L’insegnante e lo Stress

First of all will be presented some minimal results taken from the huge literature on the subject, with reference to Stress and consequent Burn Out phenomena, then will be illustrated what is deduced from the mentioned literature on the specific topic of the Teacher’s stress. Again will be provided some methodological addresses for relieving work stress in general, but useful with reference to Teachers then to illustrate the partecipatory research carried out with the World Cafè methodology, which will be shortly provided the operational features. Finally will be presented the way of stress manifest among the Teachers as it comes from the research, in order to propose a possible stress intervention procedure

Índice interno de variação de preços de materiais de consumo e de medicamentos em um hospital de ensino de alta complexidade

Modelo do estudo: Trata-se de um estudo de caso, no qual foram analisados dados dentro de um contexto real que é o do HCFMRP-USP Objetivos: Apresentar os índices de variação de preços do HCFMRP-USP (IVPH), ano 2013, geral para materiais de consumo e medicamentos; específico para materiais de consumo e específico para medicamentos. Materiais e Método: Para o IVPH foi definido o Índice de Paasche como o mais adequado para o perfil de consumo do Hospital. Para o cálculo, foi definida uma cesta de consumo considerando 40% do gasto financeiro em 2012 o que representou 13% dos itens e também pelos itens que tiveram consumo regular, ou seja, em todos os meses de janeiro a dezembro de 2013. Resultados: os IVPH gerais foram 6,74% para materiais e medicamentos; 6,97% para materiais de consumo e 6,73% para medicamentos. Conclusões: Comprar a preços praticados no mercado e utilizar ferramentas para analisar o poder de compra da instituição contribui para a aplicação correta e racional dos parcos recursos disponíveis. A proposta de criar o índice interno de variação de preços vem contribuir como ferramenta para gestão dos recursos e para a análise da evolução do poder de compra do HCFMRP-USP, assim como os índices padronizados de variação de preço são utilizados para análise do poder de compra da moeda.Study model: This is a case study in which data from a real hospital context were analyzed. Objectives: To describe the price variation indexes of HCFMRP-USP (IVPH), in the year 2013, general for consumer materials and medicines, specific for consumer and specific for drugs. Methods: For the IVPH, the Paasche Index was defined as the most adequate for the hospital consumption. For the calculation, a consumption set was defined as 40% of the financial expense in 2012, which represented 13% of the items and also the items that had regular consumption, that is, in all the months of January to December 2013. Results: The general IVPH were 6.74% for materials and medicines; 6.97% for consumer materials and 6.73% for medicines. Conclusions: Buying at prices practiced in the market and using tools to analyze the purchasing power of institution contributes to the correct and rational application of the meager resources available. The proposal to create the internal price variation index is to contribute as a resource management tool and to analyze the evolution of purchasing power of the HCFMRP-USP, as well as the standardized index of price variation is used to analyze the power of purchase of the currency

METFORMIN USAGE TO INDUCE OVULATION IN WOMEN WITH POLYCYSTIC OVARY SYNDROME: META-ANALYSIS

Objective: To evaluate the use of MET in ovulation induction and pregnancy rates in a woman with polycystic ovary syndrome (PCOS).Methods: A meta-analysis of randomised clinical trials (RCT) that presented ovulation and gestation rates in women with PCOS, after administering CC or M et al. one or combined was performed. The studies were selected according to the inclusion criteria in PCOS patients, resistant to CC or not.Results: The meta-analysis demonstrated that MET and CC did not significantly increase the ovulation (Odds Ratio 1.72 [0.71, 4.12]) and gestation (OR 1.33 [0.88, 2.02]) rates when compared to the usage of CC itself in women not resistant to CC. However, in women with CC-resistant PCOS, the group treated with CC and MET presented higher rates of ovulation (Odds Ratio = 14.57 [4.96, 42.81]) and gestation (Odds Ratio = 11.86 [2.45, 57.36]) than patients treated only with CC.Conclusion: The combination of MET and CC did not show advantages over the administration of CC alone in women not resistant to CC. However, MET may show satisfactory results in women resistant to CC

Effect of a single tetanus-diphtheria vaccine dose on the immunity of elderly people in São Paulo, Brazil

Epidemiological data regarding tetanus and diphtheria immunity in elderly people in Brazil are scarce. During the First National Immunization Campaign for the Elderly in Brazil in April 1999, 98 individuals (median age: 84 years) received one tetanus-dyphtheria (Td) vaccine dose (Butantan Institute, lot number 9808079/G). Inclusion criteria were elderly individuals without a history of severe immunosuppressive disease, acute infectious disease or use of immunomodulators. Blood samples were collected immediately before the vaccine and 30 days later. Serum was separated and stored at -20ºC until analysis. Tetanus and diphtheria antibodies were measured by the double-antigen ELISA test. Tetanus and diphtheria antibody concentrations lower than 0.01 IU/mL were considered to indicate the absence of protection, between 0.01 and 0.09 IU/mL were considered to indicate basic immunity, and values of 0.1 IU/mL or higher were considered to indicate full protection. Before vaccination, 18% of the individuals were susceptible to diphtheria and 94% were susceptible to tetanus. After one Td dose, 78% became fully immune to diphtheria, 13% attained basic immunity, and 9% were still susceptible to the disease. In contrast, 79% remained susceptible to tetanus, 4% had basic immunity and 17% were fully immune. Although one Td dose increases immunity to diphtheria in many elderly people who live in Brazil, a complete vaccination series appears to be necessary for the prevention of tetanus.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de Infectologia PediátricaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de InfectologiaUNIFESP, EPM, Disciplina de Infectologia PediátricaUNIFESP, EPM, Disciplina de InfectologiaSciEL

P53 And Expression Of Immunological Markers May Identify Early Stage Thyroid Tumors.

Besides its major role in cell proliferation, DNA repair, and apoptosis, functional p53 protein is involved in the induction of antitumor cytotoxic-T-cell activity against carcinoma cells. We aimed to investigate p53 and immune cell markers utility as diagnostic and prognostic markers of differentiated thyroid cancer (DTC). ACIS-III system was used to evaluate p53 and immune cell markers including tumor-associated macrophages (TAM); CD68 and tumor-infiltrating lymphocytes (TIL) subsets such as CD3, CD4, CD8, and CD20 in 206 thyroid carcinomas, 105 benign nodules, and 18 normal tissues. Also, TP53 was sequenced in 78 out of 164 patients with papillary thyroid carcinoma. P53 expression was observed more frequently in malignant than in benign lesions (P < 0.0001) and helped discriminate follicular patterned lesions. In addition, p53 was more frequent in smaller (P = 0.0015), unique tumors (P = 0.0286), with thyroiditis (P = 0.0486) and without metastasis at diagnosis (P = 0.0201). TAM was more frequent in P53 negative tumors (P = 0.002). Infiltration of CD8+ TIL was found in 61.7% of P53 positive and 25.6% of P53 negative DTC (P < 0.001). We suggest that p53 and CD8+ TIL immune profile analysis might be useful in DTC.201384658

Laparotomia Exploradora para retirada de corpo estranho em TGI – Relato de caso

Bezoares são corpos estranhos que impactam o lúmen do aparelho digestivo a partir da ingestão continuada, prolongada e intencional de materiais não comestíveis ou de medicamentos de uso contínuo que podem apresentar extensão em continuidadepara o intestino delgado ou fragmentação com múltiplas massas detectáveis em qualquer segmento intestinal. O objetivo desse manuscrito é relatar um caso de ingestão de corpo estranho (200 pregos), descrevendo a conduta instituída para a retirada deste Trato Gastroinstestinal (TGI). Paciente masculino de 51 anos atendido no Hospital Universitário Sul Fluminense (HUSF) – Vassouras/RJ, com queixa de ingestão de corpos estranhos em tentativa de suicídio. Foi submetido à laparotomia exploradora com retirada de 200 pregos em região gástrica. Retornou ao HUSF com recorrência do quadro por mais 2 vezes e foi submetido a novas cirurgias para retirada dos pregos. Não é comum na literatura médica, a descrição de bezoar composto exclusivamente por material metálico, o que justifica o relato desse caso

Management of motor rehabilitation in individuals with muscular dystrophies. : 1st Consensus Conference report from UILDM – Italian Muscular Dystrophy Association (Rome, January 25-26, 2019)

Muscular dystrophy (MD) is a group of neuromuscular diseases characterized by progressive muscle weakness due to various mutations in several genes involved in muscle structure and function. The age at onset, evolution and severity of the different forms of MD can vary and there is often impairment of motor function and activities of daily living. Although there have been important scientific advances with regard to pharmacological therapies for many forms of MD, rehabilitation management remains central to ensuring the patient’s psychophysical well-being. Here we report the results of an Italian consensus conference promoted by UILDM (Unione Italiana Lotta alla Distrofia Muscolare, the Italian Muscular Dystrophy Association) in order to establish general indications and agreed protocols for motor rehabilitation of the different forms of MD

Apolipoprotein E in idiopathic nephrotic syndrome and focal segmental glomerulosclerosis

Apolipoprotein E in idiopathic nephrotic syndrome and focal segmental glomerulosclerosis.BackgroundHyperlipemia characterizes nephrotic syndrome (NS) and contributes to the progression of the underlying nephropathy. The data in the literature support an implication of apolipoprotein E (apoE) in both hyperlipemia and focal segmental glomerulosclerosis (FSGS), a malignant condition associated with NS.MethodsThe apoE genotype was determined in 209 nephrotic patients, who were classified according to age and their response to steroids as resistant children (N = 96) and adults (43), and steroid dependent (33) and steroid responder (37) children. A total of 123 presented the histological features of FSGS. In a subgroup of 28 patients, serum and urinary levels of apoE and renal deposits were evaluated by immunofluorescence.ResultsThe allelic frequencies of the three major haplotypes γ2, γ3, and γ4 were the same in nephrotic patients versus controls, and homozygosity for γ3γ3 was comparably the most frequent genotype (70 vs. 71%) followed by γ3γ4, γ2γ3, γ2γ4, γ4γ4. Serum levels of apoE were fivefold higher in NS and in FSGS patients than in controls, with a direct correlation with hypercholesterolemia and proteinuria. ApoE genotypes did not influence serum levels. Urinary levels were 1/10,000 of serum with an increment in nephrotic urines. Finally, immunofluorescence demonstrated the absence of apoE in sclerotic glomeruli, while comparably nephrotic patients with membranous nephropathy had an increased glomerular expression of apoE.ConclusionsApoE is dysregulated in NS with a marked increment in serum, which is a part of the complex lipid metabolism. Down-regulation of glomerular apoE instead is a peculiarity of FSGS and may contribute to the pathogenesis of the disease. The normal distribution of apoE genotypes in nephrotic patients with FSGS excludes a pathogenetic role of genetic variants

Are both distinct epithelial and stromal cells molecular analysis from phyllodes tumors versus fibroadenoma components affected in breast fibroepithelial progression?

ABSTRACT Purpose: To determine molecular events involved in the tumorigenesis of phyllodes tumors (PT) and the role of each stromal (SC) and epithelial (EC) cell. Methods: Frozen breast samples enriched with epithelial and stromal cells from three fibroadenomas and 14 PT were retrieved and laser microdissected. Sanger and polymerase chain reaction-based sequencing of exon 2 MED12 and TERT promoter hotspot mutations were performed; 44K microarray platform was used to analyze gene expression. Results: All three fibroadenomas (FAs) presented mutations in MED12, but not in TERT, whose mutation was observed in five of the 14 PTs. EC and SC of each affected tumor displayed identical alterations. Of the total differentially expressed genes (DEG) (EC = 1,543 and SC = 850), 984 were EC-eDEGs and 291 were SC-eDEGs. We found a high similarity of diseases and functions enriched by both cell types, but dissimilarity in the number of enriched canonical pathways. Three signaling canonical pathways overlapping with EC and SC were predicted to be activated in one cell type and inactivated in the other, while no overlap in eDEGs was assigned to them. We also identified 13 EC-eDEGs and five SC-eDEGs enriched networks, in which the SC-eDEGs were able to segregate FA from PT samples. Conclusions: Identical TERT mutations from both SC and ES origins might affect the PTs tumorigenesis. Gene expression differences suggest coordinated molecular processes between these components with determinant differences acquired by SC, able to fully distinguish PTs from FAs lesions