Análise de determinantes intrapessoais e interpessoais como motivosde recaída no contexto da dependência química / Análise de determinantes intrapessoais e interpessoais como motivos de recaída no contexto da dependência química

Objetivo: identificar os motivos de recaída de dependentes químicos, em tratamento em um Centrode Atenção Psicossocial para álcool e drogas. Método: pesquisa descritiva e exploratória, comabordagem qualitativa. Os dados foram coletados por meio de entrevista semiestruturada, com 15pessoas em tratamento ativo para dependência química. Os dados foram tratados por meio da análisede conteúdo. Resultados: dentre os determinantes interpessoais identificados, destacam-se o apoiofamiliar, o grupo de convívio social, a moradia fixa, e também o vínculo empregatício. Em geral, oambiente externo adequado minimiza a probabilidade de reuso. Em relação aos intrapessoais, sãorecorrentes a fissura, a dependência psíquica e a capacidade de lidar com frustrações. Conclusão:acredita-se que para evitar uma recaída, o dependente químico em tratamento, necessita de umainternação domiciliar, assim quando os determinantes interpessoais e intrapessoais ocorrerem, opaciente estará assistido, com menor risco de relapso.

Objective: this study aimed to identify the relapse reasons of drug addicts in treatment in aPsychosocial Care Center - alcohol and drugs. Method: a descriptive and exploratory research with aqualitative approach was carried out. Data were collected through semi-structured interviews with15 people in active treatment for chemical dependency, and they are analyzed by content analysis.Results: the main interpersonal determinants perceived by drug addicts as causes of relapse werefamily support, social circle, fixed residence and job opportunity. Generally, the adequate externalenvironment decreases the probability of a relapse. When regarding the intrapersonal determinants,fissure, psychological dependency and resilience are the most recurring. Conclusion: it is believedthat, prevent a relapse, the addict in treatment, needs home care, therefore, when bothinterpersonal and intrapersonal determinants appear, the patient will be assisted, with minorchances of relapse.

Comercialização de Plantas Medicinais no Município de Arapiraca-AL / Medicinal Plants commercialization in the city of Arapiraca-AL

RESUMO O comércio de plantas medicinais em feiras livres faz parte da cultura de muitas cidades da região Nordeste do Brasil. Objetivou-se com esta pesquisa verificar a existência de padrões de comercialização de plantas medicinais nas feiras livres do município de Arapiraca-AL. A metodologia incluiu a realização de entrevistas semiestruturadas, aplicadas a vendedores de plantas medicinais, sendo estas gravadas em áudio após assinatura do Termo de Consentimento Livre e Esclarecido, as técnicas da observação direta, “bola de neve” e lista livre. Os informantes indicaram 42 plantas medicinais, tendo Fabaceae com maior destaque em número de espécies. Do total de espécies identificadas, a maior parte é nativa (82%) e o hábito predominante é o arbóreo. Este estudo revelou que a produção e comercialização de plantas medicinais possuem um padrão local, com as plantas adquiridas através de terceiros, não havendo um padrão mínimo de qualidade, sendo necessária a implantação de políticas públicas voltadas a capacitação destes profissionais, agregando valor ao saber popular sobre plantas medicinais.

ABSTRACT The marketing of medicinal plants in street fairs is part of the culture of many cities in the Northeast of Brazil. The aim of this study was to identify the marketing patterns of medicinal plants in Arapiraca-AL city. The methodologies involved semi-structured interviews, givento the merchants of medicinal plants, t after a Free and Clear Consent Form, by which the survey participants were aware of the risks and benefits of it and can stop it if necessary to judge, the interviews were recorded. Snow-ball and free list techniques were also used. The informants indicated 42 species; Fabaceae had the highest number of species. From the total of identified medicinal plants, 80% were native and the predominant habitat was arboreous. This study revealed that the production and marketing of medicinal plants has a local pattern, with the plants being acquired through outsourcing, and there is no minimum quality standard, requiring the implementation of public policies for the training of these professionals, adding value to the common knowledge of medicinal plants.

Contrast-enhanced CT and MRI for detecting neck metastasis of oral cancer: comparison between analyses performed by oral and medical radiologists.

OBJECTIVES: The aim of the study was to verify the concordance of contrast-enhanced CT (CECT) and MRI evaluation among four radiologists in detecting metastatic cervical lymph nodes of oral cancer patients. METHODS: Ten patients underwent clinical and imaging examinations (CECT and MRI). Four radiologists, two oral and maxillofacial radiologists (OMRs) and two medical radiologists (MRs), independently analysed the images twice. Cohen's kappa index and Wilcoxon signed-rank test were used to verify the concordance between all analyses. RESULTS: Regarding the interobserver agreement, the OMRs presented excellent kappa values for determining the regional lymph nodes (N-stage) in both CECT and MRI. The MRs presented moderate agreement for CECT evaluation at the first reading, but no concordance was found for the other analyses. When each imaging modality was analysed separately, kappa values were higher between all examiners. Greater variability was demonstrated between N-stage evaluation using different examinations. All radiologists were able to identify a greater number of metastatic lymph nodes in CECT than in MRI, except one MR, but no significant difference was found for all readers. The differences between the number of metastatic lymph nodes among all radiologists were not statistically significant. Moderate intraobserver agreement was observed for CECT and MRI evaluation, except for one MR. CONCLUSIONS: The differences found between the N-stage performed by OMRs and MRs support the necessity of a multidisciplinary approach in the imaging evaluation of metastatic nodes. Further studies are necessary to confirm which imaging modality should be employed when evaluating neck areas.

Comparison between computed tomography and clinical evaluation in tumour/node stage and follow-up of oral cavity and oropharyngeal cancer.

OBJECTIVES: The aim was to verify the concordance of CT evaluation among four radiologists (two oral and maxillofacial and two medical radiologists) at the TN (tumour/node) stage and in the follow-up of oral cavity and oropharyngeal cancer patients. The study also compared differences between clinical and CT examinations in determining the TN stage. METHODS: The following clinical and tomographic findings of 15 non-treated oral cavity and oropharyngeal cancer patients were compared: tumour size, bone invasion and lymph node metastases. In another 15 patients, who had previously been treated, a clinical and tomographic analysis comparison for the presence of tumoural recurrence, post-therapeutic changes in muscles and lymph node metastases was performed. The concordances of tomographic evaluation between the radiologists were analysed using the kappa index. RESULTS: Significant agreement was verified between all radiologists for the T stage, but not for the N stage. In the group of treated patients, CT disclosed post-therapeutic changes in muscles, tumour recurrence and lymph node metastases, but no concordance for the detection of lymph node metastases was found between radiologists. In the first group, for all radiologists, no concordance was demonstrated between clinical and tomographic staging. CT was effective for delimitating advanced lesions and for detecting lymph node involvement in N0 stage patients. CT revealed two cases of bone invasion not clinically detected. CONCLUSIONS: Interprofessional relationships must be stimulated to improve diagnoses, and to promote a multidisciplinary approach to oral cavity and oropharyngeal cancer. Although CT was important in the diagnosis and follow-up of cancer patients, differences between medical and dental analyses should be acknowledged.

Frontal sinus adenocarcinoma.

CONTEXT: Paranasal sinus cancer is considered rare, with an incidence of less than 1 per 100,000 per year, with the frontal sinus being the primary site in only 0.3%. We report a case of adenocarcinoma arising in the frontal sinus. DESIGN: Case report. CASE REPORT: A 59-year-old woman, secretary, came in February 1998 with a 4-month history of low intensity frontal headache. She denied contact with wood dust. On examination a non-tender swelling was noted over her right forehead next to the medial aspect of the right orbit. CT scan showed a soft-tissue mass involving frontal sinus with intracranial invasion through the posterior wall. The anterior ethmoid sinus and the medial aspect of the right orbit were also involved. MRI demonstrated dural thickening in communication with the frontal mass. She underwent an en-bloc tumor resection by craniotomy including orbital clearance. Histology revealed an adenocarcinoma. After surgery she had tumor recurrence, and chemotherapy and radiotherapy were started resulting in partial improvement.

[Cavernous hemangioma of the internal auditory canal. Apropos of a case]. / Hémangiome caverneux intracanalaire. A propos d'un cas.

A case of cavernous hemangioma in the internal auditory canal was reported. There were no specific symptoms or physical or neurotological findings to differentiate from acoustic neuroma. The clinical and surgical aspects of this rare tumor were reviewed and discussed.

American cutaneous leishmaniasis in Pernambuco, Brazil: eco-epidemiological aspects in 'Zona da Mata' region.

American cutaneous leishmaniasis (ACL) has been increasing in Pernambuco, thus becoming an important problem for Public Health. The incindence is predominant in the region called 'Zona da Mata', in the east of this state. This region corresponds geographically to the primitive area of the Atlantic forest. In order to characterize the eco-epidemiology expression of ACL in this region, two localities situated in the municipalities of Amaraji e Cortes have been selected by the criterion of higher incindence of human cases. Five stocks of patients were characterized and identified on the basis of enzyme profiles as a new variant of Leishmania (V.) braziliensis. A survey of wild and domestic animals was carried out by means of a parasitological and serological diagnosis. Through the analysis of the spleen and liver imprints, were detected amastigotes compatible with Leishmania in five Nectomys s. squamipes, five Bolomys 1. pixuna, two Rattus r. alexandrinus and one Rattus r. frugivorus. For two years we carried out monthly sandflies captures using CDC light traps as well as manual captures. Lutzomyia whitmani was predominant, which accounted for 97.4% of the total. These data indicate a strong evidence on the vector and the potential reservoirs of L. braziliensis in this region.