Avaliaçäo do comportamento alimentar em crianças e adolescentes de Belo Horizonte / Assesment of eating attitudes of children and adolescents in Belo Horizonte city

Estudo da prevalência do comportamento alimentar de estudantes com relaçäo à imagem corporal, à prática de hiperfagia ou orgia alimentar, ao uso de dieta para emagrecimento e métodos purgativos para perda de peso (anorexígenos, diuréticos, laxantes e vômitos auto-induzidos). Delineamento tipo in

[Knowledge, strategies and ideologies of nursing: a reflection based on the Lopes' study]. / Saberes, estratégias, ideologias de enfermagem: reflexão baseada no estudo de Lopes.

This paper makes a reflection on the knowledge and ideologies present in the nursing practice within a hospital context, based on theoretical references used by the sociologist Noemia da Glória Mendes Lopes in her MS dissertation in Lisbon, Portugal, in 1994. In this dissertation she analyzes the work of nurses within hospital contexts. The author observed that within the professional context of nursing there are many social practices of work indicating different strategies of valuing and revaluating the profession. It was concluded from this reflection that there are better possibilities of performing such strategies in specialized services than in medical clinic services.

Bradykinin release from high molecular weight kininogen and increase in plasma kallikrein-like activity following sensory stimulation by food in the rat.

Cephalic stimulation by food elicits, among other responses, dilatation of mesenteric blood vessels preparatory for digestion. The possible participation of bradykinin (BK), a powerful endogenous vasodilator, in this response was studied in fasted rats prior and following stimulation by sight and scent of food (sensory stimulation, SS), actual ingestion being denied to the animals. BK content of plasma high (HK) and low molecular weight kininogen (LK) was determined by bioassay on the atropinized, antihistamine-treated isolated guinea-pig ileum following release by trypsin from heat/acid denatured plasma. BK corresponding to LK was estimated in plasma which prior to denaturation had been incubated with kaolin, a process which leads to quantitative release and inactivation of BK from HK, but does not affect LK. BK corresponding to (HK + LK) was determined in plasma not exposed to kaolin. BK contained in HK was the difference between BK of (HK + LK) and of BK of LK. Plasma and glandular kallikreins were estimated by fluorimetry, using specific synthetic substrates. A 40.6+/-4.0% decrease (P<0.001) of BK in HK occurred in rats after 90 s of SS; LK remained unaffected. Ten minutes of SS did not result in further change. Atropine inhibited the effect of SS. Return of HK to pretreatment levels occurred when, following 90s of SS, rats were allowed to rest for 60 min in the absence of food. Renewed capacity to respond to SS was then observed. Plasma kallikrein, but not glandular kallikrein, increased in plasma of rats after SS. Increased free BK was detected in the circulation of Enalapril-protected rats after SS. Electrical stimulation of the distal sector of the sectioned left abdominal vagus nerve of Nembutal-anesthetized fasted rats reproduced the effect of SS on HK. It is concluded that visuo-olfactory stimulation by food generates nerve impulses, possibly carried by the vagus nerve, which by activating plasma kallikrein lead to cleavage of circulatory HK and release of BK in the rat.

[Leadership in nursing in Brazil: approaching its demystification]. / Liderança na enfermagem brasileira: aproximando-se de sua desmitificação.

This study aims at understanding the view about the nursing leadership question, through critical analysis of the literature produced predominantly in Brazil on this theme, from 1930 to 1995, contributing to its "dismythification". From the assumption that nursing is a social practice, and therefore articulated with other health practices, we conducted the investigation under a historical-social approach. Empirical data were obtained from the discourses about the issue or related themes, contained in 14 periodicals, from which 12 were of nursing. Besides them, we used proceedings from nursing events, as well as research and researcher catalogs and 3 theses. We analysed data according to time delimitation, distributed in four historical periods, intending to maintain the similarity of the peculiar discourses of each period, according to the context in these moments. The study demonstrated that the nursing leadership question has been treated, in the profession, in an idealized, mythical and crystalized way, contributing, thus, to the maintenance of the status quo and nursing professional's alienation.

[Turnover of nursing staff in hospitals of the municipality of Ribeirão Preto]. / Rotatividade dos trabalhadores de enfermagem nos hospitais do Município de Ribeirão Preto.

The present study was carried out in 1990 with the objective of measuring and analyzing the turnover of nursing personnel in nine general hospitals located in Ribeirão Preto, São Paulo State, Brazil. The population under study consisted of nurses, nursing assistants, nursing technicians, and nursing attendants who started work or left their jobs between 1 January and 31 December 1990. Employment status for these workers was checked monthly based on information from the human resources department of each hospital. Two types of turnover indices were calculated: the liquid rate of substitution and the median length of service of the departing workers. Results showed that the number of nursing personnel employed in Ribeirão Preto increased in 1990. However, results also revealed a high turnover rate, especially for philanthropic and private institutions, with liquid substitution rates of 32% and 39% per year and median lengths of service of 8 months and 12 months, respectively. These circumstances could lead to higher costs and reduced productivity. The only public hospital in the study presented the lowest level of turnover (liquid substitution rate of 6% and median length of service of 42 months). Nurses and attendants had the highest substitution rates and thus were the least stable categories.

Neuroethological and morphological (Neo-Timm staining) correlates of limbic recruitment during the development of audiogenic kindling in seizure susceptible Wistar rats.

Acute audiogenic seizures are a model of generalized tonic-clonic seizures, induced by high intensity acoustic stimulation in genetically susceptible rodents. The neural substrate are sensory motor brainstem nuclei. Recruitment of forebrain structures takes places upon repetition of acoustically evoked seizures. The term audiogenic kindling means forebrain kindling evoked by repeated brainstem seizures and has been described in several strains of genetically epilepsy-prone rats. Thus, the present work was conducted in order to test the hypothesis that audiogenic kindling recruits the forebrain, which may be behaviorally evaluated and associated with morphological changes as well. The behavioral sequences observed during the development of audiogenic kindling were assessed by neuroethological methods (cluster analysis), with the ETHOMATIC program. Seizure severity indexes (brainstem and limbic seizures) and latencies of wild running and tonic-clonic seizures were measured to quantify seizure evolution. Densitometric analysis of Neo-Timm staining was used for assessing morphological changes associated with audiogenic kindling. In group I, II resistant (R) and 16 susceptible (S) animals were stimulated (120 dB) 21 times, and allowed a 10 day recovery period prior to retesting. In group II, 22 R and 20 S were stimulated 60 times, and allowed a 2 month recovery period prior to retesting. Repetition of the acoustic stimulation in group I and group II susceptible animals led to a progressive and statistically significant attenuation of the behaviors associated with brainstem seizures and a concomitant increased expression of the behaviors associated with limbic seizures. After either a 10 day (group I) or 2 month (group II) recovery period, acoustic stimulation preferentially evoked brainstem-associated behaviors and seizures rather than limbic ones in the audiogenic susceptible animals, although in some animals overlapped brainstem and limbic seizures were detected. Latencies for the wild running and tonic seizures after acoustic stimulation significantly increased during audiogenic kindling for both group I and group II susceptible animals. The quantitative ethological evaluation in both group I and group II, illustrated by flowcharts, showed the evolution of the kindling installation by the presence of limbic seizure clusters, competing in time with the original tonic-clonic clusters. Expression of limbic seizures by group I animals, after acoustic stimulation, was not associated with changes in the mossy fiber Neo-Timm staining pattern of these animals. In group II however, Neo-Timm staining revealed mossy fiber sprouting in the ventral hippocampus (but not in the dorsal), and a significant change in the optical density of amygdaloid nuclei and perirhinal cortex in susceptible animals as compared to resistant ones. In conclusion, audiogenic kindling effectively recruits forebrain structures, responsible for the appearance of limbic seizures. It is possible that the paradigm used in group I was subthreshold for the development of clear-cut synaptic reorganization in the hippocampal mossy fiber system, since the behavioral patterns reverted ten days after the last seizure induction. In group II, however, an increased number of evoked seizures and a more prolonged time after the last chronic seizure showed structural re-arrangements in amygdala, perirhinal cortex and hippocampus, associated with permanence in terms of behavioral data (lack of regression of limbic seizures to control values).

[Information systems in the management process of the health services. Reflections]. / O sistema de informações no processo gerencial dos serviços de saúde: algumas reflexões.

The present study aims at reflecting about the organization of the information system as an important tool in the management of health services, especially in the process of municipalization.

[Reflections on health planning and on health reform in Brazil]. / Reflexões sobre o planejamento em saúde e o processo da reforma sanitária Brasileira.

The authors considered carefully the brazilian social policies at the regimes of populism and militarism as well as at the democratic transition following the presupposition that the social planning in Latin America emerged as an instrument for social policies formulation. The authors also considered some tendencies of the Latin America Planning, emphasizing the Strategic Focus of the Health Program formulated by the Public Health School of Medellin; the Strategic Thought elaborated by Mario Testa; and the Strategic Situational Planning developed by Carlos Matus.

[Nursing: the reality and future in care and management]. / Enfermagem: realidade e perspectiva na assistência e no gerenciamento.

The authors discuss the activities developed by Nursing in two general orientations: the assistance and the management, concerning the concrete work and its perspectives. Therefore, they engage in polemics around the administrative versus assistance functions and attract the attention to the impossibility of thinking the nursing work inarticulated of different health practices, as a whole they accomplish each other in attempting the necessities of health of the population in a social level.

Kininogen changes evoked in plasma by feeding, pseudo-alimentary, vagal and carbamylcholine stimulation of the rat.

Changes in plasma total (BKg), low (LKg), or high (HKg) molecular weight kininogens are indirect means of studying the participation of kinins in biological processes. To investigate kinin involvement in digestive activity, rats fasted overnight, but given access to water, were allowed to feed for one hour. BKg levels increased by 18% (p less than 0.0001); LKg by 29% (p less than 0.01); HKg remained apparently unchanged. Changes were reversed after 120 min. Decreases in circulatory HKg are probably masked by a compensatory response of the organism aimed at rapidly re-establishing kinin precursor levels in the circulation following their consumption by parasympathetic activity accompanying feeding. This conclusion is based on observations showing that fasted rats submitted to sham-feeding caused by visual/olfactory stimulation by food, present extensive (61%) reduction (p less than 0.001) of HKg, but not of LKg. It is further supported by results demonstrating that electrical stimulation of the distal stump of the cut left abdominal vagus nerve, as well as intravenous administration of carbamylcholine, a parasympathomimetic drug, also produce these changes, all of which were prevented by prior atropinization of the experimental animals. These results open the way for investigations on a possible role of kinins in the control of post-prandial vascular changes.

Parasympathetically-mediated swelling of mast cell granules during feeding.

Mesentery mast cells have been observed to swell and to spontaneously return to their original size following feeding of 12-h fasted rats. This effect may be controlled by parasympathetic efferent nerve impulses, since it is inhibited by atropine. It was reproduced in vitro in isolated rat peritoneal fluid mast cells exposed for 30s to 10(-8)-10(-11) M acetylcholine. When examined under the electron microscope, mast cell average granule diameters had increased by 29% (p less than 0.001) following treatment. Swollen granules did not leave (exocytose) acetylcholine-treated mast cells. They gradually and spontaneously returned to their original size. This recovery only differed from that occurring in the fed rat by its greater speed.

Reversible rat mesenteric mast cell swelling caused by vagal stimulation or sham-feeding.

Fragments of rat mesentery were examined using acetylthiocholine to detect cholinergic nerve fibers and toluidine blue to identify mast cells. 59.2 +/- 2.6 percent of mast cells were at less than one-half mean cell diameter (4-5 microns), from the nerve fibers. Under the electron microscope, the membrane of mast cells was within less than 50 nm from axon membranes, suggesting a synaptic type of connection. Average mast cell area in fasted rats increased following feeding, stimulation of the left abdominal vagus nerve or exposure of the animal to the smell of food. It returned to control values within 60-80 min. Granule exocytosis was not observed. Mast cell swelling was prevented by atropine and induced by intravenously administered carbamylcholine. It appears that in rat mesentery, impulses travelling via cholinergic, parasympathetic fibers innervating mast cells, cause mast cell swelling. Compound 48/80 administered to rats at doses causing little degranulation and minimum release of histamine, caused extensive, reversible swelling of mesentery mast cells.

Increased levels of histamine observed in the skin of adrenaline-treated rats or mice are not the result of histamine synthesis by mast cells.

Like the skin of rats and mice injected with adrenaline (AD), rat isolated peritoneal mast cells display increased levels of perchloric acid-soluble histamine following incubation with AD. Although pre-exposure to alpha-fluoromethyl histidine (FMH), an inhibitor of histidine decarboxylase, prevented the effect of AD in vivo and in vitro, this compound was also found to inhibit mast cell granule swelling evoked by AD, a response linked to histamine changes. Absence of increased levels of isotopic histamine in mast cells incubated with labelled histidine in the presence of AD, as well as the insufficient amounts of would-be precursor histidine found in untreated mast cells, confirm the conclusion that AD does not increase mast cell histamine by stimulating its synthesis.

Atropine and hexamethonium-sensitive, Ca/K-modulated, reversible swelling of mast cells in rat mesentery, due to feeding or exposure to carbachol.

Transitory swelling of mesenteric mast cells was observed when 24 h-fasted rats were given access to food. Atropine, an anti-muscarinic drug given (1 mg/kg, i.p.) 60 min prior to feeding, prevented this response; carbachol, a cholinomimetic drug caused it to occur when given (2 micrograms/kg, i.v., 10 min) to fasted rats. Mast cells in the mesentery excised from fasted rats, presented swelling in vitro within 1 min following exposure to 10(-7) M carbachol. This response was inhibited by atropine (10(-8) M) or hexamethonium (10(-8) M), indicating that stimulation of a parasympathetic nerve pathway, reported to exist in rat mesentery, could induce mast cell swelling. Exposure to a Ca2+ free medium also led to rapid swelling of mast cells in the mesentery excised from fasted rats. This result, as well as inhibition of the mast cell response to carbachol caused by increasing the Ca2+ (but not by increasing the Mg2+) content of the incubation medium, suggests that swelling was caused by a sudden decrease of Ca at mast cell membrane sites controlling ion/water fluxes. Mast cells swollen by feeding, carbachol or Ca-lack, reverted to their original condition within 20 min when incubated in balanced salt buffer. Such reversal did not occur in a KCl-enriched medium. An equivalent (in terms of ionic strength), increase in NaCl, did not reproduce this effect, indicating that mast cells have K+-dependent means of compensating for endogenously or drug-induced volume changes. Swelling caused by cholinergic stimulation of mast cells was not accompanied by granule exocytosis.2+ carbachol-treated rat blood in vivo or in vitro, is discussed in terms of putative mast cell-controlled, localized homeostasis in the rat mesentery.

Stimulation by epinephrine of histamine synthesis by rat peritoneal fluid mast cells in vitro.

In vitro exposure of mast but not of other cells of rat peritoneal fluid to epinephrine leads, within 1 min, to progressing levels of histamine in both fluid and sedimentable phases of the incubates, which present no increase in their free/total histamine ratio. Histamine increase was blocked by alpha-fluoromethyl histidine (alpha FMH), acting after a significant lag period. When compared with controls under the electron microscope, epinephrine-treated mast cells show less electron-dense, swollen intracellular granules, apparent maintenance of cell membrane continuity and an apparent decrease of peripheral finger-like projections. Histamine accumulation by epinephrine-treated mast cells may be the result of an enhanced ability of pre-formed mast cell histidine decarboxylase to attack its cell-borne substrate, consequent to an unfolding of the cell membrane during cell tumefaction evoked by epinephrine.