Promoção de medidas não farmacológicas no tratamento de pacientes com Hipertensão Arterial Sistêmica, através da instituição de um grupo de caminhada no mini posto Parque Alian, São João de Meriti - RJ

Introdução: A Hipertensão Arterial Sistêmica (HAS) é o principal fator de risco de morte entre as doenças não transmissíveis, mostrando relação com risco cardiovascular, sendo ainda um importante problema de saúde pública. Situação problema: Dificuldade de adesão a medidas não farmacológicas para controle da pressão arterial em hipertensos. Justificativa: O tratamento não farmacológico é uma medida sem nenhum ou pouco custo que pode ser realizada pela maioria dos pacientes e que traz benefícios já a curto prazo, sendo capaz de parar o curso da doença, diminuir o uso de medicamentos ou até mesmo substituí-lo. Objetivo geral: Melhorar a adesão ao tratamento de pacientes com Hipertensão Arterial Sistêmica, promovendo a criação de um Grupo de Caminhada na unidade de saúde. Metodologia: Foi feito o levantamento do perfil da população de hipertensos atendida no posto pela aplicação de um questionário, sendo analisados 32 pacientes hipertensos de 38 a 64 anos, e proposto um grupo de Caminhada. Resultados esperados: O grupo de Caminhada servirá para estimular os pacientes hipertensos a realizarem atividades físicas dentro e fora do grupo de caminhada, para que conheçam pessoas que estão na mesma situação e que troquem experiências e estímulos para o combate da Hipertensão Arterial Sistêmica.

Redução dos hipertensos sem controle da doença na população da equipe de Saúde da Família de Barra Longa-MG

A doença hipertensão arterial sistêmica é considerada um problema de saúde pública de âmbito mundial. Devido aos riscos decorrentes das complicações e dificuldades de controle é classificada como uma doença crônica, de natureza multifatorial. No Brasil, de acordo com a Sociedade Brasileira de Hipertensão, a doença é a principal causa de morte no país. A partir do conhecimento dos agravos decorrentes da hipertensão na população acompanhada do município de Barra Longa- MG foi elaborado um projeto de intervenção com o objetivo de reduzir o número de pacientes hipertensos sem controle da doença no município. A equipe da Estratégia de Saúde da Família de Barra Longa utilizou o método de Planejamento Estratégico Situacional para levantar os problemas da comunidade e eleger o problema prioritário para uma proposta de intervenção. O tema escolhido foi a alta incidência de hipertensos sem controle no município. Com a Proposta de Intervenção buscou-se modificar hábitos e estilos de vida, aumentar o nível de conhecimento da população sobre a doença e suas complicações, melhorar a estrutura e qualidade dos serviços para atendimento a pacientes hipertensos, melhorar a abordagem da equipe em relação aos pacientes hipertensos e finalmente conseguir a redução do número de pacientes hipertensos sem controle no município de Barra Longa

Redução de hipertensos idosos descontrolados na população da equipe do município de Barra Longa, Minas Gerais

A hipertensão arterial sistêmica (HAS) é uma condição clínica multifatorial caracterizada por níveis elevados e sustentados da pressão arterial (PA). Associa se frequentemente a alterações funcionais, e ou estruturais dos órgãos alvos, coração, encéfalo, rins e vasos sanguíneos e as alterações metabólicas, com consequente aumento do risco de eventos cardiovasculares fatais e não fatais (VI DIRETRIZES DE HIPERTENSÃO, 2010). O número elevado de portadores de doenças crônicas que utilizam os serviços de saúde repetida vezes pode revelar, entre outros fatores, o seguimento inadequado da terapêutica, além de aumentar a demanda dos serviços de saúde, favorece a internação hospitalar ou contribui para ampliar a sua duração. O presente trabalho tem como objetivo elaborar uma proposta de intervenção com vistas à redução de hipertensos idosos descontrolados no município de Barra longa. Foi feita uma revisão de literatura, nas bases de dados eletrônicos do Scientific Electronic Library Online (SCIELO), Biblioteca Virtual em Saúde (BVS), e do Ministério de Saúde (MS). Foram selecionados os estudos atualizados, dando-se preferência para aqueles dez artigos publicados nos últimos dez anos. O plano de ação foi baseado no método do Planejamento Estratégico Situacional (PES) conforme Campos Faria, Santos (2010). Concluiu-se que as dificuldades de mudança dos hábitos e vida, associam-se a diversos fatores, no caso da população idosa de Barra Longa, principalmente a condição financeira desfavorável, cultural e social. Diante dessa realidade, a participação de vários profissionais da área de saúde, com uma abordagem multidisciplinar, é de grande importância para oferecer orientações e assistência adequada referente aos tratamentos da HAS, e assim facilitar a adesão ao tratamento anti-hipertensivo e consequentemente aumentar o controle da pressão arterial

Arachnoid cyst: adversity ans plasticity

We report four cases of surgically treated intracranial arachnoid cysts, one with cyst-peritoneal shunt and three with craniotomy and arachnoid membrane resection. Their classification and etiopathogeny are discussed, and especially the different methods of treatment comparing the drastic complications (adversities) with the favorable solutions in severe clinical cases (plasticity) treated at our institution.

Cota racial e estado: abolição do racismo ou direitos de raça?

The objective of this article is to examine the current government proposal of racialization in the Brazilian population, in order to offer support to affirmative action programs that meet the specific needs of those who classify themselves as black. Firstly we focused on the revival of the notion of race among scholars, politicians, and anti-racism activists, as well as on the difficulty in determining who is black in Brazil. Next we examined the racial quota system in the United States and its proclaimed success. Finally, we assessed the extent to which the introduction of racial quota in employment and university enrollment should be imposed as the sole political option for those intending to eliminate racism in Brazilian society.

Caracterização de dois equipamentos de beneficiamento e classificação de tomates para mesa

On the last years, in Brazil, sorting and classifying fruits and vegetables using packing lines have increased. This work aimed at characterizing the cleaning process for fresh market tomatoes at two packing lines, one imported and one national located at Campinas, São Paulo State. Characterization included data, number, types and brushes velocity, water use, fruit standing time and cleaning efficiency. Standing time was measured correlating to fruit diameter (CEAGESP). For measuring cleaning efficiency an equipment was developed that was mainly composed of a ring involved with white cloth. Samples were taken before and after the cleaning step and evaluated using a colorimeter HUNTER Lab. The results showed a strong difference between the two equipments. The imported equipment showed lower number on brushes and rotation than national one, however a higher water consumption. For imported equipments this relation was not found. Both packing lines showed the same cleaning efficiency. Cleaning efficiency is related to be an interaction among the studies parameters, and it could be necessary a better management than the one used on both equipments.

Otimização da eficiência de limpeza em equipamento de beneficiamento de tomate de mesa

The post-harvesting cleaning process in fresh market tomatoes production is essential to the consumer acceptance, since the degree of dirtiness of the fruits is directly related to its quality. However, the washing stage of the cleaning process of commercial packinghouse demands an excessive water volume, bringing serious environmental concerns. The objective of this work was to compare the cleaning efficiency in two cleaning systems through the evaluation of different operational conditions of the cleaning process, related with the brush rotation, water flow and fruit standing time under the system. It was compared the conventional system utilized in commercial equipment with a system using commercial sprays. The results showed that the cleaning efficiency was not directly related to the water volume used, but to the water pressure, standing time and brushes rotation. Therefore, the use of commercial sprays can bring benefits to the cleaning efficiency, increasing it up to 13%, and to the environmental, decreasing water consumption.

Otimização do descascamento químico de raízes do yacon (Polymnia sonchifolia Poepp.)

A full factorial design 2³ was used to evaluate the effect of process variables in chemical peeling of yacon roots, cultivated in Curitiba, State of Paraná. Eleven treatments, with three central points, were done in which they had been evaluated at three different levels of sodium hydroxide solution, % (g/100 mL) [6, 10, 14], temperature of the same solution, °C [70, 80, 90], and residence time in the sodium hydroxide solution, minutes [2, 4, 6]. All the studied variables had affected significantly (p<0.05) the yield of yacon roots subjected to chemical peeling. The variable that most affected the yield was the time of permanence in the sodium hydroxide solution. The mathematical model obtained for the yield (%) was good with R² aj = 0.8497, and non significant lack of fit (p=0.9312).Therefore, the model can be used for predictive purposes. In the central point a satisfactory yield (84% to 87%) with a high percentage of removed peel was obtained (96% to 98%) indicating that the treatment with 10% of sodium hydroxide solution, temperature of 80º C per 4 minutes can be used in the chemical peeling of yacon roots.

Programas de educação de jovens e adultos e pesquisa acadêmica: a contribuição dos estudos do letramento

The purpose of this article is to introduce elements that allow building an interface between the academic research and the programs of basic education for youngsters and adults. It discusses contributions to these programs that can be found in the results of qualitative research studies. To this end, results of a five-year long project on teacher education are used, which aim was that of analyzing the interaction between teacher and student in youngster and adult literacy classes. The research project was conducted in natural contexts with the purpose of understanding a given social reality, and not of establishing general laws. Therefore, the credibility of its results was built through the observation of multiple contexts, and the gathering of data was made through various methods, from the perspective of several participants observed during a prolonged period of time. This empirical basis was used to evaluate recommendations contained in the report commissioned by Unesco to the International Literacy Institute for presentation at the World Forum on Education held in 2000 in Dakar. This report proposed that the continuous attendance of students to basic education programs is one of the great challenges of the new millennium. With respect to the problem of adult evasion from courses and programs, the article discusses the motivation and accessibility factors, pointed out in official documents as relevant factors to the success or failure of the programs.

História, filosofia e sociologia da educação matemática na formação do professor: um programa de pesquisa

We present and discuss in this article some features of a research program whose central object of investigation is the way in which the recent fields of history, philosophy, and sociology of mathematical education could take part in a critical and qualified manner in the initial and continuing training of teachers in this area. For that, we endorse the viewpoint that the courses for mathematics teacher education should be based on a conception of specificity through which a new pedagogical project could be established. In such project those new fields of investigation would participate, in an organic and clarifying way, in the constitution of multidimensional problematizations of school practices, in which mathematics would be involved, and that would be guided by academic investigations about the issues that currently challenge teachers in the critical work of incorporation, resignification, production, and transmission of mathematical culture in the context of the school institution.

O papel da interação no processo de ensino-aprendizagem de português para alunos surdos em uma escola inclusiva

In this article, it is discussed the role of interaction in the process of teaching and learning Portuguese of deaf students at an inclusive school. In the context where the research took place, the hearing teacher does not understand sign language, and there are, in her classroom, hearing students and four deaf students, being three of them sign language users. As the communication between the hearing teacher and the deaf students occurred in different codes - Portuguese and Brazilian sign language - and having a social-interactional approach of language (MOITA LOPES, 1986; FREIRE, 1999), we observed if the interaction among the subjects enabled the deaf students to understand what was being taught. The results showed that the fact of having four deaf students in the same classroom allowed them to work in a cooperative way. Besides, the sign language became more visible in this institution. On the other hand, the interaction between the teacher and her deaf students revealed to be of little significance to the learning process of this small group.

Fatores associados à maior mortalidade e tempo de internação prolongado em uma unidade de terapia intensiva de adultos

OBJECTIVE: The intensive care unit is synonymous of high severity, and its mortality rates are between 5.4 and 33%. With the development of new technologies, a patient can be maintained for long time in the unit, causing high costs, psychological and moral for all involved. This study aimed to evaluate the risk factors for mortality and prolonged length of stay in an adult intensive care unit. METHODS: The study included all patients consecutively admitted to the adult medical/surgical intensive care unit of Hospital das Clínicas da Universidade Estadual de Campinas, for six months. We collected data such as sex, age, diagnosis, personal history, APACHE II score, days of invasive mechanical ventilation orotracheal reintubation, tracheostomy, days of hospitalization in the intensive care unit and discharge or death in the intensive care unit. RESULTS: Were included in the study 401 patients; 59.6% men and 40.4% women, age 53.8±18.0. The mean intensive care unit stay was 8.2±10.8 days, with a mortality rate of 13.5%. Significant data for mortality and prolonged length of stay in intensive care unit (p <0.0001), were: APACHE II>11, OT-Re and tracheostomy. CONCLUSION: The mortality and prolonged length of stay in intensive care unit intensive care unit as risk factors were: APACHE>11, orotracheal reintubation and tracheostomy.

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.

Coma mixedematoso em paciente com neurofibromatose tipo 1: associação rara

Myxedema coma, a rare but fatal emergency, is an extreme expression of hypothyroidism. We describe a 51-year-old male patient who has discontinued hypothyroidism treatment 10 months earlier and developed lethargy, edema, and cold intolerance symptoms. He also had a previous diagnosis of neurofibromatosis. After admission, he progressed to respiratory insufficiency and coma. The prompt recognition of the condition, thyroid hormone replacement, and management of the complications (hypoventilation, cardiogenic shock associated with swinging heart, adrenal and renal insufficiency and sepsis), resulted in a favorable evolution.

Influência da redução medicamentosa da pressão intra-ocular na medida da espessura da camada de fibras nervosas da retina de olhos hipertensos e glaucomatosos pela polarimetria de varredura a laser

PURPOSE: To evaluate changes in retinal nerve fiber layer thickness as measured by scanning laser polarimetry (SLP) after the use of medication to reduce intraocular pressure (IOP) in glaucomatous or ocular hypertensive patients. METHODS: The authors prospectively enrolled 37 eyes of 37 patients in whom IOP was reduced by more than 25% after the use of medication. The images were obtained before and 15 to 30 days after the introduction of medication. The SLP parameters measured before and after the use of medication were compared using paired Student's t Test. RESULTS: The mean IOP was significantly reduced from 26.57±4.23 mmHg to 16.54 ±2.92 mmHg after the use of medication (p<0.05). None of the 10 SLP analyzed parameters was significantly affected by the reduction of IOP with medication (p>0.05). CONCLUSION: The retinal nerve fiber layer thickness, as measured by SLP, is not affected by the reduction of IOP with medication in patients with glaucoma or ocular hypertension.