RESUMO
Este artigo apresenta um recorte da pesquisa "1º Inventário de Saúde do Trabalhador 2009", desenvolvida pela Coordenação Geral de Saúde do Trabalhador do Ministério da Saúde. Buscou-se identificar lacunas e potencialidades da implantação da Rede Nacional de Atenção Integral em Saúde do Trabalhador (Renast), focando as ações de Vigilância em Saúde do Trabalhador (Visat) e variáveis estruturantes dos Centros de Referência em Saúde do Trabalhador (Cerest), como o financiamento, a equipe profissional e a participação dos trabalhadores. Analisaram-se as atividades de Visat e destacaram-se as articulações dos Cerests intra e intersetoriais, entre elas instâncias regionais da Previdência Social e universidades, além das internas ao SUS, sobretudo com instâncias da Vigilância em Saúde. Os resultados demonstraram que as ações de Visat estão acontecendo na maioria dos Cerests (58,4%) e que há uma adequação estrutural e da equipe, além de relativa participação dos trabalhadores nas Comissões Intersetoriais de Saúde do Trabalhador (CIST) dos Conselhos de Saúde. São apresentadas considerações para a construção de parâmetros para futuras pesquisas e recomendações visando ao fortalecimento da Renast. Destaca-se a necessidade de intensificação da capacidade de análise das informações decorrentes das ações de vigilância e do registro de casos.
This paper presents partial records of the first report on worker's health 2009 produced by the Workers' Health General Coordination (CGSAT) of the Ministry of Health. It identifies gaps and potentialities in implanting the Brazilian National Network for Worker's Health Integrated Care (Renast). It is focused on actions performed by the Worker's Health Surveillance (VISAT) and structural indexes of the Workers' Health Reference Centers (Cerest), such as its financial flow, its professional team and the workers' participation. It also presents the VISAT activities carried out and the inter and intra sector articulations of the Cerests, among then, universities as well as the regional spheres of the Brazilian Social Security Ministry. The results evidences that VISAT actions are taking place in most Cerests (58,4%), and show that the services physical structure and technical teams are appropriate and also that there is a reasonable participation of workers in the Workers' Heath Inter-sector Commissions (CIST) of the Regional Health Committees. The paper presents parameters viewing future research and recommendations aimed at empowering Renast. Finally it emphasizes the need to intensify the capacity to analyze information resulting from surveillance actions and case records.
RESUMO
The cardiovascular effects of microinjection of the amino acids glutamate and glycine within the rostral ventrolateral medulla (RVLM) after swimming training (ST) in unrestrained awake rats were investigated. Unilateral microinjection of l-glutamate (5, 20 and 50 mM, in 100 nl) produced a dose dependent increase in mean arterial pressure (MAP) in control (C) (16+/-5 mm Hg; 29+/-6 mm Hg; 43+/-6 mm Hg) and swim (SW) (1+/-1 mm Hg; 16+/-2 mm Hg; 25+/-3 mm Hg) groups. However, the magnitude of this response was lower in the swim group. Prazosin injection produced hypotension and tachycardia in both groups (C=-43+/-3 mm Hg/98+/-16 bpm; SW=-61+/-5 mm Hg/115+/-32 bpm). In the SW group the hypotension caused by prazosin was greater compared to C group, but the tachycardia was not different between them. After prazosin, glutamate response in RVLM was blocked in both groups as well. When glycine (10 mM or 1 M, in 100 nl) were microinjected into the RVLM of C group we observed two different effects: decrease in MAP with the lower dose and an increase in MAP with the higher dose (10 mM=-13+/-2 mm Hg; 1 M=47+/-6 mm Hg). However, after ST the hypertensive response to glycine was blunted with no alterations in the hypotensive response (10 mM=-14+/-1 mm Hg; 1 M=18+/-4 mm Hg). These findings suggest that RVLM is involved in the modulation of the sympathetic outflow to the cardiovascular system during exercise training.
