RESUMO
Este estudo teve o objetivo de promover interseção entre direito e saúde e refletir sobre o papel do operador do direito perante as políticas de saúde. Foram realizados um estudo de caso com base em análise documental da petição inicial de uma Ação de Improbidade Administrativa sobre Saúde Mental e pesquisa bibliográfica sobre as políticas de saúde mental, o bloco carnavalesco Os Conspirados e conceitos de saúde relacionados. A ação judicial desconsiderou o bloco de carnaval dos usuários da saúde mental como ação de saúde, reprovando a destinação de verbas do Fundo Municipal de Saúde de Ouro Preto (MG) para sua manutenção. Observou-se, a partir desse caso, uma necessidade de maior aproximação entre as áreas e os atores do direito e da saúde para melhorar a técnica, o diálogo e a racionalização da judicialização da saúde.
This study aimed to promote the intersection between law and health and reflect on the role of the law operator in relation to health policies. A case study was conducted based on documentary analysis of the initial petition of an Administrative Misconduct Action on Mental Health, and a bibliographic research was also conducted on Mental Health policies, the carnival block Os Conspirados and related health concepts. The lawsuit disregarded the carnival block of mental health users as a health action, disapproving the allocation of funds from Ouro Preto's Municipal Health Fund for its maintenance. It was observed, from this case, that is a need for closer approximation between the areas and the actors of law and health, to improve the technique, dialogue and rationalization of the judicialization of health.
RESUMO
Este trabalho foi composto por um estudo transversal, feito em Ouro Preto, Minas Gerais, Brasil, para avaliar os fatores associados à qualidade de vida em mulheres no climatério. Foram usados o questionário de qualidade de vida SF36 e uma entrevista sobre dados socioeconômicos, demográficos, uso de medicamentos e hábitos de vida. A média de idade das 113 participantes foi de 53,3 ± 4,4 anos. Dessas, 49,6% conviviam com companheiro e 77,4% eram usuárias exclusivas do Sistema Único de Saúde. Foi observado que a renda de 54% delas era menor ou igual a um salário mínimo e 69% tinham baixa escolaridade. Na avaliação da associação entre as variáveis da entrevista e os oito domínios do questionário SF36, observouse diferença significativa na qualidade de vida em relação a: (i) idade no domínio saúde mental; (ii) viver com ou sem companheiro nos domínios estado geral de saúde e limitação por aspecto emocional; (iii) presença de alguma doença crônica nos domínios estado geral de saúde e saúde mental; (iv) uso de medicamento contínuo no domínio saúde mental. Concluise que o aumento da idade, a presença de doenças crônicas e o uso de medicamentos agrava a qualidade de vida dessas mulheres. Entretanto, a convivência com parceiro modifica positivamente alguns domínios associados à qualidade de vida.
A crosssectional study was conducted in Ouro Preto, Minas Gerais, Brazil to evaluate the factors associated with quality of life in climacteric women. It was used for this evaluation the questionnaire SF36 of quality of life and one interview about socioeconomic, demographic, medicines used and living habits. The average age of the 113 participant was 53.3±4.4 years, 49.6% living with a partner and 77.4% using the public health system as the exclusive health insurance. It was observed that the income of 54% of them were less than or equal to the minimum wage and 69% had low education. Assessing the association between the variables of the interview and the eight domains of the SF36, there was significant difference in the quality of life in relation to: (i) age, in the mental health domain; (ii) living with or without a partner, related to general health and limitation by emotional aspect; (iii) the presence of any chronic disease correlated to general health and mental health; (iv) continuoususe medication in the mental health domain. Concluding, the higher the age, in association with chronic diseases and medicines intake, the worse the quality of life of these women. Moreover, living with a partner positively modifies some areas associated with quality of life.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Climatério , Uso de Medicamentos , Menopausa , Qualidade de Vida , Inquéritos e Questionários/estatística & dados numéricosRESUMO
Trypanosoma cruzi infection may be caused by different strains with distinct discrete typing units (DTUs) that can result in variable clinical forms of chronic Chagas disease. The present study evaluates the immune response and cardiac lesions in dogs experimentally infected with different T. cruzi strains with distinct DTUs, namely, the Colombian (Col) and Y strains of TcI and TcII DTU, respectively. During infection with the Col strain, increased levels of alanine aminotransferase, erythrocytes, haematocrit and haemoglobin were observed. In addition, CD8+ T-lymphocytes isolated from the peripheral blood produced higher levels of interleukin (IL)-4. The latter suggests that during the acute phase, infection with the Col strain may remain unnoticed by circulating mononuclear cells. In the chronic phase, a significant increase in the number of inflammatory cells was detected in the right atrium. Conversely, infection with the Y strain led to leucopoenia, thrombopoenia, inversion of the ratio of CD4+/CD8+ T-lymphocytes and alterations in monocyte number. The Y strain stimulated the production of interferon-γ by CD4+ and CD8+ T-lymphocytes and IL-4 by CD8+ T-cells. In the chronic phase, significant heart inflammation and fibrosis were observed, demonstrating that strains of different DTUs interact differently with the host.
Assuntos
Animais , Cães , Doença de Chagas/imunologia , Miocárdio/patologia , Trypanosoma cruzi/imunologia , Alanina Transaminase/sangue , /metabolismo , /metabolismo , Doença Crônica , Doença de Chagas/sangue , Doença de Chagas/patologia , Modelos Animais de Doenças , Contagem de Eritrócitos , Citometria de Fluxo , Fibrose/imunologia , Fibrose/parasitologia , Hematócrito , Hemoglobinas/análise , /metabolismo , Contagem de Linfócitos , Leucócitos Mononucleares/química , Miocárdio/química , Miocárdio/imunologia , Fenótipo , Trypanosoma cruzi/metabolismoRESUMO
Chagasic megaoesophagus and megacolon are characterised by motor abnormalities related to enteric nervous system lesions and their development seems to be related to geographic distribution of distinct Trypanosoma cruzi subpopulations. Beagle dogs were infected with Y or Berenice-78 (Be-78) T. cruzi strains and necropsied during the acute or chronic phase of experimental disease for post mortem histopathological evaluation of the oesophagus and colon. Both strains infected the oesophagus and colon and caused an inflammatory response during the acute phase. In the chronic phase, inflammatory process was observed exclusively in the Be-78 infected animals, possibly due to a parasitism persistent only in this group. Myenteric denervation occurred during the acute phase of infection for both strains, but persisted chronically only in Be-78 infected animals. Glial cell involvement occurred earlier in animals infected with the Y strain, while animals infected with the Be-78 strain showed reduced glial fibrillary acidic protein immunoreactive area of enteric glial cells in the chronic phase. These results suggest that although both strains cause lesions in the digestive tract, the Y strain is associated with early control of the lesion, while the Be-78 strain results in progressive gut lesions in this model.
Assuntos
Animais , Cães , Doença de Chagas/parasitologia , Colo/parasitologia , Modelos Animais de Doenças , Esôfago/parasitologia , Plexo Mientérico/parasitologia , Trypanosoma cruzi/classificação , Autopsia , Reação de Fase Aguda/parasitologia , Doença Crônica , Doença de Chagas/patologia , Colite/parasitologia , Colo/patologia , Progressão da Doença , Acalasia Esofágica/parasitologia , Esofagite/parasitologia , Esôfago/patologia , Megacolo/parasitologia , Especificidade da EspécieRESUMO
To confirm that Beagle dogs are a good experimental model for Chagas disease, we evaluated hematological alterations during the acute and chronic phases in Beagle dogs infected with the Y, Berenice-78 (Be-78) and ABC strains of Trypanosoma cruzi, correlating clinical signs with the parasitemia curve. We demonstrate that the acute phase of infection was marked by lethargy and loss of appetite. Simultaneously, we observed anemia, leukocytosis and lymphocytosis. Also,we describe hematological alterations and clinical signs that were positively correlated with the parasitemia during the experimental infection with the three strains of T.cruzi, and demonstrate that experimental infection of Beagle is a trustworthy model for Chagas disease.
Para confirmar que cães Beagle são um bom modelo para doença de Chagas, foram avaliadas as alterações hematológicas durante as fases aguda e crônica em cães Beagle infectados com as cepas Y, Berenice-78 (Be-78) e ABC de Trypanosomacruzi, correlacionando os sinais clínicos com a curva de parasitemia. Foi demonstrado que a fase aguda da infecção foi marcada por letargia e perda de apetite. Simultaneamente, observou-se anemia, leucocitose e linfocitose. Ainda, foram descritas alterações hematológicas e sinais clínicos positivamente correlacionados com a parasitemia durante a infecção experimental com as três cepas de T.cruzi estudadas, demonstrando que a infecção em cães Beagle constitui um modelo fidedigno para a doença de Chagas.
Assuntos
Animais , Cães , Anemia , Doença de Chagas , Leucocitose , Linfocitose , Parasitemia , Trypanosoma cruzi/parasitologia , Trypanosoma cruzi/patogenicidade , Modelos Animais de DoençasRESUMO
This paper aimed to verify the influence of the inoculum source (blood or metacyclic trypomastigote) and the route of inoculation (intraperitoneal or conjunctival) on the course of T. cruzi infection in dogs, using comparatively the T. cruzi strains Berenice-62 and Berenice-78. All dogs inoculated intraperitoneally became infected independently of the T. cruzi strain and source of trypomastigotes used. High level of infectivity was also observed when metacyclic trypomastigotes of both strains were inoculated by conjunctival route. However, when blood trypomastigotes were inoculated by conjunctival route the percentages of infectivity were significantly lower in dogs inoculated with both strains. Parasitaemia was significantly higher in animals infected with metacyclic trypomastigotes via the conjunctival route independently of the T. cruzi strain used. All animals infected with Berenice-78 strain showed severe acute myocarditis. On the other hand, animals infected with Berenice-62 showed severe acute myocarditis only when infected with metacyclic trypomastigote, via the intraperitoneal route. The results suggest that the source of the inoculum and the route of inoculation remarkably influence the evolution of the infection for the T. cruzi in the vertebrate host even when the same strain of the parasite is used.