Representações sociais de educação em saúde em tempos de AIDS / Social representations of health education in a time of AIDS / Representaciones sociales de educación para la salud en la era del SIDA

Estudo qualitativo e descritivo, cujo objetivo foi identificar e analisar as representações sociais de educação em saúde à pessoa vivendo com HIV entre profissionais de saúde. Os cenários foram três serviços de atenção à DST/HIV/AIDS, em Belém-PA, Brasil, e 37 profissionais de saúde participaram da pesquisa. A coleta de dados deu-se em 2012-2013 por meio de entrevista em profundidade; a análise utilizou o software Alceste 4.10. Com base no conjunto dos resultados foi possível vislumbrar que a educação em saúde pode ser compreendida a partir de categorias: a configuração do agir educativo; as condições sine qua non: educação no trabalho e estrutura da unidade; o processo pedagógico. Conclui-se que as representações sociais configuram-se como orientação-informação para precaução-prevenção e revelam-se no movimento do agir persistente ao emergente, o que suscita uma educação em saúde permanente para se chegar à integralidade nos serviços.

This is a qualitative and descriptive study, which aimed at identifying and analyzing social representations of health education to HIV patients among health professionals. The setting included three healthcare DST/HIV/AIDS services in Belém-PA, Brazil, and 37 health professionals participated in the study. Data collection was conducted in 2012-2013 on the basis of in-depth interviews and analysis was made on Alceste 4.0 software. Final results indicated that health education can be comprehended in light of categories: educational action; sine qua non: education and training at work, and unit structure; teaching-learning process. Conclusions show that social representations are set as guidance-information for precaution-prevention and that they come forth along continuous and emerging action flow, bringing about permanent health education to ensure healthcare services in full.

Estudio cualitativo y descriptivo, que objetivó identificar y analizar las representaciones sociales de educación en salud a la persona viviendo con HIV entre profesionales de salud. Los escenarios fueron tres servicios de atendimiento al DST/HIV/ SIDA, en Belém-PA, Brasil, y 37 profesionales de salud participaran del estudio. La colecta de datos se dio en 2012-2013, por medio de entrevista en profundidad y el análisis utilizo el software Alceste 4.10. Con base en el conjunto de los resultados fue posible vislumbrar que la educación en salud puede ser comprendida a partir de categorías: la configuración del acto educativo; las condiciones sine qua non: educación en el trabajo y estructura de la unidad; el proceso pedagógico. Se concluye que las representaciones sociales se configuran como orientación-información para precaución-prevención y se revelan en el movimiento del acto persistente al emergente, lo que suscita una educación en salud permanente para llegarse a la integralidad en los servicios.

Impact of castration with or without alpha-tocopherol supplementation on the urethral sphincter of rats

OBJECTIVE: To analyze the impact of low levels of testosterone induced by orchiectomy and the effect of alpha-tocopherol supplementation on oxidative stress in the urethral sphincter. MATERIALS AND METHODS: Forty male Wistar rats weighing 250-300g were divided into four groups with 10 each: Sham group; Orchiectomy group: bilateral orchiectomy; Orchiectomy-pre-Tocopherol group: bilateral orchiectomy preceded by alpha-tocopherol supplementation for four weeks; Orchiectomy-full-Tocopherol group: bilateral orchiectomy with alpha-tocopherol supplementation for four weeks preceding the procedure and for eight weeks afterwards. At the protocol end, animals were euthanized and had the sphincter analyzed stereologically focusing on collagen and muscle fibers percentage. Oxidative stress levels were determined using 8-epi-PGF2. RESULTS: The 8-epi-PGF2 levels were statistically higher (p < 0.0003) in the Orchiectomy group compared to others groups while Sham and Orchiectomy-full-Tocopherol groups presented statistically similar values (p = 0.52). Collagen volumetric densities were significantly lower in Sham and Orchiectomy-full-Tocopherol groups (p < 0.022). Sham group presented statistically greater muscle fiber percent. CONCLUSION: Castration caused oxidative stress in the urethral sphincter complex, with increased collagen deposition. Alpha-tocopherol had a protective effect and its supplementation for twelve weeks provided the greatest protection.

Relación del colesterol total con la concentración sérica de tocoferoles, un estudio probabilístico en preescolares mexicanos / Relation of total cholesterol in serum tocopherols

Estudios epidemiologicos han demostrado el efecto del estado nutricional de los tocoferoles y el desarrollo de enfermedades cardiovasculares, las cuales son cada vez mas frecuentes en edades tempranas de la vida. Este trabajo relaciona el colesterol total con las concentraciones sericas de tocoferoles en una poblacion de ninos mexicanos, evaluando ademas su estado antioxidante y oxidante. De octubre a diciembre de 2003, se cuantifico en suero a-tocoferol, γ-tocoferol y colesterol total en 1155 niños (12-59 meses) residentes de localidades urbanas y rurales; se evaluo la capacidad antioxidante y el estado oxidante con la produccion de TBARS. Los ninos con cifras de colesterol > 240 mg/dL fue de 577.3 ± 200.8 μg/dL. Sin embargo, cuando se expresaron los tocoferoles en relacion con el colesterol total (μmol/mmol), se observo que los niños con + 1.19), lo que los ubicaba en un adecuado estado nutricional de a-tocoferol, a diferencia del grupo con > 240 mg/dL de colesterol en quienes la relacion fue baja (1.93 ± 0.69). No se observaron diferencias en la capacidad antioxidante del suero, pero si en la produccion de TBARS para los niños con > 200 mg/dL de colesterol. En preescolares los incrementos en el colesterol total limitan la disponibilidad de tocoferoles sericos para los lipidos circulantes, esta condicion a traves del tiempo puede condicionar el desarrollo prematuro de lesiones vasculares mediadas por estres oxidativo.

Epidemiological studies have shown the effect of nutritional status of tocopherols and development of cardiovascular diseases that now are more frequent during early years of life. In this work we evaluated the association between the total cholesterol and serum levels of tocopherols in a population of Mexican children in whom we measured the oxidant status and antioxidant capacity (December 2003). In 1155 children (12-59 months) residents of urban and rural locations we quantified in serum a-tocopherol, γ-tocopherol and total cholesterol; the antioxidant capacity and oxidative status were evaluated with the production of TBARS. Children with serum cholesterol > 240 mg/dL cholesterol recorded an average of 577.3 ± 200.8 μg/dL. However, when tocopherols were expressed in relation to total cholesterol (μmol/mmol) found that children with > 240 mg/dL of cholesterol in whom the relationship was low (1.93 ± 0.69). There were no differences in serum antioxidant capacity, but if in the production of TBARS for children with > 200 mg/dL cholesterol. In preschools the increases in total cholesterol limits the availability of serum tocopherol for circulating lipids, this condition over time could determine the early development of vascular injury mediated by oxidative stress.

Comparison of serum concentration and dietary intake of alpha-tocopherol in a sample of urban and rural Costa Rican adolescents

Results from several studies have suggested that vitamin E intake could inhibit the progression of atherosclerotic lesions. Therefore, this study was designed to evaluate Costa Rican adolescents' serum alpha-tocopherol levels and their correlation with Body Mass Index (BMI) and the dietary intake of vitamin E and saturated and polyunsaturated fat. Ninety-five healthy, non-smoking adolescents and non-vitamin supplement users (aged 13-18) from urban and rural areas in San José, Costa Rica, were included in this study. Serum levels of lipid adjusted alpha-tocopherol were significantly higher in rural adolescents compared with urban youngsters (4.192 mumol/mmol +/- 0.831 and 3.486 mumol/mmol +/- 0.996, respectively). Likewise, reported mean daily 1000 kcal adjusted-vitamin E intake was higher in rural adolescents than in urban youngsters (9.2 +/- 3.7 mg. 16.0 +/- 8.7 mg). An important correlation was observed between intake of energy from saturated fat and adjusted-alpha-tocopherol serum levels (r = 0.430). Contrariwise, they correlated poorly with dietary alpha-tocopherol (r = 0.273), suggesting that serum is not a good biomarket of intake for alpha-tocopherol. Additionally, our results showed a negative relationship between BMI and adjusted-serum vitamin E levels (beta = 0.189; CI 95 per cent -0.153, -0.013). The analysis of vitamin E intake showed that over 25 per cent of adolescents have inadequate intake of the nutrient. This study suggests that nutritionists and pediatricians should encourage alpha-tocopherol intake and monitor the food sources of the nutrient and the adolescents' body weight as part of the strategies aimed at developing a healthy lifestyle.

Preventive Effects of Intracisternal Alphatochopherol on Cerebral Vasospasm in Experimental Subarachnoid Hamorrhage

Vasospasm is an important cause of morbidity and/or mortality with a subarachnoid haemorrhage (SAH). The roles of lipid peroxidation in a vasospasm caused by a SAH remain to be investigated. The effect of an intracisternal administration of alphatochopherol on a cerebral vasospasm was investigated in an experimental model. The authors assessed whether the administration of alphatochopherol reduced the vasospasm. By means of an intracisternal blood injection model, a SAH was induced in 30 rats, which were randomly divided into three groups, as follows: group I (G1), without a SAH and drug, group II (G2), a SAH alone, group III (G3), a SAH and alphatochopherol. Following the withdrawal of cerebrospinal fluid (CSF), a fresh unheparinized arterial blood was injected into the cisterna magna to induce a SAH. In G3, 20 U (0.4ml) alphatochopherol was intracisternally injected forty-five hours after induction of the SAH. All rats were sacrificed 72 hours after the induction. The basilar artery, with surrounding tissue, was removed from the cranium. The cross-sectional diameter of the lumen and vessel wall of the rat basilar artery was assessed from a planimetric analysis, and changes compared with G1 and G2. The reduction in the luminal cross-sectional diameter of the vessels exposed to subarachnoid blood was found to be 29.01 % (p=0.001). The group treated with alphatochopherol had a 9% reduction (p=0.004). The role of lipid peroxidation on a vasospasm caused by SAH is well known to be critical. Data from the present study indicated that antioxidant therapy, with topical alphatochopherol, may be promising on a vasospasm caused by a SAH.