AS INSTITUIÇÕES DE ENSINO SUPERIOR DA CIDADE DE GUARUJÁ (SP) E A INSTITUCIONALIZAÇÃO DAS ATIVIDADES DE EXTENSÃO

O presente trabalho possui como objetivo geral a análise da institucionalização da extensão universitária, tendo como foco as instituições de ensino superior (IES) particulares do município de Guarujá (SP). A pesquisa se justifica pela importância que a extensão tomou no contexto da educação no Brasil, tendo em vista a indissociabilidade entre Ensino, Pesquisa e Extensão. A pergunta norteadora é: De que forma a institucionalização dos projetos de extensão universitária vem sendo administrada nas IES do município de Guarujá (SP)? Como objetivos específicos foram delimitados: a) Identificar as concepções políticas, assim como as práticas extensionistas declaradas pelas IES e b) Analisar a visão do gestor na administração da extensão no que tange a sua institucionalização. A abordagem metodológica foi de cunho qualitativo, exploratório, por meio de estudos de casos múltiplos. Os instrumentos de coleta de dados foram documentos e entrevistas semiestruturadas. Os principais resultados encontrados foram: 1) A execução dos projetos de extensão é realizada de forma burocrática somente para cumprir requisitos legais e políticos; e 2) A institucionalização dos projetos de extensão é feita de forma lenta somente com objetivos legais e/ou políticos para atender uma parcela da população no entorno da instituição, porém sem fins sociais legítimos no que tange à essência dos valores de extensão universitária. Constatou-se, portanto, a ausência da indissociabilidade entre ensino, pesquisa e extensão

Comparação das atividades musculares durante a mastigação nas maloclusões de classe I e II de Angle

O objetivo deste estudo foi comparar a atividade muscular dos músculos da face e pescoço nas maloclusões Classe I e II de Angle, segundo o sexo. A amostra constou de 36 indivíduos, sendo 22 indivíduos com maloclusão classe I com média de idade de 22,4 anos e 14 indivíduos com maloclusão Classe II com média de idade de 22,8 anos. Os registros foram realizados por um eletromiógrafo de superfície, sendo analisada a atividade dos músculos masseter, temporal feixe anterior, esternocleidomastoídeo e digástrico ventre anterior dos lados direito e esquerdo durante a mastigação dos alimentos uva passa, bolacha água e sal e goma de mascar-PLOC. Após análise estatística descritiva e análise de variância os resultados mostraram que houve diferença estatisticamente significante apenas para os músculos: masseter direito durante a mastigação de uva passa quando comparadas as maloclusões de Classe I e II no sexo masculino; para o músculo digástrico direito quando comparado sexo e as maloclusões Classe I e II durante a mastigação dos três alimentos. Por fim, para o músculo digástrico esquerdo durante a mastigação de uva passa também encontramos diferença estatisticamente significante entre os sexos para as maloclusões Classe I e II. Nossos resultados sugerem que dependendo da consistência do alimento o tipo de maloclusão e sexo podem influenciar na atividade muscular durante a função da mastigação.(AU)

QUALIDADE DE VIDA, PERCEPÇÃO DE SUPORTE SOCIAL E CONSUMO DE MEDICAMENTOS EM IDOSAS PARTICIPANTES DA UNIVERSIDADE PARA A TERCEIRA IDADE

A presente dissertação de mestrado abordou a qualidade de vida, a percepção de suporte social e o consumo de medicamentos em idosas participantes de um programa da Universidade para a Terceira Idade, no município de São Caetano do Sul - São Paulo - Brasil. O estudo objetivou descrever uma possível relação entre o perfil sociodemografico da amostra, a percepção subjetiva da qualidade de vida, a percepção subjetiva de suporte social, e o consumo de medicamentos, submetendo a testes estatísticos, um conjunto de possíveis relações entre as características sociodemográficas, percepção de qualidade de vida, percepção de suporte social e consumo de medicamentos. Utilizou-se o método descritivo exploratório, de corte transversal, e de caráter quantitativo. Os dados foram coletados entre os meses de agosto a outubro de 2014, através de uma amostra de conveniência, formada por 150 mulheres, com idade média de 66,13 anos. Foram utilizados instrumentos autoaplicáveis: WHOQOL-OLD e WHOQOL-BREF (Word Health Organization Quality of Life Instrument); Escala de Percepção de Suporte Social (EPSS); um questionário sobre a utilização de medicamentos de uso geral, e um questionário contendo os dados sociodemográficos. Dos resultados, 59,3% da amostra concluiu o ensino fundamental, 49,3% é casada, 79,3% não exerce atividade remunerada, e 78,7% não exerce atividades voluntárias. Apresentou boa percepção de Qualidade de Vida Global (82,90%), sendo o domínio com menor valor médio o Funcionamento do Sensório (12,56%), e maior escore médio no domínio Autonomia (14,66%). Sente segurança ao recorrer à rede de suporte social prático (53,08%), e insegurança ao recorrer à sua rede de apoio social emocional (28,88%). A prevalência do uso de medicamentos foi de 3,6%, todos prescritos, e os princípios ativos mais utilizados pertenciam aos tratamentos da hipertensão e sistema cardiovascular. Não foram evidenciadas correlações significativas relevantes entre as variáveis do estudo, do ponto de vista estatístico. Apesar de residirem em um município com elevado Índice de Desenvolvimento Humano, conclui-se que o aumento das possíveis incapacidades físicas das idosas apontam dificuldades de acesso aos recursos do ambiente, onde a amostra estava inserida. Sugere-se a criação de pesquisas e intervenções com idosas, incluindo nos programas de educação continuada, espaços para debate com o tema da finitude e o envelhecimento, bem como a realização de novos estudos de natureza qualitativa, para aprofundar o conhecimento sobre a qualidade de vida, a percepção do suporte social e o consumo de medicamentos nesta população, como também a inclusão de outros grupos sociodemográficos de idosas, em estudos longitudinais.

A IMPORTÂNCIA DAS TICS E DA EDUCAÇÃO COMO PROCESSO COMUNICACIONAL DIALÓGICO NO ENSINO SUPERIOR: Um Estudo da Universidade Estadual de Mato Grosso do Sul

Esta tese teve por objetivo saber como o corpo docente da Universidade Estadual de Mato Grosso do Sul (UEMS) percebe, entende e reage ante a incorporação e utilização das Tecnologias de Informação e Comunicação (TICs) nos cursos de graduação dessa Instituição, considerando os novos processos comunicacionais dialógicos que elas podem proporcionar na sociedade atual. Metodologicamente, a tese é composta por pesquisa bibliográfica, buscando fundamentar as áreas da Educação e Comunicação, assim como a Educomunicação; pesquisa documental para contextualização do lócus da pesquisa e de uma pesquisa exploratória a partir da aplicação de um questionário online a 165 docentes da UEMS, que responderam voluntariamente. Verificou-se que os professores utilizam as TICs cotidianamente nas atividades pessoais e, em menor escala, nos ambientes profissionais. Os desafios estão em se formar melhor esse docente e oferecer capacitação continuada para que utilizem de forma mais eficaz as TICs nas salas de aula. Destaca-se ainda que os avanços em tecnologia e os novos ecossistemas comunicacionais construíram novas e outras realidades, tornando a aprendizagem um fator não linear, exigindo-se revisão nos projetos pedagógicos na educação superior para que estes viabilizem diálogos propositivos entre a comunicação e a educação. A infraestrutura institucional para as TICs é outro entrave apontado, tanto na aquisição como na manutenção desses aparatos tecnológicos pela Universidade. Ao final, propõe-se realizar estudos e pesquisas que possam discutir alterações nos regimes contratuais de trabalho dos docentes, uma vez que, para atuar com as TICs de maneira apropriada, exige-se mais tempo e dedicação do docente.

Relatório de estágio de biologia e geologia realizado na Escola Secundária Jaime Moniz

O estágio pedagógico é uma etapa fundamental na formação inicial pois promove a transição do aluno a professor, permitindo a primeira experiência com a profissão docente e a aplicação prática num contexto real de ensino dos conhecimentos adquiridos durante o curso. O presente relatório visa descrever de forma contextualizada, as atividades de ensino e aprendizagem desenvolvidas durante o estágio pedagógico realizado no ano letivo 2012/2013 na Escola Secundária Jaime Moniz (ESJM), no âmbito do Mestrado em Ensino de Biologia e Geologia no 3º Ciclo do Ensino Básico e no Ensino Secundário. Pretende também refletir criticamente sobre as experiências de ensino-aprendizagem realizadas e sobre as vivências, dificuldades sentidas, competências adquiridas e aspetos a melhorar. Este relatório descreve os intervenientes neste processo e as atividades de ensino aprendizagem desenvolvidas. Uma das atividades de maior importância durante o estágio pedagógico foi a Prática Letiva (PL), pois permitiu a aquisição de várias competências necessárias à intervenção pedagógica, através do Processo de Ensino-Aprendizagem e da Assistência às Aulas. Por sua vez, as Atividades de Integração no Meio (AIM), compostas pela Caracterização da Turma e pelo Estudo de Caso foram particularmente importantes para conhecer os alunos da turma, e adequar a intervenção pedagógica às suas características. As Atividades de Intervenção na Comunidade Escolar (AICE) proporcionaram a oportunidade de desenvolver competências na área da organização de eventos e promoveram a integração na Escola. A Atividade de Natureza Científico-Pedagógica (ANCP) foi importante sobretudo no desenvolvimento de competências investigativas. O estágio pedagógico constitui para o professor em formação um importante processo de aprendizagem, pois possibilita a tomada de consciência das funções que este deve desempenhar na escola, e a aquisição e desenvolvimento de competências pessoais e profissionais necessárias para o desempenho da profissão.

Benefícios e Determinantes do Sistema de Custeio Baseado nas Atividades (ABC): Um Estudo de Caso

O presente trabalho visa abordar a aplicação do sistema de custeio Activity Based Costing (ABC) numa empresa de fabricação de carroçarias para autocarros, identificando os benefícios da sua adoção e os fatores que mais influenciaram a sua implementação. Para o efeito utilizamos a metodologia de investigação qualitativa com recurso ao método do estudo de caso. Constatamos que o ABC é uma ferramenta de gestão que permite o apuramento dos custos indiretos de produção de uma forma mais precisa e racional do que os demais sistemas de custeio da contabilidade tradicional. Por outro lado, foi possível concluir que os fatores que mais influenciaram a implementação do ABC foram o apoio da gestão de topo, a familiaridade com outras ferramentas de gestão e a elevada formação dos recursos humanos.

Açude do cais: uma proposta de aplicação de uma sequência de atividades didáticas em um contexto real

Currently it is expected that science education will enable a more comprehensive conception of the world and of the relationship between scientific knowledge, technology and society. Thus, we seek the science teaching attend around contexts related to science, technology and society (STS). According CTS approaches, the science education should promote learning in the scientific, technological and social fields, from experienced real contexts, generating motivation to students, offering them tools to work as scientifically literate citizens. For this, it becomes crucial to resort to innovative activities and the various methodologies and appropriate teaching materials, and there is a lack of this perspective in general basic education, which drives the practice of an STS approach. Therefore, the aim of this research is the production of an instructional sequence for the exploration of the theme: "The quality of the water in the municipality of Cuité-PB," according to focus CTS in the 2nd year of high school. The choice of this topic is due to the problem caused by the quality of water in this municipality, with the concern to address an issue that came to work the critical / reflective understanding of a real context, in order to sensitize students to the importance of scientific / technological knowledge. The selection criteria of STS subjects were also observed. In this research the materials were produced and applied by the teacher / researcher. For data collection we used the observation and analysis of student records. The results were encouraging in the sense of participation, motivation and skill acquisition. This research contributes to the teaching of science with a focus STS, as well as encourage the use of perspective in new contexts with real questioning

Atividades biológicas de extratos salinos de sementes de plantas da caatinga contra Aedes Aegypti e investigação da participação de proteínas bioativas

Dengue fever, currently the most important arbovirus, is transmitted by the bite of the Aedes aegypti mosquito. Given the absence of a prophylactic vaccine, the disease can only be controlled by combating the vector insect. However, increasing reports of resistance and environmental damage caused by insecticides have led to the urgent search for new safer alternatives. Twenty - um plant s eed extracts from the Caatinga were prepared , tested and characterized . Sodium phosphate ( 50 mM pH 8.0) was used as extractor. All extracts showed larvicidal and ovipositional deterrence activity . Extracts of D. grandiflora, E. contortisiliquum, A. cearenses , C. ferrea and C. retusa were able to attract females for posture when in low co ncentration . In the attractive concentrations, the CE of E. contortisiliquum and A. cearenses were able to kill 52% and 100% of the larvae respectively . The extracts of A. cearenses , P. viridiflora, E. velutina, M. urundeuva and S. brasiliensis were also pupicides, while extracts of P. viridiflora, E. velutina, E. contortisiliquum , A. cearenses, A. colubrina, D. grandiflora , B. cheilantha , S. spectabilis, C. pyramidalis, M. regnelli e G. americana displayed adulticidal activity. All extracts were toxic to C. dubia zooplankton . The EB of E. velutina and E. contortisiliquum did not affect the viability of fibroblasts . In all extracts were identified at least two potential insecticidal proteins such as enzyme inhibitors, lectins and chitin - binding proteins and components of secondary metabolism . Considering all bioassays , the extracts from A. cearenses, P. viridiflora, E. contortisiliquum , S. brasiliensis, E. velutina and M. urundeuva were considered the most promising . The E. contortisiliquum extracts was the only one who did not show pupicida activity, indicating that its mechanism of action larvicide and adulticidal is related only to the ingesti on of toxic compounds by insect , so it was selected to be fragmenting. As observed for the CE , th e protein fractions of E. contortisiliquum also showed larvicidal activity, highlighting that F2 showed higher larvicidal activity and lower en vironmental toxicity than the CE source. The reduction in the proteolytic activity of larvae fed with crude extra ct and fractions of E. contortisiliquum suggest ed that the trypsin inhibitors ( ITEc) would be resp onsible for larvicidal activity . However the increase in the purification of this inhibitor resulted in loss of larvicidal activity , but the absence of trypsin inhibitor reduced the effectiveness of the fractions , indicating that the ITEC contributes to the larvicidal activity of this extract. Not been observed larvicidal activity and adulticide in rich fraction vicilin, nor evidence of the contribution o f this molecule for the larvicidal activity of the extract. The results show the potential of seeds from plant extracts of Caatinga as a source of active molecules against insects A. aegypti at different stages of its development cycle, since they are comp osed of different active compounds, including protein nature, which act on different mechanisms should result in the death of insec

A geometria do compasso (1797) de Mascheroni (1750 – 1800) em atividades com o GeoGebra

The present work aims to show a possible relationship between the use of the History of Mathematics and Information and Communication Technologies (TIC) in teaching Mathematics through activities that use geometric constructions of the “Geometry of the Compass” (1797) by Lorenzo Mascheroni (1750-1800). For this, it was performed a qualitative research characterized by an historical exploration of bibliographical character followed by an empirical intervention based on use of the History of Mathematics combined with TIC through Mathematical Investigation. Thus, studies were performed in papers dealing with the topic, as well as a survey to highlight problems and /or episodes of the history of mathematics that can be solved with the help of TIC, allowing the production of a notebook of activities addressing the resolution of historical problems in a computer environment. In this search, we came across the problems of geometry that are presented by Mascheroni stated previously in the work that we propose solutions and investigations using GeoGebra software. The research resulted in the elaboration of an educational product, a notebook of activities, which was structure to allow during its implementation, students can conduct historical and/or Mathematics research, therefore, we present the procedures for realization of each construction, followed at some moments by original solution of the work. At the same time, we encourage students to investigate/reflect its construction (GeoGebra), in addition to making comparisons with the solution Mascheroni. This notebook was applied to two classes of the course of Didactics of Mathematics I (MAT0367) Course in Mathematics UFRN in 2014. Knowing the existence of some unfavorable arguments regarding the use of history of mathematics, such as loss of time, it was found that this factor can be mitigated with the aid of computational resource, because we can make checks using only the dynamism of and software without repeating the construction. It is noteworthy that the minimized time does not mean loss of reflection or maturation of ideas, when we adopted the process of historical and/or Mathematics Investigation

A saúde do trabalhador na atenção básica: concepções e práticas dos enfermeiros

This study aims to analyze concepts and practices developed by nurses in occupational health in primary care, and it is justified by the need to expand knowledge of this thematic area. This is an analytical qualitative study carried out in primary care units of health districts of the city of Natal-RN, in one health unit in each neighborhood. Data collection was held from August to October 2014, through semistructured interviews, in the following order: Selection of respondents and scheduling of interview; interviews and application of data collection instrument in order to trace socio-demographic profile of the target population; transcription of interviews; categorization of information and analysis in light of hermeneutic-dialectic. The concept of Occupational Health reported by subjects investigated, although simplified with respect to specificities of workers, was revealed with a wide dimension, with perspective of workers’ approach in their physical, mental and social context, suggesting a good seizure according to the expanded concept of health. Furthermore, it was possible to affirm the recognition of an incipient performance of primary care nurses on Occupational Health, whose performance was appointed as defective. In general, some specific actions of Occupational Health, carried out in health facilities, were cited. Other activities showed up to be routine, being held by a minority of professionals aware of the importance and need to reach these users, in order to engage them in the routine of the health unit. Most professionals reported not having approached Occupational Health during undergraduate nursing, highlighting a lack in theoretical and practical aspects of the area

Cartografia do trabalho de agentes penitenciários: reflexão sobre o “dispositivo prisão”

The Brazilian prison system is going through a serious crisis, not only due to the growth in the number of prisoners and the consequent overcrowding of prisons, but also for the violation of human rights, institutionalization and difficulty in social rehabilitation of inmates. Furthermore, the harmful effects of the prison system affect their workers, who generally are not prioritized by researchers, health programs and government policies. The literature pointing to some consequences of work in prison, among them, the mental illness, stress, alcohol abuse, etc., but little is known about this profession, their problems, the difficulties of their work routine, so as subjective processes involved. So, what are the effects of this work in the prison in the lives of correctional officers? What strategies developed to address the work in prison? This research aims to analyze the effects of this work in the prison in the lives of correctional officers from the state prison in Parnamirim, located in the metropolitan region of Natal-RN. Within the theoretical and methodological perspective of institutional analysis and cartography were carried conversation circles, interviews, in addition to participant observation of the correctional officers work’s routine. The results point to a working routine marked by the performance of procedures that involve risk to the worker, generating situations of tension and stress. Besides, the culture of violence (which is implemented in jail everyday) as well as the training and initial learning of the profession, are responsible for the militarization process of the subjectivities of the correctional officers, producing hard subject, disciplined, stiff, likely to violent practices and other rights violations. Other mapped effects relate to the acquisition of knowledge about the human (“psy” knowledge) responsible for forging the conception of the criminal as "dangerous subject", which, in turn, acts as subjectivity vector in the daily life of prison guards by setting up a way of life crossed by fear and insecurity outside the work environment. Produces a control in the open about their lives and their families, limiting them with regard to family and community life and the realization of leisure activities in public spaces. In this sense, it appears that the arrest acts producing “bad meetings” (from Espinosa's perspective), once it produces sad affections responsible for weakening the conatus, limiting the possibilities of action of these subjects. Although agents develop some strategies to deal with the difficulties of working in prison (among which stand out the development of other professional or leisure activities, spirituality / religiosity and the ability to separate the labor moments from those of their the personal lives, is advocated that such strategies do not offer significant resistance, since they do not question the contemporary legal-criminal logic. The thesis presented supports the proposals of penal abolitionism to present other conceptions of crime and justice through the invention of other practical and conceptual strategies.

Análise fitoquímica e avaliação das atividades anti-inflamatória, antipeçonhenta e citotóxica de extratos aquosos de Aspidosperma pyrifolium e Ipomoea asarifolia

Envenomation caused by venomous animals, mainly scorpions and snakes, are a serious matter of public health. Tityus serrulatus is considered the most venomous scorpion in South America because of the high level of toxicity of its venom. It is responsible for causing serious accidents, mainly with kids. The species Bothrops jararaca is a serpent that has in its venom a complex mixture of enzyme, peptides and other molecules. The toxins of the venom of B. jararaca induce local and systemic inflammatory responses. The treatment chosen to serious cases of envenomation is the intravenous administration of the specific antivenom. However, the treatment is not always accessible to those residents in rural areas, so that they use medicinal plant extracts as the treatment. In this context, aqueous extracts, fractions and isolated compounds of Aspidosperma pyrifolium (pereiro) and Ipomoea asarifolia (salsa, salsa-brava), used in popular medicine, were studied in this research to evaluate the anti-inflammatory activity in the peritonitis models induced by carrageenan and peritonitis induced by the venom of the T. serrulatus (VTs), and in the local oedema model and inflammatory infiltrate induced by the venom of the B. jararaca, administrated intravenously. The results of the assays of cytotoxicity, using the MTT, showed that the aqueous extracts from the plant species presented low toxicity to the cells that came from the fibroblast of the mouse embryo (3T3).The chemical analysis of the extracts by High Performance Liquid Chromatography revealed the presence of the rutin flavonoid, in A. pyrifoliu, and rutin, clorogenic acid and caffeic acid, in I. asarifolia. Concerning the pharmacological evaluation, the results showed that the pre-treatment using aqueous extracts and fractions reduced the total leukocyte migration to the abdominal cavity in the peritonitis model caused by the carrageenan and in the peritonitis model induced by the T. serulatus venom. Yet, these groups presented anti-oedematous activity, in the local oedema model caused by the venom of the B. jararaca, and reduced the inflammatory infiltrate to the muscle. The serum (anti-arachnid and anti-bothropic) specific to each venom acted inhibiting the inflammatory action of the venoms and were used as control. The compounds identified in the extracts were also tested and, similar to the plant extracts, showed meaningful anti-inflammatory effects, in the tested doses. Thus, these results are indicating the potential anti-inflammatory activity of the plants studied. This is the first research that evaluated the possible biological effects of the A. pyrifolium and I. asarifolia, showing the biological potential that these species have.

Ensinar e aprender História na relação dialética entre interpretação e consciência histórica crítica

Teaching and learning History in dialectical relationship between interpretation and critical historical awareness has investigated the triggering of a theoretical-practical training process developed with a history teacher, her mediation in the teaching and learning of the discipline process, related to the appropriation of history text interpretation and the development of critical historical consciousness by public school 8 th-grade students of elementary level. It aims to analyze the relationship between mediation of teaching activity and ownership by the student on this level, the interpretation of history texts and development of this consciousness. It has been opted for collaborative research, as training and strategy, and was employed as procedures for the formation of knowledge: Meeting, Cycles of Reflexive Studies, Planning (with teachers), Observation performed in real life and portfolio (involving students). The teacher appropriated of contributions of the theory by P. Ya . Galperin and critical historical consciousness and developed a teaching process using a methodology grounded in theoretical constructs this author. The students appropriated the interpretation of history texts and demonstrated to be in a process of developing a critical historical consciousness. Performance of the students occurred more consistently in the interpretations implemented in groups, with teacher guidance and support of the activity map. Training processes, performed in and about teaching and student activities, revealed an improvement in teacher's professional development and the knowledge and expertise of the students. It has contributed to this, the critical reflection experienced in the investigative process. Given these findings, as needs of new thinking, research recommends the development of teaching and learning processes in other years of elementary school, involving the interpretation of history texts and the development of critical historical consciousness of students.

Atividade de formação interprofissional em urgência pré-hospitalar

To acting in emergencies it is important that health professionals develop specific and differentiated skills, which shows us the importance of training in emergency planning. So undergraduate courses in medicine and nursing should encourage the development of these skills and evaluate them through various instruments targeted to the different fields. The aim of this study was to implement an optional and interprofessional curricular component, focusing on interprofessional education in pre-hospital emergency for medical and nursing courses Federal University of Rio Grande do Norte (UFRN). This is an exploratory descriptive study, with 24 medical and nursing graduates of last year undergraduate of supervised training, who underwent theoretical and practical training in the care of pre-hospital emergency services. There were theoretical and practical lessons per week for one school semester, taught by doctors and nurses of the Emergency Medical Service (EMS), where the topics discussed were: basic and advanced life support, safe transport in clinical emergencies, trauma, gynecological, obstetric, pediatric and psychiatric diseases, and have been carried out practical activities in ambulances. The students were evaluated by pre-test, post-test and practical stations made through the Objective Structured Clinical Evaluation (OSCE), in the skills laboratory of the Health Sciences Center. During the activities the students were encouraged to critical and reflective thinking, highlighting the importance of integration between the various health care professionals. It was observed that 88% of the students had a score increase over the pre-test. In the evaluation process carried out by medical students and nursing UFRN have similar expectations regarding the essential skills acquired during the training activity. The results of this study will form the basis for the organization of interprofessional education activity in pre-hospital emergency medical students and nursing, as well as helped to organize practices stations, identifying basic clinical skills, and implementing student assessment tools UFRN.

Avaliação comparativa da eficácia dos meios de diagnóstico das vulvovaginites: implantação de tecnologia no ensino prático da ginecologia

Inaccurate diagnosis of vulvovaginitis generates inadequate treatments that cause damages women's health. Objective: evaluate the effectiveness of methods when diagnosing vulvovaginitis. Method: a cross-sectional study was performed with 200 women who complained about vaginal discharge. Vaginal smear was collected for microbiological tests, considering the gram stain method as gold standard. The efficacy of the available methods for diagnosis of vaginal discharge was assessed (sensitivity, specificity, positive predictive value and negative predictive value). Data were inserted to Graphpad Prism 6, for statistical analysis. Results: the following results were obtained: wet mount for vaginal candidiasis: sensitivity = 31%; specificity = 97%; positive predictive value (PPV) = 54%; negative predictive value (NPV) =93%; accuracy = 91%. Wet mount for bacterial vaginosis: sensitivity = 80%; specificity =95%; positive predictive value (PPV) = 80%; negative predictive value (NPV) = 95%; accuracy = 92%. Syndromic approach for bacterial vaginosis: sensitivity = 95%; specificity=43%; positive predictive value (PPV) =30%; negative predictive value (NPV) = 97%; accuracy = 54%. Syndromic approach for vaginal candidiasis: sensitivity = 75%; specificity =91%; positive predictive value (PPV) = 26%; negative predictive value (NPV) = 98%; accuracy = 90%. Pap smear for vaginal candidiasis: sensitivity = 68%, specificity = 98%; positive predictive value (PPV) = 86%; negative predictive value (NPV) =96%; accuracy = 96%. Pap smear for bacterial vaginosis: sensitivity = 75%; specificity = 100%; positive predictive value (PPV) = 100%; negative predictive value (NPV) =94%; accuracy = 95%. There was only one case of vaginal trichomoniasis reported – diagnosed by oncological cytology and wet mount – confirmed by Gram. The syndromic approach diagnosed it as bacterial vaginosis. From the data generated and with support on world literature, the Maternidade Escola Januário Cicco’s vulvovaginitis protocol was constructed. Conclusion: Pap smear and wet mount showed respectively low and very low sensitivity for vaginal candidiasis. Syndromic approach presented very low specificity and accuracy for bacterial vaginosis, which implies a large number of patients who are diagnosed or treated incorrectly.