Análise do programa de controle de hipertensão arterial em Unidade Básica de Saúde da Família de São José do Rio Preto / Analysis of the arterial hypertension control program in a family health careunit of Sao Jose do Rio Preto

O Programa Saúde da Família (PSF) tem sua atenção centrada na família, a partir de seu ambiente, com a equipe multiprofissional atuando além das práticas curativas e prestando assistência integral. No PSF insere-se o programa de controle da Hipertensão Arterial Sistêmica (HAS) que é desenvolvido, principalmente,através de ações educativas. Este estudo teve como objetivo analisar a opinião dos pacientes participantes do programa de HAS e a atuação da equipe de saúde envolvida no mesmo, em uma Unidade Básica de Saúde da Família (UBSF) no município de São José do Rio Preto. A pesquisa é do tipo descritivo exploratória, realizada no período de março a outubro de 2006, através de entrevistas. A amostra foi composta de 30 pacientes e 4 profissionais de saúde e os dados foram analisados por estatística descritiva. A população estudada era, em sua maioria, do sexo feminino (76,67%); com idade entre 56 e 65 anos (26,70%); com ensino fundamental incompleto (90%); 75% já se internou devido à crise hipertensiva e 85% praticavam caminhada como exercício físico. Dos pacientes 46,67% relataram que após freqüentarem o grupo, aprenderam a controlara pressão arterial; 60% afirmaram que seus conhecimentos sobre o tema aumentaram, após participar das reuniões e 13,33% gostariam de obter mais informações sobre exames, medicamentos e dieta. Sobre a equipede saúde, os agentes comunitários relataram que os hipertensos começaram a seguir as orientações passadas, sendo observados pela auxiliar de enfermagem responsável pela coordenação do grupo. A enfermeira que realiza visitas domiciliares e consultas de enfermagem, refere aumento da motivação dos pacientes comconseqüente melhora da sua qualidade de vida. Portanto, ações educativas são fundamentais na adesão ao tratamento da HAS, com necessidade de participação dos pacientes e profissionais de saúde, para que haja conscientização e mudanças nos hábitos de vida

The Family Healthcare Program has its attention centered on the family, starting with its environment, whichincludes a multiprofessional team whose work goes beyond simple healing practices providing integralassistance. In the Family Healthcare Program, an arterial hypertension control program is included, anddeveloped, mainly through educational actions. This study aimed at analyzing the patients´ opinion on theirparticipation of arterial hypertension program as well as the health team´s performance in that Family HealthcareUnit, in the city of Sao Jose do Rio Preto. This was a descriptive study, exploratory nature; some interviewswere used, and it was accomplished between March and October 2006. The sample group comprised 30patients and 4 healthcare professionals. Data were analyzed using descriptive statistics. The majority of thestudied population was female (76.67%); the ages ranged from 56-65 years (26.70%); with incompleteelementary school (90%); 75% had already been hospitalized due to hypertensive crisis and 85% practicedwalk as physical exercise. Out of the patients, 46.67% reported that after participating in the group, theylearned to control arterial pressure; 60% claimed that their knowledge on the subject increased after participatingin the meetings and 13.33% would like to obtain more information about tests, medications and diet. Concerningthe healthcare team, the communitary agents reported changes in the lives of the hypertensive patients, thesame being observed by the auxiliary nurse responsible for the organization of the group. The nurse, who hasbeen performing visits at home and nursing consultations, reported an increase in the patients´s motivationwith consequent improvement in their quality of life. Therefore, educational actions are fundamental inadhesion to the treatment of arterial hypertension. The participation of patients and healthcare professionalsis necessary to achieve awareness and some changes in the patients´ lifestyle

Estrogen effects on thyroid iodide uptake and thyroperoxidase activity in normal and ovariectomized rats.

Sex steroids interfere with the pituitary-thyroid axis function, although the reports have been controversial and no conclusive data is available. Some previous reports indicate that estradiol might also regulate thyroid function through a direct action on the thyrocytes. In this report, we examined the effects of low and high doses of estradiol administered to control and ovariectomized adult female rats and to pre-pubertal females. We demonstrate that estradiol administration to both intact adult and pre-pubertal females causes a significant increase in the relative thyroid weight. Serum T3 is significantly decreased in ovariectomized rats, and is normalized by estrogen replacement. Neither doses of estrogen produced a significant change in serum TSH and total T4 in ovariectomized, adult intact and pre-pubertal rats. The highest, supraphysiological, estradiol dose produced a significant increase in thyroid iodide uptake in ovariectomized and in pre-pubertal rats, but not in control adult females. Thyroperoxidase activity was significantly higher in intact adult rats treated with both estradiol doses and in ovariectomized rats treated with the highest estradiol dose. Since serum TSH levels were not significantly changed, we suggest a direct action of estradiol on the thyroid gland, which depends on the age and on the previous gonad status of the animal.

Rapid regulation of thyroid sodium-iodide symporter activity by thyrotrophin and iodine.

Transport of iodide into thyrocytes, a fundamental step in thyroid hormone biosynthesis, depends on the presence of the sodium-iodide symporter (NIS). The importance of the NIS for diagnosis and treatment of diseases has raised several questions about its physiological control. The goal of this study was to evaluate the influence of thyroid iodine content on NIS regulation by thyrotrophin (TSH) in vivo. We showed that 15-min thyroid radioiodine uptake can be a reliable measurement of NIS activity in vivo. The effect of TSH on the NIS was evaluated in rats treated with 1-methyl-2-mercaptoimidazole (MMI; hypothyroid with high serum TSH concentrations) for 21 days, and after 1 (R1d), 2 (R2d), or 5 (R5d) days of withdrawal of MMI. NIS activity was significantly greater in both MMI and R1d rats. In R2d and R5d groups, thyroid iodide uptake returned to normal values, despite continuing high serum TSH, possibly as a result of the re-establishment of iodine organification after withdrawal of MMI. Excess iodine (0.05% NaI for 6 days) promoted a significant reduction in thyroid radioiodide uptake, an effect that was blocked by concomitant administration of MMI, confirming previous findings that iodine organification is essential for the iodide transport blockade seen during iodine overload. Therefore, our data show that modulation of the thyroid NIS by TSH depends primarily on thyroid iodine content and, further, that the regulation of NIS activity is rapid.