Analyzing the users perception concerning the access difficulties existent in the SUS healthcare services in the 2000s. Materials and Methods: The work presents a qualitative approach, having a large general hospital located in the city of Rio de Janeiro as its scenario. 24 users under care in the chosen scenario participated in the study. The data was collected utilizing the semi-structured interview technique. The data analysis was performed through Bardin’s content analysis technique. Results and Discussion: The users acknowledge the existence of rights at SUS and the broadening of the access. Among the difficulties found are the ones related to the system flow and entry, since obtaining care, consultation, to hospitalization. Conclusion: In view of that, we observe that the users are aware of their rights and realize they are not being totally reached. It is believed that the confrontation of the difficulties becomesa way to achieve a health system that promotes some social justice in thecountry.

To present a clinical case on Melasma and the main social and personal impacts of those living with the disease.Case Report:A 39-year-old female patient, Fitzpatricks Phototype III was seen at the Integral Medicine Clinic of the Faculty of Medicine of Valença due to the appearance of brownish macules in the malar region, which also affected the nasal, supra-labial and the supra orbital region bilaterally. The treatment proposed by the modified Kligman technique is usually very effective, especially when associated with sunscreens properly used with color or sunscreen of the white type associated with makeup, because color and makeup act as physical protectors that protect against sunlight and the cold light. Conclusion:The treatment of melasma is of great importance, not because it is a merely aesthetic problem, but mainly because of the psychological factors that these women suffer from the loss ofself-esteem, besides avoiding complications such as melanomas caused by excessive exposure to ultraviolet rays. Accompanied patients should seek effective ways to treat injuries and participate in psychological support groups while on treatment.

Nutrition in addition to goals like longevity, wellness, beauty and the skin, digestive function also prevents diseases. Dogs have a short digestive enzymes and oriented mainly protein and fat digestion. The objective of this study and identify theexact amount of dry matter , crude protein , calcium , lipids , ash and crude fiber.12 dry rations of adult dogs were acquired in April, 4 standart feed, 4 and 4 premium feed super premium feed, which are distinguished by the quality of raw material used in manufacturing. Samples of these rations were sent for chemical analysis at UNESP, where calcium levels were analyzed, ether extract, crude protein, dry matter, ash and crude fiber. It concludes that a low moisture content in the diet causes the urine becomes concentrated, increasing the chances of urolithiasis. A diet low in carbohydrates leads to variables disorders such as intense hunger. Excessive intake of calcium causes mild zinc deficiency and can lead to an increase of osteoarticular diseases. These changed parameters can bring harm to the animal health.

Resistance to antimicrobials, especially the latest generation, such as carbapenems, is one of the major public health problems of 21st century, and in recent years there has been a significant increase in morbidity and mortality in healthcare-associated infections. The aim of present studyis to survey carbapenemases already described in several species of gram-negative bacilli with emphasis on their first descriptions. Carbapenemases can be divided in: serine carbapenemases of Ambler class A;metallocarbapenemases;and serine carbapenemases of Ambler class D (oxacillinases). Class A enzymes can causeresistance to all beta-lactams. Among enzymes of this class, the most widespread is KPC which was initially described in Klebsiella pneumoniae, although it has been described in several other bacterial genera worldwide; the metallocarbapenemases have an action against all betalactamics, except for the monobactamics, where the enzymes IMP, VIM, and NDM are the most widespread in the world; the class D serine carbapenemase, called oxacillinases, are able to confer resistance to all beta-lactams, and are commonly described in enterobacteria, Acinetobacterspp., and Pseudomonasspp. These enzymes, which have already been described in several genera of gram-negative bacilli, have prevented treatment of several infections by beta-lactams and their spread has already taken on global dimensions.

The objective of the present study is to present a clinical case of a brain abscess as a complication of an untreated bacterial sinusitis, paying attention to itsdiagnosis and conduct. Case report:Female patient, according to the patient’s anamnesis, a story of bacterial rhinosinusitis was suggested, not adequately treated. After two weeks, she evolved with intense headache without relief in use of regular analgesics, leading to repeated searches to medical attendance, with attenuating symptomatic treatment. The disease presented progressive evolution, culminating in an episode of consciousness loss, when was done computerized tomography compatible with a brain abscess, empiric intravenous antibiotic therapy and craniotomy with drainage of the purulent material, in a short period of time the patient presented improvement of the clinical, laboratorial and radiologic parameters. Conclusion:We concluded that bacterial rhinosinusitis must be promptly treated and that it’s necessary to pay attention to it’s possible complications for an early diagnosis and effective treatment.

Correlate the level of physical activity with alteration of blood pressure values in the elderly of the city of Valença-RJ. Metodologia: The reference descriptive quantitative study with a cross-sectional design was carried out by members of the Academic League of Sports Medicine and ExerciseOf the Faculty of Medicine of Valença / RJ. The sample consisted of 146 individuals, both sexes over 60 years of age. Data were collected at the Mercado Municipal de Valença / RJ. Blood pressure (BP) was measured using the auscultatory method, according to the norms recommended by the Brazilian Society of Hypertension. In order to verify the level of physical activity, an anamnesis was performed, which presented a question about physical exercise practice, being considered a practitioner who reported being able to exercise at least 3 times a week. For characterization of the sample, descriptive statistics were used and the normality of the sample was analyzed through the Kolmogorov-Smirnov test. To search for the relationship between the variables, the point-biserial correlation test was used, considering p = 0.05 for significance. Data analysis was performed using the statistical package SPSS version 20.0.Results: No correlation was found between the practice of physical activity and changes in systolic blood pressure and diastolic blood pressure in the elderly in the city of Valença / RJ. Conclusion: The values of systolic blood pressure and diastolic blood pressure did not present changes when correlated with the level of physical activity of the elderly, therefore, it must be emphasized that the evaluated group was mostly an active population with controlled blood pressure, the Which leads us to believe that physical exercise performed at least 3 times a week may be contributing to blood pressure control in elderly individuals.

The demodicosisis a skin disease also known as canine demodectic mange, follicular mange or red mange. It is characterized by excessive proliferation of Demodexcanis mites in the skin of dogs. It affects animals both in the young stage as in the adult, is more common inpuppies and young animals. The demodicosis is classified in relation to the lesions localized or generalized. Dogs with demodectic mange have a T cell immunodeficiency, which favors mite proliferation, leading to immunosuppression, which is related to disease development. Such immunosuppression may also be caused by steroids and diseases that suppress the immune system like, for example, hyperadrenocorticism. This study aimed to report a case of secondary demodicosis to iatrogenic hyperadrenocorticism in dogs. The animal had been submitted to corticoterapiadurante long time. It was performed trichogram, and the diagnosis of demodicosis was confirmed from the observation of the mite blade. The dosage basal cortisol before and after application of ACTH showedthe hiperadrenocoticismoiatrogênico.Omoxidectin treatment was associated with shampoo benzoyl peroxide. The increase was given after two parasitological examinations shaved negative deep skin with three week intervals. It is concluded that manifests demodicosis associated with immunosuppression, which, in turn, may be caused by a primary disease, it is important to the diagnosis and treatment of the underlying disease. Treatment with lactonamacrocíclica, moxidectin is effective.

The present study sought to analyze the functional evolution suffered by prosecutors throughout its history, with special focus to the ministerial performance in Brazilian lands, especially after the proclamation of the Federal Constitution of 1988. In addition, a critical analysis of their functional activity as well as the points that still must be enhanced so that the action of the Prosecutor is fully compatible with the dictates of the brasilian Constitution.

Introdução: A Educação Interprofissional se apresenta como um novo conceito em saúde pela adoção de elementos capazes de inverter a lógica da educação verticalizada, promovendo o aprendizado compartilhado e colaborativo, contribuindo para a formação e qualificação dos profissionais de saúde, possuindo uma abordagem mais integrada e multidimensional das doenças crônicas. Objetivos: O estudo teve como objetivos analisar e descrever a contribuição do PET-Saúde/Interprofissionalidade a partir da Educação Interprofissional para a formação de alunos e a visão dos preceptores da área da saúde inseridos nesse programa e criar uma ferramenta interprofissional de acolhimento e estratificação de risco para o atendimento de pacientes diabéticos e/ou hipertensos em uma Estratégia de Saúde da Família. Materiais e métodos: Trata-se de um estudo exploratório e descritivo com abordagem quali- quantitativa realizado durante o Programa de Educação pelo Trabalho para a Saúde - PET-Saúde Interprofissionalidade do município de Valença nos anos de 2020 e 2021. A coleta de dados foi realizada em uma Estratégia de Saúde da Família desse município. Resultados e Discussão: O presente estudo evidenciou a importância do trabalho interprofissional, bem como a integração entre ensino-serviço-comunidade, além de ratificar a importância do PET-Saúde/Interprofissionalidade enquanto estratégia para a formação profissional e aperfeiçoamento do modelo de atendimento ao usuário no SUS. Conclusão: A EIP é um modo de formação em saúde que promove o trabalho em equipe colaborativo e integrado entre profissionais de diferentes áreas de saúde da população, com a finalidade de melhorar as respostas dos serviços a essas necessidades e a qualidade da atenção à saúde.

Interdigital hyperplasia is a proliferative reaction of the skin and subcutaneous tissue with neoformationof the firm subsequent tissue characterized by lameness, inflammation of the subcutaneous tissues of the interdigital space and infection by anaerobic bacteria. It may be unilateral or bilateral and is more common in the lower limb, especially in adults and heavy animals in confinement and semi regime. Objective:The work aims to report a case of interdigital hyperplasia in cattle and point out that this disease, among other foot problems assume disturbing character in cattle confined or semiconfined.Casereport: A mixedbreed cow created in semi-extensive system showed volume increase in interdigital space of the left hind leg that progressed to the severe form with irregular growth nipper nail side of the left hind limb and appearance of necrosis at somepoint and the interdigital space presented with hyperplastic tissue bleeding and appearance of necrosis with unpleasant odor suggestive of myiasis. In season the cow had column bending and discomfort support turns the footprints of the hind limbs, showingsigns of pain, swelling and redness of the pastern region. The animal has undergone surgery for the removal of hyperplastic tissue, the site was sanitized, submitted to curative and evaluated weekly until significant clinical improvement.Conclusion: Itis concluded that interdigital hyperplasia is a disease of major importance, especially for animals that live in predisposing local. The attention of the producer and the veterinarian are of paramount importance for the treatment of affected animals and to prevent new cases in the property.