Predictors of Interstitial Lung Disease in Mixed Connective Tissue Disease.

Interstitial lung disease (ILD) frequently complicates mixed connective tissue disease (MCTD) and contributes to increased mortality. We aimed to identify predictors of ILD in MCTD patients. This is a nationwide, multicentre, retrospective study including patients with an adult-onset MCTD clinical diagnosis who met Sharp's, Kasukawa, Alarcón-Segovia, or Kahn's diagnostic criteria and had available chest high-resolution computed tomography (HRCT) data. Univariate and multivariate analyses were conducted. We included 57 MCTD patients, with 27 (47.4%) having ILD. Among ILD patients, 48.1% were asymptomatic, 80.0% exhibited a restrictive pattern on pulmonary function tests, and 81.5% had nonspecific interstitial pneumonia on chest HRCT. Gastroesophageal involvement (40.7% vs. 16.7%, p = 0.043) and lymphadenopathy at disease onset (22.2% vs. 3.3%, p = 0.045) were associated with ILD. Binary logistic regression identified lymphadenopathy at disease onset (OR 19.65, 95% CI: 1.91-201.75, p = 0.012) and older age at diagnosis (OR 1.06/year, 95% CI: 1.00-1.12, p = 0.046) as independent ILD predictors, regardless of gender and gastroesophageal involvement. This study is the first to assess a Portuguese MCTD cohort. As previously reported, it confirmed the link between gastroesophageal involvement and ILD in MCTD patients. Additionally, it established that lymphadenopathy at disease onset and older age at diagnosis independently predict ILD in MCTD patients.

Factors associated with the lifestyle of state basic education teachers of state during the pandemic.

OBJECTIVE: To analyze the prevalence and factors associated with the lifestyle profile of public basic education teachers in Minas Gerais during the COVID-19 pandemic. METHOD: Epidemiological websurvey carried out with public basic education teachers in Minas Gerais. Data collection took place from August to September2020 via digital form. Anthropometric, sociodemographic, work, and lifestyle characteristics were evaluated. Poisson Regression was used. RESULTS: 15,641 teachers participated and 31.1% had inadequate health habits. There was a higher prevalence among men (PR=1.38; 95%CI:1.31;1.45), older age (PR=1.20; 95%CI: 1.07;1.34), greater weekly workload (RP=1.10; 95%CI:1.03;1.17) and those dissatisfied with work (RP=1.21; 95%CI:1.15;1.27). As a protective factor, professors with longer teaching experience (RP=0.92; 95%CI:0.87;0.98) and those hired or appointed (PR=0.89; 95%CI:0.85) ;0.94). CONCLUSION: Lifestyle inadequacy was found among older male teachers, with longer working hours and job dissatisfaction.

Cycling versus swapping strategies in psoriatic arthritis: results from the rheumatic diseases Portuguese register.

OBJECTIVE: To compare the 2-year retention rate between a second tumor necrosis factor alpha inhibitor (TNFi) and secukinumab (SEK) or ustekinumab (UST), in Psoriatic Arthritis (PsA) patients with previous inadequate response to their first TNFi. METHODS: Prospective longitudinal cohort study with a follow-up period of 2 years using the Nationwide Portuguese Reuma.pt database. Patients with a clinical diagnosis of PsA who also fulfill the CASPAR classification criteria, with previous treatment failure to a first-line TNFi and having started a second biotechnological drug (TNFi, SEK or UST) were included. The Cycling group was defined as switching from a first TNFi to a second TNFi, and the Swapping group as switching from a first TNFi to SEK or UST. Sociodemographic data, disease characteristics, disease activity scores and physical function at baseline and after 6, 12 and 24 months were recorded. Cox-proportional hazards regression was used to compare retention rates between Cycling and Swapping groups. To obtain a predictor model of 2-year discontinuation, a multivariable Cox regression model was performed. RESULTS: In total, 439 patients were included, 58% were female, with a mean age (standard deviation) of 49 (12) years. Globally, 75.6% initiated a second TNFi (Cycling group), and 24.4% started SEK/UST (Swapping group). The retention rates after 6, 12 and 24 months were 72%/66%/59% in the Cycling group; and 77%/66%/59% in the Swapping group. There were no significant differences in retention rates between both strategies (HR: 1.06, 95% CI 0.72-1.16). After 2 years of follow-up, 34.4% of patients discontinued their second biologic, mainly due to inefficacy (72.8%), with no differences found between groups. Baseline treatment with glucocorticoids was the only predictor of discontinuation after 2 years of follow-up (HR:1.668, 95% CI 1.154-2.409). CONCLUSIONS: After failure of a first TNF inhibitor, Cycling and Swapping strategies result in similar retention rates suggesting that both are acceptable in the management of patients with psoriatic arthritis.

Factors associated with the lifestyle of state basic education teachers of state during the pandemic / Factores asociados al estilo de vida de los docentes de educación básica estatal durante la pandemia / Fatores associados ao estilo de vida dos professores da educação básica estadual na pandemia

ABSTRACT Objective: To analyze the prevalence and factors associated with the lifestyle profile of public basic education teachers in Minas Gerais during the COVID-19 pandemic. Method: Epidemiological websurvey carried out with public basic education teachers in Minas Gerais. Data collection took place from August to September2020 via digital form. Anthropometric, sociodemographic, work, and lifestyle characteristics were evaluated. Poisson Regression was used. Results: 15,641 teachers participated and 31.1% had inadequate health habits. There was a higher prevalence among men (PR=1.38; 95%CI:1.31;1.45), older age (PR=1.20; 95%CI: 1.07;1.34), greater weekly workload (RP=1.10; 95%CI:1.03;1.17) and those dissatisfied with work (RP=1.21; 95%CI:1.15;1.27). As a protective factor, professors with longer teaching experience (RP=0.92; 95%CI:0.87;0.98) and those hired or appointed (PR=0.89; 95%CI:0.85) ;0.94). Conclusion: Lifestyle inadequacy was found among older male teachers, with longer working hours and job dissatisfaction.

RESUMEN Objetivo: Analizar la prevalencia y los factores asociados al perfil de estilo de vida de los docentes de educación básica pública de Minas Gerais durante la pandemia de COVID-19. Método: Encuesta epidemiológica de tipo websurvey realizada con profesores de educación básica pública en Minas Gerais. La recolección de datos ocurrió de agosto a septiembre2020 a través de formulario digital. Se evaluaron características antropométricas, sociodemográficas, laborales y de estilo de vida. Se utilizó la Regresión de Poisson. Resultados: Participaron 15.641 docentes y el 31,1% presentaba hábitos de salud inadecuados. Hubo mayor prevalencia en hombres (RP=1,38; IC 95%: 1,31; 1,45), mayor edad (RP=1,20; IC 95%: 1,07; 1,34), mayor carga de trabajo semanal (RP=1,10; IC 95%: 1,03). ;1,17) y los insatisfechos con el trabajo (RP=1,21; IC95%:1,15;1,27). Como factor protector, profesores con mayor experiencia docente (RP=0,92; IC95%:0,87;0,98) y contratados o nombrados (RP=0,89; IC95%:0,85;0,94). Conclusión: Se encontró inadecuación en el estilo de vida entre los maestros hombres y mayores, con jornadas laborales más largas e insatisfacción laboral.

RESUMO Objetivo: Analisar a prevalência e fatores associados ao perfil do estilo de vida dos professores da educação básica pública de Minas Gerais na pandemia da COVID-19. Método: Inquérito epidemiológico websurvey realizado com professores da educação básica pública de Minas Gerais. A coleta de dados ocorreu de agosto a setembro/2020 via formulário digital. Foram avaliadas as características antropométricas, sociodemográficas, laborais e estilo de vida. Utilizou-se a Regressão de Poisson. Resultados: Participaram 15.641 professores e 31,1% apresentaram hábitos inadequados de saúde. Houve maior prevalência entre homens (RP=1,38; IC95%:1,31;1,45), maior idade (RP=1,20; IC95%: 1,07;1,34), maior carga semanal de trabalho (RP=1,10; IC95%:1,03;1,17) e os insatisfeitos com o trabalho (RP=1,21; IC95%:1,15;1,27). Como fator de proteção encontraram-se os professores com mais tempo de trabalho docente (RP=0,92; IC95%:0,87;0,98) e contratados ou designados (RP=0,89; IC95%:0,85;0,94). Conclusão: Verificou-se inadequação do estilo de vida entre os professores homens mais velhos, com maior jornada laboral e insatisfação com o trabalho.

Captopril oral solution for pediatric use: formulation, stability study and palatability assessment in vivo

Abstract he aim of this work was to develop an oral solution of captopril at 5 mg/mL preservative-free. Two formulations were prepared, one containing sweetener (formulation 1) and the other without this excipient (formulation 2). The results found of validation parameters from analytical method performed by HPLC for captopril were, linearity 0.9998, the limit of detection 15.71 µg/mL, the limit of quantification 47.60 µg/mL, repeatability 1.05%, intermediate precision 2.42%, accuracy intraday 101,53%, accuracy inter-day 99.85%. Moreover, the results found for captopril disulfide were, linearity 0.9999, limit of detection 0.65 µg/mL, limit of quantification 1.96 µg/mL, repeatability 2.28%, intermediate precision 1.51%, accuracy intraday 101.36%, accuracy inter-day 100.29%. The appearance of formulations was clear and colorless, pH measures were 3.12 and 3.04, dosage of captopril and captopril disulfide were 99.45% and 99.82%, 0.24% and 0.12% for formulation 1 and formulation 2, respectively. The stability study demonstrated that the concentration of captopril and captopril disulfide in the formulations was > 90% and below 3%, respectively. The in vivo palatability study in animals and humans showed that Formulation 1 containing the sweetener had better acceptance. Thus, the sweetener was able to improve the unpleasant taste of the formulation

In Vivo and In Vitro Taste Assessment of Artesunate-Mefloquine, Praziquantel, and Benznidazole Drugs for Neglected Tropical Diseases and Pediatric Patients.

The assessment of drug taste is crucial for pediatric treatments so that formulations can be developed to enhance their effectiveness. In this study, in vivo and in vitro methods were applied to evaluate the taste of tablets of three drugs administered to children without taste-masking excipients to treat tropical diseases, namely artesunate-mefloquine (ASMQ), praziquantel (PZQ), and benznidazole (BNZ). In the first method, a model of rat palatability was adapted with recirculation to ensure sample dispersion, and the data were analyzed using ANOVA (single factor, 95%). The taste assessment results (in vivo) indicated an aversion to the three medicines, denoted by the animals retracting themselves to the bottom of the box after the first contact with the drugs. For the placebo samples, the animals behaved normally, indicating that taste perception was acceptable. The second method was based on the in vitro analysis of capacitance data from a homemade impedimetric electronic tongue. Consistent with the in vivo taste assessment results, the data points obtained with PZQ, ASMQ, and BNZ were far away from those of their placebos in a map built with the multidimensional projection technique referred to as Interactive Document Mapping (IDMAP). A combined analysis of the results with the two methods allowed us to confirm the bitterness of the three drugs, also pointing to electronic tongues as a promising tool to replace in vivo palatability tests.

Dancing with oils - the interaction of lipases with different oil/water interfaces.

The use of enzymes as biocatalysts in industrial applications has received much attention during the last few years. Lipases are widely employed in the food and cosmetic industry, for the synthesis of novel biomaterials and as a greener solution for the treatment of waste cooking oils (WCO). The latter topic has been widely explored with the use of enzymes from several origins and types, for the treatment of different used and non-used cooking oils. The experimental conditions of such works are also quite broad, hampering the detailed understanding of the process. In this work we present a detailed characterization of the interaction of several commonly used lipases with different types of vegetal oils and food fats through coarse-grained molecular dynamics simulations. First, the molecular details of the oil/water (O/W) mixtures, namely at the O/W interface, are described. The O/W interface was found to be enriched in triglyceride molecules with higher polarity. Then, the interaction of lipases with oil mixtures is characterized from different perspectives, including the identification of the most important protein residues for this process. The lipases from Thermomyces lanuginosus (TLL), Rhizomucor miehei (RML) and Candida antarctica (CALB) were found to bind to the O/W interface in a manner that makes the protein binding site more available for the oil molecules. These enzymes were also found to efficiently bind to the O/W interface of all oil mixtures, which in addition to reactivity factors, may explain the efficient applicability of these enzymes to a large variety of edible oils and WCO.

Towards Customized Footwear with Improved Comfort.

A methodology enabling the customization of shoes for comfort improvement is proposed and assessed. For this aim, 3D printed graded density inserts were placed in one of the critical plantar pressure zones of conventional insoles, the heel. A semi-automated routine was developed to design the 3D inserts ready for printing, which comprises three main stages: (i) the definition of the number of areas with different mesh density, (ii) the generation of 2D components with continuous graded mesh density, and (iii) the generation of a 3D component having the same 2D base mesh. The adequacy of the mesh densities used in the inserts was previously assessed through compression tests, using uniform mesh density samples. Slippers with different pairs of inserts embedded in their insoles were mechanically characterized, and their comfort was qualitatively assessed by a panel of users. All users found a particular pair, or a set, of prototype slippers more comfortable than the original ones, taken as reference, but their preferences were not consensual. This emphasizes the need for shoe customization, and the usefulness of the proposed methodology to achieve such a goal.

In vitro and in silico studies for barbinervic acid, a triterpene isolated from Eugenia punicifolia that inhibits vasopressor tone.

We investigated the role of triterpene barbinervic acid from Eugenia punicifolia dichloromethane extract in vasopressor responses. Renal arteries were cannulated and perfused with Krebs-Hepes solution. Changes in aorta isometric tension were recorded and transferred to a data acquisition system. Cumulative curves were constructed based on the maximum effect of agonists. Barbinervic acid reduced the renal tonus induced by NA in a NO-dependent manner (IC50 = 30 µM). Triterpene (70 µM) also induced rapid and transient relaxation in aorta that had been precontracted with K+ (53.2 ± 0.05%) or phenylephrine (36.7 ± 0.05%). In silico data revealed two possible active sites for interactions between barbinervic acid and NO synthase. Barbinervic acid showed a vasodilator effect and could potentially be used as a template for developing new molecules for the treatment of cardiovascular disease.

Microwave Assisted Synthesis of 4-Phenylquinazolin-2(1H)-one Derivatives that Inhibit Vasopressor Tonus in Rat Thoracic Aorta.

Quinazolinones have pharmacological effects on vascular reactivity through different mechanisms. We synthesized 4-phenylquinazolin-2(1H)-one derivatives under microwave irradiation and tested them on the rat thoracic aorta. The prepared compounds 2a-2f were obtained in about 1 h with suitable yields (31-92%). All derivatives produced vasorelaxant effects with IC50 values ranging from 3.41 ± 0.65 µM to 39.72 ± 6.77 µM. Compounds 2c, 2e and 2f demonstrated the highest potency in endothelium-intact aorta rings (IC50 4.31 ± 0.90 µM, 4.94 ± 1.21 µM and 3.41 ± 0.65 µM respectively), and they achieved around 90% relaxation (30 µM). In aorta rings without an endothelium, the effect of compound 2f was abolished. Using the MTT assay to test for cell viability, only compound 2b induced cytotoxicity at the maximum concentration employed (30 µM). The results show that vasorelaxation by 4-phenylquinazolin-2(1H)-one derivatives might depend on the activation of a signalling pathway triggered by endothelium-derived factors.

Investigation of a Microemulsion Containing Clotrimazole and Itraconazole for Transdermal Delivery for the Treatment of Sporotrichosis.

The aim of this study was to develop a microemulsion (ME) formulation containing an association of itraconazole (ITC) and clotrimazole (CLT) as a transdermal delivery system for the treatment of sporotrichosis. Pseudoternary phase diagrams were constructed to optimize the ME formulation. The ME formulation selected contained 1% (w/w) ITC and 1% (w/w) CLT and was composed of 23.07% Tween® 60 (surfactant), 23.07% propylene glycol (cosurfactant/cosolvent), 30.77% benzyl alcohol (oil), and 21.09% water. The ITC/CLT-loaded ME (ITC/CLT-ME) had a droplet size value of 217 ± 0.9 nm, with a polydispersity index of 0.5 ± 0.1. Permeation experiments on pig ear skin were conducted for ITC/CLT-ME, and the results indicated that the drug permeation performance was influenced by CLT, indicating that CLT acts as a promoter enhancer. In the in vitro antifungal activity assay using Sporothrix brasiliensis yeast, the inhibition halo produced by ITC/CLT-ME exhibited a mean diameter of 43.67 ± 2.31 mm. The ITC/CLT-ME formulation did not cause skin irritation in mice. The results suggest that ITC/CLT-ME is a promising tool for the transdermal treatment of sporotrichosis.

Pacemaker implantation in familial amyloid polyneuropathy: when and for whom?

BACKGROUND: Despite the important role of cardiac pacing in preventing syncope and sudden cardiac death in familial amyloid polyneuropathy (FAP), we lack clear guidelines as to the ideal timing and indications for permanent pacemaker implantation. PURPOSE: The purpose of this study was to evaluate the ideal timing for pacemaker implantation in FAP patients submitted to liver transplantation. METHODS: Retrospective study of 258 FAP patients submitted to liver transplantation between 1992 and 2012. Comparison of three groups: (A) patients without pacemaker (N = 122); (B) patients submitted to pacemaker implantation after liver transplantation, with documented conduction disorders (N = 73); and (C) patients submitted to "prophylactic" pacemaker implantation before transplantation, (N = 73). Patients were followed up for 12.2 ± 6.7 years. RESULTS: The majority of patients (57%) were referred for pacemaker implantation, which occurred before liver transplantation in 50% of cases. Patients who required pacemaker after transplantation presented significantly higher Machado-Joseph Score during pre-transplant evaluation than those who did not require pacemaker (24 ± 10 vs 20 ± 10, p = .025), and also exhibited higher levels of hepatic cytolysis enzymes and hyperbilirubinemia. The most common indication for permanent pacemaker was first degree atrioventricular block, with a mean time between transplantation and pacemaker implantation of 8.7 ± 4.2 years. During long-term follow-up, all-cause mortality was 27% and was lowest in the group submitted to pacemaker implantation only after liver transplantation (p = 0.002). CONCLUSION: The majority of FAP patients submitted to liver transplantation will need a pacemaker at some time of follow-up. However, it seems that there is no benefit in "prophylactic" cardiac pacing before liver transplantation.

Volatile phenols depletion in red wine using molecular imprinted polymers.

Wines can be modified by microorganisms during the ageing process, by producing off-flavours like volatile phenols (VP), leading to their deterioration, with great economic losses. The development of methods to recover wines affected by unwanted VP became an important target. Molecular imprinted polymers (MIPs) are synthetic materials with artificially-generated recognition sites for selective extraction of organic compounds from different matrices. In this work, two MIPs to remove unwanted VP from wines were developed and their effects were evaluated. Volatile compounds were determined by GC-FID and GC-IT/MS and phenolic compounds (non-coloured and anthocyanins) by HPLC-DAD. The treatment with MIP-4EG and MIP-4EP significantly reduced the content of 4-ethylguaiacol and 4-ethylphenol, respectively. Nevertheless, the changes observed in wine non-coloured and coloured phenolics and sensorial analysis indicate that their specificity and selectivity regarding off-flavours still needs to be improved.

Phenolic profile and biological potential of Endopleura uchi extracts.

OBJECTIVE: To improve the knowledge on the metabolite composition of Endopleura uchi bark, concerning phenolic compounds, and to evaluate some of its biological capacities for further possible exploitation in food and pharmaceutical industries associated to their health-promoting qualities. METHODS: Two different extracts (infusion and hydroethanolic) were studied concerning phenolic composition and biological potential. RESULTS: Five compounds were determined by HPLC-DAD, being bergenin the major one. In general way, infusion presents a greater richness in these metabolites. The antioxidant, acetylcholinesterase, butyrylcholinesterase, α-glucosidase and antibacterial activity were checked by in vitro assays. A dose-dependent response was noticed against DPPH, superoxide and nitric oxide radicals, acetylcholinesterase, butyrylcholinesterase and against α-glucosidase inhibitory assay. Antibacterial capacity of both extracts was investigated against Gram-positive and Gram-negative bacteria, being more effective against the first one. The concentrations of infusion extract tested here revealed that is non-toxic for intestinal (Caco-2) cells line. CONCLUSIONS: The results suggest that the extracts of Endopleura uchi may be interesting for incorporating in pharmaceutical preparations for human health, since it can suppress hyperglycaemia and inhibit cholinesteases, and or as food additive due to its antiradical and antibacterial activities.

Synthesis and tripanocidal activity of ferrocenyl and benzyl diamines against Trypanosoma brucei and Trypanosoma cruzi.

Trypanosoma brucei and Trypanosoma cruzi are the etiologic agents of sleeping sickness and Chagas disease, respectively, two of the 17 preventable tropical infectious diseases (NTD) which have been neglected by governments and organizations working in the health sector, as well as pharmaceutical industries. High toxicity and resistance are problems of the conventional drugs employed against trypanosomiasis, hence the need for the development of new drugs with trypanocidal activity. In this work we have evaluated the trypanocidal activity of a series of N1,N2-dibenzylethane-1,2-diamine hydrochlorides (benzyl diamines) and N1-benzyl,N2-methyferrocenylethane-1,2-diamine hydrochlorides (ferrocenyl diamines) against T. brucei and T. cruzi parasite strains. We show that incorporation of the ferrocenyl group into the benzyl diamines increases the trypanocidal activity. The molecules exhibit potential trypanocidal activity in vitro against all parasite strains. Cytotoxicity assay was also carried out to evaluate the toxicity in HepG2 cells.

Trabalho da enfermeira na saúde da família: potência de (re)construção do modelo assistencial e (re)criação do trabalho da enfermagem? (O)

Neste est udo buscamos c aracterizar o cenário, as enf ermeiras e as aç ões de enfermagem das equipes de Saúde da Família dos municípios vinculados à DIR XVIII -SP, assim c omo a percepção das enf erm eiras quanto ao desenv olviment o do seu trabalho. Este foi tomado com o uma prátic a s ocial, sendo com preendido e determinado pela finalidade social do trabalho. Para t al, utilizamos como referencial teóric o o Process o de Trabalho em Saúde, num estudo ex plorat ório e descritivo. Utilizamos para a colet a de dados a triangulaç ão com f ontes doc um ent ais, com o "Inventário de Ações de Enf ermagem" testado e v alidado pelo Projet o CIPESC e a entrevista semi¬estrut urada c om enf ermeiras das equipes de Saúde da F amília. Na análise, trouxem os uma parte quantit ativ a com a caracterizaç ão dem ográfica e de experiência profissional, assim com o a f reqüência das aç ões de enf erm agem. N a parte qualitativa, por meio da análise de conteúdo, na m odalidade temátic a das entrevistas com as enf erm eiras, identificamos dois temas: Em busca de um novo modelo assist encial e A rec onfiguração do t rabalho da enf ermeira -possibilidades de (re) criação com o Programa de Saúde da Família. Assim, identificamos um aum ento da f reqüência de atividades próprias da enferm eira, ações coletiv as e ações educativ as de apoio e qualificaç ão da assistência, discutindo sob quallógica est ão v oltadas, visto que a finalidade das aç ões nem s empre s e apresenta da f orma clara. As atividades c omplementares a outros profissionais, assim como as voltadas à organizaç ão do processo de trabalho, infra-estrutura e planejamento de serviços continuam sendo desenvolvidas com grande freqüência, gerando conflitos e a necessidade de artic ulação entre as duas dimens ões: administrar e cuidar, um a vez que as mesmas perc ebem ess as atividades como dicotômicas....

Perfil dos trabalhadores de enfermagem no Programa de Saúde da Família / The profile of nursing personnel in the Family Health Program

O estudo objetiva caracterizar a configuração demográfica dos trabalhadores ligados à enfermagem de equipes do PSF de 3 municípios de São Paulo e analisar a percepção destes quanto ao perfil profissional necessário à atuação junto ao PSF. Utilizou-se como instrumento para coleta de dados a entrevista semi-estruturada. Para a sistematização inicial dos dados utilizou-se do software ETHNOGRAPH, e, posteriormente realizou-se análise temática. Os temas identificados na fala dos trabalhadores, apontam para um "perfil necessário" à atuação do PSF: há uma percepção de que os trabalhadores devem ser comunicativos, dedicados, envolvidos, solidários, carinhosos, ter bom relacionamento, disponibilidade e ajudar a população. O conjunto dos dados, embora aponte em alguns momentos para um perfil profissional que contemple uma prática de caráter assistencialista, ao mesmo tempo encaminha para uma reflexão acerca de uma nova configuração da prática assistencial alicerçada na humanização e integralidade da assistência, assim como na construção da cidadania.

O trabalho de enfermagem em atenção primária à saúde: a assistência à saúde da família / The nursing work in primary attention to health: the family health assistance

Este estudo insere-se no projeto integrado de pesquisa A organização do trabalho em atenção primária à saúde - uma perspectiva para o trabalho de enfermagem. Tem como objetivo estudar a percepção dos trabalhadores de enfermagem quanto à configuração da prática de enfermagem em atenção primária à saúde na perspectiva de atenção à saúde das famílias. A investigação configura-se como um estudo de caso, tomando por foco os trabalhadores que atuam no Programa de Saúde da Família no município de Batatais, sendo realizada entrevista semi-estruturada com os trabalhadores de enfermagem da equipe do PSF. Foi realizada a análise temática do conjunto dos dados, sendo a categorização inicial efetivada com o auxílio do softaware ETHNOGRAPH. Os temas identificados na fala dos trabalhadores referem-se à: integralidade, cuidar da saúde, ir em busca do usuário e vínculo. Estes temas encaminham para uma percepção acerca do trabalho no PSF como cheio de dificuldades mas que conduz para uma prática voltada para a efetivação da integralidade da assistência e de maior compartilhar das decisões com a clientela.