Characterization of hepatic fatty acids using magnetic resonance spectroscopy for the assessment of treatment response to metformin in an eNOS-/- mouse model of metabolic nonalcoholic fatty liver disease/nonalcoholic steatohepatitis.

Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide. Liver biopsy remains the gold standard for diagnosis and staging of disease. There is a clinical need for noninvasive diagnostic tools for risk stratification, follow-up, and monitoring treatment response that are currently lacking, as well as preclinical models that recapitulate the etiology of the human condition. We have characterized the progression of NAFLD in eNOS-/- mice fed a high fat diet (HFD) using noninvasive Dixon-based magnetic resonance imaging and single voxel STEAM spectroscopy-based protocols to measure liver fat fraction at 3 T. After 8 weeks of diet intervention, eNOS-/- mice exhibited significant accumulation of intra-abdominal and liver fat compared with control mice. Liver fat fraction measured by 1 H-MRS in vivo showed a good correlation with the NAFLD activity score measured by histology. Treatment of HFD-fed NOS3-/- mice with metformin showed significantly reduced liver fat fraction and altered hepatic lipidomic profile compared with untreated mice. Our results show the potential of in vivo liver MRI and 1 H-MRS to noninvasively diagnose and stage the progression of NAFLD and to monitor treatment response in an eNOS-/- murine model that represents the classic NAFLD phenotype associated with metabolic syndrome.

Assessment of hepatic fatty acids during non-alcoholic steatohepatitis progression using magnetic resonance spectroscopy.

INTRODUCTION AND OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver abnormalities including steatosis, steatohepatitis, fibrosis, and cirrhosis. Liver biopsy remains the gold standard method to determine the disease stage in NAFLD but is an invasive and risky procedure. Studies have previously reported that changes in intrahepatic fatty acids (FA) composition are related to the progression of NAFLD, mainly in its early stages. The aim of this study was to characterize the liver FA composition in mice fed a Choline-deficient L-amino-defined (CDAA) diet at different stages of NAFLD using magnetic resonance spectroscopy (MRS). METHODS: We used in-vivo MRS to perform a longitudinal characterization of hepatic FA changes in NAFLD mice for 10 weeks. We validated our findings with ex-vivo MRS, gas chromatography-mass spectrometry and histology. RESULTS: In-vivo and ex-vivo results showed that livers from CDAA-fed mice exhibit a significant increase in liver FA content as well as a change in FA composition compared with control mice. After 4 weeks of CDAA diet, a decrease in polyunsaturated and an increase in monounsaturated FA were observed. These changes were associated with the appearance of early stages of steatohepatitis, confirmed by histology (NAFLD Activity Score (NAS) = 4.5). After 10 weeks of CDAA-diet, the liver FA composition remained stable while the NAS increased further to 6 showing a combination of early and late stages of steatohepatitis. CONCLUSION: Our results suggest that monitoring lipid composition in addition to total water/fat with MRS may yield additional insights that can be translated for non-invasive stratification of high-risk NAFLD patients.

Metabolite cycled liver 1 H MRS on a 7 T parallel transmit system.

INTRODUCTION: Single-voxel 1 H MRS in body applications often suffers from respiratory and other motion induced phase and frequency shifts, which lead to incoherent averaging and hence to suboptimal results. METHODS: Here we show the application of metabolite cycling (MC) for liver STEAM-localized 1 H MRS on a 7 T parallel transmit system, using eight transmit-receive fractionated dipole antennas with 16 additional, integrated receive loops. MC-STEAM measurements were made in six healthy, lean subjects and compared with STEAM measurements using VAPOR water suppression. Measurements were performed during free breathing and during synchronized breathing, for which the subjects did breathe in between the MRS acquisitions. Both intra-session repeatability and inter-session reproducibility of liver lipid quantification with MC-STEAM and VAPOR-STEAM were determined. RESULTS: The preserved water signal in MC-STEAM allowed for robust phase and frequency correction of individual acquisitions before averaging, which resulted in in vivo liver spectra that were of equal quality when measurements were made with free breathing or synchronized breathing. Intra-session repeatability and inter-session reproducibility of liver lipid quantification were better for MC-STEAM than for VAPOR-STEAM. This may also be explained by the more robust phase and frequency correction of the individual MC-STEAM acquisitions as compared with the VAPOR-STEAM acquisitions, for which the low-signal-to-noise ratio lipid signals had to be used for the corrections. CONCLUSION: Non-water-suppressed MC-STEAM on a 7 T system with parallel transmit is a promising approach for 1 H MRS applications in the body that are affected by motion, such as in the liver, and yields better repeatability and reproducibility compared with water-suppressed measurements.

Brown Algae Padina sanctae-crucis Børgesen: A Potential Nutraceutical.

Padina sanctae-crucis Børgesen is distributed worldwide in tropical and subtropical seas; belongs to the Dictyotaceae family, and has proven to be an exceptional source of biologically active compounds. Four compounds were isolated and identified, namely: dolastane diterpene new for the genus Padina; phaeophytin and hidroxy-phaeophytin new for the family Dictyotaceae, and; mannitol first described in this species. Saturated fatty acids as compared to the percentages of unsaturated fatty acids were shown to be present in greater abundance. Palmitic and linolenic acid were the main saturated and unsaturated acids, respectively. Cytotoxic and antioxidant activities were evaluated using human erythrocytes. In vivo evaluations of acute toxicity and genotoxicity were performed in mice. Methanolic extract of P.sanctae-crucis presented antioxidant activity and did not induce cytotoxicity, genotoxicity or acute toxicity. Since Padina sanctae-crucis is already used as food, has essential fatty acids for the nutrition of mammals, does not present toxicity and has antioxidant activity, it can be considered as a potential nutraceutical.

Toxicity and antitumor potential of Mesosphaerum sidifolium (Lamiaceae) oil and fenchone, its major component.

BACKGROUND: The essential oil from Mesosphaerum sidifolium (L'Hérit.) Harley & J.F.B.Pastore (syn. Hyptis umbrosa), Lamiaceae (EOM), and its major component, have been tested for toxicity and antitumor activity. METHODS: EOM was obtained from aerial parts of M. sidifolium subjected to hydro distillation, and gas chromatography-mass spectrometry was used to characterize the EOM chemical composition. The toxicity was evaluated using haemolysis assay, and acute toxicity and micronucleus tests. Ehrlich ascites carcinoma model was used to evaluate the in vivo antitumor activity and toxicity of EOM (50, 100 and 150 mg/kg), and fenchone (30 and 60 mg/kg) after 9 d of treatment. RESULTS: The EOM major components were fenchone (24.8%), cubebol (6.9%), limonene (5.4%), spathulenol (4.5%), ß-caryophyllene (4.6%) and α-cadinol (4.7%). The HC50 (concentration producing 50% haemolysis) was 494.9 µg/mL for EOM and higher than 3000 µg/mL for fenchone. The LD50 for EOM was approximately 500 mg/kg in mice. The essential oil induced increase of micronucleated erythrocytes only at 300 mg/kg, suggesting moderate genotoxicity. EOM (100 or 150 mg/kg) and fenchone (60 mg/kg) reduced all analyzed parameters (tumor volume and mass, and total viable cancer cells). Survival also increased for the treated animals with EOM and fenchone. For EOM 150 mg/kg and 5-FU treatment, most cells were arrested in the G0/G1 phase, whereas for fenchone, cells arrested in the S phase, which represents a blockage in cell cycle progression. Regarding the toxicological evaluation, EOM induced weight loss, but did not induce hematological, biochemical or histological (liver and kidneys) toxicity. Fenchone induced decrease of AST and ALT, suggesting liver damage. CONCLUSIONS: The data showed EOM caused in vivo cell growth inhibition on Ehrlich ascites carcinoma model by inducing cell cycle arrest, without major changes in the toxicity parameters evaluated. In addition, this activity was associated with the presence of fenchone, its major component.

Essential oil from fruit of Xylopia langsdorffiana: antitumour activity and toxicity.

CONTEXT: The genus Xylopia L. (Annonaceae) includes aromatic plants that have both nutritional and medicinal uses. Essential oils of Xylopia species have antitumour effects. However, the efficacy of the essential oil from the fruit of Xylopia langsdorffiana St. Hil & Tul. (EOX) has not been examined. OBJECTIVE: EOX was evaluated to determine its chemical composition, antitumour activity and toxicity. MATERIALS AND METHODS: EOX was obtained from fresh fruits of X. langsdorffiana subjected to hydrodistillation, and gas chromatography-mass spectrometry was used to characterize the chemical composition of EOX. The toxicity of EOX was evaluated using haemolysis, acute toxicity and micronucleus assays. The in vitro antitumour activity of EOX was investigated using the sulforhodamine B assay. The sarcoma 180 murine tumour model was used to evaluate the in vivo antitumour activity and toxicity of EOX (50 and 100 mg/kg) after 7 d of treatment. RESULTS: The major components of EOX were α-pinene (34.57%) and limonene (31.75%). The HC50 (concentration producing 50% haemolysis) was 293.6 µg/ml. EOX showed greater selectivity for the leukaemia cell line K562, with total growth inhibition (TGI) (concentration producing TGI) of 1.8 µg/ml, and for multidrug-resistant ovarian tumour cell line NCI/ADR-RES (TGI of 45.4 µg/ml). The LD50 was approximately 351.09 mg/kg. At doses of 50 and 100 mg/kg, EOX inhibited the in vivo growth of sarcoma 180 by 38.67 and 54.32%, respectively. EOX displayed minor hepatic alterations characteristic of acute hepatitis and induced no genotoxicity. CONCLUSION: EOX showed in vitro and in vivo antitumour activity and low toxicity, which warrants further pharmacological studies.

Chemical composition, antitumor activity, and toxicity of essential oil from the leaves of Lippia microphylla.

The chemical composition, antitumor activity and toxicity of the essential oil from Lippia microphylla leaves (OEL) were investigated. The major constituents were thymol (46.5%), carvacrol (31.7%), p-cymene (9%), and γ-terpinene (2.9%). To evaluate the toxicity of OEL in non-tumor cells, the hemolytic assay with Swiss mice erythrocytes was performed. The concentration producing 50% hemolysis (HC50) was 300 µg/mL. Sarcoma 180 tumor growth was inhibited in vivo 38% at 50 mg/kg, and 60% at 100 mg/kg, whereas 5-FU at 50 mg/kg caused 86% inhibition. OEL displays moderate gastrointestinal and hematological toxicity along with causing some alteration in liver function and morphology. However, the changes were considered reversible and negligible in comparison to the effects of several anticancer drugs. In summary, OEL displays in vivo antitumor activity and a moderate toxicity, which suggests further pharmacological study.

Antitumor activity of monoterpenes found in essential oils.

Cancer is a complex genetic disease that is a major public health problem worldwide, accounting for about 7 million deaths each year. Many anticancer drugs currently used clinically have been isolated from plant species or are based on such substances. Accumulating data has revealed anticancer activity in plant-derived monoterpenes. In this review the antitumor activity of 37 monoterpenes found in essential oils is discussed. Chemical structures, experimental models, and mechanisms of action for bioactive substances are presented.

In vitro and in vivo antitumor effect of trachylobane-360, a diterpene from Xylopia langsdorffiana.

Trachylobane-360 (ent-7α-acetoxytrachyloban-18-oic acid) was isolated from Xylopia langsdorffiana. Studies have shown that it has weak cytotoxic activity against tumor and non-tumor cells. This study investigated the in vitro and in vivo antitumor effects of trachylobane-360, as well as its cytotoxicity in mouse erythrocytes. In order to evaluate the in vivo toxicological aspects related to trachylobane-360 administration, hematological, biochemical and histopathological analyses of the treated animals were performed. The compound exhibited a concentration-dependent effect in inducing hemolysis with HC50 of 273.6 µM, and a moderate in vitro concentration-dependent inhibitory effect on the proliferation of sarcoma 180 cells with IC50 values of 150.8 µM and 150.4 µM, evaluated by the trypan blue exclusion test and MTT reduction assay, respectively. The in vivo inhibition rates of sarcoma 180 tumor development were 45.60, 71.99 and 80.06% at doses of 12.5 and 25 mg/kg of trachylobane-360 and 25 mg/kg of 5-FU, respectively. Biochemical parameters were not altered. Leukopenia was observed after 5-FU treatment, but this effect was not seen with trachylobane-360 treatment. The histopathological analysis of liver and kidney showed that both organs were mildly affected by trachylobane-360 treatment. Trachylobane-360 showed no immunosuppressive effect. In conclusion, these data reinforce the anticancer potential of this natural diterpene.

Lipoprotein receptor SR-B1 deficiency enhances adipose tissue inflammation and reduces susceptibility to hepatic steatosis during diet-induced obesity in mice.

Scavenger receptor class B type 1 (SR-B1) is a membrane lipoprotein receptor/lipid transporter involved in the pathogenesis of atherosclerosis, but its role in obesity and fatty liver development is unclear. Here, we determined the effects of SR-B1 deficiency on plasma metabolic and inflammatory parameters as well as fat deposition in adipose tissue and liver during obesity. To induce obesity, we performed high-fat diet (HFD) exposure for 12 weeks in male SR-B1 knock-out (SR-B1-/-, n = 14) and wild-type (WT, n = 12) mice. Compared to HFD-fed WT mice, plasma from HFD-fed SR-B1-/- animals exhibited increased total cholesterol, triglycerides (TG) and tumor necrosis factor-α (TNF-α) levels. In addition, hypertrophied adipocytes and macrophage-containing crown-like structures (CLS) were observed in adipose tissue from HFD-fed SR-B1 deficient mice. Remarkably, liver from obese SR-B1-/- mice showed attenuated TG content, dysregulation in hepatic peroxisome proliferator-activated receptors (PPARs) expression, increased hepatic TG secretion, and altered hepatic fatty acid (FA) composition. In conclusion, we show that SR-B1 deficiency alters the metabolic environment of obese mice through modulation of liver and adipose tissue lipid accumulation. Our findings provide the basis for further elucidation of SR-B1's role in obesity and fatty liver, two major public health issues that increase the risk of advanced chronic diseases and overall mortality.

Factors associated with occupational stress among nursing professionals in health services of medium complexity.

OBJECTIVE: To analyze the factors associated with occupational stress among nursing workers in health services of medium complexity. METHODS: Epidemiological, cross-sectional, exploratory study. A randomly selected sample of 126 nursing professionals from medium complexity services in three cities in the state of Bahia (Santo Antônio de Jesus, Feira de Santana and Itabuna) was investigated. Data were collected in 2011 and 2012. The demand-control model proposed by Karasek was used to assess occupational stress. Simultaneous analysis of occupational stressors was performed using Poisson regression with robust variance. RESULTS: The prevalence of occupational stress among nursing professionals was 77%. Occupational stress was associated with the professional category of nursing technician (p=0.01). CONCLUSION: The data indicates a concerning situation of exposure to occupational stressors, which requires coping strategies in order to protect the health of the worker.

Intrahepatic fatty acids composition as a biomarker of NAFLD progression from steatosis to NASH by using 1H-MRS.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the world and it is becoming one of the most frequent cause of liver transplantation. Unfortunately, the only available method that can reliably determine the stage of this disease is liver biopsy, however, it is invasive and risky for patients. The purpose of this study is to investigate changes in the intracellular composition of the liver fatty acids during the progression of the NAFLD in a mouse model fed with Western diet, with the aim of identify non-invasive biomarkers of NAFLD progression based in 1H-MRS. Our results showed that the intracellular liver fatty acid composition changes as NAFLD progresses from simple steatosis to steatohepatitis (NASH). Using principal component analysis with a clustering method, it was possible to identify the three most relevant clinical groups: normal, steatosis and NASH by using 1H-MRS. These results showed a good agreement with the results obtained by GC-MS and histology. Our results suggest that it would be possible to detect the progression of simple steatosis to NASH using 1H-MRS, that has the potential to be used routinely in clinical application for screening high-risk patients.

"Waiting for a miracle": Spirituality/Religiosity in coping with sickle cell disease.

OBJECTIVE: To understand spirituality/religiosity as experienced by people with sickle cell disease, and its influence on coping with the disease. METHOD: A qualitative, descriptive, and exploratory study conducted in the State of Bahia. Twenty-nine respondents participated in semi-structured interviews. Content analysis was used to analyze the empirical material. RESULTS: Individuals with sickle cell disease experience spirituality/religiosity motivated by their hope for a miracle, and fear of death; among their rites are: reading religious materials, individual and group prayer, and attendance at worship services. The effects on their health include: comfort by means of coping by comparing two evils, anxiety relief, social support, and lifestyle changes; however, spirituality/religiosity may be impaired. FINAL CONSIDERATIONS: This study demonstrates the need to qualify health professionals to address spiritual issues of these individuals during illness, with the aims of diagnosing suffering and anguish, and providing care, comfort and strengthening of the spiritual bonds of these individuals.

Self-care of men with priapism and sickle cell disease.

OBJECTIVE: To identify self-care demands of men with sickle cell disease and priapism and describe self-care measures in light of Orem's Self-Care Theory. METHOD: This is a descriptive exploratory study with qualitative approach conducted with nine men with a history of sickle cell disease and priapism. Data were analyzed using Orem's Self-Care Theory. RESULTS: Some demands were identified: from universal self-care - difficulty in social interaction and solitude, changes in self-image, self-esteem and sexual activity; from development - the experience with priapism and little knowledge about the pathophysiology of the disease; regarding health deviations - pain crises. CONCLUSION: Orem's theory allowed to identify self-care demands, which are essential for the nursing care provided for men with priapism. Nursing has an essential role in the measures for the different demands presented.

Dosimetric evaluation of X-ray examinations of paranasal sinuses in pediatric patients.

OBJECTIVE: To estimate the entrance surface air kerma (Ka,e) and air kerma in the region of radiosensitive organs in radiographs of pediatric paranasal sinuses. MATERIALS AND METHODS: Patient data and irradiation parameters were collected in examinations of the paranasal sinuses in children from 0 to 15 years of age at two children's hospitals in the city of Recife, PE, Brazil. We estimated the Ka,e using the X-ray tube outputs and selected parameters. To estimate the air kerma values in the regions of the eyes and thyroid, we used thermoluminescent dosimeters. RESULTS: The Ka,e values ranged from 0.065 to 1.446 mGy in cavum radiographs, from 0.104 to 7.298 mGy in Caldwell views, and from 0.113 to 7.824 mGy in Waters views. Air kerma values in the region of the eyes ranged from 0.001 to 0.968 mGy in cavum radiographs and from 0.011 to 0.422 mGy in Caldwell and Waters views . In the thyroid region, air kerma values ranged from 0.005 to 0.932 mGy in cavum radiographs and from 0.002 to 0.972 mGy in Caldwell and Waters views. CONCLUSION: The radiation levels used at the institutions under study were higher than those recommended in international protocols. We recommend that interventions be initiated in order to reduce patient exposure to radiation and therefore the risks associated with radiological examination of the paranasal sinuses.

OBJETIVO: Estimar o kerma no ar na superfície de entrada (Ka,e) e o kerma no ar na região de órgãos radiossensíveis em radiografias pediátricas dos seios paranasais. MATERIAIS E MÉTODOS: Foram coletados os dados dos pacientes e parâmetros de irradiação em exames de seios paranasais de crianças com 0 a 15 anos, em dois hospitais infantis na cidade do Recife, PE. O Ka,e foi estimado utilizando os rendimentos dos tubos de raios X e os parâmetros selecionados. Os valores de kerma no ar nas regiões dos olhos e tireoide foram estimados utilizando dosímetros termoluminescentes. RESULTADOS: Os valores de Ka,e variaram de 0,065 a 1,446 mGy para radiografias cavum, 0,104 a 7,298 mGy para Caldwell e 0,113 a 7,824 mGy para Waters. Os valores de kerma no ar na região dos olhos variaram de 0,001 a 0,968 mGy para cavum e 0,011 a 0,422 mGy para Caldwell e Waters. Na região tireóidea, os valores de kerma no ar variaram de 0,005 a 0,932 mGy para cavum e 0,002 a 0,972 mGy para Caldwell e Waters. CONCLUSÃO: Os parâmetros de irradiação utilizados pelas instituições foram mais elevados do que os recomendados em protocolos britânicos. Ações de otimização são recomendadas de modo a contribuir para a redução da radiação nos pacientes e, portanto, os riscos.

Assessment of Pradosia huberi effects on the reproductive system of male rats.

Pradosia huberi is a species found in the Amazon region and used as an antiulcerogenic and gastroprotective agent; however, phytochemical analysis has revealed the presence of compounds with potential toxic effects on the reproductive system. For the evaluation of the toxicity of P. huberi on male fertility, male Wistar rats were divided into four groups: one control (distilled water p.o.) and three treated (hydroalcoholic extract of the stem bark of P. Huberi (PH-HAE) at doses of 1.22, 6.1, and 30.5 mg/kg p.o.) once daily, for 63 days. In the last week of treatment (from the 57th to the 63rd day), the rats were mated with untreated virgin females (n = 30/group) and were killed on day 64. To investigate the toxic potential of PH-HAE on the reproductive system of rats the following parameters were evaluated: sperm production, genotoxicity, and general development. The production of gametes and their morphology did not differ between control and treated groups. Treatment with PH-HAE did not result in fewer vaginal plugs formed, indicating that the ability to mate was not impaired, but caused an increase of 14.3 and 10.8% in the preimplantation loss index, a reduction of 14.3 and 10.8% in the implantation index, and a reduction of 5.6 and 8.2% in the postimplantation loss index of female rats mated with rats treated with 6.1 and 30.5 mg/kg, respectively, indicating a possible toxic action of PH-HAE on the reproductive system of rats.

Factors associated with occupational stress among nursing professionals in health services of medium complexity / Factores asociados al estrés laboral entre profesionales de enfermería en servicios de salud de mediana complejidad / Fatores associados ao estresse ocupacional entre profissionais de enfermagem em serviços de saúde de média complexidade

ABSTRACT Objective: To analyze the factors associated with occupational stress among nursing workers in health services of medium complexity. Methods: Epidemiological, cross-sectional, exploratory study. A randomly selected sample of 126 nursing professionals from medium complexity services in three cities in the state of Bahia (Santo Antônio de Jesus, Feira de Santana and Itabuna) was investigated. Data were collected in 2011 and 2012. The demand-control model proposed by Karasek was used to assess occupational stress. Simultaneous analysis of occupational stressors was performed using Poisson regression with robust variance. Results: The prevalence of occupational stress among nursing professionals was 77%. Occupational stress was associated with the professional category of nursing technician (p=0.01). Conclusion: The data indicates a concerning situation of exposure to occupational stressors, which requires coping strategies in order to protect the health of the worker.

RESUMEN Objetivo: analizar los factores asociados al estrés laboral entre trabajadores de enfermería de servicios de salud de mediana complejidad. Métodos: estudio epidemiológico, de diseño transversal y exploratorio. Se investigó una muestra de 126 profesionales de enfermería en tres municipios de Bahía. Los datos se recogieron durante los años 2011 y 2012. Para evaluar el estrés laboral, se utilizó el modelo demanda-control propuesto por Karasek. El análisis simultáneo de los factores laborales estresores se llevó a cabo mediante la regresión de Poisson con variancia robusta. Resultados: La prevalencia del estrés laboral entre profesionales de enfermería era del 77%. Dicho estrés estaba asociado a la categoría profesional de técnico/a de enfermería (p=0,01). Conclusión: Los datos demuestran la existencia de una situación preocupante en ese grupo, con exposición a estresores laborales, haciéndose necesario la adopción de estrategias de enfrentamiento a fin de garantizar una protección integral para la salud de los trabajadores.

RESUMO Objetivo: Analisar os fatores associados ao estresse ocupacional entre trabalhadores de enfermagem dos serviços de saúde de média complexidade. Métodos: Estudo epidemiológico, transversal, exploratório. Investigou-se amostra, aleatoriamente selecionada, de 126 profissionais de enfermagem dos serviços de média complexidade de três municípios na Bahia: Santo Antônio de Jesus, Feira de Santana e Itabuna. Os dados foram coletados nos anos de 2011 e 2012. Para avaliar o estresse ocupacional, utilizou-se o modelo demanda-controle, proposto por Karasek. A análise simultânea dos fatores ocupacionais estressores foi feita com emprego de regressão de Poisson com variância robusta. Resultados: A prevalência de estresse ocupacional entre profissionais de enfermagem foi de 77%. Estresse ocupacional associou-se à categoria profissional de técnico/a de enfermagem (p=0,01). Conclusão: Os dados evidenciam situação preocupante de exposição desse grupo a estressores ocupacionais, sendo necessária a adoção de estratégias de enfrentamento a fim de garantir proteção integral à saúde do/a trabalhador/a.

[Tumoral form of neurocysticercosis: case report]. / Forma tumoral de neurocisticercose: relato de caso.

The authors report a case of neurocysticercosis by giant cyst (3.9 x 3.4 cm), where there were clinical manifestations of increased intracranial pressure and characteristics of image in computed tomography of cranium of expansive process with mass effect in central nervous system (CNS). They comment the possibility of the tumoral form of this disease having clinical and radiological presentation similar to other expansive processes of CNS and stress the surgical procedure as a form of treatment and diagnostic confirmation.

"Waiting for a miracle": Spirituality/Religiosity in coping with sickle cell disease / "Esperando un milagro": Espiritualidad/Religiosidad en el afrontamiento de la enfermedad de célula falciforme / "À espera de um milagre": espiritualidade/religiosidade no enfrentamento da doença falciforme

ABSTRACT Objective: To understand spirituality/religiosity as experienced by people with sickle cell disease, and its influence on coping with the disease. Method: A qualitative, descriptive, and exploratory study conducted in the State of Bahia. Twenty-nine respondents participated in semi-structured interviews. Content analysis was used to analyze the empirical material. Results: Individuals with sickle cell disease experience spirituality/religiosity motivated by their hope for a miracle, and fear of death; among their rites are: reading religious materials, individual and group prayer, and attendance at worship services. The effects on their health include: comfort by means of coping by comparing two evils, anxiety relief, social support, and lifestyle changes; however, spirituality/religiosity may be impaired. Final considerations: This study demonstrates the need to qualify health professionals to address spiritual issues of these individuals during illness, with the aims of diagnosing suffering and anguish, and providing care, comfort and strengthening of the spiritual bonds of these individuals.

RESUMEN Objetivo: Entender la espiritualidad / religiosidad como la experimentan las personas con enfermedad de células falciformes y su influencia en el afrontamiento de la enfermedad. Método: Un estudio cualitativo, descriptivo y exploratorio realizado en el estado de Bahía. Veintinueve encuestados participaron en entrevistas semiestructuradas. Se utilizó análisis de contenido para analizar el material empírico. Resultados: Las personas con enfermedad de células falciformes experimentan espiritualidad / religiosidad motivadas por su esperanza de un milagro y el miedo a la muerte; entre sus ritos se encuentran: lectura de materiales religiosos, oración individual y grupal, y asistencia a los servicios de adoración. Los efectos en su salud incluyen: comodidad mediante el manejo del afrontamiento, alivio de la ansiedad, apoyo social y cambios en el estilo de vida; sin embargo, la espiritualidad / religiosidad puede verse afectada. Consideraciones finales: Este estudio demuestra la necesidad de preparar a los profesionales de la salud para abordar los problemas espirituales de estos individuos durante la enfermedad, con el objetivo de diagnosticar el sufrimiento y la angustia, y de brindar atención, comodidad y fortalecimiento de los vínculos espirituales de estos individuos.

RESUMO Objetivo: Compreender a Espiritualidade/Religiosidade vivenciadas por pessoas com doença falciforme e sua influência sobre o enfrentamento da doença. Método: Estudo qualitativo, descritivo, exploratório, realizado no Estado da Bahia. Participaram 29 pessoas que responderam a entrevistas semiestruturadas. O material empírico foi submetido a análise de conteúdo. Resultados: Pessoas com doença falciforme vivenciam a Espiritualidade/Religiosidade motivadas pela esperança de um milagre e por medo da morte; seus ritos são as leituras de textos religiosos, orações individuais e em grupo, e frequência a cultos; os efeitos sobre sua saúde são: conforto através do coping de comparação, alívio da ansiedade, apoio social, mudança no estilo de vida, porém a Espiritualidade/Religiosidade podem manifestar-se prejudicadas. Considerações finais: Este estudo ressalta a necessidade da qualificação dos profissionais de saúde para a abordagem das questões espirituais dessas pessoas adoecidas, com a preocupação de diagnosticar possíveis sofrimentos, angústias e assim prestar auxílio, conforto e fortalecer os vínculos espirituais desses indivíduos.