Ambulatório de seguimento a pacientes oncológicos pós tratamento: sistematização e implantação da consulta de enfermagem ambulatorial

Trabalho apresentado no 31º SEURS - Seminário de Extensão Universitária da Região Sul, realizado em Florianópolis, SC, no período de 04 a 07 de agosto de 2013 - Universidade Federal de Santa Catarina.Trata-se de um projeto de extensão que busca sistematizar e implantar a consulta de enfermagem a pacientes pós-tratamento para câncer de mama, cólon e próstata atendidos no Ambulatório SUS do Hospital Santa Rita da Santa Casa de Misericórdia de Porto Alegre. As consultas de enfermagem iniciaram no dia 07 de junho de 2013, uma vez por semana, das 08:00 as 12:00 horas. A carga-horária prevista para o projeto é de 192 horas. Foram realizadas, até o momento, 7 consultas a pacientes com câncer de mama. A consulta compreende o histórico de enfermagem, identificação dos diagnósticos, as intervenções e os resultados esperados de acordo com a taxonomia NANDA I, Nursing Interventions Classification (NIC) e Nursing Outcomes Classification (NOC). Os registros são realizados em instrumentos desenvolvidos para este fim. Até o momento foram identificados 8 diagnósticos: Constipação (2); Eliminação intestinal prejudicada (1), Disfunção sexual (1), Risco de baixa autoestima(1), Risco de glicemia instável(1), Ansiedade(1), Dor crônica (2), Incontinência Urinária de Esforço (1), Nutrição desequilibrada: maior do que as necessidades corporais (1), Medo (1), Incontinência urinária de esforço (1), Risco de queda (1), Risco de trauma (1), Conhecimento deficiente (1), Risco para infecção (2). Dentre eles a constipação, dor crônica e risco de infecção foram mais evidenciadas. As intervenções de enfermagem foram realizadas no momento da consulta por meio de educação para a saúde, assim como o planejamento dos resultados que serão avaliados nas reconsultas. A ação busca contribuir para a promoção da saúde, a prevenção da doença, a manutenção da qualidade de vida, bem como no enfrentamento da situação de sobrevida e no preparo do paciente para o retorno de cuidado a saúde na atenção primária. No contexto do ensino, envolve a inserção do acadêmico de enfermagem no processo de trabalho para que possa desenvolver conhecimentos, habilidades e atitudes necessárias em sua formação profissional alinhada as necessidades de saúde desta população tanto no seguimento quanto na atenção primária

Diagnosis, management, and follow-up of extensive dermoid cyst of the submental region

Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features

Estudantes universitários em tempos de HIV: o contexto da testagem

The aim of this study was to better explain the attitudes of university students regarding the decision to undergo HIV testing and the possibility of taking part in studies on vaccinations, by categorizing these students from a socio-demographic viewpoint. The participants were 645 students from different undergraduate courses at a university in the South of Brazil – mean age 25.32 years, 442 (68.5%) were female and 202 (31.3%) were male). A questionnaire was administered, with 33 multiple choice questions, covering socio-demographic data, as well as objective and hypothetical situations. The results clearly showed that 197 (30.5%) of the participants had been tested for HIV. One met a statistical significant association (Exact of Fisher = 0,000) and a high correlation (0,000) between having been tested and to have thoughts on the same. The study revealed the need for university spaces to provide for the possibility of discussions and specific campaigns.   Keywords: aids; testing; undergraduate students.  El objetivo del estudio era saber la colocación de los estudiantes de la universidad del VIH en cuanto a la decisión si probó y a la posibilidad para participar de estudios en vacuna, caracterizando a tales estudiantes del punto de vista socio-demográfico. Habían participado del estudio 645 estudiantes de diversos cursos de la graduación de una universidad situada en la región del sur del Brasil. Entre los participantes, la edad media era de 25,32 años, 442 (68.5%) de sexo femenino y 202 (31,3%) del sexo masculino. Un cuestionario con 33 preguntas, el acercarse dado era socio-demográfico usado, así como situaciones objetivas e hipotéticas, con opciones de la opción simple y múltiple. Los resultados indicaran que 197 (30.5%) de los participantes si estuvieron tenidos probado para el VIH. Uno resolvió una asociación significativa estadística (exacta de Fisher = 0,000) y una alta correlación (0,000) entre llevar a través de la prueba y haber pensado en igual; e una asociación significativa estadística (exacta de Fisher = 0.034) y una correlación débil (0,079) entre llevarla a través de la prueba VIH y considerar necesario la prueba. La investigación divulgó la necesidad de los espacios de la universidad para ofrecer posibilidades de discussión y de campañas específicas que enfocaban la orientación y para tener acceso al testagem para el VIH.O objetivo do estudo foi conhecer o posicionamento de estudantes universitários diante da decisão de se testarem para o HIV e da possibilidade de participarem em estudos sobre vacina, caracterizando tais estudantes do ponto de vista sociodemográfico. Os participantes foram 645 estudantes matriculados em diferentes cursos de graduação de uma universidade localizada na região sul do Brasil, dentro esses participantes a média de idade era de 25,32 anos, 442 (68,5%) eram do sexo feminino e 202 (31,3%) do sexo masculino. Um questionário foi aplicado, com 33 questões, abordando dados sociodemográficos, bem como situações objetivas e hipotéticas, com opções de escolha simples e múltiplas. Os resultados indicaram que 197 (30,5%) dos partiticpantes se testaram para o HIV. Encontrou-se uma associação estatisticamente significativa (Teste Exato de Fisher = 0,000) e uma correlação alta (0,000) entre terem realizado o teste e terem pensado sobre o mesmo. A investigação revelou a necessidade dos espaços universitários oferecerem possibilidades de discussão e de campanhas específicas.   Palavras-chave: aids; testagem; estudantes universitários

Generalized hereditary gingival fibromatosis in a child: clinical, histopathological and therapeutic aspects

Hereditary gingival fibromatosis (HGF) is a rare genetic condition characterized by slow and progressive gingival enlargement. The gingival overgrowth often delays teeth eruption and may cause serious functional and aesthetic problems. We reported a case of a 10-year-old female child presenting a generalized gingival enlargement covering almost all the maxillary and mandibular teeth and resulted in problems for swallowing, speaking, and poor aesthetics. An incisional biopsy was performed and revealed a hypocellular and hypovascular dense collagenous tissue covered by squamous epithelium exhibiting acanthosis and elongated rete ridges. The diagnosis was HGF. The treatment instituted was an association of gingivectomy with a rigorous program of oral hygiene and follow-up. Herein, we describe a rare non-syndromic case of generalized HGF, including clinical and microscopical features, as well as highlighting the importance of correct diagnosis of this genetic condition

Does antennal sensilla pattern of different populations of Triatoma maculata (Hemiptera: Reduviidae) reveal phenotypic variability?

Background: In Brazil, Triatoma maculata is only found in the State of Roraima and is a vector of Trypanosoma cruzi, the etiological agent of Chagas disease. It occurs in wild, peridomestic and domestic habitats, with an urban infestation in Boa Vista, the capital of this Brazilian state. The aim of this study was to assess the morphological variability of the T. maculata antennal phenotype in three populations of Roraima State, using the antennal sensilla pattern analyzed under optical microscopy. Methods: The number and distribution of four antennal sensilla types (bristles, thin and thick walled trichoidea, and basiconic) of three Brazilian populations of T. maculata from Roraima State were compared. Univariate and multivariate analyses were performed. Results: The antenna of T. maculata presented the four types of sensilla. According to the density and distribution of the antennal sensilla characteristics, the multivariate analyses showed that the laboratory population is morphologically structured. Urban specimens showed a pronounced phenotypic variability. The main differences were observed in the pedicel segment, and between males and females. Conclusions: We determined the antennal phenotype in three Roraima populations of T. maculata. These results support the idea that the patterns of antennal sensilla are sensitive markers for distinct populations in the Triatominae. The infestations of T. maculata in different habitats reinforces the ability of this vector to become adapted to a variety of environments, which, could have eco-epidemiological implications for the T. cruzi transmission that are still not well understood.Fil: Nogueira Müller, Josiane. Instituto Oswaldo Cruz; BrasilFil: Monte Gonçalves, Teresa. Instituto Oswaldo Cruz; BrasilFil: Ricardo Silva, Alice Helena. Instituto Oswaldo Cruz; BrasilFil: Coutinho Souza, Amanda. Instituto Oswaldo Cruz; BrasilFil: Maciel Santos, Francisco. No especifíca;Fil: Santos, Rosangela. No especifíca;Fil: Coelho Vargas, Nathalia. No especifíca;Fil: Macedo Lopes, Catarina. Instituto Oswaldo Cruz; BrasilFil: Carbajal de la Fuente, Ana Laura. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Centro Nacional de Diagnóstico e Investigaciones Endemo-epidémicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; Argentin

Alterações nos marcadores aterotrombóticos em atletas usuários de esteróides anabolizantes

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A human type 5 adenovirus-based Trypanosoma cruzi therapeutic vaccine re-programs immune response and reverses chronic cardiomyopathy

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is a prototypical neglected tropical disease. Specific immunity promotes acute phase survival. Nevertheless, one-third of CD patients develop chronic chagasic cardiomyopathy (CCC) associated with parasite persistence and immunological unbalance. Currently, the therapeutic management of patients only mitigates CCC symptoms. Therefore, a vaccine arises as an alternative to stimulate protective immunity and thereby prevent, delay progression and even reverse CCC. We examined this hypothesis by vaccinating mice with replication-defective human Type 5 recombinant adenoviruses (rAd) carrying sequences of amastigote surface protein-2 (rAdASP2) and trans-sialidase (rAdTS) T. cruzi antigens. For prophylactic vaccination, naive C57BL/6 mice were immunized with rAdASP2+rAdTS (rAdVax) using a homologous prime/boost protocol before challenge with the Colombian strain. For therapeutic vaccination, rAdVax administration was initiated at 120 days post-infection (dpi), when mice were afflicted by CCC. Mice were analyzed for electrical abnormalities, immune response and cardiac parasitism and tissue damage. Prophylactic immunization with rAdVax induced antibodies and H-2Kb-restricted cytotoxic and interferon (IFN)gamma-producing CD8+ T-cells, reduced acute heart parasitism and electrical abnormalities in the chronic phase. Therapeutic vaccination increased survival and reduced electrical abnormalities after the prime (analysis at 160 dpi) and the boost (analysis at 180 and 230 dpi). Post-therapy mice exhibited less heart injury and electrical abnormalities compared with pre-therapy mice. rAdVax therapeutic vaccination preserved specific IFNgamma-mediated immunity but reduced the response to polyclonal stimuli (anti-CD3 plus anti-CD28), CD107a+ CD8+ T-cell frequency and plasma nitric oxide (NO) levels. Moreover, therapeutic rAdVax reshaped immunity in the heart tissue as reduced the number of perforin+ cells, preserved the number of IFNgamma+ cells, increased the expression of IFNgamma mRNA but reduced inducible NO synthase mRNA. Vaccine-based immunostimulation with rAd might offer a rational alternative for re-programming the immune response to preserve and, moreover, recover tissue injury in Chagas\u27 heart disease