Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 50
Filtrar
1.
PLoS One ; 15(10): e0239622, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33052903

RESUMO

A scale with robust statistical validation is essential to diagnose pain and improve decision making for analgesia. This blind, randomised, prospective and opportunist study aimed to develop an ethogram to evaluate behaviour and validate a scale to assess acute ovine postoperative pain. Elective laparoscopy was performed in 48 healthy sheep, filmed at one preoperative and three postoperative moments, before and after rescue analgesia and 24 hours after. The videos were randomised and assessed twice by four evaluators, with a one-month interval between evaluations. Statistical analysis was performed using R software and differences were considered significant when p <0.05. Based on the multiple association, a unidimensional scale was adopted. The intra- and inter-observer reliability ranged from moderate to very good (intraclass correlation coefficient ≥ 0.53). The scale presented Spearman correlations > 0.80 with the numerical, simple descriptive, and visual analogue scales, and a correlation of 0.48 with the facial expression scale. According to the mixed linear model, the scale was responsive, due to the increase and decrease in pain scores of all items after surgery and analgesic intervention, respectively. All items on the scale demonstrated an acceptable Spearman item-total correlation (0.56-0.76), except for appetite (0.25). The internal consistency was excellent (Cronbach's α = 0.81) and all items presented specificity > 0.72 and sensitivity between 0.61-0.90, except for appetite. According to the Youden index, the cut-off point was ≥ 4 out of 12, with a diagnostic uncertainty zone of 4 to 5. The area under the curve > 0.95 demonstrated the excellent discriminatory capacity of the instrument. In conclusion, the Unesp-Botucatu pain scale in sheep submitted to laparoscopy is valid, reliable, specific, sensitive, with excellent internal consistency, accuracy, discriminatory capacity, and a defined cut-off point.


Assuntos
Dor Abdominal/veterinária , Medição da Dor/veterinária , Dor Pós-Operatória/veterinária , Carneiro Doméstico/cirurgia , Dor Abdominal/diagnóstico , Analgesia/métodos , Analgesia/veterinária , Animais , Brasil , Feminino , Laparoscopia/veterinária , Modelos Anatômicos , Modelos Animais , Variações Dependentes do Observador , Medição da Dor/métodos , Dor Pós-Operatória/diagnóstico , Estudos Prospectivos , Carneiro Doméstico/fisiologia , Gravação em Vídeo
2.
Artigo em Inglês | MEDLINE | ID: mdl-32857307

RESUMO

The dyes Auramine and Auramine O are used in several industrial products, despite the scarce information regarding their ecotoxicity. The aim of the present study was to assess the acute and chronic toxicity of both dyes to aquatic organisms from different trophic levels (Raphidocelis subcapitata, Daphnia similis, Hydra attenuata, and Danio rerio) and calculate their predicted non-effect concentrations (PNEC). Auramine and Auramine O induced toxicity to all selected test organisms with L(E)C50 values ranging from 300 to 4800 ug/L. Both dyes induced inhibition in the growth rate of exposed algae, negatively affecting the reproduction of D. similis and induced deformities in H. attenuata (clubbed tentacles and shortened tentacles) and D. rerio (edemas, tail malformation and delay in yolk sac absorption). PNEC values of 0.92 µg/L and 4.0 µg/L were obtained for Auramine and Auramine O, respectively, based on results of the most sensitive test system (algae). Test results were analyzed using the Criteria of Reporting and Evaluating Ecotoxicity Data (CRED), confirming their reliability and relevance. Thus, PNEC values can be used in future risk assessments of those substances in freshwater systems.

5.
Artigo em Inglês | MEDLINE | ID: mdl-32585365

RESUMO

Fluoxetine (FLX) is among the top 100 pharmaceutical prescribed annually worldwide and consequently is often detected in wastewater treatment plant effluent and surface waters, in concentrations up to 2.7 and 0.33 µg/L, respectively. Despite the presence of FLX in surface waters, little is known about its chronic effects in fish. Thus, this study aimed at investigating the chronic toxicity of FLX to Danio rerio adults. Rate of weight gain, behavior (feeding and swimming activity) and tissue organization (liver and intestine) were evaluated, after 30 days exposure. A lower rate of weight gain was observed at 100 µg/L FLX. The food intake time decreased, showing a decrease in fish appetite. The preference for the upper aquarium layer was observed at 10 and 100 µg/L of FLX, indicating an inhibition of the stress level (anxiolytic effect). Mild to moderate damage of hepatic tissue and a decrease epithelium height and increase in villus height of intestine were observed in fish exposed to concentrations as low as 0.01 µg/L. Based on obtained results, chronic exposure of fish to FLX could affect swimming and feeding behavior and alter morphological structure of liver and intestine tissues at environmental levels.

6.
J Equine Vet Sci ; 85: 102846, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31952636

RESUMO

Photobiomodulation therapy (PBMT) effects depend on the energy settings and laser penetration. We investigated the penetration time profiles of two different light therapy devices, at the dark and light skin regions in horses. Six light skin and six dark skin adult clinically healthy Arab and Quarter horses were used. A cutometer was used to measure the width of the skin fold from both sides of the cervical area, followed by three measurements of the thickness of the same skin fold by transversal and longitudinal ultrasonography (US). The depth of light penetration was compared based on the percentage of penetration versus power, between a portable PBMT device versus a class IV laser device. The laser mean power output was measured with an optical power meter system for 120 seconds after penetrating the skin. Skin width and laser penetration were compared among equipment by paired "t" test. There was no difference in the width of the skin fold between measurements acquired by the cutometer against either longitudinal or transversal US or between the US measurements at cervical versus metacarpus area. Light penetration was greater in both kinds of skins in the PBMT (0.01303 ± 0.00778) versus class IV laser (0.00122 ± SD 0.00070) (P < .001). The PBMT device provided a greater energy penetration than the class IV laser in unclipped light and dark skin, suggesting that the former may produce a better therapeutic effect. The color of the skin changes penetration profiles of PBMT.


Assuntos
Terapia com Luz de Baixa Intensidade/veterinária , Animais , Cavalos , Lasers , Pele
7.
Arch. endocrinol. metab. (Online) ; 63(6): 630-637, Nov.-Dec. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1055026

RESUMO

ABSTRACT Acromegaly is a systemic disease associated with increased morbidity, presenting cardiovascular, metabolic, respiratory, neoplastic, endocrine, articular and bone complications. Most of these comorbidities can be prevented or delayed with adequate disease treatment and, more recent studies with the use of modern treatments of acromegaly, have shown a change in the severity and prevalence of these complications. In addition, acromegaly is associated with increased mortality, but recent studies (especially those published in the last decade) have shown a different scenario than older studies, with mortality no longer being increased in adequately controlled patients and a change in the main cause of death from cardiovascular disease to malignancy. In this review, we discuss this changing face of acromegaly summarizing current knowledge and evidence on morbimortality of the disease. Arch Endocrinol Metab. 2019;63(6):630-7


Assuntos
Humanos , Acromegalia/complicações , Acromegalia/fisiopatologia , Acromegalia/mortalidade , Causas de Morte
8.
Ciênc. cuid. saúde ; 18(02): 7, 2019-03-18.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1121529

RESUMO

Objetivo: relatar a experiência acadêmico-assistencial de um grupo de estudantes de Enfermagem, ao promover uma ação educativa com profissionais de Enfermagem de duas Unidades de Terapia Intensiva. Metodologia:estudo descritivo, do tipo relato de experiência, desenvolvido com base em atividades práticas supervisionadas, em hospital de grande porte da Região Metropolitana de Belém, Pará, Brasil, durante o mês de março de 2017. Está ancorado nas etapas da Metodologia da Problematização com o Arco de Maguerez, resultando em propostade intervenção exequível na prática. Resultados: obteve-se o percentual de participação de 85,7% da equipe de Enfermagem. Os demais profissionais estavam em reunião, inviabilizando sua presença na ação. Os participantes responderam de forma positiva à intervenção, colaborando, discutindo e valorizando o conhecimento construído com a relação dialógica, apresentando profundas reflexões nos discursos ao grupo interventor. Considerações finais: constatou-se que ações de cunho educativo, pautadas nas necessidades do público-alvo, podem provocar mudanças significativas por meio da reflexão crítica e da qualificação profissional. Os profissionais de Enfermagem oferecem importantes contribuições para prevenir e controlar lesões na córnea, bem como para investigar e produzir conhecimento relativo ao tema.


Objective: to report the academic-assistance experience of a group of Nursing students, by promoting an educational action with Nursing professionals of two Intensive Care Units. Methodology: a descriptive, experience-based study on supervised clinical activities in a large hospital in the Metropolitan Region of Belém, Pará, Brazil, during the month of March 2017. It is anchored in the stages of the Problem-Solving Methodology with the Arch of Maguerez, resulting in a feasible intervention proposal in practice. Results: the percentage of participation of 85.7% of the nursing team was obtained. The other professionals were in a meeting, making it impossible to be present. The participants responded positively to the intervention, collaborating, discussing and valuing the knowledge built with the dialogic relationship, presenting deep reflections in the speeches to the intervener group. Final considerations: it was found that educational actions, based on the needs of the target audience, can cause significant changes through critical reflection and professional qualification. Nursing professionals offer important contributions to prevent and control corneal lesions, as well as to investigate and produce knowledge related to the subject.

9.
Arch Endocrinol Metab ; 63(6): 630-637, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31939488

RESUMO

Acromegaly is a systemic disease associated with increased morbidity, presenting cardiovascular, metabolic, respiratory, neoplastic, endocrine, articular and bone complications. Most of these comorbidities can be prevented or delayed with adequate disease treatment and, more recent studies with the use of modern treatments of acromegaly, have shown a change in the severity and prevalence of these complications. In addition, acromegaly is associated with increased mortality, but recent studies (especially those published in the last decade) have shown a different scenario than older studies, with mortality no longer being increased in adequately controlled patients and a change in the main cause of death from cardiovascular disease to malignancy. In this review, we discuss this changing face of acromegaly summarizing current knowledge and evidence on morbimortality of the disease. Arch Endocrinol Metab. 2019;63(6):630-7.


Assuntos
Acromegalia , Acromegalia/complicações , Acromegalia/mortalidade , Acromegalia/fisiopatologia , Causas de Morte , Humanos
10.
J Int Med Res ; 46(8): 3042-3052, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29996676

RESUMO

Background The consumption of addictive substances is common in adolescence and raises concerns about future addiction. We investigated addictive substance consumption among young people to inform the design of drug intervention programmes. Methods Participants were a population-based sample of 14- to 24-year-olds from Paredes, northern Portugal. A self-report questionnaire measured social and health variables, including tobacco, alcohol and illicit drug consumption. Results Data were analysed for 731 valid responses. Participants who had drunk alcohol did so first at 14.7 years (mean); 15.3% (95% confidence intervals [CI]: 12.9-18.1) drank alcohol regularly (more than 1/week, adjusted for age and sex) (95% CI: 12.9-18.1). Participants who had smoked tobacco did so first at 14.8 years (mean); 16.6% (95% CI: 14.0-19.5) were regular smokers. Illicit drug consumption was reported by 16.7% of participants (95% CI: 14.2-19.6) and 10.4% consumed drugs regularly. Conclusion We found a high prevalence of addictive substance consumption, particularly alcohol. As cultural attitudes likely influence alcohol consumption, a multigenerational approach is needed to address adolescent consumption. Participants' main sources of drug information were family members. Strategies are needed to promote drug literacy in parents and other relatives to change adolescents' culturally acquired habits of addictive substance consumption.


Assuntos
Comportamento de Procura de Droga , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Feminino , Educação em Saúde , Humanos , Drogas Ilícitas/efeitos adversos , Masculino , Portugal/epidemiologia , Autorrelato , Transtornos Relacionados ao Uso de Substâncias/etiologia , Inquéritos e Questionários , Uso de Tabaco/epidemiologia , Adulto Jovem
11.
Clin Case Rep ; 6(6): 1109-1111, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29881576

RESUMO

Congenital erythrocytosis is a hereditary disorder due to an increase in red cell mass that can be caused by mutations in proteins involved in HIF-α pathway, as PHD2. Hereby, we describe a new familial mutation in PHD2 gene. Considering an increased thrombotic potential, patients began antiplatelet aggregation therapy and phlebotomies.

12.
J Psychiatr Res ; 95: 269-275, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28923721

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is a very common psychiatric disorder across the life cycle and frequently presents comorbidities. Since ADHD is highly heritable, several studies have focused in the underlying genetic factors involved in its etiology. One of the major challenges in this search is the phenotypic heterogeneity, which could be partly attributable to the sexual dimorphism frequently seen in psychiatric disorders. Taking into account the well-known sexual dimorphic effect observed in serotonergic system characteristics, we differentially tested the influence of HTR1B SNPs (rs11568817, rs130058, rs6296 and rs13212041) on ADHD susceptibility and on its major comorbidities according to sex. The sample comprised 564 adults with ADHD diagnosed according to DSM-IV criteria and 635 controls. There was no association of any HTR1B SNPs tested in relation to ADHD susceptibility. As for the comorbidities evaluated, after correction for multiple tests, significant associations were observed for both rs11568817 and rs130058 with substance use disorders (Pcorr = 0.009 and Pcorr = 0.018, respectively) and for rs11568817 with nicotine dependence (Pcorr = 0.025) in men with ADHD. In women with ADHD, the same rs11568817 was associated with generalized anxiety disorder (Pcorr = 0.031). The observed effects of rs11568817 G allele presence conferring risk to either substance use disorders or generalized anxiety disorder according to sex, suggest an overall scenario where a higher transcriptional activity of HTR1B, resulting from the presence of this allele, is related to externalizing behaviors in men and internalizing behaviors in women. These results are consistent with and expand previous evidence of sexual dimorphism of the serotoninergic system.


Assuntos
Transtornos de Ansiedade/genética , Transtorno do Deficit de Atenção com Hiperatividade/genética , Receptor 5-HT1B de Serotonina/genética , Caracteres Sexuais , Transtornos Relacionados ao Uso de Substâncias/genética , Adulto , Transtornos de Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Tabagismo/epidemiologia , Tabagismo/genética , Adulto Jovem
13.
Case Rep Pediatr ; 2017: 2962794, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29410926

RESUMO

ANCA-positive systemic vasculitides, rare in paediatric age, present multiorganic involvement. A female teenager presented with a history of subglottic stenosis diagnosed at the age of 12. From the investigation carried out, we highlight hematoproteinuria and negative ANCAs. At 15 years old, she was admitted for gastrointestinal symptoms and respiratory distress. She presented poor peripheral perfusion, pulmonary haemorrhage, respiratory failure, and severe renal insufficiency. She was started mechanical ventilation and emergency haemodialysis. The immunological study revealed ANCA MPO positive. A presumptive diagnosis of ANCA-positive vasculitis was made, and she was started corticotherapy, cyclophosphamide, and plasmapheresis. A renal biopsy, performed later, showed crescentic glomerulonephritis with chronicity signs. Positive ANCA vasculitis may progress slowly or suddenly. The diagnosis was confirmed by a biopsy; however, we can make a presumptive diagnosis based on clinical findings and in a positive ANCA test in order to start an early treatment and decrease the associated morbimortality.

14.
Rev. enferm. atenção saúde ; 6(2): 144-152, jul.-dez. 2017.
Artigo em Inglês, Português | BDENF - Enfermagem | ID: biblio-1034676

RESUMO

Este estudo tem como objetivo relatar a experiência de acadêmicos de enfermagem com gestantes no pré-natal sobre a prevenção da obesidade como fator de risco para a gravidez em uma unidade de referência em Belém. Trata-se de um relato de experiência desenvolvido a partir de observações pelos estudantes de enfermagem do 6º período da Universidade do Estado do Pará, durante as aulas práticas em uma unidade de referência em gestação de alto risco em Belém no período de 10 a 25 de setembro de 2015. Os resultados obtidos durante a oficina “Cuide-se! Obesidade como fator de risco” evidenciam pouco conhecimento das gestantes, depoimentos e perguntas sobre o tema, assim como a satisfação das mesmas por terem tirado suas dúvidas sobre a importância da prevenção. O objetivo do estudo foi alcançado ao relatar a vivência de acadêmicos de enfermagem na prevenção da obesidade na gestação por meio de uma ação educativa .


This study has as objective to report the experience of nursing students with pregnants during their prenatal stages relative to the obesity as a risk factor to the pregnancy, at a reference unit located in Belém. The paper presents an experience report of the observations of 6th-period nursing students from Universidade do Estado do Pará acquired at practical classes at a high-risk gestation reference unit located in Belém, from september, 10th to september 25th, in 2015. The results obtained during the “Cuide-se! Obesidade como fator de risco” workshop evidence that, on the pregnants' side, there is little knowledge about the subject, testimonies and questions, as well as the satisfaction of them for having raised their doubts about the importance of obesity prevention. The objective of the study was reached when reporting the experience of nursing academics in the prevention of obesity during pregnancy through an educational action .


Este estudio tiene como objetivo relatar la experiencia de estudiantes de enfermería con las mujeres embarazadas en control prenatal en la prevención de la obesidad como factor de riesgo para el embarazo en una unidad de referencia en Belém. Se trata de un relato de experiencia desarrollada a partir de las observaciones de los estudiantes de enfermería 6º periodo Universidade do Estado do Pará durante las clases prácticas en una unidad de referencia en el embarazo de alto riesgo en Belem en el período 10-25 de septiembre de 2015. Los resultados obtenidos durante el taller "¡cuídate! La obesidad como factor de riesgo ", muestran poco conocimiento de las mujeres embarazadas, declaraciones y preguntas sobre el tema, así como la satisfacción de la misma, ya que han tenido sus dudas acerca de la importancia de la prevención. El objetivo del estudio fue alcanzado al relatar la vivencia de estudiantes de enfermería en la prevención de la obesidad en la gestación por medio de una acción educativa .


Assuntos
Feminino , Humanos , Gravidez , Cuidado Pré-Natal , Educação em Saúde , Gestantes , Obesidade
15.
Rev. abordagem gestál. (Impr.) ; 22(1): 39-48, jun. 2016.
Artigo em Português | Index Psicologia - Periódicos técnico-científicos | ID: psi-68343

RESUMO

O aqui-e-agora é um conceito relevante e característico da Gestalt-terapia. Entretanto o termo encontra diferentes acepções na literatura, revelando um problema conceitual com repercussões sobre a prática clínica. O presente trabalho preocupou-se em investigar a forma pela qual o aqui-e-agora é descrito e compreendido por profissionais da área. Foram realizadas três entrevistas com teóricos da Gestalt-terapia, analisadas pelo método fenomenológico-qualitativo. As entrevistas evidenciaram quatro eixos principais de significados: O mal-entendido conceitual, A especialização do aqui-e-agora como contraposição a outras perspectivas temporais, Definição do termo e O lugar que o aqui-e-agora ocupa na prática clínica. Os resultados obtidos apontam para o fato de que o termo é frequentemente utilizado de modo equivocado. Evidenciam um aqui-e-agora que difere de uma simples presentificação, abrangendo um momento psicoterapêutico em que o sujeito está fluindo no campo temporal existencial. Isso significa que, mesmo na prática, o termo excede configurações técnicas, instrumentais ou metodológicas. Há, portanto, a necessidade de se compreender o aqui-e-agora fora de conotações valorativas entre passado, presente e futuro, retornando ao suporte filosófico da fenomenologia.(AU)


The here-and-now is a relevant and distinctive concept of Gestalt therapy. However, the word has different meanings in literature, which reveal a conceptual problem with consequences for clinical practice. This work aims to investigate how practioners in Gestalt therapy describe here-and-now. In other that, we interviewed three thinkers in Gestalt therapy and submitted the corpus to a phenomenological qualitative analysis. The interviews highlighted four main groups of meanings: Conceptual misunderstanding, Focus on here-and-now as a counterpoint to other temporal perspectives, Definition of the term and Place here and now assumes in the clinical practice. The results show that here and now differs from a pure present moment, covering a psychotherapeutic moment in which the subject is flowing in the existential temporal field. It means that even in practice the term exceeds technical, instrumental or methodological settings. Therefore, there is the requirement to reconnect it to philosophical phenomenology in order to understand here and now above past, present and future's evaluative connotations.(AU)


El aquí-y-ahora es un concepto relevante y distintivo de la terapia Gestáltica. Sin embargo el término presenta diferentes significados en la literatura, que revelan un problema conceptual con implicaciones para la práctica clínica. Este estudio ha investigado la forma en que el aquí-y-ahora es descrito y comprendido por los profesionales. Se realizaron tres entrevistas con teóricos de la terapia Gestáltica, analizadas segundo el método fenomenológico cualitativo. Las entrevistas destacaron cuatro grupos principales de significados: El malentendido conceptual, la especialización del aquí-y-ahora frente a otros marcos de tiempo, Definición de la expresión y el lugar que el aquí-y-ahora ocupa en la práctica clínica. Los resultados apuntan al hecho de que lo término es a menudo utilizado erróneamente, revelan un aquí-y-ahora que se diferencia de un momento presente puro porque se refiere a un momento psicoterapéutico en lo cual el sujeto está fluyendo en el campo temporal existencial. Esto significa que incluso en la práctica, el término excede las configuraciones técnicas, instrumentales o metodológicas. Por tanto, hay la necesidad de comprender el aquí-y-ahora más allá de las connotaciones valorativas de pasado, presente y futuro, para que se regrese a la base filosófica de la fenomenología.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Terapia Gestalt , Psicologia Clínica , Existencialismo/psicologia
16.
Rev. abordagem gestál. (Impr.) ; 22(1): 39-48, jun. 2016.
Artigo em Português | LILACS | ID: lil-791882

RESUMO

O aqui-e-agora é um conceito relevante e característico da Gestalt-terapia. Entretanto o termo encontra diferentes acepções na literatura, revelando um problema conceitual com repercussões sobre a prática clínica. O presente trabalho preocupou-se em investigar a forma pela qual o aqui-e-agora é descrito e compreendido por profissionais da área. Foram realizadas três entrevistas com teóricos da Gestalt-terapia, analisadas pelo método fenomenológico-qualitativo. As entrevistas evidenciaram quatro eixos principais de significados: O mal-entendido conceitual, A especialização do aqui-e-agora como contraposição a outras perspectivas temporais, Definição do termo e O lugar que o aqui-e-agora ocupa na prática clínica. Os resultados obtidos apontam para o fato de que o termo é frequentemente utilizado de modo equivocado. Evidenciam um aqui-e-agora que difere de uma simples presentificação, abrangendo um momento psicoterapêutico em que o sujeito está fluindo no campo temporal existencial. Isso significa que, mesmo na prática, o termo excede configurações técnicas, instrumentais ou metodológicas. Há, portanto, a necessidade de se compreender o aqui-e-agora fora de conotações valorativas entre passado, presente e futuro, retornando ao suporte filosófico da fenomenologia.


The here-and-now is a relevant and distinctive concept of Gestalt therapy. However, the word has different meanings in literature, which reveal a conceptual problem with consequences for clinical practice. This work aims to investigate how practioners in Gestalt therapy describe here-and-now. In other that, we interviewed three thinkers in Gestalt therapy and submitted the corpus to a phenomenological qualitative analysis. The interviews highlighted four main groups of meanings: Conceptual misunderstanding, Focus on here-and-now as a counterpoint to other temporal perspectives, Definition of the term and Place here and now assumes in the clinical practice. The results show that here and now differs from a pure present moment, covering a psychotherapeutic moment in which the subject is flowing in the existential temporal field. It means that even in practice the term exceeds technical, instrumental or methodological settings. Therefore, there is the requirement to reconnect it to philosophical phenomenology in order to understand here and now above past, present and future's evaluative connotations.


El aquí-y-ahora es un concepto relevante y distintivo de la terapia Gestáltica. Sin embargo el término presenta diferentes significados en la literatura, que revelan un problema conceptual con implicaciones para la práctica clínica. Este estudio ha investigado la forma en que el aquí-y-ahora es descrito y comprendido por los profesionales. Se realizaron tres entrevistas con teóricos de la terapia Gestáltica, analizadas segundo el método fenomenológico cualitativo. Las entrevistas destacaron cuatro grupos principales de significados: El malentendido conceptual, la especialización del aquí-y-ahora frente a otros marcos de tiempo, Definición de la expresión y el lugar que el aquí-y-ahora ocupa en la práctica clínica. Los resultados apuntan al hecho de que lo término es a menudo utilizado erróneamente, revelan un aquí-y-ahora que se diferencia de un momento presente puro porque se refiere a un momento psicoterapéutico en lo cual el sujeto está fluyendo en el campo temporal existencial. Esto significa que incluso en la práctica, el término excede las configuraciones técnicas, instrumentales o metodológicas. Por tanto, hay la necesidad de comprender el aquí-y-ahora más allá de las connotaciones valorativas de pasado, presente y futuro, para que se regrese a la base filosófica de la fenomenología.


Assuntos
Humanos , Masculino , Feminino , Adulto , Existencialismo/psicologia , Terapia Gestalt , Psicologia Clínica
17.
Aust N Z J Psychiatry ; 50(6): 557-65, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26460329

RESUMO

OBJECTIVES: In accordance with consolidated clinical practice, Diagnostic and Statistical Manual of Mental Disorders, 5th edition suggests a key role of collateral information in the evaluation of retrospective childhood attention-deficit/hyperactivity disorder symptoms in adults despite poor evidence supporting its use. This study aims to assess the incremental value of collateral information on the presence of childhood attention-deficit/hyperactivity disorder symptoms when evaluating adults with attention-deficit/hyperactivity disorder. METHODS: Adult patients with attention-deficit/hyperactivity disorder (n = 449) and non-attention-deficit/hyperactivity disorder subjects (n = 143) underwent an extensive clinical assessment based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. For patients, retrospective collateral information regarding childhood attention-deficit/hyperactivity disorder was obtained and used to sort them into two groups: agreement (n = 277) and disagreement (n = 172) between self- and collateral reports. We compared demographic, clinical and response to treatment profiles among groups to test the relevance of collateral information on the specific issue of childhood attention-deficit/hyperactivity disorder symptoms. RESULTS: Both attention-deficit/hyperactivity disorder groups had higher rates of several comorbidities (oppositional defiant, conduct, substance use and bipolar disorders; all p < 0.001) and impairments than controls. Disagreement between self- and collateral reports on childhood attention-deficit/hyperactivity disorder symptoms occurred in 38% of patients. Overall, attention-deficit/hyperactivity disorder disagreement and agreement groups had similar profiles in response to treatment and comorbidity, and the few differences detected in impairment measures were of small magnitude (Eta(2) < 0.05). CONCLUSION: Although collateral report has an important role for diagnosing attention-deficit/hyperactivity disorder in children, it has no incremental value in the evaluation of childhood attention-deficit/hyperactivity disorder symptoms in adults with a self-reported history of attention-deficit/hyperactivity disorder assessed in clinical settings.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/uso terapêutico , Adolescente , Adulto , Brasil , Criança , Comorbidade , Demografia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Autorrelato , Índice de Gravidade de Doença
18.
RBM rev. bras. med ; 72(N Esp G3)nov. 2015.
Artigo em Português | LILACS-Express | LILACS | ID: lil-786401

RESUMO

Introdução: Durante a primeira metade do século XX, o pênfigo foliáceo endêmico (fogo selvagem) teve importante impacto social, econômico e político no Brasil. Após mais de um século desde seus primeiros relatos essa doença ainda guarda interrogações sobre o envolvimento de fatores ambientais desencadeantes e sua característica autoimune e endêmica. O objetivo do trabalho é revisar trabalhos publicados por mais de um século, destacando os aspectos epidemiológicos da doença (das diferentes formas endêmicas pelo mundo) e avanços no estudo da sua etiologia. Material e Métodos: Utilizaram-se de trabalhos no PubMed, LILACS, CAPES, Google Acadêmico, Anais Brasileiros de Dermatologia. Resultados: O fogo selvagem sofreu grande redução do número de casos, principalmente a partir da década de 80 do século XX. O número de estudos sobre a doença vem diminuindo a cada década, várias informações sobre seus aspectos etiológicos e epidemiológicos permanecem há mais de um século sem comprovação precisa. Conclusões: Concluímos que o reduzido número de trabalhos atuais sobre o fogo selvagem se deve a redução considerável da sua incidência após mudanças ecológicas, avanços tecnológicos e melhoria das condições de vida da população das áreas endêmicas. As autoridades deveriam torná-la de notificação compulsória, facilitando a identificação de novos casos e de possíveis áreas endêmicas nos dias atuais. Mais estudos na área contribuiriam também ao estudo das doenças autoimunes em geral e dos fatores relacionados com o aumento da incidência de pênfigo vulgar em áreas endêmicas para fogo selvagem.

19.
Food Chem Toxicol ; 86: 9-15, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26404083

RESUMO

According to the International Agency for Research on Cancer (IARC), some hair dyes are considered mutagenic and carcinogenic in in vitro assays and exposed human populations. Epidemiological studies indicate that hairdressers occupationally exposed to hair dyes have a higher risk of developing bladder cancer. In Brazil, 26% of the adults use hair dye. In this study, we investigated the toxic effects of two hair dyes, Basic Red 51 (BR51) and Basic Brown 17 (BB17), which are temporary dyes of the azo group (R-N=N-R'), used in the composition of the black hair dye. To this end, MTT and trypan blue assays (cytotoxicity), comet and micronucleus assay (genotoxicity) were applied, with HepG2 cells. For cytotoxic assessment, dyes were tested in serial dilutions, being the highest concentrations those used in the commercial formula for hair dyes. For genotoxic assessment concentrations were selected according to cell viability. Results showed that both dyes induced significant cytotoxic and genotoxic effects in the cells, in concentrations much lower than those used in the commercial formula. Genotoxic effects could be related to the azo structure present in the composition of the dyes, which is known as mutagenic and carcinogenic. These results point to the hazard of the hair dye exposure to human health.


Assuntos
Compostos Azo/toxicidade , Dano ao DNA , Tinturas para Cabelo/toxicidade , Compostos Azo/administração & dosagem , Compostos Azo/química , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Células Hep G2 , Humanos , Testes para Micronúcleos , Mutagênicos/toxicidade , Medição de Risco
20.
Rev. baiana saúde pública ; 39(4): [740]-[754], Junho 2015.
Artigo em Português | LILACS | ID: biblio-847205

RESUMO

O objetivo do estudo é propor estratégias de descentralização dos Procedimentos Ortopédicos de Alta Complexidade (POAC) no estado da Bahia. Trata-se de análise da frequência e distribuição dos POAC no ano de 2012, comparando o percentual de procedimentos realizados em pacientes residentes ou não na cidade de Salvador. Os resultados apontam que o percentual de procedimentos realizados em Salvador pela população não residente foi de 25,25% do total quando se considerava todos os tipos de Autorização de Internação Hospitalar (AIH). A análise das Autorizações de Internações Hospitalares (AIHs) ortopédicas evidenciou que 35,33% destas era de não residentes, aumentando para 43,0% quando se tratava das AIHs de POAC. A proposta de intervenção elaborada contempla: realização de diagnóstico situacional com relação à oferta de procedimentos ortopédicos de alta complexidade e quadro de Recursos Humanos, além da elaboração e apresentação da proposta de descentralização da oferta às instâncias gestoras para validação e implantação. Concluiu-se que a elaboração de estratégias para descentralizar os POAC, fundamentadas nos princípios e diretrizes do SUS, promovem melhoria do acesso da população a bens e serviços de saúde. A distribuição equânime dos recursos tecnológicos e financeiros para os citados procedimentos e a ampliação do quadro profissional, com estímulo à fixação de especialistas em ortopedia, são estratégias prioritárias.


The objective of this study is to propose decentralization strategies of high complexity orthopedic procedures in the state of Bahia. It consists of an analysis of frequency and distribution of high complexity orthopedic procedures in 2012, comparing the percentage of procedures performed in patients who reside in Salvador to those who do not. The results show that the non-resident population comprises 25.25% of the amount, considering all types of Hospitalization Authorization (HA). The analysis of orthopedic HAs showed its 35.33% were non-residents, increasing to 43.0% as it refers to high complexity orthopedic procedures HAs. The proposal of elaborate intervention includes: conducting situational diagnosis that regards the provision of high complexity orthopedic procedures and human resources staff, besides the elaboration and submission of the proposal of the offer to the management for validation and deployment. In conclusion, the development of strategies to decentralize the high complexity orthopedic procedures, based on the principles and guidelines of SUS, enhances the improvement of the access to health goods and services for the population. In this sense, the equitable distribution of technological and financial resources to the above mentioned procedures and the expansion of professional staff, with stimulus for the establishment of orthopedic specialists, are prioritary strategies.


El objetivo de este estudio es proponer estrategias de descentralización de los procedimientos ortopédicos de alta complejidad (POAC) en el estado de Bahía. Tratase de un análisis de la frecuencia y distribución de POAC en 2012, comparando el porcentaje de procedimientos realizados en pacientes que viven o no en Salvador. Los resultados muestran que el porcentaje de procedimientos realizados en pacientes no residentes fue 25,25% del total considerando todos los tipos de Hospitalización Autorizada (HA). El análisis de las HA ortopédicos, mostró que 35,33% eran no residentes, aumentando para 43,0% cuando se trataba de las HA de POAC. La propuesta de intervención elaborada incluye: realización de diagnóstico de la situación con respecto a la oferta de procedimientos ortopédicos de alta complejidad y el cuadro de recursos humanos, además de la elaboración y presentación de la propuesta de descentralización de la oferta a las instancias administrativas para validación e implantación. Concluyóse que el desarrollo de estrategias para descentralizar los POAC, basadas en los principios y directrices del SUS, promoven la mejoría de la accesibilidad de la población a los servicios de salud. La distribución ecuánime de los recursos tecnológicos y financieros para los procedimientos antes citados y la ampliación del cuadro de personal profesional, con el estimulo a la estabilidad de especialistas, son estrategias prioritarias.


Assuntos
Humanos , Política , Procedimentos Ortopédicos , Acesso aos Serviços de Saúde
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA