BACKGROUND Lower limb ulcers are a serious medical and socioeconomic problem throughout the world. One type of chronic wound of the lower extremities is the venous ulcer. Therapeutic methods for treating venous ulcer include the use of the Unna boot. OBJECTIVES To evaluate the effectiveness of the customized Unna boot in the treatment of venous ulcers and to monitor the subsequent development and healing of the lesions. METHODS Prospective exploratory and quantitative longitudinal study, conducted at the "Outpatients Department (Wound Care) of the Grupo da Fraternidade Espírita Irmão Alexandre" in the city of Pouso Alegre (MG), Brazil, in 2008. The sample consisted of 32 patients with venous ulcers who underwent treatment with the Unna boot and 11 patients (control group), who used a simple bandage application. The patients'lesions were monitored over a three month period. RESULTS The average age of the predominently female (65.1%) patients was 61.88. From observing the differences in healing times at the three evaluation stages, it was clear that after the initial evaluation the wound area decreased in Groups 1 and 2 (p>0.05). CONCLUSIONThe use of the customized Unna boot contributes to quicker healing. However, over a period of three months the simple bandage applications were seen to be just as effective as the Unna boot method.

RESUMOObjetivo: Avaliar a prevalência de distúrbios visuais em alunos de 8 a 10 anos de idade em uma escola pública no município de Pouso Alegre, Minas Gerais, e verificar a possível legitimidade da correlação entre um baixo desempenho escolar e algum tipo de deficit visual. Métodos: Estudo transversal e quantitativo realizado em alunos matriculados de 2 a a 4ª série na Escola Municipal Pio XII durante o ano letivo de 2009. Foram realizados o exame de acuidade visual com o uso da Escala optométrica de Snellen e a análise do boletim escolar. Resultados: Foram avaliadas 201 crianças. Quanto à acuidade visual, 11,4% da amostra apresentou acuidade visual alterada. Na análise das notas de Matemática, foi observado que os alunos que tinham deficit visual apresentaram notas significantemente menores que aqueles sem deficit (p=0,032). Não se observou significância estatística na comparação das notas de português dos alunos com e sem deficit durante a triagem inicial. Conclusão: Este estudo demonstrou que um distúrbio visual não diagnosticado pode interferir no desempenho escolar infantil.

PuRPOsE: To determine the optimum concentration of a gel obtained from unripe banana (Musa sapientum) peel for wound treatment in rats. METHOds:A randomized triple blind study was conducted with 40 Wistar rats, which were divided into 4 groups: CG, control group; G2%, 2% gel concentration group; G4%, 4% gel concentration group; and G10%, 10 % gel concentration group. The banana peel gel was applied daily, for 7 days, to a 4-cm² wound created on the back of each animal of all groups. After this period, the wounds were biopsied. Statistical analysis was carried out using the Kruskal-Wallis test complemented by the Student-Newman-Keuls test.REsuLTs: Macroscopic examination revealed that partial epithelialization occurred in all groups. Wound contraction was also observed in all groups and ranged from 1.38 to 1.57 mm in the study groups, and from 1.03 to 1.10 mm in the control group, with significant differences (p < 0.05) between the groups: CG and G10%, G2% and G4%, G2% and G10%. The interquartile deviation was smaller between the groups CG and G4%. CONCLusION:The 4% gel obtained from unripe banana peel (G4%) resulted in better epithelialization of wounds healed by secondary intention compared with other gel concentrations.Keywords: Musa sapientum. Wound Healing. Rats. REsuMO OBJETIVO: Avaliar a concentração ideal do gel da casca de Musa sapientum verde no tratamento de feridas em ratos.MéTOdOs: Estudo randomizado, triplo cego, com 40 ratos da linhagem Wistar divididos em quatro grupos: GC controle, G2% gel a 2%, G4% gel a 4%, G10% gel a 10%. Realizou-se aplicação diária do gel nas diferentes concentrações, durante sete dias, em uma ferida de 4 cm 2 realizada no dorso de cada rato. Após este período, as lesões foram biopsiadas. Para analise dos dados utilizou-se o teste de Kruskal-Wallis complementado pelo teste de Student-Newman-Keuls. REsuLTAdOs:Os achados macroscópicos demonstraram reepitelização parcial em todos os grupos. A contração da área da ferida variou entre 1,38 a 1,57 mm nos grupos de estudo, e entre 1,03 a 1,10 mm no grupo controle. Houve diferença significante (p < 0,05) entre os grupos: GC e G10%, G2% e G4%, G2% e G10%, sendo o desvio interquartílico menor entre os grupos GC e G4%.CONCLusãO: O gel a 4% da casca de M. sapientum verde promoveu maior área de epitelização em feridas com cicatrização por segunda intenção, em relação ao gel nas outras concentrações testadas.descritores: Musa sapientum. Cicatrização. Ratos. -Acta Cirúrgica Brasileira -Vol. 26 (5) 2011AtzingenI DANCV et al.

The use of 4% unripe Musa sapientum peel gel on surgical wounds in rats resulted in an increased number of polymorphonuclear cells on day 7, reduced wound contraction, reduced vascular proliferation and increased concentration of collagen fibers on day 21.

Introduction: Death and dying are daily relevant themes for health care professionals and medical students. Nonetheless, since their first years of graduation, students are contrived to supplant the holistic conception of human beings and life in favor of enhancing the technical aspects of the medical profession. Methods: Therefore, in face of the few opportunities to enquire about these future professionals’ feelings and comprehensions toward life terminality, we pursued their perceptions through the application of a semi-structured questionnaire. Ten students from each year of the medical course at UNIVAS were interviewed, encompassing 60 scholars. Students should be regularly enrolled in the medical course, as well as give their consent, by signing the Consent Term, to participate in the study. The interviews took place at the institution and the material containing students’ responses was fully destroyed afterwards. Their responses were analyzed based on the Discourse of the Collective Subject Method. Results: The idea of terminality being properly the “end of life” was paramount among the years, situation with which a great amount of the scholars (58%) admitted not being prepared to deal with, due to the lack of reflections about death, its psychological aspects and repercussions in the academic context. Interestingly, about 16% of the scholars considered themselves prepared to deal with someone’s death, although they were not prepared to intervene in the actual process. This is reinforced by the fact that students must deal with the real scenario of giving undesirable news without previously being prepared to do so, by means of reflecting upon a hypothetical related to the “life-death binomial”. Conclusion: Thus, it seems necessary to create spaces in the curriculum that yield not only theoretical-practical but also affective support in situations related to terminality. The proposal of a theoretical-practical education based on palliative care amid the learning programs would shape confident attitudes of future health care professionals towards care.

PURPOSE:To investigate the efficacy of a 10% gel of unripe banana (Musa sapientum) peel in treating surgical wounds in rats. METHODS:A longitudinal, prospective, randomized triple-blind study was conducted with 60 Wistar rats (Rattus norvegicus albinus) weighing approximately 400g. The animals were randomly divided into: control group (treated with gel containing no active ingredient) and study group (treated with 10% gel of unripe banana peel). The gel was applied every three days to a 4x4-cm surgical wound created on the back of each animal (day 0) in both groups. Tissue samples were collected for histological analysis on days 14, 21 and 28. RESULTS:On day 14, more extensive vascular proliferation (p=0.023), presence of mononuclear cells (p=0.000), fibroblast proliferation (p=0.012), re-epithelialization (p=0.000), and decreased presence of polymorphonuclear cells (p=0.010) were observed in the study group than in controls. No significant between-group difference in the presence of polymorphonuclear cells was found on day 21.Fibroblast proliferation was significantly greater (p=0.006) in the study group than in the control group on day 28. CONCLUSION:The 10% gel of unripe banana peel showed anti-inflammatory activity and stimulated wound healing in rat skin when compared with a gel containing no active ingredient.

Resumo As vacinas têm grande influência na saúde pública por sua efetividade e relação custo-benefício favorável. Entretanto, com o surgimento de novos imunizantes indisponíveis na rede pública, torna-se necessário discutir o acesso da sociedade em geral. O objetivo deste trabalho foi identificar o significado da vacinação para profissionais e população, assim como abordar a questão do acesso à imunização fora da rede pública de saúde, enfatizando a vulnerabilidade social. Foram entrevistados médicos e cidadãos leigos, e os dados foram analisados a partir de metodologia qualitativa exploratória e do discurso do sujeito coletivo. O sistema vacinal brasileiro foi entendido pelos entrevistados como bom de maneira geral, sendo as principais críticas voltadas à falta de informações e insumos. Quanto ao acesso, os dados sugerem correlação com fatores econômicos, abrindo espaço para discussões bioéticas sobre a vulnerabilidade social da maior parte da população, que não tem condições de pagar por essas imunizações.

Introduction: Death and dying are daily relevant themes for health care professionals and medical students. Nonetheless, since their first years of graduation, students are contrived to supplant the holistic conception of human beings and life in favor of enhancing the technical aspects of the medical profession. Methods: Therefore, in face of the few opportunities to enquire about these future professionals’ feelings and comprehensions toward life terminality, we pursued their perceptions through the application of a semi-structured questionnaire. Ten students from each year of the medical course at UNIVAS were interviewed, encompassing 60 scholars. Students should be regularly enrolled in the medical course, as well as give their consent, by signing the Consent Term, to participate in the study. The interviews took place at the institution and the material containing students’ responses was fully destroyed afterwards. Their responses were analyzed based on the Discourse of the Collective Subject Method. Results: The idea of terminality being properly the “end of life” was paramount among the years, situation with which a great amount of the scholars (58%) admitted not being prepared to deal with, due to the lack of reflections about death, its psychological aspects and repercussions in the academic context. Interestingly, about 16% of the scholars considered themselves prepared to deal with someone’s death, although they were not prepared to intervene in the actual process. This is reinforced by the fact that students must deal with the real scenario of giving undesirable news without previously being prepared to do so, by means of reflecting upon a hypothetical related to the “life-death binomial”. Conclusion: Thus, it seems necessary to create spaces in the curriculum that yield not only theoretical-practical but also affective support in situations related to terminality. The proposal of a theoretical-practical education based on palliative care amid the learning programs would shape confident attitudes of future health care professionals towards care.