Correlação entre a infecção genital pelo vírus do papiloma humano, a resposta imune e os achados colpocitológicos em mulheres grávidas e não grávidas

The genital HPV infection is very common between men and women worldwide, affecting particularly young women, constituting a serious public health problem in less developed regions, favored by the poor living conditions of population. The cytology and colposcopy have notorious importance in the diagnosis of precursor lesions of cervical cancer and therefore its prevention. However, even with such diagnostic tools, the number of women who develop cervical cancer is still high. This study aims to assess the prevalence of genital tract infection by HPV in pregnant and nonpregnant women, evaluating the profile of the immune response presented by the women of these two groups in order to establish correlations among profile of immune response, presence of virus and occurrence of lesions of the uterine cervix. We analyzed specimens obtained from the cervix of 221 patients, 91 pregnant and 130 non-pregnant, aged 14-72 years. The women were subjected to colposcopic and cytologic evaluation detect possible changes in the cervix and then samples were collected in order to perform HPV detection by PCR and real-time PCR for detection of mRNA of pro-inflammatory and anti-inflammatory cytokines. In the present study, the overall prevalence of HPV genital infection was 28.1%; of which 31.9% were pregnant patients and 25.4% in non-pregnant women. Young women under 30 years and those with low educational level education showed a higher risk of HPV infection. Colposcopy showed better correlation with detection of HPV DNA by PCR, when compared to cytology. Generally, HPV infected patients, pregnant or not, exhibited reduced mRNA expression of both pro-inflammatory (IFN-γ, TNF-α) and anti-inflammatory (IL -10) cytokines, when compared to patients not infected by HPV. Nonpregnant patients infected presented increase mRNA expression of IL-17 in patients without injury, whereas those with lesion showed higher mRNA expression of TGF-β. Pregnant women without injury infected exhibited increased mRNA expression of TGF-β. There was no difference in HPV prevalence between pregnant and nonpregnant women. There was a reduction of pro-inflammatory cytokines, except IL-17, in all women infected by HPV. Moreover, we observed an increase of TGF-β in HPV-infected women who are pregnant or not. The results suggest that, in women in this study, HPV infection promoted changes in the profile of cytokines necessary for activation of effective immune response, possibly favoring viral persistence

Apitidão funcional e comportamentos relacionados à saúde em mulheres idosas do município de Jequié-BA

The identification of the factors that interfere in the decline of functional conditions is useful in the planning of actions addressing the improvement in the conditions of the lives of elderly people. The purpose of this investigation was to analyze the relationship between social demographics and health aspects of the functional condition in elderly women of low income of the Brazilian northeast. This crosssectional study involved a representative sample of 222 women with an average age of 70 years (± 7.1), belonging to coexisting groups and that were resident in the urban area of the municipal district of Jequié /Bahia. In order to achieve this objective, a battery of physical tests of functional aptitude was carried out previously tested in pilot study, anthropometric measurements collected with a comparison of the measures referred to the reported weight and height as well as the application of an interview with questions containing subjects related to social demographic variables, clinical conditions and health, physical conditions and behaviors. Descriptive statistics Proceedings (frequency, average, standard deviation and percent distribution) were used for statistic analysis, and the calculation of the respective odds ratio by binary logistics regression, for the analysis of factors hierarchically grouped; p<0.05. The prevalence of 56% (n=122) of women considered with moderated or serious type of functional limitations was found, In which from multi-varied hierarchical analysis, significant association was verified with the age group over 80 years (p=0.02), conditions of widowhood (p=0.04), presence of arterial hypertension (p=0.001), and physical inactivity during leisure time (p=0.03). On the other hand for functional incapacities the prevalence was of 46.8% (n=104) being associated to the increase of the age (p=0.01), hospitalization (p=0.02), absence of physical activities along their lives (p=0.001) and the occurrence of alterations in the cognitive function (p=0.001). The normative table for the parameters of physical fitness generated conducive to health professionals in the diagnosis of health conditions and the prescription of physical exercises. The identified characteristics that are associated with the functional limitations / functional incapacities suggest a complex causal net in the determination of the functional condition in elderly women. However, actions addressed to the incentive of the practice of physical activities in the leisure time and the preservation of the cognitive function can contribute to a life with more quality for these people. This research was multidisciplinary approach to involve elements of psychology, nutrition and Physical Education in the elucidation of the object of study related to the functional condition of elderly women

Perfil epidemiológico dos distúrbios hipertensivos na gravidez

The preeclampsia is a disease that evolves to high death rate for the mother and for the fetus. The incidence of this disease in the world is variable and there are no data of this disturb in the Brazilian population. This paper had the objective to determine the incidence and risk factors for development of hypertensive disorders of pregnancy in a neighborhood in Natal, RN, Brazil, taking place a prospective study, cohort type, with the objective of evaluating the entire pregnancy of 242 women that got pregnant between 2004-2007. The incidence of hypertensive disorders was of 17%, while the incidence of preeclampsia was of 13.8%. The age average of women that developed the hypertensive disorders was of 27.4 years (SD±.9), whilst those that developed preeclampsia was of 26.6 (SD ±7.8) years and the normotensive was of 23.9 (SD±5.8) (p=0.002). It is noted a significant increase of the hypertensive disorder with age (p=0.0265). The gestational age for those who developed preeclampsia was lower than the women that developed normotensive pregnancy (p=0.0002). The body mass index (BMI) of the group of women that developed the hypertensive disorder was of 25.8 (SD±3.9), significantly higher than the group of normotensive women with 23.5 (SD±3.7) (p=0.02). The levels of triglycerides and cholesterol tended to be higher on women with preeclampsia than on normotensive, p=0.0502 and p=0.0566, respectively. Six (6) women presented with severe preeclampsia and one (1) developed HELLP Syndrome. The resolution of the pregnancy was performed by cesarean section in 70% of women that developed hypertensive disorders, whilst the normotensive was of 23.6% (p<0.0001). A subgroup of the studied subjects was reassessed one year after labor, revealing that 50% of the patients were still hypertensive. There were no larger complications nor mother death during labor. The incidence of hypertensive disorders are above the levels noted in other studies and 30% of the women were within the poles of greater risk for the hypertensive disorders; the elevated BMI in the beginning of the pregnancy is a risk factor for hypertensive disorder. The risk of severe complication in preeclampsia is high, with imminence of eclampsia occurring in 20.1% of women who developed hypertensive disorder of pregnancy. The adequate prenatal care and the opportune labor assistance may minimize the complications of the pregnancy hypertension and avoid mother death, although the risk of women remaining hypertensive is elevated

Intervenção dietoterápica em portadores de lipodistrofia generalizada congênita do Rio Grande do Norte

Congenital generalized lipodystrophy is a rare genetic disease with autosomal recessive inheritance characterized by the generalized absence of subcutaneous adipose tissue and insulin resistance. The aim of our study was to determine the profile of patients with congenital generalized lipodystrophy (Berardinelli-Seip syndrome) through their clinical history, eating habits, and socioeconomic and cultural aspects; assess food consumption and nutritional status of the study group; propose and evaluate a diet therapy model associated to oral supplementation with zinc to help in the control and prevention of metabolic complications associated to the pathology. Initial assessment of food consumption indicated a voracious appetite in all the patients studied. The introduction of zinc reduced appetite, contributing to patient adherence to the food plan proposed. It was also observed that the proposed diet contributed mainly to glycidic control, specifically with respect to HbA1c. The nutritional status of the patients investigated was adequate in terms of body mass index (BMI), arm muscle circumference (AMC), arm muscle area AMA, but triceps skinfold (TSF) indicated serious malnutrition. Our study is unique in the literature and provides important information to the field of nutrition and to individuals with this pathology. Furthermore, it contemplates the interdisciplinary and multidisciplinary requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte (UFRN), Natal, Brazil

Desenvolvimento e caracterização de um sistema microemulsionado contendo anfotericina b para uso oftalmológico

Universidade Federal do Rio Grande do Norte

Zinco Sérico e parâmetros farmacocinéticos na determinação do estado corporal de zinco em crianças

O zinco é um micronutriente fundamental para as funções vitais de qualquer organismo vivo e sua deficiência em humanos pode causar alterações na expressão gênica, crescimento e desenvolvimento infantil, e proteção antioxidante. Devido à sua importância, as concentrações corporais de zinco são estritamente controladas por processos homeostáticos complexos. Este controle reflete no fato da deficiência grave de zinco ser detectada apenas após privação crônica. Embora se estime que a deficiência leve seja comum, os métodos existentes para avaliação individual do estado corporal de zinco são limitados e pouco eficazes. O objetivo deste trabalho foi avaliar o zinco sérico basal e os parâmetros farmacocinéticos na determinação do estado corporal de zinco em crianças, estabelecendo relação entre esses índices. O estudo foi aprovado pelo Comitê de Ética em pesquisa do Hospital Universitário Onofre Lopes (CEP-HUOL) e 129 crianças, eutróficas e aparentemente saudáveis, entre 6 e 9 anos de idade, foram avaliadas antes e após a suplementação oral de zinco (5 mg Zn/dia) durante 3 meses. No início e fim do período houve a administração venosa de zinco (0,06537 mg de Zn/kg de peso) em 40 destas crianças para avaliação dos parâmetros farmacocinéticos por meio de três diferentes fórmulas de clearance de zinco. Os limites do CI (95%) para o zinco sérico basal variaram entre 0,94 1,00 e 0,91 0,98 μg/mL em meninas e meninos, respectivamente. Em relação aos parâmetros farmacocinéticos, a fórmula específica para um compartimento apresentou correlação positiva com o zinco sérico após a suplementação e foi efetiva em detectar mudanças no estado corporal de zinco

Efetividade da terapia fisica descongestiva na cicatrização de úlceras venosas

A venous ulcer is the most serious clinical manifestation of chronic venous failure, and the most frequent in lower limbs, accounting for 70% of all ulcers. Patients may suffer from this infirmity for several years without healing of the lesion if treatment is inadequate. The aim of this investigation was to verify the effectiveness of decongestive physical therapy in the healing of venous ulcers. This is a quasi-experimental, interventionist study, with paired, non-probabilistic sampling, composed of 50 patients divided into two groups: control and intervention, each composed of 25 patients. Both groups were identically treated for six months with daily dressings and the latter also underwent complex physical therapy consisting of a combination of the following techniques: manual lymphatic drainage, compression bandaging, lower limb elevation, myolymphokinetic exercises and skin care. The study was approved (Protocol no. 59/2007) by the Ethics Committee of the State University of Southeast Bahia. The Mann-Whitney and Chi-square tests were applied for data analysis. After statistical analysis the patients who underwent therapy showed a statistically significant difference with respect to wound contraction starting in the second month of treatment. Compared to the control, the intervention group showed a greater reduction in both pain and edema starting in the third and fourth month of therapy, respectively. To reinforce these findings, the mean percentage of tissue present at the base of the ulcer (granulation/fibrin ratio) was calculated. The intervention group showed greater granulation at the base of the ulcer compared to the control, significant from the second month of treatment on. It was observed in this study that lymphotherapy, when compared between the intervention and control groups, accelerated the healing process, and reduced pain and edema in the affected limbs. It is expected, therefore, that these results widen scientific knowledge and we suggest that this therapy be used 78 not only to reduce lymphedema, but also as a treatment option for venous ulcers, given its easy application and low cost. The data, therefore, demonstrated the importance of basic care on the part of a multiprofessional and transdisciplinary health team involved in the healing process of these infirmities, thereby contributing to better quality of life in these individuals

Influência da esplenectomia na biodistribuição do ácido dimercaptosuccínico-tecnécio-99m (99mTc-DMSA) em ratos Wistar

A esplenectomia é indicada em doenças hematológicas, hiperesplenismo grave, traumas e tem sido causa de importantes alterações metabólicas e imunológicas. O objetivo do presente trabalho é avaliar se a retirada do baço altera a biodistribuição do radiofármaco DMSA Tc99m em ratos Wistar e se há correlação com possíveis alterações da função renal. Foram usados dois grupos: esplenectomia (n=6) e controle (n=6) animais não operados. Após 15 dias, foi administrado 0,1 ml de DMSA-Tc99m via plexo orbital (0,66 MBq). Trinta minutos depois, foram retiradas amostras do rim, coração, pulmão, tireóide, estômago, bexiga, fêmur, sangue. Após pesadas as amostras, foi determinado o percentual de radioatividade/g (% ATI/g) em cada uma delas, com o Wizard Gama Counter Perkin-Elmer . Dosadas uréia e creatinina sérica, hematócrito, plaquetas e leucócitos. Estatística pelo teste t, com significância 0,05. Foi observada redução significante no %ATI/g no rim e sangue (p<0,05) dos animais esplenectomizados, aumento significante (p<0,05) da uréia (88,8±18,6mg/dL) e creatinina (0,56±0,08), comparado aos controles (51,5±1,6 e 0,37±0,02mg/dL, respectivamente) assim como leucocitose, aumento de plaquetas e redução de hematócrito. Em conclusão, a esplenectomia provocou comprometimento da função renal, repercutindo na alteração da captação de DMSA 99mTc pelo rim de ratos. Uma parceria entre a Unidade de Medicina Nuclear da Liga Norteriograndense Contra o Câncer e o Núcleo de Cirurgia Experimental da Universidade Federal do Rio Grande doNorte tornou possível a realização deste trabalho, que contou com a participação de profissionais de diferentes áreas como: Biologia, Biomedicina, Medicina Nuclear, Cirurgia Geral, Bioquímica e Estatística, atestando dessa forma o caráter multidisciplinar do trabalho

Efetividade da terapia física descongestiva na cicatrização de úlceras venosas

Universidade Federal do Rio Grande do Norte

Prevalência e fatores associados à dor em professores de educação física em academias de ginástica da cidade do Salvador-BA

Physical Education professionals are usually exposed to excessive physical workloads that evolve into painful symptomatology and muscle and bone disorders that originate from the work-related exercises. Purposo: The goal of this study was to investigate the prevalence and factors associated with pain painful symptomatology in teachers in gymnastics academies. An analytical transversal cut study was performed involving 163 gymnastics teachers working in the main gyms in the city of Salvador-BA. For evaluation of pain, validated versions in Portuguese of the McGill Protocol and the Wisconsin Pain Inventory were used. For obtain results of descriptive statistical analysis of the collected data was performed, followed by TStudent, and Pearson and Spearman correlation tests to verify possible correlations between the presence of pain and other variables which were considered independent. Finally, for the identification of potential risk factors associated with pain, a binary logistic regression analysis was performed. For all statistical analysis, we cnsidered p< 0.05. Results: The painful symptoms was reported by 88.3% of the subjects surveyed. High pain levels were observed in 63.8% of the interviewed professionals, where the intensity varied from moderate to severe. Pain in the lumbar region was present in 55.2% of subjects. Positive correlations were found between the level of pain intensity and the variables related with the workload activity and daily life of the teachers in almost all body joints analyzed. Some factors had been verified associates to the painful sintomatologia as the age of the professionals, the daily hours load of labor work, and the lack of interval of rest between the lessons. Conclusions: We found a high prevalence in gym teachers working in the city of Salvador-BA, which interfered in various daily activities of their home and professional lives. The most affected region was the lumbar region, followed by the knees, neck, shoulders, ankles, hands, hips, feet, elbows and forearms. The factors associated with development of painful symptomatology were the age of the professionals, daily hours of work and the lack of rest intervals between lessons. The high prevalence of pain in Physical Education teachers can be regarded as a serious occupational health problem, which would demand the urgent deployment of preventive intervention programs to minimize the impact of pain among these professionals

Marcadores genéticos associados com a resposta inflamatória na meningite bacteriana

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Otimização evalidação de métodos analíticos para a determinação simultânea de tuberculostáticos (4-FDC) por CLAE/DAD e CLUE/ DAD

Tuberculosis is a serious disease, but curable in practically 100% of new cases, since complied the principles of modern chemotherapy. Isoniazid (ISN), Rifampicin (RIF), Pyrazinamide (PYR) and Chloride Ethambutol (ETA) are considered first line drugs in the treatment of tuberculosis, by combining the highest level of efficiency with acceptable degree of toxicity. Concerning USP 33 - NF28 (2010) the chromatography analysis to 3 of 4 drugs (ISN, PYR and RIF) last in average 15 minutes and 10 minutes more to obtain the 4th drug (ETA) using a column and mobile phase mixture different, becoming its industrial application unfavorable. Thus, many studies have being carried out to minimize this problem. An alternative would use the UFLC, which is based with the same principles of HPLC, however it uses stationary phases with particles smaller than 2 μm. Therefore, this study goals to develop and validate new analytical methods to determine simultaneously the drugs by HPLC/DAD and UFLC/DAD. For this, a analytical screening was carried out, which verified that is necessary a gradient of mobile phase system A (acetate buffer:methanol 94:6 v/v) and B (acetate buffer:acetonitrile 55:45 v/v). Furthermore, to the development and optimization of the method in HPLC and UFLC, with achievement of the values of system suitability into the criteria limits required for both techniques, the validations have began. Standard solutions and tablets test solutions were prepared and injected into HPLC and UFLC, containing 0.008 mg/mL ISN, 0.043 mg/mL PYR, 0.030 mg.mL-1 ETA and 0.016 mg/mL RIF. The validation of analytical methods for HPLC and UFLC was carried out with the determination of specificity/selectivity, analytical curve, linearity, precision, limits of detection and quantification, accuracy and robustness. The methods were adequate for determination of 4 drugs separately without interfered with the others. Precise, due to the fact of the methods demonstrated since with the days variation, besides the repeatability, the values were into the level required by the regular agency. Linear (R> 0,99), once the methods were capable to demonstrate results directly proportional to the concentration of the analyte sample, within of specified range. Accurate, once the methods were capable to present values of variation coefficient and recovery percentage into the required limits (98 to 102%). The methods showed LOD and LOQ very low showing the high sensitivity of the methods for the four drugs. The robustness of the methods were evaluate, facing the temperature and flow changes, where they showed robustness just with the preview conditions established of temperature and flow, abrupt changes may influence with the results of methods

Política ambiental e desenvolvimento urbano na serra do periperi em Vitória da conquista - BA

This present dissertation has as its aim of study an analysis of the environmental policy and the urban development at the Periperi Hill. Such analysis arose due to concerns related to the disordered occupation in that Hill and also due to the environmental problems caused by this occupation. By opening roads and developing areas for housing and mineral extraction activities, man has altered considerably the landscape natural balance in that hill and caused among other difficulties, grave environmental problems, such as the erosin at the hill coast, deforestation, obstruction and pollution of the Verruga River. Therefore, in 1998 it was decreed by the Municipal Public Power that Periperi Hill became an Environmental Preservation Area with a Unit of Conservation known as Periperi Hill Municipal Park, an environmental policy implemented at the Hill that aims to hinder this occupation and to protect areas that are of great environmental importance to the city. It looking at what is now exposed and aiming to consider the Periperi Hill s environmental policy and the relationship of the occupation process, that this present work has the objective of understanding how the expansion of the city s urban network in Vitória da Conquista BA and the mineral activities cause an influence in the process of environmental degradation at the Periperi Hill

Transplantes: re-inserção social e qualidade de vida dos transplantados cardíacos do Estado do RN

The experience of transplantation is a very serious situation from the clinical standpoint. Therefore, there must be some subjective and social breakdown in people who have been undergone such a procedure. Recent product of modernity, the transplanted is someone who owns his recover to the scientific advances of contemporary society and a deceased donor. This paper aims at examine the implications, from the changes in patterns of behavior and thought that occur after the experience of an extreme and critical situation, as the process of illness and its consequent transplant surgery. The symbolism of the heart suggests that some social impressions about the organ itself are also reflected in how the transplanted interprets the experience of this type of procedure. So investigating how the changes occurred throughout the process interfere in the re-insertion of these people to social life, after his recovery, is the purpose of this work. The concept of habitus coined by Pierre Bourdieu will be used to measure conceptually how this experience (clinical, modern and symbolic) fits in the contemporary discussion of sociology

Ovário-histerectomia vídeo-assistida com único portal em cadelas: estudo retrospectivo de 20 casos

O objetivo do presente estudo foi avaliar retrospectivamente as 20 primeiras ovário-histerectomias vídeo-assistidas com único portal (SPVA-OSH), realizadas por um cirurgião não proficiente nessa técnica. Vinte cadelas foram submetidas à laparoscopia para SPVA-OSH, com o auxílio de um endoscópio de 10mm, com canal de trabalho de 5mm, inserido por um trocarte, posicionado na região pré-púbica, e coagulação bipolar. O tempo cirúrgico médio foi de 22,95±5,17 minutos. Os cinco primeiros procedimentos consumiram mais tempo cirúrgico do que os demais. A abordagem aos pedículos ovarianos direito e esquerdo foram as etapas que apresentaram maior tempo de execução. Houve complicação leve ou moderada em seis (30%) das 20 cadelas operadas. As complicações foram: hemorragia leve ou moderada em um dos pedículos ovarianos em quatro (20%) cadelas e hemorragia grave, devido à punção do baço com agulha de Veress em dois (10%) animais. A SPVA-OSH foi realizada em cadelas por um cirurgião no início da curva de aprendizado, sem complicações maiores.