Os contextos de vulnerabilidades e a produção de cuidado como temas na formação médica

This article analyzes the offer of a curricular component in the undergraduate course Federal University of Paraiba. The module in question was offered as an optional component for students in the fourth period of the course, during the emergency remote teaching imposed by the COVID-19 in 2020. It aimed to problematize via virtual conversation circles and other participatory pedagogical strategies and address the processes of vulnerability and production of health care in different social groups. For this, a triangulation of methods (quanti-qualitative) was used by applying an electronic questionnaire and indepth interviews with the students in the module. Questionnaire data underwent descriptive analysis, whereas the interviews, thematic analysis via IRAMUTEQ. Data analysis enabled us to perceive the effects of the module as a counter-hegemonic form to the biomedical training model, providing the academic, social, and medical (re)positioning of students. We observed that medical training still follows systems of oppression such as racism, corponormativity, and patriarchy but the module enabled students to transgress this biomedical model by providing a training process which encompasses care for vulnerable populations.Este artigo analisa a oferta de um componente curricular na graduação de medicina da Universidade Federal da Paraíba. O módulo em questão foi ofertado como componente optativo, para estudantes do quarto período do curso, durante o ensino remoto emergencial imposto pela covid-19, em 2020. Seu objetivo era problematizar, por meio de rodas de conversa virtuais e outras estratégias pedagógicas participativas, os processos de vulnerabilidade e a produção do cuidado em saúde de diferentes grupos sociais. Para isso, foi utilizada uma triangulação de métodos (quanti-qualitativa) por meio da aplicação de um questionário eletrônico e entrevistas em profundidade com os discentes do módulo. Os dados do questionário passaram por uma análise descritiva, enquanto as entrevistas passaram por uma análise temática através do software IRAMUTEQ. A análise dos dados permitiu perceber os efeitos do módulo como uma forma contra-hegemônica ao modelo de formação biomédica, proporcionando um (re)posicionamento dos estudantes no âmbito acadêmico, social e médico. Percebe-se que a formação médica ainda é pautada em sistemas de opressão como o racismo, a corponormatividade e o patriarcado, porém o módulo permitiu a transgressão desse modelo biomédico ao proporcionar um processo formativo que abrange os cuidados às populações em situação de vulnerabilidade

Abordagem ortodôntica parcial fixa e remodelação estética de dentes conóides: relato de caso clínico

A aparência do sorriso apresenta grande implicação no cotidiano dos indivíduos, dentre os fatores prejudiciais a estética dentária, encontram-se as anomalias e apinhamentos, que por sua vez, podem ser decorrentes de fatores genéticos ou ambientais e distúrbios no processo de desenvolvimento do dente. O objetivo deste trabalho é relatar o caso clínico de uma paciente classe I de Angle apresentando incisivos laterais superiores conóides, no qual foi realizada a distribuição de espaço por meio da Ortodontia, seguido de confecção de laminados cerâmicos. Após avaliação clínica foi constatado que os incisivos laterais superiores direito e esquerdo estavam hígidos, porém, com largura e comprimento reduzido, exibindo forma cônica e prejudicando o equilíbrio e a harmonia do sorriso. O plano de tratamento consistiu na necessidade da instalação de aparelho ortodôntico parcial fixo para abrir e distribuir os espaços, acompanhado de laminados cerâmicos. A abordagem interdisciplinar com a comunicação e coordenação entre a ortodontia e dentística foram fundamentais para atender aos anseios estéticos da paciente

Alterações oftalmológicas decorrentes da desnutrição

INTRODUCTION: Malnutrition is a process that generates numerous consequences for the human body, especially in the development of ocular comorbidities. The effect of this impact on people has been a source of study in the literature. OBJECTIVE: To seek understanding about ophthalmological alterations due to malnutrition. METHOLOGY: A literature search was carried out based on the descriptor “malnutrition'' and "eyes changes” in the PubMed database. A total of 290 articles were found, of which, after using filters and exclusion parameters, they were 10 articles were selected, in addition, two books were used, the “Guide to clinical nutrition in childhood and adolescence” and “Ophthalmology for graduation.” All literature used for this document lists ophthalmological alterations resulting from malnutrition. RESULTS: It was found that the low intake and malabsorption of nutrients and minerals has consequences for different ocular tissues. CONCLUSION: It is important to understand about ophthalmological changes due to malnutrition, in order to obtain an early diagnosis and avoid the appearance of optical deformities.  ANTECEDENTES: La desnutrición es un proceso que genera numerosas consecuencias para el organismo humano, especialmente en el desarrollo de comorbilidades oculares. El efecto de este impacto en el hombre ha sido fuente de estudio en la literatura. OBJETIVO: Buscar comprensión sobre las alteraciones oftalmológicas por desnutrición. METODOLOGÍA: Se realizó una búsqueda bibliográfica basada en el descriptor “malnutrición” y “eyes changes” en la base de datos PubMed. Se encontraron un total de 290 artículos, de los cuales, luego de utilizar filtros y parámetros de exclusión, se seleccionaron 10 artículos. , además, se utilizaron dos libros, la “Guía de nutrición clínica en la niñez y la adolescencia” y “Oftalmología para la graduación”. Toda la literatura utilizada para este documento enumera las alteraciones oftalmológicas derivadas de la desnutrición. RESULTADOS: Se encontró que la baja ingesta y la malabsorción de nutrientes y minerales tiene consecuencias para los diferentes tejidos oculares. CONCLUSIÓN: Es importante conocer los cambios oftalmológicos por desnutrición, para obtener un diagnóstico precoz y evitar la aparición de deformidades ópticas.INTRUDUÇÃO: A desnutrição é um processo que gera inúmeras consequências para o corpo humano, sobretudo no desenvolvimento de comorbidades oculares. O efeito desse impacto no homem tem sido fonte de estudo na literatura. OBJETIVO: Buscar entendimento sobre as alterações oftalmológicas devido a desnutrição. METOLOGIA: Foi realizada uma busca literária com base no descritor “malnutrition’’ e "eyes changes” na base de dados do PubMed. Ao total, foram encontrados 290 artigos, dos quais, após a utilização de filtros e de parâmetros de exclusão, foram selecionados 10 artigos, além disso, foram utilizados dois livros, o “Guia de nutrição clínica na infância e na adolescência” e “Oftalmologia para a graduação”. Todas as literaturas utilizadas para esse documento relacionam alterações oftalmológicas decorrentes da desnutrição. RESULTADOS: Foi constatado que a baixa ingestão e a má absorção de nutrientes e de minerais gera consequências para diversos tecidos oculares. CONCLUSÃO: É relevante entender sobre as modificações oftalmológicas devido a desnutrição, em busca de obter diagnóstico precoce e evitar o aparecimento de deformidades ópticas

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

QUALIDADE FISIOLÓGICA E SANITÁRIA DE SEMENTES DE TRÊS CULTIVARES DE ALGODEIRO HERBÁCEO ARMAZENADAS

Cotton seeds require special care during storage to maintain their physiological and sanitary quality. The present work evaluated the physiological and sanitary quality of seeds of three varieties of herbaceous cotton stored for three (Lot 1) and twelve months (Lot 2). Analyses were performed in the Laboratório de Análise de Sementes e de Fitopatologia of the Centro de Ciências Agrárias, Areia-PB, and included tests for: emergence (E), vigor (IVE), green weight (PV), dry weight (PS) and the "Blotter test". Tests for physiological quality were performed in a randomized manner using a (3x2) factorial scheme, with four replicates with 25 seeds. Data on sanitary quality are presented according to the fungus index expressed as percentages. Seeds of the varieties CNPA 7H and BRS Verde demonstrated good levels of emergence after up to 12 months of storage, while seeds of the variety BRS Verde initially demonstrated dormancy, although this was overcome during storage. The fungus most commonly observed among the seed varieties in both storage lots was Rhizopus sp. The variety Aroeira do Sertão demonstrated the greatest incidence and variety of fungal species, a large majority of which were classified as storage fungi

Quantitative proteome and phosphoproteome analyses highlight the adherent population during Trypanosoma cruzi metacyclogenesis

Submitted by Manoel Barata ([email protected]) on 2018-02-09T13:08:10Z No. of bitstreams: 1 Rapidandaccurate.pdf: 801874 bytes, checksum: ff53110149296c3d9d94f6d822b57a2f (MD5)Approved for entry into archive by Manoel Barata ([email protected]) on 2018-02-26T13:04:39Z (GMT) No. of bitstreams: 1 Rapidandaccurate.pdf: 801874 bytes, checksum: ff53110149296c3d9d94f6d822b57a2f (MD5)Made available in DSpace on 2018-02-26T13:04:39Z (GMT). No. of bitstreams: 1 Rapidandaccurate.pdf: 801874 bytes, checksum: ff53110149296c3d9d94f6d822b57a2f (MD5) Previous issue date: 2017Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil / Fundação Oswaldo Cruz. Instituto Carlos Chagas. Mass Spectrometry Facility - RPT02H. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Genômica Funcional. Curitiba, PR, Brasil / Fundação Oswaldo Cruz. Instituto Carlos Chagas. Mass Spectrometry Facility - RPT02H. Curitiba, PR, Brasil.Trypanosoma cruzi metacyclogenesis is a natural process that occurs inside the triatomine vector and corresponds to the differentiation of non-infective epimastigotes into infective metacyclic trypomastigotes. The biochemical alterations necessary for the differentiation process have been widely studied with a focus on adhesion and nutritional stress. Here, using a mass spectrometry approach, a large-scale phospho(proteome) study was performed with the aim of understanding the metacyclogenesis processes in a quantitative manner. The results indicate that major modulations in the phospho(proteome) occur under nutritional stress and after 12 and 24 h of adhesion. Significant changes involve key cellular processes, such as translation, oxidative stress, and the metabolism of macromolecules, including proteins, lipids, and carbohydrates. Analysis of the signalling triggered by kinases and phosphatases from 7,336 identified phosphorylation sites demonstrates that 260 of these sites are modulated throughout the differentiation process, and some of these modulated proteins have previously been identified as drug targets in trypanosomiasis treatment. To the best of our knowledge, this study provides the first quantitative results highlighting the modulation of phosphorylation sites during metacyclogenesis and the greater coverage of the proteome to the parasite during this process. The data are available via ProteomeXchange with identifier number PXD006171

Validation of scores of use of inhalation devices: valoration of errors

AbstractObjective: To validate two scores quantifying the ability of patients to use metered dose inhalers (MDIs) or dry powder inhalers (DPIs); to identify the most common errors made during their use; and to identify the patients in need of an educational program for the use of these devices.Methods: This study was conducted in three phases: validation of the reliability of the inhaler technique scores; validation of the contents of the two scores using a convenience sample; and testing for criterion validation and discriminant validation of these instruments in patients who met the inclusion criteria.Results: The convenience sample comprised 16 patients. Interobserver disagreement was found in 19% and 25% of the DPI and MDI scores, respectively. After expert analysis on the subject, the scores were modified and were applied in 72 patients. The most relevant difficulty encountered during the use of both types of devices was the maintenance of total lung capacity after a deep inhalation. The degree of correlation of the scores by observer was 0.97 (p < 0.0001). There was good interobserver agreement in the classification of patients as able/not able to use a DPI (50%/50% and 52%/58%; p < 0.01) and an MDI (49%/51% and 54%/46%; p < 0.05).Conclusions: The validated scores allow the identification and correction of inhaler technique errors during consultations and, as a result, improvement in the management of inhalation devices

Norovirus diversity in diarrheic children from an African-descendant settlement in Belém, Northern Brazil.

Norovirus (NoV), sapovirus (SaV) and human astrovirus (HAstV) are viral pathogens that are associated with outbreaks and sporadic cases of gastroenteritis. However, little is known about the occurrence of these pathogens in relatively isolated communities, such as the remnants of African-descendant villages ("Quilombola"). The objective of this study was the frequency determination of these viruses in children under 10 years, with and without gastroenteritis, from a "Quilombola" Community, Northern Brazil. A total of 159 stool samples were obtained from April/2008 to July/2010 and tested by an enzyme immunoassay (EIA) and reverse transcription-polymerase chain reaction (RT-PCR) to detect NoV, SaV and HAstV, and further molecular characterization was performed. These viruses were detected only in the diarrheic group. NoV was the most frequent viral agent detected (19.7%-16/81), followed by SaV (2.5%-2/81) and HAstV (1.2%-1/81). Of the 16 NoV-positive samples, 14 were sequenced with primers targeting the B region of the polymerase (ORF1) and the D region of the capsid (ORF2). The results showed a broad genetic diversity of NoV, with 12 strains being classified as GII-4 (5-41.7%), GII-6 (3-25%), GII-7 (2-16.7%), GII-17 (1-8.3%) and GI-2 (1-8.3%), as based on the polymerase region; 12 samples were classified, based on the capsid region, as GII-4 (6-50%, being 3-2006b variant and 3-2010 variant), GII-6 (3-25%), GII-17 (2-16.7%) and GII-20 (1-8.3%). One NoV-strain showed dual genotype specificity, based on the polymerase and capsid region (GII-7/GII-20). This study provides, for the first time, epidemiological and molecular information on the circulation of NoV, SaV and HAstV in African-descendant communities in Northern Brazil and identifies NoV genotypes that were different from those detected previously in studies conducted in the urban area of Belém. It remains to be determined why a broader NoV diversity was observed in such a semi-isolated community