurz beschrieben. Die im Gehirn vorkommenden entzündlichen Veränderungen waren bei Braunbären besonders schwer und unterschieden sich durch die Häufigkeit der eosinophilen Leukozyten in den perivasculären und Gewebs-Infiltraten. Bei beiden Arten wurden Einschlußkörperchen nur in den Purkinje-Zellen beobachtet. Die Epizootiologie der Tollwut auf der Alaska-Halbinsel, wo Bären häufig vorkommen, wurde besprochen. Die Ergebnisse deuten an, daß Füchse wenig Virus mit dem Speichel ausscheiden, und selten soviel, daß es für die Infektion von Bären ausreicht. French title: La rage expérimentale chez les ours, Ursus spp., avec observations épizootiologiques French abstract: Dix ours noirs, Ursus americanus Pallas, et trois ours bruns, U. arctos Linnaeus, ont été inoculés avec de virus rabique provenant des renards infectés naturellement dans l'Alaska. Les ours Ont été plus résistants au virus que des espèces canines, et pour produire l'infection chez les ours, au moins 1000 MLD50 ont été requis. La titration des glandes salivaires chez des souris a données des titres peu éléves ou des résultats négatifs. La course clinique de la maladie, les observations des autopsies, et les lésions microscopiques sont decrites. Les lésions microscopiques les plus sévères ont été observées chez les ours bruns, dans lesquels la réponse inflammatoire a été distinguée par la présence de nombreux éosinophiles dans l'infiltration périvasculaire et parmi les cellules infiltrées diffusément dans Ie parenchyme. Chez les deux espèces des ours, des corps d'inclusion ont été trouvés seulement dans les cellules de Purkinje du cervelet. On a discuté l'épizootiologie de la rage dans une région où des ours sont nombreux, avec la conclusion qu'il y a dans la salive des renards rabiques une quantité de virus insuffisante pour infecter les ours. é ó í á ú Spanish title: Rabia en osos, Ursus spp., infectados experimentalmente, con anotaciones epizootológicas Spanish abstract: Diez osos negros, Ursus americanus Pallas, y tres osos pardos, U. arctos Linea, se infectaron con una estirpe campal de virus rábico aislada de zorros en Alasca. Los resultados de la experiencia permiten reconocer que los osos presentan una resistencia mayor frente a la infección rábica que los carnívoros cánidos, pues no se pudieron infectar con menos de 1.000 DML50 de virus rábico. El virus era muy raras veces identificable en las glándulas salivales de los osos enfermos de rabia. Se describen sucintamente la clínica y patología de la rabia en los osos. Las modificaciones inflamatorias en el cerebro eran muy graves en el oso pardo y se distinguían por la frecuencia de los leucocitos eosinófilos en los infiltrados perivasculares e hísticos. En ambas especies solo se hallaron corpúsculos de inclusión en las células de Purkinje. Se discute la epizootología de la rabia en la península de Alasca, donde es frecuente Ia presencia de osos. Los resultados señalan que los zorros eliminan poco virus con la saliva y casi nunca en cantidad tal que fuese suficiente para infectar los osos.

Criança dependente de tecnologia: a experiência do cuidado materno

Este estudo tem como objetivo compreender a experiência materna no cuidado ao filho dependente de tecnologia. Utilizamos a abordagem do estudo de caso etnográfico tendo como instrumentos de coleta de dados os genograma e ecomapa, entrevista aberta e observação. Os dados foram organizados em três unidades de significados: a busca pelas causas e por culpados; a alta hospitalar e as demandas para o cuidado e as redes de apoio. O estudo permitiu conhecer a experiência materna em busca por explicações, bem como os sentimentos de desconfiança, insegurança e insatisfação relacionados ao serviço de saúde. Ainda a apropriação da mãe em relação aos cuidados à criança e no que se refere à organização do ambiente domiciliar para recebê-la, a utilização das redes de apoio, destacando a carência de vínculos com familiares e vizinhos e a busca formal e informal para garantir a subsistência da criança doente e dos demais filhos.

HOPE IN HIV-POSITIVE WOMEN

The objective of this study was to assess the hope in the lives of HIV-positive women, using the Herth Hope Scale (HHS). Participants were 111 HIV-positive women who attended a referral outpatient clinic in Fortaleza-CE. From January to May 2009, interviews were held to collect biopsychosocial variables, and the HHS was applied. Data were analyzed using SPSS-8.0 and revealed an average hope index of 34.86, indicating that these women have little hope in life in view of their diagnosis of HIV. The scale item with the highest score was faith. This probably derives from the fact that Aids is incurable, transmissible and generates negative stigma, in addition to its relation with the idea of imminent death. In conclusion, measuring hope among HIV patients through the use of an instrument permits intervention assessment and planning, promoting assistance and motivation to live better and maintain a hopeful attitude.

The use of body circumferences for the prediction of intra-abdominal fat in obese women with polycystic ovary syndrome

Introduction: Computerizd tomography (CT) is the gold standard for the evaluation of intra- (IAF) and total (TAF) abdominal fat; however, the high cost of the procedure and exposure to radiation limit its routine use. Objective: To develop equations that utilize anthropometric measures for the estimate of IAF and TAF in obese women with polycystic ovary syndrome (PCOS). Methods: The weight, height, BMI, and abdominal (AC), waist (WC), chest (CC), and neck (NC) circumferences of thirty obese women with PCOS were measured, and their IAF and TAF were analyzed by CT. Results: The anthropometric variables AC, CC, and NC were chosen for the TAF linear regression model because they were better correlated with the fat deposited in this region. The model proposed for TAF (predicted) was: 4.63725 + 0.01483 x AC - 0.00117 x NC - 0.00177 x CC (R-2 = 0.78); and the model proposed for IAF was: IAF (predicted) = 1.88541 + 0.01878 x WC + 0.05687 x NC - 0.01529 x CC (R-2 = 0.51). AC was the only independent predictor of TAF (p < 0.01). Conclusion: The equations proposed showed good correlation with the real value measured by CT, and can be used in clinical practice. (Nutr Hosp. 2012;27:1662-1666) DOI:10.3305/nh.2012.27.5.5933

Sugar intake is correlated with adiposity and obesity indicators and sedentary lifestyle in Brazilian individuals with morbid obesity

Obesity is a chronic disease characterized by increased accumulation of body fat. We evaluated the socioeconomic aspects, body composition, risk of metabolic complications associated with obesity, eating habits and lifestyle in both women and men adults and elderly with body mass index (BMI) 40 kg/m(2). Among the subjects studied, 79% (n = 32) are female, 5% (n = 2) smokers, 39% (n = 16) use alcohol and only 24% (n = 10) are practitioners of physical exercise. The higher food intake was breads, followed by rice. The daily intake of fruits and vegetables is low. Positive correlation between consumption of sugar and BMI and abdominal circumference (AC) was observed. In summary, was found that morbidly obese patients that looking for nutritional counseling presents increased body fat, poor eating habits and sedentary lifestyle.

Qualifying instrument for evaluation of food and nutritional care in hospital

Establishing criteria for hospital nutrition care ensures that quality care is delivered to patients. The responsibility of the Hospital Food and Nutrition Service (HFNS) is not always well defined, despite efforts to establish guidelines for patient clinical nutrition practice. This study describes the elaboration of an Instrument for Evaluation of Food and Nutritional Care (IEFNC) aimed at directing the actions of the Hospital Food and Nutrition Service. This instrument was qualified by means of a comparative analysis of the categories related to hospital food and nutritional care, published in the literature. Elaboration of the IEFNC comprised the following stages: (a) a survey of databases and documents for selection of the categories to be used in nutrition care evaluation, (b) a study of the institutional procedures for nutrition practice at two Brazilian hospitals, in order to provide a description of the sequence of actions that should be taken by the HFNS as well as other services participating in nutrition care, (c) design of the IEFNC based on the categories published in the literature, adapted to the sequence of actions observed in the routines of the hospitals under study, (d) application of the questionnaire at two different hospitals that was mentioned in the item (b), in order to assess the time spent on its application, the difficulties in phrasing the questions, and the coverage of the instrument, and (e) finalization of the instrument. The IEFNC consists of 50 open and closed questions on two areas of food and nutritional care in hospital: inpatient nutritional care and food service quality. It deals with the characterization and structure of hospitals and their HFNS, the actions concerning the patients' nutritional evaluation and monitoring, the meal production system, and the hospital diets. "This questionnaire is a tool that can be seen as a portrait of the structure and characteristics of the HFNS and its performance in clinical and meal management dietitian activities." (Nutr Hosp. 2012;27:1170-1177) DOI:10.3305/nh.2012.27.4.5868

Relationship between body mass index with dietary fiber intake and skinfolds-differences among bodybuilders who train during morning and nocturne period

Background: The prevalence of overweight individuals has increased in recent years. Moreover, the importance of a healthy diet is associated with the practice of physical activity and attempt to verify the achievement of physical exercise influences on food choice. However, it relationship between food intake and physical activity have not been studied. Aim: To evaluate if the period in which the trainings are conducted, morning and nocturne, interfere qualitatively and quantitatively in food consumption as well as verify possible associations between anthropometric profiles and dietary habits. Methods: We collected data from 33 adult volunteers, between men and women, practitioners of bodybuilding. Results: A total of 33 volunteers were interviewed (18 (54.5%) were men and 15 (45.5%) were women). Regarding anthropometric data, it turns out that that the volunteers of the two periods had similar characteristics, differentiating only weight. The consumption of nutritional supplements was observed in 30.77% of the practitioners in the morning period vs. 35% for the nocturne. Considering macronutrient intake, there was a significant difference in the consumption of protein between the periods. The consumption during nocturne period was greater (126 +/- 5% of the daily requirement) than the morning period (115.7 +/- 2%). As for micro-nutrients, calcium intake was greater among men when compared to women. There was a positive correlation between the BMI, and arm circumference for practitioners of the morning period. Conclusion: This study show that the practitioners who train in the morning have quietly better eating habits than those in the nocturne period, however both are inappropriate.

Microbiota benefits after inulin and partially hydrolized guar gum supplementation - a randomized clinical trial in constipated women

Introduction: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation. Objectives: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids. Methods: Our study enrolled 60 constipated female health worker volunteers. Participants reported less than 3 bowel movements per week. Volunteers were randomized to treatment with prebiotic or placebo. Treatment consisted of 3 weeks supplementation with 15 g/d I-PHGG (fiber group) or maltodextrin (placebo group). Abdominal discomfort, flatulence, stool consistency, and bowel movements were evaluated by a recorded daily questionnaire and a weekly interview. Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography, respectively. Results: There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences. Total Clostridium sp significantly decreased in the fiber group (p = 0.046) and increased in the placebo group (p = 0.047). There were no changes in fecal short chain fatty acid profile. Conclusions: Consumption of I-PHGG produced clinical results comparable to placebo in constipated females, but had additional protective effects on gut rnicrobiota by decreasing the amount of pathological bacteria of the Clostridium genera.

Eating behavior and nutritional status in patients who underwent coronary angioplasty

Introduction: The identification of stages of dietary change and the factors affecting food choices can direct more effective nutritional intervention against coronary heart disease progression. Objective: Identify the stages of change of eating behavior and its relation with nutritional status, food consumption and previous cardiovascular events in patients who underwent coronary angioplasty. Methods: A cross-sectional study with 200 hospitalized patients from a specialized cardiology hospital, after elective coronary angioplasty. They were applied an algorithm that identifies the provision of change of eating habits for a healthier pattern. Variables measured were stages of change of eating behavior, nutritional status, food consumption and cardiovascular events (previous myocardial infarction or angioplasty). It was realized comparison of averages by analysis of variance or Student's test and Chi-square test for qualitative variables. Value of significance was taken at 5%. Results: The patients were classified in the following stages: 36% maintenance, 26% preparation, 17% precontemplation, 12% action and 9% contemplation. It was observed higher cardiovascular events in maintenance/action group (p = 0.04), higher consumption of calories (p = 0.04), meat/eggs (p = 0.01) and sweets (p = 0.03) in preparation stage, comparing to maintenance group, and no association between nutritional status and stages of change (p = 0.13), although 62% of the individuals in maintenance stage were overweight. Conclusions: This work contributed to identifying the stages of change and conditions that favor changes in eating pattern. Even patients that classified themselves into the maintenance stage need to adjust their eating habits in order to reach a healthy weight.

O receptor de aerobactina IutA, uma proteína isolada em coluna de agarose, não é essencial para a infecção por Escherichia coli uropatogênica

Apenas alguns relatos na literatura demonstram que lectinas são importantes nos processos de colonização e infecção por Escherichia coli. A falta de compreensão clara dos mecanismos envolvendo lectinas, no processo de colonização por E. coli, motivou a realização deste estudo para se identificar a presença de outras lectinas não descritas em E. coli. Neste trabalho, isolou-se uma proteína de 75kDa de E. coli em coluna de Sepharose, correspondente ao receptor de aerobactina férrica (IutA). A associação de IutA com virulência de cepas de E. coli é controversa, principalmente em E. coli uropatogênica (UPEC), o que levou a se avaliar a presença do gene iutA em UPECs isoladas de pacientes com infecção urinária. O gene estava presente em 38% dos isolados, sugerindo fraca associação com virulência. Devido à existência de redundância nos sistemas de captura de ferro, sugere-se, aqui, que IutA possa ser vantajosa, mas não essencial para UPEC.