CAMINHOS DA PROMOÇÃO DE SAÚDE: UM RESGATE HITÓRICO E COMPREENSIVO, POR MEIO DA REVISÃO INTEGRATIVA DA LITERATURA

Introdução: O conceito de promoção de saúde vem sendo discutido ao longo dos tempos, bem como os fatores que contribuam diretamente na sua melhoria, ou que acabam por ser agravantes negativos na saúde. A saúde deixa de ser somente ausência de doenças e passa a ter perspectivas que contemple, o equilíbrio do bem-estar físico, mental, social e ambiental. Tal equilíbrio, provém do modo e estilo de vida, bem como as condições culturais, sociais e econômicas em que as pessoas estão inseridas de maneira que se pense estrategicamente. Objetivo: O estudo tem como objetivo discutir as questões promotoras de saúde a partir do resgate histórico e compreensivo, por meio de uma revisão integrativa da literatura.   Metodologia: O estudo é de natureza descritiva e exploratória, do tipo qualitativo de revisão integrativa da literatura. As etapas percorridas para a elaboração da presente revisão deram-se pela definição da questão norteadora e objetivos da pesquisa: Como o Brasil tem se esforçado para conduzir os estudos em relação a promoção de saúde? Tendo o foco norteador em levantar as produções científicas no Brasil nos últimos 20 anos, aos quais reproduzam a temática de promoção de saúde. Foram levantados 250 artigos, restringindo-se a 38 e resultante em 20 selecionados para o estudo. Considerações: No Brasil, devido a suas grandes diferenças culturais e sociais, ainda há um longo caminho a percorrer. Para uma saúde plena é necessário educar o sujeito, de maneira que ele passe a colaborar ativamente no processo de saúde e bem-estar. De maneira que o sujeito não seja só um paciente, que o médico vá além da prescrição de medicamentos e cura, que as instituições que formam os profissionais de saúde tenham um propósito de aguçar o interesse dos alunos em se preocupar com ações dentro da nossa realidade, que vão colaborar com a saúde e o que causa a sua ausência. Conclui-se que, saúde é para todos, num país em que ainda existem muitos obstáculos a serem vencidos, mas que é possível, desde que cada um desempenhando o seu papel, possa colaborar com responsabilidade e eficácia. Também a população deve se interessar e procurar tanto seus direitos quanto seus deveres, pois também são colaboradores da saúde individual e coletiva

Alta ocorrência de Entamoeba histolytica nos municípios de Ariquemes e Monte Negro, estado de Rondônia, Amazônia Ocidental, Brasil

Introdução: Infecções por Entamoeba histolytica foram investigadas em moradores dos municípios de Ariquemes e Monte Negro, Rondônia, Brasil. Métodos: Amostras de fezes de 216 indivíduos foram processadas por microscopia óptica para detecção de cistos do complexo E. histolytica/E. dispar, seguido pelo método de imunoensaio utilizando kit de ensaio imunoenzimático para detecção específica de antígeno de E. histolytica. Resultados: Cistos de E. histolytica/E. dispar estavam presentes em 61% e 44% das amostras de Ariquemes e Monte Negro, respectivamente com diferença significativa na ocorrência da infecção entre as duas populações [p < 0,05; χ2 = 5,2; Odds relativa = 2,0 (1,1 - 3,6)]. A taxa de detecção de antígenos de E. histolytica nas amostras provenientes de Ariquemes foi de 36,6% e de 19,41% nas amostras de Monte Negro, sendo a ocorrência de amebíase significativamente maior na população de Ariquemes [p < 0,05; χ2 = 7,8; Odds relativa = 2,4 (1,2 - 4,7)]. Discussão: A elevada frequência da infecção por E. histolytica em residentes na região, bem como a indisponibilidade de avaliação clínica por testes específicos para distinção entre as duas espécies de Entamoeba, deve promover uma reflexão sobre o tratamento de infecções pelo complexo E. histolytica/E. dispar. Conclusão: Nas populações avaliadas foram detectadas elevadas ocorrências de E. histolytica.Introduction: Entamoeba histolytica infections were investigated in residents of the Ariquemes and Monte Negro municipalities in Rondônia State, Brazil. Methods: Stool samples of 216 individuals were processed by the spontaneous sedimentation method and analyzed by microscopy for detection of the E. histolytica/E. dispar complex, followed by the immunoassay method using an enzyme-linked immunosorbent assay-based kit for the E. histolytica stool antigen. Results: E. histolytica/E. dispar cysts were present in 61% (50/82) and 44% (59/134) of the samples from Ariquemes and Monte Negro respectively, with a significant difference in the occurrence of infection between the two populations [p < 0.05; χ2 = 5.2; odds ratio = 2.0 (1.1 - 3.6)]. The E. histolytica antigen detection rate was 36.6% (30/82) for stool samples from Ariquemes, and 19.4% (26/134) for stool taken from the residents of Monte Negro. The rate of the occurrence of amoebiasis was significantly higher in the population from Ariquemes [p < 0.05; χ2 = 7.8; odds ratio = 2.4 (1.2 - 4.7)]. Discussion: Due to the high occurrence of E. histolytica infected residents diagnosed in the region and the unavailability in local clinics of a test to distinguish between the two Entamoeba species, physicians should consider treating E. histolytica/E.dispar infections. Conclusion: The results indicate that E. histolytica infection is highly endemic in the studied areas

Avaliação do hábito intestinal em pacientes com câncer que utilizam morfina para o controle da dor

BACKGROUND AND OBJECTIVES: There are few data in the literature on intestinal constipation secondary to morphine in cancer patients. This study aimed at evaluating intestinal habits of cancer patients under morphine. METHOD: This is a prospective non-randomized study carried out from February to November 2007. All patients had cancer, over 4 years of age and were under morphine for pain control. Patients received laxatives 24 hours after starting with morphine. Intestinal habits were evaluated through a structured questionnaire. When needed, feces were rectally or orally desimpacted. RESULTS: Twenty-two cancer patients aged between 5 and 35 years (mean 16.7 years) were admitted, of whom 63.6% were under palliative care. During the first week under morphine and lactulose, 40.9% of patients were constipated. In the second and third weeks, constipation was present in 38.8% and 16.6% of patients, respectively. Treatment was able to control constipation in 50% of cases. CONCLUSION: Constipation was frequent however the specific attention to their intestinal habits has increased adherence to laxatives and has decreased the formation of fecal impaction.JUSTIFICATIVA E OBJETIVOS: Há poucos dados na literatura sobre constipação intestinal secundária ao uso de morfina em pacientes com câncer. O objetivo deste estudo foi avaliar o hábito intestinal de pacientes com câncer em uso de morfina. MÉTODO: Estudo prospectivo, não aleatório, realizado no período de fevereiro a novembro de 2007. Todos os pacientes tinham câncer, idade superior a quatro anos e utilizavam morfina para o controle da dor. Após 24h do início da morfina os pacientes receberam laxantes. A avaliação do hábito intestinal foi realizada através de um questionário estruturado. Quando necessário, foi realizado desimpactação das fezes por via retal ou oral. RESULTADOS: Foram admitidos 22 pacientes com câncer e idade entre cinco e 35 anos (média 16,7 anos), dos quais 63,6% estavam em cuidados paliativos. Na primeira semana de uso morfina e lactulona, 40,9% dos pacientes ficaram constipados. Na segunda e terceira semanas, a constipação ocorreu em 38,8% e 16,6%, respectivamente. Com o tratamento adotado foi possível controlar o quadro de constipação em 50% dos casos. CONCLUSÃO: A constipação intestinal foi frequente; entretanto, a atenção específica ao hábito intestinal destes pacientes aumentou a adesão aos laxantes e reduziu a formação do fecaloma.Instituto de Medicina Integral Professor Fernando Figueira Serviço de GastroenterologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PediatriaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaGrupo de Oncologia PediátricaUNIFESP, EPM, Depto. de PediatriaUNIFESP, EPMSciEL

Chemotaxis and adherence to fungal surfaces are key components of the behavioral response of Burkholderia terrae BS001 to two selected soil fungi

Burkholderia terrae BS001 has previously been proposed to be a 'generalist' associate of soil fungi, but its strategies of interaction have been largely ignored. Here, we studied the chemotactic behavior of B. terrae BS001 towards Lyophyllum sp. strain Karsten and Trichoderma asperellum 302 and the role of fungal surface molecules in their physical interaction with the bacteria. To assess the involvement of the type 3 secretion system (T3SS), wild-type strain BS001 and T3SS mutant strain BS001-Delta sctD were used in the experiments. First, the two fungi showed divergent behavior when confronted with B. terrae BS001 on soil extract agar medium. Lyophyllum sp. strain Karsten revealed slow growth towards the bacterium, whereas T. asperellum 302 grew avidly over it. Both on soil extract and M9 agar, B. terrae BS001 and BS001-Delta sctD moved chemotactically towards the hyphae of both fungi, with a stronger response to Lyophyllum sp. strain Karsten than to T. asperellum 302. The presence of a progressively increasing glycerol level in the M9 agar enhanced the level of movement. Different oxalic acid concentrations exerted varied effects, with a significantly raised chemotactic response at lower, and a subdued response at higher concentrations. Testing of the adherence of B. terrae BS001 and BS001-Delta sctD to Lyophyllum sp. strain Karsten and to cell envelope-extracted ceramide monohexosides (CMHs) revealed that CMHs in both conidia and hyphae could bind strain BS001 cells. As BS001-Delta sctD adhered significantly less to the CMHs than BS001, the T3SS was presumed to have a role in the interaction. In contrast, such avid adherence was not detected with T. asperellum 302. Thus, B. terrae BS001 shows a behavior characterized by swimming towards Lyophyllum sp. strain Karsten and T. asperellum 302 and attachment to the CMH moiety in the cell envelope, in particular of the former.</p

Antiobesity Effects of Hydroethanolic Extract of Jacaranda decurrens

Obesity is a worldwide epidemic that reduces life expectancy; therefore, the search for new alternative and effective treatments is ongoing. The aim of the present investigation was to identify the chemical compounds in the hydroethanolic extract of leaves of Jacaranda decurrens subsp. symmetrifoliolata and to evaluate their toxicity and antiobesity effects. High-performance liquid chromatography was used to identify the chemical constituents, and acute toxicity was evaluated in rats treated with doses of 2 and 5 g·kg−1 body mass. The antiobesity effect was determined in rats with hypercaloric diet-induced obesity. Our results revealed the presence of compounds, such as jacaric, ursolic, and oleic acids, as well as luteolin, quercetin, and kaempferol, in the extract. The acute toxicity tests revealed that rats treated with elevated doses of the extract showed no signs of toxicity. The extract induced reduction in total body mass and the white adipose tissue depots. The obese rats treated with the extract showed an increased fluid intake and feces excretion while their serum total cholesterol and triglyceride levels decreased compared to those in the controls, without any hematological changes. Taken together, the results showed that the constituents of J. decurrens extracts included phenolic compounds and exhibited antiobesity effects with no toxicity

The role of hydrophobicity and surface receptors at hyphae of <i>Lyophyllum</i> sp. strain Karsten in the interaction with <i>Burkholderia terrae</i> BS001:Implications for interactions in soil

The soil bacterium Burkholderia terrae strain BS001 can interact with varying soil fungi, using mechanisms that range from the utilization of carbon/energy sources such as glycerol to the ability to reach novel territories in soil via co-migration with growing fungal mycelia. Here, we investigate the intrinsic properties of the B. terrae BS001 interaction with the basidiomycetous soil fungus Lyophyllum sp. strain Karsten. In some experiments, the ascomycetous Trichoderma asperellum 302 was also used. The hyphae of Lyophyllum sp. strain Karsten were largely hydrophilic on water-containing media versus hydrophobic when aerial, as evidenced by contact angle analyses (CA). Co-migration of B. terrae strain BS001 cells with the hyphae of the two fungi occurred preferentially along the - presumably hydrophilic - soil-dwelling hyphae, whereas aerial hyphae did not allow efficient migration, due to reduced thickness of their surrounding mucous films. Moreover, the cell numbers over the length of the hyphae in soil showed an uneven distribution, i.e. the CFU numbers increased from minima at the inoculation point to maximal numbers in the middle of the extended hyphae, then decreasing towards the terminal side. Microscopic analyses of the strain BS001 associations with the Lyophyllum sp. strain Karsten hyphae in the microcosms confirmed the presence of B. terrae BS001 cells on the mucous matter that was present at the hyphal surfaces of the fungi used. Cell agglomerates were found to accumulate at defined sites on the hyphal surfaces, which were coined ‘fungal-interactive’ hot spots. Evidence was further obtained for the contention that receptors for a physical bacterium-fungus interaction occur at the Lyophyllum sp. strain Karsten hyphal surface, in which the specific glycosphingolipid ceramide mono hexoside (CMH) plays an important role. Thus, bacterial adherence may be mediated by heterogeneously-distributed fungal-specific receptors, implying the CMH moieties. This study sheds light on the physical aspects of the B. terrae BS001 – L. sp strain Karsten interaction, highlighting heterogeneity along the hyphae with respect to hydrophobicity and the presence of potential anchoring sites

First official record of Aedes (Stegomyia) albopictus (Diptera: Culicidae) in the Acre State, Northern Brazil

Aedes (Stegomyia) albopictus (Skuse, 1854) was reported in Brazil for the first time in 1986 and has shown marked expansion throughout the Brazilian territory. During a routine activity to control dengue fever conducted by the Division of Entomology of the Municipal Health Department in Rio Branco city, adults and immatures of Culicidae were collected in a peri-urban area. The identified Culicidae forms indicated that they belonged to the species Ae. albopictus. This is the first official record of the presence of Ae. albopictus in the Acre State, confirming its current presence in all Brazilian states

High occurence of Entamoeba histolytica in the municipalities of Ariquemes and Monte Negro, state of Rondônia, Western Amazonia, Brazil

Introduction: Entamoeba histolytica infections were investigated in residents of the Ariquemes and Monte Negro municipalities in Rondônia State, Brazil. Methods: Stool samples of 216 individuals were processed by the spontaneous sedimentation method and analyzed by microscopy for detection of the E. histolytica/E. dispar complex, followed by the immunoassay method using an enzyme-linked immunosorbent assay-based kit for the E. histolytica stool antigen. Results: E. histolytica/E. dispar cysts were present in 61% (50/82) and 44% (59/134) of the samples from Ariquemes and Monte Negro respectively, with a significant difference in the occurrence of infection between the two populations [p < 0.05; χ2 = 5.2; odds ratio = 2.0 (1.1 - 3.6)]. The E. histolytica antigen detection rate was 36.6% (30/82) for stool samples from Ariquemes, and 19.4% (26/134) for stool taken from the residents of Monte Negro. The rate of the occurrence of amoebiasis was significantly higher in the population from Ariquemes [p < 0.05; χ2= 7.8; odds ratio = 2.4 (1.2 - 4.7)]. Discussion: Due to the high occurrence of E. histolytica infected residents diagnosed in the region and the unavailability in local clinics of a test to distinguish between the two Entamoeba species, physicians should consider treating E. histolytica/E.dispar infections. Conclusion: The results indicate that E. histolytica infection is highly endemic in the studied areas.Instituto Nacional de Genética Médica Populacional (INAGEMP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Glucosylceramides from Lomentospora prolificans induce a differential production of cytokines and increases the microbicidal activity of macrophages

Lomentospora prolificans is an emerging opportunistic fungus with a high resistance to antifungal agents and it can cause localized infections in immunocompetent patients and disseminated infections with a high mortality rate in immunosuppressed patients. Glucosylceramides (GlcCer) are synthetized in the majority of known fungal pathogens. They are bioactive molecules presenting different functions, such as involvement in fungal growth and morphological transitions in several fungi. The elucidation of the primary structure of the fungal surface glycoconjugates could contribute for the understanding of the mechanisms of pathogenicity. In this work, GlcCer species were isolated from mycelium and conidia forms of L. prolificans and their chemical structures were elucidated by mass spectrometry (ESI-MS). GlcCer purified from both forms presented a major species at m/z 750 that corresponds to N-2-hydroxyhexadecanoyl-1-?-D-glucopyranosyl-9-methyl-4,8-sphingadienine. Monoclonal antibodies against GlcCer could recognize L. prolificans GlcCer species from mycelium and conidia, suggesting a conserved epitope in fungal GlcCer. In addition, in vivo assays showed that purified GlcCer species from both forms was able to induce a high secretion of pro-inflammatory cytokines by splenocytes. GlcCer species also promote the recruitment of polymorphonuclear, eosinophils, small peritoneal macrophage (SPM) and mononuclear cells to the peritoneal cavity. GlcCer species were also able to induce the oxidative burst by peritoneal macrophages with NO and superoxide radicals production, and to increase the killing of L. prolificans conidia by peritoneal macrophages. These results indicate that GlcCer species from L. prolificans are a potent immune response activator. Copyright © 2019 Xisto, Henao, Dias, Santos, Calixto, Bernardino, Taborda and Barreto-Bergter

Assistência obstétrica no processo de parto e nascimento / Obstetric assistance in the process of labor and birth

Objetivo: caracterizar a assistência obstétrica vivenciada por docentes de uma Universidade Pública de Minas Gerais, durante a última experiência do processo de parto e nascimento em ambiente hospitalar. Metodologia: estudo descritivo transversal quantitativo.  A coleta de dados correu nos meses de dezembro/ 2015 a fevereiro/ 2016, com 40 docentes, usando um questionário de auto preenchimento. Para a análise dos dados utilizou-se o teste Mann-Whiteney, definido com 5% de significância. Resultados: a via de parto de maior frequência foi a cesariana com 95% (38). A escolha do acompanhante foi possível para 92,5% (37). Na associação entre as variáveis escolha do acompanhante com a idade por ocasião do último parto, apresentou resultado estatisticamente significativo. Conclusão: pode-se ressaltar a necessidade de refletir quanto à assistência prestada à mulher durante o processo de parto e nascimento sendo uma das formas de garantir a maternidade segura e humanizada