La detección de la lepra y la humanización de la atención: acciones de enfermería en el programa de salud de la familia / No disponible

El municipio de São Gonçalo, en la Región Metropolitana de Río de Janeiro - Brasil es considerado una zona endémica de la lepra de acuerdo con el Ministerio de Salud. De esta observación, hemos tratado de identificar con este trabajo cuáles son las acciones realizadas por las enfermeras en El Programa de Salud Familiar (PSF) para detectar la lepra y qué tipo de atención prestan a las personas afectadas por la enfermedad, centrándose en la humanización. Así, se realizó investigación descriptiva, cualitativa y de campo en las unidades de salud de la familia de esa ciudad, con treinta y un enfermeros a través de entrevistas con preguntas abiertas. Emergiendo dos categorías: las acciones de detección de la enfermera del PSF, la atención prestada a las personas afectadas y la necesaria humanización de esos cuidados. Se concluyó que las medidas adoptadas por las enfermeras no siguen un estándar único y que algunas no tienen la capacitación necesaria para desenvolverse con los usuarios del PSF afectadas por la lepra (AU)

The Municipality of São Gonçalo in the Metropolitan Region of Rio de Janeiro - Brazil is considered an endemic area for leprosy according to the Ministry of Health. From this observation, we sought to identify with this work which actions are performed by nurses from Family Health Program (PSF) to detect leprosy and what care they provide to people affected by the disease, with the focus on humanization. Thus, we performed descriptive, qualitative and field units in the health of the family of that city, with thirty-one nurses through interviews with open questions. Two categories emerged: the detection actions made by the nurse, the care given to people affected and the humanization of care needed. It was concluded that the actions taken by the nurses do not follow a single standard and that some lack the necessary training to function with users of PSF affected by leprosy (AU)

Ascorbic acid for the healing of skin wounds in rats / Ácido ascórbico na cicatrização de feridas cutâneas em ratos

BACKGROUND: Healing is a complex process that involves cellular and biochemical events. Several medicines have been used in order to shorten healing time and avoid aesthetic damage. OBJECTIVE: to verify the topical effect of ascorbic acid for the healing of rats' skin wounds through the number of macrophages, new vessels and fibroblast verifications in the experimental period; and analyse the thickness and the collagen fibre organization in the injured tissue. METHODS: Male Rattus norvegicus weighing 270 ± 30 g were used. After thionembutal anesthesia, 15 mm transversal incisions were made in the animals' cervical backs. They were divided into two groups: Control Group (CG, n = 12) - skin wound cleaned with water and soap daily; Treated Group (TG, n = 12) - skin wound cleaned daily and treated with ascorbic acid cream (10 percent). Samples of skin were collected on the 3rd, 7th and 14th days. The sections were stained with hematoxylin-eosin and picrosirius red for morphologic analysis. The images were obtained and analysed by a Digital Analyser System. RESULTS: The ascorbic acid acted on every stage of the healing process. It reduced the number of macrophages, increased the proliferation of fibroblasts and new vessels, and stimulated the synthesis of thicker and more organized collagen fibres in the wounds when compared to CG. CONCLUSION: Ascorbic acid was shown to have anti-inflammatory and healing effects, guaranteeing a suiTable environment and conditions for faster skin repair.

FUNDAMENTOS: A cicatrização é um processo complexo que envolve eventos celulares e bioquímicos. Vários medicamentos têm sido empregados na tentativa de abreviar a cicatrização e evitar danos estéticos. OBJETIVO: verificar o efeito tópico do ácido ascórbico no processo de cicatrização de feridas cutâneas de ratos através da verificação do número de macrófagos, neovasos e fibroblastos presentes no período experimental; e analisar a espessura e a organização das fibras colágenas no tecido lesado. MÉTODOS: Foram utilizados Rattus norvegicus, machos, pesando 270 ± 30 g. Foi realizada incisão transversal na pele da região dorso-cervical de 15 mm de comprimento, após anestesia com Thionembutal. Os animais foram divididos em 2 grupos: grupo controle (GC, n = 12), feridas higienizadas diariamente com água e sabão; grupo tratado (GT, n = 12), feridas higienizadas e tratadas com creme de ácido ascórbico (10 por cento). Os fragmentos para análise histológica foram coletados no 3º, 7º e 14º dia, e as lâminas coradas com hematoxilina-eosina e picrosírius red para análise morfológica. As imagens foram capturadas e analisadas por um sistema digitalizador. RESULTADOS: O ácido ascórbico atuou em todas as etapas da cicatrização, diminuindo o número de macrófagos, aumentando a proliferação dos fibroblastos e neovasos, e favorecendo a deposição de fibras colágenas mais espessas e organizadas nas feridas. CONCLUSÃO: O ácido ascórbico mostrou ter efeito antiinflamatório e cicatrizante, promovendo ambiente e condições favoráveis para a reparação tecidual, o que abreviou o tempo da cicatrização.

Estimulación eléctrica y natación en la fase aguda de la axonotmesis: influencia sobre la regeneración nerviosa y la recuperación funcional / Electrical stimulation and swimming in the acute phase of axonotmesis: Their influence on nerve regeneration and functional recovery

Introducción. Poco se ha discutido sobre la influencia de la estimulación eléctrica fásica de baja frecuencia (EEFBF) y del ejercicio físico sobre la calidad de la regeneración nerviosa periférica y la recuperación funcional. Objetivo. Evaluar la influencia de la EEFBF, de la natación y de la asociación entre ambas con respecto a la morfología del nervio isquiático regeneradotras la axonotmesis. Materiales y métodos. Treinta ratones Wistar (222,05 ± 42,2 g) se distribuyeron en grupos: control (C), denervado (D), denervado + natación (DN), denervado + electroestimulación (DE) y denervado + natación + electroestimulación (DNE). Después de 24 horas de la axonotmesis, se electroestimuló el músculo sóleo de los grupos DE y DNE. Los grupos DN y DNE nadaron durante 22 días. Se evaluó el número de axones, los datos morfométricos del nervio y el índice funcional del nervio ciático (IFC). Resultados. El número de axones en los grupos denervados fue mayor que en el grupo control, y en el grupo DE fue mayor que en el D. El diámetro axonal fue menor en los grupos denervados; sin embargo, en el grupo DN fue mayor que en el D. Los demás parámetros morfométricos no fueron muy diferentes a los del grupo C. El IFC entre los días 7 y 14 del postoperatorio difirió del índice preoperatorio y el día 21 postoperatorio; sin embargo, el grupo DNE difirió del preoperatorio. Conclusiones. La natación y la EEFBF aplicadas individualmente no interfieren en la maduración delas fibras regeneradas o en la recuperación funcional. La EEFBF favoreció la regeneración axonal, y la asociación de los tratamientos retrasó la recuperación funcional, sin influir en la regeneración nerviosa

Introduction. Little attention has been given to the influence of low-frequency phasic electrical stimulation (LFPES) and physical exercise on the quality of peripheral nerve regeneration and functional recovery. Aim. To evaluate the influence of LFPES, swimming and the association between the two in terms of the morphology of the regenerated sciatic nervefollowing axonotmesis. Materials and methods. Thirty Wistar mice (222.05 ± 42.2 g) were distributed into groups: control (C),denervated (D), denervated + swimming (DS), denervated + electrostimulation (DE) and denervated + swimming + electrostimulation (DSE). After 24 hours of axonotmesis, the soleus muscle of the DE and DSE groups was stimulated electrically. The DS and DSE groups swam over a period of 22 days. The number of axons, morphometric data on the nerve and the functional index of the sciatic nerve (FIS) were evaluated. Results. The number of axons in the denervated groups was higher than in the control group, and in the DE group the figure was higher than in the D group. The axonal diameter was smaller in the denervated groups, yet in the DS group it was higher than in the D group. The other morphometric parameters were quitesimilar to those of the C group. The FIS between days 7 and 14 of the post-operative period was different to the pre-operative index and that measured on day 21 of the post-operative period; the DSE group, however, differed from the pre-operative values. Conclusions. Swimming and LFPES, applied on an individual basis, do not affect the maturation of the regenerated fibres or functional recovery. LFPES favoured axonal regeneration and combining the treatments delayed functional recoverywithout having any influence on nerve regeneration

[Workers' health in Brazilian state constitutions: a comparative analysis] / Análise comparativa dos dispositivos de saúde do trabalhador nas constituições estaduais brasileiras.

This article briefly analyzes the legal measures related to workers' health in the various Brazilian state constitutions. It makes a qualitative and quantitative comparison of the different provisions based on the presence, weight, and relevance ascribed to the issue, using predefined attributes: statement of guidelines; production, control, and utilization of information; labor intervention; guarantee of rights. The analysis showed legislators' intent to allocate power to the Unified Health System in the field of workers' health so as to allow for new practices in this area.