Pediatric care in Brazil's Unified Health System : reflections on the role of pediatricians in Family Healthcare Strategy

Este ensaio pretende contribuir para aclarar as possibilidades de atuação dos pediatras na Estratégia de Saúde da Família. Apresentam-se as origens, as modalidades de atuação e as implicações inerentes aos processos de mudança do Modelo de Atenção que, desde a Norma Operacio­nal Básica (NOB) de 1996 vem sendo implantado no Sistema Único de Saúde Brasileiro - SUS. ___________________________________________________________________________________________________________ ABSTRACTThis essay seeks to contribute to the elucidation of the potential activities of pediatricians in the Family Healthcare Strategy. The origins, types of care and inherent implications to the process of change in the Healthcare Model that are being implemented in the Brazilian Unified Health System (SUS) since the Basic Operational Norms were instituted in 1996 are duly presented

Caracterização físico-mecânica do laminado colado de bambu (Dendrocalamus giganteus).

The purpose of this work was to evaluate the preservative treatment effect and the adhesive type in physical-mechanical properties of glue laminated bamboo (GLB) of Dendrocalamus giganteus. Thus, the bamboo stems were treated by immersion method with chemical product (solution of 1% of active ingredients of copper chrome borate - CCB) and water by 15 days. Before treating the stems, the external and internal parts were removed to obtain the flat strips of bamboo with 4 mm of thickness, 45 cm of length and 5 cm of width. The “Cascophen RS” (resorcinol-formaldehyde) and “Cascorez-extra” (polyvinyl acetate) commercial adhesives were used to bond the flat strips. The resorcinol-formaldehyde adhesive showed superior moisture resistance than polyvinyl resin to GLB, and the samples obtained of pieces treated with CCB were more stable than treated with water. Among the mechanical properties tested, the adhesive factor was significant for the resistance to shear parallel to glue line and the preservative treatment for the rigidity. The interaction of the factors adhesive and treatment was significant for the rigidity, resistance to parallel compression and shear parallel to glue line. The pieces treated with water and adhered with resorcinol-formaldehyde presented better results for the rigidity and parallel compression to the fibers and those treated with CCB, for the shear parallel to glue line.Esta pesquisa teve como objetivo avaliar a influência do tratamento preservativo e do tipo de adesivo nas propriedades físico-mecânicas do laminado colado, confeccionado com o bambu Dendrocalamus giganteus. Para tanto, colmos de bambu foram tratados pelo método de imersão em produto químico (solução de 1% de ingredientes ativos de borato de cobre cromatado - CCB) e em água, durante 15 dias. Dos colmos tratados, foram retiradas as camadas externa e interna, obtendo-se lâminas com espessuras de 4 mm, comprimento de 45 cm e largura de 5 cm. Para a colagem das lâminas, utilizaram-se os adesivos "Cascophen RS" (resorcinol-formol) e "Cascorez-Extra" (acetato polivinílico). O adesivo à base de resorcinol-formol proporcionou maior resistência à umidade ao BLC, quando comparado àquele à base de acetato polivinílico, tendo as amostras provenientes de peças tratadas com CCB sido mais estáveis que as tratadas com água. Dentre as propriedades mecânicas testadas, o adesivo apresentou resultado significativo para o cisalhamento na linha de cola e o tratamento preservativo para o MOE. A interação dos fatores adesivo e tratamento foi significativa para o MOE, resistência a compressão paralela ao cisalhamento na linha de cola, tendo as peças tratadas com água e aderidas com resorcinol-formol apresentado melhores resultados para o MOE e compressão paralela às fibras e aquelas tratadas com CCB, para o cisalhamento na linha de cola

Physical-mechanical characterization of the glue laminated bamboo ( Dendrocalamus giganteus )

Esta pesquisa teve como objetivo avaliar a influ\ueancia do tratamento preservativo e do tipo de adesivo nas propriedades f\uedsico-mec\ue2nicas do laminado colado, confeccionado com o bambu Dendrocalamus giganteus . Para tanto, colmos de bambu foram tratados pelo m\ue9todo de imers\ue3o em produto qu\uedmico (solu\ue7\ue3o de 1% de ingredientes ativos de borato de cobre cromatado \u2013 CCB) e em \ue1gua, durante 15 dias. Dos colmos tratados, foram retiradas as camadas externa e interna, obtendo-se l\ue2minas com espessuras de 4 mm, comprimento de 45 cm e largura de 5 cm. Para a colagem das l\ue2minas, utilizaram-se os adesivos "Cascophen RS" (resorcinol-formol) e "Cascorez-Extra" (acetato polivin\uedlico). O adesivo \ue0 base de resorcinol-formol proporcionou maior resist\ueancia \ue0 umidade ao BLC, quando comparado \ue0quele \ue0 base de acetato polivin\uedlico, tendo as amostras provenientes de pe\ue7as tratadas com CCB sido mais est\ue1veis que as tratadas com \ue1gua. Dentre as propriedades mec\ue2nicas testadas, o adesivo apresentou resultado significativo para o cisalhamento na linha de cola e o tratamento preservativo para o MOE. A intera\ue7\ue3o dos fatores adesivo e tratamento foi significativa para o MOE, resist\ueancia a compress\ue3o paralela ao cisalhamento na linha de cola, tendo as pe\ue7as tratadas com \ue1gua e aderidas com resorcinol-formol apresentado melhores resultados para o MOE e compress\ue3o paralela \ue0s fibras e aquelas tratadas com CCB, para o cisalhamento na linha de cola.The purpose of this work was to evaluate the preservative treatment effect and the adhesive type in physical-mechanical properties of glue laminated bamboo (GLB) of Dendrocalamus giganteus . Thus, the bamboo stems were treated by immersion method with chemical product (solution of 1% of active ingredients of copper chrome borate - CCB) and water by 15 days. Before treating the stems, the external and internal parts were removed to obtain the flat strips of bamboo with 4 mm of thickness, 45 cm of length and 5 cm of width. The "Cascophen RS" (resorcinol-formaldehyde) and "Cascorez-extra" (polyvinyl acetate) commercial adhesives were used to bond the flat strips. The resorcinol-formaldehyde adhesive showed superior moisture resistance than polyvinyl resin to GLB, and the samples obtained of pieces treated with CCB were more stable than treated with water. Among the mechanical properties tested, the adhesive factor was significant for the resistance to shear parallel to glue line and the preservative treatment for the rigidity. The interaction of the factors adhesive and treatment was significant for the rigidity, resistance to parallel compression and shear parallel to glue line. The pieces treated with water and adhered with resorcinolformaldehyde presented better results for the rigidity and parallel compression to the fibers and those treated with CCB, for the shear parallel to glue line

Experience report on the recovery of a person infected with covid-19 with admission to the Intensive Care Unit (ICU): physical education and return to activities of daily living / Relatório de experiência sobre a recuperação de uma pessoa infectada pela covid-19 com admissão na Unidade de Terapia Intensiva (UTI): educação física e retorno às atividades da vida diária

Faced with the challenge to global health experience with the respiratory disease called Coronavirus Disease 2019 (Covid-19) - discovered in December 2019 and declared a pandemic in March 2020 -, the recovery process of a hospitalized person with severe symptomsof COVID-19 is reported, who had physical limitations, and returned to activities of daily living after the immediate rehabilitation process. The text organization is in the form of an experience report. The investigated subject had the covid-19 infection confirmed by a nasal swab exam collected on February 25, 2021. The onset of symptoms reported was four days earlier, presenting dyspnea, dry cough, headache, and fever after being hospitalized after laboratory, imaging, and clinical examinations. After medical discharge (held on March 19, 2021), he was released with the recommendation of respiratory physiotherapy activities. After four weeks of intervention with a physical education professional in resistance activities, stretching, and aerobic exercises, the individual was able to perform the activities of daily living that he did before the infection. His only current complaint is related to intense activities, in which he still feels uncomfortable, requiring longitudinal monitoring for the security of his full recovery

COVID-19 presenting as persistent hiccups: a case report

Hiccups are involuntary, spasmodic contractions of the diaphragm and intercostal muscles and can be classified as acute (< 48 h), persistent (48 h to a month) or intractable (> 1 month). A previously healthy 29-year-old man sought the Emergency Department with flu-like symptoms and a two-day history of persistent hiccups. His physical examination was otherwise unremarkable and vital signs were within normal limits. An unenhanced computed tomography scan of the chest showed small focal ground-glass opacities scattered throughout 25% of the lungs. A COVID-19 test was positive. Chlorpromazine was prescribed for the hiccups with improvement over 10 h. The patient was discharged home on the same day without hiccups and no other complications

Caracterização Mineralógica e Tecnológica do Caulim de Silvânia, Estado de Goiás.

The study aimed the mineralogical and technological characterization of various types of kaolin in the region of Silvânia - Goiás, as well as its physical and chemical processing to eliminate mineralogical impurities and upgrade the level of whiteness of kaolin. The kaolin of this region presented kaolin absolute properties, is fine to medium grained, after chemical bleaching, its whiteness reached 68.10% ISO. The results indicated that the kaolin of the region of Silvânia can be used as filler in the paper industry or in the production of ceramics

Satisfacción laboral y contexto de trabajo entre los profesionales de rehabilitación en Alagoas, Brasil: un estudio observacional

Job satisfaction is multifactorial and is directly related to the quality of health services. The main objective of this study was to characterize the level of job satisfaction and the work context of the multidisciplinary teams in specialized rehabilitation services in the state of Alagoas, Brazil. We evaluated the professional profile of participants and sociodemographic information. The Work Context Assessment Scale (WCAS) which is divided into three dimensions and questions adapted from the satisfaction and remuneration dimensions of the Great Place to Work methodology for the Organizational Climate Survey, was used. We included 190 professionals, the mean age was 35.47±9.25 and 86.3% were women. Most participants worked in the capital (60%) and 84.7% had a monthly wage ranging from R$1,000 to R$3,000. The dimension of “work organization” was crucial. The items “pace of work,” “strong demand,” “performance monitoring,” and “repetitive tasks” presented the worst results, but 92.7% are satisfied with their professional activities. The logistic regression analysis showed that more years since graduation and lower scores of Work conditions and Socio-professional relationships were associated with higher job satisfaction. Job satisfaction was found to be high, the dimension of work organization was crucial, and almost half of the participants have already thought about leaving their careersLa satisfacción laboral es multifactorial y estádirectamente relacionada con la calidad de los servicios de salud.El objetivo principal de este estudio fue identificar el nivel desatisfacción y el contexto de trabajo de equipos multidisciplinariosen servicios especializados de rehabilitación en el estado de Alagoas,Brasil. Se evaluó el perfil profesional y el perfil sociodemográfico,y se aplicaron la Escala de Evaluación del Contexto de Trabajo(EACT), dividida en tres dimensiones, y preguntas adaptadas delas dimensiones de satisfacción y remuneración de la metodologíade encuesta de clima organizacional, Great Place to Work.Se incluyeron a 190 profesionales, de los cuales el 86,3% eranmujeres, y la edad media fue de 35,47±9,25 años. La mayoríatrabajaba en la capital (60%) y el 84,7% ganaba entre R$1.000y R$3.000. La dimensión “organización del trabajo” fue crítica.Los ítems “ritmo de trabajo”, “exigencia de resultados”, “controldel rendimiento” y “tareas repetitivas” obtuvieron los peoresresultados, pero el 92,7% de los participantes estaban satisfechoscon su actividad profesional. La regresión logística mostró que a másaños de formación y puntuaciones más bajas en las dimensiones“condiciones de trabajo” y “relación socioprofesional” se asociabana una mayor satisfacción laboral. La satisfacción laboral fue alta,la dimensión “organización del trabajo” crítica, y casi la mitadde los participantes había pensado en dejar su carrera.A satisfação no trabalho é multifatorial e está diretamente relacionada com a qualidade dos serviços de saúde. O objetivo principal deste estudo foi caracterizar o nível de satisfação e o contexto de  trabalho de equipes multidisciplinares de serviços especializados em reabilitação no estado de Alagoas, Brasil. Foi avaliado o perfil profissional e sociodemográfico e foram aplicadas a escala de avaliação do contexto de trabalho (EACT), que é dividida em três dimensões, e questões adaptadas das dimensões de satisfação e remuneração da metodologia Great Place to Work da pesquisa de clima organizacional. Incluímos 190 profissionais, sendo 86,3% do sexo feminino, e a idade média foi de 35,47±9,25 anos. A maioria trabalhava na capital (60%) e 84,7% recebiam mensalmente de R$1.000,00 a R$ 3.000,00. A dimensão organização do trabalho foi considerada crítica. Os itens ritmo de trabalho, cobrança por resultados, fiscalização do desempenho etarefas repetitivas tiveram os piores resultados, mas 92,7% dos participantes estavam satisfeitos com suas atividades profissionais. A regressão logística mostrou que mais anos de formado e menores pontuações nas dimensões condições de trabalho e relações socioprofissionais estão associados com maior satisfação no trabalho. A satisfação no trabalho foi alta, a dimensão organização do trabalho crítica, e quase metade dos participantes já pensaram em deixar sua carreira

Heparin Increases HLA-G Levels in Primary Antiphospholipid Syndrome

Objectives. The aim of this study was to investigate the HLA-G serum levels in Primary Antiphospholipid Syndrome (PAPS) patients, its impact on clinical and laboratory findings, and heparin treatment. Methods. Forty-four PAPS patients were age and gender matched with 43 controls. HLA-G serum levels were measured using an enzyme-linked immunosorbent assay (ELISA). Results. An increase in soluble HLA-G levels was found in patients compared to controls (3.35 (0–22.9) versus 1.1 (0–14), P = 0.017). There were no significant differences in HLA-G levels between patients with and without obstetric events, arterial thrombosis, venous thrombosis, or stroke. Sixty-six percent of patients were being treated with heparin. Interestingly, patients treated with heparin had higher HLA-G levels than ones who were not treated with this medication (5 (0–22.9) versus 1.8 (0–16) ng/mL, P = 0.038). Furthermore, patients on heparin who experienced obstetric events had a trend to increased HLA-G levels compared to patients who were not on heparin and did not have obstetric events (5.8 (0–22.9) versus 2 (0–15.2) ng/mL, P = 0.05). Conclusion. This is the first study to demonstrate that serum HLA-G levels are increased in APS patients. We also demonstrated that heparin increases HLA-G levels and may increase tolerance towards autoantigens

Heparin Increases HLA-G Levels in Primary Antiphospholipid Syndrome

Objectives. The aim of this study was to investigate the HLA-G serum levels in Primary Antiphospholipid Syndrome (PAPS) patients, its impact on clinical and laboratory findings, and heparin treatment. Methods. Forty-four PAPS patients were age and gender matched with 43 controls. HLA-G serum levels were measured using an enzyme-linked immunosorbent assay (ELISA). Results. An increase in soluble HLA-G levels was found in patients compared to controls (3.35 (0–22.9) versus 1.1 (0–14), P = 0.017). There were no significant differences in HLA-G levels between patients with and without obstetric events, arterial thrombosis, venous thrombosis, or stroke. Sixty-six percent of patients were being treated with heparin. Interestingly, patients treated with heparin had higher HLA-G levels than ones who were not treated with this medication (5 (0–22.9) versus 1.8 (0–16) ng/mL, P = 0.038). Furthermore, patients on heparin who experienced obstetric events had a trend to increased HLA-G levels compared to patients who were not on heparin and did not have obstetric events (5.8 (0–22.9) versus 2 (0–15.2) ng/mL, P = 0.05). Conclusion. This is the first study to demonstrate that serum HLA-G levels are increased in APS patients. We also demonstrated that heparin increases HLA-G levels and may increase tolerance towards autoantigens