The Medical Residency in Occupational Medicine of Medical School of University of São Paulo

Objetivo: Descrever as características e a evolução do Programa de Residência Médica em Medicina do Trabalho na Faculdade de Medicina da Universidade de São Paulo (PMT-FMUSP), desde o seu credenciamento em 2004 até 2010. Método: Estudo descritivo retrospectivo, com base numa revisão bibliográfica de textos institucionais, artigos, e teses e também na análise de documentos arquivados pelo referido Programa e de entrevistas com seus participantes. Resultados: O PMT-FMUSP foi credenciado em 2004 prevendo 5760 horas de treinamento em serviço, divididas em dois anos letivos, com duas vagas. No período de 2004 a 2010, concluíram a residência seis médicos do trabalho. Foram realizadas atividades práticas concentradas nos ambulatórios e serviços de emergência do Hospital das Clínicas da Faculdade, estágios em serviços especializados de empresas privadas de diversos ramos de atividade econômica, sindicatos de trabalhadores e em órgãos públicos relacionados com a saúde dos trabalhadores. As atividades teórico-práticas incluíram aulas no Curso de Especialização de Medicina do Trabalho da Faculdade e reuniões científicas com discussões de casos ou artigos referentes à saúde dos trabalhadores. Conclusão: O PMT-FMUSP é recente e cumpre os requisitos mínimos previstos pela Comissão Nacional de Residência Médica. Ao longo do período em análise, sofreu alterações relacionadas à incorporação de locais de estágios como processo normal de amadurecimento de forma a dotar o médico do trabalho das competências necessárias para o exercício da medicina do trabalho no BrasilAim: Describe the characteristics and the evolution of the Program of Medical Residency in Occupational Medicine of Medical School of University of São Paulo (PMT-FMUSP), since its accreditation in 2004 until 2010. Method: A retrospective descriptive study based on a bibliographic review of institutional texts, articles and theses and also on the analysis of documents filed by the Program and interviews with the participants. Results: The PMT-FMUSP was accredited in 2004 predicting 5760 hours of service training, divided in two academic years, with two vacancies. Between 2004 and 2010, six occupational doctors graduated. The practical activities were concentrated in the ambulatories and emergency services of the College Hospital, internships in specialized services of private companies which operate in different areas of the economy, labor union and in government agencies related to the workers health. The theorical-practical activities included classes in the Specialization Course of Occupational Medicine of the University and in scientific meetings with discussions about clinical cases or articles about Workers Health. Conclusion: The PMT-FMUSP is recent and fulfills the minimum requirements according to the National Committee of Medical Residency. During the period in analysis, the course suffered changes in its structure, part of a normal process of maturing in a way to give the occupational doctor the necessary abilities for the practice of occupational medicine in Brazi

Effects of aerobic training on heart rate dynamics in sedentary subjects.

BACKGROUND: Q fever is an infection caused by Coxiella burnetii. Persistent infection (chronic Q fever) develops in 1%-5% of patients. We hypothesize that inefficient recognition of C. burnetii and/or activation of host-defense in individuals carrying genetic variants in pattern recognition receptors or adaptors would result in an increased likelihood to develop chronic Q fever. METHODS: Twenty-four single-nucleotide polymorphisms in genes encoding Toll-like receptors, nucleotide-binding oligomerization domain-like receptor-2, alphavbeta3 integrin, CR3, and adaptors myeloid differentiation primary response protein 88 (MyD88), and Toll interleukin 1 receptor domain-containing adaptor protein (TIRAP) were genotyped in 139 patients with chronic Q fever and in 220 controls with cardiovascular risk-factors and previous exposure to C. burnetii. Associations between these single-nucleotide polymorphisms and chronic Q fever were assessed by means of univariate logistic regression models. Cytokine production in whole-blood stimulation assays was correlated with relevant genotypes. RESULTS: Polymorphisms in TLR1 (R80T), NOD2 (1007fsX1), and MYD88 (-938C>A) were associated with chronic Q fever. No association was observed for polymorphisms in TLR2, TLR4, TLR6, TLR8, ITGAV, ITGB3, ITGAM, and TIRAP. No correction for multiple testing was performed because only genes with a known role in initial recognition of C. burnetii were included. In the whole-blood assays, individuals carrying the TLR1 80R-allele showed increased interleukin 10 production with C. burnetii exposure. CONCLUSIONS: Polymorphisms in TLR1 (R80T), NOD2 (L1007fsX1), and MYD88 (-938C>A) are associated with predisposition to development of chronic Q fever. For TLR1, increased interleukin 10 responses to C. burnetii in individuals carrying the risk allele may contribute to the increased risk of chronic Q fever

Deficiency of Asparagine Synthetase Causes Congenital Microcephaly and a Progressive Form of Encephalopathy

International audienceWe analyzed four families that presented with a similar condition characterized by congenital micro-cephaly, intellectual disability, progressive cerebral atrophy, and intractable seizures. We show that recessive mutations in the ASNS gene are responsible for this syndrome. Two of the identified missense mutations dramatically reduce ASNS protein abundance, suggesting that the mutations cause loss of function. Hypomorphic Asns mutant mice have structural brain abnormalities, including enlarged ventricles and reduced cortical thickness, and show deficits in learning and memory mimicking aspects of the patient phenotype. ASNS encodes asparagine synthetase, which catalyzes the synthesis of asparagine from glutamine and aspartate. The neurological impairment resulting from ASNS deficiency may be explained by asparagine depletion in the brain or by accumulation of aspartate/gluta-mate leading to enhanced excitability and neuronal damage. Our study thus indicates that asparagine synthesis is essential for the development and function of the brain but not for that of other organs