A CENA DE ENUNCIAÇÃO E A CONSTRUÇÃO DO ETHOS: UMA ANÁLISE DE TRECHOS DE O QUE OS OLHOS NÃO VÊEM, DE RUTH ROCHA

Este trabalho tem a finalidade de analisar o discurso de trechos do livro de Ruth Rocha, titulado de O que os olhos não vêem, com base nos conceitos de cena de enunciação e construção do ethos da Análise do Discurso de Linha Francesa, explorando a criticidade dessa literatura que fala sobre rei, governo e povo de maneira metafórica e leva a todos os leitores a refletirem sobre a contemporaneidade da obra. Partindo do perfil crítico da escritora, a obra em questão realiza uma espécie de denúncia à sociedade de forma geral, de situações políticas enfrentadas no Brasil durante o período da Ditadura Militar, criando um ambiente interdiscursivo entre o passado e o presente. Ao fim, evidencia-se que, apesar de escrita durante os anos 80, a obra de Ruth Rocha mostra atual em relação ao contexto social brasileiro

Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock

Introduction: We investigated whether treatment with terlipressin during recovery from hypotension due to haemorrhagic shock (HS) is effective in restoring cerebral perfusion pressure (CPP) and brain tissue markers of water balance, oxidative stress and apoptosis. Methods: In this randomised controlled study, animals undergoing HS (target mean arterial pressure (MAP) 40 mmHg for 30 minutes) were randomised to receive lactated Ringer’s solution (LR group; n =14; volume equal to three times the volume bled), terlipressin (TERLI group; n =14; 2-mg bolus), no treatment (HAEMO group; n =12) or sham (n =6). CPP, systemic haemodynamics (thermodilution technique) and blood gas analyses were registered at baseline, shock and 5, 30, 60 (T60), 90 and 120 minutes after treatment (T120). After the animals were killed, brain tissue samples were obtained to measure markers of water balance (aquaporin-4 (AQP4)), Na+-K+-2Cl− co-transporter (NKCC1)), oxidative stress (thiobarbituric acid reactive substances (TBARS) and manganese superoxide dismutase (MnSOD)) and apoptotic damage (Bcl-x and Bax). Results: Despite the HS-induced decrease in cardiac output (CO) and hyperlactataemia, resuscitation with terlipressin recovered MAP and resulted in restoration of CPP and in cerebral protection expressed by normalisation of AQP4, NKCC1, TBARS and MnSOD expression and Bcl-x/Bax ratio at T60 and T120 compared with sham animals. In the LR group, CO and blood lactate levels were recovered, but the CPP and MAP were significantly decreased and TBARS levels and AQP4, NKCC1 and MnSOD expression and Bcl-x/Bax ratio were significantly increased at T60 and T120 compared with the sham group. Conclusions: During recovery from HS-induced hypotension, terlipressin was effective in normalising CPP and cerebral markers of water balance, oxidative damage and apoptosis. The role of this pressor agent on brain perfusion in HS requires further investigation

Successful reduction of intraventricular asynchrony is associated with superior response to cardiac resynchronization therapy

<p>Abstract</p> <p>Background</p> <p>Cardiac resynchronization therapy (CRT) is generally associated with a low to moderate increase of the left ventricular ejection fraction (LVEF). In some patients, however, LVEF improves remarkably and reaches near-normal values. The aim of the present study was to further characterize these so called 'super-responders' with a special focus on the extent of intra- and interventricular asynchrony before and after device implantation compared to average responders.</p> <p>Methods</p> <p>37 consecutive patients who underwent CRT device implantation according to current guidelines were included in the study. Patients were examined by echocardiography before, one day after and six months after device implantation. Pre-defined criterion for superior response to CRT was an LVEF increase > 15% after six months.</p> <p>Results</p> <p>At follow-up, eight patients (21.6%) were identified as super-responders. There were no significant differences regarding age, gender, prevalence of ischemic heart disease and LVEF between average and super-responders at baseline. After six months, LVEF had significantly increased from 26.7% ± 5.7% to 33.1% ± 7.9% (<it>p </it>< 0.001) in average and from 24.0% ± 6.7% to 50.3% ± 7.4% (<it>p </it>< 0.001) in super-responders. Both groups showed a significant reduction of QRS duration as well as LV end-diastolic and -systolic volumes under CRT. At baseline, the interventricular mechanical delay (IVMD) was 53.7 ± 20.9 ms in average and 56.9 ± 22.4 ms in super-responders - representing a similar extent of interventricular asynchrony in both groups (<it>p </it>= 0.713). CRT significantly reduced the IVMD to 20.3 ± 15.7 (<it>p </it>< 0.001) in average and to 19.8 ± 15.9 ms (<it>p </it>= 0.013) in super-responders with no difference between both groups (<it>p </it>= 0.858). As a marker for intraventricular asynchrony, we assessed the longest intraventricular delay between six basal LV segments. At baseline, there was no difference between average (86.2 ± 30.5 ms) and super-responders (78.8 ± 23.6 ms, <it>p </it>= 0.528). CRT significantly reduced the longest intraventricular delay in both groups - with a significant difference between average (66.2 ± 36.2 ms) and super-responders (32.5 ± 18.3 ms, <it>p </it>= 0.022). Multivariate logistic regression analysis identified the longest intraventricular delay one day after device implantation as an independent predictor of superior response to CRT (<it>p </it>= 0.038).</p> <p>Conclusions</p> <p>A significant reduction of the longest intraventricular delay correlates with superior response to CRT.</p

Estratégias de coping utilizadas por familiares de indivíduos em tratamento hemodialítico

This descriptive, qualitative study aims to identify the coping strategies used most by the family members of patients with chronic kidney disease receiving hemodialysis. The data were collected through interviews, with the Coping Strategies Inventory questionnaire administered to ten family members, and were submitted to descriptive statistics and to thematic content analysis. The strategy used most was escape-avoidance, demonstrating that the family members prefer not to face the situation. The second most-used strategy was social support, ratified by the fact that they stated that they talk with other persons and professionals, seeking information about the problem, and because they accept the support received positively. The third was problem resolution, represented by the attitude of accepting responsibility for the care, either through strong affective bonds or through a feeling of responsibility established prior to the disease. The families use coping strategies of different intensities, while, nevertheless, indicating involvement and major participation in the care for the patient.Estudio cualitativo, que trató de identificar las estrategias de afrontamiento empleadas por las familias de los pacientes con insuficiencia renal crónica en hemodiálisis. Se aplicó el Inventario de Estrategias de Afrontamiento y una questión abierta con diez familiares. Los datos cuantitativos fueron sometidos a procedimientos estatísticos y análisis de contenido cualitativo. La estrategia de mayor utilización fue el escape y evitación (oito), lo que demuestra que los miembros de las familisa preferían no tener que enfrentar esta situación. La siguiente estrategia fue utilizada más apoyo social, ya hablé con otras personas y profesionales que buscan información sobre el problema, y aceptar el apoyo positivo recibido. A terceira foi resolução de problemas, representada pela atitude em assumir o cuidado, seja pelo forte vínculo afetivo ou pelo sentimento de responsabilidade já estabelecido antes da doença. Familias de las estrategias de afrontamiento empleadas con diferentes intensidades, pero mostrando una gran implicación y la participación en el cuidado del paciente crónico.Estudo descritivo, de natureza quali-quantitativa, que objetivou identificar as estratégias de enfrentamento mais utilizadas por familiares de pacientes com doença renal crônica em hemodiálise. Os dados foram coletados por meio de entrevista, com aplicação do Inventário de Estratégias de Coping a dez familiares, e submetidos à estatística descritiva e à análise de conteúdo temática. A estratégia mais utilizada foi fuga e esquiva, demonstrando que os familiares preferiam não enfrentar a situação. A segunda estratégia mais usada foi suporte social, ratificada ao afirmarem que conversaram com outras pessoas e profissionais buscando informações sobre o problema, e por aceitarem positivamente o apoio recebido. A terceira foi resolução de problemas, representada pela atitude em assumir o cuidado, seja pelo forte vínculo afetivo ou pelo sentimento de responsabilidade já estabelecido antes da doença. As famílias empregaram estratégias de enfrentamento com intensidades diferentes, porém indicando envolvimento e grande participação no cuidado ao doente.Universidade Federal de São Paulo (UNIFESP)aff2Universidade Estadual de MaringáUEMUNIFESPSciEL

A modified echocardiographic protocol with intrinsic plausibility control to determine intraventricular asynchrony based on TDI and TSI

<p>Abstract</p> <p>Background</p> <p>Established methods to determine asynchrony suffer from high intra- and interobserver variability and failed to improve patient selection for cardiac resynchronization therapy (CRT). Thus, there is a need for easy and robust approaches to reliably assess cardiac asynchrony.</p> <p>Methods and Results</p> <p>We performed echocardiography in 100 healthy subjects and 33 patients with left bundle branch block (LBBB). To detect intraventricular asynchrony, we combined two established methods, i.e., tissue synchronization imaging (TSI) and tissue Doppler imaging (TDI). The time intervals from the onset of aortic valve opening (AVO) to the peak systolic velocity (S') were measured separately in six basal segments in the apical four-, two-, and three-chamber view. Color-coded TSI served as an intrinsic plausibility control and helped to identify the correct S' measuring point in the TDI curves. Next, we identified the segment with the shortest AVO-S' interval. Since this segment most likely represents vital and intact myocardium it served as a reference for other segments. Segments were considered asynchronous when the delay between the segment in question and the reference segment was above the upper limit of normal delays derived from the control population. Intra- and interobserver variability were 7.0% and 7.7%, respectively.</p> <p>Conclusion</p> <p>Our results suggest that combination of TDI and TSI with intrinsic plausibility control improves intra- and interobserver variability and allows easy and reliable assessment of cardiac asynchrony.</p

Antibacterial activity and mode of action of selected glucosinolate hydrolysis products against bacterial pathogens

Plants contain numerous components that are important sources of new bioactive molecules with antimicrobial properties. Isothiocyanates (ITCs) are plant secondary metabolites found in cruciferous vegetables that are arising as promising antimicrobial agents in food industry. The aim of this study was to assess the antibacterial activity of two isothiocyanates (ITCs), allylisothiocyanate (AITC) and 2-phenylethylisothiocyanate (PEITC) against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Listeria monocytogenes. The antibacterial mode of action was also characterized by the assessment of different physiological indices: membrane integrity, intracellular potassium release, physicochemical surface properties and surface charge. The minimum inhibitory concentration (MIC) of AITC and PEITC was 100 g/mL for all bacteria. The minimum bactericidal concentration (MBC) of the ITCs was at least 10 times higher than the MIC. Both AITC and PEITC changed the membrane properties of the bacteria decreasing their surface charge and compromising the integrity of the cytoplasmatic membrane with consequent potassium leakage and propidium iodide uptake. The surface hydrophobicity was also non-specifically altered (E. coli and L. monocytogenes become less hydrophilic; P. aeruginosa and S. aureus become more hydrophilic). This study shows that AITC and PEITC have strong antimicrobial potential against the bacteria tested, through the disruption of the bacterial cell membranes. Moreover, phytochemicals are highlighted as a valuable sustainable source of new bioactive products.This work was supported by the Operational Programme for Competitiveness Factors - COMPETE and by the Portuguese Foundation for Science and Technology through Project Phytodisinfectants - PTDC/DTP-SAP/1078/2012 (COMPETE: FCOMP-01-0124-FEDER-028765), the PhD grant awarded to Ana Abreu (SFRH/BD/84393/2012), and the post-doctoral grants awarded to Anabela Borges (SFRH/BPD/98684/2013) and Lucia C. Simoes (SFRH/BPD/81982/2011). Also, this work was undertaken as part of the European Research Project SUSCLEAN (Contract no FP7-KBBE-2011-5, project number: 287514) and the COST Action FA1202. The authors are solely responsible for this work. It does not represent the opinion of the European Community, and the Community is not responsible for any use that might be made of data appearing herein

Satisfação no trabalho da equipe de enfermagem: revisão integrativa

Job satisfaction consists of a feeling of wellbeing, resulting from the interaction of several occupational aspects, and may influence the worker's relationship with the organization, clients and family. Hence, it becomes important for the quality of nursing care to reflect on this topic in depth. Therefore, this study aimed to examine the scientific evidence related to job satisfaction in Brazilian nursing. An integrative literature review was carried out in the databases LILACS, MEDLINE, BDENF and Cochrane Library, totaling 17 publications, categorized in: Job Satisfaction, Job Dissatisfaction and Associated Factors. It was concluded that job satisfaction is determined by a complex network of factors and may vary depending on the group studied. Additional research, particularly of evidence level III in different nursing fields, covering all of Brazil, is necessary to support the implementation of occupational improvements.La satisfacción en el trabajo consiste en un sentimiento de bienestar resultante de la interacción de varios aspectos ocupacionales, pudiendo influenciar la relación del trabajador con la organización, clientes y familia. Es importante para la calidad de la asistencia de enfermería realizar una reflexión profunda sobre este tema, por eso se objetivó en este estudio analizar las evidencias científicas referentes a la satisfacción en el trabajo del equipo de enfermería brasileño. Se trató de una revisión integradora de la literatura en las bases de datos LILACS, MEDLINE, BDENF y Biblioteca Cochrane, totalizando 17 publicaciones categorizadas en: Satisfacción en el Trabajo, Insatisfacción en el Trabajo y Factores Asociados. Se concluyó que la satisfacción en el trabajo es determinada por una red compleja de factores, pudiendo variar conforme el grupo estudiado. Investigaciones adicionales, especialmente con niveles de evidencias III, en diferentes campos de actuación de la enfermería, abarcando todo el Brasil, son necesarias para subsidiar la implantación de mejorías ocupacionales.A satisfação no trabalho consiste em sentimento de bem-estar. resultante da interação de vários aspectos ocupacionais, podendo influenciar a relação do trabalhador com a organização, clientes e família. Torna-se importante, para a qualidade da assistência de enfermagem, reflexão aprofundada sobre esse tema, e, por isso, objetivou-se neste estudo analisar as evidências científicas referentes à satisfação no trabalho da equipe de enfermagem brasileira. Trata-se de revisão integrativa da literatura nas bases de dados LILACS, MEDLINE, BDENF e Biblioteca Cochrane, totalizando 17 publicações categorizadas em: satisfação no trabalho, insatisfação no trabalho e fatores associados. Conclui-se que a satisfação no trabalho é determinada por rede complexa de fatores, podendo variar conforme o grupo estudado. Pesquisas adicionais, especialmente com níveis de evidências III, em diferentes campos de atuação da enfermagem, abrangendo todo Brasil, são necessárias para subsidiar a implantação de melhorias ocupacionais

Quantitative iTRAQ-Based Proteomic Identification of Candidate Biomarkers for Diabetic Nephropathy in Plasma of Type 1 Diabetic Patients

# The Author(s) 2010. This article is published with open access at Springerlink.com Introduction As part of a clinical proteomics programme focused on diabetes and its complications, it was our goal to investigate the proteome of plasma in order to find improved candidate biomarkers to predict diabetic nephropathy. Methods Proteins derived from plasma from a crosssectiona

Minor psychiatric disorders among Brazilian ragpickers: a cross-sectional study

BACKGROUND: Ragpickers are informal workers who collect recyclable materials to earn a small wage. Their life and working conditions are extremely difficult. We examined minor psychiatric disorders (MPD) among a cohort of ragpickers in Pelotas, a city in southern Brazil. METHODS: Ragpickers were matched by sex, age, and years of schooling with a sample of non-ragpickers from the same poor neighborhoods. The cross-sectional study gathered data by interview on 990 individuals in 2004. MPD were assessed using a standard self-reporting questionnaire, the SRQ-20. RESULTS: The prevalence of MPD among ragpickers was 44.7%, higher than reported by neighborhood controls (33.6%; p < 0.001). MPD were more common among females, those of lower economic level, smokers and alcoholics. Among occupational characteristics, MPD prevalence was associated with frequent static postures, low job satisfaction and recent work accidents. CONCLUSION: Ragpickers more frequently report MPD than other poor workers living in the same neighborhoods, with many of the same life conditions. Improving the work lives of these precarious workers should address not only the physical hazards of their jobs but their mental and emotional health as well