Fashion Systema; propuesta de análisis teórico de la Moda - desde la crítica cultural

Propuesta para el análisis teórico del Sistema de la Moda, desde una perspectiva de los estudios culturales, para la incorporación del campo de estudio en mallas curriculares de carreras vinculadas al estudio de la Indumentaria y la Moda

Judicialização da saúde: uma análise do fenômeno e suas consequências para a sociedade brasileira

Embora o Sistema Único de Saúde tenha avançado desde sua criação, ainda há falhas no fornecimento de medicamentos e serviços. Com isso, cidadãos têm utilizado o sistema judiciário para aquisição de bens de saúde, prática conhecida como judicialização da saúde, que teve um crescimento abrupto nos últimos anos. Diante disso, o trabalho tem como objetivo analisar as ações judiciais que requerem bens de saúde ao SUS para proporcionar melhor compreensão dos efeitos da naturalização da judicialização da saúde. Foram realizadas uma revisão bibliográfica e análise de 100 processos judiciais do portal eletrônico do Tribunal de Justiça do Estado de São Paulo. Os resultados indicaram que, em 2010, o gasto do governo federal com a judicialização da saúde foi de R$120 milhões. Já em 2016, esse gasto foi de cerca de R$ 1,6 bilhão, com 1.346.931 processos movidos no Brasil. A análise descritiva realizada demonstrou que, no mesmo ano, 22,1% das ações judiciais selecionadas solicitaram medicamentos padronizados pelo SUS e, em relação às demais solicitações, 82,8% possuíam alternativa terapêutica disponível na rede pública. Os valores apresentados demonstram a desestabilização do planejamento orçamentário para a área da saúde gerada pela judicialização. É necessário buscar estratégias de garantia do direito à saúde e ampliar o conhecimento das listas disponibilizadas pela rede pública para médicos e juízes. Dessa forma, a judicialização da saúde permanecerá viável para a garantia dos direitos em casos não contemplados pelo sistema de saúde, sem prejuízo ao planejamento orçamentário e acesso universal ao Sistema Único de Saúde.Although the Brazilian National Health System advanced since its creation, there are still failures in supplying medicines and services. For this reason, citizens have been using the judicial system to acquire health assets, what is known as judicialization of health. In the last years, this practice had an abrupt increase. This work has the purpose of analyzing the lawsuits that request provision of health assets through SUS to provide greater understanding of the effects of the naturalization of judicialization of health. To do this, a bibliographic review was conducted, besides the analysis of 100 lawsuits on the Tribunal de Justiça do Estado de São Paulo’s website. The results indicated that in 2010, the government spending on judicialization of health was R$120 million, whereas in 2016 it was around R$ 1.6 billion, reaching 1,346,931.00 actions moved in Brazil. The descriptive analysis demonstrated that, in the same year, nearly 22.1% of the selected lawsuits requested medicines, which are standardized by SUS. In relation to the other requests, 82.8% disposed of therapeutic alternative available in public system. The numbers demonstrate the destabilization of budget planning to the health sector caused by judicialization. It is necessary to seek strategies to ensure the right to health and to enlarge the knowledge of standardized lists provided in public system to doctors and judges. The judicialization will therefore remain available to guarantee rights in cases not covered by the health system, without the excesso of lawsuits damaging the budget planning and universal access to the system

Community-acquired invasive liver abscess syndrome caused by a K1 serotype Klebsiella pneumoniae isolate in Brazil: a case report of hypervirulent ST23

Universidade Federal de São Paulo (UNIFESP) Departamento de MedicinaUniversidade Federal de São Paulo (UNIFESP) Departamento de Medicina Divisão de Doenças InfecciosasUNIFESP, Depto. de MedicinaUNIFESP, Depto. de Medicina Divisão de Doenças InfecciosasSciEL

Diet, DNA methylation and systemic lupus erythematosus: evidence and perspectives focused on personalized nutrition

Background: The pathoetiology of systemic lupus erythematosus (SLE) involves a multifactorial interaction consisting of various genetic, epigenetic and environmental factors. Considering epigenetic characteristics, notable alterations in DNA methylation, particularly hypomethylation in immune-related pathways, such as T cell receptor have been observed. In turn, these alterations are associated with the overexpression of genes related to autoimmunity and a loss of immunological self-tolerance. Furthermore, DNA hypomethylation levels in SLE may contribute to disease progression and also impact disease activity and clinical manifestations. Summary: It is well-established that nutritional epigenetics elucidates the role of nutrition and dietary factors on the interactions of metabolic systems with the molecules that bind to DNA, regulating gene expression. Specific nutritional interventions may reverse initial epigenetic patterns, thereby significantly impacting the chronic disease´s treatment and prognostic. In fact, dietary nutrients and bioactive food compounds may influence DNA methylation patterns by inhibiting enzymes related to DNA methylation reactions or by altering the availability of different substrates involved in DNA methylation process (e.g methyl-donor nutrients). Key Messages: The knowledge of how diet plays a role in changing DNA methylation patterns in SLE is in the early stages. While a few studies in the literature have assessed the effects of nutrient intake, supplementation, or treatment on DNA methylation levels and have demonstrated their relevance, further research is imperative to deepen our comprehension of the interactions between epigenetics and nutrients, which is vital for the development of novel precision nutrition approaches

Efeito da dieta cetogênica clássica no tratamento de crises epilépticas refratárias

Objective The ketogenic diet is used as a therapeutic alternative for the treatment of epilepsy in patients with refractory epilepsy. It simulates biochemical changes typical of fasting. The present study verified the nutritional impact of the ketogenic diet on children with refractory epilepsy. Methods Nutritional status data (dietary, biochemical and anthropometric measurements), seizure frequency, and adverse events were collected from the medical records and during outpatient clinic visits of children over a period of 36 months. Results Of the 29 children who initiated the ketogenic diet, 75.8% presented fewer seizures after one month of treatment. After six months, 48.3% of the patients had at least a 90.0% decrease in seizure frequency, and 50.0% of these patients presented total seizure remission. At 12 months, eight patients continued to show positive results, and seven of these children remained on the ketogenic diet for 24 months. There was an improvement of the nutritional status at 24 months, especially in terms of weight, which culminated with the recovery of proper weight-for-height. There were no significant changes in biochemical indices (total cholesterol and components, triglycerides, albumin, total protein, creatinine, glycemia, serum aspartate transaminase and serum alanine transaminase). Serum cholesterol levels increased significantly in the first month, fell in the following six months, and remained within the normal limits thereafter. Conclusion In conclusion, patients on the classic ketogenic diet for at least 24 months gained weight. Moreover, approximately one third of the patients achieved significant reduction in seizure frequency, and some patients achieved total remission.OBJETIVO: A dieta cetogênica é empregada como uma terapia alternativa para o tratamento da epilepsia em pacientes com epilepsia refratária e simula as alterações bioquímicas de jejum. Neste trabalho, verificouse o impacto nutricional da dieta cetogênica em crianças com epilepsia refratária.\ud MÉTODOS: Os dados sobre o estado nutricional (bioquímica, alimentar e medidas antropométricas), a frequência de crises e os eventos adversos de crianças acompanhadas durante 36 meses foram coletados de prontuários médicos e visitas ambulatoriais.\ud \ud RESULTADOS: Vinte e nove crianças iniciaram o tratamento; após um mês, 75,8% apresentaram redução das crises. Em seis meses, 48,3% dos pacientes tiveram pelo menos 90,0% de redução na frequência de crises, e, desses, 50,0% obtiveram o controle completo das crises. Aos doze meses, oito pacientes continuaram a apresentar Resultados positivos, e, desses, sete permaneceram em dieta cetogênica durante 24 meses. Observouse melhora do estado nutricional aos 24 meses de tratamento, especialmente em termos de peso, o que indica a recuperação da condição peso para altura. Não houve mudanças significativas nos índices bioquímicos analisados (colesterol total e de componentes, triglicerídeos, albumina, proteína total, creatinina, glicemia, transaminase glutâmico oxalacética sérica e transaminase glutâmico pirúvico sérica). Os níveis de colesterol aumentaram significativamente no primeiro mês, mas diminuíram nos seis meses seguintes e, posteriormente, se mantiveram dentro dos valores de referência.\ud \ud CONCLUSÃO: Os pacientes em uso da dieta cetogênica clássica por pelo menos 24 meses apresentaram melhora de peso e cerca de um terço dos pacientes conseguiu uma redução significativa da frequência de crises, com alguns pacientes completamente livres delas

Dinâmica do crescimento de árvores dominantes em povoamentos clonais de Tectona grandis Linn. F.

O objetivo deste trabalho foi avaliar a dinâmica das árvores dominantes na classificação da capacidade produtiva de sítios florestais e verificar se a estrutura sugerida por Schumacher é estatisticamente indicada para descrever o crescimento em altura dominante de árvores clonais de teca. Para este fim foram abordadas duas distintas formas de classificação de árvore dominante. Uma primeira que fixa estas árvores na primeira medição da parcela de inventário florestal, sendo, portanto, uma única classificação durante toda a rotação do povoamento. Uma segunda que classifica uma árvore dominante em cada medição da parcela, e posterior cálculo da altura médias das arvores dominantes. Nesta pesquisa os dados foram originados do monitoramento contínuo de 121 parcelas de campo, com idade variando de 1,1 a 8,1 anos, de plantios comerciais de Tectona grandis Linn. F, localizados na região centro-sul do estado de Mato Grosso.  Para fins de comparação das duas abordagens do estudo, foram utilizadas as estatísticas de coeficiente de determinação (R²) e o erro padrão em escala percentual. As estatísticas dos modelos foram complementadas pela análise da estabilidade das parcelas na rotação do povoamento, e também pela identidade das curvas. As estatísticas de ambos os métodos de classificação foram muito próximas, com R² de 0,9950 e 0,9953, e erro padrão residual de 22,56 e 21,48%. Quanto à estabilidade, o modelo de Schumacher, para ambos os métodos, classificou como estável mais de 90% das parcelas utilizadas no estudo. E sobre a identidade das curvas, pôde-se inferir que ambas as curvas de sítios foram similares na classificação da capacidade produtiva. Portanto, foi possível concluir que não existe diferença estatística entre as curvas de sítios quando consideradas as diferentes classificações de árvores dominantes, o que comprova a hipótese de que árvores dominantes se mantém dominantes durante toda a rotação florestal

Inactivation of CDK/pRb Pathway Normalizes Survival Pattern of Lymphoblasts Expressing the FTLD-Progranulin Mutation c.709-1G>A

8 figuras, 2 tablasBackground Mutations in the progranulin (PGRN) gene, leading to haploinsufficiency, cause familial frontotemporal lobar degeneration (FTLD-TDP), although the pathogenic mechanism of PGRN deficit is largely unknown. Allelic loss of PGRN was previously shown to increase the activity of cyclin-dependent kinase (CDK) CDK6/pRb pathway in lymphoblasts expressing the c.709-1G>A PGRN mutation. Since members of the CDK family appear to play a role in neurodegenerative disorders and in apoptotic death of neurons subjected to various insults, we investigated the role of CDK6/pRb in cell survival/death mechanisms following serum deprivation. Methodology/Principal Findings We performed a comparative study of cell viability after serum withdrawal of established lymphoblastoid cell lines from control and carriers of c.709-1G>A PGRN mutation, asymptomatic and FTLD-TDP diagnosed individuals. Our results suggest that the CDK6/pRb pathway is enhanced in the c.709-1G>A bearing lymphoblasts. Apparently, this feature allows PGRN-deficient cells to escape from serum withdrawal-induced apoptosis by decreasing the activity of executive caspases and lowering the dissipation of mitochondrial membrane potential and the release of cytochrome c from the mitochondria. Inhibitors of CDK6 expression levels like sodium butyrate or the CDK6 activity such as PD332991 were able to restore the vulnerability of lymphoblasts from FTLD-TDP patients to trophic factor withdrawal. Conclusion/Significance The use of PGRN-deficient lymphoblasts from FTLD-TDP patients may be a useful model to investigate cell biochemical aspects of this disease. It is suggested that CDK6 could be potentially a therapeutic target for the treatment of the FTLD-TDPThis work has been supported by grants from Ministry of Education and Science (SAF2007-61701, SAF2010-15700, SAF2011-28603), Fundación Eugenio Rodríguez Pascual, and Basque Government (Saiotek program 2008–2009). NE holds a fellowship of the JAE predoctoral program of the CSICPeer reviewe

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon