132 research outputs found

    Influencia del tabaco sobre el periodonto

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    Tesis (Cirujano Dentista)--Universidad Americana, Managua, 2004Analizar la influencia del tabaco sobre el periodonto en estudiantes de la Facultad de Odontología de la Universidad Americana (UAM) en el año 2004. Así como también determinar la frecuencia de sangrado gingival en estudiantes fumadores y no fumadores de cigarrillo y su estado de higiene oral, se tomaron como parámetro 52 estudiantes fumadores y 50 estudiantes no fumadores del total de los alumnos registrados en la Facultad de Odontología

    Financial incentives for model change in primary health care in São Paulo municipalities

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    Este artigo objetiva caracterizar as transferências financeiras no âmbito do Bloco da Atenção Básica para os municípios do estado de São Paulo, no período entre 2011 e 2017, e sua relação com a mudança de modelo de atenção na Atenção Primária à Saúde (APS). Trata-se de um estudo descritivo e exploratório, de natureza quantitativa e de corte longitudinal retrospectivo. Foram analisadas transferências ocorridas no âmbito do Piso da Atenção Básica Variável (PAB Variável), agregadas segundo vinculação com mudança de modelo. Também foram considerados cobertura de Estratégia Saúde da Família (ESF), número de visitas domiciliares e o percentual de municípios que aderiram ao Programa de Melhoria do Acesso de Qualidade da AB (PMAQ). Os resultados indicam a relevância que os Incentivos para mudança de modelo assumiram no financiamento da atenção básica no estado de São Paulo, em especial para municípios de pequeno porte, sugerindo o interesse da gestão municipal em implementar as medidas propostas. Contudo, constatam-se obstáculos para a identificação de mudança das práticas, de forma que o modelo de atenção em vigência não fica devidamente explicitado, a partir dos indicadores analisados. Conclui-se a necessidade de complementar a utilização do financiamento como dispositivo indutor de mudança de modelo com processos avaliativos voltados, especificamente, para a consolidação da APS abrangente.This article aims to characterize financial transfers within the scope of the Primary Care Block to the municipalities of the state of São Paulo, in the period between 2011 and 2017, and its relationship with the health care model change in Primary Health Care (PHC). This is a descriptive and exploratory study, of quantitative nature and with a retrospective longitudinal section. Transfers that occurred within the scope of the Variable Primary Care Floor (Variable PCF) were analyzed, aggregated according to its link with the model change. Family Health Strategy (FHS) coverage, number of home visits, and the percentage of municipalities that adhered to the Program for Access and Quality Improvement in Primary Care (PMAQ) were also considered. The results indicate the relevance of the Incentives for model change in the financing of primary health care in the state of São Paulo, especially for small municipalities, suggesting the interest of these municipalities in implementing the proposed measures. However, there are obstacles to identifying changes in practices, thus the current health care model is not properly explained from the analyzed indicators. In conclusion, complementing the use of funding as a model change-inducing device with evaluative processes specifically aimed at consolidating comprehensive PHC is needed

    El teatro para el fortalecimiento de la expresi?n oral, en los estudiantes del ciclo 2 del Instituto comercial Loreto sede Castilla localidad Octava

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    215 p. Recurso Electr?nicoEl proyecto de intervenci?n pedag?gica ?El teatro para el fortalecimiento de la expresi?n oral en los estudiantes del Ciclo 2 del Instituto Comercial Loreto sede Castilla de la localidad octava? se realiz? para involucrar los estudiantes en el desarrollo de su expresi?n oral, que se ve afectada por diferentes factores, reflejados en el uso del lenguaje, llev?ndolos a aislarse de sus compa?eros, sin la interacci?n verbal; evidenciados por medio de la Investigaci?n Acci?n Participativa y el uso de herramientas etnogr?ficas como diarios de campo, estudio de caso y entrevistas, aplicados a la muestra poblacional de 25 estudiantes de Ciclo 2, las cuales se registraron y sistematizaron, para analizar los resultados y proceder a dise?ar y aplicar. Este proyecto se implement? con el objetivo de fortalecer la expresi?n oral en los estudiantes, realizado en 20 sesiones, divididas en cuatro talleres: Diagn?stico, en donde se evidencio la problem?tica; Sensibilizaci?n, se acerc? a los estudiantes al reconocimiento del teatro; Exploraci?n, el objetivo de esta sesiones fue romper el hielo, utilizando t?cnicas como: la relajaci?n, la improvisaci?n, musidrama, control de respiraci?n a trav?s de los trabalenguas y el mon?logo. Aplicaci?n, esta sesi?n permiti? acercar al estudiante a una obra de teatro, reconocer elemento y participantes, prepararse para presentar una puesta en escena. En esta ?ltima etapa los estudiantes mostraron avances y soluciones a la problem?tica, su desenvolvimiento en escena y la emotividad que tuvieron al realizar la presentaci?n, previamente estaban ansiosos, pero todo eso quedo olvidado cuando son? la m?sica e iniciaron la presentaci?n.Pedagogical intervention Project ? theater for strengthening oral expression in cycle 2 of the INSTITUTO COMERCIAL LORETO?s students of the eight town, district of Castilla; was held to involve students in the development of the oral expression, which affected for different factors, reflected in the language use and isolated their partners, without verbal interaction evidenced through. Research, participatory action and the use and ethnographic tools such as field diaries, case studies and interviews applied to a population sample of 25 students in cycle 2, which were recorded and systematized to analyze the results and proceed to design and implement. This project was implemented with the purpose to strengthen oral expression in students; this was done in 20 sessions, divided into four workshops: diagnosis, where the problem is evidenced. Sensibilisation, students approached the knowledge of theater. Exploration, relaxation techniques, improvisation, musidrama and control breathing through the twister and monologue were used. Application, the students approached a rolplay theater, recognize elements and participants preparing to submit staging. In this last stage, the students showed progress and solution to the problem, this development stage and the emotion that had to make the presentation, the students were previously anxious, but all that was forgotten when the music played and began the presentation. Keywords: Theater, education, strategy, research, participatory action, intervention, oral expression

    Efeito do Cowpea aphid-borne mosaic virus sobre crescimento e variação quantitativa de fenois totais e flavonoides de Passiflora edulis Sims

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    Cowpea aphid-borne mosaic virus induz o endurecimento do pericarpo do fruto, nanismo, mosaico foliar e bolhas em plantas de maracujá. Os teores totais de fenois e flavonoides de folhas sadias e artificialmente infectadas foram quantificados pelo método de Folin-Ciocalteu e reação com cloreto de alumínio. Alturas de todas as plantas foram medidas no início e no final do experimento. As plantas infectadas apresentaram alturas 80% menores do que as plantas sadias. Não houve diferença estatística nos teores de fenois totais e de flavonoides entre tratamentos

    Migrânea vestibular: aspectos clínicos e epidemiológicos

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    Introduction: Vestibular migraine (VM) is one of the most often common diagnoses in neurotology, but only recently has been recognized as a disease. Objective: To analyze the clinical and epidemiological profile of patients with VM. Methods: This was a retrospective, observational, and descriptive study, with analysis of patients' records from an outpatient VM clinic. Results: 94.1% of patients were females and 5.9% were males. The mean age was 46.1 years65.6% of patients had had headache for a longer period than dizziness. A correlation was detected between VM symptoms and the menstrual period. 61.53% of patients had auditory symptoms, with tinnitus the most common, although tonal audiometry was normal in 68.51%. Vectoelectronystagmography was normal in 67.34%, 10.20% had hyporeflexia, and 22.44% had vestibular hyperreflexia. Electrophysiological assessment showed no abnormalities in most patients. Fasting plasma glucose and glycemic curve were normal in most patients, while the insulin curve was abnormal in 75%. 82% of individuals with MV showed abnormalities on the metabolism of carbohydrates. Conclusion: VM affects predominantly middle-aged women, with migraine headache representing the first symptom, several years before vertigo. Physical, auditory, and vestibular evaluations are usually normal. The most frequent vestibular abnormality was hyperreflexia. Most individuals showed abnormality related to carbohydrate metabolism. (C) 2015 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Introdução: Migrânea vestibular (MV) corresponde a um dos mais frequentes diagnósticos em otoneurologia, o que justifica a importância de seu estudo, embora tenha sido apenas recentemente reconhecida como entidade nosológica. Objetivo: Analisar os perfis clínico e epidemiológico dos pacientes atendidos em um ambulatório de migrânea vestibular. Método: Estudo retrospectivo, observacional e descritivo, com análise de prontuários dos pacientes do ambulatório de MV. Resultados: O ambulatório é composto por 94,1% de mulheres e 5,9% de homens, com média de idade 46,1 anos. O tempo de cefaleia foi superior ao de vertigem em 65,6% dos pacientes. Observou-se correlação entre os sintomas e o período menstrual. A maioria (61,53%) dos indivíduos apresentou algum sintoma auditivo, sendo o zumbido o mais frequente, embora a audiometria tenha sido normal em 68,51%. A vectoeletronistagmografia apresentou-se normal em 67,34%, enquanto 10,20% apresentaram hiporreflexia e 22,44% hiperreflexia vestibular. Exames eletrofisiológicos não mostraram alterações na maioria dos pacientes. Glicemia dejejum e curva glicêmica foram normais para a maioria dos pacientes, enquanto a curva insulinêmica mostrou-se alterada em 75% dos indivíduos. 82% dos indivíduos com MV apresentaram alguma alteração relativa ao metabolismo dos carboidratos. Conclusão: Migrânea vestibular acomete, predominantemente, mulheres de meia idade, com cefaleia migranosa e vertigem, sendo a primeira de instalação mais precoce. O exame físico no período intercrise, bem como as avaliações auditiva e vestibular, mostram-se, geralmente, normais. O tipo de alteração vestibular mais observado foi a hiperreflexia labiríntica. A maioria os indivíduos avaliados apresentou alterações relativas ao metabolismo dos carboidratos.Univ Fed Sao Paulo UNIFESP, Dept Otorhinolaryngol & Head & Neck Surg, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Otorhinolaryngol & Head & Neck Surg, Sao Paulo, SP, BrazilWeb of Scienc

    Prophylactic treatment of vestibular migraine

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    Introduction: Vestibular migraine (VM) is now accepted as a common cause of episodic vertigo. Treatment of VM involves two situations: the vestibular symptom attacks and the period between attacks. For the latter, some prophylaxis methods can be used. The current recommendation is to use the same prophylactic drugs used for migraines, including beta-blockers, antidepressants and anticonvulsants. The recent diagnostic definition of vestibular migraine makes the number of studies on its treatment scarce. Objective: To evaluate the efficacy of prophylactic treatment used in patients from a VM outpatient clinic. Methods: Review of medical records from patients with VM according to the criteria of the Barany Society/International Headache Society of 2012 criteria. The drugs used in the treatment and treatment response obtained through the visual analog scale (VAS) for dizziness and headache were assessed. The pre and post-treatment VAS scores were compared (the improvement was evaluated together and individually, per drug used). Associations with clinical subgroups of patients were also assessed. Results: Of the 88 assessed records, 47 were eligible. We included patients that met the diagnostic criteria for VM and excluded those whose medical records were illegible and those of patients with other disorders causing dizziness and/or headache that did not meet the 2012 criteria for VM. 80.9% of the patients showed improvement with prophylaxis (p < 0.001). Amitriptyline, Flunarizine, Propranolol and Topiramate improved vestibular symptoms (p < 0.001) and headache (p < 0.015). The four drugs were effective in a statistically significant manner. There was a positive statistical association between the time of vestibular symptoms and clinical improvement. There was no additional benefit in hypertensive patients who used antihypertensive drugs as prophylaxis or depressed patients who used antidepressants in relation to other prophylactic drugs. Drug association did not show statistically significant results in relation to the use of a single drug. Conclusions: Prophylactic medications used to treat VM improve the symptoms of this disease, but there is no statistically significant difference between the responses of prophylactic drugs. The time of vestibular symptom seems to increase the benefit with prophylactic treatment. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Univ Fed Sao Paulo UNIFESP, Dept Otorrinolaringol & Cirurgia Cabeca & Pescoco, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Otorrinolaringol & Cirurgia Cabeca & Pescoco, Sao Paulo, SP, BrazilWeb of Scienc

    Aspectos clínicos e epidemiológicos da infecção pelo vírus linfotrópico de células T humanas do tipo 2 (HTLV-II) em São Paulo, Brasil: presença de paraparesia espástica tropical/mielopatia associada ao HTLV em pacientes co-infectados pelo HIV-1

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    In this study, the epidemiological and clinical features observed in solely HTLV-II-infected individuals were compared to those in patients co-infected with HIV-1. A total of 380 subjects attended at the HTLV Out-Patient Clinic in the Institute of Infectious Diseases "Emilio Ribas" (IIER), São Paulo, Brazil, were evaluated every 3-6 months for the last seven years by infectious disease specialists and neurologists. Using a testing algorithm that employs the enzyme immuno assay, Western Blot and polymerase chain reaction, it was found that 201 (53%) were HTLV-I positive and 50 (13%) were infected with HTLV-II. Thirty-seven (74%) of the HTLV-II reactors were co-infected with HIV-1. Of the 13 (26%) solely HTLV-II-infected subjects, urinary tract infection was diagnosed in three (23%), one case of skin vasculitis (8%) and two cases of lumbar pain and erectile dysfunction (15%), but none myelopathy case was observed. Among 37 co-infected with HIV-1, four cases (10%) presented with tropical spastic paraparesis/HTLV-associated myelopathy (TSP/HAM) simile. Two patients showed paraparesis as the initial symptom, two cases first presented with vesical and erectile disturbances, peripheral neuropathies were observed in other five patients (13%), and seven (19%) patients showed some neurological signal or symptoms, most of them with lumbar pain (five cases). The results obtained suggest that neurological manifestations may be more frequent in HTLV-II/HIV-1-infected subjects than those infected with HTLV-II only.Neste estudo, as características epidemiológicas e clínicas observadas nos indivíduos infectados pelo HTLV-II foram comparadas com os pacientes co-infectados com HIV-1. Um total de 380 indivíduos atendidos na clínica do Ambulatório HTLV do Instituto de Infectologia "Emilio Ribas" (IIER), São Paulo, Brasil, foram avaliados a cada 3-6 meses nos últimos sete anos por especialistas em doenças infecciosas e neurologistas. Usando um algoritmo que emprega ensaio imunoenzimático, Western Blot e reação em cadeia de polimerase, foram incluídos 201 (53%) pacientes infectados pelo HTLV-I e 50 (13%) infectados pelo HTLV-II. Trinta e sete (74%) eram co-infectados pelo HTLV-II e HIV-1. Dos 13 (26%) indivíduos unicamente infectados pelo HTLV-II, infecção do trato urinário foi diagnosticada em três, um com vasculite e em dois casos dor lombar e disfunção erétil mas nenhum caso de mielopatia foi observado. Entre 37 pacientes co-infectados com HIV-1, quatro (10%) casos apresentaram com paraparesia espástica tropical/mielopatia associada ao HTLV similar. Dois casos mostraram paraparesia como sintoma inicial, dois outros casos se apresentaram primeiramente com distúrbios vesical e erétil e as neuropatias periféricas foram observadas em cinco pacientes (13%). Outros sete (19%) pacientes mostraram algum sinal ou sintoma neurológico, a maioria deles com dor lombar (cinco casos). Os resultados sugerem que as manifestações neurológicas podem ser mais freqüentes em indivíduos co-infectados pelo HTLV-II/HIV-1 do que nos indivíduos infectados somente pelo HTLV-II

    Significados atribuídos ao tabagismo por pessoas que vivem com HIV

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    Objetivo: compreender os significados do tabagismo navida de pessoas que vivem com o vírus da imunodeficiênciahumana. Metodologia: pesquisa de cunho qualitativoque incluiu 38 pessoas tabagistas que vivem com o vírusda imunodeficiência humana, atendidas em serviço deambulatórios especializados do interior paulista. Os dadosforam obtidos por entrevista semiestruturada e analisadosempregando o referencial metodológico do Discurso doSujeito Coletivo. Resultados: a maioria dos entrevistados erado sexo masculino (63,1%), com idade média de 41,8±10,4anos; 10,5% faziam uso de drogas ilícitas e 44,7% de bebidaalcoólica e 63,1% não praticavam atividades físicas. Dosdiscursos emergiram três ideias centrais distintas: I) Me dáprazer, alivia o estresse e a ansiedade, é um companheiro, mascausa prejuízos, arrependimento e ódio; II) Está associadocom minha rotina, com a bebida, as drogas, o café e os amigose III) Minha relação com o cigarro após a descoberta do vírusda imunodeficiência humana. Conclusão: o uso do tabacorelacionou-se com condições emocionais, comportamentaise com a infecção pelo vírus da imunodeficiência humana.O reconhecimento dos significados do tabagismo poderáfavorecer estratégias de prevenção e controle do tabagismonesse grupo populacional.Objetivo: comprender el significado del tabaquismo en la vida de las personas que viven conel virus de la inmunodeficiencia humana. Metodología: investigación cualitativa que incluyó a38 fumadores que viven con el virus de la inmunodeficiencia humana, atendidos en consultasexternas especializadas del interior de São Paulo. Los datos se obtuvieron a través de entrevistassemiestructuradas y se analizaron utilizando el marco metodológico del Discurso Colectivo delSujeto. Resultados: la mayoría de los encuestados era de sexo masculino (63,1%), tenía unaedad media de 41,8 ± 10,4 años; el 10,5% consumía drogas ilícitas y el 44,7% alcohol y el 63,1%no practicaba actividad física. Tres ideas centrales distintas surgieron de los discursos: I) Me daplacer, alivia el estrés y la ansiedad, es un compañero, pero causa daño, arrepentimiento y odio;II) Está asociado con mi rutina, con la bebida, las drogas, el café y los amigos y III) Mi relacióncon el cigarrillo tras el descubrimiento del virus de la inmunodeficiencia humana. Conclusión: elconsumo de tabaco se relacionó con condiciones emocionales y conductuales y con la infecciónpor el virus de la inmunodeficiencia humana. Reconocer los significados del tabaquismo puedefavorecer las estrategias de prevención y control del tabaquismo en este grupo poblacional.Objective: to understand the meanings of smoking in the lives of people living with the humanimmunodeficiency virus. Methodology: a qualitative research study that included 38 smokersliving with the human immunodeficiency virus, treated at specialized outpatient clinics in theinland of São Paulo. The data were obtained through semi-structured interviews and analyzedusing the methodological framework of the Collective Subject Discourse. Results: most of therespondents were male (63.1%), with a mean age of 41.8±10.4 years old; 10.5% used illicitdrugs; 44.7% drank alcoholic beverages; and 63.1% did not practice physical activities. Threedifferent central ideas emerged from the testimonies: I) It gives me pleasure, relieves stressand anxiety; it is a companion, but it causes harm, regret and hatred; II) It is associated withmy routine, with drinking, drugs, coffee and friends; and III) My relationship with smokingafter discovering the human immunodeficiency virus. Conclusion: tobacco use was relatedto emotional and behavioral conditions and to the human immunodeficiency virus infection.Recognizing the meanings of smoking may favor tobacco prevention and control strategies inthis population group

    La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos de Cesar, Santander y Norte de Santander

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    Hablar del conflicto armado, nuestra nación ha sido promotora de violencia desde lo más recóndito de las montañas hasta las principales calles de nuestras ciudades, dejando panoramas con miles de personas en situaciones vulnerables, con heridas psicológicos, diversas enfermedades mentales y expuestos a la violación de todos sus derechos, al ser discriminados y excluidos de los diferentes escenarios socio-políticos por las huellas originadas en esta guerra. Cada actos violento ejercido sobre la humanidad, tiene el vil propósito de destruir a personas en particular, a familias y comunidades completas, algunos teniendo que abandonar sus posesiones para quedar a la intemperie, otros soportan el dolor por la desaparición de sus familiares y cercanos, padres enterrando sus jóvenes hijos y muchos mutilados por la inclemencia de las minas que buscan apagar la vida y alegría de nuestros paisanos, pero que en medio de esta cruda realidad, cada víctima de una u otra manera, ha recibido acompañamiento psicosocial que les ha empoderado para convertirse en personas resilientes que se han demostrado así mismos lo capaz de su accionar y el potencial que se tenía y que no se había descubierto para iniciar un nuevo camino con nuevas oportunidades. Sustentados por el enfoque narrativo desde el estudio de casos, se realizaron lecturas a cuatro relatos, con el fin de construir el estudio reflexivo a partir de cinco preguntas orientadoras. En consenso se escogió el relato No.5 de Carlos Arturo, para complementar su análisis; y, desde la subjetividad en contextos de violencia, se formularon nueve preguntas con enfoque reflexivas, circulares, y estratégicas, con miras de realizar una posible entrevista. Finalmente, se presenta un análisis realizado al asunto de Peñas Coloradas, y se establecen estrategias y/o propuestas desde el enfoque psicosociales para una posible intervención a sus pobladores.Talking about the armed conflict, our nation has been a promoter of violence from the depths of the mountains to the main streets of our cities, leaving scenes with thousands of people in vulnerable situations, with psychological wounds, various mental illnesses and exposed to the violation of all their rights, being discriminated against and excluded from the different socio-political scenarios due to the traces caused by this war. Each violent act exerted on humanity, has the vile purpose of destroying people in particular, families and entire communities, some having to abandon their possessions to stay in the open, others bear the pain of the disappearance of their relatives and close ones, parents burying their young children and many mutilated by the inclemency of the mines that seek to extinguish the life and joy of our countrymen, but in the midst of this harsh reality, each victim in one way or another, has received psychosocial support that has empowered them to become resilient people who have shown themselves the capacity of their actions and the potential they had and had not discovered to start a new path with new opportunities. Supported by the narrative approach from the case study, four stories were read, in order to build the reflective study from five guiding questions. In consensus, Carlos Arturo's story No.5 was chosen to complement his analysis; and, from subjectivity in contexts of violence, nine questions were formulated with a reflective, circular, and strategic approach, with a view to conducting a possible interview. Finally, an analysis of the Peñas Coloradas issue is presented, and strategies and/or proposals are established from the psychosocial approach for a possible intervention to its inhabitants
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