PROMOÇÃO DE SAÚDE DA POPULAÇÃO IDOSA POR MEIO DA INCLUSÃO DIGITAL

O envelhecimento da população e os avanços tecnológicos evidenciam a ausência de habilidades digitais do público idoso. O uso das tecnologias pela população idosa tornou-se uma preocupação na busca de uma sociedade mais inclusiva. Os sistemas de apoio existentes acabam sendo ineficientes, reforçando a necessidade de um treinamento “sob medida” que possibilite a acessibilidade digital. Assim, verificou-se a necessidade da criação de um material para facilitar a conectividade dessa população. Para tanto, objetivamos desenvolver um material educativo direcionado ao público idoso para o letramento digital dessa população. Para a construção desse material, focado na acessibilidade e necessidades dos idosos, houve cuidado com a diagramação de imagens e textos, com as cores utilizadas no material, com o uso de linguagem acessível, simples e objetiva, além da busca pela identificação do leitor nas imagens e conteúdo. Como resultado, em outubro de 2020, foi publicado o livro Bê-á-Bá Digital. Sua versão virtual está disponível para acesso gratuito e possui, até o momento, mais de 8.000 downloads. Sua versão física, com uma tiragem de 8.500 exemplares, foi financiada pelo Fundo Municipal do Idoso de Porto Alegre e distribuída pelo Banco de Alimentos ao público idoso. A obra também foi adotada pela Federação das Indústrias do Estado de Mato Grosso do Sul para integrar o Projeto 60+, aplicado em mais de 40 municípios do estado. &nbsp

Effectiveness of citrate buffer-fluoride mixture in Terumo tubes as an inhibitor of in vitro glycolysis

Introduction: Glycolysis affects glucose determination in vitro. The placement of sample tubes in ice-water slurry with plasma separation within 30 minutes is recommended, or alternatively the use of a glycolysis inhibitor. The aim of our two-steps study was to evaluate which Terumo tube is best for glucose determination in routine clinical setting. Materials and methods: In the first study, blood from 100 volunteers was collected into lithium heparin (LH), NaF/Na heparin (FH) and NaF/citrate buffer/Na2EDTA (FC-Mixture) tubes. LH sample was treated as recommended and considered as reference, while FH and FC-Mixture samples were aliquoted, maintained at room temperature (RT) for 1, 2 and 4 hours; centrifuged and plasma analysed in triplicate. In the second study, samples from 375 volunteers were collected in LH, FH and FC-Mixture tubes and held at RT before centrifugation from 10 to 340 minutes, depending on each laboratory practice. Samples were analysed in one analytical run. Results: In the first study, FH glucose concentrations were 5.15 ± 0.66 mmol/L, 5.05 ± 0.65 mmol/L and 5.00 ± 0.65 mmol/L (P < 0.001) in tubes stored at RT for 1, 2 and 4 hours, respectively. Mean biases in all time points exceeded the analytical goal for desirable bias based on biological variation criteria. FC-Mixture glucose concentrations were 5.48 ± 0.65 mmol/L, 5.46 ± 0.6 mmol/L and 5.46 ± 0.64 mmol/L in tubes stored at RT for 1, 2 and 4 hours, respectively. Mean biases for FC-Mixture glucose in all time points reached optimal analytical goals. In the second study, the biases for LH and FH glucose compared to reference FC-Mixture glucose exceeded the preset analytical goals, regardless of the blood collection to centrifugation time interval. Conclusions: FC-mixture tubes glucose concentrations were preserved up to 4h storage at RT. We confirmed that NaF alone does not allow immediate glycolysis inhibition in real life pre-centrifugation storage conditions (up to 340 minutes). FC-Mixture should be used exclusively for glucose determination in laboratories unable to implement the recommended blood samples’ treatment

Translational recoding as a feedback controller : systems approaches reveal polyamine-specific effects on the antizyme ribosomal frameshift

Peer reviewedPublisher PD

Dermoscopic, Histological, Confocal Microscopy Correlation of Atypical-Dysplastic Melanocytic Nevi

Introduction: The term "atypical melanocytic nevus" (AMN) is used as a synonym for dysplastic nevus (DN) in clinical practice. Although the criteria for diagnosis of AMN/DN by the Agency for Research on Cancer helps to differentiate AMN/DN from common acquired nevi, they do not have high degrees of specificity, as they are similar to those used for the diagnosis of melanoma. Objectives: In this retrospective study we evaluated the correlation and diagnostic concordance of dermoscopy, confocal microscopy, and histological examination in 50 AMN. Methods: A graded scale was used to compare histological examination with dermoscopy and confocal microscopy. Low magnification histological images of only the central part of lesions were examined. This allowed histological diagnoses based almost exclusively on architectural criteria instead of simultaneously architectural and cytological, as in the global histological examination. Results: Our data demonstrate that the diagnostic accuracy of dermoscopy and confocal microscopy diagnosis of the clinical aspects of AMN/DN as nevi or melanomas tends to be equivalent, being fair for nevi and excellent for melanomas. The total percentage of AMN suggested that the accuracy of confocal microscopy in the diagnosis of melanoma (86.7%) is greater than that of dermoscopy (73.3%). Conclusions: This study demonstrated that diagnostic assessments of AMN/DN by dermoscopy and confocal microscopy are accurate and often coincide with those of histological examination and that their combined use helps to better manage and monitor these patients by facilitating early detection of melanomas and reducing unnecessary excisions of benign melanocytic lesions

Comparison between invasive breast cancer with extensive peritumoral vascular invasion and inflammatory breast carcinoma: a clinicopathologic study of 161 cases.

Objectives: Extensive peritumoral neoplastic lymphovascular invasion (ePVI) is a marker of aggressiveness in invasive breast carcinoma (BC). Methods: We explored the impact of ePVI on different BC subtypes. In a total of 2,116 BCs, 91 ePVI-BCs, 70 inflammatory breast carcinomas (IBCs), and 114 casual BCs as a control group (CG-BC) were recruited. Results: Patients affected by ePVI-BC were younger, had larger tumors, higher histologic grade, elevated Ki-67 score, Her2/neu overexpressed, and more lymph node metastases compared with CG-BC ( P < .001). Interestingly, only younger mean age at diagnosis differentiated patients with ePVI-BC from patients affected by IBC. ePVI-BC showed a clinical outcome intermediate between the prognoses of IBC and CG-BC. Conclusions: Results suggest that ePVI-BC and IBC may share some pathologic processes, providing a novel perspective on the heterogeneity of BC. Epidemiologic data and molecular studies on gene expression features are needed to rationally classify these tumors into their identified subtypes

Predominance of the SARS-CoV-2 lineage P.1 and its sublineage P.1.2 in patients from the metropolitan region of Porto Alegre, southern Brazil in March 2021

Almost a year after the COVID-19 pandemic had begun, new lineages (B.1.1.7, B.1.351, P.1, and B.1.617.2) associated with enhanced transmissibility, immunity evasion, and mortality were identified in the United Kingdom, South Africa, and Brazil. The previous most prevalent lineages in the state of Rio Grande do Sul (RS, Southern Brazil), B.1.1.28 and B.1.1.33, were rapidly replaced by P.1 and P.2, two B.1.1.28-derived lineages harboring the E484K mutation. To perform a genomic characterization from the metropolitan region of Porto Alegre, we sequenced viral samples to: (i) identify the prevalence of SARS-CoV-2 lineages in the region, the state, and bordering countries/regions; (ii) characterize the mutation spectra; (iii) hypothesize viral dispersal routes by using phylogenetic and phylogeographic approaches. We found that 96.4% of the samples belonged to the P.1 lineage and approximately 20% of them were assigned as the novel P.1.2, a P.1-derived sublineage harboring signature substitutions recently described in other Brazilian states and foreign countries. Moreover, sequences from this study were allocated in distinct branches of the P.1 phylogeny, suggesting multiple introductions in RS and placing this state as a potential diffusion core of P.1-derived clades and the emergence of P.1.2. It is uncertain whether the emergence of P.1.2 and other P.1 clades is related to clinical or epidemiological consequences. However, the clear signs of molecular diversity from the recently introduced P.1 warrant further genomic surveillance

Vacinas no Brasil: Análise Histórica do Registro Sanitário e a disponibilização no Sistema de Saúde

Given the COVID-19 pandemic and the importance of public social protection policies, health issues, including immunizations, have gained prominence. This paper aims to analyze the dynamics of vaccine registration in Brazil and the vaccines made available through the National Immunization Program (PNI), with emphasis on the 2004-2018 vaccination schedule. This descriptive, exploratory, documentary research analyzed processes of vaccine registration with the Brazilian Health Regulatory Agency (Anvisa) and the incorporation of vaccine products into the PNI. The study drew on information from the national sanitary registration database, made available by Anvisa, a document analysis of official/normative publications, and the published literature. The data do demonstrate the incorporation of vaccines into the PNI, evincing a country with industrial potential for vaccine production, but still focused on the transfer of technologies, and in need of public attention and investments in new technologies as a way to ensure the sector's independence.Com a pandemia da COVID-19 e a importância das políticas públicas de proteção social, questões sanitaristas incluindo as imunizações se tornaram destaque. O estudo tem o objetivo de analisar a dinâmica dos registros sanitários de vacinas no país e as vacinas disponibilizadas por meio do Programa Nacional de Imunização (PNI), com destaque para o calendário vacinal no período entre 2004 e 2018. Realizou-se um estudo descritivo, documental e exploratório dos processos de registro sanitário na Agência Nacional de Vigilância Sanitária (Anvisa) e a incorporação dos produtos no PNI. Como base da pesquisa foram utilizados o banco de dados de registro sanitário disponibilizado pela Anvisa, a análise documental de publicações oficiais/normativas e dados da literatura. Os dados demonstram a incorporação das vacinas no PNI, assim como um país com potencial industrial para a produção das vacinas, no entanto ainda centrado na transferência de tecnologias, necessitando de investimentos e atenção pública no desenvolvimento de novas tecnologias, garantindo a independência do setor

Prevenzione e interventi precoci a supporto della relazione genitore-bambino: il Dialogic Book-Sharing

I primi mille giorni di vita sono i più significativi per quanto riguarda lo sviluppo neuromentale del bambino (Imbasciati, Cena, 2018) in quanto, tra i processi di apprendimento, la comunicazione linguistica acquisisce una importanza specifica in questo periodo evolutivo. Gli studi dell’Infant Research hanno messo in evidenza come il bimbo alla nascita manifesti già competenze comunicative primarie, apprese durante il periodo prenatale, che si sviluppano se adeguatamente stimolate dai caregivers. L’acquisizione del linguaggio avviene attraverso progressive fasi che si succedono con modalità simili e, al tempo stesso, questo processo è caratterizzato da grandissime variabili individuali che riguardano non solo i tempi, ma anche i modi e le strategie di apprendimento. Lo sviluppo linguistico può essere favorito dalle esperienze ambientali e in questa prospettiva la lettura da parte del genitore al bambino in età precoce si è dimostrata un “mediatore” efficace nella prima infanzia per promuovere lo sviluppo delle abilità linguistiche (Bus, Van IJzendoorn, 1995; Demir-Lira et al., 2019; Leech et al., 2022): con questa pratica educativa i genitori etichettano gli oggetti più frequentemente rispetto ad altre attività come il gioco o i pasti e forniscono ai bambini un feedback linguistico più coerente e informativo (Snow, Goldfield, 1983; Wells, 1985). Nella prima infanzia la lettura avviene attraverso lo scambio interattivo: l’adulto e il bambino possono focalizzarsi su aspetti comuni e condivisi guardando le illustrazioni, facendo domande e parlando della storia, con modalità differenti a seconda della età e capacità (Rowland et al., 2016). La lettura condivisa ha un impatto significativo sullo sviluppo del vocabolario, sulla comprensione orale, sulla consapevolezza fonemica e sulle capacità di riconoscimento delle parole (Centre for Com- munity Child Health, 2008): ricerche empiriche sulla lettura condivisa hanno messo in evidenza che queste capacità a 8 mesi correlano con le abilità linguistiche a 12 mesi e, ancor di più, a 16; tale effetto si riscontrerebbe prevalentemente nel linguaggio espressivo, più di quello ricettivo (Karrass, Braungart-Rieker, 2005). Nelle ricerche internazionali da oltre un decennio sono stati Lynne Murray e Peter Cooper (Università di Reading, UK) a mettere in evidenza con ricerche empiriche come la condivisione “dialogica” del libro nella prima infanzia, creando uno spazio intersoggettivo privilegiato possa favorire non solo lo sviluppo cognitivo, ma emotivo-affettivo del bambino. Viene indicato lo stile dialogico intersoggettivo dell’adulto (Murray et al., 2022) come il più efficace nel favorire una buona relazione genitore-bambino

Short-Term Consequences of SARS-CoV-2-Related Pneumonia: A Follow Up Study

The aim of the study was to assess the short-term consequences of SARS-CoV-2-related pneumonia, also in relation to radiologic/laboratory/clinical indices of risk at baseline. This prospective follow-up cohort study included 94 patients with confirmed COVID-19 admitted to a medical ward at the Montichiari Hospital, Brescia, Italy from February 28th to April 30th, 2020. Patients had COVID-19 related pneumonia with respiratory failure. Ninety-four patients out of 193 survivors accepted to be re-evaluated after discharge, on average after 4 months. In 1/4 of the patients an evidence of pulmonary fibrosis was detected, as indicated by an altered diffusing capacity of the lung for carbon monoxide (DLCO); in 6-7% of patients the alteration was classified as of moderate/severe degree. We also evaluated quality of life thorough a structured questionnaire: 52% of the patients still lamented fatigue, 36% effort dyspnea, 10% anorexia, 14% dysgeusia or anosmia, 31% insomnia and 21% anxiety. Finally, we evaluated three prognostic indices (the Brixia radiologic score, the Charlson Comorbidity Index and the 4C mortality score) in terms of prediction of the clinical consequences of the disease. All of them significantly predicted the extent of short-term lung involvement. In conclusion, our study demonstrated that SARS-CoV-2-related pneumonia is associated to relevant short-term clinical consequences, both in terms of persistence of symptoms and in terms of impairment of DLCO (indicator of a possible development of pulmonary fibrosis); some severity indices of the disease may predict short-term clinical outcome. Further studies are needed to ascertain whether such manifestations may persist long-term