Margaridas africanas : trabalhadoras negras do serviço público municipal de Porto Alegre : fios e tramas do racismo estrutural

A presente dissertação aborda o tema sobre as trabalhadoras negras no serviço público municipal de Porto Alegre, evidenciando suas histórias de vida e trajetórias profissionais, no contexto do racismo estrutural, no período pós 1990 do século XX. Para fins de investigação, a problematização do estudo partiu de inquietações referentes às trajetórias profissionais das trabalhadoras negras no município, que atuam nas áreas da educação, saúde e assistência social. A metodologia utilizada teve como aporte teórico-metodológico o materialismo histórico-dialético, onde foi realizada uma pesquisa exploratória e descritiva analítica, com aplicação da técnica de triangulação das informações. Bem como, se utilizou a história oral para a escuta das histórias e trajetórias no contexto do racismo estrutural, que afeta diretamente as mulheres negras ao longo de suas vidas, com questões relacionadas à classe, ao gênero e à raça. Foram entrevistadas seis mulheres negras servidoras públicas de Porto Alegre, militantes da luta antirracista. Também se utilizou da técnica da análise documental sobre servidores(as) públicos(as) negros(as) na Prefeitura de Porto Alegre. Como resultados, constatouse que do total de servidores(as) públicos de Porto Alegre, 6,11% são servidoras negras. E dentre as servidoras mulheres, 10,29% são negras. Verifica-se que os fios e tramas do racismo estrutural, tendo como protagonistas as mulheres negras servidoras públicas de Porto Alegre, apontam o entrelaçamento entre classe, raça e gênero, demonstrando as formas de lutas e resistências das mulheres negras em seu tempo sócio-histórico. Evidenciam a histórica desigualdade das mulheres negras trabalhadoras na sociedade capitalista/racista e o acirramento desta pós golpe de 2016. O racismo estrutural se particulariza no trabalho, na realidade e vivência das mulheres negras servidoras públicas da prefeitura, onde constatou-se que todas as servidoras negras pesquisadas sofreram e sofrem racismo em seus locais de trabalho de diversas maneiras. Conclui-se que as lutas sociais vividas pelas trabalhadoras negras servidoras do município, especialmente no que diz respeito às formas de organização e resistência contra o racismo estrutural e o racismo institucional no serviço público municipal, fortalecem a resistência como um aspecto central para a luta pela emancipação humana, sendo esta permanente e num processo histórico contínuo, e no leito da luta.This dissertation addresses the issue of black female workers in the municipal public service of Porto Alegre, highlighting their life stories and professional trajectories, in the context of structural racism, in the post-1990s period of the 20th century. For research purposes, the problematization of the study came from concerns regarding the professional trajectories of black women workers in the municipality, who work in the areas of education, health and social assistance. The methodology used had the historical-dialectical materialism as a theoreticalmethodological contribution, where an exploratory and analytical descriptive research was carried out, with the application of the information triangulation technique. As well, oral history was used to listen to stories and trajectories in the context of structural racism, which directly affects black women throughout their lives, with issues related to class, gender and race. Five black women public servants from Porto Alegre, activists of the anti-racist struggle, were interviewed. The document analysis technique was also used on black public servants in the Porto Alegre City Hall. As a result, it was found that of the total public servants in Porto Alegre, 6.11% are black servants. And among female servants, 10.29% are black. It is verified that the threads and plots of structural racism, having as protagonists the black women public servants of Porto Alegre, point out the intertwining between class, race and gender, demonstrating the forms of struggle and resistance of black women in their socio-historical time. They highlight the historical inequality of black women workers in capitalist/racist society and the intensification of this post-2016 coup. Structural racism is particularized in the work, in the reality and experience of black women public servants of the city hall, where it was found that all black servants surveyed suffered and still suffer racism in their workplaces in different ways. It is concluded that the social struggles experienced by black workers who serve the municipality, especially with regard to the forms of organization and resistance against structural racism and institutional racism in the municipal public service, strengthen resistance as a central aspect of the struggle for human emancipation, which is permanent and in a continuous historical process, and in the bed of struggle

Arthroscopic transosseous versus suture anchor repair: Clinical outcomes in patients with bilateral rotator cuff tears.

The aim of our study was to define if Arthroscopic Transosseous Rotator Cuff Techniques should have comparable results to those of the suture-anchors technique in a single row configuration. We reported the preliminary results of a consecutive population of 22 patients who underwent a rotator cuff treatment on the left and right sides for average medium-sized thickness tears with minimal fatty infiltration with the two different techniques: transosseous rotator cuff repair technique on one side and single row with suture-anchors on the other side, in different times. Subjective evaluation with DASH questionnaires, Constant Scores and Numerical Rating Scale (NRS) for pain evaluation, have been submitted pre and postoperatively after both operations. A statistical analysis was performed to assess the superiority of one technique and to compare pre and postoperative ROM data and clinical outcomes. A transosseous rotator cuff repair was performed in 7 patients on the dominant arm, while the other 15 patients had dominant arm cuff tear lesions repaired by using suture-anchors technique. At last follow-up a significant improvement, in shoulder pain and function, was referred at both sides. Also, DASH, Constant Scores and NRS for pain evaluation improved with both techniques, but no statistical difference was found between them. Arthroscopic transosseous rotator cuff repair technique shows comparable results to those of the suture-anchors technique in a single row configuration

Utilizzo della tomografia ottica computerizzata (SV-OCT) per la valutazione del coinvolgimento ungueale nell’acrodermatite continua di Hallopeau

Recentemente è stato proposto l’utilizzo della Tomografia Ottica Computerizzata (SV-OCT) nella valutazione delle lesioni psoriasiche. Tale metodica è in grado evidenziare in modo accurato alterazioni cutanee ed ungueali clinicamente non valutabili. Presentiamo la nostra esperienza preliminare nell’utilizzo della SV-OCT in una donna di 75 anni affetta da una grave Acrodermatite continua di Hallopeau delle mani. Le valutazioni cliniche e strumentali sono state eseguite al basale e dopo 4 settimane di trattamento con 40 mg di adalimumab ogni 2 settimane e 25 mg di prednisone/die. Prima del trattamento le dita delle mani mostravano una grave onicodistrofia con pustole dolorose che coinvolgevano il letto ungueale, circondate da aree di intenso eritema ed ipercheratosi. SV-OCT evidenziava un marcato ispessimento ed irregolarità dello strato superficiale e ventrale della lamina ungueale; inoltre, si osservavano alcune aree iperriflettenti. L’analisi delle immagini mostrava la presenza di diffuse aree rosse nel letto ungueale, corrispondenti alla flogosi. Dopo 4 settimane di terapia abbiamo osservato la scomparsa delle pustole con una iniziale ricrescita delle unghie. SV-OCT mostrava un aspetto regolare dello strato superficiale e ventrale della lamina ungueale ed una marcata riduzione delle aree rosse corrispondenti all’infiammazione

Uso della tomografia a coerenza ottica nella valutazione dell’efficacia del trattamento in paziente con acrodermatite di Hallopeau

Si presenta il caso di una donna di 75 anni affetta da una grave forma di acrodermatite di Hallopeau delle mani trattata con 40 mg di adalimumab ogni 2 settimane e 25 mg di prednisone al giorno. Prima del trattamento le dita mostravano una grave onicodistrofia con pustole dolorose che coinvolgevano il letto ungueale, circondate da aree di intenso eritema ed ipercheratosi. La tomografia a coerenza ottica evidenziava marcato ispessimento della lamina ungueale ed irregolarità degli strati dorsale e ventrale; inoltre, si osservavano alcune aree iperriflettenti. L’analisi delle immagini mostrava la presenza di diffuse aree rosse nel letto ungueale corrispondenti alla flogosi. Dopo 4 settimane dall’inizio della terapia si è osservata la scomparsa delle pustole con un’iniziale ricrescita delle unghie. La tomografia a coerenza ottica mostrava un aspetto regolare degli strati superficiale e ventrale della lamina ungueale ed una marcata riduzione delle aree rosse corrispondenti all’infiammazione

Aprendizado baseado em problemas

The Problem-Based Learning (PBL), introduced at McMaster University School of Medicine, Canada, in 1969, is a student-centered pedagogical approach based on critical thinking and problem solving. In order to solve a problem, students use their prior knowledge, discuss, study, acquire and integrate new information. This learning integration, combined with a practical application, facilitates knowledge retention. Therefore, students become actively involved in the learning process and improve the capacity of learn how to learn. PBL has several advantages, such as, it stimulates the development of autonomy on learning; interdisciplinary; integration of knowledge and practice; development of teamwork, critical thinking and communication skills; and continuing education. However, to be able to implement PBL on curriculum, it’s necessary investments in human and material resources, including a well-structured training program for teachers and students.A Aprendizagem Baseada em Problemas (ABP), introduzida no ensino de Ciências da Saúde na McMaster University, Canadá, em 1969, é uma proposta pedagógica que consiste no ensino centrado no estudante e baseado na solução de problemas, reais ou simulados. Os alunos, para solucionar esse problema, recorrem aos conhecimentos prévios, discutem, estudam, adquirem e integram os novos conhecimentos. Essa integração, aliada à aplicação prática, facilita a retenção do conhecimento. Portanto, a ABP valoriza, além do conteúdo a ser aprendido, a forma como ocorre o aprendizado, reforçando o papel ativo do aluno neste processo, permitindo que ele aprenda como aprender. A ABP oferece diversas vantagens, como o desenvolvimento da autonomia, a interdisciplinaridade, a indissociabilidade entre teoria e prática, o desenvolvimento do raciocínio crítico e de habilidades de comunicação, e a educação permanente. Porém, para a sua utilização são necessários investimentos em recursos humanos e materiais, além de um programa de capacitação de professores e alunos bem estruturado, que devem sempre ser considerados antes de sua implementação

Dual training as clinician-scientist in child and adolescent psychiatry : are we there yet?

Peer reviewe

Phosphodiesterase 3B Is Localized in Caveolae and Smooth ER in Mouse Hepatocytes and Is Important in the Regulation of Glucose and Lipid Metabolism

Cyclic nucleotide phosphodiesterases (PDEs) are important regulators of signal transduction processes mediated by cAMP and cGMP. One PDE family member, PDE3B, plays an important role in the regulation of a variety of metabolic processes such as lipolysis and insulin secretion. In this study, the cellular localization and the role of PDE3B in the regulation of triglyceride, cholesterol and glucose metabolism in hepatocytes were investigated. PDE3B was identified in caveolae, specific regions in the plasma membrane, and smooth endoplasmic reticulum. In caveolin-1 knock out mice, which lack caveolae, the amount of PDE3B protein and activity were reduced indicating a role of caveolin-1/caveolae in the stabilization of enzyme protein. Hepatocytes from PDE3B knock out mice displayed increased glucose, triglyceride and cholesterol levels, which was associated with increased expression of gluconeogenic and lipogenic genes/enzymes including, phosphoenolpyruvate carboxykinase, peroxisome proliferator-activated receptor γ, sterol regulatory element-binding protein 1c and hydroxyl-3-methylglutaryl coenzyme A reductase. In conclusion, hepatocyte PDE3B is localized in caveolae and smooth endoplasmic reticulum and plays important roles in the regulation of glucose, triglyceride and cholesterol metabolism. Dysregulation of PDE3B could have a role in the development of fatty liver, a condition highly relevant in the context of type 2 diabetes

Tissue factor as a potential coagulative/vascular marker in relapsing-remitting multiple sclerosis

ObjectivesRecent studies supported coagulation involvement in multiple sclerosis, an inflammatory-demyelinating and degenerative disease of the central nervous system. The main objectives of this observational study were to identify the most specific pro-coagulative/vascular factors for multiple sclerosis pathogenesis and to correlate them with brain hemodynamic abnormalities.MethodsWe compared i) serum/plasma levels of complement(C)/coagulation/vascular factors, viral/microbiological assays, fat-soluble vitamins and lymphocyte count among people with multiple sclerosis sampled in a clinical remission (n=30; 23F/7M, 40 ± 8.14 years) or a relapse (n=30; 24F/6M, age 41 ± 10.74 years) and age/sex-matched controls (n=30; 23F/7M, 40 ± 8.38 years); ii) brain hemodynamic metrics at dynamic susceptibility contrast-enhanced 3T-MRI during relapse and remission, and iii) laboratory data with MRI perfusion metrics and clinical features of people with multiple sclerosis. Two models by Partial Least Squares Discriminant Analysis were performed using two groups as input: (1) multiple sclerosis vs. controls, and (2) relapsing vs. remitting multiple sclerosis.ResultsCompared to controls, multiple sclerosis patients had a higher Body-Mass-Index, Protein-C and activated-C9; and a lower activated-C4. Levels of Tissue-Factor, Tie-2 and P-Selectin/CD62P were lower in relapse compared to remission and HC, whereas Angiopoietin-I was higher in relapsing vs. remitting multiple sclerosis. A lower number of total lymphocytes was found in relapsing multiple sclerosis vs. remitting multiple sclerosis and controls. Cerebral-Blood-Volume was lower in normal-appearing white matter and left caudatum while Cerebral-Blood-Flow was inferior in bilateral putamen in relapsing versus remitting multiple sclerosis. The mean-transit-time of gadolinium-enhancing lesions negatively correlated with Tissue-Factor. The top-5 discriminating variables for model (1) were: EBV-EBNA-1 IgG, Body-Mass-Index, Protein-C, activated-C4 and Tissue-Factor whereas for model (2) were: Tissue-Factor, Angiopoietin-I, MCHC, Vitamin A and T-CD3.ConclusionTissue-factor was one of the top-5 variables in the models discriminating either multiple sclerosis from controls or multiple sclerosis relapse from remission and correlated with mean-transit-time of gadolinium-enhancing lesions. Tissue-factor appears a promising pro-coagulative/vascular biomarker and a possible therapeutic target in relapsing-remitting multiple sclerosis.Clinical trial registrationClinicalTrials.gov, identifier NCT04380220

Musculoskeletal manifestations in children with Behçet's syndrome: data from the AIDA Network Behçet's Syndrome Registry

This study aims to describe musculoskeletal manifestations (MSM) in children with Behçet's syndrome (BS), their association with other disease manifestations, response to therapy, and long-term prognosis. Data were retrieved from the AIDA Network Behçet's Syndrome Registry. Out of a total of 141 patients with juvenile BS, 37 had MSM at disease onset (26.2%). The median age at onset was 10.0 years (IQR 7.7). The median follow-up duration was 21.8 years (IQR 23.3). Recurrent oral (100%) and genital ulcers (67.6%) and pseudofolliculitis (56.8%) were the most common symptoms associated with MSM. At disease onset, 31 subjects had arthritis (83.8%), 33 arthralgia (89.2%), and 14 myalgia (37.8%). Arthritis was monoarticular in 9/31 cases (29%), oligoarticular in 10 (32.3%), polyarticular in 5 (16.1%), axial in 7 (22.6%). Over time, arthritis became chronic-recurrent in 67.7% of cases and 7/31 patients had joint erosions (22.6%). The median Behçet's Syndrome Overall Damage Index was 0 (range 0-4). Colchicine was inefficacious for MSM in 4/14 cases (28.6%), independently from the type of MSM (p = 0.46) or the concomitant therapy (p = 0.30 for cDMARDs, p = 1.00 for glucocorticoids); cDMARDs and bDMARDs were inefficacious for MSM in 6/19 (31.4%) and 5/12 (41.7%) cases. The presence of myalgia was associated with bDMARDs inefficacy (p = 0.014). To conclude, MSM in children with BS are frequently associated with recurrent ulcers and pseudofolliculitis. Arthritis is mostly mono- or oligoarticular, but sacroiliitis is not unusual. Prognosis of this subset of BS is overall favorable, though the presence of myalgia negatively affects response to biologic therapies. ClinicalTrials.gov Identifier: NCT05200715 (registered on December 18, 2021)

Covid-19 and the role of smoking: the protocol of the multicentric prospective study COSMO-IT (COvid19 and SMOking in ITaly).

The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for -COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality