Levando em conta os vários estudos e reflexões a respeito do novo modelo de assistência ao parto e nascimento (assistência humanizada), e trabalhando como enfermeira obstétrica em um Centro de Parto Normal, surgiu o questionamento a respeito desse conceito, devido às diversas conotações dadas a esse termo. Este artigo foi produzido com a finalidade de divulgar nossa proposta de substituição da expressão "assistência humanizada ao parto", por "assistência obstétrica centrada nas necessidades da parturiente", e de discorrer como essa assistência é prestada no Centro de Parto Normal do Hospital Geral de Itapecerica da Serra (SP), que segue um protocolo de condutas obstétricas e normas preconizadas pelo Ministério da Saúde.

ResumoContexto: A trombose venosa profunda (TVP) é uma doença de ocorrência multidisciplinar e freqüente, incluindo as complicações relacionadas a ela, como o tromboembolismo pulmonar (TEP). Sendo a profilaxia mecânica um dos melhores (por seu baixo custo e eficácia comprovada) e mais simples meios para reduzir sua incidência, é de grande relevância que se pesquise sua utilização visando benefícios para o paciente e o serviço hospitalar.Objetivo: Determinar a freqüência da utilização da profilaxia mecânica para TVP na Unidade de Emergência Dr. Armando Lages em Maceió (AL). Métodos:Foi realizado um estudo transversal descritivo na unidade durante o período de 8 meses. A amostra foi calculada em 282 pacientes internados nas unidades de enfermarias das diversas especialidades. Os dados foram coletados em prontuários e mediante entrevista ao paciente. No prontuário de cada paciente foi pesquisada a utilização da profilaxia mecânica para TVP, além de diversos fatores para a estratificação do risco, segundo a Sociedade Brasileira de Angiologia e Cirurgia Vascular. O estudo estatístico foi realizado através do software SPSS, utilizando o teste qui-quadrado considerando o valor de p < 0,05. Resultados:Foram analisados 282 pacientes, sendo 181 (64%) homens e 101 (36%) mulheres, com idade média de 54,1 anos. Quanto ao risco, 210 (74,5%) foram classificados como alto risco, 56 (19,8%) como moderado risco e 16 (5,7%) como baixo risco. Do total de pacientes, 234 (83%) não receberam profilaxia e 48 (17%) receberam. Não houve diferença estatística entre os dados obtidos na pesquisa e os encontrados na literatura (p = 0,065). Conclusões:Apesar de ter sua eficácia comprovada e difundida, a profilaxia mecânica para TVP ainda não atinge níveis satisfatórios de utilização. Palavras-chave:Trombose venosa, profilaxia, tromboembolismo. AbstractBackground: Deep venous thrombosis (DVT) is a multidisciplinary and frequent disease, also including complications such as pulmonary thromboembolism. Mechanical prophylaxis is one of the best (due to its low cost and proven effectiveness) and simplest means to reduce its incidence; therefore, investigating its use as an attempt to enhance benefits to the patient and hospital service is of great importance.

OBJECTIVE : Early pain experiences can lead to disruption in the long-term responses to pain and in abnormal development and behavior in rodents. We evaluated the sensory and motor development of Wistar rats after exposure to painful stimulation (repetitive needle prickling) immediately after birth. METHODS : Male and female rats were followed up to 6 months of life, and sensory and motor functions were investigated by testing paw withdrawal with von Frey filaments, calibrated forceps (CF), and grip strength (GS) tests. RESULTS : Body weight increased with age and tended to be smaller in pain groups compared with their controls of the same sex. GS values also increased with age in controls but were stable and even decreased in pain groups from 120 up to 180 days. The von Frey filaments test showed higher values on the nonstimulated paws in male and female pain groups, with no differences between sides on the controls. The CF test showed smaller values on the stimulated paws in the pain group, with no differences between sides on the controls. CONCLUSIONS : Pain in the neonatal period influences sensory and motor functions negatively during development in male and female rats, even long term after the painful stimulus is ceased. The neonatal injury-induced hypersensitivity is persistent, and male and female rats respond similarly to the stimulus.

We investigated if changes in glial activity in cortical areas that process nociceptive stimuli persisted in adult rats after neonatal injury. Neonatal pain was induced by repetitive needle prickling on the right paw, twice per day for 15 days starting at birth. Wistar rats received either neonatal pain or tactile stimulation and were tested behaviorally for mechanical withdrawal thresholds of the paws and gait alterations, after 15 (P15) or 180 (P180) days of life. Brains from rats on P15 and P180 were immunostained for glial markers (GFAP, MCP-1, OX-42) and the following cortical areas were analyzed for immunoreactivity density: prefrontal, anterior insular, anterior cingulated, somatosensory and motor cortices. Withdrawal thresholds of the stimulated paw remained decreased on P180 after neonatal pain when compared to controls. Neonatal pain animals showed increased density for both GFAP and MCP-1 staining, but not for OX-42, in all investigated cortical areas on both experimental times (P15 and P180). Painful stimuli in the neonatal period produced pain behaviors immediately after injury that persisted in adult life, and was accompanied by increase in the glial markers density in cortical areas that process and interpret pain. Thus, long-lasting changes in cortical glial activity could be, at least in part, responsible for the persistent hyperalgesia in adult rats that suffered from neonatal pain.

RESUMOO Centro de Parto Normal (CPN) proporciona assistência obstétrica centrada nas necessidades da parturiente com base em evidências científicas. Este estudo teve como objetivos verificar a ocorrência de infecção puerperal em CPN e comparar as características clínico-obstétricas de mulheres reinternadas com infecção puerperal com as mulheres não reinternadas. Trata-se de uma pesquisa exploratória, não experimental, com coleta retrospectiva de dados. A amostra constou de 51 puérperas atendidas no CPN de 2000 a 2003. Os resultados mostraram que dentre 10.559 partos, 0,16% apresentaram infecção puerperal e que a assistência obstétrica prestada no CPN apresentou relação com infecção puerperal somente quanto à duração do trabalho de parto. Concluiu-se que a assistência obstétrica prestada por este modelo de atenção traz benefícios à clientela. Descritores: Infecção puerperal; Parto normal; Saúde da mulher; Enfermagem obstétrica. ABSTRACT The Delivery Center (DC) provides obstetric assistance centered on the parturient's needs according to scientific evidences. This study aimed to verify the occurrence of puerperal infection in the DC and to compare the clinical obstetric characteristics of the women readmitted in the hospital with puerperal infection to those who were not readmitted in the hospital. It is an exploratory and non-experimental

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Pain in neonates can induce long‐term changes in areas responsible for processing nociceptive stimulus [1]. Astrocytes are active in supporting and controlling neuronal signaling and in response to noxious stimuli they may undergo morphological changes, such as hypertrophy and increased expression of glial fibrillary acid protein (GFAP). We showed that rats receiving painful stimuli in the neonatal period presented changes in sensory, motor and limbic cortical areas related to nociception even after 180 days after the stimulus [1]. Alterations on the dorsal horn of the spinal cord in this model of neonatal pain were not yet investigated and to do so, we are testing a GFAP immunostaining protocol. Four male Wistar rats at 15 and 180 days of age were anesthetized and perfused with 4% buffered paraformaldehyde. Transverse sections of the spinal cord were cut at L4‐L6 levels and frozen. Cryosections (20 µm) were incubated in primary antibody polyclonal rabbit anti‐GFAP for 4 hours (1:1.500) followed by polyclonal donkey anti‐rabbit IgG for 45 minutes (1:250). Slides were washed in PBST, mounted in a mixture of glycerol/PBS (3:1) and observed with a light microscope (TS‐100, Nikon, Tokyo, Japan) equipped with a high resolution camera. Our results show that the method is reliable and reproducible for GFAP identification and quantification in the spinal cord of normal rats. Future studies will use this method to better understand the spinal cord response to noxious stimulus in the neonatal period. [1] Sanada et al 2014, Int J Dev Neurosci 35,55Support: FAPESP, CNPq, CAPES