Otoneurological evaluation: current good practice

Universidade Federal de Minas Gerais Hospital das Clínicas Ambulatório de OtoneurologiaUniversidade Federal de São Paulo (UNIFESP) Ambulatório de OtoneurologiaUniversidade de São Paulo Faculdade de Medicina Hospital das ClínicasUniversidade de São Paulo Faculdade de Medicina Departmento de OtorrinolaringologiaPontifícia Universidade Católica de Campinas Faculdade de Medicina Departmento de OtorrinolaringologiaUniversidade Federal de São Paulo (UNIFESP) Departmento de OtorrinolaringologiaHospital Sírio-LibanêsUniversidade Estadual de CampinasInstituto Penido Burnier Clínica de OtorrinolaringologiaUniversidade Federal Fluminense Faculdade de MedicinaUNIFESP, Ambulatório de OtoneurologiaUNIFESP, Departmento de OtorrinolaringologiaSciEL

Dar voz às vozes das crianças na construção da prática pedagógica

O presente artigo pretende apresentar a problemática que se destacou nas Práticas Profissionais Supervisionadas realizadas no decorrer do Mestrado em Educação Pré-Escolar (creche e de jardim de infância) no ano letivo 2012-2013. As duas práticas foram realizadas em contextos bastante distintos, sendo que esta diferença – com alguns pontos convergentes - foi um dos principais motes para nos apercebêssemos do aspeto educacional que nomeia este trabalho e sobre o qual iremos refletir, recorrendo às evidências que recolhemos ao longo do percurso educativo percorrido. Este texto abordará os aspetos em que nos baseámos durante o decorrer de todo o processo educativo, para construir a ação pedagógica: a concentração nas vozes das crianças e a forma como um Educador se deve posicionar para conseguir ouvir, efetivamente, os grupos com que trabalha

Brazilian multicenter study on prevalence of preterm birth and associated factors

<p>Abstract</p> <p>Background</p> <p>The occurrence of preterm birth remains a complex public health condition. It is considered the main cause of neonatal morbidity and mortality, resulting in a high likelihood of sequelae in surviving children. With variable incidence in several countries, it has grown markedly in the last decades. In Brazil, however, there are still difficulties to estimate its real occurrence. Therefore, it is essential to establish the prevalence and causes of this condition in order to propose prevention actions. This study intend to collect information from hospitals nationwide on the prevalence of preterm births, their associated socioeconomic and environmental factors, diagnostic and treatment methods resulting from causes such as spontaneous preterm labor, prelabor rupture of membranes, and therapeutic preterm birth, as well as neonatal results.</p> <p>Methods/Design</p> <p>This proposal is a multicenter cross-sectional study plus a nested case-control study, to be implemented in 27 reference obstetric centers in several regions of Brazil (North: 1; Northeast: 10; Central-west: 1; Southeast: 13; South: 2). For the cross sectional component, the participating centers should perform, during a period of six months, a prospective surveillance of all patients hospitalized to give birth, in order to identify preterm birth cases and their main causes. In the first three months of the study, an analysis of the factors associated with preterm birth will also be carried out, comparing women who have preterm birth with those who deliver at term. For the prevalence study, 37,000 births will be evaluated (at term and preterm), corresponding to approximately half the deliveries of all participating centers in 12 months. For the case-control study component, the estimated sample size is 1,055 women in each group (cases and controls). The total number of preterm births estimated to be followed in both components of the study is around 3,600. Data will be collected through a questionnaire all patients will answer after delivery. The data will then be encoded in an electronic form and sent online by internet to a central database. The data analysis will be carried out by subgroups according to gestational age at preterm birth, its probable causes, therapeutic management, and neonatal outcomes. Then, the respective rates, ratios and relative risks will be estimated for the possible predictors.</p> <p>Discussion</p> <p>These findings will provide information on preterm births in Brazil and their main social and biological risk factors, supporting health policies and the implementation of clinical trials on preterm birth prevention and treatment strategies, a condition with many physical and emotional consequences to children and their families.</p

The germline mutational landscape of BRCA1 and BRCA2 in Brazil

The detection of germline mutations in BRCA1 and BRCA2 is essential to the formulation of clinical management strategies, and in Brazil, there is limited access to these services, mainly due to the costs/availability of genetic testing. Aiming at the identification of recurrent mutations that could be included in a low-cost mutation panel, used as a first screening approach, we compiled the testing reports of 649 probands with pathogenic/likely pathogenic variants referred to 28 public and private health care centers distributed across 11 Brazilian States. Overall, 126 and 103 distinct mutations were identified in BRCA1 and BRCA2, respectively. Twenty-six novel variants were reported from both genes, and BRCA2 showed higher mutational heterogeneity. Some recurrent mutations were reported exclusively in certain geographic regions, suggesting a founder effect. Our findings confirm that there is significant molecular heterogeneity in these genes among Brazilian carriers, while also suggesting that this heterogeneity precludes the use of screening protocols that include recurrent mutation testing only. This is the first study to show that profiles of recurrent mutations may be unique to different Brazilian regions. These data should be explored in larger regional cohorts to determine if screening with a panel of recurrent mutations would be effective.This work was supported in part by grants from Barretos Cancer Hospital (FINEP - CT-INFRA, 02/2010), Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, 2013/24633-2 and 2103/23277-8), Fundação de Apoio à Pesquisa do Rio Grande do Norte (FAPERN), Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS), Ministério da Saúde, the Breast Cancer Research Foundation (Avon grant #02-2013-044) and National Institute of Health/National Cancer Institute (grant #RC4 CA153828-01) for the Clinical Cancer Genomics Community Research Network. Support in part was provided by grants from Fundo de Incentivo a Pesquisa e Eventos (FIPE) from Hospital de Clínicas de Porto Alegre, by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, BioComputacional 3381/2013, Rede de Pesquisa em Genômica Populacional Humana), Secretaria da Saúde do Estado da Bahia (SESAB), Laboratório de Imunologia e Biologia Molecular (UFBA), INCT pra Controle do Câncer and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). RMR and PAP are recipients of CNPq Productivity Grants, and Bárbara Alemar received a grant from the same agencyinfo:eu-repo/semantics/publishedVersio

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Las exportaciones olivícolas en el Departamento Arauco: evolución histórica y proyecciones.

El presente proyecto tiene como propósito conocer la evolución, en la última década, de las exportaciones del sector olivícola en el Departamento Arauco, Provincia de La Rioja, como punto de partida para delinear una proyección de la actividad y además elaborar propuestas de políticas orientadas al fomento de las mismas.En primer lugar se realizará un relevamiento estadístico de las exportaciones olivícolas desde el año 2000 a la fecha; estos datos serán complementados con testimonios de personas vinculadas directamente a la actividad.En segundo lugar se estudiarán los factores políticos, socio económico, natural y cultural (tanto interno como externo) que definen el tipo de exportación; esto es: los condicionamientos internos de la región y del país que generan la oferta, como también la demanda externa de exportación específica.En tercer lugar se estudiarán y analizarán antecedentes en el país y en el mundo para encontrar puntos de contacto que permitan una explicación a la situación actual.En cuarto lugar se asociarán los factores concurrentes para vislumbrar nuevos escenarios posibles de continuidad y acrecentamiento de las exportaciones, incluyendo posibilidades y riesgos.Finalmente se elaborará una propuesta de mejoras para el sector, en cuanto a la calidad de su oferta exportadora, dotándola de solidez y valor agregado, que le permitan crecer más allá de los ciclos económicos, entendiendo que ello generará una transferencia directa de bienestar laboral, social y económico a los habitantes de la zona.AbstractThe present Project pretends to know the evolution of olive industry exports during the last decade in Arauco Department, La Rioja Province, as a starting point to outline a projection of the activity as well as to elaborate policies proposals focused on their promotion.On the first place, an olive industry exports survey from 2000 to the present day will be made; the information gathered will be complemented with testimonies of people directly connected to the activity.On the second place, political, socioeconomic, natural and cultural factors (internal and external) that define the type of export will be studied; that is to say, the internal restrictionsof the region and the country that the offer creates, as well as the specific export external demand.On the third place, the country and world antecedents will be studied and analyzed to find contact points that allow an explanation of the present situation.On the forth place, concurrent factors will be associated to foresee new scenarios with possible continuity and exports increase, including opportunities and risks.Finally, a sector improvement proposal will be elaborated, regarding its export offer quality with strength and value added that allows it to grow beyond economic cycles, understanding that this fact, will directly contribute with the labor, social and economic welfare of the people from the region.Key Words:Exports; Olivícola; Prospects; Arauco; Production; Implantation; Variety

Estudo da evolução estrutural de multicamadas de Fe/SiO/sub 2/ submetidas a tratamento térmico em alto vácuo

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Focal dermal hypoplasia: a case report and literature review

Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: e11-e18)Univ São Paulo, Fac Odontol, Dept Orthodont & Pediat Dent, BR-22270550 São Paulo, BrazilUniv São Paulo, Dept Pediat Dent, BR-22270550 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Morphol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Morphol, São Paulo, BrazilWeb of Scienc