ABSTRACT BACKGROUND: The role of transient obstructive cholestasis on liver histology remains undetermined. OBJECTIVE: To investigate whether transient cholestasis impairs liver histology. DESIGN AND SETTING: Cross-sectional study at a public university hospital (UNICAMP), Brazil. METHODS: 169 individuals undergoing cholecystectomy, with or without cholestasis. were enrolled. Histopathological findings were correlated with clinical and biochemical characteristics. RESULTS: Biliary hepatopathy was more frequent in individuals with resolved cholestasis than in those with active obstruction or no jaundice (P < 0.01), as also were fibrosis and ductular proliferation (P = 0.02). Cholestasis was commoner in individuals with resolved obstruction than in those with no history (P < 0.01) or active cholestasis (P < 0.05). Biliary hepatopathy was associated with longer duration of cholestasis (P < 0.001) and higher bilirubin levels (P = 0.02) in individuals with active obstruction; with lower body mass index (P = 0.02) and longer cholestasis (P < 0.001) in individuals with resolved obstruction; and with longer cholestasis (P < 0.001) and longer interval between endoscopic retrograde cholangiopancreatography and surgery (P = 0.03) overall. In individuals with active obstruction, duration of cholestasis (R = 0.7; P < 0.001) and bilirubin levels (R = 0.6; P = 0.004) were independently correlated with cholestasis severity. Duration of cholestasis (R = 0.7; P < 0.001) was independently correlated with ductular proliferation severity. CONCLUSIONS: Transient cholestasis was associated with significant histopathological changes, even after its resolution. Longer duration of obstruction correlated with greater severity of histopathological changes, especially cholestasis and ductular proliferation. This emphasizes the need for early treatment of obstructive cholestasis.

Objective to understand the care of drug users in a Basic Health Unit. Methods a qualitative study through semi-structured interviews with 13 subjects in a Basic Care Unit of a health district. Results after thematic analysis, three categories were revealed: Home as routing and factors that determine the practice, showing that factors such as feelings and personal characteristics of workers, lack of training and awareness of lower resoluteness by nursing professionals held a routing logic avoided accountability for the care, keeping its fragmentation; Host, link and routing, in which bond and co-responsibility were incipient practices, hindering the comprehensive care; and Home and predominant care models, showing that the host supported on the biomedical model, but contradictions were observed between different models and practices. Conclusion it is necessary to overcome the biomedical model, from the expanded clinic and restructuring vocational training.

Objetivo compreender o acolhimento a usuários de drogas em uma Unidade Básica de Saúde. Métodos estudo qualitativo realizado por meio de entrevistas semiestruturadas com 13 sujeitos em uma Unidade Básica de Saúde de um distrito de saúde. Resultados após a análise temática, emergiram três categorias: Acolhimento como encaminhamento e fatores que determinam essa prática, evidenciando que fatores como sentimentos e características pessoais dos trabalhadores, falta de capacitação e percepção de menor resolutividade pelos profissionais de enfermagem sustentaram uma lógica de encaminhamento que evitava a responsabilização pelo cuidado, mantendo sua fragmentação; Acolhimento, vínculo e encaminhamento, em que vínculo e corresponsabilização eram incipientes nas práticas, dificultando o cuidado integral; e Acolhimento e modelos de atenção predominantes, mostrando que o acolhimento apoiava-se no modelo biomédico, porém observaram-se contradições entre modelos distintos e práticas. Conclusão faz-se necessário superar o modelo biomédico, a partir da clínica ampliada e da reestruturação na formação profissional.