Repositório RCAAP

Various follow-up studies of children hospitalized with bronchiolitis caused by respiratory syncytial virus have demonstrated that a significant proportion of infants (50%) have recurrent wheezing during childhood. Nevertheless, the relationship between these two entities, if any, has not been established. In order to explain this observation, several hypotheses have been proposed. The first suggests that some children could have an individual predisposition to bronchiolitis caused by respiratory syncytial virus and recurrent wheezing. The virus could be a marker of this condition, and the individual predisposition could in turn be related to an individual hypersensitivity to common allergens (atopy), airway hyperreactivity, or to some disorder related to pulmonary anatomy or physiology that was present before the acute episode of bronchiolitis. Another hypothesis proposes that respiratory syncytial virus could be directly responsible for recurrent wheezing. During an episode of bronchiolitis, the damage in the airway mucosa caused by the vital inflammatory response to infection contributes to sensitivity to other allergens or exposes irritant receptors, resulting in recurrent wheezing. For this review, we analyzed the studies that discuss these hypotheses with the purpose of clarifying the mechanisms for the important issue of recurrent wheezing in childhood.

Breastfeeding is the natural and safe way of feeding small infants, providing nutritional, immunological, psychological and economic recognized and unquestionable advantages. These qualities are especially important in premature infants, because of their vulnerability. Despite highly desirable, there is, in general, little success in breastfeeding preterm infants, especially in special care neonatal units. There are evidences that a high supportive hospital environment, with an interdisciplinary team, makes possible to these infants to be breastfed. In this article, the authors present an up-to-date review about the components of human milk and its unique characteristics, as well as describes aspects that make the breast milk particularly suitable for feeding the premature newborn.

OBJECTIVE AND METHODS: Screening for abdominal aortic aneurysms may be useful to decrease mortality related to rupture. We conducted a study to assess the prevalence of abdominal aortic aneurysms in southern Brazil and to define risk factors associated with high prevalence of this disorder. The screening was conducted using abdominal ultrasound. Three groups were studied: Group 1 - cardiology clinic patients; Group 2 - individuals with severe ischemic disease and previous coronary surgery, or important lesions on cardiac catheterism; Group 3 - individuals without cardiac disease selected from the general population. All individuals were male and older than 54 years of age. The ultrasonographic diagnosis of aneurysm was based on an anteroposterior abdominal aorta diameter of 3 cm, or on an abdominal aorta diameter 0.5 cm greater than that of the supra-renal aorta. RESULTS: A total of 2.281 people were screened for abdominal aortic aneurysms in all groups: Group 1 - 768 individuals, Group 2 - 501 individuals, and Group 3 - 1012 individuals. The prevalence of aneurysms was 4.3%, 6.8% and 1.7%, respectively. Age and cigarette smoking were significantly associated with increased prevalence of aneurysms, as was the diagnosis of peripheral artery disease. DISCUSSION: We concluded that screening may be an important tool to prevent the mortality associated with abdominal aortic aneurysms surgery. Additionally, the cost of screening can be decreased if only individuals presenting significant risk factors, such as coronary and peripheral artery disease, smokers and relatives of aneurysm patients, are examined.

PURPOSE: To report the experience of a radiology department in the use of computed tomography guided biopsies of mediastinal lesions with fine and cutting needles, describing the differences between them. The results of adequacy of the sample and histologic diagnoses are presented according to the type of needle used. METHODS: We present a retrospective study of mediastinal biopsies guided by computed tomography performed from January 1993 to December 1999. Eighty-six patients underwent mediastinal biopsy in this period, 37 with cutting needles, 38 with fine needles, and 11 with both types (total of 97 biopsies). RESULTS: In most cases, it was possible to obtain an adequate sample (82.5%) and specific diagnosis (67.0%). Cutting-needle biopsy produced a higher percentage of adequate samples (89.6% versus 75.5%, P = 0.068) and of specific diagnosis (81.3% versus 53.1%, P = 0.003) than fine-needle biopsy. There were no complications that required intervention in either group. CONCLUSION: Because they are practical, safe, and can provide accurate diagnoses, image-guided biopsies should be considered the procedure of choice in the initial exploration of patients with mediastinal masses. In our experience, cutting needles gave higher quality samples and diagnostic rates. We recommend the use of cutting needles as the preferred procedure.

PURPOSE: Infertility is one of the less common presenting features associated with testicular tumors. We evaluated the histologic and biochemical findings, and pregnancy outcome in patients presenting with infertility who were found to have testicular tumors. METHODS: Seven patients with infertility were found to have testicular cancer over a 15-year period. All patients had a testicular ultrasound evaluation. The indications for the ultrasound were testicular pain in 2 patients, suspicious palpable mass in 4, and to rule out the presence of germ cell neoplasia in a patient with carcinoma in situ detected on a previous biopsy. Physical exam, histological findings, hormonal levels, tumor markers, and pregnancy outcome results were recorded from the patients medical charts. RESULTS: Two men had elevated serum follicle stimulant hormone and luteinizing hormone levels, 1 of them had an abnormally low serum testosterone level. Tumor markers were normal in all patients. In 4 patients the tumor was on the right side and in 3 on the left. The histological diagnoses were seminoma (n = 5), Leydig cell tumor (n = 1), and carcinoma in situ (n = 1). Of the 7 patients, 5 underwent adjuvant radiation therapy. Two patients had sperm cryopreserved. Follow up on fertility status was available in 6 cases. One patient has established a pregnancy and 5 did not achieve a pregnancy after treatment for their cancer. CONCLUSIONS: Most of the men who have testicular cancer and male infertility have a seminona. Therefore, men who present with infertility should be thoroughly investigated to rule out such serious, concomitant diseases along with their infertility.

PURPOSE: to describe the patterns of the gastric myoelectrical activity, pre-and postprandially, in clinically stable neonates of different gestational ages, during their first two weeks of life by means of Electrogastrography. PATIENTS AND METHODS: Electrogastrography was recorded in forty-five clinically stable neonates of different gestational ages (group I: 15 neonates of > 37 weeks, group II: 15 premature neonates of 32-37 weeks; Group III: 15 premature neonates of 28-31 weeks) receiving intermittent enteral feedings during their first two weeks of life. Electrogastrography recordings were performed for 1 hour pre-and postprandially. The Electrogastrography signal was recorded using the portable MicroDigitrapper Electrogastrography recording device and after motion artifacts were deleted, the remaining Electrogastrography data were submitted to quantitative analysis based on the "Running Spectrum Analysis". RESULTS: The percentages of normogastria, pre-and postprandially were greater than the percentages of gastric dysrythmias in all three studied groups. Furthermore, all neonates had the mean values of the Electrogastrography dominant frequency predominantly within the normogastria range, in both periods analyzed. There were no significant differences in the relative change of the Electrogastrography dominant power among the groups. CONCLUSION: This study demonstrates that the Electrogastrography patterns are similar between premature and full term neonates during the pre-and postprandial periods. The results of this study also indicate that the gastric myoelectrical activity in premature and full term neonates is immature, as compared to that described for older neonates, children and adults.

INTRODUCTION: In the postmenopausal period, an average of 25% of women will present symptomatic ovarian failure requiring hormonal replacement therapy. Estrogen can relieve vasomotor symptoms. Hormonal replacement therapy is generally not recommended for breast cancer patients due to the potential risk of tumor recurrence. To answer the questions about the safety of hormonal replacement therapy in this subgroup of women, it is necessary to establish the acceptance of treatment. METHODS: Between September 1998 and February 2001, a cohort of 216 breast cancer patients were asked to complete a questionnaire. All patients had completed their treatment and were informed about survival rates after breast cancer and hormonal replacement therapy. RESULTS: Among the 216 patients, 134 (62%) would refuse hormonal replacement therapy. A hundred patients were afraid of relapse (74.6%). Adjuvant tamoxifen therapy was the only statistically significant variable (70.3% versus 29.7% p=0.003). Understanding clinical stage (p= 0.045) and type of medical assistance (private versus public , p=0.033) also seemed to influence the decision. Early stage disease (p= 0.22), type of surgical procedure (radical versus conservative, p=0.67), adjuvant chemotherapy (p=0.082) or marital status (p=0.98 ) were not statistically significant in decision making. Several patients submitted to adjuvant chemotherapy (41.6%) would accept hormonal replacement therapy under medical supervision, as did most of advanced clinical stage patients (58.3%; p=0.022). CONCLUSION: There is a high level of rejection for hormonal replacement therapy among breast cancer patients when current data on tumor cure rates, and potential risks of estrogen use is available. Adverse effects of tamoxifen in the adjuvant setting may be the reason for refusal of hormonal replacement therapy .

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Desde meados dos anos 1990, o cooperativismo popular-solidário é incentivado por meio de programas sociais, com parceria de sindicatos, universidades e poder público, e tende, de modo geral, a reafirmar o sentido social do trabalho, embora faça parte de um contexto no qual a força de trabalho, com poucas qualificações, tem se submetido aos efeitos de uma grave crise do emprego. Pretende-se relacionar esse fenômeno à formulação de políticas públicas de geração de trabalho e renda, vinculada, particularmente, à concepção de economia solidária no Grande ABC Paulista, de 1997 a 2007. Objetiva-se analisar as concepções que norteiam as vertentes da economia solidária que dão sustentação à promoção do trabalho em cooperativas, como formas alternativas de organização do trabalho, para, em seguida, relacioná-las à crescente utilização de formas flexibilizadas do trabalho, nessa região, que propiciam, de um lado, a geração do aumento do trabalho informal e da precarização da condição de vida e do trabalho e, de outro, a destruição dos direitos sociais dos trabalhadores. 

Este trabalho tem o objetivo de discutir um modo de fazer etnográfico realizado em uma pesquisa sobre práticas populares de consumo, desenvolvida em uma região periférica da cidade de São Paulo. Pelo acompanhamento de um artefato específico – o cartão de crédito – e das práticas que se desenrolam a partir dele, procura-se demonstrar, ao longo deste artigo, a possibilidade de construir uma análise que articule questões globais com questões próprias ao campo de observação empírica, sem cair em uma dicotomização das categorias de riqueza e pobreza, exclusão e inclusão, local e global. Assim, a análise aqui apresentada pretende contribuir com novas questões sociológicas que cruzam as fronteiras do campo etnográfico tradicional. 

O objetivo mais geral deste artigo é apresentar a leitura crítica de Michael Löwy acerca da modernidade. Para tanto, busca-se compreender o trajeto teórico da crítica da modernidade em Michael Löwy, em sua valorização da análise weberiana da modernidade, da crítica de Walter Benjamin às ideologias do progresso e, por fim, da rejeição ecossocialista do modelo civilizatório moderno. Pretende-se, enfim, situar preliminarmente a crítica “marxista-romântica” da modernidade – efetuada por Löwy – no contexto do congestionamento histórico da crença no progresso e na modernização. Parte-se da hipótese, portanto, de que a obra de Michael Löwy, especialmente seus textos dirigidos à crítica da modernidade, responde às transformações contemporâneas do capitalismo, insistindo na necessidade de uma ruptura do marxismo com o paradigma civilizatório moderno. 

Neste artigo, analiso o processo de articulação entre internacionalização do saber jurídico, aqui representada pela pauta da Justiça Restaurativa, e redes profissionais locais, em dois municípios paulistas: São Carlos e São Caetano do Sul. Na primeira cidade foi verificada uma perda de interesse pela Justiça Restaurativa, concomitante a uma configuração local de disputas políticas em torno do campo dos adolescentes em conflito com a lei. Já a segunda cidade se constitui como uma das três regiões do país em que se estabeleceu um programa piloto de mediação nos moldes do tipo informal de resolução de conflitos em questão. A partir de uma revisão bibliográfica com base na área da Sociologia das Profissões, discute-se como essa proposta de conteúdo mais político vem sendo tratada, mais especificamente no âmbito das profissões do Direito, tendo como premissa que essas profissões, singulares em sua tradição histórica e forte ligação com o Estado, assumiram a neutralidade do saber e forte demarcação com o campo político como estratégia dominante para a construção de sua autonomia.