Melhoria da atenção à saúde bucal dos alunos de 6 a 14 anos da Escola Municipal São Francisco de Assis, área de abrangência da Unidade Básica de Saúde Alto Paraíso, Aparecida de Goiânia-GO

A faixa etária de 6 a 14 anos corresponde à idade escolar ideal para desenvolver hábitos saudáveis e para participação em programas preventivos e educativos de saúde bucal (BRASIL, 2008), além de corresponder ao período de transição de dentição decídua, mista e permanente. O objetivo desta intervenção foi melhorar a atenção à saúde bucal dos alunos de 6 a 14 anos da Escola Municipal São Francisco de Assis. A intervenção ocorreu entre os meses de novembro de 2013 a abril de 2014. Desenvolvemos a intervenção visando reorganizar as ações e os serviços em saúde bucal na Unidade Básica de Saúde Alto Paraíso, Aparecida de Goiânia/GO. As ações foram desenvolvidas em quatro eixos: monitoramento e avaliação, organização e gestão, engajamento público, qualificação da prática clínica. Adotamos como protocolo os Cadernos de Atenção Básica de Saúde Bucal e Saúde na Escola, e as ações foram registradas em fichas espelhos, prontuários, livro ata e planilha de coleta de dados. Alcançamos uma cobertura de 44,2% dos escolares, com destaque para a ampliação da escovação dental supervisionada, aplicação tópica de flúor e a conclusão do tratamento dentário dos escolares com primeira consulta odontológica. Os ganhos e crescimento na qualidade do atendimento são nítidos, pois não existia uma cobertura delimitada e sistemática desse grupo. Além disso, a melhora nos registros das informações organizou o atendimento clínico, facilitando também o monitoramento e busca ativa dos escolares. A intervenção realizada foi um sucesso, alcançando a maioria dos objetivos e metas planejadas. A assistência odontológica aos escolares é referência no município, reconhecida como uma atenção de alta qualidade pela comunidade. Teremos condições de superar algumas dificuldades encontradas, dada a melhor capacidade para a realização das ações e o apoio da gestão municipal. Percebo que a equipe está integrada e incorporando a intervenção à rotina do serviço. O desafio é continuar com qualidade o trabalho iniciado.

Confiabilidade do exame de VDRL no diagnóstico da sífilis e responsabilidade do médico na interpretação - relato de casos no PSF Vila Norma

A sífilis é uma Infecção Sexualmente Transmissível (IST) de interesse em saúde pública causada pela bactéria Treponema pallidum subespécie pallidum. Seu controle é feito por meio de ações e medidas eficazes de saúde pública, em virtude de apresentar testes diagnósticos sensíveis, tratamento efetivo e de baixo custo. Se não tratada, a doença pode evoluir a estágios que comprometem a pele e órgãos internos, como o coração, fígado e sistema nervoso central. A sífilis congênita é decorrente da disseminação hematogênica do Treponema pallidum da gestante não tratada ou inadequadamente tratada para o seu concepto, por via transplacentária. A transmissão pode ocorrer em qualquer fase da gestação e em qualquer estágio da doença, com probabilidade alta na sífilis primária e secundária, média na sífilis latente precoce e baixa na sífilis latente tardia. O presente projeto visa alertar os profissionais de saúde para a avaliação criteriosa dos sintomas dos pacientes, especialmente das gestantes e parceiros, bem como para a leitura crítica de qualquer exame laboratorial dado que fui motivado por um número muito alto de pacientes que apresentaram VDRL positivo na minha prática médica. Os resultados me intrigaram, e solicitei repetições em outro laboratório, que retornaram com resultado negativo mesmo sem tratamento ou realizado incompletamente. Assim, proponho estratégias de minimização dos impactos negativos da sífilis gestacional, causados por resultados falso-positivos em unidade de saúde da família do Município de São João de Meriti por meio de teste de rápido de triagem e grupos de promoção da saúde.

Hypothermia And Early Neonatal Mortality In Preterm Infants.

To evaluate intervention practices associated with hypothermia at both 5 minutes after birth and at neonatal intensive care unit (NICU) admission and to determine whether hypothermia at NICU admission is associated with early neonatal death in preterm infants. This prospective cohort included 1764 inborn neonates of 22-33 weeks without malformations admitted to 9 university NICUs from August 2010 through April 2012. All centers followed neonatal International Liaison Committee on Resuscitation recommendations for the stabilization and resuscitation in the delivery room (DR). Variables associated with hypothermia (axillary temperature <36.0 °C) 5 minutes after birth and at NICU admission, as well as those associated with early death, were analyzed by logistic regression. Hypothermia 5 minutes after birth and at NICU admission was noted in 44% and 51%, respectively, with 6% of early neonatal deaths. Adjusted for confounding variables, practices associated with hypothermia at 5 minutes after birth were DR temperature <25 °C (OR 2.13, 95% CI 1.67-2.28), maternal temperature at delivery <36.0 °C (OR 1.93, 95% CI 1.49-2.51), and use of plastic bag/wrap (OR 0.53, 95% CI 0.40-0.70). The variables associated with hypothermia at NICU admission were DR temperature <25 °C (OR 1.44, 95% CI 1.10-1.88), respiratory support with cold air in the DR (OR 1.40, 95% CI 1.03-1.88) and during transport to NICU (OR 1.51, 95% CI 1.08-2.13), and cap use (OR 0.55, 95% CI 0.39-0.78). Hypothermia at NICU admission increased the chance of early neonatal death by 1.64-fold (95% CI 1.03-2.61). Simple interventions, such as maintaining DR temperature >25 °C, reducing maternal hypothermia prior to delivery, providing plastic bags/wraps and caps for the newly born infants, and using warm resuscitation gases, may decrease hypothermia at NICU admission and improve early neonatal survival.

Cerebral Cortex Involvement In Machado-joseph Disease.

Machado-Joseph disease (MJD/SCA3) is the most frequent spinocerebellar ataxia, characterized by brainstem, basal ganglia and cerebellar damage. Few magnetic resonance imaging based studies have investigated damage in the cerebral cortex. The objective was to determine whether patients with MJD/SCA3 have cerebral cortex atrophy, to identify regions more susceptible to damage and to look for the clinical and neuropsychological correlates of such lesions. Forty-nine patients with MJD/SCA3 (mean age 47.7 ± 13.0 years, 27 men) and 49 matched healthy controls were enrolled. All subjects underwent magnetic resonance imaging scans in a 3 T device, and three-dimensional T1 images were used for volumetric analyses. Measurement of cortical thickness and volume was performed using the FreeSurfer software. Groups were compared using ancova with age, gender and estimated intracranial volume as covariates, and a general linear model was used to assess correlations between atrophy and clinical variables. Mean CAG expansion, Scale for Assessment and Rating of Ataxia (SARA) score and age at onset were 72.1 ± 4.2, 14.7 ± 7.3 and 37.5 ± 12.5 years, respectively. The main findings were (i) bilateral paracentral cortex atrophy, as well as the caudal middle frontal gyrus, superior and transverse temporal gyri, and lateral occipital cortex in the left hemisphere and supramarginal gyrus in the right hemisphere; (ii) volumetric reduction of basal ganglia and hippocampi; (iii) a significant correlation between SARA and brainstem and precentral gyrus atrophy. Furthermore, some of the affected cortical regions showed significant correlations with neuropsychological data. Patients with MJD/SCA3 have widespread cortical and subcortical atrophy. These structural findings correlate with clinical manifestations of the disease, which support the concept that cognitive/motor impairment and cerebral damage are related in disease.

Spinal Cord Damage In Machado-joseph Disease.

Machado-Joseph disease (SCA3) is the most frequent spinocerebellar ataxia worldwide and characterized by remarkable phenotypic heterogeneity. MRI-based studies in SCA3 focused in the cerebellum and connections, but little is known about cord damage in the disease and its clinical relevance. To evaluate the spinal cord damage in SCA3 through quantitative analysis of MRI scans. A group of 48 patients with SCA3 and 48 age and gender-matched healthy controls underwent MRI on a 3T scanner. We used T1-weighted 3D images to estimate the cervical spinal cord area (CA) and eccentricity (CE) at three C2/C3 levels based on a semi-automatic image segmentation protocol. The scale for assessment and rating of ataxia (SARA) was employed to quantify disease severity. The two groups-SCA3 and controls-were significantly different regarding CA (49.5 ± 7.3 vs 67.2 ± 6.3 mm(2), p < 0.001) and CE values (0.79 ± 0.06 vs 0.75 ± 0.05, p = 0.005). In addition, CA presented a significant correlation with SARA scores in the patient group (p = 0.010). CE was not associated with SARA scores (p = 0.857). In the multiple variable regression, we found that disease duration was the only variable associated with CA (coefficient = -0.629, p = 0.025). SCA3 is characterized by cervical cord atrophy and antero-posterior flattening. In addition, the spinal cord areas did correlate with disease severity. This suggests that quantitative analyses of the spinal cord MRI might be a useful biomarker in SCA3.

Machado-Joseph disease versus hereditary spastic paraplegia: case report

Machado-Joseph disease (MJD) is the most common autosomal dominant spinocerebellar ataxia and presents great phenotypic variability. MJD presenting with spastic paraparesis was recently described in Japanese patients. We report the case of 41-year-old woman with the phenotype of complicated hereditary spastic paraplegia. Her father died at the age of 56 years due to an undiagnosed progressive neurological disease that presented parkinsonism. She had an expanded allele with 66 CAG repeats and a normal allele with 22 repeats in the gene of MJD. MJD should be considered in the differential diagnosis of autosomal dominant complicated HSP. A patient with the phenotype of complicated HSP and relatives with other clinical features of a neurodegenerative disease should raise the suspicion of MJD.

A metalinguagem como lugar da interpretação: terminologia e bases de dados informatizadas

The main objective of this work is to discuss the notion of metalanguage concerning the use of thesaurus (symbols systems, functions indicators, descriptors) utilized by indexers for article representation in computerized bibliographical databases. Our corpus comprises article abstracts and bibliographical database descriptors LILACS (Literatura Latino-Americana em Ciências da Saúde) and SOCIOFILE Sociological Abstracts. We aim at clarifying the effects of subjectivity in the functioning of indexing taking account the grounds for interpretation that allow different meanings.

Syllable-timing in Brazilian Portuguese: uma crítica a Roy Major

This paper reintroduces the discussion about stress-timing in Brazilian Portuguese (BP). It begins by surveying some phonetic and phonological issues raised by the syllable- vs stress-timed dichotomy which culminated with the emergence of the p-center notion. Strict considerations of timing of V-V units and stress groups are taken into account to analyze the long term coupling of two basic oscillators (vowel and stress flow). This coupling allows a two-parameter characterization of language rhythms (coupling strength and speech rate) revealing that BP utterances present a high-degree of syllable-timing. A comparison with other languages, including European Portuguese, is also presented. The results analyzed indicate that Major's arguments for considering Portuguese (sic) as stress-timing are misleading.

Por uma lingüística crítica: linguagem, identidade e questão ética

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Variação sazonal da fotossíntese, condutância estomática e potencial da água na folha de laranjeira 'Valência'

Seasonal variation in environmental conditions may influence gas exchange rates as well as water relations in perennial species. This work was carried out to evaluate photosynthetic rates (A), transpiration (E), stomatal conductance (g) and leaf water potential (psi f ) in 'Valencia' orange trees grafted on four different rootstocks. Measurements were made twice a day: from 9h00 to 11h00 a.m. and from 1h00 to 3h00 p.m., during January, March and July. A and g were significantly lower and psif was significantly more negative, in the afternoon. The decrease in A may be related to the reduction in g, due to the increase in the vapor pressure deficit between the air and the leaf (VPDair-leaf ) in the afternoon, when temperatures are higher. In spite of the partial stomatal closure in the afternoon, the values for E were approximately the same as those measured in the morning, due to the increase in the VPDair-leaf . A decrease in A and g could also be noted from January to July, that is, from the hot and humid summer months, to the colder and drier winter ones. It was suggested that the decrease in A and g observed from January through March, may be related to the decrease in plant growth rates, which could have influenced the source-sink relationships, since the climatic conditions for both months were similar. The decrease in A and g showed in July, seems to be related to the decrease in both the night temperature and the growth rate of plants.

Suplementação com caldo de cana de açucar comparado com outros carboidratos na reposição do glicogenio e cinetica de biomarcadores pos-exercicio agudo em ratos

Universidade Estadual de Campinas . Faculdade de Educação Física

Efeito de onze semanas de treinamento sobre a velocidade critica e o limiar anaerobio em nadadores

Universidade Estadual de Campinas . Faculdade de Educação Física

O universo desportivo de cegos e deficientes visuais : uma interpretação

Universidade Estadual de Campinas . Faculdade de Educação Física

Análise do jogo de goalball : modelação e interpretação dos padrões de jogo da Paralimpíada de Pequim 2008

Universidade Estadual de Campinas . Faculdade de Educação Física

Modelo de análise técnico-tática do jogo de handebol : necessidades, perspectivas e implicações de um modelo de interpretação das situações de jogo em tempo real

Universidade Estadual de Campinas . Faculdade de Educação Física