[Tubal obstruction with an implant inserted by hysteroscopy: a report of 50 cases]. / Obstrucción tubaria con un implante insertado mediante histeroscopia: reporte de 50 casos.

BACKGROUND: The Essure contraceptive device consists of a titanium and nickel coiled spring containing Dacron fibers. It is placed under hysteroscopic visualizaron in the proximal section of the Fallopian tube. The microinsert acts by inducing a tissue reaction that permanently blocks the tube within three months. OBJECTIVE: Show our experience in the use and insertion of the Essure device, in a private office. METHODS: We reviewed insertion procedure, complications, degree of tolerance and acceptance by user. Between June 2008 and May 2013 fifty cases with Essure placement were made in our office. RESULTS: The average age was 36 years, as for the average number of pregnancies was two. The procedure time average was 6 minutes 25 seconds, no intraoperative complication was reported. All patients expressed very good tolerance and high degree of satisfaction with the procedure. A simple abdominal radiography was performed three months after the hysteroscopy to dem6nstrate the correct placement and position of the device, in all patients. CONCLUSION: [corrected] The number of patients is enough to show the advantages of the method and the possibility of performing it in an ambulatory environment, as it can be a private office with the correct equipment to do it.

Analysis of human tremor in patients with Parkinson disease using entropy measures of signal complexity.

Tremor in Parkinson's disease (PD) is a fundamental feature used in the determination of disease onset and progression. Traditionally, tremor has been evaluated using frequency domain analysis. However, in many cases, this analysis did not show significant differences comparing healthy elders and individuals with PD. Given its complex nature, recently the interest in nonlinear dynamical analysis for better understanding of tremor has grown. In this paper, we examine the effect of PD on the complexity of the tremor time series of PD patients using the approximate entropy method (ApEn). Tremor was also evaluated in the frequency domain. This study involved 11 healthy and 11 PD patients. The peak frequency was similar in both groups, while the amplitude and power in the peak frequency and the total power were significantly higher in PD patients (p < 0.0001). A significant reduction (p < 0.001) in ApEn was observed in PD. ROC analysis showed that ApEn differentiated physiological tremor from tremor in PD patients with high accuracy. These results are in close agreement with pathophysiological fundamentals, and provide evidence that in PD patients the tremor pattern becomes less complex. Furthermore, our findings also suggest that ApEn has a high clinical potential in assessing PD patients.

[The knowledge of chagasic patients about their disease: collective construction of a research instrument and test of its applicability]. / O saber do paciente chagásico sobre a sua doença: construção compartilhada de um instrumento para a pesquisa e teste de sua aplicabilidade.

This article describes the collective construction of a research instrument (interview guideline) for investigating the knowledge of chagasic patients attended at the Chagas Disease Reference Center of the Oswaldo Cruz Foundation. A multi-professional team worked sequentially on six versions of the guideline for semi-structured interviews. The instrument aims collecting data for a qualitative approach to concepts and perceptions of the patients from the perspective of the human relationships in the context of life and health. It detects the individual experiences regarding the diseasing process, the knowledge about the disease (and the infection), the emotions, reactions, and affections. Some theoretical aspects were discussed based on sociological and anthropological practices used in public health actions. We performed a complete interview with a patient for testing and adjusting the instrument. The interview guideline was tested and showed to be a suitable instrument for investigating the knowledge of chagasic patients, covering many subjective and cognitive aspects. This knowledge can be a useful contribution to the development of strategies, actions and information material aimed at improving and humanizing the care delivered to Chagas disease patients.

O saber do paciente chagásico sobre a sua doença: construção compartilhada de um instrumento para a pesquisa e teste de sua aplicabilidade / The knowledge of chagasic patients about their disease: collective construction of a research instrument and test of its applicability

Relatamos a experiência de construção compartilhada de um instrumento de pesquisa (roteiro de entrevista) para investigar os saberes de pacientes chagásicos atendidos na Fundação Oswaldo Cruz. Profissionais de diferentes setores de pesquisa da instituição participaram da experiência de desenvolvimento do roteiro de entrevista semi-estruturada, passando por seis versões. O roteiro elaborado objetiva recolher dados para uma abordagem qualitativa das concepções e percepções de pacientes sob uma perspectiva de relações humanas no contexto de saúde e vida, identificando as vivências do processo de adoecer, seus conhecimentos sobre a doença (e a infecção), suas emoções, reações e afetos. Pontuamos aspectos teóricos oriundos da reflexão sobre as práticas sociológica e antropológica em ações em saúde coletiva. Submetido a teste para ajustes, o roteiro de entrevista confirmou-se adequado para o estudo de saberes de pacientes chagásicos, captando diversos aspectos subjetivos e cognitivos que podem ser úteis para a formulação de estratégias, ações e materiais informativos que contribuam para a melhoria e humanização da atenção ao paciente chagásico.

This article describes the collective construction of a research instrument (interview guideline) for investigating the knowledge of chagasic patients attended at the Chagas Disease Reference Center of the Oswaldo Cruz Foundation. A multi-professional team worked sequentially on six versions of the guideline for semi-structured interviews. The instrument aims collecting data for a qualitative approach to concepts and perceptions of the patients from the perspective of the human relationships in the context of life and health. It detects the individual experiences regarding the diseasing process, the knowledge about the disease (and the infection), the emotions, reactions, and affections. Some theoretical aspects were discussed based on sociological and anthropological practices used in public health actions. We performed a complete interview with a patient for testing and adjusting the instrument. The interview guideline was tested and showed to be a suitable instrument for investigating the knowledge of chagasic patients, covering many subjective and cognitive aspects. This knowledge can be a useful contribution to the development of strategies, actions and information material aimed at improving and humanizing the care delivered to Chagas disease patients.

Desenvolvimento de materiais para educação popular em dengue: estudo das concepções de estudantes do ensino de jovens e adultos em Nova Iguaçu / Development of materials for popular education in affection: study of the conceptions of students of the education of young and adults in Nova Iguaçu

A pesquisa foi realizada no município de Nova Iguaçu, Rio de Janeiro, Brasil em uma região de risco, com alto índice de infestação e de ocorrência de casos de Dengue. Nos anos entre 2002 e 2003, coletamos concepções de 120 estudantes (67 mulheres e 53 homens, da educação de jovens e adultos) sobre a Dengue, seus sintomas, e os fatores correlacionados com a incidência da doença na região onde estudam e moram. O perfil dominante nos alunos era o de trabalhadores, negros com vínculo religioso, e motivados para a presença na escola por diferentes fatores, dentre os quais se destaca o ambiente escolar como instrumento de proteção contra a exclusão social e a violência. Os alunos expressavam conceitos corretos quanto à associação do mosquito com a doença, sintomas e medidas preventivas. Percebemos falta de clareza quanto aos conceitos de agentes transmissor e causal, uma importante concepção errônea (25por cento dos entrevistados) de que a Dengue pode ser transmitida diretamente entre humanos e não através da picada do mosquito Aedes aegypti. O estudo identificou a ausência de falas sobre a Febre Hemorrágica da Dengue, bem como indícios de que a população participante da pesquisa realiza automedicação. 93por cento dos alunos desconheciam o ciclo de vida do mosquito, não compreendendo a relação entre as propostas preventivas, que se concentram na fase aquática da vida do vetor, e o mosquito adulto. Com base nos dados obtidos e análise das concepções apresentadas pelos estudantes desenvolvemos, entre o laboratório da Fiocruz e a comunidade escolar, um processo de construção compartilhada de materiais educativos lúdicos, para explorar os conceitos considerados relevantes para a melhor atuação na prevenção da Dengue: ciclo biológico dos Aedes aegypti, condicionantes biológicos e sociais de sua proliferação. Como objetivo propusemos identificar as concepções de estudantes sobre Dengue e a construção de componentes lúdicos como estratégias de ensino-aprendizagem sobre...