Prevalence of frailty and its association with oral hypofunction in older adults: a gender perspective.

BACKGROUND: Previous studies have indicated an association between oral hypofunction and frailty in community-dwelling older adults. However, this issue has not been evaluated in institutionalized older patients. We aimed to determine the prevalence of physical frailty in this particularly vulnerable group and evaluate its association with oral hypofunction, analyzing possible differences by gender. METHODS: This cross-sectional study was conducted in private and public care homes in Guayaquil (Ecuador) from January 2018 until December 2019. Participants were classified as robust, pre-frail, and frail according to the Fried's frailty phenotype. Oral hypofunction was defined as the presence of at least three positive items in the following list: poor oral hygiene, oral dryness, reduced occlusal force, decreased masticatory function, and deterioration of swallowing function. The relationships between frailty and oral hypofunction were analyzed using logistic regression models for the whole sample and stratified by gender. Statistical analyses were performed using STATA 15.0 software (Stata Corp. LP, College Station, TX, USA). RESULTS: Among the 589 participants analyzed (65% women), the median age was 72 years (interquartile range: 66-82). Pre-frailty and frailty were presented in 66.7% and 28.9% of them respectively. Weakness was the most frequent item (84.6%). There was a significant relationship between frailty and oral hypofunction in women. In the overall sample, the frequency of frailty was 2.06 times higher (95% CI 1.30-3.29) in patients with oral hypofunction, and this association was maintained in women (ORa: 2.18; 95% CI 1.21-3.94). Reduced occlusal force and decreased swallowing function were items significantly associated with the presence of frailty (ORa: 1.95; 95% CI 1.18-3.22 and ORa: 2.11; 95% CI 1.39-3.19, respectively). CONCLUSION: The prevalence of frailty and pre-frailty was high among institutionalized older people and was associated with the presence of hypofunction, especially in women. Decreased swallowing function was the most strongly item associated with frailty.

Anorexia and bulimia nervosa in the practice of the paediatric dentist.

OBJECTIVE: This systematic review aimed to highlight the usefulness of the clinical examination of the oral cavity for the diagnostic suspicion of anorexia (AN) and bulimia nervosa (BN), being of main interest to the paediatric dentist and paediatrician due to the early onset of symptoms in Eating Disorders (EDs). METHOD: A systematic search, applying PICO question, was carried out in biomedical and other electronic databases from 2005 to 2020. Both case reports and case series of patients under 65 years of age with AN and BN were included. Data were extracted and statistically analysed. RESULTS: A sample of 111 studies was obtained (n = 192; 92.78% female). The most prevalent diagnosis was restrictive type AN (n = 110; 57.29%). Only 16 (8.33%) patients had been clinically examined at the oral cavity, indicating the presence or absence of oral manifestations (OM) and showing dental erosion (n = 10) as the most frequent. CONCLUSION: There is a lack of information about the oral examination of anorexic and bulimic patients. Dental erosion and other oral manifestations can help us to make an early ED diagnosis. Clinical observation and basic erosive wear examination (BEWE) Index are necessary steps to detect and record any anomaly in oral cavity during the evaluation of these patients.

Dopamine-loaded nanoparticle systems circumvent the blood-brain barrier restoring motor function in mouse model for Parkinson's Disease.

Parkinson's disease (PD) is a progressive and chronic neurodegenerative disease of the central nervous system. Early treatment for PD is efficient; however, long-term systemic medication commonly leads to deleterious side-effects. Strategies that enable more selective drug delivery to the brain using smaller dosages, while crossing the complex brain-blood barrier (BBB), are highly desirable to ensure treatment efficacy and decrease/avoid unwanted outcomes. Our goal was to design and test the neurotherapeutic potential of a forefront nanoparticle-based technology composed of albumin/PLGA nanosystems loaded with dopamine (ALNP-DA) in 6-OHDA PD mice model. ALNP-DA effectively crossed the BBB, replenishing dopamine at the nigrostriatal pathway, resulting in significant motor symptom improvement when compared to Lesioned and L-DOPA groups. Notably, ALNP-DA (20 mg/animal dose) additionally up-regulated and restored motor coordination, balance, and sensorimotor performance to non-lesioned (Sham) animal level. Overall, ALNPs represent an innovative, non-invasive nano-therapeutical strategy for PD, considering its efficacy to circumvent the BBB and ultimately deliver the drug of interest to the brain.

Effects of a biomimetic analog-based experimental bonding system on caries-affected and sound dentin.

This study compared the ultrastructure, chemical composition, and proteases activity (PA) of sound (SD) and caries-affected dentin (CAD) in the dentin hybrid layer after using an experimental bonding system containing pyromellitic dianhydride glycerol methacrylate and biomimetic analogs. The bonding system used a three step and a total-etch procedure. Polyacrylic acid (5%) and sodium trimetaphosphate (5%) were added to the primer and monocalcium phosphate monohydrate (9%), beta-tricalcium phosphate (10.5%), and calcium hydroxide (0.5%) were added to the adhesive. Transmission electron microscopy (TEM) was used to evaluate the resultant structure, particularly the adhesive-dentin and the demineralized-SD interfaces. The chemical composition was evaluated through energy-dispersive X-ray spectroscopy (EDS) and selected area electron diffraction (SAED). The PA was measured with the Coomassie Blue-G250 coloring test, and the PA data were analyzed by ANOVA. EDS identified the presence of isolated calcium phosphate nanoparticles in the demineralized region; however, the SAED analysis did not show any evidences of hydroxyapatite (HA) neoformation in SD and CAD. The biomimetic analog-based adhesive system inhibited the activities of dentin proteases immediately after treatment. Additionally, the proteolytic activity on the affected dentin resembled that of the SD. In conclusion, no HA formed in the demineralized SD and CAD although there were calcium and phosphate deposits. The experimental adhesive system inhibited dentin proteases. The present study uses a new approach to investigate the hybrid layer behavior in dentin. The experimental adhesive system was synthesized and used on sound and affected-caries dentin as the substrate to reproduce real clinical conditions.

Efeitos de tecnologia no conhecimento, atitude e prática de gestantes para o parto / Effects of technology on knowledge, attitude and practice of pregnant women for childbirth

Objetivo avaliar os efeitos de vídeo educativo sobre o conhecimento, a atitude e a prática de gestantes para o parto ativo. Métodos estudo quase experimental, desenvolvido em dez unidades básicas de saúde da família, com 167 gestantes no último trimestre, por meio de instrumento construído e validado para levantamento do conhecimento, da atitude e prática. No Grupo Intervenção, a investigação foi aplicada, acompanhada de sessão educativa, com exposição de vídeo. Para o Grupo Controle, a investigação e a consulta pré-natal de rotina foram aplicadas. Resultados o Grupo Intervenção apresentou maior adequação em conhecimento, atitude e prática, com estatísticas significativas em todas as variáveis, destacando a influência do vídeo educativo para o parto ativo. Conclusão o uso de vídeo educativo se destacou positivamente como tecnologia educacional para conhecimento, atitude e prática de gestantes em relação ao parto ativo.

Objective to evaluate the effects of educational video on the knowledge, attitude and practice of pregnant women for active childbirth. Methods a quasi-experimental study, developed in ten basic family health units, with 167 pregnant women in the last trimester, through a built and validated instrument to survey knowledge, attitude and practice. In the Intervention Group, the research was applied, accompanied by an educational session, with video exposure. For the Control Group, routine prenatal investigation and consultation were applied. Results the Intervention Group presented greater adequacy in knowledge, attitude and practice, with significant statistics in all variables, highlighting the influence of educational video for active childbirth. Conclusion the use of educational video stood out positively as educational technology for knowledge, attitude and practice of pregnant women in relation to active childbirth.

Repercussões da gravidez na adolescência na vida da mulher adulta / Repercussions of teenage pregnancy in the life of adult women

Desvelar as repercussões da gravidez ocorrida na adolescência para a vida da mulher na idade adulta. Métodos: estudo qualitativo realizado em uma Unidade Básica de Saúde. Para coleta de dados, foram realizadas entrevistas individuais e gravadas com sete mulheres. Para organização dos dados, adotou-se a Análise de Categorias Temáticas. Resultados: emergiram três categorias: Recordando as vivências da gravidez na adolescência, Repercussões positivas e negativas da gravidez na adolescência na visão das mulheres e Resgatando conhecimentos sobre os métodos contraceptivos na adolescência. Conclusão: a gravidez ocorrida na adolescência repercutiu de forma positiva quando relatado o desenvolvimento da responsabilidade e da maturidade, constituição de uma família, e ser mãe. Quanto aos aspectos negativos a não conclusão dos estudos;medo de ter outro filho; responsabilidade; dificuldade no alcance de planos para o futuro.

Objective: to uncover the repercussions of pregnancy during adolescence on the life of women in adulthood.Methods: a qualitative study performed in a Basic Health Unit. Individual data were collected and recordedwith seven women for data collection. For the organization of the data, the Thematic Categories Analysis wasadopted. Results: three categories emerged: recalling the experiences of pregnancy in adolescence, positive andnegative repercussions of teenage pregnancy in the view of women and rescuing knowledge about contraceptivemethods in adolescence. Conclusion: the pregnancy occurred in adolescence had positive repercussions whenreporting the development of responsibility and maturity, the constitution of a family, and being a mother. Asfor the negative aspects, the following were observed: the non-completion of the studies; fear of having anotherchild; responsibility; difficulty in reaching plans for the future.

Knowledge of oral cancer among the community served during the stomatological lesion prevention campaign conducted at Universidad Católica de Santiago de Guayaquil - Ecuador.

The aim of this study was to evaluate the level of knowledge on oral cancer and level of preventive care among the population. A descriptive cross-sectional study was performed to evaluate 408 individuals through a face-to-face survey at Universidad Católica de Santiago de Guayaquil during the 2016 academic year. Sixty-one percent (61%) of respondents said they knew of the existence of oral cancer, but 56.1% did not know that 'white spots' in the oral cavity could become malignant, and 50.7% did not know that 'lumps'could be oral cancer. Moreover, 81.8% said they had never undergone screening for oral cancer. This shows the continued need to implement preventive measures such as educating patients in self-examination of the oral cavity, intensifying prevention campaigns and raising awareness among dentists regarding their responsibility in early detection.

Este estudio tuvo como objetivo evaluar el nivel de conocimiento de la población sobre el cáncer bucal y evaluar el nivel de atención preventiva. Se realizó un estudio descriptivo y de corte transversal que evaluó 408 individuos a través de una encuesta de forma personal. El estudio se realizó en la Universidad Católica de Santiago de Guayaquil durante el periodo lectivo 2016. El 61% de los encuestados indicaron conocer la existencia del cáncer bucal, sin embargo 56,1% ignoraban que las "manchas blancas" en cavidad bucal podrían malignizar; 50,7% desconocían que los "bultos"podrían ser un cáncer bucal. Por otra parte, el 81,8% respondieron nunca haber sido sometidos a un examen de prevención contra el cáncer bucal. Esto nos muestra que es necesario continuar estableciendo medidas preventivas tales como educar a los pacientes en la realización de un autoexamen de la cavidad bucal, intensificar las campañas de prevención y concientizar a los odontólogos en cuanto a su responsabilidad en la detección precoz.

Knowledge of oral cancer among the community served during the stomatological lesion prevention campaign conducted at Universidad Catolica de Santiago de Guayaquil - Ecuador

The aim of this study was to evaluate the level of knowledge on oral cancer and level of preventive care among the population. A descriptive crosssectional study was performed to evaluate 408 individuals through a facetoface survey at Universidad Católica de Santiago de Guayaquil during the 2016 academic year. Sixtyone percent (61%) of respondents said they knew of the existence of oral cancer, but 56.1% did not know that 'white spots' in the oral cavity could become malignant, and 50.7% did not know that 'lumps' could be oral cancer. Moreover, 81.8% said they had never undergone screening for oral cancer. This shows the continued need to implement preventive measures such as educating patients in selfexamination of the oral cavity, intensifying prevention campaigns and raising awareness among dentists regarding their responsibility in early detection (AU)

Este estudio tuvo como objetivo evaluar el nivel de cono cimiento de la población sobre el cáncer bucal y evaluar el nivel de atención preventiva. Se realizó un estudio descriptivo y de corte transversal que evaluó 408 individuos a través de una encuesta de forma personal. El estudio se realizó en la Universidad Católica de Santiago de Guayaquil durante el periodo lectivo 2016. El 61% de los encuestados indicaron conocer la existencia del cáncer bucal, sin embargo 56,1% ignoraban que las "manchas blancas" en cavidad bucal podrían malignizar; 50,7% desconocían que los "bultos" podrían ser un cáncer bucal. Por otra parte, el 81,8% respondieron nunca haber sido sometidos a un examen de prevención contra el cáncer bucal. Esto nos muestra que es necesario continuar estableciendo medidas preventivas tales como educar a los pacientes en la realización de un autoexamen de la cavidad bucal, intensificar las campañas de prevención y concientizar a los odontólogos en cuanto a su responsabilidad en la detec ción precoz (AU)

Antinociceptive properties of the mastoparan peptide Agelaia-MPI isolated from social wasps.

Analgesic therapy is based on the sequential treatment of pain, in which opioids are drugs of last resource and known to be highly effective, but are also responsible for undesirable side effects, tolerance and addiction. There is a need for new drugs with alternative targets in order to minimize side effects and improve treatment efficacy. Mastoparans are an abundant class of peptides in wasp venom and have shown great potential as new drugs, as well as being excellent tools for the study of G-protein-coupled receptors. The objective of this study was to investigate the antinociceptive activity of the mastoparan Agelaia-MP I and the mechanisms involved. Agelaia-MP I (MW 1565 Da) showed dose-dependent antinociceptive activity in mice submitted to i.c.v. injection in two different models. The highest dose produced a maximum effect for up to 4 h, and nociception remained low three days after injection. Further experiments showed that Agelaia-MPI induced partial and reversible blockade of the amplitude of action potential, probably interacting with voltage-gated sodium channels. These results revealed the significant potential impact of compounds isolated from wasp venom on the central nervous system (CNS). In addition, the antinociceptive effect described here is a novel activity for mastoparans.

Pathophysiological effects caused by the venom of the social wasp Synoeca surinama.

Envenomation by wasp stings is a public health preoccupation, and signals after stings have variable effects depending on the number of attacks and individual sensitivities. Even with the high rate of wasp sting cases, the study of phatophysiological effects of the envenomation is still very incipient. In this context, early and accurate assessment of this prognostic can aid in the reduction of the symptomatology and complete remission of the later symptoms. Then, the present study evaluated the toxicological effects caused by envenomation produced by Synoeca surinama, a wasp easily found in Neotropical regions. In vivo tests comprised the evaluation of LD50 (OECD 423), nociception, edema, myotoxic lesion and hemorrhage induction, in vitro tests were realized to evaluate hemolysis, contractile and coagulation alteration. The envenomation effects observed were dose- and time-dependent; the LD50 observed for S. surinama was 178 µg/kg, approximately 17 times more lethal than that of the honeybee. Moreover, a potent algesic and oedema effect, and weak hemorrhagic signal were observed after injection of the venom wasp. Assays in vitro showed that this venom is able to prolong the clotting time of plasma and to increase creatine kinase levels. Our results demonstrated that this venom induced serious local and systemic effects in mammals and, so, to avoid permanent damage to the patient, health professionals should carefully investigate each accident. Moreover, due to its high occurrence in Neotropical regions, ecological management, particularly in areas with free access of children and elderly, should be performed.

Anxiolytic activity and evaluation of potentially adverse effects of a bradykinin-related peptide isolated from a social wasp venom.

Anxiety disorders are major health problems in terms of costs stemming from sick leave, disabilities, healthcare and premature mortality. Despite the availability of classic anxiolytics, some anxiety disorders are still resistant to treatment, with higher rates of adverse effects. In this respect, several toxins isolated from arthropod venoms are useful in identifying new compounds to treat neurological disorders, particularly pathological anxiety. Thus, the aims of this study were to identify and characterize an anxiolytic peptide isolated from the venom of the social wasp Polybia paulista. The peptide was identified as Polisteskinin R, with nominal molecular mass [M+H](+)=1301Da and primary structure consisting of Ala-Arg-Arg-Pro-Pro-Gly-Phe-Thr-Pro-Phe-Arg-OH. The anxiolytic effect was tested using the elevated plus maze test. Moreover, adverse effects on the spontaneous behavior and motor coordination of animals were assessed using the open field and rotarod tests. Polisteskinin R induced a dose-dependent anxiolytic effect. Animals treated with the peptide and diazepam spent significantly more time into the open arms when compared to the groups treated with the vehicle and pentylenetetrazole. No significant differences in spontaneous behavior or motor coordination were observed between the groups, showing that the peptide was well tolerated. The interaction by agonists in both known BK receptors induces a variability of physiological effects; Polisteskinin R can act on these receptors, inducing modulatory activity and thus, attenuating anxiety behaviors. The results of this study demonstrated that the compound Polisteskinin R exerted potent anxiolytic effects and its analogues are promising candidates for experimental pharmacology.

Sífilis secundaria: lesiones orales como única manifestación. Informe de caso en adolescente / Secondary syphilis: oral lesions as the only physical feature: case report in an adolescent

Comunicar un caso clínico poco frecuente para contribuir al conocimiento de las características clínico-diagnósticas de las manifestaciones bucales de la sífilis y del abordaje terapéutico de esta patología. Caso clínico: una paciente femenina de 15 años de edad, sin antecedentes patológicos, fue derivada a la Cátedra de Odontología Integral Niños de la Universidad de Buenos Aires, por lesiones orales de 30 días de evolución. Clínicamente, se observaron rosáceas en filtrum, escamas en semimucosa labial, pápulas y erosiones; además, se hallaron adenopatías submaxilares bilaterales y occipitales. Se solicitaron hemograma completo, eritrosedimentación, VDRI cuantitativa y cualitativa, FTA-abs y prueba de Elisa para VIH. Tras los resultados, la paciente fue derivada a un servicio de infectología, con diagnóstico presuntivo de secundarismo sifilítico. Allí recibió tratamiento con penicilina G benzatínica 2.400.000 Ul en dosis única. Conclusión: el diagnóstico oportuno y un tratamiento precoz evitan las complicaciones serias y la diseminación de la enfermedad...

Síndrome de hiperinmunoglobulinemia E: revisión de la casuística con énfasis en las manifestaciones orofaciales / Hyperimmunoglobulinemia E syndrome: a review of the literature with emphasis on orofacial manifestations

El síndrome de Hiper EgE (SHIE) es una rara inmunodeficiencia caracterizada por abscesos cutáneos, neumonías recurrentes, conformación de neumatoceles y elevados niveles de IgE en suero. Se ha reconocido la asociación de rasgos faciales, esqueléticos y dentales, pero su frecuencia es poco conocida. Objetivo: describir la epidemiología, presentación clínica, hallazgos de laboratorio y tratamiento de este síndrome desde el punto de vista médico y odontológico, con énfasis en las manifestaciones estomatológicas y dentales. Métodos. Métodos: realizamos una revisión científica sistemática de todos los reporte y series de casos de SHIE en las bases de datos Lilacs, Medline, SciELO y Biblioteca Cochrane, utilizando como descriptores DeCS/MeSH las palabras claves: hyper IgE AND immunodeficiency, hypereosinophilia, Job´s syndrome, hiperinmunoglobulinemia E. Resultados: revisamos 31 publicaciones con 328 pacientes. Los abscesos cutáneos se encontraron en 89 pior ciento de los casos, la neumonía en el 87 por ciento y la IgE sérica dio una mediana de 3.417 Ul/mL. Los rasgos faciales característicos estuvieron en el 69 por ciento, las alteraciones dentarias en 58 por ciento y la candidiasis oral fue reportada en 53 por ciento de los pacientes. Conclusión: el síndrome de IgE es un desorden multisistémico que afecta a la dentición, el esqueleto, el tejido conectivo y el sistema inmune. Por esto, el odontopediatra debe ser capaz de reconocer el fenotipo orofacial para mejorar la calidad del diagnóstico y brindar el abordaje terapéutico apropiado...

Tecnologias utilizadas por acompanhantes no trabalho de parto e parto: estudo descritivo / Las tecnologías utilizadas por acompañantes en el trabajo de parto y parto: estudio descriptivo / Technology used by companions in labor and childbirth: a descriptive study

To evaluate the knowledge of companions about the use of support techniques during childbirth. Method: A descriptive, cross-sectional quantitative study undertaken at the Assis Chateaubriand Maternity Hospital with a sample of 62 companions. Data collection was undertaken from May to November 2011, through individual interviews and a survey. The Pearson's chi-square tests and Fisher's exact test for statistical associations were used. Results: 59 (95.2%) of the companions who witnessed the birth did not undergo any training; 32 (51.6%) were selected at the time of entry of the pregnant women in the emergency room; emotional support activities were predominant. The experience of witnessing the birth was considered to be positive on the part of 58 (96%) of the companions. Discussion: the most common relationship between companion and the pregnant woman were mother and daughter respectively. Feelings of insecurity and fear were experienced by some of the companions. Conclusion: the companion's presence during labor constitutes a major form of care...

Verificar o conhecimento de acompanhantes acerca das técnicas de apoio durante o parto. Método: estudo descritivo, transversal e quantitativo realizado na Maternidade Escola Assis Chateaubriand com amostra de 62 acompanhantes. A coleta de dados correu de maio a novembro de 2011, por meio de entrevista individual com utilização de um formulário. Utilizaram-se os testes Qui-quadrado de Pearson e Teste Exato de Fisher para as associações estatísticas. Resultados: 59 (95,2%) acompanhantes que presenciaram o parto não realizaram capacitação; 32 (51,6%) foram escolhidos no momento de entrada da gestante na emergência; predominaram atividades de apoio emocional. A experiência de ter acompanhado o parto foi considerada positiva por 58 (96%) acompanhantes. Discussão: as relações de parentesco entre acompanhante e parturiente mais frequentes foram mãe e filha. Sentimentos de insegurança e medo acompanharam alguns acompanhantes. Conclusão:o acompanhante durante o parto constitui-se em importante tecnologia de cuidado...

Verificar el conocimiento de acompañantes sobre las técnicas de apoyo durante el parto. Método: estudio descriptivo, transversal y cuantitativo realizado en la Maternidad Escuela Assis Chateaubriand con muestra de 62 acompañantes. La recolección de datos cse pasó de mayo a noviembre de 2011, por medio de entrevista individual con utilización de un formulario. Se utilizaron los testes Qui-quadrado de Pearson y Teste Exato de Fisher para las asociaciones estadísticas. Resultados: 59 (95,2%) acompañantes que presenciaron el parto no realizaron capacitación; 32 (51,6%) fueron elegidos en el momento de entrada de la mujer embarazada en la emergencia; predominaron actividades de apoyo emocional. La experiencia de tener acompañado el parto fue considerado positivo por 58 (96%) acompañantes. Discusión: las relaciones de parentesco entre acompanhante y parturiente mais frecuentes fueron madre y hija. Sentimientos de inseguridad y miedo acompañaron algunos acompañantes. Conclusión: el acompañante durante el parto se constituye en importante tecnologia de cuidado...

Assistência multiprofissional à mulher vítima de violência: atuação de profissionais e dificuldades encontradas / Multiprofessional assistance to the woman who is a victim of domestic violence: the professionals' functioning and the difficulties found / Asistencia multiprofesional a la mujer víctima de violencia: actuación de profesionales y dificultades encontradas

Objetivou-se identificar o papel de profissionais atuantes em serviço de referência à mulher vítima de violência e descrever as dificuldades encontradas. Estudo descritivo, qualitativo, realizado em centro de referência em atendimento à vítimas de violência, em Fortaleza-Ceará, entre setembro e outubro de 2009. Foram entrevistados 20 profissionais atuantes no serviço, cujos dados foram coletados e analisados, conforme a técnica de análise de narrativas. Os resultados mostram que as mulheres seguiam fluxo de atendimento por meio da equipe multidisciplinar, com a assistência de profissionais de nível elementar, médio e superior. Os profissionais enfatizaram diversos obstáculos relacionados à ressocialização das vítimas, a não aceitação de acompanhamento psicológico e a escassez de recursos humanos. Enfatiza-se a necessidade de maior interação da rede de saúde com os serviços de referência, proporcionando a reestruturação emocional e social da mulher vítima de violência.

The aim was to identify the role of the professionals acting in a service of excellence for women who are victims of domestic violence, and to describe the difficulties found. This descriptive and qualitative study was undertaken in a center of excellence in treating victims of violence, in Fortaleza-Ceará, between September and October 2009. Interviews were held with 20 professionals working in this service; their data was collected and analyzed in line with the technique of analysis of narratives. The results show that the women followed a route of attendance via the multidisciplinary team, with the assistance of professionals from the elementary, middle and higher levels. The professionals emphasized various obstacles related to the re-socialization of the victims, their refusal to accept psychological follow-up, and the scarcity of human resources. The need is emphasized for greater interaction of the healthcare network with the services of excellence, providing emotional and social restructuring of the woman who is the victim of violence.

Estudio cuyo objetivo fue identificar el papel de profesionales actuantes en servicio de referencia a la mujer víctima de violencia y describir las dificultades encontradas. Estudio descriptivo, cualitativo, realizado en centro de referencia en atendimiento a las víctimas de violencia, en Fortaleza, Ceará, entre septiembre y octubre de 2009. Fueron entrevistados 20 profesionales actuantes en el servicio, cuyos datos fueron obtenidos y analizados de acuerdo con la técnica de análisis de narrativas. Los resultados muestran que las mujeres seguían flujo de atendimiento por medio del equipo multidisciplinar, con asistencia de profesionales de nivel elementar, medio y superior. Los profesionales enfatizaron diversos obstáculos acerca de la resocialización de las víctimas, la no aceptación de acompañamiento psicológico y la escasez de recursos humanos. Se destaca la necesidade de más interacción de la red de salud con los servicios de referencia, proporcionando la restructuración emocional y social de la mujer víctima de violencia.

Arthropod venoms: a vast arsenal of insecticidal neuropeptides.

Arthropods are the most diverse animal group on the planet, and occupy almost all ecological niches. Venomous arthropods are a rich source of bioactive compounds evolved for prey capture and defense against predators and/or microorganisms. These highly potent chemical arsenals represent an available source for new insecticidal compounds as they act selectively on their molecular targets. These toxins affect the invertebrate nervous system and, until the moment, several insecticidal compounds belonging to the class of peptides or polyamine-like compounds have been purified and characterized from the venom of arachnids and hymenopterans. This review focuses on invertebrate-specific peptide neurotoxins that have been isolated from the venom ofspiders, scorpions, centipedes, ants, and wasps, discussing their potential in pest control and as invaluable tools in neuropharmacology.

Percepções de enfermeiras sobre a assistência prestada a mulheres diante do óbito fetal / Nurses' perception on the assistance provided to women facing fetal death / Percepciones de enfermeros acerca de la atención a la mujeres delante de la muerte del feto

OBJETIVO: Objetivou-se analisar as percepções de enfermeiras quanto à assistência de enfermagem prestada a mulheres diante do diagnóstico de óbito fetal. Pesquisa com abordagem qualitativa, realizada em uma maternidade-escola de Fortaleza-CE, Brasil, entre setembro e outubro/2009. A amostra constou de nove enfermeiras que atuavam no serviço de gestação de alto risco. Os resultados evidenciaram que o foco da assistência prestada era a oferta de apoio psicológico, através da permissão fornecida às mulheres ou familiares para verem o feto morto. As dificuldades mais citadas estiveram associadas à questão estrutural da maternidade, que não possuía uma enfermaria específica para as mães com diagnóstico de óbito fetal. Ademais, citaram a sobrecarga de trabalho, uma vez que exerciam funções que não integravam os procedimentos de práxis. Destaca-se, portanto, a necessidade de uma assistência diferenciada às mulheres ante o óbito fetal, que abranja, além dos recursos humanos, questões estruturais dos serviços de saúde.

This study aimed to assess the nurses' perception on the nursing care provided to women facing the diagnosis of fetal death. Research with qualitative approach carried out in a maternity school in Fortaleza-CE, Brazil, from September to October 2009. The sample was composed of nine nurses who worked in the service of high-risk pregnancy.The results showed that the focus of assistance offered was the provision of psychological support, through the permission given to women or family members to see the dead fetus. The difficulties most frequently mentioned were associated with the structural issue of motherhood that did not have a specific ward for mothers with a diagnosis of fetal death. They also mentioned the heavy workload, once they had functions that were not part of the procedures of praxis. Thus, we emphasize the need for a different assistance to women facing fetal death covering, in addition to human resources, structural issues of health services.

El objetivo del estudio fue analizar las percepciones de enfermeras sobre la atención en enfermería a la mujer con diagnóstico de muerte fetal. Investigación cualitativa, realizada en una maternidad escuela de Fortaleza-CE, Brasil, entre septiembre y octubre de 2009. La muestra consistió de nueve enfermeras del servicio de embarazo de alto riesgo. Los resultados mostraron que el enfoque de la asistencia fue la prestación de apoyo psicológico, a través de la autorización fornecida a las mujeres o familiares para miraren el feto muerto. Las dificultades más frecuentes estuvieron asociadas a la estructura de la maternidad, que no tiene sala específica para las madres con diagnóstico de muerte fetal. Citaron, también, la sobrecarga de trabajo, pues actuaban en procedimientos además de la praxis. Se apunta, así, la necesidad de una atención diferenciada a la mujer con muerte del feto que señale, además de los recursos humanos, las cuestiones estructurales de los servicios de salud.

Saúde e cuidado na percepção de estudantes adolescentes: contribuições para a prática de enfermagem / Health and care in the perception of adolescent students: contributions to nursing practice / Salud y cuidado en la percepción de estudiantes adolescentes: contribuciones para la práctica de enfermería

O estudo teve por objetivo descrever as percepções de adolescentes sobre saúde e cuidado. Trata-se de uma pesquisa descritiva de abordagem qualitativa realizada com 15 adolescentes de uma escola pública de Fortaleza-Ceará, nos meses de agosto a outubro de 2009. Utilizou-se o grupo focal como estratégia de coleta de dados, cujo conteúdo foi analisado utilizando a técnica de análise categorial por temática, surgindo as categorias: Percepções de saúde para os adolescentes e Percepções de cuidado para os adolescentes. Os participantes concebem a saúde como atitude pessoal associada ao exercício físico e boa alimentação. O cuidado aproxima-se da noção de saúde, por meio da manutenção das relações sociais, mas também numa relação com a doença e a procura de serviços médicos. Dessa forma, refletir as percepções dos adolescentes sobre saúde e cuidado permite estimular a sua co-responsabilidade, direcionando as práticas da enfermagem para esse público específico...

The study aimed to describe the perceptions of adolescents about health and care. It is descriptive research with a qualitative approach, undertaken with 15 adolescents from a state school in Fortaleza-Ceará, in the period August to October of 2009. The focus group was used as a data collection strategy. The content was analyzed using the technique of categorical data analysis by theme, with the following categories emerging: Perceptions of health for adolescents and Perceptions of care for adolescents. The participants conceive of 'health' as a personal attitude associated with physical exercise and good eating habits. 'Care' is close to the notion of health, via maintenance of social relations, but also in a relationship with illness and the search for medical services. In this way, reflecting adolescents' perceptions about health and care permits the stimulation of their co-responsibility, directing nursing practices toward this specific population...

Este estudio tuvo el propósito de describir las percepciones de adolescentes sobre salud y cuidado. Es una investigación descriptiva de abordaje cualitativo realizada con 15 adolescentes de una escuela pública de Fortaleza - Ceará, en los meses de agosto a octubre de 2009. Fue utilizado el grupo focal como estrategia para recoger los datos, y el contenido fue analizado utilizándose la técnica de análisis categorial por temática, surgiendo las categorías: Percepciones de salud para los adolescentes y Percepciones de cuidado para los adolescentes. Los participantes conciben la salud como actitud personal asociada al ejercicio físico y a la buena alimentación. El cuidado se aproxima de la noción de salud, por medio de la manutención de las relaciones sociales, pero también en una relación con la enfermedad y la búsqueda por servicios médicos. De esa forma, reflexionar las percepciones de los adolescentes sobre salud y cuidado permite estimular sua corresponsabilidad, direcionando las prácticas de la enfermería para ese público específico...

Violência contra a mulher: caracterização de casos atendidos em um centro estadual de referência / Violence against women: characterization of cases assisted in a state reference center

Estudo descritivo, quantitativo, cujos objetivos foram traçar o perfil socioeconômico e tocoginecológico de mulheres vítimas de violência, identificar os principais tipos de violência e conhecer os motivos desta. Realizado em um Centro Especializado de Referência em atendimento a mulheres vítimas de violência, em Fortaleza-CE, Brasil. Foram entrevistadas 64 mulheres entre abril e maio/2009. Encontrou-se um perfil de mulheres jovens (75%), com 1 a 3 filhos (73,4%), que viviam com o companheiro (81,2%), principal agressor (81,2%), que cometeu principalmente violência psicológica (100%) na própria residência (84,3%). As lesões físicas resultaram em denúncia, na maioria dos casos (93,5%), porém poucos resultaram na realização de exames de corpo de delito (42%). Enfatiza-se o papel dos profissionais de saúde em reconhecer possíveis situações de violência e desta forma orientar e encaminhar as vítimas às unidades de referência, de modo a prevenir a ocorrência de novos casos de violência.

O significado do cuidado ao parto na voz de quem cuida: uma perspectiva à luz da humanização / The meaning of the childbirth care according to the caregiver: a perspective regarding humanization / El significado de la atención al parto según la voz de quien cuida: una perspectiva a la luz de la humanización

Objetivamos analisar o significado do cuidado ao parto por enfermeiras que atuam em sala de parto. O estudoqualitativo foi realizado em uma maternidade pública federal na cidade de Fortaleza-CE, no mês de abril de 2007, através deentrevista semiestruturada com sete enfermeiras obstetras. A análise das informações obedeceu à técnica de Análise deConteúdo de Bardin. Os resultados após a análise de 713 unidades temáticas e 25 subcategorias foram classificadas em cincocategorias: a mulher como protagonista do seu parto; a família, o ambiente e a assistência: aspectos importantes no processode cuidar; a formação profissional para o parto humanizado; o trabalho em equipe: fundamento para o cuidado ao partohumanizado e gestão das instituições de saúde: co-responsabilidade pelo parto humanizado. O cuidar humanizado deve estarpautado em uma assistência multiprofissional, tendo como foco principal o bem-estar do binômio mãe e filho.

This study aimed to analyse the meaning of the childbirth care performed by nurses that work in the deliveryroom. The qualitative study was carried out at a large public maternity in the city of Fortaleza-CE, in April 2007, through asemi-structured interview with seven obstetrician nurses. The information was analyzed according to Bardin ContentAnalysis. The results after the analysis of 713 thematic units and 25 subcategories were classified in five categories: thewoman as protagonist of the childbirth; family, environment and assistance: important aspects in the care process; theformation professional for the humanized childbirth; team work: base of the childbirth care humanized of Health institutions:co-responsibility for the humanized childbirth. It is considered that the humanized care should be ruled in a multiprofessionaland assistance with focus in the well-being of the binomial mother and son.

Objetivamos analizar el significado del cuidado al parto por enfermeras que actúan en la sala de parto. Elestudio cualitativo fue realizado en una maternidad pública federal en la ciudad de Fortaleza-CE, en el mes de abril de 2007,a través de una entrevista semiestructurada con siete enfermeras obstetras. El análisis de las informaciones obedeció a latécnica de Análisis del Contenido de Bardin. Los resultados después del análisis de 713 unidades temáticas y 25subcategorías fueron clasificadas en cinco categorías que fueron: la mujer como protagonista de su parto; la familia, elambiente y la asistencia: aspectos importantes en el proceso de cuidar; la formación profesional para el parto humanizado;el trabajo en equipo: fundamento para el cuidado al parto humanizado y gestión de las instituciones de salud:corresponsabilidad por el parto humanizado. La atención humanizada debe estar pautada en una asistencia multiprofesional,teniendo como foco principal el bienestar del binomio madre e hijo.