Stpahylococcus aureus biofilms on central venous haemodialysis catheters

As infecções devido a biofilmes bacterianos são comuns em pacientes sob tratamento em hemodiálise. Neste estudo, 16 pacientes (7 homens, 9 mulheres, de 22 a 81 anos, média 50 anos de idade), com um total de 25 cateteres de hemodiálise (3 de triplo-lúmen e 22 de duplo-lúmen) de poliuretano inseridos em veia subclávia foram estudados. Os cateteres permaneceram no local de 3 a 91 dias (média de 47 dias). Os cateteres foram removidos devido ao: mau funcionamento (44%), suspeita de infecção relacionada ao cateter (20%), viabilidade de um acesso permanente (16%), remoção acidental (12%), sinais e sintomas de infecção no local da inserção do cateter (4%) e contaminação exógena (4%). Culturas positivas de ponta foram observadas em sete cateteres (28%), concomitantemente com três culturas positivas de sangue. Das culturas de sangue foram identificados Staphylococcus aureus (12%) e de uma das conexões foi isolado S. aureus. Biofilmes foram observados sobre todas as pontas de cateteres. Os S. aureus isolados do sangue e cateter (ponta e conexão) eram resistentes a pencilina e sensíveis a azitromicina, ciprofloxacina, clindamicina, cloranfenicol, gentamicina, oxacilina, rifampicina, sulfametoxazole, tetraciclina e vancomicina. As cepas de S. aureus isoladas de sangue, ponta de cateter e conexão foram consideradas idênticas devido à coincidência do perfil de sensibilidade. E similaridade genética, avaliada por meio de ribotipagem.

Influência da fisioterapia complexa descongestiva associada à ingestão de triglicerídeos de cadeia média no tratamento do linfedema de membro superior

OBJETIVO: Verificar a influência da utilização da fisioterapia complexa descongestiva associada à dietoterapia com triglicerídeos de cadeia média (TCM) como forma de intervenção no linfedema de membro superior (MS). MÉTODOS: Para a avaliação do linfedema, foram utilizadas cirtometria, volumetria, pregas cutâneas e quantidade de água corporal total. A Escala Visual Análoga (EVA) foi utilizada para avaliar as sensações de desconforto, peso e dor no MS. Participaram deste estudo dez mulheres mastectomizadas com linfedema de MS homolateral à cirurgia, com idade média de 65,9 ± 10,4 anos e índice de massa corpórea (IMC) de 26,8 ± 3,0kg/m² que, após avaliação nutricional, foram divididas aleatoriamente em dois grupos: Grupo Controle (n= 5), submetido ao tratamento fisioterapêutico constando da terapia complexa descongestiva (massagem clássica, drenagem linfática manual, bandagem compressiva e cuidados com a pele) três vezes na semana, durante quatro semanas; Grupo TCM (n= 5), submetido ao mesmo protocolo fisioterapêutico somado ao tratamento dietético diário com ingestão de TCM, por quatro semanas. RESULTADOS: Ao final da intervenção, a análise da cirtometria e da volumetria mostraram diferenças significativas entre os grupos (< 0,05), com maior redução do linfedema no Grupo TCM. Não houve diferença significativa nos valores das pregas cutâneas e da quantidade de água corporal total. A sensação de peso no membro superior, antes e após a intervenção, foi significativamente menor (< 0,05) no Grupo TCM. CONCLUSÕES: O tratamento fisioterapêutico somado à dietoterapia com ingestão de TCM em mulheres portadoras de linfedema de MS pós-cirurgia e tratamento de câncer de mama foi efetivo na involução desta condição.

Centros de especialidades odontológicas: avaliação da atenção de média complexidade na rede pública da Grande Natal

The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems

Padrão de distribuição e caracterização morfológica de fibras serotonérgicas nos núcleos da linha Média/ intralaminares do tálamo do mocó (Kerodon rupestris)

The midline/intralaminar nuclei form a remarkable group of nuclei of the medial and dorsal thalamus. The midline nuclei, in rats, comprises the paratenial nuclei (PT), paraventricular (PV), intermediodorsal (IMD), reuniens (Re) and rhomboid (Rh). The intralaminar nuclei comprises the central medial (CM), paracentral (PC), central lateral (CL) and parafascicular (PF). Such nuclei have dense serotonergic innervation originating from the brainstem, especially from the so-called ascending activation system. These nuclei, in turn, send projections to various cortical and subcortical areas, specifically to limbic areas, which suggests the important role of this neurotransmitter in the limbic circuitry. The aim of this study was to characterize the distribution pattern and morphology of serotonin fibers in the nuclei of the midline and intralaminar thalamic of rocky cavy (Kerodon rupestris), a tipical rodent from brazilizan northeast. To reach this aim we used four rock cavies adults. Following the transcardially perfusion with paraformaldehyde and brain microtomy steps was performed immunohistochemistry for serotonin (5-HT), Nissl technique and subsequent achievement and image analysis to characterize the cytoarchitecture of these nuclei and the serotonergic fibers visualized. An analysis was made of Relative Optical Density (ROD) to semi-quantify the concentration of serotonin fibers in the areas of interest. Thus, we observed a cytoarchitectonic arrangement of these nuclei similar to that found in rats. In case of fibers distribution, those immunoreactive to 5-HT were presented in a higher concentration according as ROD in the midline nuclei relative to intralaminar; Re being the core which has a higher pixel value followed by the PV , Rh, IMD and PT. In intralaminar CL showed higher pixels, followed by nuclei CM, PC and PF. The serotonergic fibers were classified as number of varicosities and axon diameter, therefore find three types of fibers distributed through this nuclear complex: fibers rugous, granular and semi-granular. In PV fibers predominated rugous; in PT fibers predominated granular; IMD, CL and PF fibers were represented by semi-granular and Re, Rh, PC and CM fibers showed granular and semi-granular. Morphological characterization of serotonergic fibers and differences in density between the nuclei may suggest different patterns of synaptic organization of this neurotransmitter beyond confirming his large repertoire functional

Uso de produto à base de enzima e levedura na dieta de bovinos: digestibilidade dos nutrientes e desempenho em confinamento

Objetivou-se, com este trabalho, avaliar os efeitos da adição de diferentes níveis de enzima mais levedura na dieta de bovinos sobre a digestibilidade aparente dos nutrientes e o desempenho em confinamento, utilizando-se 18 animais machos, mestiços, de origem leiteira, com peso vivo (PV) médio de 190±10 kg e 12 meses de idade, e 27 animais da raça Guzerá com PV médio de 325 kg e idade média de 27 meses. Os níveis de enzima mais levedura foram zero (controle), 5 g de enzima (E) mais 5 g de levedura (L) e 10 g de E mais 5 g de L por animal por dia. Todos os animais receberam a mesma dieta, constituída de 65% de silagem (50% de milho:50% de sorgo) e 35% de concentrado composto de milho (24,6%), farelo de algodão (7,4%), uréia (1,2%), sal mineralizado (0,54%) e calcário (0,86%). Esta dieta apresentava 12,4% de PB; 10,1 MJEM/kg MS e 41,1% de FDN. A adição de enzima mais levedura não alterou o consumo de MS (3,31% do PV ou 126,6 g/kg PV0,75), e CDA da MS (63,0%), PB (68,2%), EE (83,3%), CHOT (61,3%), FDN (47,2%), FDA (43,8%) e valor de NDT (62,8%). O GMD e o CMS diminuíram de forma quadrática e a CA alimentar piorou linearmente, em função dos dias de confinamento. O fornecimento de enzima mais levedura para bovinos de corte não traz benefícios nutricionais ou de desempenho.

Efeitos da irrigação e adubação nitrogenada sobre a massa de forragem de cultivares de Panicum maximum Jacq.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito de aditivos no valor nutritivo de silagens feitas com subproduto da extração do palmito de pupunha (Bactris gasipaes H.B.K.)

O objetivo deste experimento foi determinar a qualidade e o valor nutritivo de silagens do subproduto da pupunha, produzidas com aditivos, conforme os tratamentos: T1 - Testemunha (sem aditivo); T2 - Adição de 2,5% de açúcar; T3 - Adição de 10,0% de polpa cítrica e T4 - Adição de 10,0% de milho moído, base da matéria natural. Verificou-se que a adição 10% de polpa cítrica (PC) ou milho moído (MM) elevou o teor de matéria seca da massa a ser ensilada, bem como da silagem, em 6,5 e 8,0 unidades percentuais, respectivamente. Silagens com aditivos apresentaram menores valores de nitrogênio amoniacal (N-NH3 / NT) e pH. O consumo de matéria seca foi maior para as silagens feitas com PC ou MM, atingindo 85 g/kg PV0,75 ou 2,1% do PV, contra 44,7 g/kgPV0,75 ou 1,12%, para as silagens sem aditivo ou com 2,5% de açúcar. O coeficiente de digestibilidade aparente da matéria seca, também foi superior para as silagens contendo 10% de PC ou MM (65,0%) em relação à média das demais (52,0%). A digestibilidade da parede celular não mostrou tendência definida em função dos tratamentos. A silagem de subproduto da pupunha feita com a adição de 10% de polpa cítrica ou milho moído, apresentou valor nutritivo semelhante às silagens de forrageiras convencionais.

A apreciação musical infantil: aspectos da constituição da infância contemporânea no discurso de crianças do Ensino Fundamental

Music can be found in peculiar historical and social context with distinct functions, such as religious rituals, ethic-esthetic education of subjects, therapeutic elements, critic and maintenance of established patterns, among others. Considered as language, music acts on dialogue dimensions of the body, the senses, the affectionate-cognitive and of social interactions. Their uses reveal the social forces that cross the culture and constitution of subjectivities. The attribution of senses by the subjects to musical production reveals the cultural voices in dialogue, that circumscribe determined social places to them. Our aim in this work is to investigate the child musical appreciation, with children about 7 to 9 years old, and, by attributing uses and senses to music, unveil the voices that settle the places intended and assumed by infancy in contemporaneity The child constructs its musical appreciation through cultural access and mediation, possible by circulation in several socializing groups like family, school, church, infant groups, community groups and, more recently, publicity and media These last two spheres, enabled by the development of the technological means of communication, contributed to the dissemination of the set of consume ideas and for the emergence of the cultural industry, characteristic of the capitalistic production way in its present configuration. They develop new possibilities of perception of the world, in which the limits between childhood and adulthood are not anymore the same that have been established in previous centuries. So, the child musical appreciation is constituted by homogeneity regarding the senses built and disseminated by cultural industry and by the logical merchandizing, and singularities, associated to the construction of senses in interaction with global, local, and multiple contexts, through which the subject circulates and constitutes himself polyphonically

Composição da artropodofauna entomófoga associada a diferentes genótipos de sorgo granífero no cerrado do Sudeste do Brasil

Espécies de artrópodos entomófagos foram coletadas e identificadas nos genótipos sorgo AF-28, IAC-83/75-5-1-6, TX-2536, BR-300, IPA-201 e SAR, no Município de Selvíria, MS. Foram conduzidos três experimentos em campo, com os genótipos sendo semeados em 03/1988, 10/1988 e 02/1989, respectivamente. Para contagem dos artrópodos entomófagos, no início do florescimento foram marcadas 560 panículas por genótipo. Após esse momento, diariamente e durante 14 dias seguidos, foram coletadas 40 panículas por genótipo (10 por parcela). Nas coletas foram utilizados sacos plásticos com 10 litros de capacidade para envolver as panículas e capturar os artrópodos presentes. As panículas coletadas foram levadas para o Laboratório de Entomologia da Faculdade de Engenharia/UNESP, Campus de Ilha Solteira, SP, para separação, contagem e identificação dos artrópodos. Nas panículas provenientes da semeadura da seca coletou-se, em média, maior número de artrópodos entomófagos em relação à semeadura das águas. Dos artrópodos entomófagos coletados, as aranhas apresentaram maior número de espécies e, desses, a tecelã Alpaida veniliae (Keys.), a aranha corredora noturna Cheiracanthium inclusum (Blackwall), e a caçadora de emboscada, Misumenops pallidus (Keys.), foram as mais abundantes. O genótipo de sorgo IPA-201 comportou-se como o mais atrativo ao percevejo Orius sp. e à tesourinha Doru lineare (Eschs.), enquanto que o IAC-83/75-5-1-6 foi medianamente atrativo a D. lineare. As aranhas foram coletadas em maior número nos genótipos BR-300 e SART.

(Con)vivendo em fortalezas: o outro lado do morar bem

The intensification of the fear in the city and in the spaces controlled by this feeling has contributed to a growing socio-spatial inequality, and the rapid growth of market protection. The residential condos emerge as a possible solution to the problem. This is a housing typology expanding worldwide which is seen, especially by the urban middle class, as enablers of quality of life and safety. In Brazil, especially in large cities, the quest for quality of life is directly connected with the desire for security translated through space control (use of high walls, gates, entrance hall, security cameras) and people who use it. This thesis aims at investigating how the different categories of inhabitants of an area predominantly occupied by vertical residential condos realize the socio-spatial dimension and the socio-urban space determined by this type of development. It especially takes into consideration the issue of urban insecurity, based on the assumption that, although published and sold by marketing as safe places , synonym of welfare and supporters of community life , the living in these condos, may even inhibits, social relationships, contributing to socio-spatial isolation and consequent social weakness. This is a survey that seeks to meet the assumptions of Environmental Psychology towards the comprehension of person-environment studies, emphasizing the use of different methods (desk research, observations of and group interviews, focus group technique using photographic resources), as well as the focus on current problems of the urban scene and the knowledge gained in Social Psychology

Agricultura familiar: uma perspectiva da qualidade de vida do produtor rural orgânico da Paraíba

Knowledge of quality of life is a very complex and rich in cultural and subjective dimensions, understood in a broad sense and multivariate theme. Considering the rural areas from agriculture, it is observed that the production standard defines significant changes in the environmental context and the quality of life of rural workers. To explain the relationship between quality of life and Family Organic Agriculture, we sought to analyze the quality of life of the organic family farmer, after change in agricultural management. The research, based on a procedure exploratory study supported the articulation theoretically constructed, showed their relevance and allowed to delimit with greater security, the central question of work. The WHOQOL - 100 treated the instrument of research on quality of life that directed the field study with organic farmers from the town of Lagoa Seca / PB. Farmers and family members are from rural regions Almeida, Alvinho, Lagoa de Barro, Lagoa Gravatá, Oiti and Pau Ferro. The average time is 39 years farming and organic family farm is 16 years. In the analysis work was found that the process of production of vegetables and fruits is divided into 08 steps and with respect to workloads observations showed the presence of: physical loads, mechanical stresses, psychological burden and ergonomic factors. Most farmers reported symptoms were fatigue and cramps in the legs . Regarding the quality of life was noticed that the Psychological Domain contributed positively to the quality of life with mean and standard deviation (17.83 ± 12.78) and Domain Environment negatively contributing to the quality of life of this group (9.00 ± 6.82). We conclude that the practice of Family Organic Agriculture should be seen as an effective strategy in promoting quality of life and social values in between, since it presents environmental sustainability with regard to life and socio-cultural diversity of populations

Medida da preditividade de instrumentos psicológicos nas avaliações psicológicas de condutores

The object of this study was to identify the possibility of predicting the involvement in traffic infractions from the results of the psychological tests carried out by psychologists specialized in the process of driver licensing in the state of Rio Grande do Norte (RN). The proposal consisted in identifying the penalty points recorded in national driving licenses (CNH) and identifying the corresponding tests and scores obtained, verifying if the average scores in the tests of drivers with and without an infraction record were significantly different and if there is any relation between the test scores and the frequency of the infractions. The results of the psychological instruments were collected in two moments the first being in the act of acquisition of the CNH and the second being during license renewal at the only certified clinic and at the DETRAN-RN. A population of 839 drivers of 14 municipalities were identified. 127 protocols of psychological tests were identified in the records of the DETRAN-RN (2002) and 76 at the clinic (2007), pointing out failures in the process of safekeeping of the psychological material, as well as in its retrieval from the record files. The sample was thus reduced to 68 drivers, all male, with age range between 18 and 41 years old, mean of 21,72 years old (DP = 5,24). 54 drivers were identified without a record of infraction, and 14 with a record. The latter committed 29 infractions. The penalty points recorded in their CNH ranged from 0 to 35 and the typical value of points (median) was zero. In the group with a record of infractions the number of points ranged between 3 and 35, mean of 10,79 (DP = 7,73). Differences were observed in the composition of the battery of tests in the two moments with the same subjects. The use of different tests to assess the same construct of the subject, first and second moment of assessment, did not allow for some analyzes with more efficient statistical proof. It was pointed out that five tests were not carried out and 118 were not corrected/analyzed. Significant differences between the groups were not identified with the psychological instruments used. In another attempt to establish differences between the means, the application of the independent t-Test evidenced a significant difference in the scores of the instruments of concentrated attention in 2002 (t = 2,21, gl = 25, p = 0.037) and of diffuse attention in 2002 (t = 2,37, gl = 24, p = 0.026). The results also did not evidence significant correlation between the scores of the tests and the penalty points of the infractions. Based on this study, it cannot be concluded with precision that the high or low scores are good criteria to determine that a driver will commit more or less traffic infractions, nor that the drivers with higher scores in the tests commit less infractions and vice-versa. Furthermore, the problems to find the instruments and the most basic data require a stronger monitoring on the part of the certified clinic and of the DETRAN-RN.

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Adaptação e validação da escala de motivação à prática de atividades físicas

The study of the motivation to practice physical activities is relevant once through this it is possible to develop intervention strategies for sedentary population. In this way, the present dissertation aimed to adapt and validate for the Brazilian context the Motives for Physical Activity Measure Revised (MPAM-R). It was investigated yet the relation of some socio-demographic variables (age, gender, Body Mass Index - BMI, types of physical activity; way to practice and time of practice) and the participants means in the motives studied. The physical activity (PA) is defined as any bodily movement produced by skeletal muscles resulting in energy expenditure above the basal level. However, in the present study it was considered motivation for two types of PA: the physical exercises and sports. The Self-Determination Theory (SDT) underlay this research, once it has been used in the sportive context, beyond the facto of it was used as theoretical base to the development of MPAM-R. To attain the proposed goals, it was accomplished translations to Portuguese of the original English scale. Next, was carried out the semantic analysis and the judge analysis. For the empirical analysis of items, participated 309 practitioner of PA, classified in physical exercises practitioners and sports practitioners, with ages between 16 and 74 years, distributed equally by sex. They answered the final version in Portuguese of the MPAM-R and socio-demographic questions. The data was collected in Natal/RN, where the researcher approached people in some places where the PA is practiced, following she communicated that their involvement will be spontaneous and their responses will be confidential. The obtained results pointed the confirmation of the existence of five factors in the final version of the instrument, that was composed by 26 items that presented the following statistics indexes: x² (289) = 757.75, p < 0.000, x²/DF = 2.62, with GFI of 0.83, AGFI of 0.80 and RMSEA of 0.07. The reliability (Cronbach Alpha) of the complete instrument was 0.90, and the indexes of each factor were considered satisfactory too: Enjoyment (α = 0.88), Health (α = 0.84), Appearance (α = 0.79), Competence (α = 0.85) and Social (α = 0.75). It was observed that, in general, the main motive presented by the participants to practice PA was Health. It was verified yet, that women and aged had a higher mean in the Health factor; among the exercise practitioners was found a higher mean in the Appearance factor; and a higher mean in the Social factor was found among those that practice PA with accompaniment. It was concluded that the MPAM-R presented satisfactory psychometric parameters, became it useful in futures researches. Moreover, proposed the accomplishment of new studies that considered others variables to the intent of the better understanding of motivation to practice physical activity