Planejamento reprodutivo e os fatores limitantes para participação masculina: uma revisão integrativa / Reproductive planning and the limiting factors for male participation: an integrative review / La planificación reproductiva y los factores limitantes de la participación masculina: una revisión integradora

Objetivo: identificar o que tem sido retratado na literatura acerca da participação dos homens no planejamento reprodutivo e os fatores intervenientes a inserção masculina nos serviços de saúde. Método: trata-se de uma revisão integrativa, realizada no período de setembro de 2018, com artigos científicos completos nas bases de dados SciELO, BVS e BDENF, publicados em português (nacionais e internacionais), no período de dez anos (2008-2018). Foram analisados 10 artigos, no qual, 100% destes apresentam uma abordagem qualitativa, com maior parcela publicada no ano de 2014 (50%) e realizada no Brasil (90%). Resultados: evidenciou-se que as questões de gênero e masculinidade estiveram mais associadas as principais dificuldades para a participação e inserção dos homens no PR, como a persistência de uma desigualdade de papeis sociais entre o homem e a mulher, historicamente construída por uma cultura patriarcal, no qual, a mulher é tida como a única responsável pelos cuidados de reprodução e dos filhos. Conclusão: para uma maior adesão masculina ao PR, é necessário que os serviços se tornem mais apropriados para homens, como já acontece em algumas regiões brasileiras com a flexibilização de horários das unidades, além de capacitar os profissionais para trazer os homens para junto das equipes de saúde, incentivando a desmistificação dos preconceitos, com a finalidade de contribuir para uma participação mais efetiva.

Objective: to identify what is portrayed in the literature about the participation of men in reproductive planning and the factors involved in male insertion in health services. Method: this is an integrative review, carried out in the period of September 2018, with complete scientific articles in the SciELO, BVS and BDENF databases, published in Portuguese (national and international), in the period of ten years (2008-2018). 10 articles were analyzed, in which 100% of them have a qualitative approach, most of them published in 2014 (50%) and carried out in Brazil (90%). Results: it became evident that gender and masculinity issues were more associated with the main difficulties for the participation and insertion of men in public relations, such as the persistence of an inequality of social roles between men and women, historically built by a culture. patriarchal, in which the woman is considered solely responsible for the care of reproduction and children. Conclusion: for greater male adherence to PR, services need to be more suitable for men, as is already the case in some Brazilian regions with the flexibility of the units' schedules, in addition to training professionals to bring men to the teams. health, promoting the demystification of prejudices, in order to contribute to a more effective participation.

Objetivo: identificar lo retratado en la literatura sobre la participación de los hombres en la planificación reproductiva y los factores involucrados en la inserción masculina en los servicios de salud. Método: se trata de una revisión integradora, realizada en el período de septiembre de 2018, con artículos científicos completos en las bases de datos SciELO, BVS y BDENF, publicados en portugués (nacional e internacional), en el período de diez años (2008-2018). Se analizaron 10 artículos, en los cuales el 100% de ellos tienen un enfoque cualitativo, la mayoría publicados en 2014 (50%) y realizados en Brasil (90%). Resultados: se evidenció que las cuestiones de género y masculinidad estaban más asociadas a las principales dificultades para la participación e inserción de los hombres en las relaciones públicas, como la persistencia de una desigualdad de roles sociales entre hombres y mujeres, históricamente construida por una cultura. patriarcal, en el que la mujer es considerada la única responsable del cuidado de la reproducción y los hijos. Conclusión: para una mayor adherencia masculina a la RP, los servicios deben ser más adecuados para los hombres, como ya ocurre en algunas regiones brasileñas con la flexibilidad de los horarios de las unidades, además de capacitar a los profesionales para traer hombres a los equipos. salud, promoviendo la desmitificación de los prejuicios, para contribuir a una participación más efectiva.

Percepções de enfermeiras sobre a gestão do cuidado no contexto da Estratégia de Saúde da Família / Nurses' perceptions of care management in the context of the Family Health Strategy / Percepciones de las enfermeras sobre la gestión del cuidado en el contexto de la Estrategia Salud de la Familia

Objetivo: analisar as representações sociais de enfermeiras sobre a gestão do cuidado em Estratégia de Saúde da Família. Método: pesquisa exploratória com metodologia qualitativa, realizada com dez enfermeiras de saúde da família. Utilizou-se entrevista semiestruturada com um roteiro pré-estabelecido, e para análise e discussão dos dados, a técnica de análise de conteúdo. Resultados: as representações sociais de enfermeiras sobre a gestão do cuidado estão relacionadas aos problemas de acesso e acessibilidade, mas também à importância da gestão do cuidado na atenção básica. Conclusão: as representações sociais de enfermeiras que atuam em atenção básica relacionam-se diretamente aos problemas e carências que são vivenciados na rotina do serviço diário que impactam diretamente a gestão do cuidado.

Objective: to analyze nurses' social representations about care management in Family Health Strategy. Method: exploratory research with qualitative methodology, carried out with ten family health nurses. A semi-structured interview with a pre-established script was used, and for data analysis and discussion, the content analysis technique. Results: nurses' social representations of care management are related to problems of access and accessibility, but also to the importance of care management in primary care. Conclusion: the social representations of nurses who work in the attention basic are directly related to the problems and needs that are experienced in the daily service routine that directly impact care management.

Objetivo: analizar las representaciones sociales del enfermero sobre la gestión del cuidado en la estrategia Salud de la Familia. Método: investigación exploratoria con metodología cualitativa, realizada con diez enfermeras de salud familiar. Se utilizó una entrevista semiestructurada con un guión preestablecido, y para el análisis y discusión de datos, una técnica de análisis de contenido. Resultados: las representaciones sociales de las enfermeras sobre la gestión del cuidado están relacionadas con problemas de acceso y accesibilidad, pero también con la importancia de la gestión del cuidado en la atención primaria. Conclusión: las representaciones sociales de los enfermeros que laboran en la atencíon basica están directamente relacionadas con los problemas y necesidades que se viven en la rutina del servicio diario que impactan directamente en la gestión del cuidado.

Phenylketonuria Pathophysiology: on the Role of Metabolic Alterations.

Phenylketonuria (PKU) is an inborn error of phenylalanine (Phe) metabolism caused by the deficiency of phenylalanine hydroxylase. This deficiency leads to the accumulation of Phe and its metabolites in tissues and body fluids of PKU patients. The main signs and symptoms are found in the brain but the pathophysiology of this disease is not well understood. In this context, metabolic alterations such as oxidative stress, mitochondrial dysfunction, and impaired protein and neurotransmitters synthesis have been described both in animal models and patients. This review aims to discuss the main metabolic disturbances reported in PKU and relate them with the pathophysiology of this disease. The elucidation of the pathophysiology of brain damage found in PKU patients will help to develop better therapeutic strategies to improve quality of life of patients affected by this condition.

Percepção do enfermeiro acerca da sua autonomia na prevenção da pneumonia associada à ventilação mecânica / Perception of nurses about their autonomy in prevention of pneumonia associated with mechanical ventilation / Percepción de enfermeras sobre su autonomía en la prevención de neumonía asociada a la ventilación mecánica

Objetivo: descrever as percepções dos enfermeiros acerca de sua autonomia na prevenção de pneumonia associada à ventilação mecânica. Método: estudo qualitativo, realizado com oito enfermeiros da Unidade de Terapia Intensiva de um hospital universitário em Curitiba/PR. As entrevistas foram gravadas, transcritas e analisadas conforme técnica de análise de conteúdo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, CAAE 04335312.5.000.0103. Resultados: após a análise emergiram três categorias: 1. Percepções relacionadas ao exercício das competências gerenciais do enfermeiro; 2. O processo de trabalho na enfermagem como interveniente na articulação de medidas preventivas; 3. As medidas preventivas preconizadas para a prevenção das PAV como forma de autonomia técnica para o enfermeiro. Conclusão: houve percepções positivas acerca da autonomia do enfermeiro, principalmente no que se refere à educação permanente, a prescrição de enfermagem e a comunicação, porém permeadas por desafios como a realização da sistematização da assistência de enfermagem.(AU)

Objective: describing the perceptions of nurses about their autonomy in the prevention of ventilatorassociated pneumonia. Method: a qualitative study conducted with eight nurses of the ICU of a university hospital in Curitiba/PR. The interviews were recorded, transcribed and analyzed according to the technique of content analysis. The study was approved by the Ethics Committee in Research, CAAE 04335312.5.000.0103. Results: after analyzing, three categories emerged: 1. perceptions related to the exercise of managerial skills of the nurse; 2. the process of nursing work as intervening in the articulation of preventive measures; 3. the recommended preventive measures for the prevention of VAP as a form of technical autonomy for nurses. Conclusion: there were positive perceptions of autonomy of nurses, mainly in regard to continuing education, prescription of nursing and communication, but permeated with challenges such as performing the systematization of nursing care.(AU)

Objetivo: describir las percepciones de las enfermeras acerca de su autonomía en la prevención de la neumonía asociada a la ventilación mecánica. Método: un estudio cualitativo con ocho enfermeras de la unidad de cuidados intensivos de un hospital universitario de Curitiba/PR. Las entrevistas fueron grabadas, transcritas y analizadas según la técnica de análisis de contenido. El estudio fue aprobado por el Comité de Ética en Investigación, CAAE 04335312.5.000.0103. Resultados: tras el análisis surgieron tres categorías: 1. percepciones relacionadas con el ejercicio de la capacidad de gestión de la enfermera; 2. el proceso de trabajo de enfermería como intervenir en la articulación de medidas preventivas; 3. las medidas preventivas recomendadas para la prevención de la PAV como una forma de autonomía técnica para las enfermeras. Conclusión: hubo una percepción positiva de la autonomía de las enfermeras, especialmente en lo que respecta a la educación continua, la prescripción de la enfermería y la comunicación, pero impregnadas de retos tales como la realización de la sistematización de la asistencia de enfermería.(AU)

O agir comunicativo do enfermeiro na assistência ao paciente criticamente enfermo / Nurse’s communicative act in the care to the critically ill patient

Objetivo: refletir sobre o agir comunicativo do enfermeiro na assistência ao paciente crítico. Método: trata-se de uma reflexão teórica. Resultados: foram construídas duas categorias reflexivas, sendo que na primeira se fez uma breve explanação sobre a Teoria do Agir Comunicativo, de Jürgen Habermas, a qual serviu como pano de fundo para a segunda etapa da reflexão, que teceu considerações acerca das interfaces da referida teoria com a atuação do enfermeiro na prestação de cuidados a indivíduos criticamente enfermos. Conclusão: por meio da análise da literatura conclui-se que o referencial teórico em questão pode contribuir para a humanização da assistência de enfermagem ao paciente em estado crítico, uma vez que, ao submeter suas atitudes a um agir comunicativo, o enfermeiro estará em busca de uma maior interação com o paciente, a família, sua equipe e os demais profissionais da saúde.

Objective: reflect on the nurse’s communicative act in the care to the critical patient. Method: this is a theoretical reflection. Results: two reflective categories were constructed, in the first there was a brief explanation of Jürgen Habermas’ Theory of Communicative Act, constituting a backdrop for the second reflection stage, which presented considerations on the interfaces of that theory with the nurse’s action when providing critically ill individuals with care. Conclusion: through literature analysis, one concludes that the theoretical framework concerned may contribute to the humanization of nursing care to the patient in a critical condition, since, by submitting his attitudes to a communicative act, the nurse will be in search of a greater interaction with the patient, the family, his team, and the other health professionals.

Objetivo: reflexionar acerca del acto comunicativo del enfermero en la atención al paciente crítico. Método: es una reflexión teórica. Resultados: fueron construidas dos categorías reflexivas, en la primera hubo una breve explicación acerca de la Teoría del Acto Comunicativo, de Jürgen Habermas, que sirvió de escenario para la segunda etapa de reflexión, que tejió consideraciones acerca de las interfaces de esa teoría con la actuación del enfermero en la atención a individuos críticamente enfermos. Conclusión: por medio del análisis de la literatura se concluye que el referencial teórico en cuestión puede contribuir a la humanización de la atención de enfermería al paciente en estado crítico, ya que, al someter sus actitudes a un acto comunicativo, el enfermero estará en búsqueda de una mayor interacción con el paciente, la familia, su equipo y los demás profesionales de la salud.

Oxidative stress markers are not associated with outcomes after pediatric heart surgery.

OBJECTIVES: To investigate whether perioperative serum levels of oxidative stress markers, thiobarbituric acid reactive substances (TBARS), and carbonyl moieties are associated with outcomes in children after heart surgery. BACKGROUND: Oxidative stress markers are increased following heart surgery with cardiopulmonary bypass (CPB) and can play a role in ischemia-reperfusion injury, but its associations with myocardial dysfunction, low cardiac output syndrome (LCOS), and outcomes are not proven. METHODS: In a retrospective secondary analysis of a cohort study comprising 55 children (median age, 109 [2-611] days), we compared pre-, intra- and postoperative serum levels of TBARS and carbonyl moieties among patients with and without postoperative LCOS, cyanotic and acyanotic congenital heart disease (CHD), and survivors and nonsurvivors. We also assessed the independent effect of TBARS and carbonyl moieties peak levels on the mortality-adjusted hospital length of stay (aLOS). RESULTS: Patients who developed postoperative LCOS (n = 36) were significantly younger, more frequently cyanotic, more severely ill, and underwent more complex procedures with longer CPB. However, TBARS and carbonyl moieties serum levels did not change significantly over time. Moreover, they were not significantly different in patients with or without LCOS, cyanotic and acyanotic CHD, or survivors and nonsurvivors. There was a significant correlation between TBARS and tumor necrosis factor alpha (TNF-α) peak serum levels. Neither TBARS nor carbonyl moieties peak serum levels were independently associated with aLOS. CONCLUSIONS: In conclusion, oxidative stress markers TBARS and carbonyl moieties were not associated with the development of LCOS, the aLOS, or mortality in children after heart surgery with CPB.

Determinants of human immunodeficiency virus (HIV) prevalence in homosexual and bisexual men screened for admission to a cohort study of HIV negatives in Belo Horizonte, Brazil: Project Horizonte.

Project Horizonte, an open cohort of homosexual and bisexual human immunodeficiency virus (HIV-1) negative men, is a component of the AIDS Vaccine Program, in Belo Horizonte, Minas Gerais, Brazil. The objective of this study was to compare volunteers testing HIV positive at cohort entry with a sample of those who tested HIV negative in order to identify risk factors for prevalent HIV infection, in a population being screened for enrollment at Project Horizonte. A nested case-control study was conducted. HIV positive volunteers at entry (cases) were matched by age and admission date to three HIV negative controls each. Selected variables used for the current analysis included demographic factors, sexual behavior and other risk factors for HIV infection. During the study period (1994-2001), among the 621 volunteers screened, 61 tested positive for HIV. Cases were matched to 183 HIV negative control subjects. After adjustments, the main risk factors associated with HIV infection were unprotected sex with an occasional partners, OR = 3.7 (CI 95% 1.3-10.6), receptive anal intercourse with an occasional partner, OR = 2.8 (95% CI 0.9-8.9) and belonging to the negro racial group, OR = 3.4 (CI 95% 1.1-11.9). These variables were associated with an increase in the risk of HIV infection among men who have sex with men at the screening for admission to an open HIV negative cohort.

Determinants of Human Immunodeficiency Virus (HIV) prevalence in homosexual and bisexual men screened for admission to a cohort study of HIV negatives in Belo Horizonte, Brazil: Project Horizonte

Project Horizonte, an open cohort of homosexual and bisexual human immunodeficiency virus (HIV-1) negative men, is a component of the AIDS Vaccine Program, in Belo Horizonte, Minas Gerais, Brazil. The objective of this study was to compare volunteers testing HIV positive at cohort entry with a sample of those who tested HIV negative in order to identify risk factors for prevalent HIV infection, in a population being screened for enrollment at Project Horizonte. A nested case-control study was conducted. HIV positive volunteers at entry (cases) were matched by age and admission date to three HIV negative controls each. Selected variables used for the current analysis included demographic factors, sexual behavior and other risk factors for HIV infection. During the study period (1994-2001), among the 621 volunteers screened, 61 tested positive for HIV. Cases were matched to 183 HIV negative control subjects. After adjustments, the main risk factors associated with HIV infection were unprotected sex with an occasional partners, OR = 3.7 (CI 95 percent 1.3-10.6), receptive anal intercourse with an occasional partner, OR = 2.8 (95 percent CI 0.9-8.9) and belonging to the negro racial group, OR = 3.4 (CI 95 percent 1.1-11.9). These variables were associated with an increase in the risk of HIV infection among men who have sex with men at the screening for admission to an open HIV negative cohort

Molecular epidemiology of HIV-1 in Rio Grande, RS, Brazil

We conducted a molecular epidemiological study to investigate HIV-1 strains in Rio Grande, southern Brazil, searching for an association with transmission mode and risk behavior. Patients (185) identified at an AIDS treatment reference Hospital, from 1994 to 1997, were included; from which 107 blood samples were obtained. Nested PCR was realized once for each sample; for amplified samples (69) HIV subtypes were classified using the heteroduplex mobility assay. Subtypes identified were B (75 percent), C (22 percent) and F (3 percent). All infections with C were diagnosed after 1994. Comparing patients with B and C, no differences were detected regarding demographic, clinical and laboratory characteristics; survival analysis did not reveal differences in HIV to AIDS evolution. A higher proportion of injecting drug users, IDU (not significant, p<.07) was found among those with C. This suggests that C may have been introduced in this area through IDU, and is being spread, probably by their sexual partners, to persons with other risk practices

Molecular epidemiology of HIV-1 in Rio Grande, RS, Brazil.

We conducted a molecular epidemiological study to investigate HIV-1 strains in Rio Grande, southern Brazil, searching for an association with transmission mode and risk behavior. Patients (185) identified at an AIDS treatment reference Hospital, from 1994 to 1997, were included; from which 107 blood samples were obtained. Nested PCR was realized once for each sample; for amplified samples (69) HIV subtypes were classified using the heteroduplex mobility assay. Subtypes identified were B (75%), C (22%) and F (3%). All infections with C were diagnosed after 1994. Comparing patients with B and C, no differences were detected regarding demographic, clinical and laboratory characteristics; survival analysis did not reveal differences in HIV to AIDS evolution. A higher proportion of injecting drug users, IDU (not significant, p < .07) was found among those with C. This suggests that C may have been introduced in this area through IDU, and is being spread, probably by their sexual partners, to persons with other risk practices.