Avaliação da adesão ao tratamento com Tamoxifeno por mulheres com câncer de mama / Tamoxifen treatment adherence assessment by women breast cancer / Evalución de adherencia al tratamento com Tamoxifeno em mujeres com cáncer de seno

Justificativa e objetivos: A terapia antineoplásica oral apresenta vantagens comparada a outras terapias para o tratamento do câncer, por ser administrada em domicílio, de forma simples e rápida, no entanto, essa terapia aumenta a responsabilidade do paciente em relação ao seu tratamento e a adesão é fundamental para a sua eficácia. Evidenciam-se poucos estudos referente ao acompanhamento farmacoterapêutico na terapia antineoplásica oral, nesses contexto, o presente estudo busca avaliar a adesão ao tratamento com tamoxifeno em mulheres com câncer de mama, antes e após acompanhamento farmacoterapêutico. Métodos: Trata-se de um estudo clínico randomizado e quantitativo. A coleta de dados foi realizada durante seis meses. A randomização aleatória dividiu-se em Grupo Controle e Grupo Acompanhamento, sendo o acompanhamento subdividido: Antes e Após o Acompanhamento. O Grupo acompanhamento recebeu mensalmente intervenções farmacêuticas individuais. A adesão foi avaliada pelo Brief Medication Questionnair e Problemas Relacionados aos Medicamentos quanto Necessidade, Efetividade e Segurança. Resultados: Após acompanhamento farmacêutico observou-se diferença entre os grupos Grupo Acompanhamento e Grupo Controle quanto à prática de atividade física (p=0,043), adesão ao tratamento (p=0,006), redução de efeitos adversos (p=0,003) e doenças associadas (p=0,002). Os Problemas Relacionados a Medicamentos mais frequentes foram de segurança e adesão, para os quais foram realizadas 54 intervenções farmacêuticas. As reações adversas descritas pelas pacientes acometiam principalmente sistema genital e trato gastrintestinal. Conclusão: Evidenciou-se que o acompanhamento farmacoterapêutico contribuiu efetivamente na adesão ao tratamento com tamoxifeno e as intervenções farmacêuticas realizadas contribuíram para prevenção e redução dos problemas associados a farmacoterapia.(AU)

Background and objectives: Oral antineoplastic therapy has advantages compared to other therapies for the treatment of cancer, because it is administered at home, in a simple and fast, however, this therapy increases the responsibility of the patient regarding its treatment and adherence is critical to its effectiveness. There are few studies on pharmacotherapeutic monitoring in oral antineoplastic therapy. In this context, the present study aims to evaluate to adherence with tamoxifen in women with breast cancer, before and after of pharmaceutical care. Methods: It is a randomized and quantitative clinical study. Data collection was performed during six months. Random randomization was divided into Control Group and Monitoring Group. The follow-up was subdivided: Before and After Monitoring. The Monitoring Group received monthly individual pharmaceutical interventions. Adherence was assessed by the Brief Medication Questionnaire and Drug Related Problems as Need, Effectiveness, and Safety. Results: There was a significant difference between the follow-up group and control group regarding physical activity (p = 0.043), adherence to treatment (p = 0.006), reduction of adverse effects (p = 0.003) and associated diseases (p = 0.002). The most frequent drug-related problems were safety and adherence, for which 54 pharmaceutical interventions were performed. The adverse reactions described by the patients mainly affected the genital system and the gastrointestinal tract. Conclusion: It was evidence the pharmaceutical care effectively contributed to the adherence to tamoxifen treatment and the performed pharmaceutical interventions contributed to the prevention and reduction of the problems associated with phamacoterapy.(AU)

Justificación y objetivo: La terapia antineoplásica oral presenta ventajas comparadas a otras terapias para el tratamiento del cáncer, por ser administrada a domicilio, de forma simple y rápida, sin embargo, esta terapia aumenta la responsabilidad del paciente en relación a su tratamiento y la adhesión es fundamental para su eficacia. Se evidencian pocos estudios referentes al seguimiento farmacoterapéutico en la terapia antineoplásica oral, en ese contexto, el presente estudio busca evaluar la adhesión al tratamiento con tamoxifeno en mujeres con cáncer de mama, antes y después de seguimento farmacoterapéutico. Métodos: Se trata de un estudio clínico aleatorizado y cuantitativo. La recolección de datos se realizó durante seis meses. La aleatorización aleatoria se dividió en Grupo Control y Grupo Seguimiento, siendo el acompañamiento subdividido: Antes y Después del Acompañamiento. El Grupo de seguimiento recibió mensualmente intervenciones farmacéuticas individuales. La adhesión fue evaluada por el Brief Medication Questionnair y los problemas relacionados con los medicamentos como la necesidad, la eficacia y la seguridad. Resultados: Después del seguimiento farmacéutico se observó diferencia entre los grupos Grupo Acompañamiento y Grupo Control en cuanto a la práctica de actividad física (p = 0,043), adhesión al tratamiento (p = 0,006), reducción de efectos adversos (p = 0,003) y enfermidades asociadas (p = 0,003) p = 0,002). Los problemas relacionados con los medicamentos más frecuentes fueron de seguridad y adhesión, para los que se realizaron 54 intervenciones farmacéuticas. Las reacciones adversas descritas por las pacientes acometieron principalmente sistema genital y tracto gastrointestinal. Conclusión: Se evidenció que el seguimiento farmacoterapéutico contribuyó efectivamente a la adherencia al tratamiento con tamoxifeno y las intervenciones farmacéuticas realizadas contribuyeron a la prevención y reducción de los problemas asociados con la farmacoterapia.(AU)

Bovine Endometritis and the Inflammatory Peripheral Cholinergic System.

Endometritis is an inflammation of the endometrium associated with bacterial infection. The pathogenesis of endometritis in cows is still not completely understood. The combined analysis of the markers of inflammation and oxidative stress has contributed to a better understanding of disease mechanisms, but is still unexplored in uterine disorders. Moreover, research provides evidence about an important role of the vagus nerve in regulating the innate immune function through the cholinergic anti-inflammatory pathway in response to bacterial infections. This new pathway has demonstrated a critical role in controlling the inflammatory system. The aim of this study was to evaluate the activity of cholinesterase in total blood, lymphocytes, and serum of dairy cows with clinical and subclinical endometritis. Sixty-one Holstein cows, between 30 and 45 days in milk, were classified into 3 groups of animals: presenting clinical endometritis (n = 22), subclinical endometritis (n = 17), and healthy (n = 22). Mean leukocyte counts did not differ among groups, but the neutrophil number was significantly higher in cows with clinical endometritis than those in healthy animals. Also, serum concentration of interleukin-1beta (pg/mL) was significantly higher in cows with endometritis. The activity of acetylcholinesterase in blood and lymphocytes increased in both groups with endometritis. Animals with endometritis presented an increase in lipid peroxidation, but the antioxidant enzyme activity (catalase levels) was higher in endometritis groups than in normal cows. In conclusion, the inflammatory process of clinical and subclinical endometritis leads to systemic lipid peroxidation despite the compensatory increase of the antioxidant enzyme. These data also provide evidence of an important role of the cholinergic pathway in regulating dairy cows with clinical and subclinical endometritis.

Avaliação de resistência à insulina e fatores de risco para doenças cardiovasculares em pacientes com vitiligo / Evaluation of insulin resistance and risk factors for cardiovascular diseases in patients with vitiligo

Introdução: A relação entre doença cardiovascular, resistência à insulina e vitiligo tem sido avaliada em estudos. No entanto, ainda não há consenso sobre o assunto. Objetivos: Avaliar a relação entre resistência à insulina e vitiligo, além da prevalência de fatores de risco para doença cardiovascular em adultos com vitiligo quando comparados ao grupo controle. Métodos: Estudo transversal com grupo controle. Foi utilizada uma amostra de conveniência de pacientes consecutivos com 14 anos ou mais. Pacientes e controles foram investigados com exames laboratoriais e medidas antropométricas. Foram calculados os índices LAP, HOMA-IR, e HOMAß. Resultados: Foram incluídos 130 pacientes, 73 com diagnóstico de vitiligo e 57 controles. Não houve diferença significativa entre os grupos quando avaliadas as medidas do LAP, HOMA-IR, e HOMAß. Dentre os fatores de risco para doença cardiovascular, a pressão arterial sistólica foi significativamente maior nos pacientes com vitiligo. Conclusões: Não foi observada maior prevalência de resistência à insulina entre pacientes com vitiligo. Quanto aos fatores de risco para doenças cardiovasculares, apenas a pressão arterial sistólica foi maior nos pacientes com vitiligo. Novos estudos são necessários para elucidar a prevalência de resistência à insulina e fatores de risco cardiovascular em pacientes com vitiligo.

Introduction: The relationship between cardiovascular disease, insulin resistance and vitiligo has been evaluated in studies. However, there is still no consensus on the subject. Objectives: To evaluate the relationship between insulin resistance and vitiligo, in addition to the prevalence of risk factors for cardiovascular disease, in adults with vitiligo when compared to the control group. Methods: Cross-sectional study with a control group. A convenience sample of consecutive patients aged 14 years and over was used. Patients and controls were assessed with laboratory tests and anthropometric measurements. The LAP, HOMA-IR, and HOMAß indices were calculated. Results: We included 130 patients, 73 with a diagnosis of vitiligo and 57 controls. There were no significant differences between groups when LAP, HOMA-IR, and HOMAß were evaluated. Among the risk factors for cardiovascular disease, systolic blood pressure was significantly higher in patients with vitiligo. Conclusions: There was no higher prevalence of insulin resistance among patients with vitiligo. Regarding the risk factors for cardiovascular diseases, only systolic blood pressure was higher in patients with vitiligo. Further studies are needed to elucidate the prevalence of insulin resistance and cardiovascular risk factors in patients with vitiligo.

Sintomas de estresse em familiares de pacientes adultos em terapia intensiva / Stress symptoms in relatives of adult patients undergoing intensive therapy

Correlacionar sintomas físicos e psicológicos das fases de estresse identificadas em familiares de pacientes internados em Unidade de Terapia Intensiva Adulto. Estudo quantitativo, transversal, analítico, realizado em um hospital geral do Rio Grande do Sul. A amostra foi composta por 22 familiares e para coleta de dados foi utilizado formulário sociodemográfico e Inventário de Sintomas de Estresse. Constatou-se que 45,5% dos participantes da pesquisa encontravam-se na fase final e 40,9% na intermediária. Houve correlação estatisticamente significante entre número de sintomas fisiológicos e psicológicos presentes nas diferentes fases. O reconhecimento de sintomas de exaustão em familiares de pacientes em terapia intensiva pelo enfermeiro é importante aliado às estratégias de enfrentamento adequadas, que incluem acolhimento, instrumentalização, orientação e apoio aos familiares neste período.

Current qualitative, transversal and analytic study corelates physical and psychological symptoms of stress phases identified in relatives of hospitalized patients in ITUs in a general hospital in the state of Rio Grande do Sul, Brazil. The samples comprised 22 relatives. A socio-demographic form and the Stress Symptoms Inventory were employed for data collection. Data show that 45.5% of participants in research were in the final phase and 40.9% in the intermediate phase. There was a statistically significant co-relationship between the number of physiological and psychological symptoms in the different phases. Acknowledgement of exhaustion in relatives of patients in ITUs by nurses is important, coupled to adequate coping strategies. These include welcome, instrumentalization, guidance and help to relatives during the period.

Obesity, bariatric surgery and oxidative stress.

INTRODUCTION:: Obesity refers to the accumulation of fatty tissues and it favors the occurrence of oxidative stress. Alternatives that can contribute to body weight reduction have been investigated in order to reduce the production of reactive oxygen species responsible for tissue damage. The aim of the current study was to assess whether the oxidant and antioxidant markers of obese women before and after bariatric surgery were able to reduce oxidative damage. METHOD:: We have assessed 16 morbidly obese women five days before and 180 days after the surgery. The control group comprised 16 non-obese women. Levels of thiobarbituric acid-reactive substances, carbonylated proteins, reduced glutathione and ascorbic acid were assessed in the patients' plasma. RESULTS:: Levels of lipid peroxidation and protein carbonylation in the pre-surgical obese women were higher than those of the controls and post-surgical obese women. Levels of reduced glutathione in the pre-surgical obese women were high compared to the controls, and declined after surgery. Levels of ascorbic acid fell in the pre--surgical obese women compared to the control and post-surgical obese women. CONCLUSION:: Body weight influences the production of reactive oxygen species. Bariatric surgery, combined with weight loss and vitamin supplementation, reduces cellular oxidation, thus reducing tissue damage.

Obesity, bariatric surgery and oxidative stress / Obesidade, cirurgia bariátrica e estresse oxidativo

Summary Introduction: Obesity refers to the accumulation of fatty tissues and it favors the occurrence of oxidative stress. Alternatives that can contribute to body weight reduction have been investigated in order to reduce the production of reactive oxygen species responsible for tissue damage. The aim of the current study was to assess whether the oxidant and antioxidant markers of obese women before and after bariatric surgery were able to reduce oxidative damage. Method: We have assessed 16 morbidly obese women five days before and 180 days after the surgery. The control group comprised 16 non-obese women. Levels of thiobarbituric acid-reactive substances, carbonylated proteins, reduced glutathione and ascorbic acid were assessed in the patients' plasma. Results: Levels of lipid peroxidation and protein carbonylation in the pre-surgical obese women were higher than those of the controls and post-surgical obese women. Levels of reduced glutathione in the pre-surgical obese women were high compared to the controls, and declined after surgery. Levels of ascorbic acid fell in the pre--surgical obese women compared to the control and post-surgical obese women. Conclusion: Body weight influences the production of reactive oxygen species. Bariatric surgery, combined with weight loss and vitamin supplementation, reduces cellular oxidation, thus reducing tissue damage.

Resumo Introdução: Na obesidade, verifica-se um acúmulo de tecido adiposo, o que favorece a ocorrência de estresse oxidativo. A fim de diminuir a produção das espécies reativas que levam a danos teciduais, buscam-se alternativas que contribuam para a redução do peso corporal. Este estudo avaliou se os marcadores oxidantes e antioxidantes de obesas antes e após cirurgia bariátrica reduziram o dano oxidativo. Método: Foram avaliadas 16 mulheres obesas mórbidas cinco dias antes e 180 dias após o procedimento cirúrgico. O grupo controle constituiu-se de 16 mulheres não obesas. Os níveis das substâncias reativas ao ácido tiobarbitúrico, das proteínas carboniladas, da glutationa reduzida e do ácido ascórbico foram avaliados no plasma dessas pacientes. Resultados: Os níveis de lipoperoxidação e da carbonilação de proteínas nas obesas pré-cirúrgicas eram mais elevados quando comparados ao controle e às obesas pós-cirúrgicas; os níveis de glutationa reduzida eram maiores nas obesas pré-cirúrgicas em comparação ao controle e diminuíram após a cirurgia; os níveis de ácido ascórbico eram menores nas obesas pré-cirúrgicas em relação ao controle e às obesas pós-cirúrgicas. Conclusão: Observou-se que a massa corporal influenciou na produção das espécies reativas. A cirurgia bariátrica, somada à perda de peso e à suplementação vitamínica, diminui a oxidação celular e, com isso, reduz os danos teciduais.

Triphenyltin hydroxide induces changes in the oxidative stress parameters of fish.

Among all organotin compounds , triphenyltin hydroxide (TPhTH) is widely used as fungicide and moluscicide in Brazil. However, the effects of TPhTH on the biochemical parameters of non-target organisms, such as fish, are little known. The aim of the present study is to assess the possible toxic effects of different concentrations of waterborne TPhTH on silver catfish belonging to species Rhamdia quelen. The fish were exposed to two different concentrations of TPhTH (1.08 and 1.70 µg/L as Sn) for 15 days and then compared to the control group (triplicate, n = 3). The antioxidant profile (catalase (CAT) and the glutathione S-transferase (GST)) and the oxidative stress parameters (TBARS-thiobarbituric acid-reactive substances and protein carbonyl (PC)) were set after the exposure to TPhTH. The TBARS level and the PC content increased in several organs of the Rhamdia quelen (brain, liver, muscle and gills) under the two concentrations of TPhTH in comparison to the control group. The CAT activity in the liver and gills has enhanced in all tested TPhTH concentrations. The GST activity increased in the brain, liver and muscle tissues under all the TPhTH concentrations. The significant changes in the biomarkers indicated that the investigated pesticide could have harmful effect on fish, in the field. However, these biomarkers were measured after the fish received doses lower than the recommended for use in agriculture.

Quality of Life Impairment in Children and Adults with Vitiligo: A Cross-Sectional Study Based on Dermatology-Specific and Disease-Specific Quality of Life Instruments.

BACKGROUND: Vitiligo can negatively affect a patient's quality of life (QoL). A specific questionnaire has been developed and validated in the English language: the vitiligo-specific quality-of-life instrument (VitiQoL). The instrument was translated, culturally adapted and validated into Brazilian Portuguese (VitiQoL-PB). OBJECTIVE: The aim of this study was to assess the QoL in adult patients through the VitiQoL and Dermatology Life Quality Index (DLQI) and in pediatric patients through the Children's Dermatology Life Quality Index (CDLQI) in a sample of patients with vitiligo. METHODS: Subjects were selected from a dermatological outpatient clinic and from a private practice in Porto Alegre. The QoL of pediatric patients was evaluated using the CDLQI questionnaire. In adult patients we used the VitiQoL-PB and the DLQI. RESULTS: A strong correlation between the scores of the total VitiQoL and DLQI was observed (r = 0.81; p < 0.001). The factor that most contributed to the final score of VitiQoL was stigma. In our sample, women had higher scores than men (p < 0.05). Psychiatric problems were associated with lower QoL. In the pediatric population, the median score of the CDLQI was 3 (interquartile range 1.3-7.3). There was a statistically significant correlation between the child's age and the CDLQI score (rs = 0.41, p = 0.044). CONCLUSION: This study confirms that the VitiQoL is easy to administer and adds important information about the impact of vitiligo on a South American population. Stigmatization is very present in the disease. There are groups of patients that are more vulnerable, like women, patients with psychiatric diseases and adolescents.

Translation, cultural adaptation and validation for Brazilian Portuguese of the Cardiff Acne Disability Index instrument.

BACKGROUND: The Cardiff Acne Disability Index was originally developed in English for measuring quality of life of acne patients. Considering the psychosocial impact of this disease, it is important to have instruments culturally and linguistically validated for use in Brazilian adolescents. OBJECTIVE: To translate the Cardiff Acne Disability Index into Brazilian Portuguese, culturally adapt it, and verify its reliability and validity in adolescent patients with acne. METHODS: In the first step, the Cardiff Acne Disability Index was translated and validated linguistically to Brazilian Portuguese in accordance with international guidelines published. In the second step, the validation of the Cardiff Acne Disability Index into Brazilian Portuguese instrument was performed, when patients aged from 12 to 20 years with acne were selected. The participants were interviewed to collect demographic data, submitted to the classification of acne by the Global Acne Grading System and invited to respond the Cardiff Acne Disability Index into Brazilian Portuguese version and DLQI (>16 years) or CDLQI (≤16 years). The internal consistency of Cardiff Acne Disability Index into Brazilian Portuguese was assessed by Cronbach's alpha coefficient and concurrent validity was measured by the Spearman correlation coefficient and Student 's t-test for paired samples. RESULTS: The study included 100 adolescents. The Cardiff Acne Disability Index into Brazilian Portuguese version showed good reliability and internal consistency (Cronbach's alpha = 0.73). The concurrent validity of the scale was supported by a strong and significant correlation with CDLQI / DLQI instruments (rs=0.802;p<0.001). CONCLUSIONS: Cardiff Acne Disability Index into Brazilian Portuguese version is a reliable, valid and valuable tool to measure the impact of acne on quality of life in adolescent patients.

Role of ambulatory blood pressure monitoring in patients with acromegaly.

BACKGROUND: Hypertension is associated with increased cardiovascular deaths in patients with acromegaly. OBJECTIVE: To evaluate the accuracy of blood pressure (BP) by 24-h ambulatory blood pressure monitoring (ABPM) and office BP measurements to represent the real BP status in acromegalic patients and its relationship with acromegalic activity and echocardiogram parameters. PATIENTS AND METHODS: Cohort of 37 patients with acromegaly in a tertiary endocrine outpatient service. RESULTS: Twenty-three percent of the patients were considered hypertensive by ABPM versus 32% by office BP measurements (P = 0.006). BP obtained from the ABPM was associated with growth hormone, insulin-like growth factor type 1 levels and echocardiogram parameters of acromegalic myocardiopathy. Nondipper behavior presented a significant association with the hormonal profile. CONCLUSION: BP levels assessed by ABPM were associated with acromegalic activity and echocardiogram parameters. ABPM can correctly identify BP levels and their repercussion on acromegalic patients.

Translation, cultural adaptation and validation for Brazilian Portuguese of the Cardiff Acne Disability Index instrument

Abstract BACKGROUND: The Cardiff Acne Disability Index was originally developed in English for measuring quality of life of acne patients. Considering the psychosocial impact of this disease, it is important to have instruments culturally and linguistically validated for use in Brazilian adolescents. OBJECTIVE: To translate the Cardiff Acne Disability Index into Brazilian Portuguese, culturally adapt it, and verify its reliability and validity in adolescent patients with acne. METHODS: In the first step, the Cardiff Acne Disability Index was translated and validated linguistically to Brazilian Portuguese in accordance with international guidelines published. In the second step, the validation of the Cardiff Acne Disability Index into Brazilian Portuguese instrument was performed, when patients aged from 12 to 20 years with acne were selected. The participants were interviewed to collect demographic data, submitted to the classification of acne by the Global Acne Grading System and invited to respond the Cardiff Acne Disability Index into Brazilian Portuguese version and DLQI (>16 years) or CDLQI (≤16 years). The internal consistency of Cardiff Acne Disability Index into Brazilian Portuguese was assessed by Cronbach’s alpha coefficient and concurrent validity was measured by the Spearman correlation coefficient and Student ‘s t-test for paired samples. RESULTS: The study included 100 adolescents. The Cardiff Acne Disability Index into Brazilian Portuguese version showed good reliability and internal consistency (Cronbach’s alpha = 0.73). The concurrent validity of the scale was supported by a strong and significant correlation with CDLQI / DLQI instruments (rs=0.802;p<0.001). CONCLUSIONS: Cardiff Acne Disability Index into Brazilian Portuguese version is a reliable, valid and valuable tool to measure the impact of acne on quality of life in adolescent patients.

Translation, cross-cultural adaptation and validation of the vitiligo-specific health-related quality of life instrument (VitiQoL) into Brazilian Portuguese.

BACKGROUND: Vitiligo, although asymptomatic, highly compromises patients' quality of life (QoL). Therefore, an adequate evaluation of QoL is essential. OBJECTIVES: Translation, cultural adaptation and validation of VitiQol (Vitiligo-specific health-related quality of life instrument) into Brazilian Portuguese. METHODS: The study was conducted in two stages; the first stage was the translation and cultural/linguistic adaptation of the instrument; the second stage was the instrument's validation. RESULTS: The translated VitiQol showed high internal consistency (Cronbach alpha = 0.944) and high test-retest reliability and intraclass correlation coefficient=0.95 (CI 95% 0.86 - 0.98), p<0.001. There was no statistically significant difference between the means of the first completion of the VitiQoL questionnaire and the retest, p = 0.661. There was a significant correlation between VitiQoL and DLQI (r = 0.776, p <0.001) and also between VitiQoL-PB and subjects' assessment of the severity of their disease (r = 0.702, p <0.001). CONCLUSIONS: The impact of vitiligo on the QoL of Brazilian patients can be assessed by a specific questionnaire.

Alterações bioquímicas e toxicológicas de agricultores familiares da região do Alto Jacuí, Rio Grande do Sul / Biochemical and toxicological changes among family farmers from the Alto Jacui region, Rio Grande do Sul state, Brazil

Objetivos: Avaliar possíveis alterações de marcadores bioquímicos e toxicológicos oriundas da exposição aos agroquímicos em trabalhadores rurais da região do Conselho Regional de Desenvolvimento Alto Jacuí, no Rio Grande do Sul. Métodos: Foram incluídos agricultores que tinham contato com pesticidas há mais de cinco anos e um grupo de indivíduos saudáveis, não expostos a agrotóxicos, recrutados na comunidade. Os agricultores foram submetidos a provas de função hepática e renal e atividade da enzima butirilcolinesterase. Foram ainda determinados os níveis de substâncias reativas ao ácido tiobarbitúrico (TBARS), proteínas carboniladas (PCs) e glutationa reduzida (GSH), sendo os resultados destes parâmetros de estresse oxidativo comparados entre o grupo de agricultores expostos aos agrotóxicos e o grupo controle. Resultados: Participaram do estudo 106 agricultores com exposição a pesticidas e 103 indivíduos saudáveis, sem contato com agrotóxicos. Os valores obtidos para os parâmetros hepáticos e renais avaliados encontravam-se normais, enquanto a atividade da butirilcolinesterase estava diminuída. Os níveis plasmáticos dos parâmetros de estresse oxidativo dos agricultores estavam aumentados em relação ao grupo controle: TBARS 9,51 vs. 6,719 nmol MDA/mL (p=0,0422); PCs 11,78 vs. 9,23 nmol carbonil/mg proteína (p=0,0337); GSH 0,7180 vs. 0,3649 µmol GSH/mL (p<0,0001). Verificou-se que 51,62% dos agricultores utilizavam equipamentos de proteção individual, 8,06 % faziam uso eventual e 40,32 % não faziam uso de nenhum tipo de proteção. Conclusões: Os trabalhadores rurais avaliados apresentaram alterações que indicam estresse oxidativo, evidenciando a importância do monitoramento das condições de saúde dos mesmos, bem como do incentivo à utilização de equipamentos de proteção individual.

Aims: To evaluate possible changes in biochemical and toxicological markers in rural workers exposed to pesticides in the Alto Jacui region, Rio Grande do Sul, Brazil. Methods: The study included 106 farmworkers exposed to pesticides for over five years and 103 healthy individuals, not exposed to pesticides, selected from the community. The farmworkers were submitted to liver and kidney function tests and to butyrylcholinesterase measurements. The levels of thiobarbituric acid reactive substances (TBARS), protein carbonyls (PCs), and reduced glutathione (GSH) were also determined, and the results of these oxidative stress parameters were compared with the group of pesticide-exposed farmworkers and the control group. Results: The evaluated hepatic and renal parameters were within the reference values whereas butyrylcholinesterase activity was found to be low. The plasma levels of oxidative stress parameters in exposed farmworkers were higher than in the control group: TBARS 9.51 vs. 6.179 nmol MDA/mL (p=0.0422); PCs 11.78 vs. 9.23 nmol carbonyl/mg protein (p.0.0337); GSH 0.7180 vs. 0.3649 µmol GSH/mL (p<0.0001). Personal protective equipment was worn by 51.62% of the farmworkers, but 8.06% wore it occasionally, and 40.32% did not wear any protective clothing or gear. Conclusions: Rural workers presented changes that indicate oxidative stress, thus highlighting the importance of monitoring their health conditions, as well as encouraging the use of personal protective equipment.

Translation, cross-cultural adaptation and validation of the vitiligo-specifi c health-related quality of life instrument (VitiQoL) into Brazilian Portuguese

Abstract BACKGROUND: Vitiligo, although asymptomatic, highly compromises patients' quality of life (QoL). Therefore, an adequate evaluation of QoL is essential. OBJECTIVES: Translation, cultural adaptation and validation of VitiQol (Vitiligo-specific health-related quality of life instrument) into Brazilian Portuguese. METHODS: The study was conducted in two stages; the first stage was the translation and cultural/linguistic adaptation of the instrument; the second stage was the instrument's validation. RESULTS: The translated VitiQol showed high internal consistency (Cronbach alpha = 0.944) and high test-retest reliability and intraclass correlation coefficient=0.95 (CI 95% 0.86 - 0.98), p<0.001. There was no statistically significant difference between the means of the first completion of the VitiQoL questionnaire and the retest, p = 0.661. There was a significant correlation between VitiQoL and DLQI (r = 0.776, p <0.001) and also between VitiQoL-PB and subjects' assessment of the severity of their disease (r = 0.702, p <0.001). CONCLUSIONS: The impact of vitiligo on the QoL of Brazilian patients can be assessed by a specific questionnaire. .

Changes in oxidative markers, endogenous antioxidants and activity of the enzyme acetylcholinesterase in farmers exposed to agricultural pesticides - a pilot study / Alterações em marcadores oxidativos, antioxidantes endógenos e na atividade da enzima acetilcolinesterase em trabalhadores rurais expostos a pesticidas agrícolas - um estudo piloto

Agricultural practices are directly related to the use of pesticides, which indiscriminately and without due care may contribute to the occurrence of numerous intoxications. Several studies have demonstrated the relationship of certain pesticides and the occurrence of oxidative stress and therefore, in recent years have developed methods of analysis of several biomarkers of cellular damage that can be measured and quantified. In this context, the objective of this study was to evaluate the possible changes in biochemical markers: glutamic aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, urea, total protein, and oxidative markers such as lipid peroxidation, damage to proteins and the activity of the enzymes acetylcholinesterase (AChE) and catalase (CAT) in farmers exposed to different pesticides for at least five years from Ibirubá - RS city. With the exception of AST and ALT, the results showed a significant difference between the mean total protein, urea and creatinine in the control group, showing that no changes in liver or kidney function of rural workers. In the oxidative parameters, there was a decrease in AChE activity and CAT in the control group; there were an increase in protein carbonyl and a decreased on TBARS compared to control group. Therefore, the results demonstrated a change in oxidative status of rural workers compared with the control group, mainly by possible inhibition of AChE activity and the occurrence of oxidative stress without showing changes in biochemical parameters.

As práticas agrícolas estão diretamente relacionadas com o uso de agrotóxico, que, de forma indiscriminada e sem o devido cuidado, podem contribuir para a ocorrência de inúmeras intoxicações. Diversos estudos demonstraram a relação de determinados pesticidas e a ocorrência do estresse oxidativo e, portanto, nos anos recentes, tem-se desenvolvido métodos de análise de diversos biomarcadores de dano celular, o qual pode ser medido e quantificado. Nesse contexto, o objetivo deste estudo foi avaliar as possíveis alterações nos marcadores bioquímicos: aspartato aminotransferase (AST), alanina aminotransferase (ALT), creatinina, ureia, proteína total, e marcadores oxidativos como: a peroxidação de lipídios, danos nas proteínas e a atividade das enzimas acetilcolinesterase (AChE) e catalase (CAT), em agricultores da cidade de Ibirubá, RS, expostos a diferentes agrotóxicos por pelo menos cinco anos. Com exceção da AST e da ALT, os resultados mostraram diferença significativa entre as médias das proteínas totais, ureia e creatinina, no grupo controle, mostrando que não houve alterações na função hepática ou renal dos trabalhadores rurais. Nos parâmetros oxidativos avaliados, houve uma diminuição da atividade da AChE e da CAT em relação ao grupo controle; um aumento das proteínas carboniladas e uma diminuição dos níveis de TBARS em relação ao grupo controle. Portanto, os resultados demonstram uma alteração oxidativa nos trabalhadores rurais, comparados com o grupo controle, principalmente pela possível inibição da AChE e ocorrência do estresse oxidativo, sem demonstrar mudança nos parâmetros bioquímicos analisados.

Valorização do adequado preenchimento do prontuário eletrônico do cidadão na ESF Ernesto Araújo

A adequada documentação do histórico do paciente no prontuário, pelos profissionais de saúde, respeita um dos princípios principais da Atenção Básica de Saúde: a Longitudinalidade. A informatização do prontuário através do PEC (prontuário eletrônico do cidadão), com a criação do sistema E-SUS AB, veio contribuir com esse princípio de forma muito importante, à medida que garante uma documentação segura, sem riscos de perda, totalmente legível, de fácil acesso a qualquer profissional de saúde da equipe, com maior capacidade de armazenamento, entre outras vantagens. Este trabalho trata-se de um estudo clínico Intervencional, cujo objetivo geral é garantir documentação integral do histórico dos pacientes da equipe 3 da ESF Ernesto Araújo, que se encontram em cuidado continuado, no Prontuário Eletrônico do Cidadão (PEC).