Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness

Churg-Strauss syndrome - High resolution CT and pathologic findings

Objectives: the purpose of this study was to evaluate high-resolution CT findings in 7 patients with Churg-Strauss syndrome and to compare the CT with the histopathologic findings.Materials and Methods: High-resolution CT scans of 7 asthmatic patients (4 women, 3 men, age range, 34-62 years, mean 49 years) with Churg-Strauss syndrome were reviewed by 2 observers. Histologic specimens of lung obtained at surgical (n = 3) or transbronchial (n = 3) biopsy or autopsy (n = 1) were reviewed by an expert lung pathologist. the diagnosis of Churg-Strauss was based on clinical, laboratory, and histologic findings.Results: Parenchymal and airway abnormalities included ground-glass opacities (n = 5), areas of air-space consolidation (n = 4), centrilobular nodules (n = 5), nodules 1-3 cm in diameter (n = 3), interlobular septal thickening (n = 4), bronchial wall thickening in = 4), and areas of atelectasis (n = 1). Surgical biopsy (n = 3) and autopsy (n = 1) specimens demonstrated airspace disease in 3 patients, interlobular septal thickening in 3 patients, and airway abnormalities in 2 patients. Histologically, the airspace disease included eosinophilic pneumonia (n = 2) and small foci of organizing pneumonia (n = 1). the septal thickening was due to edema combined with numerous (n = 2) or few (n = 1) eosinophils. the airway abnormalities (n = 2) included muscle hypertrophy and large airway wall necrosis (n = 1) and eosinophilic infiltration of the airway walls (n = 1). Transbronchial biopsy (n = 3) demonstrated increased eosinophils.Conclusion: the main high-resolution CT findings of Churg Strauss syndrome consist of airspace consolidation or ground-glass opacities, septal lines, and bronchial wall thickening. These reflect the presence of eosinophilic infiltration of the airspaces, interstitium, and airways, and interstitial edema.Vancouver Gen Hosp, Dept Radiol, Vancouver, BC V5Z 1M9, CanadaUniversidade Federal de São Paulo, Dept Diagnost Imaging, São Paulo, BrazilKurume Univ, Sch Med, Kurume, Fukuoka 830, JapanOsaka Univ, Sch Med, Dept Radiol, Suita, Osaka, JapanUniv British Columbia, Dept Pathol, Vancouver, BC, CanadaUniversidade Federal de São Paulo, Dept Diagnost Imaging, São Paulo, BrazilWeb of Scienc