The relationships between exogenous and endogenous antioxidants with the lipid profile and oxidative damage in hemodialysis patients

Background: We sought to investigate the relationships among the plasma levels of carotenoids, tocopherols, endogenous antioxidants, oxidative damage and lipid profiles and their possible effects on the cardiovascular risk associated with hemodialysis (HD) patients. Methods: The study groups were divided into HD and healthy subjects. Plasma carotenoid, tocopherol and malondialdehyde (MDA) levels, as well as erythrocyte reduced glutathione (GSH), were measured by HPLC. Blood antioxidant enzymes, kidney function biomarkers and the lipid profiles were analyzed by spectrophotometric methods. Results: Plasma lycopene levels and blood glutathione peroxidase (GPx) activity were significantly decreased in HD patients compared with healthy subjects. Total cholesterol, low-density lipoprotein cholesterol (LDL-c), creatinine, urea, MDA, GSH, superoxide dismutase (SOD) and catalase (CAT) were significantly increased in HD (p < 0.05). Lycopene levels were correlated with MDA (r = -0.50; p < 0.01), LDL-c (r = -0.38; p = 0.01) levels, the LDL-c/HDL-c index (r = -0.33; p = 0.03) and GPx activity (r = 0.30; p = 0.03). Regression models showed that lycopene levels were correlated with LDL-c (β estimated = -31.59; p = 0.04), while gender was correlated with the TC/HDL-c index and triglycerides. Age did not present a correlation with the parameters evaluated. GPx activity was negatively correlated with MDA levels and with the LDL-c/HDL-c and CT/HDL-c indexes. Conclusions: Lycopene may represent an additional factor that contributes to reduced lipid peroxidation and atherogenesis in hemodialysis patients

ANÁLISE CRÍTICA DO SERVIÇO DE ENFERMAGEM DE UM HOSPITAL UNIVERSITÁRIO

Este artigo reflete a organização do serviço de enfermagem de um hospital universitário do estado da Bahia, Brasil, e procura identificar os aspectos gerenciais que caracterizam este serviço. Partindo de uma coleta de dados realizada no mês de outro de 2002, mediante uma entrevista com a chefe de enfermagem e da vivência de duas das autoras que são trabalhadoras desse hospital, são apresentados inicialmente os aspectos gerais que caracterizam a organização do serviço e, posteriormente, são registradas algumas reflexões críticas sobre os dados apresentados. Fica evidenciada a inoperância do modelo gerencial hierárquico adotado pelo serviço frente às suas características e aos aspectos críticos encontrados. É também demonstrada a necessidade de revisão de paradigmas conceituais, humanos e políticos por parte das gerentes de enfermagem desta organização hospitalar

As razões da escola médica: sobre professores e seus valores. Os valores dos médicos e os impasses da escola médica Medical school and its reasons: on professors and their values. Physicians' values and impasses in medical school

Este trabalho teve por objetivo conhecer o professor médico, no que diz respeito a seus valores e comportamentos profissionais, a partir da hipótese de que os mesmos são elementos presentes no chamado currículo oculto ao longo do curso médico. Pressupõe-se, sobretudo, que tais elementos apresentam estreita relação com a formação médica, compondo, ao final, uma cultura adquirida na escola, ao longo do processo de socialização do estudante. Este processo é tão importante para a identidade profissional, para sua pertinência à corporação, quanto a aquisição de habilidades e conteúdos cognitivos relativos ao exercício técnico da profissão. Com este objetivo, o trabalho analisou a história de vida profissional de alguns docentes em uma escola pública do Rio de Janeiro, privilegiando as categorias de autonomia, ideal de serviço, mentalidade clínica e relacionamento interpares da Sociologia das Profissões, além de apreender os relatos específicos sobre a trajetória do médico que se torna professor. Optou-se pela história oral obtida de entrevistas com docentes de diferentes especialidades, em um total de onze entrevistas. Concluiu-se que os professores estão nostálgicos de um passado em que sua profissão apresentava uma situação de prestígio inquestionável e um tanto perplexos frente às novas situações, principalmente de restrições à autonomia liberal. Sem um projeto político para a escola e para a corporação, estão menos motivados do que no passado, e isto pode se constituir como fator negativo na socialização e na formação de valores éticos entre seus alunos.<br>This study focuses on medical school professors and their professional values and behaviors, based on the hypothesis that the latter are present in the so-called hidden curriculum in medical education. The primary supposition is that such elements bear a close relationship to medical training, ultimately comprising a culture acquired in medical school over the course of the student's socialization process. This process is as important for professional identity (or belonging to the medical corporation) as the acquisition of skills and technical contents related to the actual exercise of the medical profession per se. The study thus analyzed the life histories of several professors from a public medical school in Rio de Janeiro, concentrating on the categories of autonomy, service ideal, clinical reasoning, and inter-peer relations as defined in the Sociology of Professions, in addition to recording specific reports on the careers of physicians who had become professors. We used oral histories obtained through eleven interviews with professors from different specialties. The article concludes that medical professors feel nostalgia for a past in which their profession bore unquestionable prestige, meanwhile expressing bewilderment at new situations, especially restrictions over their autonomy as liberal professionals. Lacking a policy proposal for either the teaching school or the medical corporation, they are less motivated than in the past, and this may constitute a negative factor in the socialization and formation of ethical values among their students

Cancer cluster among young Indian adults living near power transmission lines in Bom Jesus do Tocantins, Pará, Brazil

A case study was carried out to explore the occurrence of a cancer cluster in 1992 among young indian adults living in an Amazonian village near two 500 kV power transmission lines that began operating a decade ago. Current blood levels of DDT and organophosphorus pesticides and metal levels in hair samples were measured. Extremely low magnetic field exposure was determined during current daily activities carried out by the Indian villagers. Taking into account the cancer incidence rates in different Brazilian cities, the probability of the occurrence of this cluster by chance was considered remote (p< 0.003, Poisson distribution). High blood levels of p,p'-DDT (median levels ranging from 26 to 58 ppb) were observed. As a whole, this community showed a pattern of low exposure to organophosphorus pesticides, and high recent exposure was only observed in a few blood samples. Continuous exposure to extremely low electromagnetic fields originated in the power transmission lines (which reached 95.0 mG under the lines) was observed on several opportunities during daily activities carried out by Indian villagers. Further observational studies should evaluate the interaction between exposure to extremely low electromagnetic fields and prior exposure to tumor initiators in cancer development