Adaptations in the Treatment of Congenital Lymphedema Centered on the Quality of Life

Case Description. This report describes the evolution, necessary adaptations, and complications in the treatment of a 9-year-old child with primary congenital lymphedema. Description of Intervention. The clinical treatment of lymphedema was started in the first year of the patient’s life and for five years she was only treated using the Godoy & Godoy technique of cervical stimulation. Three years ago the patient was prescribed a compression stocking made from a cotton-polyester fabric (grosgrain) because of a sudden increase in the lymphedema after she started to take growth hormones. Outcome and Conclusion. The combination of cervical stimulation and a compression stocking was effective to keep the child’s life relatively normal, performing all day-to-day and recreational activities

Superficial Thrombophlebitis of Great Saphenous Vein Following Vaccine

This paper reports on the occurrence of thrombose of the left great saphenous vein (GSV) soon after being given the AstraZeneca vaccine and two recurrent events within three days after the suspension of the anticoagulant. A 53-year-old patient had superficial thrombophlebitis of the GSV in the left leg three days after taking the second dose of the AstraZeneca vaccine for COVID-19 and initiated treatment with rivaroxaban (XareltoTM) 15 mg twice a day, subsequently increasing to 20 mg. After 45 days, the patient contracted dengue and stopped taking the anticoagulant. Two days later, the patient had another thrombosis in the left GSV. The patient is currently in outpatient care with a prophylactic dose of 10mg/day of anticoagulant and undergoes evaluations at three-month intervals. The result of our study is a rare event

Education of the asthmatic patient: the nursing approach

Background: Asthma education programs induce better asthma control and are one of main recommendations in guidelines. The programs recommendations should include a nurse in the educational team applying the structured program. The purpose of the intervention is to bring a change in the daily life of the patient and the family in order to improve disease control and quality of life. Aim: To standardize and apply a structured post-consultation model as part of multidisciplinary care in an educational program for asthmatic patients seen at the outpatient clinic of a public hospital, and to monitor the changes in asthma knowledge and quality of life. Methods: A longitudinal prospective study over six months with regular visits at four week intervals (total = 6 visits), conducted at the outpatient department of UNIFESP/EPM/HSP, and the patients were included after signing a consent form. The asthma structured educational plan was conducted by a multidisciplinary team and addressed the following issues: what is asthma, relief and prevention medicines, daily report of symptoms and dyspnea score, training of the correct use of inhaled medication, discussion and actions regarding triggering factors and how to avoid them, and tips to recognize the signals of uncontrolled asthma. A standard questionnaire about general knowledge on asthma and a quality of life questionnaire were applied at the beginning, during the course, and at the end of the program. Results: 26 asthmatics were followed over six months and showed a statistically significant improvement in their identification and management of asthma skills as well as better quality of life indices. Conclusion: The model of care and the approach and training techniques were adequate and useful in the development of a structured educational program for socially deprived patients.Introdução: Programas de educação em asma levam a melhor controle da asma e são uma das recomendações dos consensos. Os programas devem incluir uma enfermeira no grupo educacional que aplicará o programa estruturado. A proposta da intervenção é mudar a vida diária do paciente e sua família e melhorar o controle da doença e qualidade de vida. Objetivo: Padronizar e aplicar um modelo estruturado de pós-consulta, como parte de atendimento multidisciplinar dentro de um programa educativo para pacientes asmáticos em um ambulatório de um hospital público e acompanhamento das mudanças no conhecimento da asma e qualidade de vida. Método: Estudo longitudinal, prospectivo, com duração de seis meses, realizado no ambulatório de Pneumologia do Hospital São Paulo (UNIFESP/EPM), dentro de um programa de educação para pacientes asmáticos, em que foram agendadas seis consultas, com intervalo de quatro semanas, com os seguintes temas: o que é asma, medicações de alívio e prevenção, diário de sintomas e escore de dispnéia, uso correto do aerossol, discussão dos fatores desencadeantes e profilaxia, e também reconhecer os sinais de descontrole da asma. Um modelo padronizado do questionário de conhecimentos sobre asma e outro sobre qualidade de vida foram aplicados no início, durante e no final do estudo. Resultados: 26 asmáticos foram acompanhados por seis meses e mostraram melhora significante na identificação dos problemas relacionados ao manejo da asma, como também nos índices de qualidade de vida. Conclusão: O modelo de atendimento, como também as técnicas de treinamento, foram adequadas e úteis no desenvolvimento de um programa educativo estruturado para pacientes asmáticos.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Disciplina de PneumologiaFaculdade de Medicina Unisa Disciplina de PneumologiaUNIFESP, Disciplina de PneumologiaSciEL

Biosynthetic pathways and the role of the MAS receptor in the effects of Angiotensin-(1-7) in smooth muscles.

Ang-(1-7) is produced via degradation of Ang II by the human angiotensin converting enzyme, also known as ACE2. In the cardiovascular system, Ang-(1-7) has been shown to produce effects that are opposite to those of Ang II. These include smooth muscle relaxation and cardioprotection. While the roles of Ang-(1-7) in other systems are currently topic of intense research, functional data suggest a relaxation action in gastrointestinal smooth muscles in a way that corroborates the results obtained from vascular tissues. However, more studies are necessary to determine a relevant role for Ang-(1-7) in the gastrointestinal system. The Ang-(1-7) actions are mediated by a distinct, functional, Ang-(1-7) receptor: the Mas receptor as shown by diverse studies involving site-specific binding techniques, selective antagonists, and targeted gene deletion. This paper provides an overview of the functional role and the molecular pathways involved in the biosynthesis and activity of Ang-(1-7) in diverse systems

INCIDENCIA DE LA EXPERIENCIA EN LA ELECCIÓN DE LA METODOLOGÍA DE EN-SEÑANZA EN NATACIÓN

The purpose of this research was to investigate why swimming teachers, when planning their teaching, choose one methodology over another; analysing the reasons why a high percentage of them do not apply the teaching methodologies they study during their training as physical education graduates. The objective was to analyse the impact of experience, training and institutional guidelines on the choice of methodology applied by swimming teachers. We opted for a qualitative-quantitative research, linking the qualitative method in data collection with the quantitative method in data analysis. A transversal, non-experimental field design was used, opting for an intensive sample, which was composed of 50 graduates who work as teachers in two sports institutions in the field of non-formal education in Montevideo. As an instrument, a semi-structured interview was applied through a questionnaire, comparing the answers obtained with the data that emerged in the exploratory study carried out for this research. From an interpretative perspective, we sought to describe and explain the phenomenon. It was possible to conclude that the teachers who were part of the sample prioritise the use of reproductive methodologies over production methodologies, leaving aside the participatory methodologies studied in the training institutes and recommended by their employers. It was also found that the methodologies used by these teachers reproduce the traditional models with which they learned the sport.La finalidad de esta investigación, fue indagar por que los docentes de natación, al planificar la enseñanza, eligen una metodología frente a otra; analizando las causas por las que un alto porcentaje de estos, no aplican las metodologías de enseñanza que estudian durante su etapa de formación como licenciados de educación física. El objetivo fue: analizar cuál es la incidencia de la experiencia, la formación y los lineamientos institucionales en la elección de la metodología aplicada por los docentes de natación. Se optó por una investigación de corte cuali-cuantitativo, vinculando el método cualitativo en la recolección de datos, con el cuantitativo en el análisis de los mismos. Se utilizó un diseño de campo, no experimental de corte transversal, optando por una muestra intensional, que estuvo compuesta por 50 licenciados que trabajan como profesores en dos instituciones deportivas, del ámbito de la enseñanza no formal de Montevideo. Como instrumento, se aplicó la entrevista semiestructurada, a través de un cuestionario, comparando las respuestas obtenidas, con los datos que surgieron en el estudio exploratorio, realizado para esta investigación. Desde una perspectiva interpretativa, se buscó describir y explicar el fenómeno. Se pudo concluir que los docentes que fueron parte de la muestra, priorizan el uso de metodologías de corte reproductivo, frente a las de producción, dejando de lado las metodologías participativas estudiadas en los institutos de formación y recomendadas por sus empleadores. Asimismo, se pudo constatar que las metodologías utilizadas por estos docentes, reproducen los modelos tradicionales, con los cuales ellos aprendieron el deporte.O objetivo desta pesquisa foi investigar por que os professores de natação, ao planejarem seu ensino, escolhem uma metodologia em vez de outra; analisando as razões pelas quais uma alta porcentagem delas não aplica as metodologias de ensino que estudam durante sua formação como graduados em educação física. O objetivo foi analisar o impacto da experiência, da formação e das diretrizes institucionais sobre a escolha da metodologia aplicada pelos professores de natação. Optou-se por uma pesquisa qualitativa-quantitativa, vinculando o método qualitativo na coleta de dados com o método quantitativo na análise de dados. Foi utilizado um projeto de campo transversal e não experimental, optando por uma amostra intensiva, composta por 50 graduados que trabalham como professores em duas instituições esportivas na área de educação não formal em Montevidéu. Como instrumento, foi aplicada entrevista semiestruturada por meio de questionário, comparando as respostas obtidas com os dados que surgiram no estudo exploratório realizado para esta pesquisa. De uma perspectiva interpretativa, procuramos descrever e explicar o fenômeno. Foi possível concluir que os professores que fizeram parte da amostra priorizam o uso de metodologias reprodutivas sobre metodologias de produção, deixando de lado as metodologias participativas estudadas nos institutos de formação e recomendadas por seus empregadores. Verificou-se também que as metodologias utilizadas por esses professores reproduzem os modelos tradicionais com os quais aprenderam o esporte

Influence of oscillating positive expiratory pressure and the forced expiratory technique on sputum cell counts and quantity of induced sputum in patients with asthma or chronic obstructive pulmonary disease

OBJECTIVE: To evaluate whether respiratory therapy techniques influence the number of cells within and quantity of induced sputum in patients with asthma or chronic obstructive pulmonary disease (COPD). METHODS: Randomized clinical trial, in which patients with asthma or COPD under intervention (n = 16 and 10, respectively) were compared with control groups (n = 16 and 10). Patients in the asthma/intervention (A/I) and COPD/intervention (C/I) groups were submitted to oscillating positive expiratory pressure maneuvers for 5 min, followed by 10 forced expiratory technique sequences. These patients were also submitted to an induced sputum protocol with inhaled hypertonic saline (3%, 4% or 5%; A/I group) or inhaled isotonic saline (C/I group). The asthma/control (A/C) and COPD/control (C/C) groups were submitted only to the standard induced sputum protocol. RESULTS: The final mean weight of the sputum samples was significantly greater in the A/I group than in the A/C group (2,767.25 ± 998.08 mg vs. 1,689.17 ± 1,189.96 mg; p = 0.03). The mean/median total cell counts (×10(6)/mL) were higher in the A/I and C/I groups than in the A/C and C/C groups (4.06/0.95 and 0.63/0.39, p = 0.05, vs. 5.08/1.77 and 0.64/0.40, p = 0.02). There were no statistically significant differences among the groups in terms of cell viability. CONCLUSIONS: The use of respiratory therapy techniques can increase sputum sample weight in asthma patients, as well as increasing total cell counts in patients with asthma or COPD.OBJETIVO: Avaliar se técnicas fisioterápicas interferem no número de células e na quantidade do escarro obtido por coleta induzida, em pacientes com asma e doença pulmonar obstrutiva crônica (DPOC). MÉTODOS: Ensaio clínico prospectivo e randomizado, no qual os pacientes com asma ou DPOC sob intervenção (n = 16 e 10, respectivamente) foram comparados com grupos controle (n = 16 e 10). Pacientes dos grupos asma/intervenção (A/I) e DPOC/intervenção (D/I) foram submetidos a manobras de pressão expiratória positiva oscilante por 5 min, seguidas de 10 repetições da técnica de expiração forçada. Além disso, esses pacientes foram submetidos a um protocolo de indução de escarro com a inalação de solução salina hipertônica (3%, 4% e 5%), no caso dos A/I, e de solução salina isotônica, no caso dos D/I. Os grupos asma/controle(A/C) e DPOC/controle (D/C) foram somente submetidos ao protocolo padrão de indução de escarro. RESULTADOS: Houve aumento significante do peso média final de escarro no grupo A/I vs. grupo A/C (2.767,25 ± 998,08 mg e 1.689,17 ± 1.189,96 mg, respectivamente; p = 0,03). O número absoluto de células (×10(6)/mL) foi maior nos grupos A/I e D/I do que nos grupos A/C e D/C (média/mediana, 4,06/0,95 e 0,63/0,39, respectivamente; p = 0,05; e 5,08/1,77 e 0,64/0,40; p = 0,02). A viabilidade celular não apresentou diferença estatisticamente significante entre os grupos. CONCLUSÕES: O uso de técnicas respiratórias pode aumentar o peso do escarro em pacientes com asma, assim como aumentar o número absoluto de células em pacientes com asma ou DOPC.Universidade Regional IntegradaUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Palabras de los miembros docentes del Comité Editor

La Revista Tesis está dirigida a los noveles investigadores y pretende crear un espacio de contacto y circulación de sus trabajos. Busca favorecer la difusión de las indagaciones en ese primer escalón de la producción científica que es el Trabajo Final de Licenciatura, culminación de la formación académica de grado e inicio en la investigación.publishedVersionFil: Godoy, Juan Carlos. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Ana Maria, Alderete. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Marino, Julián. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina

PDE ESCOLA E PDE INTERATIVO: IMPLEMENTAÇÃO NAS ESCOLAS MUNICIPAIS DE CAMPO GRANDE-MS

A presente pesquisa tem como objeto a implementação do denominado Plano de Desenvolvimento da Escola (PDE Escola), criado pelo governo federal no âmbito do Ministério da Educação e do Fundo Nacional de Desenvolvimento da Educação (FNDE) por meio da Portaria Normativa do Ministro da Educação nº 27, de 21 de junho de 2007, que visa ao atendimento prioritário dos Estados e municípios com os mais baixos índices de desenvolvimento da educação (IDEB)

Comparison of MICE and Etest with CLSI Agar Dilution for Antimicrobial Susceptibility Testing against Oxacillin-Resistant Staphylococcus spp.

Objective: the main objective of this study was to comparatively evaluate the performance of M. I. C. E. and Etest methodologies to that of agar dilution for determining the antimicrobial susceptibility profile of oxacillin-resistant Staphylococcus spp.Methods: A total of 100 oxacillin-resistant Staphylococcus spp. isolates were collected from hospitalized patients at a teaching hospital. Antimicrobial susceptibility testing for vancomycin, teicoplanin and linezolid was performed using the reference CLSI agar dilution method (2009), Etest and M. I. C. E. methodologies. the MIC values were interpreted according to CLSI susceptibility breakpoints and compared by regression analysis.Results: in general, the essential agreement (+/- 1-log(2)) between M. I. C. E. and CLSI agar dilution was 93.0%, 84.0% and 77.0% for linezolid, teicoplanin and vancomycin, respectively. Essential agreement rates between M. I. C. E. and Etest were excellent (>90.0%) for all antibiotics tested. Both strips (M. I. C. E. and Etest) yielded two very major errors for linezolid. Unacceptable minor rates were observed for teicoplanin against CoNS and for vancomycin against S. aureus.Conclusions: According to our results, linezolid and teicoplanin MICs against all staphylococci and S. aureus, respectively, were more accurately predicted by M. I. C. E. strips. However, the Etest showed better performance than M. I. C. E. for predicting vancomycin MICs against all staphylococci. Thus, microbiologists must be aware of the different performance of commercially available gradient strips against staphylococci.Thermo Fisher Scientific, São Paulo, BrazilConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Lab Alerta, Disciplina Infectol, São Paulo, BrazilUniversidade Federal de São Paulo, Hosp São Paulo, Lab Cent, São Paulo, BrazilUniversidade Federal de São Paulo, Lab Alerta, Disciplina Infectol, São Paulo, BrazilUniversidade Federal de São Paulo, Hosp São Paulo, Lab Cent, São Paulo, BrazilCNPq: 307816/2009-5Web of Scienc