Programa de Pós-graduação em Ciências da Saúde

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Abordagens médica e odontológica da neuralgia trigeminal
(Universidade Federal de Goiás, 2014-07-18) Tacon, Kelly Cristina Borges; Ribeiro-Rotta, Rejane Faria; http://lattes.cnpq.br/9466795079344876; Marcelo, Vânia Cristina; Ribeiro-Rotta, Rejane Faria; Marcelo, Vânia Cristina; Brasil, Virginia Visconde; Pereira, Edna Regina Silva; Parreira, Samara Lamounier Santana
Introduction: Among the neuropathic pain to trigeminal neuralgia (TN) belongs to the group of chronic painful conditions of the head and neck region, characterized by paroxysmal and recurrent attacks of excruciating and sudden pain, shock-like. Various specialties may be involved in the process of differential diagnosis and treatment, and the lack of integration of this process a major cause of the complexity of diagnosis and lack of treatment effectiveness. There are few specialized services to treat this type of chronic pain and the knowledge about the existing approaches of those is of fundamental importance for stimulating the process of integrating them, the translation of accumulated knowledge to other professionals and creating new ones. Objective: To investigate the medical and dental approaches front of trigeminal neuralgia in two at a public university services. Methodology: An exploratory study, cross-sectional, qualitative. The subjects were 19 professionals working in one of the services studied. The data collection instrument was an interview guide with 13 questions divided into four axes, based on literature: a) pathophysiology and diagnosis of TN; b) knowledge and use of different treatments; c) professionals' perception of the services and d) routing flows and monitoring of patients. The taped interview, open and semi-structured guided the construction of a descriptive analysis that enabled the identification of emerging analytical categories (Bardin, 1995). Results: Of the analyzed statements seven categories. Among the main results are: lack of consensus among professionals about the pathophysiology; the diagnostic process was considered eminently clinical, while further tests are requested for differential diagnosis and exclusion of secondary causes for TN; perceived lack of training for the diagnosis, particularly for dental professionals; the choice of treatment is associated with vocational training, and the reported pharmacotherapy as the most used; integrative and complementary practices are known as part of the TN treatment, reported by some use; the limitations found in the treatment included the professional integration of disabled and knowledge to suit the individual needs of patients and also those found in the Unified Health System (UHS); as the perception of the services, despite reporting poor infrastructure, understand that there are other more significant problems such as those related to human resources; lack of specific nuclei for the treatment of pain; the teaching-learning environment as a facilitator for the care and multiprofessional and multidisciplinary approach; the lack of effectiveness of previous treatment and the limitations of the UHS regulation system as increased demand generators in the investigated services; the lack of understanding on the part of patients, that healing does not occur when pain control achieved by therapeutic dose, makes it difficult to follow. Considerations: The investigation of medical and dental approaches against TN in both investigated services identified aspects that can motivate and closer to them and the enhancement of existing resources, creating more favorable results to affected individuals, vocational training, research and the solvability of UHS actions.
O absenteísmo-doença da equipe de enfermagem de um hospital universitário
(Universidade Federal de Goiás, 2014-06-27) Marques, Divina de Oliveira; Pereira, Milca Severino; Oliveira, Ênio Chaves de; http://lattes.cnpq.br/7046861881778720; Pereira, Milca Severino; Barbosa, Maria Alves; Coelho, Maria Alice; Vila, Vanessa da Silva Carvalho; Oliveira, Ênio Chaves de
Introduction: Unplanned absenteeism negatively affects the institutional routine in different ways, representing a complex administrative problem. Objective: to analyze absenteeism due to illness among the nursing staff of a university hospital. Methodology: a retrospective study with a quantitative approach, conducted in a university hospital, located in Goiania, Goias, Brazil, for the period 2008 to 2012. Data collection used a script, developed based on the records of workers. The study sample consisted of all employees of the nursing team, belonging to the permanent staff of the institution, who were absent from work with medical justification. Data were collected in conjunction with the workers’ employment records. Results: we identified 1574 medical justification certificates, it was found a majority of certificates involving diseases of the musculoskeletal system (19.7%), followed by mental and behavioral disorders (18.0%), as the most frequent causes of absenteeism. Regarding the professional category, the nurse technicians had the highest number of certificates. The services with the highest number of certificates were: outpatient with 201 reports (12.8%), followed by the Medical Clinic with 177 (11.2%) and Emergency with 143 (9.1%). Conclusion: the study concludes that absenteeism related to illness affects the operation of the health service, directly affecting the nursing staff and patients, resulting in work overload, and consequently hindering nursing care. It is necessary to adopt preventive and curative measures to decrease absences of employees of the nursing staff due to illness as well as increase their level of job satisfaction, with the goal of more human nursing care and a reduction in institutional and public spending.
O acesso a medicamentos pela via administrativa no setor público de saúde no Brasil
(Universidade Federal de Goiás, 2015-05-08) Soares, Amanda Queiroz; Provin, Mércia Pandolfo; http://lattes.cnpq.br/1809891256443044; Amaral, Rita Goreti; http://lattes.cnpq.br/3665611660713029; Amaral, Rita Goreti; Dâmaso, Andréa Homsi; Andrade, Eli Iola Gurgel; Medeiros, Marcelo; Contezini, Silvana Nair Leite
Although the Brazilian public healthcare system is based on the principles of the universality and integrality of access to health services, severe problems remain with respect to guaranteeing access to pharmaceutical drugs. This situation has contributed to the creation of new institutional frameworks, including the administrative channel, institutionalized by the executive power with the aim of meeting the repressed demand for pharmaceutical drugs not obtained within the public health service. This study analyzed access to pharmaceutical drugs through the administrative channel within the Brazilian public health sector. As part of this larger study, various methodologies were applied, including a case-control study, a descriptive study and an interpretive case study in which the focal group technique was used. The study was developed in the town of Goiânia, in Brazil’s mid-western region. General users of primary healthcare units (or their accompanying persons), users specifically requesting pharmaceutical drugs through the administrative channel and users who had successfully obtained pharmaceutical drugs through this channel participated in the study. Results show that administrative demands for access to pharmaceutical drugs are inserted within a multifactorial context that involves users’ economic and sociodemographic characteristics, as well as the characteristics of healthcare, pharmaceutical care and healthcare conditions. Furthermore, users who had gained access to at least one pharmaceutical drug requested through the administrative channel were found to be predominantly those who were less socioeconomically vulnerable, those with a positive self-evaluation of their state of health, those requesting insulin analogs and individuals who in general did not consult or obtain medication within the public healthcare sector. The steps taken by most of the individuals who had their request approved reveal their fluidity between the public and private healthcare sectors, characterizing their efforts to guarantee healthcare. Therefore, the administrative channel was found not to be free from the barriers to achieving access to pharmaceutical drugs that exist within the public health sector in view of its interdependency on a system with shortcomings both within the health sector itself and at higher levels within the system.
Acupuntura combinada com auriculoterapia no tratamento e qualidade de vida de pacientes com Síndrome da Ardência Bucal (SAB): ensaio clínico de braço único
(Universidade Federal de Goiás, 2015-12-04) Franco, Faraina Rodrigues Vasconcelos; Ribeiro-Rotta, Rejane Faria; http://lattes.cnpq.br/9466795079344876; Ribeiro-Rotta, Rejane Faria; Silva, João Bosco Guerreiro da; Freire, Maria do Carmo Matias; Costa, Luciane Ribeiro de Rezende Sucasas da; Queiroz, Maria Goretti
Abstract: The Burning Mouth Syndrome (BMS) is part of the framework of chronic pain which is difficult to diagnose, refractory to treatment, more prevalent in women in pre and postmenopausal phase. Acupuncture and auriculotherapy have been suggested as options in the treatment of pain, since they promote analgesia favoring the reduction of symptoms with lower doses of drugs and allowing greater patient compliance to treatment, and positive impact on quality of life. However, the phobia to needles or fear of adverse reactions can trigger anxiety, nervousness, abandon treatment, generating stress, which can lead to the release of glucocorticoids, such as cortisol. Clinical trials investigating the effectiveness of acupuncture in the treatment of BMS are scarce in the literature. Objective: To investigate combined acupuncture and auriculotherapy in the treatment and quality of life of patients with BMS. Methods: Sixty patients with burning mouth were subjected to a thorough process of differential diagnosis of BMS. Of these, 12 met the inclusion criteria and agreed to participate. Eight patients have completed treatment with acupuncture and auriculotherapy with previously established protocol. The outcome variables were analyzed before and after treatment: pain / burning (VAS - visual analog scale), salivary flow (unstimulated sialometry), quality of life (OHIP14) and stress levels (salivary cortisol). Results: Significant reduction in the intensity of pain / burning in the first treatment sessions was observed; the low values of EVA (0-2) and subjective indicator of quality of life (μ = 5.37 ± 3.50) revealed improvement in quality of patients´ life. There was no relationship between salivary flow and intensity of pain / burning. Salivary cortisol levels were significantly lower before (P = 0.03) and during (P = 0.01) acupuncture / auriculotherapy sessions (1st, 11th), with P <0.005 for all comparisons to baseline upon awaking, revealing that the procedures under the study conditions, did not promote stress on the patients. Conclusions: Combined acupuncture / auriculotherapy was effective in reducing the intensity of burning and improving quality of life, not generating stress during treatment sessions. There was no relationship between salivary flow and intensity of burning mouth.
Adaptação marginal de cimentos à base de silicato de cálcio à parede dentinária de cavidades retrógadas
(Universidade Federal de Goiás, 2019-07-05) Renovato, Sara Rodrigues; Silva, Julio Almeida; http://lattes.cnpq.br/1022830186974104; Estrela, Carlos; http://lattes.cnpq.br/3611967334176683; Estrela, Carlos; Alencar, Ana Helena Gonçalves de; Decurcio, Daniel de Almeida; Pécora, Jesus Djalma; Siqueira, Patrícia Correia de
Objective: To analyse the marginal adaptation of calcium silicate-based cements in root-end cavity by SEM. Material and Methods: Fifty bovine roots were prepared with K-File #60 and filled with gutta-percha and MTA Fillapex. Roots were apicetomized and a 3-mm-deep root-end cavity was prepared using ultrasonic tips. Samples were randomly divided into five groups (n = 10): 1. Mk Life bioceramic cement; 2. Biodentine®; 3. Bio-C Repair®; 4. Endosequence® BC RRM™; 5. MTA Angelus® (MTA) - positive control. Root-end cavities were filled with the materials prepared according to the manufacturers’ instructions. EDTA was used prior the retro-filling material insertion in half of the samples from each group (n = 5). Samples were prepared for SEM and photomicrographs were taked in x40, x150 and x500. The images of root-end fillings were divided into four áreas and distributed into five scores: 0 - absence of gaps; 1 - presence of gap in 1 area; 2 - presence of gap in 2 areas; 3 - presence of gap in 3 areas; 4 - presence of gaps in 4 areas. The analysis of transverse dimension of the gap (μm) was performed using Image J software. Qualitative variables were evaluated by Fisher Exact Test and quantitative variables by Analysis of Variance (ANOVA) . The level of significance was 0.05%. Results: No gaps were observed in MTA Angelus® group (0%). Presence of gaps were observed in Mk Life bioceramic cement (90%), Biodentine® (80%), Bio-C Repair® (100%) and Endosequence® BC RRM™ (80%). Significant difference was observed when MTA were compared to Mk Life bioceramic cement, Biodentine®, Bio-C Repair® and Endosequence® BC RRM™ (p <0.05). No significant difference were observed in the transverse dimension of the gap between Mk Life bioceramic cement, Biodentine®, Bio-C Repair® and Endosequence® BC RRM™ groups. MTA show significantly better result than Mk Life bioceramic cement and Bio-C Repair® groups (p <0.05), but without significant difference with Biodentine® and Endosequence® BC RRM™ Conclusion: MTA Angelus® showed better marginal adaptation compared to MK Life bioceramic cement, Biodentine® , BioC Repair® and Endosequence® BC RRM™. Marginal gaps were not observed in samples of MTA Angelus® group.
Adaptação transcultural do ghent developmental balance test, confiabilidade e validade concorrente de sua versão em língua portuguesa para crianças pré-escolares
(Universidade Federal de Goiás, 2015-09-08) Bizinotto, Thailyne; Formiga, Cibelle Kayenne Martins Roberto; http://lattes.cnpq.br/5231575956660644; Vieira, Marcus Fraga; http://lattes.cnpq.br/4153462617460766; Vieira, Marcus Fraga; Costa, Paula Hentschel Lobo da; Sacco, Isabel de Camargo Neves
One of the importante skills of children in school age is the balance, important for maintaining bipedal posture as opposed to the constant action of gravity. The objectives of this study were to cross-cultural adapt, verify the reliability and concorrent validity the Development Test Balance Ghent (TDEG) for children between 22 months and 6 years. This study evaluated 47 children between 22 months and 6 years old of both sexes in Goiânia. The instruments used were: Ghent Developmental Balance Test (GDBT); Gross Motor Function Classification System (GMFCS); Sitting-Rising Test (TSL); Denver II Developmental Screening Test; Pediatric Balance Scale (EEP). To check the inter-observers reliability, the assessment of children was videotaped and passed to four (4) observers. To check the intra-observer reliability, a new evalluation through the videos was performed six (6) months after the first score. In order to determine the intra-rater reliability, a second evaluation of the child was performed up to 30 days after the first evaluation. After the translation into Portuguese some terms were discussed and consensus was carried out, some of which related to the content and semantics were changed to become the test more understandable and appropriate. The results of intra-rater reliability analysis of the TDEG total score was excellent, provided ICC = 0.94 . The inter-observers reliability of the TDEG total score of and TSL can be considered excellent withICC = 0.98 and 0.85, respectively. The inter-observers agreement of the EEP total score was considered moderate, with ICC = 0.56. By correlating TDEG with the EEP considering the entire sample, it was found an r = 0.70 (p <0.001), indicating a strong and significant correlation between these instruments. Analysing the second instrument used for validation, a moderate correlation with r = 0.42 and significant (p = 0.005) between TDEG and TSL was found when considering the entire sample. From these results we conclude that the TDEG has concurrent validity and is reliable for use in the age group which it proposes to assess, especially in the total score. Furthermore, the TDEG is a good tool for scientific research and ambulatory care about balance disorders of children under five years old.
Adaptação transcultural e propriedades psicométricas do COPE breve em uma amostra brasileira
(Universidade Federal de Goiás, 2012-03-30) Brasileiro, Sarah Vieira; Costa, Luciane Ribeiro de Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305
Evidence indicates that some strategies of coping may play an important role in the disease psychological adaptation. It is important to evaluate the different ways of how people respond to stressful situations. Questionnaires for the assessment of coping have been widely used and recommended both in clinical practice and for research. The aim of this study was therefore to adapt the Brief COPE for the Brazilian population and to evaluate the psychometric properties of this instrument in a Brazilian sample. The cross-cultural adaptation of the Brief COPE followed procedures recommended by Beaton et al. and the final version was tested on a sample of 30 patients. Two hundred and thirty-seven individuals participated in the evaluation of the psychometric properties of the adapted version (Brief COPE). The intra-observer reliability was assessed in the reapplication of the Brief COPE after four weeks by the same observer. Factor analysis was conducted to evaluate the factorial validity of the Brief COPE. The internal consistency was estimated using the Cronbach’s alpha, calculated for each sub-scale and full scale factors. Regarding the results, the test-retest rateswere mostly above 0.75, demonstrating good reliability. Cronbach’s alpha for the whole Brief Cope was 0.84; 2 out of 14 sub-scales achieved Cronbach's alpha of at least 0.70, the other sub-scales were below this parameter. Factor analysis revealed four factors. We conclude that the Brief COPE was properly translated for use in the Brazilian population, demonstrating to be a reliable instrument to assess coping strategies.
Adenovírus humano em água tratada e avaliação da sua recuperação em solução com sólidos tropicais
(Universidade Federal de Goiás, 2013-10-10) Silva, Hugo Delleon da; Anunciação, Carlos Eduardo; García-Zapata, Marco Tulio Antonio; http://lattes.cnpq.br/3672512339058369; García-Zapata, Marco Tulio Antonio; Tada, Mauro Shugiro; del Aguila, Nora Katia Saavedra; Fiaccadori, Fabiola Souza; Souza, Guilherme Rocha Lino de
Human adenovirus (HAdV) is indicated as a viral biomarker of water quality. Thus, studies that show or even the occurrence of these interactions in water are of great importance, since these studies are still scarce. The aims of these studies were: (i) to detect, quantify and molecularly characterize the HAdV serotypes that can to circulate in the water supply treatment in the city of Goiania; (ii) evaluate the infectivity and recovery of genomic copies (GC) of HAdV-5 in simulated condition with solids derived from tropical soils and under controlled conditions of the pH and the presence of organic matter (OM); (iii) establish a mathematical equation to evaluate the recovery rate of virus genome copies in simulated conditions with clay soils. Thus, in the second half of 2012, we collected sample water in a volume of 5 L of 4 treated water reservoir and their respective points in the distribution network in the city of Goiania, totaling 80 samples. The samples were concentrated, quantified by qPCR and sequenced. Altogether 76.6% (100 - 109 CG/mL) and 37.5% (101 - 108 CG/mL) of the samples were positive for the reservoir and their respective points in the distribution network respectively. Therefore, Goiânia’s treated water is contaminated with a high number of HAdV type C. In the study of the interaction of HAdV-5 with the solid (sediments), a hydromorphic soil sample was divided into two parts: soil organic matter (WOM) and soil less organic matter (LOM). Then, it was added separately 5, 25 and 50 mg of soil WOM and LOM in sterile polypropylene tubes of 50 mL, added ultrapure water and adjusted the pH to 6.0 and 8.0. Then was added 1 mL of viral aliquot and the volume made up to 50 mL. The tubes in replica were shaken at 150 rpm for 1h at 24 °C followed by decantation. The viral genome was quantified (GC/mL) by Real-Time PCR and the Infectivity by Assay Plate Lysis. Water with solids promoted a reduction in the number of GC/mL and viral infectivity. The OM did not affect the recovery of GC/mL (p> 0.05). However, the OM was harmfulto to the infectivity of the virus, with a reduction of 2 log10 of Plaque Forming Units per milliliter (PFU/mL), when compared with treatments LMO. The acidic pH is unfavorable to virus inactivation, and the clay is the main element responsible for the interaction of HAdV-5. The mathematical equation is useful in assessing the recovery of viral genomic copies in clay solutions. These data can offer support in ecoepidemiological studies of viral inactivation or water treatment.
Adequabilidade dos esfregaços cervicais frente aos principais fatores pré-laboratoriais que podem interferir na análise do exame citopatológico.
(Universidade Federal de Goiás, 2009-02-16) MARTINS, Marcelo Rodrigues; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029
Background: Cervical cancer in Brazil has one of the highest incidence rates. Screening this neoplasia is effective when a cytopathological test stained by Papanicolaou method is performed. However, the quality of cytopathological samples directly influences the screening effectiveness. Eventhough, this method has been criticized due to the high rates of false-negative, due to collection errors, routine scrutiny and the interpretation of cytological changes. Amongst the collection errors, the absence of endocervical cells and bad fixation are highlighted as one of the main concerns. Objectives: to assess the profile of professionals in charge of collecting cytopathological samples as well as verify whether the experience time and the working conditions are associated with sample adequability, verify the main difficulties and easiness reported by the professionals regarding cervical smears collection by using different fixation techniques, verify which fixation technique shows better performance concerning samples adequability and whether the fixation technique influences the detection of precursory injuries; verify the frequency of satisfactory cervical smears, the factors which could partially make samples obscure or make them unsatistactory for the analysis, as well as verify the presence or absence of transformation zone, and whether the presence of these cells is associated with the detection of cervical cancer precursory injuries. Methodology: 19 professionals -doctors and nurses- in charge of collecting cytopathological samples took part in this study. 1,354 cytopathological smears were included in this study, which were divided into three groups, submitted to different fixation techniques and distributed in the following manner: first group: 414 smears fixed with alcohol 95%; second group: 445 fixed with dropping fixation (alcohol 95% + polyethylene glycol) and third group: 495 fixed with spray (alcohol 95% + polyethylene glycol). The cervical material collected was referred to the cytology sector at the Rômulo Rocha Clinical Analyses Center and submitted to scrutiny routine regardless to the fixation technique. The cytopathological outcomes were classified in accordance with Brazilian Nomenclature for Cervical Diagnoses. At the end of the study, a questionnaire was applied to the professionals in which they reported difficulties and easiness concerning the use of different techniques. Data was inserted and processed in the Epi Info 3.3.2 software, and for statistic analysis we used the SAS 9.1.3 software. Outcomes: from the 19 professionals in charge of cytopathological screening 16 (84.2%) are nurses and 3 (15.8%) are doctors. From the 19 professionals in charge of collection, 58% pointed the spray technique as of very easy handling. In the limited smears the most frequent obscuring factor was leukocyte infiltration followed by dissecation, whereas for the unsatisfactory the majority was of dissecation followed by hypocellular material. Conclusions: this study showed that spray fixation technique had the worst performance concerning adequability of sample when compared to alcohol and drops, and that the professionals considered the spray fixation as of easier handling. There was no association between the precursory injuries diagnosis and the fixation technique used. The experience time and the Abstract proper collection environment influenced the quality of cervical material samples and the alcohol 95% fixation technique had the highest rate of difficulty reported, when compared to the drop and spray fixation. We also observed that the transformation zone representation was significant both for the most severe and less severe cervical cancer precursory injuries.
Adesão ao tratamento medicamentoso em insuficiência cardíaca
(Universidade Federal de Goiás, 2018-03-09) Freitas, Elis Marra da Madeira; Dewulf, Nathalie de Lourdes Souza; http://lattes.cnpq.br/1244479719591748; Rassi, Salvador; http://lattes.cnpq.br/7236834842677715; Rassi, Salvador; Lopes, Flávio Marques; Afiune Neto, Abrahão; Resende Filho, Joffre
Pharmacological treatment for heart failure evolved in the last decades. Betablockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and aldosterone antagonists have been widely used, as they were proven to reduce morbi/mortality in heart failure. Patient adherence has been studied all over the world in the last years in acute and chronic heart failure. Many factors knownly can influence the patient adherence to treatment. This study purpose was to evaluate pharmacological treatment in patients diagnosed with heart failure in outpatient follow up in a university hospital. Different methods were used to get to this objective, comparing each other and also clustering patients in more adherent and less adherent to pharmacological treatment, furthermore, we described the factors influencing patient adherence to pharmacological treatment. Thereunto, the Morisky questionnaire was used. Also a questionnaire made by the author and a form to collect data in patient’s chart were applied. Data frequency was described and then hierarchic clusters analysis was performed. Adherence measured by the Morisky questionnaire resulted in 71% of patients more adherent to pharmacological treatment and 26% less adherent. A different result and with more expressive values was found in the self-report adherence to pharmacological treatment by the patient, where 90% of the patients considered themselves as more adherent to pharmacological treatment and 8% considered themselves as less adherent. When comparing treatment prescribed and treatment reported by the patients, the majority of patients (78%) reports at least one drug different from the prescription. When measured by different methods, adherence can show not uniform results. The clinical factors and factors related to the satisfaction with the service did not influence the patient adherence to pharmacological treatment. In the other hand, some sociodemographics factors, like age (p = 0,0476), employment condition (p = 0,0132), schooling (p = 0,0167), marriage status (p = 0,011), family income (p = 0,0123), and factors related to the use of medications, as having family help to the the medications (p = 0,006), use medication alone (p = 0,0186) and have medical orientation bout the use of medication (p = 0,0077) had influence in patient adherence to pharmacological treatment. Thus, it was observed that patients being followed up in the Heart Failure Clinic of Hospital das Clínicas da Universidade Federal de Goiás are well medicated and have satisfactory adherence to pharmacological treatment.
Adesão de pessoas adoecidas de AIDS (Síndrome da Imunodeficiência Adquirida) à terapia antiretroviral: estudo clínico e laboratorial à partir da orientação de Enfermagem
(Universidade Federal de Goiás, 2011-02-21) BRASILEIRO, Marislei de Sousa Espíndula; CUNHA, Luiz Carlos da; http://lattes.cnpq.br/6349547031976679
Adherence to antiretroviral therapy reduces the risk of treatment failure, toxicity and resistance, so the therapeutic monitoring is necessary in the treatment of infection by human immunodeficiency virus. The aim of this study was to determine, through clinical and laboratory studies, the compliance of individuals sickened by HIV / AIDS with antiretroviral therapy before and after three nursing interventions. The study design was analytical, descriptive, prospective and quantitative, using data from medical records, interviews and blood sampling for plasma levels of efavirenz by HPLC analysis, including subjects with a diagnosis of HIV / AIDS, attended at the Hospital for Diseases Tropical Goiânia - Goiás and treated with zidovudine/ lamivudine and efavirenz. The results of analysis of data from 15 subjects indicate a socio-demographic profile, predominantly male, young, heterosexual. After nursing intervention, there was a change in 48% of the diagnoses. We also noticed a positive change in the rates of CD4, corresponding to 14%. As viral count, an increase of subjects with undetectable loads of 1 st to 2 nd nursing intervention (20%, or 73.3% to 93.3%). Chromatographic analysis of plasma of the subjects indicated that 60% of them had adequate medication adherence, and 40% increased adhesion between the 1st and 2nd visits by nurses, 10% between the 1st and 3rd and 10% between the 2nd and 3rd queries. The factor that was associated with high concentration rate after adjustment in nursing diagnoses and prescriptions was having difficulty using the antiretroviral in the same time. It was also demonstrated significant difference between mean plasma concentrations of efavirenz from the 1st, 2nd and 3rd interventions. Considering the reference measurement of plasma concentrations of efavirenz, the method of accession had a sensitivity and specificity, with high proportion of agreement between the rate of CD4, nursing diagnosis and analysis of the plasma of subjects. Conclusions: the systematization of nursing care and determination of plasma concentrations should be incorporated into the routine outpatient care, for better monitoring of adherence to antiretroviral therapy of individuals sickened by HIV / AIDS.
Alterações cognitivas em pacientes idosos com insuficiência cardíaca
(Universidade Federal de Goiás, 2017-04-24) Afiune, Fernanda Guedes; Rassi, Salvador; http://lattes.cnpq.br/7236834842677715; Rassi, Salvador; Jardim, Paulo César Brandão Veiga; Barboza, Sandra de Fátima; Sá, Luis Antônio Batista de
Among the various diseases that affect the elderly stand out from them cardiovascular disease among them heart failure (HF). Recently seeks to check for cognitive impairment associated with physical and psychological damage commonly known in the IC. We analyzed a population of patients with heart failure in order to compare their cognitive performance with that of individuals with normal aging in paired age. It was also verified whether there was any more specific impairment of some cognitive function in these HF patients. Through neuropsychological tests it was compared to 78 elderly and 37 in the control group (mean age 68.3 ± 6.3), 41 clinical group with mean age of 68.6 ± 6.9). The subjects were matched to the level of education with a predominance of elderly people with 0-4 years of education (65.9% in the Clinical Group and 59.5% in the control group). We used 11 neuropsychological tests covering the cognitive functions: attention, language, memory, mood and executive function. The results showed significant differences mainly in executive functions which include planning capacity, organization, alternation and evocation of Previously stored information. Cognitive performance in other functions was similar between the groups. The data collected when indicating cognitive impairment in individuals with HF, suggest that new studies be performed with this population since the impairments in cognitive abilities have implications in the daily life of the individual, in their independence and quality of life, as well as in adherence to treatment.
Alterações dentofaciais em meninas com puberdade precoce
(Universidade Federal de Goiás, 2016-12-22) Paula Junior, Delcides Ferreira de; Mendonça, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847; Leles, Claudio Rodrigues; http://lattes.cnpq.br/6740286066154410; Leles, Claudio Rodrigues; Mendoça, Elismauro Francisco de; Roriz, Virgilio Moreira; Dias, Danilo Rocha; Castro, Anelise Daher Vaz
The objective of this study was to evaluate the prevalence of malocclusion, the need for orthodontic treatment and dentofacial changes in girls with Precocious Puberty (PP). This work gave rise to two distinct studies and data analyzes including descriptive statistics, Pearson's correlation analysis, paired t-test and t-test for one sample: 1- the cross-sectional study included 39 girls (6 to 11 years old) with confirmed PP diagnosis. The Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need (IOTN) were used for malocclusion evaluation and need for orthodontic treatment. Cephalometric analyzes were performed for the diagnosis of facial growth abnormalities. There was a high prevalence (64.1%) of severe and very severe malocclusion (DAI grades 3 and 4) and 82.1% of cases requiring moderate to high treatment (IOTN grades 3 and 4). 2- the control case study included 39 girls (6 to 11 years old) with confirmed PP diagnosis (case group). In this group, dental panoramic and hand and wrist radiographs were made. The control group consisted in 78 panoramic radiographs of girls without PP, randomly selected. Each panoramic radiograph of the 39 from case group was compared with two radiographs from control group, that is, a ratio of 1: 2. The chronological chart of dental mineralization of Nicodemus was used to identify the dental age. A significant difference (p <0.001) was found between chronology and bone age. Dental age (mean = 117) was lower than bone age (mean = 123) in girls with PP, but higher than dental age (mean = 111.5) in the control group. There was a significant correlation between chronological age and dental age. It was concluded that PP can have an impact on the development of dentition and craniofacial growth, a relevant factor for the diagnosis and the choice of the best moment for orthopedic / orthodontic intervention in malocclusion.
Alterações metabólicas, qualidade de vida e capacidade funcional de idosos atendidos na estratégia de saúde da família de um munícipio de Goiás
(Universidade Federal de Goiás, 2016-05-27) Avelar, Ivan Silveira de; Silva, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496; Silva, Maria Sebastiana; Souza, Nilva Pessoa de; Campos, Mário Hebling; Nora, Fernanda Grazielle da Silva Azevedo; Gassi, Ewerton Rodrigo
Aging involves neural structural, functional and chemical changes that generate a number of diseases. Among the diseases that affect the elderly stand out metabolic and functional, such as metabolic syndrome and loss of muscle strength, which are closely related to the quality of life and are influenced by inadequate nutritional status and physical inactivity. Studies show that protein supplementation can increase muscle strength and improve body composition. The objective of the study was to evaluate the metabolic changes and the quality of life as well as the effects of a water aerobics program associated with supplementation of soy protein in muscle strength, hydration status and body composition of the elderly. The research began with the participation of 63 elderly aged ≥ 60 years. We determined the frequency of metabolic syndrome and assessed the quality of life of those with and without SM, using the SF-36. Still, the elderly were subjected to a water aerobics program associated with supplementation of soy protein for six months and evaluated for manual pressure force by force transducer manual, and state hydration and body composition by BIA. The normality of the data was assessed by the Shapiro-Wilk. The Mann-Whitney test was used to compare the variables of MS and the scores of quality of life between the groups with metabolic syndrome (CSM) and without metabolic syndrome (SSM). The scores of each SF-36 domain were divided into tertiles and associated with individuals with and without MS using the chi-square test of Pearson (2). In the study evaluating the effect of water aerobics program with or without supplementation used the Student t test for independent samples to compare the variables with normal distribution between the groups and the Mann-Whitney test to compare variables without normal distribution. In the above analysis we used the SPSS software and adopted the significance level of p <0.05. The vectors of BIVA were analyzed by Hotelling's T2 tests and univariate analysis (F test). The distances between the vectors in each group were correlated, was also calculated and, using Mahalanobis distance D (D). The vectors were analyzed using the software BIVA 2002. The effect of supplementation on strength and body composition was assessed by analysis of variance (ANOVA) for repeated measures with Bonferroni post hoc. The results indicated a prevalence of 79.03% of elderly patients with metabolic syndrome. There was no difference between the domains of quality of life among older people with and without MS. qualitative improvement was observed in the above hydration. The study indicated a high frequency of metabolic syndrome but did not affect the quality of life of the studied group. The manual force had a significant increase (p=0.001) in the group that underwent aquatic exercise performed and consumed the soy protein supplement. Fat-free mass was significant loss in the group that used the protein supplement. The practice of gymnastics, with or without supplementation increased the manual pressure force, but did not change the body composition of the elderly.
Alterações pulmonares espirométricas e tomográficas após exposição à fumaça da combustão de lenha
(Universidade Federal de Goiás, 2011-05-05) MOREIRA, Maria Auxiliadora Carmo; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225
Introduction: Exposure to smoke from wood combustion contributes significantly to the prevalence of COPD in many countries. Findings from studies in other countries are not fully applicable to Brazil due to the diversity of vegetation used as firewood, the almost exclusive use of firewood for cooking, and limited use of other types of biomass in Brazil. The importance of high-resolution computed thorax tomography (HRCT) as an adjuvant tool to complement spirometry for COPD diagnosis has increased and studies of diseases caused by wood smoke are still scarce. Objectives: Identify women with COPD and a history of wood smoke exposure and to characterize this group in terms of exposure and clinically, demographically, spirometrically and tomographically. Particularly in regard to tomography, the goal was to add to the limited literature on this subject, both in Brazil and internationally. Methods: One hundred sixty female non-smokers exposed to smoke from burning wood and 31 normal controls with no history of exposure to wood smoke were included in the study. Through a validated questionnaire, demographic and clinical data (respiratory symptoms) and information about environmental exposures were obtained. Spirometries were carried out on all the women and the lung volume of those with COPD was measured. Forty-two patients with COPD and all of the control group underwent HRCT.
An€álise da resposta de Paracoccidioides brasiliensis a diferentes tipos de agentes estressores e osmoreguladores e express o heteró‚loga e localizaçãƒ o de β-1.3-glicana sintase
(Universidade Federal de Goiás, 2010-02-26) TOMAZETT, Patrícia Kott; PEREIRA, Maristela; http://lattes.cnpq.br/1345781867765758
Paracoccidioides brasiliensis is a thermo-dimorphic human pathogenic fungus that lives at 23”C in the mycelium phase (infecting phase) and at 37”C in the yeast phase (parasite phase). In attempt to survive, the cell wall of fungi can change its composition and/or structure in response to environmental stress by compensatory mechanisms. The molecules involved in these mechanisms are possible target for the development of effective antifungal agents. In P. brasiliensis, the main components of the cell wall are glucans and chitin polymers. These polymers make a primary barrier that is responsible for the structural integrity and form of the cell wall. In this work the behavior of P. brasiliensis was evaluated against stress conditions with the aim of study, for the first time, the mechanisms used by this fungus in the maintenance of the cell wall integrity. Our results shown that P. brasiliensis yeast cells are sensitive to cell wall stressors calcofluor white (CFW), congo red (CR), SDS, KCl, NaCl and sorbitol. There was an increase in the PbFKS1 transcripts expression and in the content of cell wall β- 1,3-glicana after treatment with all stressor agents. After treatment with SDS and KCl the PbGFA1 transcripts expression and the cell wall GlcNAc residues also increased. The transcript expression of PbGEL3 was also evaluated being increased after treatment with CFW, NaCl and sorbitol. Thus we showed that these molecules are involved in the maintenance of the cell wall against stress conditions. Apart from these analyses we obtained the active recombinant protein PbFks1pc. Through the anti-PbFks1pc antibody we performed immunocitolocalization assays. These experiments revealed the localization of PbFks1p in regions of apical growth in the mycelium phase and in the cell surface in yeast phase.
Análise Biomecânica da Inicialização da Marcha de Amputados Transtibiais Protetizados
(Universidade Federal de Goiás, 2012-03-30) AVELAR, Ivan Silveira de; SILVA, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496
The amputee patient undergoes several changes after the amputation, not only physical but also emotional and socioeconomic, requiring the use of prosthesis. One of the physical changes that affects the amputee's gait when using your prosthesis ambulation is compromised. The march is the natural way that humans use to move from one location to another. The march is a complex activity because it depends on a series of interactions between the two lower limbs multithreaded and total body mass. Therefore, assessing the impact of the use of prostheses in locomotor through the analysis of strategies for startup of the march transtibial amputees. We evaluated the speed and displacement of the COP, knee and ankle angles of the support member during initialization of the march. For the kinematic analysis was set 34 markers on anatomical landmarks of interest, two AMTI force platforms. For statistical analysis we used the Student t test and correlation between variables. Difference was only statistically significant variables in the knee angle and average speed side. The absence of a flexible ankle joint may result in limitations in the function of the prosthesis. Amputees to achieve an adequate control in propulsion and balance it was necessary to use several strategies to adjust. The prosthesis provided by SUS serves its purpose, which is to provide a walking person. But this improvement in the ankle joint can facilitate the process of walking boot. Another fact of great importance is the frequent evaluation of prosthetic to verify the necessary adjustments of the prosthesis.
Análise bioquímica das alterações salivares relacionadas à adaptação funcional de pacientes usuários de próteses totais
(Universidade Federal de Goiás, 2014-12-18) Breseghelo, Maria de Lourdes; Guillo, Lídia Andreu; http://lattes.cnpq.br/3401436781775091; Leles, Cláudio Rodrigues; http://lattes.cnpq.br/6740286066154410; Leles, Cláudio Rodrigues; Ferreira, Reginaldo Nassar; Barcelos, Bento Alves de; Cardoso, Clever Gomes; Paula, Juliê Marra de
Complete dentures represent the main treatment for total edentulism in the overall population. However this type of treatment can lead to the onset of physiological and functional alterations during the adaptative period after the installation of the denture. The objective of this work was to evaluate modifications in biochemical parameters (nitric oxide and cortisol levels) in complete denture user's saliva and verify its association with clinical parameters like levels of functional adaptation, trauma, salivary flux, and viscosity. Nineteen totally toothless patients in need of installation or substitution of dentures were selected and evaluated during the installation, adaptation and in the post-adaptation period. The protocol for making the complete dentures followed clinical and laboratory procedures. The nitric oxide concentration dosage was performed via the Griess reaction, where the measurement taken is the nitrite concentration, since nitric oxide is very unstable and rapidly transforms into nitrite. The points for construction of the calibration curve were made in triplicate using the nitrite concentration, which varied from 5 to 150 μM, wherein for each analyzed plate a new curve was built. The salivary cortisol concentration was performed using Salimetrics No. 1-3002 (single) enzymatic kit. A descriptive statistical analysis was done for representation of summary measures of the variables measured. Non-parametric tests (Friedman, Wilcoxon, Mann-Whitney and Kruskal-Wallis tests) were used for group comparison. Salivary nitric oxide levels were quantified for each evaluation period and correlated between themselves, showing statistically significant differences among them. The adaptative periods showed a decrease in nitric oxide levels between installation and post-installation. There were no significant differences in correlations between salivary nitric oxide concentrations and levels of functional adaptation, trauma, salivary flux and viscosity. The salivary cortisol levels were evaluated at two periods, in the post-adaptative and after some months of denture use, showing great variation at the first period and stabilization at the second. There was no significant difference when correlated to the levels of functional adaptation and trauma. It was concluded that the prosthetic treatment caused alterations in salivary nitric oxide and cortisol levels during adaptation to dentures however these levels came back to normal after that period.
Análise cinética dos distúrbios de marcha nos pacientes com esclerose múltipla: proposta de categorização e suas possíveis repercussões no desempenho
(Universidade Federal de Goiás, 2017-03-10) Corrêa, Paulo Fernando Lôbo; Diniz, Denise Sisterolli; http://lattes.cnpq.br/5139602841690387; Diniz, Denise Sisterolli; Souza, Doralina Guimarães Brum; Gervásio, Flávia Martins; Rosa, Heitor
Background: Multiple sclerosis (MS) causes gait disturbances that interfere in the independence and activities of daily living. For Understand the cause of these gait disturbances this study focused on the kinetics analysis of these patients gait, more specifically in the analysis of the vertical component of the ground reaction force (VCGRF). It permits estimate loss in the capacity to accelerate or decelerate the body center of mass upwards and downwards during gait. To make the analysis of this component more objective, the Ben Lomonding classification has been proposed. However, so far, it has only been tested in children with cerebral palsy (CP). Objective: To analyze the kinetics of gait disorders in MS and its repercussions on patient performance in different levels of impairment Method: A cross-sectional Control case study was developed and evaluated the gait in selfselected speed of 50 healthy adult (25 women and 25 men) and 49 adult patients (42 women and 7 men) with MS and EDSS between 1.5 and 6.0. Recruited at a Reference in MS and accomplished the three-dimensional and instrumented evaluation of the gait in a Movement Analysis laboratory of the Rehabilitation. In which, the data collection was accomplished through the VICON® system and 4 force platforms of the brand AMTI®. The speed fast analysis performed through the Timed 25-foot Walk (T25FW) test. Patients’ gait was assessed by a single rater, always in the morning, in an air-conditioned room. The VCGRF analysis was performed through Ben Lomonding’ s classification. Results: Analyzing VCGRF and possible decrease in FZ2 using Ben Lomonding classification permitted categorize VCGRF of patients with MS in five of its eight levels, since types 0, 1, 2, 3, and A were found. Of the limbs assessed, 47.0% presented alteration in VCGRF, and of these, 19.4% presented a decrease in FZ2. In patients with worse EDSS score, decrease in FZ2 was more frequent. Patients with more severity types of Ben Lomonding had higher depletion in the patient’ s performance measured by the test T25FW, cadence, speed, step and stride length, double support time and stance time. Also they presented worse performace cerebellar. Conclusion: Ben Lomonding classification can be applied to adults with MS. Additionally, the decrease in FZ2 was more frequent in patients with more severe MS, which suggests influence of MS severity on decrease in FZ2. The FZ2 reductions seem to worsen the performance of the patient gait.
Análise clínica e microbiológica de úlceras venosas de pacientes atendidos em Unidades Básicas de Saúde de Goiânia
(Universidade Federal de Goiás, 2012-03-30) SANTOS, Silvana de Lima Vieira dos; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635
This cross-sectional study was performed in the dressing rooms of the primary healthcare network of Goiânia, Goiás, Brasil, with the following objectives: to identify the prevalence of Gram-negative bacteria (GNB) in venous ulcers (VU) with clinical signs of infection; analyze the susceptibility profile of the isolates; detect the production of AmpC β-lactamases and metallo-beta-lactamases, and extended spectrum beta-lactamase (ESBL); describe the clinical signs and symptoms of infection in VU; evaluate the wounds clinical stage of infection and its relationship with the presence of GNB. The data were analyzed by means of descriptive statistics procedures, proportion and Chi-square tests (p<0.05). All ethical aspects were followed. The participants were 69 patients with venous ulcers, with or without arterial complication, totaling 98 wounds. It was verified that 74.5% of the wounds showed GNB growth, particularly enterobacteria (53.8%) and non-fermenting gram-negative bacteria (46.2%). The prevalent species among the enterobacteria was Escherichia coli (24.5%), followed by Enterobacter aerogenes, Pantoea agglomerans and Proteus mirabilis (12.2% each). Regarding the non-fermenting gram-negative bacteria, the prevalent genre was Pseudomonas (66.6%), particularly the species P. aeruginosa (59.5%), present in 25.5% of the analyzed wounds. Regarding the susceptibility profile of the enterobacteria, the highest resistance rates were to tetracycline (38.8%) and amoxicillin-clavulanic acid (26.5%). Among P. aeruginosa, the highest resistance was observed for cefoxitin (100%). Regarding the production of the AmpC enzyme, 30% of the microorganisms in the CESP (Citrobacter spp., Enterobacter spp., Serratia spp. and Providencia spp.) group, and 100% of the P. aeruginosa were resistant to cefoxitin. The remaining microorganisms of the CESP group (70%) that were sensitive to cefoxitin were subjected to a confirmatory test, and 37.5% were found to be positive for the production of the AmpC enzyme. Regarding metallo-beta-lactamase, 23.8% of the non-fermenting gram-negative bacteria showed reduced sensitivity to imipenem, meropenem or ceftazidime. When subjected to the confirmatory test, 8% of the P. aeruginosa were positive for the MBL enzyme. Regarding the clinical signs and symptoms of infection, the highlighted results with >70% frequency are: opaque and/or reddish brown discoloration; increase in exudate volume and pain. Stage-three infection was the most prevalent (71.4%). An association was found between cellulitis and friable granulation tissue that bleeds easily and the culture for GNB. In conclusion, the presence of gram-negative pathogens with resistance profiles in primary healthcare patients suggests the need to implement microbiological surveillance for patients with VU experiencing a prolonged or difficult healing process, and that the identification VU infection should be guided by knowledge regarding the etiology, classic characteristic and clinical stages of infection.

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