ENTREVISTA: MEDICINA DO TRABALHO ALGUMAS REFLEXÕES

Nesta entrevista o Dr. Carlos Campos, especialista em Ortopedia e Traumatologia, Medicina do Trabalho, Medicina Legal e Perícias Médicas; também Diretor Técnico do IERGO – Instituto de Ergonomia Ltda, discorre sobre sua trajetória profissional no campo da Medicina do Trabalho; fala da importância da transdisciplinaridade durante sua carreira e promove junto a ela a atenção integral à saúde dos trabalhadores. Destaca também a respeito dos principais Riscos Psicossociais que afetam o trabalhador, levando em conta o contexto da pandemia da Covid-19 e esclarece quais são os principais desafios trazidos pela pandemia para os profissionais que atuam na área da Medicina do Trabalho

La configuración de formas de pensamiento funcional en la educación básica primaria. un estudio con problemas relativos a las relaciones funcionales lineales

La presente investigación se ocupa del estudio de las diversas formas de pensamiento funcional que se configuran en un grupo de estudiantes de tercero y cuarto grado de Educación Básica Primaria, cuando trabajan con problemas que involucran relaciones funcionales lineales. Así, se describen algunos aspectos que dieron lugar al problema y se presentan los referentes teóricos y metodológicos, los cuales sirvieron de base para diseñar, implementar y gestionar la secuencia de problemas propuestos. Los principales hallazgos ponen de relieve que las categorías de análisis construidas resultan útiles para caracterizar y ahondar, en términos de los sistemas de representación, en las estrategias empleadas y las formas de pensamiento funcional configuradas por los estudiantes de tercero y cuarto grado. En el marco de la actividad matemática, si bien la mayoría de los estudiantes de grado tercero logran establecer la relación entre dos cantidades variables, están supeditados a una forma de pensamiento funcional que corresponde a patrones recursivos dado que ponen énfasis en el cambio de una sola cantidad hasta reconocer la manera en que se da dicha relación. En contraste, gran parte de los estudiantes de grado cuarto configuran el pensamiento de correspondencia caracterizado por el reconocimiento rápido del patrón y el posterior establecimiento de la relación entre las variables involucradas. Esta investigación aporta, entre otros elementos, un insumo importante reflejado en el fundamento teórico y metodológico de los problemas propuestos que puede ser empleado para favorecer el ámbito de la enseñanza de las matemáticas en la Educación Básica Primaria, en particular con lo relacionado al desarrollo del pensamiento funcional.PregradoLICENCIADO(A) EN EDUCACIÓN BASICA CON ÉNFASIS EN MATEMATICA

Median eminence blood flow influences food intake by regulating ghrelin access to the metabolic brain

Central integration of peripheral appetite-regulating signals ensures maintenance of energy homeostasis. Thus, plasticity of circulating molecule access to neuronal circuits involved in feeding behavior plays a key role in the adaptive response to metabolic changes. However, the mechanisms involved remain poorly understood despite their relevance for therapeutic development. Here, we investigated the role of median eminence mural cells, including smooth muscle cells and pericytes, in modulating gut hormone effects on orexigenic/anorexigenic circuits. We found that conditional activation of median eminence vascular cells impinged on local blood flow velocity and altered ghrelin-stimulated food intake by delaying ghrelin access to target neurons. Thus, activation of median eminence vascular cells modulates food intake in response to peripheral ghrelin by reducing local blood flow velocity and access to the metabolic brain.</p

In vitro antimicrobial efficacy of a fixed-dose combination of RHZE against M. tuberculosis

The use of drugs in fixed-dose combination (FDC) is now recommended by the World Health Organization (WHO) due to the emergence of multidrug-resistant strains of Mycobacterium tuberculosis. FDC uses different drugs against tuberculosis (TB) in a single tablet for phase-intensive therapeutic intervention. This therapy aims to optimize treatment, to prevent inappropriate use of drugs, and to prevent the emergence of new resistant strains. This study aims to evaluate the susceptibility of clinical isolates of M. tuberculosis against rifampicin, isoniazid, ethambutol, and pyrazinamide. The antimicrobials were tested separately and in associations according to FDC. This was used for broth microdilution method, which was compared to the proportions method previously considered as the gold standard. In antimicrobials testing alone, several strains were resistant to one, two, or three drugs. However, when applied to association of drugs in FDC, there was no antimicrobial resistance. The results strengthen the FDC's concept, which aims to unite the four anti-TB drugs to combat bacterial resistance

A randomised clinical trial of intrapartum fetal monitoring with computer analysis and alerts versus previously available monitoring

<p>Abstract</p> <p>Background</p> <p>Intrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related to fetal surveillance. Cardiotocographic (CTG) monitoring remains the basis of intrapartum surveillance, but its interpretation by healthcare professionals lacks reproducibility and the technology has not been shown to improve clinically important outcomes. The addition of fetal electrocardiogram analysis has increased the potential to avoid adverse outcomes, but CTG interpretation remains its main weakness. A program for computerised analysis of intrapartum fetal signals, incorporating real-time alerts for healthcare professionals, has recently been developed. There is a need to determine whether this technology can result in better perinatal outcomes.</p> <p>Methods/design</p> <p>This is a multicentre randomised clinical trial. Inclusion criteria are: women aged ≥ 16 years, able to provide written informed consent, singleton pregnancies ≥ 36 weeks, cephalic presentation, no known major fetal malformations, in labour but excluding active second stage, planned for continuous CTG monitoring, and no known contra-indication for vaginal delivery. Eligible women will be randomised using a computer-generated randomisation sequence to one of the two arms: continuous computer analysis of fetal monitoring signals with real-time alerts (intervention arm) or continuous CTG monitoring as previously performed (control arm). Electrocardiographic monitoring and fetal scalp blood sampling will be available in both arms. The primary outcome measure is the incidence of fetal metabolic acidosis (umbilical artery pH < 7.05, BD_ecf> 12 mmol/L). Secondary outcome measures are: caesarean section and instrumental vaginal delivery rates, use of fetal blood sampling, 5-minute Apgar score < 7, neonatal intensive care unit admission, moderate and severe neonatal encephalopathy with a marker of hypoxia, perinatal death, rate of internal monitoring, tracing quality, and signal loss. Analysis will follow an intention to treat principle. Incidences of primary and secondary outcomes will be compared between groups. Assuming a reduction in metabolic acidosis from 2.8% to 1.8%, using a two-sided test with alpha = 0.05, power = 0.80, and 10% loss to follow-up, 8133 women need to be randomised.</p> <p>Discussion</p> <p>This study will provide evidence of the impact of intrapartum monitoring with computer analysis and real-time alerts on the incidence of adverse perinatal outcomes, intrapartum interventions and signal quality. (Current controlled trials ISRCTN42314164)</p

Thyroid-stimulating hormone pulses finely tune thyroid hormone release and TSH receptor transduction

Detection of circulating thyroid-stimulating hormone (TSH) is a first-line test of thyroid dysfunction, a major health problem (affecting about 5% of the population) that, if untreated, can lead to a significant deterioration of quality of life and adverse effects on multiple organ systems. Human TSH levels display both pulsatile and (non-pulsatile) basal TSH secretion patterns; however, the importance of these in regulating thyroid function and their decoding by the thyroid is unknown. Here, we developed a novel ultra-sensitive ELISA that allows precise detection of TSH secretion patterns with minute resolution in mouse models of health and disease. We characterised the patterns of ultradian TSH pulses in healthy, freely-behaving mice over the day-night cycle. Challenge of the thyroid axis with primary hypothyroidism due to iodine deficiency, a major cause of thyroid dysfunction worldwide, results in alterations of TSH pulsatility. Induction in mouse models of sequential TSH pulses that mimic ultradian TSH profiles in periods of minutes were more efficient than sustained rises in basal TSH levels at increasing both thyroid follicle cAMP levels, as monitored with a genetically-encoded cAMP sensor, and circulating thyroid hormone (TH). Hence this mouse TSH assay provides a powerful tool to decipher how ultradian TSH pulses encode thyroid outcomes, and to uncover hidden parameters in the TSH-TH set-point in health and disease.</p

Nanostructured system based on hydroxyapatite and curcumin: A promising candidate for osteosarcoma therapy:A promising candidate for osteosarcoma therapy

Osteosarcoma is the most common type of bone cancer. Despite therapeutic progress, survival rates for metastatic cases or that do not respond well to chemotherapy remain in the 30% range. In this sense, the use of nanotechnology to develop targeted and more effective therapies is a promising tool in the fight against cancer. Nanostructured hydroxyapatite, due to its biocompatibility and the wide possibility of functionalization, is an interesting material to design nanoplatforms for targeted drug delivery. These platforms have the potential to enable the use of natural substances in the fight against cancer, such as curcumin. Curcumin is a polyphenol with promising properties in treating various types of cancer, including osteosarcoma. In this work, hydroxyapatite (n-HA) nanorods synthesized by the hydrothermal method were investigated as a carrier for curcumin. For this, first-principle calculations based on the Density Functional Theory (DFT) were performed, in which the modification of curcumin (CM) with the coupling agent (3-aminopropyl) triethoxysilane (APTES) was theoretically evaluated. Curcumin was incorporated in n-HA and the drug loading stability was evaluated by leaching test. Samples were characterized by a multi-techniques approach, including Fourier transform infrared spectroscopy (FTIR), UV–visible spectroscopy (UV–Vis), X-ray diffraction (XRD), X-ray fluorescence spectrometry (FRX), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), zeta potential analysis (ζ), X-ray photoelectron spectroscopy (XPS) and transmission electron microscopy (TEM). The results show that n-HAs with a 90 nm average size were obtained and successful incorporation of curcumin in the nanostructure was achieved. Cell viability and the number of osteosarcoma cells were decreased by CMAP-HA treatment. Furthermore, the stability test suggests that hydroxyapatite nanoparticles present great potential for the transportation of curcumin in the bloodstream, crediting this system for biological performance evaluations aiming at the treatment of osteosarcomas. Keywords: nanostructures, curcumin, hydroxyapatite, osteosarcoma

Atividade nefrotóxica da peçonha de loxosceles spp / Nephrotoxic activity of loxosceles spp venom

Aranhas do gênero Loxosceles são animais peçonhentos cuja picada pode apresentar diversas manifestações, dentre elas a possibilidade de acometimento renal. Evidenciar a atividade nefrotóxica, direta e indireta, das diferentes substâncias contidas na peçonha da Loxosceles spp. O presente estudo trata-se de uma revisão literária de artigos científicos publicados nos últimos 25 anos, indexados na base de dados científicas PUBMED, SCIELO, Science Direct. Vinte e um artigos que correspondiam aos critérios de inclusão foram selecionados para integrar este estudo. Na peçonha de Loxosceles spp., existem compostos que causam, direta e indiretamente, efeitos deletérios em seres humanos. Estes efeitos podem ser locais ou sistêmicos, sendo a lesão renal aguda (LRA) a forma mais grave. A peçonha referida é capaz de afetar o tecido sanguíneo, podendo levar a distúrbios hemolíticos intravasculares e à coagulação intravascular disseminada (CIVD). Um de seus componentes é a fosfolipase-D (previamente conhecida como esfingomielinase), que embora não seja a proteína com a maior expressividade na toxina da aranha Loxosceles, é a mais definida e estudada pela literatura e possui papel fundamental tanto na ação local, quanto sistêmica, induzindo à dermonecrose e hemólise. Nos rins, a peçonha se liga às células glomerulares, tubulares e membranas basais, podendo levar à LRA. A fosfolipase-D tem como principal ação a hidrólise da esfingomielina, componente da membrana externa dos eritrócitos, mas pode promover o mesmo efeito em outros constituintes da membrana celular. Essa enzima provoca a lise celular renal em humanos, concomitante à ativação e secreção de metaloproteases da matriz extracelular (MEC). Ao hidrolisar fosfolipídios, postula-se que a toxina dermonecrótica ative vias de sinalização em diferentes células, causando alterações fisiopatológicas. Um estudo detectou que a toxina se liga aos glomérulos e túbulos renais de camundongos, reforçando a ideia de uma relação direta com a LRA. O processamento da hemoglobina resultante da hemólise contribui, indiretamente, para este quadro

Extragalactic Star Cluster Science with the Nancy Grace Roman Space Telescope's High Latitude Wide Area Survey and the Vera C. Rubin Observatory

The Nancy Grace Roman Telescope's High Latitude Wide Area Survey will have a number of synergies with the Vera Rubin Observatory's Legacy Survey of Space and Time (LSST), particularly for extragalactic star clusters. Understanding the nature of star clusters and star cluster systems are key topics in many areas of astronomy, chief among them stellar evolution, high energy astrophysics, galaxy assembly/dark matter, the extragalactic distance scale, and cosmology. One of the challenges will be disentangling the age/metallicity degeneracy because young ($\sim$Myr) metal-rich clusters have similar SEDs to old ($\sim$Gyr) metal-poor clusters. Rubin will provide homogeneous, $ugrizy$ photometric coverage, and measurements in the red Roman filters will help break the age-metallicity and age-extinction degeneracies, providing the first globular cluster samples that cover wide areas while essentially free of contamination from Milky Way stars. Roman's excellent spatial resolution will also allow measurements of cluster sizes. We advocate for observations of a large sample of galaxies with a range of properties and morphologies in the Rubin/LSST footprint matching the depth of the LSST Wide-Fast-Deep field $i$ band limit (26.3 mag), and recommend adding the F213 filter to the survey.Comment: white paper submitted for Roman CCS inpu