Differences in prenatal care between health services under the Family Health Strategy and traditional primary care clinics in Rio Grande, Rio Grande do Sul State, Brazil

This study aimed to evaluate differences in prenatal care between services under the Family Health Strategy (FHS) and traditional public primary care clinics in Rio Grande, Rio Grande do Sul State, Brazil. A cross-sectional study was performed with all women who gave birth from January 1st to December 31st, 2007, and who received prenatal care in the municipal health system. The procedures recommended by the Ministry of Health were compared according to model of care. Among the 961 pregnant women, those treated under the FHS received a higher percentage of some forms of care (use of ferrous sulfate, tetanus vaccination, and HIV and syphilis tests). Other procedures were also more frequent under the FHS, but failed to reach the recommended levels (breast examination and Pap smear). Measurement of blood pressure, uterine height, and weight were quite frequent in both groups. Identification of pregnant women in the first trimester failed to reach 70%. Women under the FHS received better care, but some procedures still fell short of expected levels, and efforts are thus needed to improve the quality of prenatal care.     

Undergraduate students in orthopedic nursing care

This study identifies some undergraduate nursing students' imaginary manifestations concerning themselves and care delivered to patients with orthopedic and/or trauma disorders. The Social Poetics method was used and the research group was composed of 15 undergraduate students. Only the categories and subcategories exclusively related to the "student" are presented in this paper. Data revealed that care provided by orthopedic nursing students is the result of a care relationship that emerges from their sensitivity toward patients and their own knowledge, skills and attitudes. The orthopedic treatment, equipment and procedures, to which patients are submitted, cause important emotional distress for students, empathic behavior and encourage them to search for ways to minimize their patients' pain. All the aspects that permeate care provided by orthopedic nursing students should be identified in order to enable reassessment of the teaching-learning process.     

In vitro studies on the inhibition of colon cancer by butyrate and polyphenolic compounds

Our aim was to investigate the effect of several dietary polyphenols on uptake of (14)C-butyrate ((14)C-BT) by Caco-2 cells and try to correlate this effect with the modulation of the anticarcinogenic effect of BT in these cells. Acutely, uptake of (14)C-BT (10 μM) was decreased by resveratrol, quercetin, myricetin, and chrysin, and increased by xanthohumol, catechin, and epicatechin; and uptake of (14)C-BT (20 mM) was reduced by resveratrol, quercetin, myricetin, chrysin, EGCG, and epicatechin. Resveratrol acts as a competitive inhibitor of (14)C-BT uptake. Chronically, quercetin and EGCG increased uptake of (14)C-BT (10 μM), whereas myricetin, rutin, chrysin, and xanthohumol decreased it. Moreover, catechin (1 μM), quercetin, myricetin, rutin, EGCG, and chrysin increased uptake of (14)C-BT (20 mM), whereas catechin (0.1 μM) decreased it. EGCG, myricetin, and catechin decreased MCT1 mRNA expression, while chrysin increased it; quercetin, rutin, and xanthohumol had no effect. BT (5 mM; 48 h) markedly decreased cellular viability and proliferation and increased cell differentiation and apoptosis. In general, combination of polyphenolic compounds with BT did not significantly modify these changes. In conclusion, changes in uptake of BT induced by polyphenols do not correlate with changes on the effect of BT upon cell viability, cell proliferation, differentiation, and apoptosis.     

Synthesis and anticancer activities of some novel 2-(benzo[d]thiazol-2-yl)-8-substituted-2H-pyrazolo[4,3-c]quinolin-3(5H)-ones

A series of 2-(benzo[d]thiazol-2-yl)-8-substituted-2H-pyrazolo[4,3-c]quinolin-3(5H)-ones (3a-g) have been synthesized and evaluated for their in vitro antiproliferative activities against four human cancer cell lines: MDA-MB-435 (breast), HL-60 (leukemia), HCT-8 (colon) and SF-295 (central nervous system). The results showed that the compounds 3b (2-(benzo[d]thiazol-2-yl)-8-methyl-2H-pyrazolo[4,3-c]quinolin-3(5H)-one) and 3c (2-(benzo[d]thiazol-2-yl)-8-bromo-2H-pyrazolo[4,3-c]quinolin-3(5H)-one) exhibited good cytotoxicity for three cell lines with IC₅₀ values lower than 5 μg/mL. Analysis of theoretical toxicity risks have shown medium tumorigenic and irritant risks related to 3b and 3c in contrast to doxorubicin, the positive control.     

Validity and reliability of clinical tests for assessing hip passive stiffness

Inadequate levels of hip passive joint stiffness have been associated with the occurrence of movement dysfunction, development of pathologies and reduction in performance. Clinical tests, designed to evaluate hip joint stiffness, may allow the identification of improper stiffness levels. The purpose of this study was to determine the concurrent validity as well as the intra- and inter-examiners reliabilities of clinical measures used to assess hip passive stiffness during internal rotation. Fifteen healthy participants were subjected to test-retest evaluations by two examiners. Two clinical measures were performed: 'position of first detectable resistance' and 'change in passive resistance torque'. The results of these tests were compared to the passive stiffness measured with an isokinetic dynamometer (gold standard measure). A significant correlation was found between the stiffness measured with the isokinetic dynamometer and the clinical measures of 'position of first detectable resistance' (r=-0.85 to -0.86, p<0.001) and 'change in passive resistance torque' (r=0.78 to 0.84, p≤0.001). The Intraclass Correlation Coefficients for intra- and inter-examiners reliabilities varied from 0.95 to 0.99. Thus, the results demonstrated that the clinical measures have adequate validity and reliability for obtaining information on hip passive stiffness during internal rotation.     

Risk for decreased cardiac output: validation of a proposal for nursing diagnosis

Aim: To verify the content validity of the nursing diagnosis risk for decreased cardiac output (RDCO). Background: DCO is a phenomenon that is not restricted to individuals or environments that specifically focus on cardiovascular care. It is not only prevalent in cardiovascular care units, but also in post‐anaesthesia units and non‐cardiac care units among individuals with non‐cardiogenic disorders. A significant decrease in cardiac output is a life‐threatening situation, demonstrating the need for developing a risk nursing diagnosis for early intervention. The development of this diagnosis requires the construction of a diagnosis label, a definition of the diagnostic concept and the risk factors associated with the diagnosis. Methods: The research was carried out in two methodological stages based on the Fehring diagnosis content validation model. The quantitative analysis consisted of the calculation of the weighted mean of the values attributed by experts to each risk factor, the level of agreement/disagreement between the experts regarding the operational definitions of risk factors and the index of diagnostic content validity (DCV). Results: The label ‘risk for decreased cardiac output' was considered representative of a nursing diagnosis defined as ‘at risk of developing a health status characterized by an insufficient quantity of blood pumped by the heart to meet physical metabolic demands'. Critical risk factors (DCV ≥ 0·7) were myocardial dysfunction (0·887), blood loss (0·875), increase in intrapericardial pressure (0·825), condition that leads to changes in cardiac rhythm and/or electrical conduction (0·812), deficient fluid volume (0·725), plasma loss (0·712), ineffective tissue perfusion (0·712) and electrolyte imbalance (0·7). Conclusions: The research identified eight risk factors with valid content for assessment of RDCO. Implications for nursing practice: The identification of risk factors for DCO assists nurses to intervene early and minimize the consequences of a deficient cardiac function.     

Improving diagnosis of urogenital schistosome infection

Schistosomiasis (commonly known as bilharzia or snail fever) is the second (to malaria) most important human parasitic disease in tropical and subtropical in regions. In Africa, Schistosoma haematobium, the causative agent of urogenital schistosomiasis, is the most prevalent species causing human disease and is responsible for most of the schistosome-related disease in the region. Diagnosis of morbidity in field settings mainly relies on the detection of hematuria (blood in the urine) and proteinuria (protein in the urine) which results from the passage of parasite eggs through the bladder wall. Ultrasound scans of the urinary tract are also used to detect morbidity but are less practical in the majority of field settings owing to the requirement of specialized equipment and trained personnel. Current diagnosis of infection relies on detecting excreted eggs and excreted or circulating parasite products. Diagnostic methods include microscopic examination of eggs in urine (currently considered the gold standard), microscopic examination of tissue biopsies, serological and reagent strip diagnosis of circulating parasite proteins detectable in blood and urine and, more recently, detection of parasite DNA in urine or vaginal lavage samples. All currently used diagnostic methods have limitations associated with them. In particular, the gold standard microscopic enumeration of eggs in urine is less sensitive in low infections and does not detect single sex or prepatent infections, which makes it particularly inaccurate in young children harboring light infections and in older individuals with chronic infections who both excrete low levels of eggs. The detection of parasite DNA in urine samples by PCR described in the article by Ibironke et al. improves on this limitation. This article reviews the method described by Ibironke et al., compares it with current methods and discusses its potential use in field settings.