ABSTRACT
Este trabalho teve origem na integração teórico-práticadas atividades da ênfase Atenção Básica em Saúde Coletiva,da Residência Integrada em Saúde da Escola de SaúdePública, do Rio Grande do Sul, Brasil. A proposta foi realizarum estudo de caso acerca de uma família, do territóriode uma Estratégia de Saúde da Família, discutindo atemática das imunizações, a partir de um contexto real epossível. Utilizou-se como método a proposta do ProjetoTerapêutico Singular, da Política Nacional da Humaniza-ção, do Ministério da Saúde. Os dados foram coletadosentre os meses de novembro e dezembro de 2011. Os resultadosdemonstraram a potência do trabalho na Aten-ção Primária em Saúde pela interseção dos modelos tecno-assistenciaisda vigilância, da clínica e da humanização.Entre os instrumentos de intervenção, a visita domiciliarapresentou-se como um disparador de potencializaçãodas práticas em saúde no território. Por fim, concluiu-seque a atenção desprendida na saúde deve ir aquém dasteceduras da vida, de cada usuário, família e comunidade.Assim, faz-se necessário um trabalho interdisciplinar daequipe de saúde, capaz de articular a rede, seja de serviço,social, e afetiva.
This work originated in the theoretical-practical integrationof activities, with emphasis on Primary Health Care, ofthe Integrated Health Residency at the School of PublicHealth, Rio Grande do Sul State, Brazil. The proposal wasto conduct a case study about a family, covered at a FamilyHealth Strategy unit, discussing the topic of immunizationsbased on a real and possible context. The method usedwas the Singular Therapeutic Project proposal, from theNational Policy on Humanization, Ministry of Health,Brazil. The data were collected between November andDecember 2011. Results demonstrated the potential ofPrimary Health Care working through the intersectionof the techno-care models of surveillance, clinicalpractice, and humanization. Among the instrumentsof intervention, home visits appeared as a trigger forenhancement of health practices in the coverage area.It was concluded that the health attention offered mustgo over the symptoms or the clinical, crossing the users?,families? and community?s ways of life. Thus the needfor an interdisciplinary health team able to connect theservice, social, and affective networks.
Subject(s)
Primary Health Care , Comprehensive Health Care , Unified Health System , Surveillance in Disasters , Humanization of Assistance , Health ServicesABSTRACT
BACKGROUND: Leiomyomas are the most common tumors of the female reproductive tract and a major public health problem. The mechanism of tumorigenesis is unknown, but evidence suggests that estrogens regulate cell proliferation and myoma growth. This effect might be due to different amounts of estrogen receptors (ERα and ERß) in normal and myoma tissues and overexpression of aromatase P450 in myomas. PURPOSE: To assess protein expression of ERs and aromatase in leiomyomas and normal adjacent myometrium of premenopausal women. METHODS: Samples were collected from 12 premenopausal women admitted for abdominal hysterectomy due to fibroids. RESULTS: The protein expression of ERα, ERß and aromatase was similar in leiomyoma and normal myometrium (p = 0.239, p = 0.695 and p = 0.203, respectively). CONCLUSIONS: In this analysis of 12 matched leiomyoma and myometrial samples, the data do not support the theory that overexpression ERα, ERß and aromatase in uterine leiomyomas compared to adjacent myometrium are the cause of tumor growth. The estrogens may exert their growth-stimulatory effects on leiomyomas intermediated by other elements, such as cytokines and growth or apoptosis factors. The effect of estrogen on the growth and development of fibroids is complex and far from being completely understood.
Subject(s)
Aromatase/metabolism , Estrogen Receptor alpha/metabolism , Estrogen Receptor beta/metabolism , Leiomyoma/metabolism , Myometrium/metabolism , Uterine Neoplasms/metabolism , Adult , Aromatase/genetics , Blotting, Western , Estrogen Receptor alpha/genetics , Estrogen Receptor beta/genetics , Female , Gene Expression , Humans , Hysterectomy , Leiomyoma/surgery , Middle Aged , Premenopause , Uterine Neoplasms/surgeryABSTRACT
PURPOSE: To assess gene and protein expression of progesterone receptor isoforms A and B, cell cycle regulators p53 and p21 in leiomyoma and myometrium. METHODS: Samples were collected from 14 patients in reproductive age who underwent abdominal hysterectomy. Gene expression of PRA, PRB, p53 and p21 was analyzed by real-time PCR. Protein expression was assessed by Western blots. RESULTS: There was no change in gene and protein expression of PRA and PRB in both tissues. The ratio between isoforms (PRA:PRB) was not different between tissues and showed a strong correlation (r = 0.767, P = 0.004). The analysis of gene expression and protein showed increased levels of mRNA and protein p53 in leiomyoma compared to myometrium (P = 0.030 and P = 0.002, respectively). The same increase was observed in p21 mRNA levels (P = 0.016) and protein p21 levels (P = 0.026) in samples of uterine leiomyoma. CONCLUSIONS: PRA:PRB ratio is similar in normal myometrium and leiomyomas. p53 and p21 mRNA and protein levels are increased in leiomyomas.
