Acolhimento no processo de trabalho do enfermeiro da atenção básica: estudo qualitativo / Welcoming in the work process of the primary care nurse: qualitative study

Objetivos: analisar a percepção de enfermeiros da atenção básica de saúde sobre acolhimento no processo de trabalho. Métodos: pesquisa qualitativa, realizada com 21 enfermeiras de município do interior paulista. A análise dos dados pautou-se na vertente fenomenológica, modalidade estrutura do fenômeno. Resultados: o acolhimento no processo de trabalho revelou-se como sistematização do trabalho, escuta das necessidades do usuário e estabelecimento de vínculo,organização da demanda para que o usuário consiga agendamento à consulta médica, como demonstração de interesse pelas necessidades do usuário, além de atribuir valor ao mesmo por se tratar do cenário de atenção básica. Considerações finais: observa-se esforços dos diferentes atores para incorporar o acolhimento na mudança do modelo assistencial.

Evaluation of an rK39-based immunochromatographic test for the diagnosis of visceral leishmaniasis in human saliva

Visceral leishmaniasis (VL) is a tropical neglected disease endemic in 98 countries and affects more than 58 000 individuals per year. Several serological tests are available for VL diagnosis, including an immunochromatographic (IC) test with the rK39 antigen and finger prick-collected blood, a rapid and low-invasive test. Here, we investigate the possibility to use saliva as a non-invasive source of biological material for the rK39 IC test. Blood samples from 84 patients with suspected VL were screened by the rK39 IC test, and 29 were confirmed as being infected by a positive rK39 IC test and the presence of amastigotes on smears slides or parasite DNA (detected using PCR-RFLP) from bone marrow aspirate. The rK39 IC test using saliva samples was positive for 17 of the 29 confirmed VL cases (58.6%). The amount of Leishmania-specific IgG or total IgG, as evaluated by an immunoenzymatic assay, was higher in the saliva of patients who had rK39 IC test positivity using saliva, whereas the amount of Leishmania-specific IgA or total IgA was similar to the healthy donors. These results suggest that saliva is not an appropriated material for diagnosing VL with this test.

Estudios radiográfico de la prevalencia de impactaciones dentarias de terceros molares y sus respectivas posiciones / Radiographic study of the prevalence of dental impaction of third molars and their respective positions

El objetivo de esta investigación fue verificar la prevalencia de las impactaciones dentales de terceros molares por medio de radiografías panorámicas, en pacientes dentados, realizadas en el Sector de Radiología de la Clínica Odontológica de la Universidad Estatal de Maringá, en el período de 2009 a 2011, clasificando las posiciones de los terceros molares, de acuerdo con Winter, Pell y Gregory y Sandhu y Kaur. Mil cuatro radiografías fueron analizadas utilizando el software Image Tool, registrando edad, género, presencia o no de terceros molares retenidos y su clasificación. Fueron aplicados análisis cuantitativa y test chi-cuadrado (x2). En la clasificación de Winter, la posición vertical del diente 38 fue la de mayor prevalencia en el género femenino, presentando diferencia estadísticamente significante en relación al masculino. De acuerdo con Pell y Gregory, la Clase C del diente 18 y la Clase II del diente 38, las dos en el género femenino, se presentaron con mayores prevalencias. Con respecto al método de Sandhu y Kaur, el diente 38 en el género femenino, presentó mayor prevalencia y una angulación entre 11° a 70° (mesio angular). Los terceros molares inferiores son los más comúnmente impactados, siendo que el promedio de edad de la muestra total fue de 23,29 años y con un sensible predominio en el género femenino.

The objective of this research was to determine the prevalence of tooth impaction of third molars by panoramic radiographs, performed in the Dental Clinic of Radiology, State University of Maringá, in the period from 2009 to 2011, ranking the positions of third molar, according to Winter, Pell and Gregory and Sandhu and Kaur. One thousand four radiographs were analyzed using the Image Tool, recording age, gender, presence or absence of third molar and its classification. We applied quantitative analysis and chi-square (x2). According to Winter's classification, the vertical position of tooth 38 was the most prevalent in females, showing a statistically significant difference when compared to males. According to Pell and Gregory, Class C and Class II tooth 18 and tooth 38, both in females, presented with the highest prevalence. Regarding the method of Sandhu and Kaur, the tooth 38 in females, had higher prevalence and an angle between 11° to 70° (mesio angular). The third molars are more commonly affected, with the average age of the total sample was 23.29 years old and with a sensitive female predominance.

Proyecto de vida e inclusión social en adolescentes / Project life and social inclusion in adolescents

Tras una aproximación contextual que enmarca el problema de la exclusión social en jóvenes, se efectúa una introducción a los recientes enfoques que estudian la calidad de vida y bienestar emocional en dicho grupo etario, caracterizándose como específicamente relevante el concepto proyecto de vida. Seguidamente se presenta la estrategia metodológica de la investigación evaluativa y los resultados obtenidos en las Instituciones seleccionadas en las tres fases de la intervención, que se caracterizan como: a) Diagnóstico y construcción del problema; b) Evaluación del proceso; c) Sistematización de la intervención, en la cual se informa sobre la cobertura lograda en alumnos universitarios y del nivel medio participantes y se describen los resultados cualitativos obtenidos respecto del grado de adhesión a la experiencia. Se realiza finalmente un análisis y discusión en torno a los principales hallazgos, y las transferencias establecidas a los miembros de la comunidad educativa que participaron en el presente estudio.

Estudo farmacobotânico das folhas de Garcinia brasiliensis Mart. (Clusiaceae) / Pharmacobotanical studies of Garcinia brasiliensis Mart. (Clusiaceae) leaves

A espécie Garcinia brasiliensis Mart. (Clusiaceae), nativa da região Amazônica e cultivada em todo o território brasileiro, vem sendo bastante estudada devido seu potencial farmacológico, porém são escassos estudos que tratam da caracterização farmacobotânica desta espécie. Considerando as propriedades terapêuticas para tornar-se um medicamento fitoterápico, o presente trabalho teve como objetivos estudar a anatomia e histoquímica da folha e do pecíolo e elaborar dados macroscópicos e microscópicos que forneçam características marcantes para sua identificação além de dar subsídios para a análise farmacognóstica no controle de qualidade da droga vegetal. O material vegetal foi fixado e submetido às técnicas usuais de microscopia de luz e a testes histoquímicos. As folhas de G. brasiliensis são opostas, simples, descolores, forma elíptica com nervação peninérvia. As células epidérmicas, em vista frontal, apresentam contorno sinuoso e estômatos paracíticos somente na face abaxial. O mesofilo é dorsiventral, a nervura central apresenta contorno biconvexo e feixe vascular em forma de semi-arco fechado envolto por bainha esclerenquimática. Inclusões inorgânicas de cristais na forma de drusas e orgânicas representadas por compostos fenólicos e grãos de amidos estão dispersos ao longo de toda lâmina foliar e pecíolo. Observa-se com frequência a presença de canais secretores preenchidos por um conteúdo lipídico dispersos pelo parênquima fundamental e próximos aos feixes vasculares. Estes dados fornecem subsídios para o controle de qualidade da matéria-prima utilizada para a produção de fitoterápicos.

The Garcinia brasiliensis Mart. (Clusiaceae) species, native of the Amazon region and cultivated throughout the Brazilian territory, has been widely studied due to its pharmacological potential, but there are few studies dealing with the pharmacobotanic characterization of this species. Considering the therapeutic properties in order to become an herbal medicine, the present paper had the purpose of studying the anatomical and histochemical characterization of the leaf and petiole, as well as producing macroscopic and microscopic data that provide important characteristics for its identification, in addition to providing subsidies for the pharmacognostical analysis in order to offer elements for the quality assurance of the drug. The botanical material was prepared through the usual optical and histochemical microtechniques. The leaves of G. brasiliensis are simple, opposed, colorless, and they show an elliptical shape. As seen from the front, the epidermal cells have a sinuous contour, and paracytic stomata occur on the low surface. The leaves are hipostomatic and dorsiventral with heterogeneous mesophile. The mesophile is dorsiventral, the central midrib shows a biconvex contour and vascular system in a semi-closed arch shape surrounded by a sclerenchymatic sheath. Inorganic inclusions of crystals in the shape of druses, and organic inclusions represented by phenolic compounds and starch grains are found throughout the leaf blade and petiole. It is common to find secretory canals filled with a lipid content dispersed throughout the parenchyma and near the vascular bundles. These data support the quality assurance of the elements used to produce herbal medicines.

Honey Bees of Santa Catarina, Brazil, have only African mitochondrial DNA / Abelhas de Santa Catarina, Brasil, possuem apenas DNA mitocondrial africano

As diferenças entre a subspécie de abelha africana (Apis mellifera scutellata) e as subspécies europeias (Apis mellifera mellifera e Apis mellifera ligustica) nos quesitos comportamento higiênico e agressividade são marcantes. Diferenças acentuadas no comportamento higiênico entre colônias de abelhas foram relatadas em Santa Catarina, Brasil. Suspeitou-se que essas diferenças fossem devidas a um possível fluxo gênico entre as abelhas africanizadas brasileiras e as abelhas europeias da Argentina. Amostras de abelhas de 30 localidades de Santa Catarina foram analisadas por meio do uso de um marcador PCR-RFLP do DNA mitocondrial específico para identificação da origem da linhagem maternal. Os resultados indicaram ausência de linhagem materna de origem europeia em Santa Catarina. Baseando-se em hipóteses e resultados de trabalhos anteriores, conclui-se que não há fluxo gênico entre as populações das diferentes subespécies. O resultado também reforça que a eliminação do DNA maternal europeu é um indicativo de ineficácia de introduções de abelhas de subespécies europeias, no Brasil, com propósitos de melhoramento do atributo agressividade.

Clinical and immunological aspects of envenomations by Bothrops snakes: [review]

Accidents caused by snakes, especially in tropical and subtropical countries, still constitute a serious public health problem due to the lack of knowledge of health professionals and the precariousness of health systems in the regions where most accidents occur. Snake venoms contain a range of molecules that may provoke local swelling, pain, renal and respiratory insufficiencies. The study of the effects of each molecule on humans can help the development of complementary therapy. Similarly, the knowledge of clinical aspects of envenomations provides a better identification and implementation of appropriate treatment. In addition, to understand Bothrops envenomations and improve the therapeutic strategy, it is necessary to understand and study the role of important inflammatory mediators, particularly nitric oxide (NO), cytokines and the complement system.

Correlation of serum leptin and insulin levels of pregnant protein-restricted rats with predictive obesity variables

During pregnancy and protein restriction, changes in serum insulin and leptin levels, food intake and several metabolic parameters normally result in enhanced adiposity. We evaluated serum leptin and insulin levels and their correlations with some predictive obesity variables in Wistar rats (90 days), up to the 14th day of pregnancy: control non-pregnant (N = 5) and pregnant (N = 7) groups (control diet: 17 percent protein), and low-protein non-pregnant (N = 5) and pregnant (N = 6) groups (low-protein diet: 6 percent). Independent of the protein content of the diet, pregnancy increased total (F1,19 = 22.28, P < 0.001) and relative (F1,19 = 5.57, P < 0.03) food intake, the variation of weight (F1,19 = 49.79, P < 0.000) and final body weight (F1,19 = 19.52, P < 0.001), but glycemia (F1,19 = 9.02, P = 0.01) and the relative weight of gonadal adipose tissue (F1,19 = 17.11, P < 0.001) were decreased. Pregnancy (F1,19 = 18.13, P < 0.001) and low-protein diet (F1,19 = 20.35, P < 0.001) increased the absolute weight of brown adipose tissue. However, the relative weight of this tissue was increased only by protein restriction (F1,19 = 15.20, P < 0.001) and the relative lipid in carcass was decreased in low-protein groups (F1,19 = 4.34, P = 0.05). Serum insulin and leptin levels were similar among groups and did not correlate with food intake. However, there was a positive relationship between serum insulin levels and carcass fat depots in low-protein groups (r = 0.37, P < 0.05), while in pregnancy serum leptin correlated with weight of gonadal (r = 0.39, P < 0.02) and retroperitoneal (r = 0.41, P < 0.01) adipose tissues. Unexpectedly, protein restriction during 14 days of pregnancy did not alter the serum profile of adiposity signals and their effects on food intake and adiposity, probably due to the short term of exposure to low-protein diet.

Matrix metalloproteinases: the most important pathway involved with periodontal destruction

Periodontitis is an infectious disease estimated to occur in approximately a third of adults over the age of 35, being the major cause of adult tooth loss. The tissue destruction seems to be regulated by four major pathways. Plasminogen-dependent, phagocytic, osteoclastic and matrix metalloproteinase pathway. The matrix metalloproteinases (MMPs) pathway seems to be the most relevant in periodontal disease. The purpose of the current study was to review the roles of MMPs on periodontal disease, with emphasis on periodontal ligament and alveolar bone destruction. Particular attention is given on the mechanisms that control MMPs genes transcription, the regulation of protein activity, and the influence of MMP genes polymorphisms in inflammatory diseases.

Caracterización de aislamientos de rizobios de suelos ácidos y alcalinos en la región semiárida de Pernambuco / [Characterization of Rhizobium isolates from acid and alkaline soils in semi-arid regions of Pernambuco]

The genetic variety of the Rhizobium isolates from acid and alkaline soils in the semiarid zone of Pernambuco state was evaluated through the use of 17 primers of arbitrary sequence. Amplified products were separated by electrophoresis in agarose gel at 1.4

and visualized by ethidium bromide coloration. The results obtained suggest a high genetic variety of the isolates in relation to the standard strain. Data were analyzed by UPGMA (unweighted pair-group method with arithmetic average), based on Jaccard’s coefficient and visualized through dendrograms. The strains isolated from the acid soils were included in one group whereas the strains from alkaline soils were located in other three groups. Meanwhile, one of the groups formed by strain Isol-14, isolated from acid soils is more related to the groups of strains isolated from acid soils than to the remaining groups from alkaline soils.

Consumo de alcohol y relaciones sexuales en adolescentes del sexo femenino / Alcohol drinking and sexual relation in female adolescents

El alcohol es un droga lícita y su consumo es aceptado socialmente en mayores de edad; sin embargo, llama la atención la cantidad de adolescentes que consumen alcohol. Este trabajo busca determinar la incidencia del consumo de alcohol y su relación con las relaciones sexuales en adolescentes del sexo femenino. Se trata de un estudio analítico y descriptivo, realizado a través de encuestas practicadas a 331 estudiantes de sexo femenino. El 66,77 por ciento de los adolescentes tenía entre 15 y 16 años; el 82,18 por ciento de ellas consume alcohol; con inicio precoz (edad media: 12,83 años); el 15,44 por ciento tiene problemas por el consumo; el 43,50 por ciento refiere tener pareja, de ellas 23 tienen relaciones sexuales después de consumir. El consumo de alcohol en las adolescentes es alto, y el inicio precoz de la relaciones sexuales parece estar relacionado al consumo de alcohol

An epidemiological study of Haemophilus influenzae at a Brazilian Day Care Center

Day care centers are a relatively new phenomenon in Brazil that bring together large numbers of young children susceptible to contagious diseases. Haemophilus influenzae (Hi) is an important infection in the age range of those attending day care centers. In the present study, the carriage rate of haemophilus influenzae was identified in 38 day care attendees age 6 to 37 months, and 23 staff members, at a day care center in Ribeirao Preto - Sao Paulo, in 1997. To identify the carriers, two nasopharyngeal swabs were collected; one in july and one in december. The rate of H. influenzae carriers among the children was 77 percent. Only 2 of 23 staff members (9 percent) had Hi. Among the children, there were 58 isolates in the two sampling periods; 6 of the Hi were serotype b, 1 was serotype e, and 48 isolates were non-typeable. Two were identified as H. parainfluenzae. One adult had a non-typeable Hi and 1 had H. paraphrohaemolyticus. Three of the 6 children with type B had received a conjugate vaccine against H. influenzae type b, but they still carried this bacterium in the nasopharynx (50 percent). Forty ribotype patterns were found among the isolates, showing a high exchange rate of nontypeable H. influenzae carriers. The results indicate that, because of the high and changing biotype of Hi carriage, day care centers should be carefully monitored as potential point source of Hi disease in the community.

Malformación adenomatoidea quística: evolución y factores pronósticos. Análisis de 20 casos consecutivos / Cystic adenomatous malformations: evlolution and prognosis factors. Analysis of 20 consecutive cases

La malformación adenomatoidea quística(MAQ)es una enfermedad congénita pulmonar rara,con cuadro clínico variable,pudiendo ser asintomática y diagnosticada a través de radiografías de tórax ocasionales o presentar graves síntomas en la vida intrauterina llevando la hidropesía fetal y muerte antes del nacimiento.En los 16 siguientes el diagnóstico fue realizado en el periódo prenatal,siendo analizados los signos y síntomas,el pronóstico y el resultado quirúrgico.Los autores concluyen que la forma microquística y la hidropesía fetal son los factores de peor pronóstico.La desviación del mediastino sin hidropesia y la precocidad del diagnóstico no están asociados a peor pronóstico.La intervención quirúrgica del feto sólo debe ser indicada en los pacietnes menores de 32 semanas,cuando presenta asociación de un quiste pulmonar grande produciendo hidropesia.La lobectomía,tratamiento definitivo de los pacientes sintomáticos,debe efectuarse luego del nacimiento -

Evaluation of radioinduced damage and repair capacity in blood lymphocytes of breast cancer patients

Genetic damage caused by ionizing radiation and repair capacity of blood lymphocytes from 3 breast cancer patients and 3 healthy donors were investigated using the comet assay. The comets were analyzed by two parameters: comet tail length and visual classification. Blood samples from the donors were irradiated in vitro with a 60Co source at a dose rate of 0.722 Gy/min, with a dose range of 0.2 to 4.0 Gy and analyzed immediately after the procedure and 3 and 24 h later. The basal level of damage and the radioinduced damage were higher in lymphocytes from breast cancer patients than in lymphocytes from healthy donors. The radioinduced damage showed that the two groups had a similar response when analyzed immediately after the irradiations. Therefore, while the healthy donors presented a considerable reduction of damage after 3 h, the patients had a higher residual damage even 24 h after exposure. The repair capacity of blood lymphocytes from the patients was slower than that of lymphocytes from healthy donors. The possible influence of age, disease stage and mutations in the BRCA1 and BRCA2 genes are discussed. Both parameters adopted proved to be sensitive and reproducible: the dose-response curves for DNA migration can be used not only for the analysis of cellular response but also for monitoring therapeutic interventions. Lymphocytes from the breast cancer patients presented an initial radiosensitivity similar to that of healthy subjects but a deficient repair mechanism made them more vulnerable to the genotoxic action of ionizing radiation. However, since lymphocytes from only 3 patients and 3 normal subjects were analyzed in the present paper, additional donors will be necessary for a more accurate evaluation

Enfermedad vascular de dieulafoy como una emergencia quirúrgica: revisión / Vascular dieulafoy disease how a surgical emergency: review

Se presenta un caso de enfermedad de dieulafoy en una paciente de 51 años quien presentó hemorragia digestiva superior profusa, con deterioro hemodinámico. Se realizó intervención quirúrgica encontrándose lesión fúndica, sangrante, compatible con la enfermedad de dieulafoy y situs abdominalis inversus, falleciendo en el postoperatorio inmediato. Esta enfermedad poco frecuente es causa de hemorragia digestiva superior y se diagnostica por endoscopia en el curso de una laparatomia, observándose arteria de mediano calibre sangrante en las porciones altas del estómago. El tratamiento suele ser quirúrgico pero recientemente la endoscopia superior ha tomado la pauta diagnóstica y terapéutica. Se hacen consideraciones teórico-analíticas de tan inusual patología

Relación entre apolipoproteínas A-1 y B-100 e infarto al miocardio / Relation between apolipoproteins A-1 and B-100 e infarction myocardial

La enfermedad ateroesclerótica (EA) es la primera causa de muerte en Venezuela, determinándose marcadores más específicos para EA, en 47 sobrevivientes al infarto de miocardio y 40 controles (sexo masculino, 30-60 años). Indicadores: apolipoproteínas (Apo) A-1 y B-100, Colesterol total (Ct), HDLc, LDLc, Vldlc, triglicéridos y sus relaciones. Diferencias estadísticamente significativas: Apo A-1, Ct/HDLc y LDLc/HDLc (p<0.0005); B-100 y LDLc (p<0.05); HDLc (p<0.025); Apo A-1/Apo B-100, LDLc/Apo A-1 y Ct/Apo A-1 (p>0.0001). Apo A-1 [CD=68 por ciento; Vp(+)=71], Apo A-1/Apo B-100 [CD=75 por ciento, Vp(+)=75 por ciento], LDLc/Apo A-1 [CD=66 por ciento, Vp(+)=71 por ciento] y Ct/Apo A-1 [CD=70 por ciento, Vp(+)=71 por ciento] constituyeron marcadores de riesgo más especifícos para EA que el perfil lipídico y que las relaciones utilizadas actualmente [Ct/HDLc: CD=66 por ciento, Vp(+)=67 por ciento, LDLc/HDLc: CD=65 por ciento, Vp(+)=67 por ciento]

Diagnóstico citológico de tumor mamário metastático canino em derrame pleural / Cytological diagnosis of metastatic canine mammary tumor in pleural effusion

Descreveram-se os achados citomorfológicos de um tumor maligno de mama em uma cadela Poodle de sete anos de idade, o qual foi observado inicialmente pelo exame citológico do derrame pleural. Comparam-se os aspectos citológicos do derrame pleural e punçäo aspirativa com agulha fina do tumor com aqueles descritos para o câncer de mama na espécie humana

Enhanced mucosal re-epithelialization induced by short chain fatty acids in experimental colitis

The short chain fatty acids (SCFA) are the best nutrients for the colonocytes. Glucose is poorly used as a fuel but may be transformed into SCFA by colonic bacteria. The aim of this study was to investigate the effect of SCFA or glucose on experimental colitis. Colitis was induced in 30 Wistar rats by colonic instillation of 4 percent acetic acid. Five days later they were randomized to receive twice a day colonic lavage containing saline (controls, N = 10), 10 percent hypertonic glucose (N = 10) or SCFA (N = 10) until day 8 when they were killed. At autopsy, the colon was removed and weighed and the mucosa was evaluated macro- and microscopically and stripped out for DNA assay. Data are reported as mean + or -SD or median [range] as appropriate. All animals lost weight but there was no difference between groups. Colon weight was significantly lower in the SCFA group (3.8 + or - 0.5 g) than in the control (5.3 + or - 2.1 g) and glucose (5.2 + or - 1.3 g) groups (PP<0.05). Macroscopically, the severity of inflammation was less in SCFA (grade 2 [1-5]) than in control (grade 9 [4-10]) and glucose-treated (grade 9 [2-10]) animals (P<0.01). Microscopically, ulceration of the mucosa was more severe in the glucose and control groups than in the SCFA group. The DNA content of the mucosa of SCFA-treated animals (8.2 [5.0-20.2] mg/g of tissue) was higher than in glucose-treated (5.1 [4.2-8.5] mg/g of tissue; P<0.01) and control (6.2 [4.5-8.9] mg/g of tissue; P<0.05) animals. We conclude that SCFA may enhance mucosal re-epithelialization in experimental colitis, whereas hypertonic glucose is of no benefit