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Eficiência do pré-escrutínio rápido, revisão aleatória de 10% e critérios clínicos de risco como métodos de controle interno da qualidade dos exames citopatológicos cervicais
(Universidade Federal de Goiás, 2007-09-06) TAVARES, Suelene Brito do Nascimento; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029
Cytopathology is an effective method of screening for cervical cancer; however, this method has high rates of false-negative results (FNR). To reduce FNR, routine measures of internal and external quality control are required in laboratories. The 10% random review of negative smears (R-10%) is the most commonly used method; however, it is not effective in reducing FNR. Nevertheless, there is evidence that the review of smears selected according to clinical risk factors (RCRF) and rapid prescreening (RPS) of all smears present good results. This study evaluated the performance of RPS, R-10% and RCRF as methods of internal quality control of cervical smear testing. The sample was composed of a total of 6,135 cervical smears from women who had attended Basic Health Clinics in Goiânia Goiás between March 2006 and March 2007. The cytopathological results were classified according to the 2001 Bethesda System. Initially, 6,135 smears were submitted to RPS followed by routine scrutiny (RS). Following RS, smears classified as negative were selected on the basis of clinical risk criteria, while 10% of all the smears were selected randomly, both sets then being submitted to the respective reviews. Four cytologists were responsible for RPS, RS, R-10% and RCRF, and three for reviewing the abnormal and discordant smears from any of the reviews. The smears classified as negative in RPS, RS, R-10% and RCRF were considered to have a final diagnosis (FD) of negative. Smears considered suspect or unsatisfactory at RPS were analyzed separately by two other cytologists. Smears considered abnormal or unsatisfactory at RS, R-10% and/or RCRF were likewise reviewed. When the two reviewing cytologists reached concordant diagnoses, these were considered the FD. Discordant results were analyzed by a third cytologist and a consensus meeting was held to define the FD. All stages of the study were performed blinded except for the consensus meeting. Smears classified as negative at RS, which were suspect at RPS and/or considered abnormal at R-10% and RCRF and confirmed abnormal in the FD, were considered FN results. Of the 6,135 smears, 5,522 were classified as negative, 84 as unsatisfactory and 529 as abnormal in the FD. Sensitivity of RPS was 63.0% for all abnormalities and 96.7% for high-grade squamous intraepithelial lesion (HSIL) compared to RS. The sensitivity of RPS was 74.9% for all abnormalities and 95.0% for HSIL compared to FD. The sensitivity of R-10% was 53.8% for all abnormalities when compared to FD. R-10% failed to detect any cases of HSIL. The sensitivity of RCRF was 64.0% for all abnormalities and 75.0% for HSIL compared to the FD. RPS identified an additional 132 (2.15%) abnormal smears, whereas R-10% and RCRF identified an additional 7 (0.11%) and 32 (0.52%), respectively. In conclusion, RPS is an effective method of internal quality control and has better sensitivity than R-10% and RCRF for the detection of FN results. It also allows the FN rate of the laboratory to be monitored and permits continuous evaluation of the prescreening cytologist and the routine screening cytologist.
Encontro do Paciente surdo que usa língua de sinais com os profissionais da saúde
(Universidade Federal de Goiás, 2007-09-12) CHAVEIRO, Neuma; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225; PORTO, Celmo Celeno; http://lattes.cnpq.br/9673684282497548
This dissertation was built in the modality scientific article and it has three articles: the first and second ones of systematic revision of literature about the theme of the study and the third article consist of the experimental part of the dissertation. The first article, accepted in Revista da Escola de Enfermagem da USP, has as title Literature Revision about the attendance of the deaf patient by health professionals, with emphasis on the communication between deaf patient and health professional. In the second one, accepted to publish in Revista Brasileira de Otorrinolaringologia and entitled Relation between deaf patient and the doctor, the legal and sociocultural aspects of the relation between deaf patient and the doctor were presented. The third article, submitted to Revista de Saúde Pública, with the title Meeting of deaf patient who uses sign language with health professionals, has as content the object of this dissertation and has as purpose to evaluate the meeting of the deaf patient who use sign language with health. It was developed in a qualitative approach, of descriptive-analytical nature. Eleven deaf people, who use the Brazilian Sign Language to communicate, including 8 males and 3 females, with ages between 19 and 36 years old, had participated of the research. For data collection a half-structured interview was used and it had questions that approach the expectations of the death person about the meeting with health professionals, the means of communication used, the presence of a Brazilian Sign Language interpreter as a mediator and what the person judges necessary to favor a good relation. The data were organized using the content analysis, proposed by Bardin, that allowed to identify three categories: Established Communication, Interpreter Presence and Lack of Autonomy. In the first category, two sub-categories had been distinguished: facilities and difficulties. As facilitator the visual resources stood out and as difficulties inefficiency in the communication, even reaching the extreme of feeling hindered to search assistance. Other difficulties were the written language and non capable professionals to attend. The category Interpreter Presence presents as eminence the complexity of this mediator. In some moments his presence is valued, while in others it turned to a barrier. In Lack of Autonomy, it was verified that their rights haven t been respected and they stay apart from the decisions taken mainly by the family. It followed that deaf patients face a lot of barriers in the meeting with health professional, since the appointment, the moment of the meeting, until the decurrent unfoldings. And in many stories it was verified that they can t solve their problems and they can t comprehend the reason of the attitudes taken by professionals, so they feel excluded and not respected in their autonomy. So an effective participation of the deaf patient in clinical meetings requires special attention from the health professionals.
Ingestão de nutrientes e anemia em crianças de creches municipais em Goiânia
(Universidade Federal de Goiás, 2008-02-14) BERALDO, Fernanda Carneiro; HADLER, Maria Claret Costa Monteiro; http://lattes.cnpq.br/6754793957094104; FORNÉS, Nélida Schmid; http://lattes.cnpq.br/0630711826568302
Introduction: The high prevalence of anemia, which is a serious public health problem, together with an early and in appropriate introduction of food for children, shows a close relationship between feeding practices and the presence of anemia. Objectives: To compare anemia among anemic and non-anemic children enrolled in municipal day nurseries of Goiânia, the socioeconomic and demographic characteristics, nutritional status, distribution of the consumption of macronutrients and the intake of micronutrients (calcium, iron and vitamin C), for Dietary Reference Intakes; evaluate and compare the ingestion of total iron, heme and non-heme iron and the bioavailable iron in the diets of anemic and non-anemic children from 12 to 24 months and compare the bioavailable iron according to algorithms developed by Monsen et al. and FAO / WHO. Methods: Observational study of cross-sectional analysis with children from 6 to 24 months in Goiânia-Goiás, in the years of 2005 and 2006. Investigations of socioeconomic, demographic and food (direct food weighing and 24 hour dietary recall) were applied for 2 days and the anthropometric evaluation and the dosage of hemoglobin were done. The diagnosis of anemia was determined by the level of hemoglobin less than 11 g / dL. Results: 89 children were studied. The prevalence of anemia was 53.9%. It was observed an statistically significant difference between anemic and non-anemic children as for per capita income. The proportion of macronutrients in the diets of the evaluated groups was appropriate and there was no difference statistically significant. Among the anemic children (n = 47), the prevalence of inadequacy was 12.8% for iron and 8.5% for vitamin C, whereas in the non-anemic ones (n = 41), the prevalence of inadequacy for iron and vitamin C was: 14.6% and 7.3%, respectively. The average intake of calcium was 50% above the recommendations in both groups. By the criterion of the World Health Organization, it was realized an anthropometric evaluation in three moments and the anemic had greater z-score according to the weight / length than non-anemic in the 2 and 3 moments (p = 0.015 p = 0.006) respectively . The average consumption of total iron, non-heme and bioavailable iron were low in the groups studied, showing no statistically significant difference. There was an intense positive correlation between the methodologies used to evaluate the iron bioavailable (r = 0.91 r = 0.84) for nonanemic and anemic children, respectively. Conclusion: There was a statistically difference between per capita income and anemia. It was observed a greater z-score for the index weight / length in the anemic children. There was no statistically difference between the two groups in relation to the consumption of calcium, iron and vitamin C, however there was a significant prevalence of inadequacy of iron and vitamin C, besides a high intake of calcium in the diet. There was a low total consumption of iron, heme and non-heme and bioavailable iron that reinforces the importance of the knowledge of food consumption of children, as well as the adoption of measures that ensure the supply of food sources of iron and food promoters of bioavailability of this micronutrient.
Avaliação da eficiência de três métodos utilizados como controle da qualidade dos exames citopatológi- cos cervicais classificados como negativos no escrutí- nio de rotina
(Universidade Federal de Goiás, 2008-03-16) MANRIQUE, Edna Joana Cláudio; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029
This study compared the effectiveness of quick review 100%, 10% random review and revision of smears selected based on clinical criteria as a method of internal quality control of cervical smears negative on routine screening and found that the false-negative results identified by review rapid vary with the quality of the sample and the woman's age. Was based on the female population user of the Unified Health System in Goiânia-GO, which was subjected to cytological examination performed at the Laboratory of Clinical Analysis of the Romulus Rock School of Pharmacy, Federal University of Goiás The 5,530 smears classified as negative scrutiny underwent routine method for quick review 100%, then the smears were selected based on clinical criteria and 10% of negative smears and submitted to the respective revisães. Four cytologists alternated during revisions. After the revisions concordant results were considered final diagnosis, whereas the divergent were analyzed by a third cytologist, which consensus meeting defined the final diagnosis. All steps were blindly and the results classified according to the Bethesda System. For statistical analysis, the variables were analyzed descriptively and applied the chi-square test. A Quick Review of 100% smears identified 141 suspects, 84 of these (59.6%) tested positive for the final diagnosis, of which 36 (25.5%) were classified as atypical squamous cells of undetermined significance (ASC-US) five (3.5%) as atypical squamous cells can not exclude high-grade lesion (ASC-H), 34 (24.1%) as squamous intraepithelial lesions of low-grade (LSIL), six (4.3 %) as squamous intraepithelial lesion, high-grade (HSIL) and three (2.1%) atypical glandular cells (AGC). Smears of 84 suspected and confirmed the final diagnosis, 62 (73.8%) were classified as satisfactory and 22 (26.2%) satisfactory, but with some limitation, but no significant difference was with the woman's age. The method of rapid review identified 19 as unsatisfactory smears, 16 of these (84.2%) were confirmed in the final diagnosis. Of the 1,279 smears reviewed based on clinical criteria, 24 were considered abnormal. Of these 19 (79.2%) were confirmed as positive by the final diagnosis, nine (47.3%) classified as ASC-US, one (5.3%) ASC-H, eight (42.1%) and LSIL One (5.3%) HSIL. Of the 560 smears examined by reviewing 10%, 13 were considered abnormal, these six (46.2%) were confirmed in the final diagnosis, four (30.8%) classified as ASC-US, one (7.7%) and LSIL (7.7%) HSIL. Therefore, a quick review of 100% is a more efficient alternative for the detection of false-negative results of cervical screening as a method of internal quality control, than the random review of 10% and revision based on clinical criteria. It was observed also that the quick review showed better performance when the sample was classified as adequate for analysis, but does not vary with the age of the woman.
Estudo dos parasitos oportunistas em águas fluviais de uso humano no município de Goiânia-Goiás, Brasil, 2006/2007
(Universidade Federal de Goiás, 2008-03-26) Santos, Sônia de Fátima Oliveira; Anunciação, Carlos Eduardo; http://lattes.cnpq.br/3144104514016268; Garcia-Zapata, Marco Tulio Antonio; García-Zapata, Marco Tulio Antonio; Gomes, Abraão Garcia; Lacerda, Elisângela de Paula Silveira
Introduction: Water is a substance of vital importance for beings, but, due to the antropic action, several microorganisms are disseminated by it. Within these microorganisms, one special attention must be given to the opportunistic parasites. These ones come to the aquatic environments through the faeces of man and other animals, and they can unchain several offences to health, especially in immunodepressed and immunosuppressed individuals. By routine of tracking, the bacteriums of the coliformes’ groups are used normally as microbiological parameter, which does not evidence the real contamination by other pathogens, involving the real microbiological quality of water. In this context, most sensitive techniques must be developed and aggregated normally to the used ones as routine of environmental tracking. Objectives: to evaluate the quality of water in human use from the Municipal District of Goiania-Goiaz in relation to the presence of helminthes and opportunistic protozoa, with emphasis in the research of the Coccideos and intestinal Microsporas. Methodology: The samples of water were collected monthly – from february2006 to january2007, in six points: in Meia-Ponte River and Ribeirão João Leite River, which supply the Municipal District of Goiania; and Bosque dos Buritis Lake and Parque Vaca Brava Lake. The laboratorial analysis were achieved in NUPEREME and LDGM. The procedures for the study of water was the method of filter membrane commended by “Standard Methods for the Examination of Water and Wastewater”. The opportunistic parasite agents were identified by the technique of concentration and specific coloration for coccideos and microsporidios, immunofluorecence by Kit MeryFluor and bio-molecular techniques, using PCR. The helminthes were identified by the method of Hoffman Pons and Janner (1934). Results: Of 72 collected samples, two of them were positive for Cryptosporidium spp by the technique of Ziehl-Nelseen and the Kit Mery-Fluor. Utilizing the technique of PCR, the specimen Cryptosporidium parvum was confirmed to the collected sample in Meia-Ponte River, 2km from ETE-Goiania, which did not occur with other sample identified in Vaca Brava Lake. Utilizing the technique of Hoffman Pons and Janner (1934), on confirmation by the technique of immunofluorescence of the Kit Mery-Fluor, cysts of Giardia were found in Ribeirão João Leite River, in a point before the act of captivating from SANEAGO (Sanitation of Goiás) at 2.77%(2/72), and another one in Municipal of Goianápolis at 1.38%(1/72), where receives a great part of the sewerage generated by Anapolis City. The techniques of Kynioum and Hot- Cromotrope did not showed positivity for any of the opportunistic protozoa researched in this work. About the helminthes, 23.6% (17/72) of the samples were positive for larvas of free life, and 2.77%(2/72) for eggs, detecting Ascaris lumbricoides and Hymenolepis diminuta. In relation to the temperature and humidity, significant result was not obtained statistically. However, it did not influence on the occurrence of the protozoarios and helminths. Conclusion: The applied parasitological methodologies showed to be at low cost, relatively fast ones, even not specific. For the specific identification was necessary to utilization of molecular methods helminthes showed major positivity, maybe by the practicality of the method, demonstrating speed and low cost to the diagnosis.
EFEITOS DO MÉTODO PILATES E DO TREINAMENTO COM PESOS NA MARCHA, NO PESO CORPORAL, NA CAPACIDADE FÍSICA FUNCIONAL E NA QUALIDADE DE VIDA DE MULHERES OBESAS
(Universidade Federal de Goiás, 2008-09-29) CARNEIRO, Juliana Alves; VIEIRA, Marcus Fraga; http://lattes.cnpq.br/4153462617460766; SILVA, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496
The physical exercise is, currently, a means to intervene in the epidemics of obesity, helping with the weight loss, enhancing the capacity to perform daily activities and decrease the factors of risk of chronicle diseases. Objective: Assess the effectiveness of two programs of physical exercises (Pilates and weight training) and nutritional orientation, in the body weight, in the biomechanics gait, in the functional physical capacity and in the quality of life of obese women. Methodology: For twelve weeks, a group of fifteen obese women participated in a program of aerobic exercises and Pilates method and another group of fourteen obese women participated in a program of aerobic exercises and weight training. The groups participated of nutritional orientation. The exercise training lasted sixty minutes, three times a week. Were evaluated: the body weight, the body mass index (BMI), the six-minute walk test, the stand-up test, the sit-and-reach test, the SF-36(The Medical Outcomes Study 36 item) and the kinematics of the gait through recorded images and digitalized using specific software (Kwon 3D). Results: There was significant reduction of the body weight and the BMI, development in the rates of all tests of functional physical capacity and in the variables of the angular movement of the knee after twelve weeks of intervention in the two groups. The Pilates group showed significant improvement in five domains of SF-36, after twelve weeks and in the domain functional capacity between the two groups. The group trained with weights showed meaningful development in most of the space-time variables of the gait after twelve weeks. Conclusion: Both programs were effective to promote weight loss and enhance the functional physical capacity after twelve weeks. The Pilates method was more effective providing obese women with a better quality of life, mainly in the aspect of physical health. The weight training program was more effective to alter positively the kinematics variable which increased the dynamic stability of the gait of obese women after twelve weeks of intervention.
SEDAÇÃO EM ODONTOPEDIATRIA: PERCEPÇÕES DE ACOMPANHANTES E EQUIPE PROFISSIONAL
(Universidade Federal de Goiás, 2008-10-16) LIMA, Alessandra Rodrigues de Almeida; COSTA, Luciane Ribeiro de Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305
The management of a child s behavior in a dental setting is routinely accomplished by a good communicative technique known as basic methods. Advanced me thods (protective stabilization, sedation, and general anesthesia) have been indicated for resistant children. When the basics methods are not enough to provide a safe and effective treatment, Brazilian dentists seem to prefer the protective stabilization to restrain a child. After the establishment of rules for nitrous oxide sedation in Brazil, a change in practice can be expected. In minimal and moderate sedation, patient can respond to every dental treatment s stimulus with cry and struggle. The purpose of this study was to known the perceptions of sedation by accompanying adults and a sedation team. This was a qualitative research, based on three in-depth interviews with two groups of accompanying adults groups and one group of a dental sedation team. Interviews were transcribed verbatim and independently analyzed by three investigators through the thematic content method. The first analysis explored the ACCOMPANYING ADULTS SATISFACTION; two categories emerged: the good side (conscious, safety, satisfaction, behavior management) and the bad side (suffering, adverse effects) of pediatric dental sedation. The second analysis regarding the MEANINGS OF SEDATIONFOR ACCOMPANYING ADULTS generated FOUR categories: Protective stabilization (to bind, to protect on sedation), sedation (positive and negative side) , general anesthesia (positive point of a view) and mothers feelings (aversion peace, fair, security, motivation). Three categories emerged from the third interview about DENTAL TEAM PERCEPTIONS: knowledge (technique, indication, aim, amnesia, unexpected), disappointment (hopes, disappointment, depreciation), and difficulties (expense, accompanying adults and care team s opposition, tendency to be better). Accompanying adults did not accept physical restraint, but were satisfied with dental sedation despite its limitations and saw general anesthesia as an alternative method. The dental sedation team was aware of the sedation s advantages and flaws, but was pessimist about the method
Monitoração terapêutica das concentrações plásmaticas da digoxina em pacientes com insuficiência cardíaca
(Universidade Federal de Goiás, 2008-10-27) BARROS, Isabel Cristina Medeiros; RASSI, Salvador; http://lattes.cnpq.br/7236834842677715; CUNHA, Luiz Carlos da; http://lattes.cnpq.br/6349547031976679
It was investigated the clinical, lab and plasma digoxin concentration profiles in 15 cardiac heart failure (CHF) outpatients of the Cardiac Heart Service of the Goias Federal University Clinical Hospital. It was aimed to know plasma digoxin concentration profile in 15 cardiac heart failure (CHF) outpatients by two analytical methods, taking account clinical, laboratorial, habits, anthropometric data and drug usage. Digoxin dosage was developed by LC/MS/MS and immunoassay methods; questionnaire and consults handbooks were performed. Results and Conclusions: 87% of the patients who over 46 years of age (33% above 61), the masculine majority; the IC of Chagas disease origin presented greater occurrence, followed of the hipertensive and idiopatic (59%); IC functional classroom II (53.33%); hypertension and diabetes had been distinguished as co-morbidities (26.67% and 20%); tobaccoism, overweight and obesity degree I had presented low occurrence. No patients presented relevant clinical data suggestive of digitalis intoxication. No observed changes in biochemical and hematological exams. The ejection fractions were good by means 41.7 ± 9%. Some drugs with interaction potential had been associated to the treatment, apparently without alterations. Statistical significative difference between both methods was observed (P < 0.05, ANOVA, Tukey Test). In the immunoassay method, all the patients were inside of the therapeutical range (0, 5-2, 0 ng/mL), whereas for the LC-MS/MS method, 8 patients they would be in subtherapeutical concentrations. However, no patient presented signals or symptoms of poisoning or inefficacy of the digoxin, demonstrating biological variability. The two methods are useful, since that it has a correlation with the clinical and laboratorial state of the patients.
Prevalência do Transtorno de Déficit de Atenção e Hiperatividade (TDAH) em uma População de Crianças e Adolescentes Índias da Etnia Karajá.
(Universidade Federal de Goiás, 2009-02-04) AZEVÊDO, Paulo Verlaine Borges e; CAIXETA, Leonardo Ferreira; http://lattes.cnpq.br/9536747113677509
Few studies have been carried out worldwide about ADHD among indigenous children and no study has been conducted in Brazil so far. This study aims to evaluate the estimated prevalence of ADHD among the indigenous populations of Karajá children and adolescents aged 7 to 14 years old. Three of the largest settlements pertaining to this ethnic group were investigated and a sample of 144 subjects of a total population of 350 individuals was collected. The sample was randomly collected and stratified according to the age bands and gender (male and female) proportionally to the size of each participating settlement. Both the CBCL/6-18 (Child Behavior Checklist for ages 6 18) and the TRF (Teacher s Report Form 6-18) were used as instruments of epidemiological tracking of behavioral and emotional problems. Of these instruments, the data used were those compatible with the DSM-IV and ADHD diagnoses as well as Affective Disorder, Anxiety Disorders, Oppositional Defiant Disorders and Conduct Disorders comorbidities. The results indicate a prevalence of 10.4% (95% CI 6.6 14.2) when the respondents are either the parents or the guardians and 2.8% (95% CI 0.7 4.8) when the respondents are the teachers. Of the 144 interviewed participants, 30 had ADHD and comorbidities were 86.7% (95% CI 74.5 98.8) for conduct disorders, 86.7% (95% CI 74.5 98.8) for oppositional defiant disorders, 83.3% Abstract xxviii (95% CI 70.0 96.7) for anxiety disorders and 60% (95% CI 42.5 77.5) for affective disorders. ADHD is then concluded to exist in a population so culturally diverse from that of the east white and to have a high prevalence rate and the comorbidities routinely found in all populations of children from a number of diverse cultures around the globe.
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.
Impacto da capacitação em Boas Práticas de Fabricação na presença de Staphylococcus aureus e Escherichia coli em mãos e fossas nasais de manipuladores de panificadoras e confeitarias da região central de Goiânia-Goiás
(Universidade Federal de Goiás, 2009-02-26) SILVA, Ana Clara Martins e; CAMPOS, Maria Raquel Hidalgo; http://lattes.cnpq.br/9910969694141110; SERAFINI, álvaro Bisol; http://lattes.cnpq.br/9849440763539845
The target of this study was to identify the presence of Escherichia coli and The aim of this study was to evaluate the impact of training in good manufacturing practices (GMP) in the presence of Escherichia coli and Staphylococcus aureus on hands and nasal cavities of food handlers of bakeries and confectioners, the central region of Goiânia, Goiás, Brazil. Samples were collected from hands and nasal cavities with sterile swab, 36 food handlers, 20 bakeries in the central region of Goiânia, two food handlers for each facility, clerk and baker before and one month after training in GMP. Check list was applied based on Resolution 216 in DRC, the National Health Surveillance Agency of the Ministry of Health, in bakeries and pre-test and post-test on GMP in defeat. Training on GMP for food handlers was given using two different methodologies, and application of traditional Arch of Maguerez. The bakeries and patisseries surveyed 90.0% were classified as unsatisfactory as the physical-functional, with risk of contamination of food. The hygiene of defeat was the main critical control point identified, as 90.0% of them are not trained to perform their functions, and ignore the principles of GMP. The correct post-test were higher than the pre-test with significant difference, indicating an increase of knowledge about GMP. There was no significant difference in learning for both methodologies applied. Prevalence of Staphylococcus aureus in the hands and nasal cavities was 13.5% and 11.1% before training and 5.5% and 22.2% after, respectively. The prevalence of Escherichia coli on hands and nasal cavities was 5.5% and 11.1% before and 0.0% and 5.5% after training, respectively. Reducing the prevalence of microorganisms after training and increased knowledge of GMP confirm the influence of training on improving hygienic and sanitary conditions
Atividade antimicrobiana e produção de enzimas de interesse biotecnológico de bactérias isoladas de diferentes habitats.
(Universidade Federal de Goiás, 2009-03-17) RODRIGUES, Ariana Alves; VIEIRA, José Daniel Gonçalves; http://lattes.cnpq.br/1742731776579730
The microorganisms are essential for the environment and contribute to stabilize the environments, playing a hole in the basic ecologic process such as biogeochemistry cycles and food chains, and sometimes responsible for the maintenance of the ecologic relationship between the organisms. So we have a diversity of microorganism and in consequence bioactive molecules that they produce as a result of primary and secondary metabolism, and are used by humans in many important social-economic activities, which includes the search for new medicines and new enzymes with biotechnology interest. This study analyzed different microorganisms isolated from different habitats, and the objective was select microorganisms with the capacity of inhibit the growing of pathogenic microorganisms and that produces enzymes with biotechnological applications. The isolates antimicrobial and enzymatic activities were evaluated, bioactive substances extracted and the cytotoxic activity with Artemia salina determined. The biggest part of the isolates produces substances with antimicrobial activity for the evaluated gram-positives, and none are toxic in low levels. The isolates are great producers of esterases and β-glucosidades. The isolates described in this study are from four different environments: Cerrado soil, Mata Atlântica, Azadirachta indica A. JUSS (Nim) e cave environment and are related to unique environmental conditions, the majority part of the isolates are able to produce molecules with biotechnology activity, this suggests a great microbial potential for the production of bioactive molecules that can be used in industries and medicine. Key Words: Antimicrobial activity, microorganisms, enzymes, bioactive.
Metabolização da quercetina e produção de quercetina 2,3-dioxigenase por Beauverias bassianas isoladas da região Centro-Oeste do Brasil
(Universidade Federal de Goiás, 2009-03-25) COSTA, Eula Maria de Melo Barcelos; OLIVEIRA, Valeria de; http://lattes.cnpq.br/6300240031300604
Considering the vast biotechnological applicability described for Beauveria bassiana, the versatility microbial biotransformation exhibits, the important biological activities attributed to the flavonoid quercetin, the therapeutic perspectives of its use, and the activity the enzyme quercetin 2,3-dioxygenase has on quercetin, we intended to evaluate quercetin biotransformation by B. bassiana ATCC 7159 and isolates of B. bassiana collected in the Midwestern Region of Brazil. The objectives of this study were: evaluate the potential of B. bassiana isolates and B. bassiana ATCC 7159 to produce metabolites of quercetin; investigate quercetin 2,3-dioxygenase production by the isolates and B. bassiana ATCC 7159; determine the genetic variability among the isolates of B. bassiana and establish possible correlations between molecular data and quercetin 2,3-dioxygenase production. All isolates and B. bassiana ATCC 7159 were capable of metabolizing quercetin and form compounds described in mammalian quercetin biotransformation studies and isolate IP 94 produced a higher number of metabolites compared with the others. B. bassiana ATCC 7159 and isolates IP 94, IP 98, IP 129, IP 147 produced methylated metabolites, while isolates IP 8, IP 11, and IP 94 produced glucuronidated metabolites. All the isolates produced sulphated metabolites and methylated and glucuronidated metabolites simultaneously and were capable to synthesize quercetin 2,3-dioxygenase. Quercetin 2,3-dioxygenase synthesis on PDSM, used in its biotransformation process was higher than on basic medium. B. bassiana ATCC 7159 and the isolates IP 11 and IP 132 presented the highest quercetin 2,3-dioxigenase activity, whereas the isolates IP 153 and IP 3a presented the lowest ones. Quercetin metabolites formation and quercetin 2,3-dioxygenase production were not correlated with the geographic origin of the isolates. Genetic variability analysis by RAPD allowed the separation of the isolates into three distinct groups and showed high genetic diversity among them; however, the RFLP-PCR of ITS region did not provide characteristic markers to differentiate the isolates. The ITS region sequencing confirmed the identity of the isolates as B. bassiana. The results obtained can lead to the following conclusions: B. bassiana constitutes an interesting alternative to the use of chemical methods and biological systems to produce quercetin metabolites, but is necessary to optimize the biotransformation process in order to obtain a more expressive amount of metabolites; B. bassiana is able to produce quercetin 2,3-dioxygenase, although more detailed studies are needed to explain its production pathway, regulation, and mechanism of action.
Emprego da citotoxicidade basal in vitro na redução do número de animais em ensaios de avaliação da toxicidade oral aguda: a grandisina e seu metabólito majoritário como protótipos
(Universidade Federal de Goiás, 2009-04-14) VIEIRA, Marcelo de Sousa; BOZINIS, Marize Campos Valadares; http://lattes.cnpq.br/6157755243167018
The animal replacement in expirements has been very encouraged by government and other institutions. However, in drugs development the animal replacement is not yet a reality, like at oral acute systemic tests. The validation of in vitro protocols is necessary for data generation with reproducibility, repetability and accuracy. In this study was validated at the Laboratório de Farmacologia e Toxicologia Celular- Faculdade de Farmácia/Universidade Federal de Goiás the protocol already validated by three laboratories (two in the USA and one at United Kingdom) and coordinated by ICCVAM: In Vitro Cytotoxicity Methods for Estimating Starting Doses for Acute Systemic Toxicity Tests, using the neutral red uptake in BAL/c 3T3-A31 cell line. It was used the grandisine, a lignan, and its major metabolite taken by fungi biodegradation. Our research group has identified a potential anti-tumoral action of grandisine, data not yet published. After in house validation we estimated the LD50 of grandisin and 4-O-demethylgrandisin: 617.72 mg/kg and 429.95 mg/kg, respectively. Both were classified under the GSH category 4.
Quedas e fatores multidimensionais associados: estudo longitudinal de idosos residentes em instituições de longa permanência em Goiânia(GO)
(Universidade Federal de Goiás, 2009-04-27) MENEZES, Ruth Losada de; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635
Abstract xvii ABSTRACT Falling is a geriatric syndrome with multifactorial causes. Several studies confirm that fallings are frequent among institutionalized elders. The main objective of this study was to analyze the multidimensional factors associated with the falling episodes among elderly living at long-term care institutions in Goiania (GO) during the time of 2005-2007. A prospective longitudinal clinical trial was carried out at five philanthropic long-term care institutions for the elderly (LTCEI) in the city of Goiânia. The sample of the investigation included 59 elderly that met the inclusion and exclusion criteria. It was used a questionnaire containing socio-demographic data; information about falling episodes in the previous twelve months before the study and during may/august 2005 and may/august 2007 and the context of their occurrence; clinical data related to health/disease conditions; psycho-emotional data depression; assessment of the ability to perform Basic Activities of Daily Living (BADL) and the assessment of balance and gait. Simple frequencies of all the variables of the study were used for the data analysis. The comparisons among the variables were carried out using the McNemar test, the test of Marginal Homogeneity and the Chi-square test. Multi and univariate logistic regression analysis were performed in order to estimate the relative weight of each factor on the occurrence of fallings. The level of significance used for the statistic tests was 5%. The findings showed that there was a statistically significant increase of stroke (p=0,031) and other diseases (p=0,031) among the study population. There was an unfavorable evolution of the health for both groups (falling and non-falling elderly). The variable number of chronic diseases referred presented statistically significant difference among falling elderly, evidencing the unfavorable evolution (p=0,048). The variable other diseases presented statistically significant unfavorable evolution (p=0,021) for the non-falling elderly. Considering the study population, 54,2% of the elderly referred falling episodes, 22 (68,8%) elderly referred one episode, 06 (18,8%) referred two episodes and 04 (12,5%) referred three episodes. The context of occurrence of the falling episodes demonstrates that theses incidents took place mainly during day time, out of the indoor institution environment, during walking, on concrete floors, on dry surfaces, when they stumbled on something and when they were wearing flip-flops. The falls related for the study population were statistically associated to the female sex (p=0,015); cataract (p=0,007); lower score on the POMABrazil (p=0,038); altered performance of POMA-Balance on the following maneuvers 5th maneuver balance with eyes closed (p=0,024) and 10th maneuver perform spine extension (p=0,026); abnormal performance of POMA-Gait on the following maneuvers 15th maneuver step height Abstract xviii (p=0,047) and the 21st maneuver base of support during gait (p=0,047). The following variables were indicated as protection factors for falls by means of the univariate logistic regression analysis: male sex (OR 0,26), having cataract (OR 0,22), higher total score on POMA-Brazil (OR 0,04), normal performance on the 5th maneuver POMA-Brazil balance with closed eyes (OR 0,11), normal performance on the 6th maneuver POMA-Brazil balance when turning 360° (OR 0,29) and normal performance on the 10th maneuver POMA-Brazil spine extension (OR 0,19). By means of the multivariate logistic regression analysis, the following factors associated to falls were identified: protection variables associated to falls - male sex (OR 0,028) and the presence of cataract (OR 0,158); variable associated to risk of falls worse self-perception of health when compared to other people (OR 23,25). Because of this study it was possible to verify the decline of the elderly health during the two years investigated, characterizing the situation of functional vulnerability. Fallings cannot be underestimated and through this study it was possible to verify that the incident is present at the LTCEI of the city of Goiânia. With the dada obtained, we are able to point out the need of interventions directed to the health of the elderly, starting with a multidimensional approach that is only possible with the existence of an interdisciplinary health professional team, focusing on health promotion and health maintenance.
EFEITOS DOS PROGRAMAS DE EXERCÍCIOS AERÓBICO E RESISTIDO NA REDUÇÃO DA GORDURA ABDOMINAL DE MULHERES COM EXCESSO DE PESO
(Universidade Federal de Goiás, 2009-05-07) MACEDO, Denise; SILVA, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496
Physical exercise seems to reduce abdominal fat, however new researches comparing different kind of exercises are needed to define efficient training programs. The purpose of the study was to compare the effects of the aerobic training and the resistance training on abdominal fat loss. Participants were 31 overweight women (mean age 44,5 ± 8,6 years) with high level of abdominal fat that do not practice regular physical exercise. The training program of the aerobic group (AG), 19 women, consisted of walking and running while the resistance group (RG), 12 participants, consisted of weight lifting exercises. During 10 weeks, participants of both groups (AG and RG) were required to attend three sessions of physical exercise per week. Body weight, height, waist circumference (WC), seven skinfold thickness were assessed and body max index (BMI) and body composition were calculated at baseline and after the exercise intervention. Reduces in WC, total body fat (%BF) and abdominal skinfold thickness (AbST) were statistically significant (p < 0.01) in both groups, despite no significant changes in body weight and BMI. RG showed a higher reduction in %BF (AG = 2.3%; RG = 3.1%), WC (AG= 1.9%; RG = 2.5%) and AbST (AG = 6.6%; RG = 6.8%), however there were no significantly differences between the values of the two training groups. In conclusion, the results of the study demonstrate that 150 to 210 minutes of moderate aerobic exercise or progressive resistance training produces abdominal fat and total body fat losses among overweight and obese women
MIDAZOLAM ORAL NA SEDAÇÃO MODERADA DE CRIANÇAS DE UM A TRÊS ANOS DURANTE O TRATAMENTO ODONTOLÓGICO
(Universidade Federal de Goiás, 2009-05-15) FRANÇA, Cristiana Marinho de Jesus; COSTA, Luciane Ribeiro de Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305
Little is known about the sedatives effectiveness for dental treatment in children under 3 years. The efficacy of oral midazolam sedation associated with protective stabilization was evaluated. In this randomized clinical trial, healthy children younger than 36 months were randomly allocated in groups: 1- protective stabilization; 2-protective stabilization associated with midazolam 1.0 mg/kg. The treatment was performed by an operator in a total of 55 sessions. A total of 26 children, 15 boys and 11 girls, were analysed: Group 1 (n = 12) - age (mean ± standard deviation) 27.50 ± 6.87, Group 2 (n = 14) - age (mean ± standard deviation) 26.86 ± 5.32. Child´s behavior was assessed using the Ohio State University Behavior Rating Scale (OSUBRS) and the heart rate record. A trained dentist recorded both behavior and physiological parameters. No difference in behaviors was found between groups on child initial examination carried out without sedation. In treatment sessions, only group 2 showed negative correlation between performance and the number of invasive Abstract procedures (Spearman rho = 0.469, P = 0.049). No significant differences between groups 1 and 2 OSUBRS scores were found in treatment sessions. The boys (77.50 ± 16.69) in group 2 showed higher percentage of negative scores (OSUBRS) than girls (26.67 ± 27.33). Statistically significant differences (Mann Whitney U test) between groups 1 and 2 were observed in heart rate during the forceps or low / high rotation use (1 = 139.67 ± 29.37 beats per minute, 2 = 164.97 ± 25.84; P = 0.003) and when the suture or rubber dam was placed (1=142,94 ± 23,19; 2=164,18 ± 23,69; P=0.005). A global analysis of children behavior during dental care was made overlooking the intervention groups (Friedman test). No associations were observed between the percentage of negative scores (OSUBRS) and several treatment sessions sequences. The percentage of negative scores (OSUBRS) was correlated with child's age (Spearman s rho =- 0.522, P = 0.006) and the percentage of negative scores in treatment the sessions (Spearman s rho = 0.405, P = 0.040). It was concluded that oral midazolam was not effective for sedation in up to 3 years old children for dental treatment purposes, and that this group of children did not change their negative behavior in the next sessions required for finishing the dental treatment planned
Práticas e crenças maternas relacionadas à alimentação complementar de crianças no primeiro ano de vida
(Universidade Federal de Goiás, 2009-05-18) Correia, Márcia Helena Sacchi; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Nakano, Ana Márcia Spano; Medeiros, Marcelo; Hadler, Maria Claret Costa Monteiro; Marcelo, Vânia Cristina
The appropriate nutrition plays a fundamental role in child development. Breast milk is the ideal food for the newborn, and exclusive breastfeeding is encouraged until the sixth month. From that age on, the introduction of other foods to attend nutritional needs which are no longer supplied by breast milk is encouraged. The introduction of complementary feeding involves biological, social, economical and cultural aspects. This study aimed to analyze the practices and beliefs related to complementary feeding of children in their first year of life from a group of mothers living in the Northwestern Region of Goiânia, Goiás, Brasil, who gave birth at Nascer Cidadão Maternity Hospital. lt is a qualitative research, based on Social Psychology, seeking to understand how personal beliefs influence the maternal behavior related to the complementary feeding. The data were collected by means of individual sernistructured interviews with fifteen mothers, after free and clarified consent. Data analysis comprised two-stage. lnitially, the interviews were transcribed and then analyzed using the content analysis technique (BARDIN, 2008), and after the establishment of the thematic categorias proceeds to discuss the beliefs, according to the Rokeach Model (1981). Four thematic categories were identified: "The complementary feeding", "Child's sensibility", "Quotidian's contingencies" and "Sources of references". The mothers' testimonies showed that the process of introducing complementary feeding is built from a web of information confronted with the beliefs of every one of those mothers. lt is a period when the mother sees herself under great responsibility. ln this process, there are severa! situations which demand decision-making based upon their beliefs. The observed reality, in the present work, evidences the necessity of a closer maternal accompaniment in the complementary feeding introduction stage, to value the positive aspects and try to discuss the practices that must be revised. The identified belief system structure reveals that maternal beliefs play a crucial role in the choices and practices that guide the introduction of the complementary feeding. The information is provided by different sources and each one of them contributes in the construction of maternal beliefs references. Acknowledging the belief system is an alternative for the heatth professionals to approach this group and act effectively in health care promotion.
AVALIAÇÃO EXPERIMENTAL E REVISÃO SISTEMÁTICA DA TRANSMISSÃO DO Trypanosoma cruzi PELA CANA-DE-AÇÚCAR CONTAMINADA
(Universidade Federal de Goiás, 2009-05-25) SOUSA, Elieni Socorro Marques; LACERDA, Elisângela de Paula Silveira; http://lattes.cnpq.br/9390789693192751; GARCÍA-ZAPATA, Marco Túlio Antonio; http://lattes.cnpq.br/3672512339058369
Introduction: The oral transmission of Chagas disease has been calling the attention in the last few years, especially because of the occurrence of outbreaks due to the ingestion of food such as sugar cane juice, with the possibility of contamination by sylvatic reservoirs of Trypanosoma cruzi, such as Didelphis sp. Objectives: a) Perform a systematic literature review on sugarcane (Saccharum spp) and/or Didelphis sp contamination by T. cruzi; b) Verify the transmission of T. cruzi strains collected from the secretion of the perianal glands of D. albiventris by direct contamination of sugarcane; c) Try to elucidate T. cruzi potential of penetration in sugarcane stalks; d) Assess possible penetration of T. cruzi through sugarcane roots by examining histological sections of stalks inoculated in vivo with this protozoan. Methodology: The study was carried out in two phases: 1) Systematic review of the literature using scientific articles that address the contamination of sugarcane and/or Didelphis sp by T. cruzi, searching for information in Cochrane Library, LILACS, MEDLINE and SciELO, using as descriptors T. cruzi, Didelphis sp, and Saccharum spp. We included in this review the articles published in the American continent from 1909 to October 2008 that presented at least two descriptors associated; 2) Experimental assessment of sugarcane contamination by T. cruzi, in which opossums were experimentally infected by intraperitoneal inoculation with a suspension containing this protozoan and assessed by microhaematocrit technique, culture in LIT (liver infusion tryptose) medium, and PCR. Fragments of sugarcane were contaminated by direct inoculation of T. cruzi suspension collected from the perianal glands of these marsupials. Sugarcane juice was extracted at different intervals, using a manual grinder, and assessed by direct examination and inoculation of mice. Also, histological sections of sugarcane contaminated in vitro and in vivo were performed and analyzed using an optical microscope. Results: After reading and discussing the articles selected, we confirmed the importance of opossums and sugarcane in the transmission of Chagas disease. Nevertheless, only one study approaches directly the object of this research since the others describe experimental contamination of Didelphis sp with different strains of T. cruzi. Given the Abstract xix methods employed herein, this study showed the contamination of sugarcane through the infection of mice up to 6 h after inoculation with strain Y of T. cruzi and up to 4 h with sylvatic P12. This showed plant contamination when inoculated in the tips but not on the surface. However, it was not possible to observe the potential of T. cruzi penetration in sugarcane or the contamination through its roots with the method used during this study, and no protozoan were visualized using an optical microscope. Conclusion: A systematic review of the literature showed the lack of studies on this theme. To the best of our knowledge, this is a pioneer relevant study and lead to the conclusion that the transmission of T. cruzi by sugarcane contaminated wit secretion of the perianal glands of opossums is possible. We suggest the use of other methods for evaluating T. cruzi penetration in sugarcane, and the contamination of this plant through the roots
Detecção molecular e monitoramento sazonal de adenovírus em águas fluviais no município de Goiânia, Goiás-Brasil: correlação com parâmetros físico-químicos, bacteriológicos e Metanálise avaliativa de metodologias
(Universidade Federal de Goiás, 2009-05-27) SILVA, Hugo Delleon da; ANUNCIACAO, Carlos Eduardo; http://lattes.cnpq.br/4354412874919580; GARCÍA-ZAPATA, Marco Túlio Antonio; http://lattes.cnpq.br/3672512339058369
Although water is of vital importance for living beings, due to antropic action it becomes a way of dissemination of several microorganisms, which reach aquatic environments through the faeces of man and other animals and can cause several illnesses, especially for immunocompromised individuals. During routine environmental monitoring, coliform bacteria are normally used as a microbiological parameter of water quality, which does not evidence its contamination by viruses. Several researchers have proposed the detection of adenovirus (AdVs) by PCR as a molecular index to monitor other enteric viruses. AdVs are among the most persistent and ubiquitous enteric viruses present in water and associated with a variety of clinical manifestations. This study aimed to evaluate the quality of water collected from lakes and rivers in Goiânia as to the occurrence of AdVs. Water samples were collected monthly, from December 2007 to November 2008, at five different points in Goiânia (lakes of Bosque dos Buritis and Vaca Brava park, João Leite and Meia Ponte rivers downstream and upstream the municipal sewage treatment plant). The analyses were carried out at the Laboratório de Diagnóstico Genético e Molecular and Laboratório de Genética Molecular e Citogenética, Universidade Federal de Goiás. All the samples were filtered in a positively-charged nylon membrane followed by molecular detection using PCR and semi-nested PCR. Also, we performed physical-chemical and bacteriological tests to correlate these results with the occurrence of AdVs. Simultaneously, the Núcleo de Pesquisas em Agentes Emergentes e Re-emergentes carried out a meta-analysis to evaluate three methods of concentration of AdVs coupled to molecular detection in samples of untreated water. Since 29 out of the 54 water samples collected were positive for AdVs (39.2%), our results suggest the use of the methodology proposed in the present study for the detection of these pathogens in water. We observed statistically significant difference between nitrites, phosphates, fixed residues, total residues and the occurrence of AdVs, whereas no correlation was observed between fecal coliforms and AdVs. Furthermore, the occurrence of AdVs in the state of Goiás shows a seasonal trend. Based on the 33 studies selected for the meta-analysis, it was possible to get to the following interpretations: the most effective method to detect AdVs in samples from rivers or lakes was ultracentrifugation combined with nested-PCR; it is advisable to use a combination of microfiltration membrane and ultrafugation with the subsequent diagnosis using qPCR to detect AdVs in samples of treated and untreated sewage. This has been the first study carried out for the detection and monitoring of AdVs in water bodies in the Midwestern Region of Brazil and the present results may be useful to propose the eco-epidemiological profile of AdVs or even the routes of some neglected diseases, which points out the need to define a virus indicator

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